Sarah and Cooter

Sarah started her post at the end of a long thread from Ruby. I started a new thread for her here.

I have been watching this thread for a few days now and want to say thank you for getting all this info out there! Cooter started ProZinc Thursday evening and I needed all the info here to help me along I do have a question though.... I know the nadir on Prozinc is usually 5-7 hours after the injection, but how often have any of you seen early nadirs? Cooter seems to be at his lowest point at 3-4 hours. I have been giving him a little LC around +4, but only because he honestly appears hungry at that point, and i dont want him losing any weight since he dropped alot the last month and a half. His low point on the vetsulin was the same timing, could it just be his metabolism acting the same on both insulins?

Cooters SS
8% or less food list

 

Hi Sarah and Welcome!

Cooter's pattern is not very usual -sometimes there is an early nadir but his preshots are really high compared to his naidr.. Either the insulin isn't lasting long enough or he is bouncing. (Bouncing is when their body perceives a lower than usual level and releases extra glucose, resulting in a bounce up to a number that is not just influenced by insulin but by the extra glucose) There are a couple choices. It looks like 2 units gave him a green, even at the vet, where they tend to run higher because of vet stress. Maybe 1.5 would help - if the problem is too little insulin. You might also try feeding to smooth out the curve. So give him half his food at shot time and then give him the second half about 2 hours after the shot. That might keep him a little higher early in the cycle and flatten it out.

I would make one change at a time so you can see if it helped or not. And I'd plan to monitor the first cycle if you up the dose.

Are there any other issues? Infection or bad teeth? Are you testing for ketones? That is always wise when they are running in higher ranges. Info on ketones is here:

http://www.felinediabetes.com/ketones.htm

 

Thank you for moving this, i just thought since there was alot of Q&A on the other thread it would be a place to ask it

I am definately looking at upping the dose, but am a little gun shy after his first night on the prozinc, but now that i see his numbers for a few days, I may have panicked a little that first night. The greens were actually here at home, all the AM numbers were from the vet, except AMPS, and all the PM's were me chewing my fingernails since we'd never gotten that low and it was still off the normal nadir time of the insulin.

He has been fighting an infection in his leg on and off for almost a month now.... I do think its cleared up, he gets his last antibiotic tomorow. It may flare back up though, he knuckles and drags the foot (injection induced nerve damage in february) and got a nail bed infection, I'm doing epsom salt soaks at least once a day to keep it cleaned. His teeth arent the greatest, but nothing that requires attention....
I am checking daily for ketones, his BG scares me so I bought some strips when i found out it could cause DKA.

I'd prefer to do any dosing changes on fridays, since i usually dont work weekends and can be here to get some numbers, but if its a small change I should be able to watch him enough on a PM cycle, he seems to run lower there anyway. I will need to find some u40 syringes with half measurements, the ones Ihave are 1u increments only and I don't trust my eyes on .25 measurements

I am also looking at getting a cat proof autofeeder, the 5 meal one everyone recommends. i say catproof because i have one girl that I know will not leave it alone until it breaks or she passes out, whichever happens first.

 

An infection can raise the levels, in general. That could be part of the issue, but I am guessing more is going on. I have the PetSafe 5 and yes, it is the only one my cat has not been able to break into.

Just in general, we consider a cat regulated when they are in the mid to lower 200s at preshot and in double digits at nadir, but not below 50 - which is approaching hypo range. Once you get there, you can finesse the dose and try for a little lower.

 

Is it possible his numbers will lower a bit after a week on the prozinc, I know its not a depot type insulin, but I was wondering if his body may adapt to getting it over a little time, like how it seems to stay with some cats longer then 12 hours....

 

It's early days and yes, it could take awhile for his body to get used to the insulin. I just don't like the high preshots. Is he eating only wet low carb now?

 

95% of the time, trying to get everyone else swapped over so he has gotten into the dry a few times this week... all of his AMPS should be clear of dry food though, I pick up the dry before I go to bed, and have been watching him like a hawk in the evenings, if he gets up I follow him in the kitchen and snatch up the food before he can get it. He sits where the bowls usually are and gives me the most pitiful look lol.... Only up side of his nerve damage, I can tell when its him walking through the house now.

 

Yes, even a few pieces of kibble can drive the numbers up. Are you trying Methyl B12 for his neuropathy?

http://petdiabetes.wikia.com/wiki/Neuropathy

Lowering the levels and Methyl B12 can both help.

 

I havent started to B12 yet, plan on trying the Zobaline. I want to get some bloodwork done on him this week before we try it, check his potassium?, or phosphorus? level before we do, can't remember which one needs to be OK before we start it. I do believe that there is some neuropathy going on, besides the actual nerve damage, it could be why he is not recovering better from the damage. Thank you for helping guide me through this, I'd be so lost without all the info and wonderful folks here

 

Checking both levels would be good.

