Mauer

Discussion in 'Prozinc / PZI' started by SashaV, Nov 17, 2020.

  1. SashaV

    SashaV Member

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    Apr 25, 2020
    So I was driving with my mom and complaining about Mauers high AM pre-shot BG. And my mom said "I really do think you need to shoot higher in her PM cycle!"
    I looked back at her "Seriously?! Not you too?!?!":blackeye::arghh:

    So message received! @Deb & Wink and @JanetNJ :D
    I got it! What are the odds of getting two pm +5 in a row that's totally identical?

    By the way, I calculated wrong with Mauers insurance and therefore I'm kinda screwed until payday, and I'm running out of prozinc :banghead:
    I do have two old ones in the fridge, but both is contaminated by drawing the insulin up, and pushing it back into the vial.
    It's so clear that since I stopped doing it, the insulin has much more power!
    So how much will I mess up, by giving her from the old one? :nailbiting:
    Is it a totally bad idea?
    The other alternative is I find the money somewhere somehow....
    Seriously I'm so terrible with numbers, so besides the fact that it absolutely sucks having a diabetic cat.... all those numbers sure doesn't make it better! :arghh::eek:


    Thank you!:bighug:
    Gosh this would be overwhelmingly hard without your support and help. It's so amazing! I wish I could pay you back somehow for all your help :bighug:
     
  2. JanetNJ

    JanetNJ Well-Known Member

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    listen to your mother. lol Do at LEAST 3.5 and see what happens. We want some PM BLUES. lol I think you are going to need to go to 3.75 or 4 in the pm, but I know you are nervous about it, so work your way up. Use up every drop of the insulin you have. I doubt the contaminated ones are really that bad. Use up every drop, then if you need a few days of the old ones it's probably fine until you get a new one.
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

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    Listen to your mom! Moms know best!

    I've seen it before with other members here. Even happens from 1 hour to the next sometimes.

    You already have thanked all of us here, by continuing to treat Mauer. Simple as that.
    Depends on how old the previous vials are and how long they have been open. More than 6 months? It's a bit iffier if the insulin would be potent enough if they are that old. Does the insulin in the vials still look good? No floating particles. Never frozen accidentally by pushing the vial to the back of the fridge where it's often colder. (I've got some fresh carrots in the cold back corner of my fridge - that have frozen and re-thawed a couple of times - but they are fine and are even sweeter and tastier.) You might not see the same results from the older vials. But some older insulin is better than no insulin at all. No insulin could lead to ketones and DKA and you don't want that to happen. So use the old vials as long as they look good.

    p.s. You'll have to think of me as your "grandma"! Yes, you are young enough to be my grandchild. ;)
     
  4. SashaV

    SashaV Member

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    I did a FAT 3.25 closer to 3.50 than 3.25 and it did nothing. So I'm afraid you're right, I really do need to go higher.
    I'll use every single drop, that crap is expensive :D:eek:
     
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  5. SashaV

    SashaV Member

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    It's freaky that they're SO close! On two different days.

    I'll always continue to treat her, as long as it's in her best interest. I'm not at all ready to let her go. I can't see my life without her, and I've never had to say goodbye to someone who has been in my life that long. Totally unthinkable.

    Deb, be honest... did you put the carrots there on purpose? :D:p
    I'll check them before I decide, one is in the door of the fridge and one on a shelf in the middle. None of them is over 6 months.

    You're grandma Deb! Wise, clever and always there for good advice :bighug::bighug:

    I need a butt rubber. Or Miver does :oops:
    And right over the doorstep :banghead:
     

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  6. Deb & Wink

    Deb & Wink Well-Known Member

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    See! You've already paid us back.

    I bought those carrots back in April or May, during one of my few forays to the grocery store during lockdown, and still haven't used them. I've been buying shredded carrots which are easier to use in food dishes. I do like carrots, but I don't like to peel them, and they are too bitter to eat with the skins on.
     
  7. JanetNJ

    JanetNJ Well-Known Member

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    You don't have to tell me! I buy a new vial every 3-4 weeks.
     
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  8. SashaV

    SashaV Member

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    I'd probably do the same :D
    But I like skins. Especially on new carrots and potatoes, both uncooked.

    Did you get snow yet, Deb? :bighug:
     
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  9. SashaV

    SashaV Member

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    Oh my gosh... I'll stop complaining this instant!
    Acro is expensive!:nailbiting:
     
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  10. JanetNJ

    JanetNJ Well-Known Member

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    Indeed. Lol. Plus she gets hyperthyroidism meds. This is an expensive cat. Lol. Worth every penny.
     
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  11. SashaV

    SashaV Member

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    I know the feeling!
    Diabetes and other diseases comes with a price.. but I'd do it again.
    Can agro be seen in a blood test?
     
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  12. JanetNJ

    JanetNJ Well-Known Member

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    It's a specific test you need to request... It's not in a regular blood panel.
     
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  13. SashaV

    SashaV Member

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    When did you know? That something else was wrong...
     
