Buddy's SS up and going 4th part about dosing

Buddy is a bouncer with his numbers and it scares his Mom.

 

Good job making the new thread! There's so much to learn around here, isn't there? Hang in there with the bouncing - Buddy (and you) are going to be okay. It just takes a little while to work itself out. Sending you and Buddy lots of love!

 

Thank you so much!!! We wish you and your kitties well.

 

Are you testing PMPS soon, Teresa?

 

Kris, I am going to test him right now.

 

His Number is 507. HeLp!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1

 

Not a surprise after no shot this AM. You could try 2.5 u again because he's high but if that worries you, go down to 2.25 u or even 2 u. Your call.

 

Do you think with his numbers being high 2.5 u would probably work tonight, or do you think it would not make a difference.

 

I can't say for sure. I think 2.5 u isn't too high because his BG is elevated from bouncing. I suggested the lower doses in case you're reluctant to try 2.5 u.

 

I see that you went with 2.25 u. Maybe try for two tests this evening? He'll probably be a bit high.

 

Yep, that high number is entirely expected! Hopefully he'll come gently down for you.

 

I am a coward and I did not see your post saying that you did not think 250 would be too high because his BG was elevated until just now and it is 9:29 p.m. I gave his insulin at 7:05 p.m. He has ate several time this evening, the last time was like 8:15, so if I wait 2 hrs,, I will get in 1 test. However, I usually set the clock and get up to check his numbers.

 

I hope so.

 

You're not a coward! You're concerned for your baby...and it's really hard when you're dealing with it yourself. Even though we're here for you, it's tough because we're not right there next to you. Trust me, I know how it feels. It's so scary when you're alone with nothing but voices on the internet helping out.

 

I don't sometimes know exactly what needs to be done, experience will help with that. This morning I find myself not knowing what to do, his numbers need to come down but not to 50. Kris explained a bounce and what was going on, I was going to print it out, but naturally my printer would not print. I spent most of yesterday evening trying to get my printer to work.

 

You're too hard on yourself, Teresa. This is a hard disease for kitty owners. We do what we can do and learn along the way. I'm sorry that your printer is misbehaving. Who needs that on top of kitty worry?

I see you gave him 2.25 u this AM. No need to torture his ears too much but maybe a +3 and +6 would be useful.

 

I will do that, what dose would you have gave. I was a little early today so I went ahead with 2.25. I want to get Buddy's numbers in check, but I just am not sure what dose to give. When he came home after sx , I had decided to give him 3u all the time. I now realize that cannot be done all the time. I do not want to call his vet about dosing questions because they always say a large amount. So I bug you instead.

 

Now THAT is a big realization we all have to come to with feline diabetes!! It took me a long time to "get it" and I think there are many vets who don't get that part of treating FD. AND they often prescribe too high a dose. As is often said here, the good dose is a moving target. We're used to meds being prescribed at a certain dose for a certain condition and the dose rarely changes. Insulin doesn't work that way because it becomes part of a very complicated set of BG control processes.

The 2.25 u dose is fine in the aftermath of that green. Let's see what it does. He might be in higher numbers for a bit because of bouncing.

 

I took reading @+3 -308. I am going to run out for a bit, did not do yesterday. Hope Buddy will be alright.

 

Saw your 2 u dose for this evening. That'll be fine.

 

I wanted to know what you thought, but I did not want to bother you. I tried to go back and look at other post from other days, but I was not giving Buddy much of a dose until he had his surgery, that makes it harder to dose. Buddy is doing much better since he had his surgery, if I could get his BG numbers under control he would be even better. I hope I do not have a surprise (BG numbers) later tonight or in the morning. If I do I will be posting wanting help.

 

You're not bothering me, Teresa. It's good that you're learning to read the spreadsheet to make decisions because that will make you feel more confident. It takes time to get BG under control so muster as much patience as you can.

 

Remember that Kris and the rest of us are all here because we WANT to be. We've been in your shoes, and someone helped us. We want to be here because it's important to pay it forward.

 

I don't know if I am doing the right thing, Buddy's# is bouncing all over the place. It had been low now it is @ 456, if I give what I think he should have for 456, will that make him crash. Last night he ate extra amount of food, should that make a difference in his dose. Thank you Rachel I could use your opinion on dosing.

 

Checking your SS now, BRB!