If you need help switching the other kitties over to wet low carb, check out this website :

Www.catinfo.org
She's a vet with great ideas for transitioning.

Also ,you might post on Health and ask for transitioning from dry to wet ideas. People have some great creativ ideas that have worked for them.

 

Hi @Sarah Smith .
I wanted to jump in on your question about the nadir being on +4.
I've been experiencing that also with my kitty Baco (she's on Prozinc for a month now.)
Just like today her lowest point is at +4.. she now is at +6 but maybe comes down a little bit later on in the day.
What most of the people tell me on my thread is that Baco is bouncing from previous # days before.. it seems a little frustrating, but you will get there
I'm going to watch your thread for a while, see how Cooter is doing, because I would like to know how you are going to manage this bouncing thing hihi!

 

Well, the good news is that amps is red, not black and that you had a blue nadir around +5 which is more normal. I'd say stay with 1.2 unless you get a lower than normal preshot, and see if he settles into the dose.

Remember that he is very early to this sugar dance (I love the analogy that he is the only one who knows the steps to the dance and only he hears the music. ). And he is at a low dose and getting some good numbers. How is he feeling - playing, grooming, eating, pooping and peeing?

 

He definately seems to be feeling better. He was grooming in depth last night, when I realized I haven't really noticed him doing that for a bit. Should I be worried about the crazy drops he has though? 260 points between +1 and +3? I gave him a few bites of food at +3, I think that's what slowed him, but I'm not home during weekdays to do that I'll be off this weekend to run a curve, want to really see what he's doing during the day

 

Same here Sarah, weekdays not being home is a little bit scary, I have the same feeling about that. But you will get there with Cooter
I'm not going to comment on your question because I'm not skilled enough to awnser that (just yet) but the only thing that I can say just like Sue said earlier, it's so early in the 'sugar dance' and bouncing is a regular normal thing, from what i've heard and I see with my Baco so don't worry too much about it.
Like the saying goes in The Netherlands : every cat falls on it's paws (feet) eventually

 

Thanks Ruby I've been watching you and Baco's journey as well, I haven't posted there because I am out of my depth, but I know you have been getting some great help Its so scary, but I know it will get easier as our we and our kitties settle into the routine and find our dosing. Just getting there seems so daunting. I keep telling myself now that its a marathon, not a sprint (read that on a post the other day) but it seems like we go backwards some days . He was totally dry food free yesterday and today, so hopefully that will start showing us some progress on the spreadsheet soon.

 

I have been getting great help indeed! The people here are lovely and have very good advice.
I know that this is a marathon and not a sprint but you wil not, when you start at first, see that. I didn't saw it that way in the beginning.. It's a mind set haha (easier said then done right )
Don't be so hard on yourself, you are going to have good days but also bad days although you would like them all to be good ones
It's a rollercoaster (what I believe) to get your kitty on the right dose, and it's draining for you as well, but you will get there! I believe that, and you will 2, it takes some time to let it all sink in and settle, but im confident that you will do great with Cooter! Btw, what I CAN comment on is the 'no more dry food thing' that's a really good choice you've made there. This means that the no carb (low carb) will almost not be rising Cooter's #.
So if the # drop or rise it's because of someting else like a dose that is to high or to low. But there are other people like Sue who can help you really well with that!
I will stick around to see how everything is going

 

Have you considered getting a timed feeder such as the Pet Safe 5 to give him small feeds at +3?
You might need more than 1 if there are other cats present.

 

I am actually ordering one from amazon tomorrow BJ, had to wait for payday, I was also looking at one of the feeders that will close when he comes up to it for the rest of my crew, switching everyone over to wet is not going well so far, and everyone's cranky when I get home and they haven't eaten all day... nothing worse then angry kitties!

 

Quick question (do those exist when its me asking?!?) I have noticed a trend the last 3 days on Cooter's SS.... I've been getting home and testing him at +10.5, by PMPS his numbers slightly drop. Is this normal, or probably just a quirk of the meter accuracy? i figured it was the new meter (thought it'd be good to have a backup, and the prime strips are actually half the price of the micro!) but its not.... both are doing it. BTW, Its looking like Cooter will have 1 full day out of the black numbers (Anti-Jinx!!!)

 

We generally say that numbers like that - only 20 points apart - are really in the same range. So the lower numbers really aren't significant. Meters are allowed to have a +/- 20% variance so those numbers are about the same.

I wish we could figure out why he is so much lower at night. Things to look at - could he be getting into any higher carb food during the day? Is he eating more during the day than at night? Is he more active day or night?

 

I know it looks like he's lower at night, possibly because i dont get to check him during the day much because of work. I plan on running a curve on his AM tomorow to see what it looks like. I've been chicken to do the 1.2 during his AM the last 2 days, totally messed it up yesterday and only gave him 1u this morning. After I can see his AM cycle on that dose I will feel better using it during the week when I can't intervene.