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  14. Deb & Wink

    Deb & Wink Well-Known Member

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    We usually suggest that people ask for an acromegaly test when the dose for each cycle reaches 5 to 6 units.
    If you do get the blood drawn for the acromegaly test, you should get the IAA (Insulin Auto Antibodies) test done at the same time. Blood samples have to be sent out to a special lab. I think the only place in Europe that does this test, is the RVC outside London. Shipping is a big part of the cost.

    We had snow back on October 30th, the day before Halloween. There was 3 inches, enough to shovel since it was wet and slushy and the temperatures were going to plummet overnight, turning it to a sheet of ice on my steep, long driveway. Melted in about 4 days. No snow since then, thankfully.

    Very cold here right now, in the 20's F (6 Celcius). Warming up this weekend is expected.
     
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  15. JanetNJ

    JanetNJ Well-Known Member

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    We were up to 8 units and she still needed more. My vet kept acting like I was overdosing her and was going to kill her. She had me try lowering the dose and that just resulted in red numbers and ketones forming. She finally agreed to the test. I tried to tell her 6 months before that that I thought she had it but she said no, it's so so rare... I said it's not THAT rare, and that there's a group of acro cats on the fdmb board. She went to a seminar on FD and came back to say she learned that it's more common then once thought and agreed to do the test. Not a surprise to me, but it was positive. At least at that point the vet stepped back and stopped trying to micromanage my dosing and let me do what I needed to do again without a lecture. (yes, she actually had me arrange a "consultation" to discuss my dosing (rolls eyes). Didn't need that.) Overall she's a great vet... I don't really blame her.. I'd be concerned if I heard my patient was on that much insulin too!! BUt I knew what I was doing. She wound up going up to 12.5 units before It came back down... then went back up.... then came back down. hahaha Currently she's on about 7-7.25 u
     
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  16. Deb & Wink

    Deb & Wink Well-Known Member

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  17. SashaV

    SashaV Member

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    Idexx in Germany is also an option I believe.
    I'm back on the Cushings, she's CAN loose weight but without changes in her diet she gains it right back on.
    At some point I just don't wanna know. No cure or treatment, and if she keeps gaining weight time is very limited.


    I'm sitting in the garden, we have 2 degrees celsius right now, but no snow.
    Nice to think ahead and shovel before it turned to ice!
    I'm hoping on a white Christmas, it's been so long since we've had snow on Christmas. Or even just in December.

    Did you see her nice numbers last night?!:D
     

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  18. SashaV

    SashaV Member

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    Gosh!!!
    At least your vet knew that it was possible. My vet said cats don't get cushings o_O
    Id be concerned too, insulin is a powerful drug. But sometimes we know best, we see them everyday, know them inside out.. and our gut feeling is sometimes spot on and is worth to take into consideration.

    Mauer got diagnosed on my gut feeling that she had arthritis in her hind legs.... cause she was wet every time she went to the littertray to pee. Is was sugar spilling, x-rays didn't show anything so my vet did a urine sample, combined with her BG that we thought was caused by stress.
    Just sometimes the owners observations is a crucial part...

    What a dose!:nailbiting: Now I understand why you buy new vials so often :woot:
     
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  19. JanetNJ

    JanetNJ Well-Known Member

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    Yeah I miss the days of keeping vials for months BUT with this smaller 7 unit dose is lasting about a month where when it was 12ish it lasted just a couple of weeks.

    Good job advocating for your cat.
     
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  20. SashaV

    SashaV Member

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    It's your job, isn't it?
    Advocating for our animals who can't talk for themselves.

    Since yours has agromegaly, does she look like it? In humans it causes deformations, like huge heads for example..
     
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  21. JanetNJ

    JanetNJ Well-Known Member

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    Her face hasn't changed fortunately. It did give her a pot belly (not fat, but enlarged organs) and her front elbows bow out. We give adequan shots to help her joints.
     
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  22. SashaV

    SashaV Member

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    Sad to hear about her organs and elbows.
    Just unfair. But glad to see she's living a good life with her condition :bighug:
     
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  23. Deb & Wink

    Deb & Wink Well-Known Member

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    Mauer DID have some nice blues last night! Good for her.:cool:

    Truly, Cushings is much rarer in cats than either acromegaly or IAA.
    But since you are the one that advocates for Mauer, get the tests done that you think she needs.

    I thought you had already had Mauer tested for Cushings? Or you were going to?
     
  24. SashaV

    SashaV Member

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    You're right, but I changed my mind since she started to loose weight. Then I thought maybe I overreacted, also because this is finally working! Her spreadsheet isn't dominated by pink or yellow, it's freaking blue!

    And the recommendation if a cat has cushings...is to put them to sleep. Her limping is much better with her healthier numbers. Now she's almost at 8 kilos.
    I don't know :(
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, you are seeing more blues Sasha.

    It's up to you Sasha, if you decide to go ahead with any more blood testing for Mauer, to test for Cushing's.

    There are certain drugs that can help with Cushing's. So push back on your vet if they still recommend euthanasia.
    Perhaps this article would help you with other treatment options, if Mauer does end up having Cushing's.
    https://www.dvm360.com/view/feline-facets-cushings-diseasedo
     
  26. SashaV

    SashaV Member

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    Speaking of the devil and the blues suddenly disappear :banghead::banghead:
    She's still playful and awake but her BG isn't showing what I see. Frustrating!
     
