i just need help....it's only getting worse.

i've tried 3 different approaches to treating tom.
at first i just shot the #'s like i used to...bearing in mind he seemed much more sensitive to the insulin this time. i thought that was a good sign.
then, because of his tendency to drop like a rock at +1 or 2 i decided mr. P was kicking in after a meal so i did'nt shoot until i got a +1 # and shot (and fed again) based on that #.
that worked for about a minute but then his bg's got bigger and bigger.
now i see he's no longer dropping at +1 or 2 and doing a gentle curve peaking about +5ish.
but his pmps are just getting higher and higher as i gently increased his amps dose to 1 full unit.
if you look at my chart it might make more sense. take notice that january i skipped alot of doses thinking he did'nt really need it.
we seem to be going in the wrong direction of getting those #'s down :cry:
help....anyone?

 

I would probably try to even out the AM & PM doses a little (i.e. raise the PM dose a hair and see if you can get better AMPSs that might let you lower that dose a hair). It looks like you are getting good results going into the evening cycle, but then maybe not enough duration to keep things in the blues til morning, though it's hard to say for sure. I have no objections to sliding scale, but I think with the lowered dose you could be losing overlap. Maybe get a couple bedtime spot checks in to be sure he isn't going low & then try raising it a hair if not?

As far as the bigger picture, the only things I can think of are some sort of infection going on, or maybe he is spending enough time running just a little high that Mr. P is starting to doze off more and more. With Bix it seems like if I can get him in really good #s he will stay there for a while, but if I land him just a little bit high, then he needs another shot a lot sooner. Partially speculation though, really it is all so mysterious. :sad:

Wish I could be more help... hope things improve soon! Does he seem to feel well?

 

he's sleeping more, but seems to feel well.
those evening #'s are rising....tonite at +9 he was 180. usually at +12 he's only 140 or so.
i have no choice now but to raise his pm dose.
i can't help but feel it's not just diabetes. i'm drowning in medical debts of my own and business is way down. i took him in 2 months ago and all i found out was he's NOT hyper T
i'm just worried.
i try to just treat the best i can, at least he's happy. i know that.

 

Is he obese?

I think that you are seeing a "dawn" effect. I hate to suggest this, but is it possible to get a middle of the night (+6) to see where he is? Your PMPS readings look really good. Could you bump back your am insulin by an hour? You are at the fine-tuning stage. Hopefully Gator will be around soon to give you some suggestions.

But really, he looks good... and I think it *is* diabetes.

 

My suggestion is this.

You are not holding a steady dose so lets just say you are doing "sliding scale."

Now one of the first objective I have in SS is to find the dose that will allow the cat to have an AMPS=PMPS - the dose that will hold them even. SO in this line of thinking the current AM dose is too much insulin. Once you can get the day dose straight then the night dose you can get figured out [they will probably happen concurrently]. Am I making any sense? The bottom line is that IMHO the AM dose is too high and thus the PS to PS is not even during the day. I think I may have already said this at some previous point so I hope I'm not being annoyingly repetitive.

Once you find that even dose then you can bring them back down slowly with very small dosing chances in maybe "0.05" to 0.1u [ideally - but it doesn't always work that way] increment range.

And the infection thing too. Why were you initially concerned about the dental? This is perhaps still an outstanding issue?

 

ok, well gator i actually did the opposite of what you suggested starting on sunday where i bumped up his dose to 1 u. i did this after cureve day where hindsight says i probably should have been satisfied. look at 2/27
now, hello, i have the highest pmps ever and today for the first morning in a month or so (since the no pm shot experiment) have hit the 300's again. :cry:
i just have no money for his dental or another vet visit. i currently have a leaky roof over which i have a huge plastic tarp until i can gather funds to either fix or replace roof. i have a mountain of late medical bills of my own and it's all i can do to keep him in raw rabbit and ff.
we are kind of in survival mode here.
should i go four rounds with my new dose....or cut back immediatly?
btw, behaviorly, he's well other than sleeping indoors more often than going out and doing whatever he does out there.
and no, tomtom is not obese...he is built like a football player, all muscle and strong shouldered. i've never seen a cat as well built as tomtom!

 

Have you tried friskies? It is lots cheaper than FF. According to the food chart, there are many LC varieties. I realize that it is likely the lowest quality of the LC varieties but I think it is fine. That's what I'm feeding Soccer (and the other 4 cats) and they are doing well.

Just a note about the dental, if he isn't having immediate problems, you can do a lot of the dental care at home for very little $$. One of the best methods for cleaning cat teeth is to wrap a moist gauze pad over your finger and wipe the teeth and gums. You want to rub enough to clean the gumline but not so hard that it bleeds. I'd skip any toothpaste or wash unless you have some human peri-dex around (rx only). Peri-dex is chlorhexidine. *If* you have some of that from your own dental work, you can wipe down the teeth with it after you've cleaned them off. Again, use a moistened gauze pad (not soaked). (Don't use listerine, scope, or other OTC washes.) Also, (this is only for cooperative cats!), you can use your fingernail to chip off large plaque pieces. Gross, I know. But, you are unlikey to damage the teeth and gums with your finger and fingernail. However, you can really cause some damage if you use a scaler.

 

OK well just don't do the opposite of what I say then. LOL I'm just kidding - you can do whatever you want and as I have said before I'm a little crazy so buyer beware of my advice.

1u during the DAY seems like too much. I was suggesting to lower the day dose first because that would have been the safer route than trying to up to night dose first. The nice thing about lowering the dose is that you can always raise it back later if you want.

Also that night dose is going to be a little more tricky to figure out especially now that you shot 2x the 1/2u at 1u and he STILL went up to 300s. And before [at night] it looks like 1/3u tomtom was very sensitive too with some drops at +2? I'm not sure if I'm adding any clarification or just muddying the waters further.

Anyway, you'll get it figured out. I think you have the various theories and you can experiment with them if you wish and see what results you end up with.

Michele, I've used a scaler on a number of cats [some cooperative and others not so] over at least the past 10-15 years and never done any damage [knock on wood] :shock: . However, I do understand the caution - it's not for the faint of heart and requires a LOT of patience, a good helper and perhaps multiple sessions. Sometimes that plaque REALLY gets stuck on there and there is no possible way I could imagine a nail popping it off. Thanks for sharing the other dental tips, I've not heard of the others before and I will investigate. The worst is when you pop off one of those plaque rocks and they hit you in the face - yuck.

 

Once again, I'm reminded how lucky we are to have you here, Michele! Thank you so much for giving such good advice/tips; they are invaluable. I had no idea that you could clean cat teeth this way, and I might attempt the gauze pad suggestion on my cooperative civie to see how it goes. None of my three have ever had a dental; in fact, I had never heard of them until I came here to FDMB (how sad is that?!). Anything I can try to help prevent problems is awesome in my book.

 

I never tell people to use a scaler because you can crack a tooth, damage the enamel, or pocket the gum if you are overly-industrious (not the word I was looking for but you get my drift). But, yeah, you certainly don't need to be a vet to use one, you just need to be a bit cautious. I still like popping off tartar rocks with my fingernail... how satisfying! lol :lol: