https://www.felinediabetes.com/FDMB...5u-given-found-vomit-on-floor-this-am.263182/ Spike saw the Vet today and his BUN is stabilized at 53.9. She said it appears the Benazapril is holding it steady & hopefully is will begin to lower it when we go back in 2 months. She said his numbers looked good on phosphorus creatinine, etc and she was happy with the bloodwodk and said his spreadsheet was looking great. Naturally, I gave all the credit to the wonderful people on FDMB, @FrostD as well as @Suzanne & Darcy for the excellent and near continuous advise. She said to keep up the awesum work! I just love y'all so much for caring about my lil buddy, Spike.
Hey! Great news about Spike! This makes me smile, big time!! Melissa is awesome. But you’re pretty awesome, too, Lee. The most awesome of all is Spike. I’m pleased about the Benazepril helping. Nice vet.
Last couple of days look good! I am mulling over something like 1.25U when he's above 300...the 1U/fat doesn't seem to be keeping him down quite enough. You have a good feel for things, your call
Seems to be. I'm still following your latest dosing advice, but i don't know what Spike is gonna do next. Well, Saturday is coming up and it's always weird on Saturday nite when i get home from grocery shopping, so we'll see what he does. All things considered, he seems happy, maintaining his weight and appetite, and is just an all around happy kitty.
I dont think there's much more you can change at the moment, we'll re-evaluate when he clears the next bounce. The only thing I'd add is that the +11 to +12 rapid rise last night was fairly indicative a bounce was coming, so I personally probably would have gone a higher dose, but that might be harder for you to predict (I've just read far too many spreadsheets lol) Glad to hear he's happy! 5 P's are equally important
Assuming he didn't throw you any surprises (lower than 120) today, I would increase everything by 0.25U across the board.
This sound like a good plan, by looking at the spreadsheet. I was hoping you would get a few more tests on the weekend at night. But I just wanted to stop by and say hello to you and Spike, Lee. It sounds like Spike is a happy boy. Give him a kiss from me. Every time I look at his photo, I want to give him a little kiss him on the top of his head.
Well now that PMPS has me rethinking lol Hoping you see this before AM shot, but if he's yellow again I'd consider holding. The sliding scale hasn't been keeping him as controlled as I'd hoped lately, but I'm not sure it can be helped. It was working pretty well for a while, then he started creeping up again. Maybe a blip, maybe need to re-evaluate. I'll see how he does tomorrow. Do.you give the Benazepril at PMPS roughly?
Benazapril at PMPS feeding time. He is in the blues at PMPS+4 & going lower to 120 at +5.50. I gave him a snack because I know I'll fall over and out any minute. He is up to something tonite.
He was 347 this AMPS, but had access to LC & MC wet food while I slept. His high PS this am makes me want to give him 1.25u FAT, but his 120 (96-144 variance) makes me nervous to give him a full 1.25u dose...these are the things I struggle with me tally each time I shoot then have to leave or fall asleep. The 347 this am could be caused partially by him grazing on the wet food as I snored for 6 hours this early am....so I just erred on the side of caution......overly cautious caution...lol
I always say better safe than sorry. Remember all the way down to 50 is technically safe, so the 120 still leaves you a lot of room. Definitely at least 0.25U's worth of wiggle
I don’t know how you keep up with all these dose adjustments, Lee. Good job. Looking at his spreadsheet makes my head spin. He seems to like to throw you some curve balls. I think he reads the messages on the Board. Or you are talking to him about your plans and he understands
It might help if you record your current sliding scale in a separate tab lol that way if anyone other than me is looking, they can refer to it And at the top of 2022 tab in the Dosing Method, I would say "SLGS - Sliding Scale". And same in signature.
It might be a good idea. Some lurking ProZinc users might get confused. I know he's on a sliding scale, but others may get confused. It's kind of like my signature says not to copy the dosing (yours too, Melissa.)
I think he knows all of the above and just says ,"hold my beer and watch this"...lol Melissa has worked out a sliding scale dosing guide for us that works pretty good most of the time and makes the most sense to me. Spike does love to throw curve balls at us though.
No kidding. I liked that 220 this am and gave him .75u, only to get home and see him at 377. Gave him 1.25u just now. I'll attempt to get a +4 tonite...gotta force myself to avoid the pillow though. I half expect him to plummet 8nto the green tonite just to show he that I shouldn't have given him the extra .25u because he was so high this evening. I wish I had your knowledge and experience to be more confident with him.