 

I believe that number is due to bouncing. When Buddy hits a lower number, he seems to bounce higher for a few cycles. I think I'd give 2.5 again (can you monitor?). If that concerns you, drop it to 2.25.

Remember that bouncing happens. Some kitties just do it a lot. We had one that bounced for 2 years until remission. Bouncing kitties will just bounce until they stop and you just try to dose around it.

 

I know he is bouncing, just did not know what dose to give. His BG is high, but if I gave a larger dose was that going to cause more bouncing. I did not know what to do, so glad you answered. I feel comfortable with 2.50. I am almost a professional cat watcher, I will be here watching Buddy cat all day. Have a good day.

 

Professional cat watcher...man do I know what that's like!!

The reason I suggested 2.5 (just so you know my thought process) is because for a few cycles now, Buddy has been in high numbers. 2.25 seems to be keeping him safe, but the hope is to get lower numbers. So when I looked at your SS, I noticed that when you had a black number and gave 2.25, you got high purples for mid cycle. That's a nice, gentle curve, but it would be even better if we got down to yellows then...around 50% of preshot number. So I thought since you have a number pretty close to the same number this morning as you did PMPS of the 15th, why not give a bit of a nudge and see if it brings him down a bit more? It could cause a bounce, if he drops super low...but I think that's unlikely.

I'll try to check in on you during the day because I'm interested to see what Buddy does! It's my last day at my current job though, so I may be AWOL. I know Kris will be around later and I'll surely check on you tonight if I can't before!

 

Hi Teresa,
I'm glad Rachel was here to help. I agree with everything she said. I know from a ton of experience with Teasel how hard it is to dose a bouncy cat. What helped me A LOT was training myself to not react to these dips and dives, to stay calm, look at my SS and try what helped before or, if needed, do a little experimenting when I could monitor. A huge part of reclaiming my sanity was accepting that I have a bouncy, unpredictable cat.

As one professional cat watcher to another, I feel your pain! However, once you get more confident with all this the testing routine you have in place will give you the info you need to know if you're going to have a calm day where you can take a break, do errands, etc. or if it's a cat watching day.

Just think back to when you began - you have tons more experience with his responses now and likely have a much better idea of how to handle the surprises he gives you occasionally. Hang in there!

 

I was going to give 3u, but I was afraid it would cause him to go too low and then he would have more bouncing. If you look back on his SS we were giving really low doses until 2/1 when he had surgery, so I did not have a lot to go by. When you explained to me the reason for the dose that helps me understand even more. I hope you are not sad about this being your last day on the job. Hope you have a great day.

My SS before Buddy's surgery does not have a lot of info to work with, but now I am starting to get more info on his SS. I was glad Rachel was there because I kept thinking 3u, but I was afraid that would give me more of a bounce. I am hoping for a calm day today.

 

There's no rush to up the dose, Teresa, especially with a bouncy kitty. Also, dose changes have to be in small fractions.

Something for later:
Right now you're using U40 syringes with half unit marks to dose Buddy. They're made specifically for U40 insulin. You can use U100 syringes (with half unit marks) with is conversion chart:
http://www.felinediabetes.com/insulin-conversions.htm. This would allow you to measure 0.2, 0.4, 0.6, 0.8 u directly using the marks on the syringe and eyeball 0.1, 0.3, 0.5, 0.7, 0.9. Lots more dosing options.

 

I did look for U100 syringes the size you told me of, but none of the local stores carried them. I don't remember now what size you said, could look on line. I live in a small town in Indiana, no Cosco or those type of stores. Do you have any idea how long a bottle of ProZinc kept in the refrigerator would be suitable for use. Another question is it safe to use flea meds, the kind you get from the vet and put on the back of the neck.

 

You can order those syringes from www.adwdiabetes.com. I think ProZinc can last at least 2 months if not longer when stored and handled properly. As for flea meds, I've read on here that people use the type you're describing with no problems.

Here's a link to an example of those syringes from the website I just gave you;
https://www.adwdiabetes.com/product/carepoint-vet-u-100-pet-syringe-31g-half-unit_16367.htm

 

I hope ProZinc can last up to 2 months because I have had mine since 12/29/16. I have it in the refrigerator in a container with a lid. I talked to Buddy's vet, his histopath came back and looked fine. He said he thought his problems were caused from inflammation caused by pancreatitis, he thinks that is the reason why he could not get his diabetes stable.
I did not tell him it still is not stable.