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  27. SashaV

    SashaV Member

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    Monday the 23 she got 90% of the "new" prozinc and 10% of the old, still she went blue already at +3, it happens but usually its +4, today it happened again. No floaters, just even milk white.. maybe it wasn't as bad and lazy as I thought?!

    I shot lower on purpose today. I might need to be out of the house most of the day, a rabbit is free on it's own paws in a big city, so my friend and I might try to catch it.

    New vial is ordered and is ready at my pharmacy, I'll pick it up at payday.

    Hope you're all safe! :bighug:
     
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  28. SashaV

    SashaV Member

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    So that 77 came as a surprise.
    I'm glad I stayed home.
    I'm not unhappy with the 77 it's a healthy number, yay!
    But I'm not comfortable if it goes lower :oops::banghead:
    I'm working on it!

    Seriously thats a big drop in only an hour?! Specially since she already was blue... I really didn't see that coming! And here i thought the old vial was lazy. Darn I'm glad I didn't shoot 4.5 like yesterday, oh my...
     
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  29. SashaV

    SashaV Member

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    13.4 +2.20
    Spreadsheet is acting up again. I'll update here till amps, unless (anti-jinx!!!) I end up having my own little PJ party.
     
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  30. SashaV

    SashaV Member

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    +5 12.4
     
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  31. Deb & Wink

    Deb & Wink Well-Known Member

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    Nice green at +6 today for Mauer, even with the "Old" vial of prozinc.


    A bunny? Loose in the city? Do you mean like someone's pet rabbit got loose?
     
  32. SashaV

    SashaV Member

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    Exactly!
    Bunny won't make it for long, and the owner hasn't been found yet.
     
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  33. Deb & Wink

    Deb & Wink Well-Known Member

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    Nice run of blues for Mauer this AM. Way to go Mauer!!!!!
     
  34. SashaV

    SashaV Member

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    I know, right?! But why?!

    I've drawn the insulin up, and put it back in the vial. It wasn't as powerful the first time I used it, she only went in the yellows. It was so "tired" the first time I bought a new vial and left half of it in the fridge, in case she needed it later. I really don't understand why it's working this good.
    In my mind I was prepared to shoot higher, to counteract its laziness :p:joyful:

    I am positively surprised for sure!

    Since she's overall lower, even when she goes high she doesn't act like it. She's never "far away" in her sleep, leaking sugar in her urine even if she pees a lot. Gosh I love her!
     
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  35. SashaV

    SashaV Member

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    Gosh a day I had yesterday...
    I was going to my friends vacation home, a 100 km from my home, my sister agreed to test Mauer during the day, so I drove at +2.
    I shot lower on purpose, still she was blue.

    Seriously I ended up driving a half hour to get in and out of the area to find that stupid AMAZING house! And on my way out. Since it was an hour and 15 minutes every way, I went home to shoot the cat. When I got to the car it was frozen! I don't have the right tires to drive in minus degrees! So I drove slowly and safe - no need to kill myself rushing home to shoot the cat. And then I freaking almost ran out of fuel.
    Called my sister on my way home, saying I might not make it in time to shoot Mauer. So she agreed to do it.

    When I finally got home I did a +2, and it was going down... usually it's not, so I knew that I needed to get that +5 no matter what. So I slept with the lights on.

    That house... oh my God...
    What a view. See the picture, standing on the porch looking at the ocean.

    Then off to bed, finally! And then someone and I don't know who, but I'm guessing it was the dog.... he puked in my bed!!!!! :banghead::(:mad:


    Last week I had a talk with an awesome woman here in DK, her cat just got diagnosed and she was curious about this whole new world. She saw my comments on Facebook, and before we talked she tossed the dryfood and bought a meter - even though her vet advised her not to test :banghead:
    So she had some numbers when we were talking, only 15 and 16mmol readings with no food. Her vet only offered caninsulin and I told her to not accept it. In Denmark we have a rule that says a vet only can prescribe vet medicine, until it has proven to be ineffective. They didn't offer prozinc and wouldn't agree to prescribe it, so I told her to get a new vet. And so she did! The new vet thought prozinc was a great idea, told her how good it was to test. The vet is pro raw food! And so the vet wanted to see how the cat was doing on raw food with testing, before starting insulin. I don't believe the cat will go that much lower, but at least he'll be on a good and safe diet without the risk of a hypo.
    So I hope we get a new member some time soon! Who actually has a vet who's brain and logic is working :D
    I love being positively surprised! Just sad that vet isn't in my area :D
     

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  36. Deb & Wink

    Deb & Wink Well-Known Member

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    Oh my goodness! What adventures you had yesterday, between your scary drive back and forth to visit, getting yourself back home safely in icy driving conditions, and the vomit in your bed. I'm sure you could have done without some of that "excitement".

    I still think you could raise the PM dose a bit. Too many yellow BG numbers in the PM cycle, not enough blues.
    Her newer vet sounds like a winner!
     