I think I learned my lesson about giving him 1.25u. That seems to be the dose that drives him pretty low. I gave him .75u this AM and 1.0u tonite. I wanna get a +4 & +5 tonite b4 I fall asleep.
Worth a try, he didn't go too terribly low but yes I would not do the 1.25U, especially if you won't be home
Was that Spike’s first green of his life just yesterday night? Wow. I like it. He didn’t go too low, but yeah… if nobody is home, it changes the whole game, doesn’t it. I don’t really understand what’s going on with Spike. He’s been on higher doses than this before - back in March and April. He’s a changeable kitty.
He's had several greens before, the last one was on 5/08 mid-cycle (74). I can't believe the Vet started him on 3.0u and never even mentioned home bg testing, which he wasn't for like the first 5 or 7 days....GEEEESSSHHH!!! It's just so obvious to me why yalls work and devotion on here is just so important to us all. I think Spike is going to worry me to death with his ever changing numbers though. I wonder how low he went today while I was at work and if he came back up to this 390 that he tested at tonite. I definitely have to drink caffeine at bedtime and get a +4 or +5 to see if I need to see something. It's about time to randomly test his ketones tonite if he will let me catch him in the sandbox. He has been happy and his normal cool self lately, but I found vomit in utility room this am when I walked in there. He had been outside and I let him in. He went straight into the kitchen to hunt for food, but I had it picked up. I never saw him head to utility room,but bam, just that fast, I caught a whiff of vomit outside the litterbox. As always, I'll keep my post title edited and make any notes in the SS Remarks for yall to peruse. Happy Friday night and that is for you also @Suzanne & Darcy and @Linda and Newman .
Thank you and happy Friday night for you too. I know that every cat is different, but they all manage to keep us guessing. Working all day and caring for Spike can't be easy. I'm glad I am retired now for several years, but keeping notes in addition to the SS are a necessary part of care giving for me.
Take care, Lee. I think Spike is going to give you a lot of grey hair with his ever changing BG numbers! You’re right! I hope you get some downtime this weekend and time to go to evening church on Saturday. I admire your dedication to Spike! He’s a cool cat.
Spike seems to riding in some high numbers lately. @FrostD and @Suzanne & Darcy, do yall think that this is a bounce, or that the dosage is no longer effective, or something else just going by his recent SS numbers. Yall know that as soon as it's increased back to 1.25u, Spike will dive to the lime greens. He never disappoints with his party tricks. I would love to hear what yall are thinking based on the limited data. I hope yall are having a great day and that it didn't get to 100° like it did here at my house this afternoon. My weatherstation sensors are accurate, so yep, it really hit the century mark here.
I think bounce. Have you given Lantus/generics any more thought? You've really kind of hit the limit of what you can do with ProZinc....your only other option would be to scrap the sliding scale and try to go back to giving a consistent dose as long as he's above 200 (sliding scale sort of thing still applies under 200 since you can't always monitor). That would take at least another month or so to settle out and see what it can do. I think we hit 85 today? It's not bad, but very unseasonable for the Great Lakes. Rest of the week 90+, I think Wednesday 99 I'm not built for the humid heat!
And it is sooo hard to say what may be going on with Spike with so few recent tests. What do you think, Melissa? You have been studying Spike for a while now. It does look like he isn’t getting enough insulin, but if you can’t collect data on him, it scares me.
He just likes to swing like a monkey! The 1U drops him so far sometimes - so while yes I think he may need more insulin, you can't do it safely. That's usually the point I recommend the switch to a depot insulin. And yes some holes in the picture, but I think I have enough to see what I need to see. He has those really nice stretches sometimes, then boing. Now that the Benazepril has had some run time, I do think it might be worth trying a consistent dose again to see what happens.
A consistent dose would be easier if Spike would be a consistent cat. I try to keep him at 1.0u if above 200, which is a lot of the time. But then 2 days later he'll be at 168 at PZ time and feeling the need to give him something, I'll give the .5u or .75u...then he'll be in the 350's 2 days later and there I'll be, feeling the need to give 1.125u. I've still got 1.2 bottle of the prozinc left on hand, but I'll do whatever is best for Spike.. What kind of mess will the Lantus be like for a crazy cat like Spike? He's so bouncy and unpredictable, that I'm scared to find out!. And I sure don't want it to build up and crash him while I'm gone or asleep.
@FrostD @Suzanne & Darcy if yall look at the post topic and/last nite SS, you can see what I mean about me being clueless on how to control my Spikey Boy!!!...lol. prolly gonna see if he climbs enuf so I can shoot .25u b4 I walk out the door shortly...your thoughts???
Looks like you shot a .25 fat with a similar number before. Has he eaten yet? Or are you stalling and retesting? How long before you leave?
I guess you left already. I hope Spike will be okay today. I'll say a prayer. That's the problem with getting to know everybody's kitties... I worry about them.
Okay. Spike was reading our posts again! He has to show who's boss. Take care, Lee and Spike and have a great day!
Ohhh Spike! Lantus tends to flatten them out much better, it would take some time but I've only seen maybe 2-3 cats (out of hundreds) that continue to bounce on it like Spike has been on ProZinc. It's really up to you .. you can go through the next bottle, but it'll probably last a very long time at this dose. Probably lose efficacy before youre able to use it all.
Praise God, I got home and he was just at 239 at 5pm (+22hrs) I was so scared he would be in the black. He seems a Lil tired but I could have woken him from his nap by walking in the door...otherwise he is normal and ok. I've still got .5 bottle of the Prozinc....but it's all about spike. What can I expect if I were to get Lantus and start him on it? Is it more dangerous in that it would build up and drive him into hypo? And please don't give Spike any ideas...lol I've been wondering if my bottle of Prozincs efficacy hasn't began to fade since 3/2, just based on his higher numbers lately. But boy, HD musta got pretty low last nite, so I don't know what to make of it. @FrostD @Suzanne & Darcy.
I had been thinking the same re: efficacy but he's seen some really big drops No, typically Lantus is much more gentle and flat. So what would likely happen is he would stay in higher numbers for a bit and the Lantus would slowly - but evenly - bring him down. He would still continue to bounce probably but it should settle down
What are the downsides....and remember that Spike is full of surprises. As for tonite, he seems to have settled down. His +4 is gown to 182, which is a number that I'm comfortable with at +4 down from 241 at PS time. He just can't seem to go more than 3 days into a cycle then BAM....craziness. it seems the sliding scale is what I'm stuck with as his numbers are just so wide ranging.
There really aren't too many downsides. Hypos can last a long time due to the depot and duration BUT that shouldn't be an issue if the dose is methodically adjusted. The depot can affect things across a few cycles but there are plenty of people well versed in Lantus/the depot/reading Lantus spreadsheets over in the Lantus forum. Coat could be a possible downside? A lot of people are now getting the generics for about the same cost as ProZinc (or cheaper). Nearly all of us used to order from a pharmacy in Canada, but due to customs and shipping issues I'm seeing more and more insulin arriving far too late and exposed to heat for too long (they put a little indicator on the box).
When I mentioned Lantus to my Vet, she just kinda shrugged and said, "we don't use that one very often because we like ProZinc for cats". Well, honestly, she and we ain't the experts...lol. so I'll get with her and tell her that Spike is switching to Lantus and to order me several pens of it. Naturally, I'll just use my syringes to inject it after drawing it out of the pens, and keep the pens refrigerated. Is name brand Lantus better than the generics?? After all, Spike needs the best he can get!!! Prozinc just has him too bouncy and i don't consider him controlled at all. It's like playing whack-a-mole with his numbers. I just worry that the depot will build up and he will plummet down and it will turn into an emergency....even worse if it happens while I'm gone or passed out asleep like a rock. I'm going to assume that my Vet can get shipments that are refrigerated albeit more expensive. I don't have anyone to accept a delivery while I'm at work and it can't sit on the porch until I get home in this heat. Zpike is doing OK. I got some readings last nite but naturally overslept until +14 this am. He was 258 at +14 and I gave him .75u exactly. I am proud of how he is doing both last nite and this am tho. These are numbers that I like to see. Not too low and not too high. Let's do some more thinking and praying and reading on my part about what Lantus could do for Spike....that boy keeps me on my toes...lol. and then I'll get with the Vet and get it in so I can just pick it up from her office. I know that'll be pricey, but in the grand scheme of things, the extra dollars will be fine. If I wasn't gonna spend it on Spike, I'd just prolly blow it on a steak or something....lolol
Think of the depot like a sponge - if you are consistently adding a cup of water to a sponge twice a day, the sponge can only absorb so much and the rest of the water goes through. So yes sometimes it may be a little more full vs others, but not enough to be dangerous if you're following the methods we use. It only tends to matter when they're ready for a decrease in dose, and then you end up shooting a reduced dose or skipping - advisers in Lantus forum are very good at that. Genetics are just fine! We've had several cats go back and forth without a blip. A lot of people are actually finding them cheapest at human pharmacies - rite aid, Walgreens, Costco. Might need to call around. Sometimes they'll take a GoodRx coupon if you don't mention it's a cat lol I'm not saying lie! I'm just saying don't mention it, although with a name like Spike it might be a little obvious....lol sometimes they do take it for pets anyway Just be sure to get U100 syringes, 0.3cc, 1/2 unit markings
Hmm. Not sure I like that AMPS. It wasn't a bounce break last night so I suspect nadir was lower and earlier. My guess is below 90 just not sure how far. Your call as to if/how you want to adjust dosing.
Also - don't hesitate to tag me if you need anything. My husband had knee surgery and is now toddler #3 - I'm not floating around quite as much as I used to, mainly focusing on tags, PMs, and a quick browse if I have time.
What do you suggest? As for this mornings AMPS of 407, it is mostly my fault. Today's AMPS IS ACTUALLY AT +14.0 hours, as I gave him yesterday's PM SHOT AT 5PM BEFORE I LEFT FOR SHOPPING. When I got home from Saturday nite shopping, I fed the barn kitties their kibble and then brought the dish in and sat it on the counter instead of locking it safely in the pantry. As you can imagine, it was knocked over and Spike was sitting on the counter laughing at me and bathing his smug lil face when I walked in there just now. This thread is getting long, so I'll start a new one later today. What were you seeing with yesterday's AMPS that tipped you off that he could have got lower than 90? I'll be home today except for church at +4, & +5. Thank you for checking in on us and watching my ss and thread. I hope your hubby heals fast and your not overworking yourself... I checked Walmart for Lantus pens yesterday. $507 for a box of 5 ea. Pens.
Tbh I'm not sure what I suggest lol The only thing I can see is when he's been relatively flat yellow like he was yesterday (301 is yellow if you squint), perhaps a 0.5U or 0.5U fat. It's interesting because that's a Lantus thing - flat yellow often means action to follow. What tipped me off is I know his "typical" nadir on a non-bounce is about +6 (and I'd give him leeway to +8 ish)....so he had 4-6 hours of rising to do after that. The fact he only came up to 140 tells me he was very likely under 90, but he has occasionally shown he can have flat latter parts of the cycle. More people are having luck with prices on the generics (semglee and "insulin glargine") and places like Rite Aid and Walgreens, even the locally owned pharmacies.
Well, it's Spike, so he's a complicated cat...I gave him a fat .5u (about .6125u) this am. At +10 he was 150 and climbing to 184 at AMPS time, as u can see on the SS. Honestly, I don't have a clue what I'm doing from dose to dose with him. My logic went like this: He might have went low during the nite but he was climbing steadily @+10 & +12. Trying to keep him out of the purple at least, I felt he needed SOME insulin but not so much to crater him while I'm gone working. A fat .5u made sense to "get him low and keep him low". And by low, I mean the blues, not the greens. Please school me on what I am missing in my logic path...like I said, I'm totally playing this by ear and u4 last dosing guidelines. I hate the purples and reds and the greens and especially lime greens scare the crap out of me...it just socks that I'm either at work or totally passed out dead asked asleep at the nadirs....well, except when he nadirs at like +11 etc. I need help and prayers.
+10@302, PMPS 315. I gave him .75u. All data entered on SS. I need to start a new thread as this one is getting long.
Go ahead and start a new one and tag me. Any chance you can get one last test before bed? Tien doesn't matter, I'm just trying to see if he's beginning a bounce or not. That slow rise would say no...
Proposing some tweaks to the scale. Split out the larger BG range a bit, and I removed the 0.5U as an option even if you can monitor in the mid-blues. So new proposal is: 1U above 300 0.75U 250-299 0.5U 200-249 0.25U 150-199 (skip is totally fine based on comfort level/times you'll be home to check) Skip anything under 150 My gut is just telling me he's going a little lower than I'd like sometimes when he starts in the 200s. I don't think its dangerous, I just prefer a little more wiggle room given your situation/schedule - because should he decide he wants a reduction he's always dramatic about it I am also suspecting some mild BG-lowering effects from the Benazepril at night since you give it near PMPS, but it could also just be that they tend to run lower at night anyway
I love this new dosing schedule. It looks like it checks all the boxes to me. I think ur right about the Benazepril doing some mild work.