 

I'm so glad that the path report was fine. Yes, pancreatitis can make diabetic control hard but some cats like mine are just difficult. It helped me a lot to see others on FDMB in the same boat.

You're managing Buddy's diabetes yourself and you'll learn more about it as you go along than most vets ever know.

 

I think the doctor was talking about before Buddy's surgery. I just took a reading and Buddy's #is 368 and again I am not for sure about a dose. This morning his # was a lot higher.

 

I gave Buddy 225u, hope I gave him the right amount. Does anyone ever get their cat to the right number, I can't imagine what unit it would take for Buddy.

 

I think that was a good dose.

Yes, cats do eventually get the right dose...but even that changes. As cats get regulated, often the dose has to go down. Take a look at some Spreadsheets in the remission thread...they can help show you cats who got regulated and eventually went OTJ!

 

He'll be OK with that dose of 2.25 u.

 

This morning Buddy is at 526, does anybody have any ideas of a dose.

 

I gave him 2.75u, I am really thinking about 3u, but don't want to cause any more of a bounce than I already have.

 

He should be OK. Aim for some tests in the +3 to +7 range to see how low he goes. When you see a bounce number - which this - you take it into account when deciding on a dose but you really need to see the mid cycle numbers to assess the effectiveness of a dose.

 

If you think it is a bounce number would you go higher or lower. I take it that it can't be said for sure that this is a bounce number. Yesterday Buddy was really hungry, after he ate the amount of RC he was allowed to have, I gave him some FF classic. Would the FF cause his numbers to go so high.

 

Looking good so far today, Teresa! If you see overly high numbers at a dose that gave you good numbers recently, those are bounce numbers. They often appear when a dose has dropped the BG and it's wearing off so the BG is rising but rising too much (overreaction). The high bounce numbers can stick around longer so that the next cycle that dose appears to have no effect. If you keep the dose you'll suddenly get a drop in BG again because the bounce has stopped (or "cleared" as is often said here).

When deciding on a dose for a cat that is known to bounce, you have to base the majority of the decision on how low the BG went rather than how high. Bouncing artificially raises BG.

 

I went back and wrote down what you said about bouncing and how the liver stores glucose from the food Buddy eats, then I went to Buddy's SS. What I was wondering is, if I had given buddy a lower dose of insulin on 2/14 PMPS, would that have kept him from having such a low reading on AMPS 2/15.

 

Possibly but it's hard to say. The only way to be a little more sure of what happened and what to do next is to have LOTS of data on the SS. That's why it's so valuable as a reference.

 

I have been trying.

 

Nice blues today!

 

I hope Buddy's AMPS was not dosed too low, did not want to get a big bounce.

 

I've been reading through Buddy's story and looking at his SS, and don't get discouraged - you are doing great! My Leo was a Lantus boy before he went off the juice and was a *very* bouncy boy, but my mom is joining FDMB and her cat was just put on Prozinc, so I'm learning the difference between the two insulins by reading some spreadsheets. Bouncing is a challenge to deal with, but all that data really helps you make better decisions. Good luck and keep it up!

Lisa

 

It's really good that you're experimenting, Teresa and doing it cautiously. This is exactly how we learn to figure out doses. Let's see what the 0.75 u gives you today.

 

What would you have given.

Lisa & Leo,
Lisa is 1 of my favorite names, that is my daughter's name. Good for you and for Leo that he is OTJ. Leo looks like my cat Kitty Kat. Kitty Kat is my only cat that does not have a health problem (hope he stays that way ). Does Leo have any FIV+ related symptoms. I also have a FIV+kitty his name is Old Guy. I give Guy Lactoferrin & a Probiotic daily. Good luck to your Mom and her kitty.

 

I might have tried 2 u based on other numbers in your SS. However, you have to be comfortable in what you're doing. When I was learning I was far more cautious than I am now. I know Teasel's responses really well and I know how closely I can shave it while still keeping him safe. I still make mistakes though and Teasel will surprise me often.

 

I think I was too cautious @+6 his BG was 381, this just makes me sick. Worried about his BG numbers being high for a long time. When I talked to 1 of his doctors, she said he should always at least 2u every shoot. Maybe she was right. The Doctor who did his surgery wanted him to come in for a curve, but I talked him into letting me e-mail his SS, when he sees how I am doing he will probably make Buddy come in. My fear about Buddy going in that they will dose him too high.