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  37. SashaV

    SashaV Member

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    Uuuh! Unusual low AMPS! Exciting!
    I was about to shoot a 4U then I changed my mind, and went with a fat 3.75U almost a 4.
    Now I see, at the 6 november I did the same thing without her going green. :banghead:
    So now I wished I followed my first instinct. So typical! But she went blue last night, yaaaay!

    Her behavior is so strange! Really she's acting like a kitten again, she pupils are big, she's so playful Miver almost gets enough of her, she's talking like an idiot all the time - at the dryer, to herself, to me even. We have nice conversations with her in the bathroom and me in the living room :D
    It's really funny and so strange! She's been lazy so long, and now it's like she's on speed!

    I'm going to pick up a new vial tomorrow. Usually I lower the dose the frist few cycles to see if it bumps her down. But maybe I shouldn't?
     
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  38. Deb & Wink

    Deb & Wink Well-Known Member

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    I don't think you should lower the dose for the new vial of Prozinc.
    That is because you are very good at monitoring Mauer and so far every time you have lowered the dose for a new (or different vial), it causes Mauer a setback in her BG control.

    Hyperactive Mauer! So she is feeling good these days, and it sounds like she keeps telling you that with her constant conversations. Let's keep Mauer feeling good by NOT lowering the dose this time.

    Hesitation or second guessing yourself leads to Mauer not getting good BG numbers. So you need to overcome your fear, and stop hesitating.

    I think if you had kept Mauer at 4U this morning, 11/29/20, you would have finally seen some greens in the AM cycle. You WANT to see those greens. More greens!
    :D:D:D
     
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  39. SashaV

    SashaV Member

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    You're so right, Deb!
    7 days in a row with blue! Today is going to be the 8 :cool:

    You sure have a point, I'm testing a lot... specially in her AM cycle so I'd definitely catch her, if she goes too low. So why am I afraid? I haven't thought of it that way.

    She's feeling so great, its really amazing to see :bighug:

    I'm not sure she would have gone green though, I gave her a FAT and I really do mean a FAT 3.75U, it was a tiny drop from being a 4U.

    Now she's starting to go up on her own without food.
    Should I try something else with her food? Usually I let her go as far down as she can, and then feed her.

    I'm aiming for green! :D:p
     
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  40. SashaV

    SashaV Member

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    I take it back :banghead::(
    Doesn't look like a blue day. Her mood is still high though!

    She's still gaining weight, today she was at 8 kilos. Went to buy some raw food and decided so switch Mauer to a different version of the Mush Barf, that has 2% less fat. Hopefully that will do the trick! If not, then I'm going to get that bloodtest for IAA and cushings. But fingers crossed!
     
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  41. SashaV

    SashaV Member

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    MUHAHAHAHHA! She went freaking blue anyway!

    Okay ill stop smiling now... seems ridiculous
    I almost tried to high-five Mauer..a cat..
     
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  42. Shelley & Jess

    Shelley & Jess Member

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    You are priceless!!!
     
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  43. SashaV

    SashaV Member

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    Well, we only have the fun we make ourselves! :D
    I take that literally as you can hear! :D:p


    So she went blue, that was awesome! I fed her and went on thinking that was it... but it wasn't, cause nothing ever is. PMPS 7.4 :eek:
    She didn't eat much, but still..
    I was expecting twice that number.
    So I made the decision to shoot lower than I otherwise would, cause I have a feeling....
    She surprised me once today, and now I'm regretting not testing her after the 10 at +7..so it wouldn't be a surprise if she does something unusual like going lower without the high rise first. But we'll see about that!

    So sorry for the spam today Deb! It's been a funny unusual day :oops:

    Tomorrow its the new vial, and I'm not going lower I promise!
     
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  44. Deb & Wink

    Deb & Wink Well-Known Member

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    You really should not be feeding Mauer after the middle of the cycle, the +6 time. The insulin will have been used up by then, and the numbers will go up more if you feed after that point.

    The exception to feeding Mauer after the +6, would be if she got into the greens, say around 70 or lower. Or is she was really low in the first few hours of the cycle.

    Thank you Sasha! You made me laugh!!!!!

    Second guessing ourselves, in all the choices we make. Should have, could have, would have. "Don't sweat the small stuff, and it's all small stuff". In other words, you can't change the past so you move forward from where you are now, and see what you would like to do differently. Don't regret your decisions, big ones or small ones.

    What spam? Green eggs and spam by Dr. Suess? No, that's "Green Eggs and Ham"! But none for Mauer girl, since she needs to lose weight.
     
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  45. SashaV

    SashaV Member

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    7.9 Deb!
    I had that feeling.....
    Ill do a +6 just to make sure she's going up.
    Will answer the rest tomorrow. It's 2pm here.
     
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  46. Deb & Wink

    Deb & Wink Well-Known Member

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    I think you mean 2 AM, wee hours of the morning for you over in Denmark.

    Tomorrow is fine.
     
