Switching from vetsulin to prozinc: Part 3

I just checked a prescription bottle that had Cerenia in it for Teasel. There was no mention of food being needed or not. I'd give it with food if Smoky does better that way.

 

I can do a before bed test but usually only a +2 or maybe a +3 if I go to bed very late.
My concern he that he usually goes up a little bit in first two hours and then can drop down quite a bit from +4 to +5. I am sleeping then so it makes me worry and lose sleep.

 

I think the vet said something about it to me once. I'll give him the 2.5u for tonight and try to squeeze in at least a +2 or +2.5

 

They often do go up a bit after eating. You could give 2 u or a hair over if you're more comfortable with that.

 

Quick check online says Cerenia shouldn't be given to dogs on an empty stomach - can cause vomiting. I doubt that cats are different.

 

I wonder how his BG's will be in the morning. It will be interesting to find out.

 

AMPS was 198 so I think giving him a little over 2u wld be a good idea. I was too tired to stay up for a before bed test.

 

That sounds good, Lisa. And you're allowed to be too tired to get a before bed test. You've slipped right into sliding scale dosing with barely a blip ...

 

Yep. I wld like to get to a point where he can be given same dose each time though

 

Does that really happen with our sugar babies?

 

It can but as we say, ECID. You're still tinkering with Smoky's dose range. You've learned quickly how to respond to different PSs so even if he's the type of kitty who needs variable dosing, you'll be able to take it in stride. Early days yet ...

 

Seems like it's been years already.

 

Merry Christmas, Lisa! 2.5 u again this AM?

 

I meant to say 2.25 u in my previous post.

 

Merry Christmas Kris, I gave him 2.25u for pm and am this morning. I thought it wld be OK since his BG was nearly the same in the morning as it was last night.
Should I be worried about him dropping too low with that dose?

 

That seemed to be a good dose to me. Are you at home to check him mid cycle?

 

No I can't today, Christmas lunch at work
My roommate is keeping an eye on him for me until I get home.

 

He should be fine.

 

I thought it was a good dose to give too. Hope you are having a wonderful day with family and friends and fur babies.

 

Smoky was 227 for PMPS. I gave him just under 2.25u for pm shot, minus one big drop.

 

Smoky was at 115: AMPS, He was extremely hungry so I fed him his breakfast. I think he earned a no shot for today. I will probably have to give a higher dose for pm so am hoping he doesn't get too high for PMPS.
The only other option is to give him a shot 2 hours after feeding. I actually tested him 11 hours after pm shot but didn't realize I was an hour early. I've been a zombie lately from lack of sleep. Any advice?

 

Hi Lisa,

Wow! He really wants to give you good numbers! It's tricky finding a good dose if you wait 2 hours after feeding. You'd need one that was depleted by PM dose time or else you'd have to move that time as well. I say leave it as a no shot for today and deal with the higher PMPS. Are you home today to get some tests in?

Another thing you could do today: work out a plan for how to build some stall time in when he throws a lower number and think about a low dose range you can use when this happens. It looks like you'll be seeing more of these events. Good news but stressful.

 

I am home to get some tests in later. I need to get a few more hours sleep. I'll make sure all the food is picked up and check him a few hours after feeding today and see how he is.

It's very difficult to set time aside in the morning for stalling. I have more flexibility in the pm cycle for that. I have both work and school so it is hard.
I am so glad I am home testing as I don't want to think what cld happen if I just blindly gave him same dose without checking BG first.

 

In good news you know he won't go too low today with no shot...so get some more sleep!

 

I'm a little puzzled now I checked Smoky +5.5 hours after AMPS and his BG was 127. It was 115 for am reading and he didn't have his morning shot. I have to say this is a new situation for me to be in. I haven't a clue where to go from here.

 

Well son of a gun, Lisa! This could mean that his pancreas is working a bit. Great news. It could mean remission down the line but you have a way to go yet. The PMPS test will be an important one to help decide on a dose. You might be dropping down significantly in dose.