 

Buddy's treatment is yours to control, Teresa. The vet can advise but he/she won't be the one worrying if he goes too low.

For now you can use 2 u as your baseline or minimum dose. When in doubt give 2 u. He likely needs more than that if his PS is pink or higher. These guidelines can change but that should work for now.

 

Thank you! No, Leo doesn't show any symptoms of FIV yet. He is still pretty young, and we just make sure his diabetes is controlled and gets good food, and he gets B12 shots. Hugs to Old Guy and I hope he lives a long life with you!

 

I see you upped his dose tonight because he was higher. The higher BG was likely because his AM dose was low. Good call.

 

I hope that I have not messed up again with Buddy's dose.
I am so worried about Buddy, I don't know what to do most of the time. He has been through so much in the last 60 days and was even feeling bad before that. I'm afraid I will cause him problems with his health unnecessarily. Today I ran some errands when I came back home, in his litter box their was a very large wet spot that almost looked water had been spilled in it.

 

You're doing fine, Teresa. Focus on the fact that he's feeling better since the surgery. That large pee spot in the litter box is from him still being in high-ish numbers most of the time. That will improve when his numbers are consistently lower.

 

I really was not sure what to dose, your post helped a lot. Kept thinking I should go higher, but I am afraid of bouncing. If he keeps bouncing I will never get his BG under control. Buddy has already lost part of his pancreas, I don't know if he could lose any more.

 

Unfortunately, bouncing is hard to control. Some cats bounce and some don't. Some bounce a lot. Many bounce less as they get into lower BGs more of the time. Your best bet is to pay attention to mid cycle numbers when deciding on a dose and give less importance to the PS numbers that are often higher than they should be because of bouncing.

 

I need to start getting his numbers under control, maybe that would be by paying attention to mid cycle numbers. This is how my luck goes, I was waiting at Buddy's litter box to get a sample for a ketone check (since he has been peeing a lot) and my Mother said to me it is time for Red's medicine. I got up and walked into the other room, when I did Buddy peed in his litter box. Buddy's numbers are too high, maybe he needs a higher dose in the morning and less at night. I am baffled and worried about Buddy.

 

Two reasons for his high numbers today: 1. low dose this AM and 2. bouncing from the blues yesterday. Wait to see tomorrow's AMPS before thinking about what dose to give next.

 

Good choice of AM dose Teresa. I see that he dropped to green late last night/very early AM. You might see some higher bounce numbers today because of it. Don't worry abut them.

 

I am thinking about getting more aggressive with Buddy's dosing. How long did it take to get Teasel numbers under control.

 

I never got Teasel under control. He bounces all over the place. I just did the best I could dose wise with the ProZinc and decided to change to Lantus two weeks ago. It's early days but he seems a bit less bouncy on Lantus.

 

I have wondered about Lantus, my daughter takes Lantus, she says it is only good for 30 days. Buying every 30 days could get pricey. I do hate the bouncing, it scares me because Buddy shows no signs of being low. This AMPS Buddy was high, I gave a dose that was not large and at +5 he was @84. It seems that you never know what to do.

 

Hi Teresa. I have seen reference on the forum fairly frequently that people buy their Lantus from Canada for something like 1/3 of the cost. They also buy the pens instead of the vial. Do a search or maybe look at the stickys at the top of the Lantus forum.

 

How are you. Right now Buddy is taking ProZinc, but I am seriously wondering about Lantus. I appreciate your reply about Lantus.

 

Morris and I are good. I think you and Buddy are doing great. Buddy was diagnosed in January wasn't it? Morris and I have been figuring out the sugar dance since September. And we didn't have a major surgery like Buddy had to have. I have my frustrated days occasionally too so I know how you feel. Others can advise you about changing insulin. I just wanted to mention what I had read on the forum about purchasing it in case you ever did switch. I'm not sure they have any easier time getting to good numbers. There are still the too lows and bouncing with all types of insulin from what I've read.

 

That 84 is a really good number - not too low. You fed higher carb food to keep him from going lower so he was safe. When you're using a human meter like yours, the worry starts when he goes to 50 or below. That's hypo territory.

