2/09 Noogi - AMPS 148, +3 61, +4 113, +5 139, PMPS 394 - ups and downs

Helen + Noogi

Helen + Noogi

Active Member
Yesterday's post

Hi ... sigh...

Its been a tough day with Noogi. As mentioned yesterday I think he may have had a fur shot in the am, and was still quite high after the pm shot. At +3 this morning he dropped to 61, which felt totally out of the blue. I gave him some high carb food as I needed to make sure he was on the way up again as I knew I'd need to leave him alone all afternoon. Tried not to give him too much, and it did the trick, but he still went all the up to 394 before this evening's shot. As because he dipped below 90 as per protocol I reduced Noogi's dose by 0.25 to 0.5u from this evening.

I thought a dose increase might have been on the cards by next weekend, but now he is on an even lower dose. Not sure what to expect now in the next day or two.

He woke me up repeatedly last night so I did not sleep well. He needed me to show him his 1pm and 1am snacks in the automated feeder, and then begged me for more snacks in the early hours.

I'm also have a mini-crisis of confidence about his injections. As mentioned yesterday he has been wriggling and squeaking when I've given him his last couple shots. He has even given my hand a warning bite, which is totally out of character. Nothing has changed with my technique and I used brand new syringes both times. Not sure why the jabs are suddenly bothering him. Tonight I tried on his flank instead of in his scruff and same thing.

Also realized I have to focus really hard on getting the dose amounts correct. I have been eye-balling them. I do have the insulin ruler but have not used it - that needs to start now (as soon as I can get to a printer). I may need to revisit calipers as well - actually bought some from an online retailer but they were poor quality and not fit for purpose and had to be returned, which was such an irritation.
I know the key thing is consistency. But each time I draw up a dose I start feeling anxious if I'm doing it correctly and keep second-guessing my judgment.

After feeling like I was making real progress I feel like this weekend has been a set-back in getting Noogi regulated, and with my ability to help him. Managing this disease is tough :(
 
Please stop being so hard on yourself. To see all this blue in a newly diagnosed cat is something to be proud of I think. You would have seen a bounce from the 61 no matter how much hc he got. Managing will get easier!:bighug:
 
Helen + Noogi said:
Yesterday's post

Hi ... sigh...

Its been a tough day with Noogi. As mentioned yesterday I think he may have had a fur shot in the am, and was still quite high after the pm shot. At +3 this morning he dropped to 61, which felt totally out of the blue. I gave him some high carb food as I needed to make sure he was on the way up again as I knew I'd need to leave him alone all afternoon. Tried not to give him too much, and it did the trick, but he still went all the up to 394 before this evening's shot. As because he dipped below 90 as per protocol I reduced Noogi's dose by 0.25 to 0.5u from this evening.

I thought a dose increase might have been on the cards by next weekend, but now he is on an even lower dose. Not sure what to expect now in the next day or two.
Click to expand...

Helen, Just curious: is there a reason you are not following TR? You're certainly testing enough for it. One of the reasons I'm glad we switched Jude to TR is that we don't have to reduce his dose if he falls below 90. I think holding a dose longer really helped Jude get better numbers more consistently.

Also, take a look at Jude's SS--he was ALL over the place until his body began to feel more comfortable with lower numbers. His bouncing was so disheartening to me, but, he has eventually calmed a bit (anti-jinx!). As Elise said above, managing Noogi will get easier--you're doing a great job with him.

Helen + Noogi said:
I'm also have a mini-crisis of confidence about his injections. As mentioned yesterday he has been wriggling and squeaking when I've given him his last couple shots. He has even given my hand a warning bite, which is totally out of character. Nothing has changed with my technique and I used brand new syringes both times. Not sure why the jabs are suddenly bothering him. Tonight I tried on his flank instead of in his scruff and same thing.

Also realized I have to focus really hard on getting the dose amounts correct. I have been eye-balling them. I do have the insulin ruler but have not used it - that needs to start now (as soon as I can get to a printer). I may need to revisit calipers as well - actually bought some from an online retailer but they were poor quality and not fit for purpose and had to be returned, which was such an irritation.
I know the key thing is consistency. But each time I draw up a dose I start feeling anxious if I'm doing it correctly and keep second-guessing my judgment.
Click to expand...