  47. SashaV

    SashaV Member

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    I do mean 2 am :banghead:
    Why can't you guys use the same time as the rest of the world? And centimeters, kilograms, kilometer :D
    Am after midnight, got it. I'll forget it again I'm sure of that!:p

    But if I feed Mauer before her nadir, she won't go as low as she can? But it makes sense that feeding after that will feed the pmps. What about one meal at +4 for example?

    Anytime Deb! I'm always good for a laugh! :D:D

    I don't regret following my gut last night, she proved me right and didn't go higher as usual she just surfed down there.
    I wanted to shoot lower with the new vial, but I didn't so hopefully she'll go green! That would be awesome! And keep us on track with 9 good days in a row :cool::p
    And today I hope my gut feeling about shooting lower is wrong :nailbiting:
    Instincts is a powerful thing apparently:oops:

    I'm just spamming my own thread here, and I'll make a new one soon! Today I waited replying til after her shot :p

    She's really so fat, Deb. It's so sad that it got this far...
    I don't understand it, neither does those two wonderful ladies who's helping me with her raw diet. I brought them chocolate yesterday, and they asked why. "Well, Mauer needs company in the weight department!" :D:D
    And then I just thanked them for their advice and caring.

    Green eggs sounds....yikes. :nailbiting:
     
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  48. SashaV

    SashaV Member

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    You're on early @Deb & Wink
    She got blue!
    On the wrong side of midnight though.
    I'm going to have a light night :D
     
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  49. Deb & Wink

    Deb & Wink Well-Known Member

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    With that BG of 67 at +5 this evening, I think you'll be up for a bit.
    Just little bits of low carb food, to keep her steady in those nice green numbers.

    It's December, so the gardening has come to a screeching halt. Still have lots of other responsibilities, but it was dark early and not quite time for dinner, so I got on the
    board for a bit early today.
     
  50. SashaV

    SashaV Member

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    I gave her dryfood and 30 minutes later still the same number!
    I slept for 30 minutes... with the lights on, several alarms..
     
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  51. Deb & Wink

    Deb & Wink Well-Known Member

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    Dry food takes longer to digest, and see any impact on the BG levels.
    You could try giving her some MC (medium carb) wet food. Only a teaspoon or so, and test again in 20 minutes.
     
  52. SashaV

    SashaV Member

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    Don't know the carb content of the Sheba wet food I have.. but ill feed her some!

    Have you got snow yet? :D
     
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  53. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    You could try adding a very small drop of honey (or corn syrup, or some other sweetener that is not artificial) to her food.
    Sugars like honey do wear off in a couple of hours though. But it's worth a try, to get the BG levels back up more.

    No, we got nearly 2 inches of rain yesterday though. Glad it was warm enough to rain, as that would have been about 2 feet of snow.
     
  54. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    If she's not gone up in 16 minutes, at my 4 am - I remembered!!! - I'll give her some honey then.
    Now I went out for a cigarette. So I'm awake enough to make good decisions.

    Uh, I know what you mean! But snow lights everything up, and it's so pretty :oops:
    We haven't got a white Christmas for a decade....
     
  55. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    77 +6
    Waiting with the honey

    I'm sad she didn't go blue last cycle. I even made an unintentional curve, hoping to see blue.
     
  56. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    If she can go this low on a 3U dose, but not 24 hours ago on a 133 and 2.25U... was today's dose too high?
    I don't get it. One day 3U is too much, next day way to little on the same pre-shot readings. :banghead:
     
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  57. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I don't know Sasha, I really don't know why Mauer goes so low some cycles, but not on others.
     
  58. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    But it isn't just me, right?
    This isn't how it's supposed to be?
     
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  59. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    She's holding steady.
    I'm still not seeing the dry food I gave her 1,5 hours ago.
     
  60. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Not sure what you are asking Sasha.
     
  61. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    I don't know either. Or how to explain it..

    Same readings, same units given, but totally different outcome. Shouldn't I know within reason what's going to happen?
    I know ill never be a 100% sure, but if 3U isn't safe, how the heck did I get away with the blue pmps and 2.25 units yesterday?!
     
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  62. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    Not moving...
    I'm short 20 minutes of 2 hours without food, and a slight rise.
    When can I go back to deaming? :oops:
     
  63. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You want the BG level to be going up, and preferable above 90 mg/dL, without any food for 2 hours. That way, by waiting the 2 hours with no food, you know the BG levels are higher because the effects of the food influence on the BG has worn off. I think that 88 was close enough to say "back to dreaming."

    Not every thing is under your control Sasha.

    1. Because insulin is a hormone, it doesn't work exactly the same every single time.

    2. The insulin you give one cycle, can have an effect for several cycles after that. Because you have chosen to use sliding scale dosing, you are going to see more wild swings in the BG levels from cycle to cycle.

    3. Our cats get such tiny doses, it's very hard to accurately measure the dose consistently from one dose to the next. Your insulin syringes could be marked slightly differently on the barrel, within the same batch of syringes, and/or from batch to batch of syringes that you buy. So what looks like 2.25U could in truth be closer to 1.75U or even as much as 2.5 - 3U. I saw a thread that talked about a manufacturer that said the syringes could be as much as 1/2U different than what the markings on the barrel indicated. (So use calipers to measure the dose instead of only relying on the marked lines on the syringe.)