Re Lantus: there's no guarantee that it will solve the bouncing problem and it's very expensive in the US. Many there buy it from a Canadian pharmacy where it's much cheaper. It can be bought in packs of 5 cartridges (for the Lantus pen) that are usually good for up to 2 years if stored properly. Each cartridge once opened is good for several months if handled/stored properly. The rules for humans are stricter.

 

Buddy BG has been @50 a few times. When I can see he is starting to go low, I give him RC wet to keep him from going too low. Does every insulin have a bouncing problem.

 

Yes, they can bounce on any insulin but the longer lasting insulins like Lantus and Levemir will sometimes by helpful to reduce it in some cats.

 

Those pinks last night are bounce numbers after the green yesterday. Carry on ...

 

Maybe I should have dosed lower @AMPS. I will try to prepare for +5 thru to PMPS a can of RC.

 

Hard to know, Teresa. All you can do is try a dose and watch what happens. You're still building your data base.

 

"Data Base" I love that, Kris and plan to "borrow" it.

Teresa, I know it feels like you have been doing this forever, but think how much you have learned in such a short time. I hope it is a little less scary and you are feeling more confident. You have kept him safe and happy!

 

.

Have you looked at Buddy's SS today, we has @AMPS +6 BG59. Something happened earlier with 1 of my other cats, or I would have been on top of this and not have let it get to that point. Looking for a big bounce tonight, just what I did not want.

 

Just saw this Teresa. It's actually a nice number. you use a human meter and the "intervention required " number is 50. Did you give him some higher carb food to get him back up to 90? If these greens worry you, drop his dose to 2.25 u tonight. He'll be a bit more insulin sensitive after these lows.

 

I almost gave him 2.25u this morning, because his BG reading seemed a little less than it had been. First I gave him about 1/2 can of RC wet, it came up but went back down. Buddy then got his favorite food FF grilled w/gravy and he had about 1/2 can of that. His numbers started coming up with the FF. I wish his numbers had been caught before they got that low. Looking for a lot of bouncing, which is what we don't need.

 

You'll figure it out, Teresa. After a while, you'll be able to predict bouncing , have a better idea on how to dose around it and it won't cause you so much anxiety.

 

Bouncing isn't fun but it happens. The good news is you know the insulin is working!

 

I guess that is one way of looking at it. Bouncing scares me and when Buddy's numbers are high. Sounds like everything scares me.

 

Everything scared me when I first got here too! That's natural...it's because you love Buddy so much.

 

The red this AM is probably one of two things or both together: 1. a lower dose last night and/or 2. bouncing from the recent greens.

 

Last night he did not want to eat, I was afraid he would not eat enough for his dose. Today I thought about a higher dose, just was not sure what to do. I have a appointment tomorrow, hope I can get things turned around by then.

 

You could try 2.25 u this AM but if you're worried, go with 2 u.

 

Buddy has had so many issues and seems to be better. I am so afraid of doing something wrong and causing problems. I do love Buddy a lot.

 

I gave him 2.5u a little while ago. I will see what today holds. I tried to go low last night because he did not want to eat. I really appreciate you being there with suggestions, sometimes I just do not know what to do.

 

Glad to help when I can, Teresa. I think you're getting a handle on this yourself. Good work!

 

I went back today and looked at the conversion chart to convert from U-40 to U-100, to me it seems as though it should be just the opposite of what it is. Thinking about being able to give lower dose or an added dose.

 

Are you thinking of trying U100 syringes so you can dose in smaller fractions? If you are the least bit confused about doing this, post for help before you do.

 

I have been thinking about doing this for a while, not for sure because to me it seems backwards.

 

ProZinc (U40) is a more diluted insulin that Lantus (U100). That means it takes more space in a U100 syringe built for a concentrated insulin. That is, it takes a larger amount of ProZinc to have the same number of units in it as the same dose of Lantus.

 

I would like your opinion Buddy's BG was 193@PMPS. What would you do.

 

I would like your opinion. I took Buddy's BG @PMPS it was 193. What would do

 

Looks like he went back up to 225? Did you give a dose?

 

I was away from my computer. I see a yellow as PMPS. Did you stall for a while? What dose did you give?

 

I waited around an hour, because I did not know what dose to give. He came up to 225, I did not know what to give so I gave him 1.50u, not much but I hope it wasn't too much.