We had a conversation here recently about injection responses that might benefit you and Noogi. Here is the link: injection responses (if you search the group for "Lantus stinging" you'll see other similar convos). Jude (an otherwise very gentle cat) had begun nipping at me when I gave him his injection. What people suggested is that 1) the coldness of the insulin might bother him, so to remedy that, I've been 'warming' the insulin by placing it in between the rice-filled mittens I use to warm his ear before poking (and to be clear, I don't rewarm the mittens in the microwave--they are still a little warm from when I poke Jude, and that warmth is sufficient). And then 2) this is the other suggestion: that Lantus can cause a burning/stinging sensation for some cats when injected, even at lower doses. Given his response, I really think this is what is happening with Jude (though the coldness might also be annoying him). So, in conjunction with warming the insulin, I've begun very slowly inserting the needle (always bevel up), and very slowly injecting. He flinches when it first hits his tissue, but things aren't as 'resistant' as they were when I shot the entire dose in quickly. I also have begun injecting (in his scruff) while he is eating. I used to do this before but stopped because I can't see the needle as well, and I worry about a furshot. But I've returned to this strategy because of the distraction of Jude eating. Things have seemed to work a bit better with his responses when I've made these adjustments.

Again, you're doing a great job, and Noogi is going to get regulated in good time.
 
Marielle said:
Helen, Just curious: is there a reason you are not following TR? You're certainly testing enough for it. One of the reasons I'm glad we switched Jude to TR is that we don't have to reduce his dose if he falls below 90. I think holding a dose longer really helped Jude get better numbers more consistently.
Click to expand...
I think it is something to consider. However I am not able to feed Noogi entirely all low-carb food due to availability and expense. Options are really quite limited here in South Africa. He is having, and will continue to have for the foreseeable, a certain amount of medium carb food. That said, I am really getting a feel for how manage his lower numbers with food. I also work full-time - have been coming home to check on him every lunchtime, but this might not be something I can keep doing. I do see that some caregivers have worked out ways to manage their cats on TR when working full days, so it can be done. I think I am going to give it a week and then decide f I should change to TR.

It is great to see spreadsheets like Jude's and Pookey's. Very aspirational!

Marielle said:
We had a conversation here recently about injection responses that might benefit you and Noogi. Here is the link: injection responses (if you search the group for "Lantus stinging" you'll see other similar convos).
Click to expand...
Thank you so much for this info Marielle. Will definitely look at these tweaks to make injections more comfy for Noogs. And thank you too for your kind works of support, I really needed that today :bighug:
 
Helen + Noogi said:
I think it is something to consider. However I am not able to feed Noogi entirely all low-carb food due to availability and expense. Options are really quite limited here in South Africa. He is having, and will continue to have for the foreseeable, a certain amount of medium carb food. That said, I am really getting a feel for how manage his lower numbers with food. I also work full-time - have been coming home to check on him every lunchtime, but this might not be something I can keep doing. I do see that some caregivers have worked out ways to manage their cats on TR when working full days, so it can be done. I think I am going to give it a week and then decide f I should change to TR.
Click to expand...

I COMPLETELY understand the food expense/availability issue. And SLGS is a good protocol--cats do get regulated on it. I was just thinking about your concerns in getting him regulated and saw how much you were testing, so I thought I would ask. You have to do what is best for you, as well as what is best for Noogi. I also work fulltime, a thirty minute drive from home. So, I've been taking my cat to work with me. I'm not supposed to be doing that, but I have a private office, and he's really not a bother to anyone, so until someone tells me I can't, I'll continue taking him in while I'm still getting him regulated. Not everyone has that luxury, though, and I realize that.
 
Marielle said:
I COMPLETELY understand the food expense/availability issue. And SLGS is a good protocol--cats do get regulated on it. I was just thinking about your concerns in getting him regulated and saw how much you were testing, so I thought I would ask. You have to do what is best for you, as well as what is best for Noogi. I also work fulltime, a thirty minute drive from home. So, I've been taking my cat to work with me. I'm not supposed to be doing that, but I have a private office, and he's really not a bother to anyone, so until someone tells me I can't, I'll continue taking him in while I'm still getting him regulated. Not everyone has that luxury, though, and I realize that.
Click to expand...
Love that for you and Jude. Noogi is not a good traveller and I don't trust him not to bolt so going to the office is an option for us unfortunately, altho I wish it was! Luckily I'm not too far away.
He's such a good boy generally tho. When i think of all the changes he's had in the last few months... testing, injections, vet visits, whole new diet! And he's also lost his freedom. Used to be free to roam and was king of the block, but now he's restricted to my flat and small courtyard garden. Big adjustment! It's all a lot for an old man.
 
You’re doing so great for Noogi! Look at all that progress you two have made in a short time.

One thought about switching protocols - you can always go back to SLGS if things change or don’t work out with TR.
 
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