    Take out a dozen syringes. Line them up exactly, with the barrels exactly lined up with each other. See how the markings, the lines on the barrel differ.

    4.You don't have control over the activity level of Mauer. She's more active at different times of day, she's less active on some days. She and Miver play more, or sleep less or more during any particular cycle.

    5. You don't control exactly how much protein, fat and carbohydrates are in the food you feed. The percentages are a generalization for a batch of food tested by the manufacturer. They make food in such large batches, they can't guarantee there is only a fixed percentage of any ingredient in the food, and it doesn't vary from batch to batch. That is why most foods give a minimum or maximum amount for a particular ingredient. It could be higher or lower than that amount.

    The food is listed with "guaranteed analysis" figures. But those can vary a bit. For example, crude protein may be listed as 10% but perhaps it's 11% or 12% for a particular batch of food.That difference means the fat and carbohydrates will be different too for that batch.

    Plus, manufacturers only have to provide that guaranteed analysis figures once, unless they make substantial changes to the food. Sometimes that analysis is done in a lab, sometimes the analysis is done with a very small group of cats for a very limited time period.

    6. Maybe your cats digestive system is working slower or faster or processing the food better. No way to control what is happening with digestion.

    7. Any other health condition, even something as basic as your cat trying to vomit up a hairball can make a difference. Or some slight constipation can slow the digestive system down and impact how much glucose gets into the bloodstream. Perhaps there is an unnoticed infection. Or the teeth and gums are inflamed, or who knows what else could be going on.

    8. Prozinc tends to be a bit more volatile, in the swings of the BG levels. It's why so many people switch to a longer lasting insulin like Lantus or Levemir, for less volatility.

    9. Bouncing. When Mauer drops low the evening cycle before, she shoots back up the next morning, to compensate. You are then giving her a large dose based on a high pre-shot AND the BOUNCE. Then she drops low again for the evening cycle. You're in a vicious loop, by mainly basing the shot on the pre-shot test and using that sliding scale.

    What I'm saying is that there are simply too many variables with how food and insulin work. Most of those variables are not within your control.
    In my opinion, the sliding scale dosing is not working well for Mauer.
     
  64. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    Why don't you think it's working well?
    She's bouncing much less, spends more time in healthy numbers than before.

    If she were your cat, what would you do?
     
  65. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    Since October 1 she's had 8 red readings.
    Her SS is mostly blue in her AM cycle.
    She's bouncing much less.
    Her behavior shows no clinical signs of diabetes.
    In the hours before her AM shot, where she's usually higher she's playful, awake and happy.
    Her average BG levels is lower than ever.
    I've had far less PJ parties.

    Yes, her PM cycle could be more under control. But that's the only negative thing I see.

    So what are you really saying?
    Should I try a different approach?
    Switch to levemir or lantus?
    I'm open to suggestions and trying something different. You're the one with the experience, not me. I only want her happy and healthy, so any ideas you have is much appreciated :bighug:
     
  66. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I think the high pre-shots are causing you to see the need for more insulin in the morning. But you need to take at least the previous cycle into consideration, the evening before and not choose your dose based on the pre-shot as your main decision factor. Look at how far the dose dropped her in a cycle, what was the nadir or low? That should be your main decision factor, with only some weight given to the pre-shot test. Look at the trends in the BG numbers. Mauer was bouncing this morning, from those lows last night 12/2/20.

    Using calipers for measuring the dose, would be the way to get a more consistent dose from cycle to cycle. Using your eyes doesn't always give you the true picture.
    Using the MPM protocol, not a sliding scale dose would be a different approach.
    First thing I'd do, would be to sit down and reevaluate my goals for my cat. Nine months into this journey with diabetes, remission is not likely to happen. It's still possible, but not as likely. So what are my expectations now? Can I continue to support and test and care for my cat, the way I have been doing? Or do I need to make some changes? I'd figure out how I could take care of my cat, and still have time to take care of myself too, and handle all the responsibilities and needs of living a joyful life.

    I'd work with my vet to figure out why my cat was gaining weight, even with a reduced amount of food. Canned and raw foods have less calories than dry food, so it doesn't make sense that a cat would keep gaining weight on that type of food. In my opinion, something else has to be going on. Or Mauer is sneaking extra food somehow from other people living with you or visiting, or she is eating more of another cats food, or she is eating when she is wandering outside.

    I'd find a way to get the tests for acromegaly and IAA done. BUT I have the financial means to do that. Not everyone does.
    I'd take a close look at the food I'm feeding, getting the guaranteed analysis and running those percentages through a simple cat food carb calculator, <<<<< link to one here for you. And think about a different food if needed.

    I'd switch to a different insulin for my own cat, most likely Lantus since I have a little bit of past experience with that insulin.
    I'd be using the more intensive management guidelines (TR or tight regulation for lantus, MPM or Modified Prozinc Method for Prozinc), not the SLGS guidelines.
    I'd be trying to keep my cat in the middle green ranges most of the time, 60-90 mg/dL, as much as possible during the 12 hour cycle.