He is officially 3 days without dry food (YAY!!), and he is getting fed more in the evening because I panic after the big drop at +2 and +3. I think right now I am the biggest obstacle in his progress. I have always been a cautious person, and overthink everything. Last night I bit my cheek and let him go till +5 to see his numbers, and amazingly enough it all worked out lol....

As for activity, he used to be pretty active, constantly "patrolling" the house. He's the enforcer here, keeps everyone in line (or so we let him think) but since the injection and nerve damage to his right rear leg in February he has lost his edge, he can't walk without knuckling. The Zobaline I ordered should be here tomorow, I'm thinking his recovery from the nerve damage is compounded by some neuropathy. He has been more active the last few days, actually grooming a bit and complaining most of the time I walk by him about whatever he can... He has always been a complainer

 

If the lower number * 1.2 is greater than the higher number * 0.5, they may be considered the same.
See the glucometer reference info in my signature for more details.

 

Yay, we have a purple AMPS this morning! This is his lowest yet if I ignore the wierd number on 5/4 (still wish I knew what happened there). Going to try to get a curve on him today, at least most of one, my mom may want me to take her to the farmers market a later on. Hope everyone has a great day!

 

Well, I didnt say anything earlier, was trying not to make it true, but 100% sure now that we had a fur shot this morning. He decided to move right when I pushed the plunger, there was no wet spot though. To compound matters about 20 min later he was sleeping in the living room so I left the dry food down and ran to the bathroom. Came back in the kitchen and he was plopped down in front of the bowl . So much for curve day! He had to get SOME of the dose, but he's already just under 500.. hoping it stabilizes around nadir time and doesn't just skyrocket

 

Sarah, everyone has a fur shot - even people who have been giving shots for years. Maybe today concentrate on the dry food dilemma and try to eliminate that variable. How are you doing converting all the kitties to wet? What have you tried? Do you need more ideas?

 

Sue is right! I've done fur shots. Heck, 2 different times, I got up, tested Gypsy, fed her, PREPARED HER SHOT...then walked out the door. Remembered hours later that I never actually gave it to her. I got home and night and the syringe was sitting on the table, filled with insulin...right where I left it.
At least with a fur shot, you tried to give it to him!

I figure a fur shot is just a sign that you need a break since you don't have to worry about him going hypo.

 

....I've done that too.....
.

 

Havent done it yet, but I have no doubt it will one of these hectic mornings. I've caught myself walking away before prepping the injection. I tend to get him eating, get the bowls down feed everyone else, then come back and prep/inject. Thats what happened this morning, I waited too long and he was done eating by the time I went to give it to him and he got fussy with me messing with his scruff. He was done, and wanted off the counter, it was my problem if I didnt finish what I wanted to do, he did his part by sitting quitely for the test and eating his food lol

As for the dry transition for my crew, a few are waiting for me to put wet down for them, but 2 others wont touch it. One of them is my cancer kitty, who has had fatty liver before. She absolutely will not touch the wet, and as soon as I put the dry bowl down shes there. I dont want to stress her by really pushing it... she is 2 and a half years into the fight against mammary cancer (vet gave her 3-6 months) and stress is something I avoid like plague with her, not a huge deal, I feed her in the bedroom. My other wet food hold out absolutely freaks if I lock her in the bathroom to feed her seperate. I dont know the reasoning behind it, but if she is shut in a room by herself it is the end of the world. So I feed her in the kitchen, and pick up the bowl after. She was still eating and Cooter was "sleeping" this morning so I thought I was safe to run to the restroom... didnt count on Cooter going into Ninja mode lol.... He couldnt have gotten more then a few bites, but it just compounded the half fur shot deal we had.

 

Not too bad a PMPS, considering kibble and a fur shot! I have lots of cats too and a few are kibble addicts. Fortunately they don't mind being shut in a room with their food. Before I started that I don't know how many times Colin snuck kibble. One thing to look for is spilled pieces. One of mine eats like a pig and spills kibble and Colin the bloodhound finds it everytime...I now have to sweep before I let him in the room

 

294 for his AMPS this morning! Hes definately looking good at the 1.2 dose, didnt want to bother anyone this morning with it being mothers day (Happy Mothers Day!!), but I decided to lower his dose since his PS is so much lower this morning, and he was still dropping a little by +7 on his PM cycle. Gave him .8 instead of the 1.2, did I jump the gun?

 

Can't help you with the dosing, but YAY for the PS!!!

 

What a lovely preshot! Can you get a nadir today? It will be interesting to see what that dose gives.

 

Plan on running a curve today, managed to get to +2 with no SNAFU's this morning so i may actually get the numbers like i had planned yesterday

 

I know double digits are good, but I cant sleep when hes running this low, even when I know hes not really in the danger zone

 

Just looked at your SS. Good job last night!

 

You will get used to seeing those safe double digits at nadir and then you will get addicted to them.