    But that is me. You have to figure out what you can and want to do. There is no one size fits all method or approach. ECID Every Cat is Different, Every Caregiver is Different.

    To my mind, getting my cat Wink off insulin was a total fluke. I'm not sure I could do the same thing with another cat.

    Sasha, I could not do what you are doing now, staying up at all hours to test Mauer. The days when I could quickly fall back asleep, or take a quick nap are a long time in the past.
     
  67. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    So you're not saying that I'm totally awful at this? But that I need to consider if I can withstand this in the long run?
    The short answer is I can't.

    Prozinc keeps her down there in a least on cycle, and that's an improvement. But with all this testing, witch I find necessary because I can't trust where it's taking her, even on a regular number with the same dose makes me anxious.

    With my ADHD I am keeping to my routines at all times, and I need my sleep... and I need to know that she'll be safe even if I decide to spend a day with the twins. Not knowing if she's safe keeps my mind with her, and that's not fair.

    I'm still aiming at remission, even though I know it's a slim possibility by now. But the ultimative goal is to keep her healthy and happy.

    I know I can't fully trust any insulin to not bottoming her out, but people do this with a full time job. So I know that it's not supposed to be this hard, even when fully understanding that this is a marathon not a sprint. But I need to be able to have an actual life to do this in the long run.

    Are you recommending lantus based on your experience or because it's the best thing? I do have levemir in my fridge, but it has been stored in the door. So in theory I could switch her at any time. Lantus is about the only thing left she hasn't done yet.

    I've been thinking about the tests for IAA, cushings and agro.. but at some point I don't wanna know. If that's what causing her to not loose weight, then what? There's no cure. Will she just keep gaining weight then?
    Then it'll be what kills her. I can't with good conscience have a cat that is so fat she can't stand on her own four legs. So if I get the test and it's positive its a death sentence. And that's why I'm hesitating.

    If lantus or levemir is the way to go, I'll do that for sure.
    So how do we ship you to the lantus/levemir support groups? :D
    Pack your bags, grandma Deb, you're going on a new adventure :p:D

    I love her, and I'll do anything for her. But I've also been thinking that I've given prozinc a fair shot, and still haven't got her fully regulated. One cycle a day isn't enough to keep her healthy.

    I've been fast in the past with making decisions, so perhaps I've been waiting on you (or someone else) to tell me that we've gone as far as we can on this type of insulin.

    Seriously Deb, you couldn't have told me this last week? :D:D
    I just bought a new vial!
    I'll stick to the prozinc until the final decision has been made.

    And thank you :bighug:
    Nice to know your thoughts on this, even though they weren't what I'd hoped to hear.
    So really thank you, Deb :bighug:
     
  68. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Sasha, you're pretty darn good at this. Making your own decisions for Mauer when you can, and asking for help when you are unsure. It's tough when you live so far away, and can't get timely answers on your choices.

    Yes, that is what I wanted you to think about. I didn't expect any answer but the one you came up with on your own. The choices of what to do always have to ultimately rest with the caregiver. We care so much for our beloved cats, sometimes we sacrifice too much and end up not taking care of ourselves the way we should or need to.

    So have a good long think about what you will do going forward. Take your time. You don't have to make all those decisions in one day or even one week. Those thoughts and plans don't have to be set in stone, never changing. But try to get an idea of how you would like to proceed with Mauer's care, AND caring for yourself at the same time.

    Good goals! Seeing our cats return to some of their previous behavior, improvement in symptoms, good appetite are all worthwhile goals. Remission is ok, but your cat can live a long and healthy life on insulin for the rest of their life.
    No, 1 cycle a day isn't enough to keep her feeling good and healthy. So it's definitely time to try one of the depot type insulins. You HAVE gone about as far as you could, using Prozinc. Time to switch.

    Either of the L insulins (lantus or levemir) would be a fine choice for Mauer, for a different insulin to try. Since you already have some levemir on hand, try that one first. But this time, you will know to give it a longer chance to work and see changes. You've learned a lot in the last few months. How old is the vial? Does the insulin still look clear? No floating particles?

    About the only way I'd be found in the Lantus/Levemir support group on a regular basis, is if there were a lot more people to help with Prozinc. But there aren't. So here I am in this ISG, with the help of only one other person to manage all the new people using Prozinc. There are literally dozens of people in the L/L forum that can help. So I don't visit there much at all, only to say hi occasionally to other former Prozinc caregivers to see how they are doing since they switched insulins.

    The only other way I can think of that I would be in the L/L ISG forum, is if I fostered or adopted another diabetic cat and was not getting good control of the BG levels, and needed some help with that. But with my very skittish former feral colony cat, bringing another cat into my life is not something I would consider right now. She's been with me nearly 10 years now, and she still runs away from me at times and hides under the sofa, like this morning. No idea why this morning was any different, but she gets scared at times. I had to coax her back to her food dish to eat, and she is very food driven. Dancer walk away from food? She must be sick is my first thought, but she's fine. I simply moved too fast for her, and scared her. It happens.

    Big storm coming tomorrow 12/5/20. Heavy rain changing to wet heavy snow and high winds. Hopefully, the power stays on and my plow guy gets me dug out on Sunday morning after the storm stops. Then, it's up to me to shovel out the rest.
     
  69. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    :bighug::bighug:
    Thanks Deb!
    The positive thing about being so far away, is that Mauer drops lower at night when you're online :oops:

    Going forward I'd like to sleep :p:oops:
    At least some nights, without having to get up and test. I'd like not testing as much as I do now, without feeling it's unsafe.
    I can live with having to give insulin every 12 hours, but I'd like not having to live in 5 hour intervals. The safest time as I see it, is the first 5 hours after her shot. So I can go see the twins for 4 hours, then home and test. If I wait leaving after the +5, there's a slight possibility that Mauer is too low and I can't leave. That's the thing bugging me the most.

    Even giving insulin the rest of her life wouldn't bug me. But even now I see my old cat returning to her old self, but it would be nice having her old self back at all hours, not just her AM cycle.

    The levemir is from end of March. I'll check it before I use it. And then I want my vet on board but I don't think that'll be an issue.
    I think I have a lot better understanding of how insulin is working, and the difference between prozinc and levemir so hopefully i can avoid Mauer getting sick like the last time. Last time I didn't realize that any changes I made in her dosage wouldn't be showing right away, I used it like an in and out insulin witch I now know is wrong.

    Nice to hear you're stopping by to say hi!
    Speaking of only you and Janet to help around here, what about Panic? It's been long since I've seen her!

    Then you and Dancer should enjoy your time together! Miver gets spooked too sometimes, it just happens. Mauer is more like a dog in that way. I don't know witch is better :p:woot:
    Do you know about Dancers upbringing?

    Holy! That sounds like a big storm! :nailbiting:
    Please let me know that you're alright! At least you have Dancer as company, and I'm sure you're well prepared with lots of food :joyful:
    Do you have someone keeping an eye on you? In case you'll need help?
    You be safe Deb! :bighug:
     
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  70. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    When you first switch to levemir, you have to test more at the beginning, to see how that insulin affects Mauer. Nadir on Levemir is usually much later, like at +7 to +10, so it involves a different mindset to use. Plus, you need to let the depot fill, for several days, to see the full impact. You'll likely need to reduce the dose too, not sure to what amount right now. When you get closer to deciding to switch, you should post a thread in the L&L ISG forum and ask for help with that.

    Panic is taking some time for herself right now.

    Dancer was rescued from a feral cat colony, and she had most of her teeth removed due to suspected stomatitis, while she was at the cat shelter. So she is my "toothless wonder". She was only 18 months old when I first fostered her, and then adopted her. In the beginning, I was told she had renal lymphoma, and was not expected to survive more than 6 months. I took her in as a hospice foster cat. Ended up, she was misdiagnosed. So I adopted her.

    She was so skittish then, constantly hiding under a chair in my master bedroom. I had to learn to "not look" at her, and lay down on the floor to get her used to me. The shelter wanted me to weigh her twice a week, so I learned to quietly approach, and then quickly scoop her up for her weigh in. She has come to love laying on my legs when I'm laying down on the sofa reading. Dancer still hates being picked up and barely tolerates her nail trims and twice weekly weight checks, but she gets them done anyway by her "mean mommabean". ;)

    I mentioned the storm, because with the heavy wet snow, and the winds, there could be power outages and I might not have the ability to sign on to the message board until the power returns. Hoping for no loss of power, but it could happen.:( Current predictions are for between 6 -15 inches (15 -38 cm) of snow where I live. Right now, it's still rain and hasn't changed over to snow - yet.

    I have someone that plows my driveway, but I shovel the steps myself. I have 2 friends that I can call to check the power outage map and expected restoration times for me, and I'm all set for food. I have a gas stove, so I can cook if the power is out. I do have to use a match to light the stove, since there would be no electricity to make a spark. I've got water in jugs, and some extra water in buckets and jugs for flushing the toilet. I prepared a bit ahead of time, knowing this storm could be bad. Turned the heat up too, to keep the house a bit warmer for now. Charged my cell phone too.

    I'll let you know how it goes.
     
  71. SashaV

    SashaV Member

    Joined:
    Apr 25, 2020
    Of course a switch requires more testing at first, I'm ready to do so. A few more won't hurt :D
    I'm close to doing a curve on her blue days anyway :p

    It's understandable :bighug:
    I was just worried about her :bighug:

    Aaaaaw your toothless wonder! She sounds amazing, and what a story you have together. Nothing mean about you :bighug: I wish we could tell animals that we aren't doing things to hurt them.

    Is it Dancer or Wink on your profile picture?

    Gosh you're prepared indeed! I wouldn't have thought of any of that :oops:
    I'm so glad to hear someone is checking up on you! :bighug:
    Fingers crossed for no or just a tiiiiiny bit of snow!
    I didn't know power outages was so common. Is your heat running on power too?
    Be safe!!!
     
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