 

Thanks Kris! I figured since he was an older cat when diagnosed he had far less of a chance for going into remission.
He certainly seems to feel better today.
Smoky had his lunch already and is snoozing by the heater again.
I am really surprised his BG is still low yet but he does still have about 5 hrs before PMPS test

 

All good news! He's giving you a Christmas present.

 

Yep I guess he is. I'm glad that he is feeling better. Are FD kitties usually really hungry when their BG is lower? Smoky has always been very vocal during feeding times. He was extra loud this morning and my poor roommate was getting annoyed.

 

Smoky is hanging out on my bed with me again.

 

I think they can be hungry when it's higher or lower. Many of us have noticed various behaviours that seem to coincide with certain BG numbers. Mr. B.'s mom noticed that he was super thirsty when his BG nose dived and he wanted to drink from the toilet and shower. Good to make a mental note of these things.

 

Lovely! His colouring is very unusual isn't it? Very pale undercoat.

 

He is part Maine coon and part Russian blue. The light colored hair on his sides is where he was shaved for the ultrasound.
Russian blue cats have a very light gray undercoat and a double layer of hair for topcoat which is a shiny dark blue-gray in color. I miss his luxurious shiny coat he had before his diagnosis occurred.

 

It'll come back as he feels better, Lisa. He's been through a lot.

 

I know, I think we have both been put thru the wringer. I can see some improvement in his coat, his fur is softer than it was before. Also, most of his hair has grown back in now that he lost from his allergies.

 

I wonder what his PMPS is going to be tonight. Smoky has about an hour before his pm test. I expect his BG to be higher and think it would be good data to have on hand. I will be able to see how his numbers change after 24 hours without insulin.

 

OK so Smokys PMPS today was 233, it was 227 last night. I gave him 2.25u minus one big drop on Sunday night. My big question is shld I give same dose for pm tonight? He was too low to get an am shot (115) so his 233 doesn't seem too bad for not having any insulin for nearly 24 hours.

 

BTW, I can do a mid day test at lunchtime tomorrow if I need to. I usually end up with five minutes to eat my lunch before my lunch break is over. I have to take care of my fur baby though so guess I will have to do it.

 

Yes, a PS that was too low to shoot usually means a dose decrease is needed. What do you think of trying 2 u?

 

You read my mind Kris. I just gave him a little bit over that, a fat 2 units, 2.1 to be exact.

 

Great minds, Lisa ... great minds.

 

Yep now I'm really curious to see what he is planning on doing for his AMPS

 

Interesting times when they get to better numbers.

 

I don't know which is more stressful, it seems easier in some ways to treat high BG numbers. Lower numbers you worry more about them going too low and high numbers about damage done to organs. I'm just rambling and these are just weird thoughts that I get from time to time. What can you do? We will do anything for our "fur" kids.

 

Yes, we will! I try to keep sane by remembering that cats tolerate hyperglycemia fairly well but a bad hypo can be lethal.

 

Oh we all understand! We hope and long for those lower numbers...then we panic when they show up! I know I got a green preshot once and I completely panicked...got dizzy and scared even though I KNEW she was safe and I shouldn't dose...I had to get someone to tell me that it was okay!

 

Smoky was lower this morning than yesterday's AMPS. His BG was 104 for am so I'm not going to give him a shot. I am going to come home at lunchtime to check and feed him, wld be around +5 hours.

 

I am thinking he needs a lower dose for pm maybe so that he will be high enough in morning to get insulin. Any ideas or thoughts on that?

 

Wow! Yeah you might want to reduce some...2 shots are certainly preferable. I'd say a small reduction will hopefully keep him in good numbers and give you 2 shootable preshots.

 

I agree with Rachel. One non-shootable PS usually means a reduction is in order. Good you can test around +5. Your PMPS will help you decide on the next dose. He's doing great - so happy for you and Smoky!

 

I think I will try 1.75 u for pm depending on if he has a similar PMPS as last night.
He was pretty hungry this morning and ate two 3 oz cans of FF for his breakfast.

 

I checked Smoky at +4 after his no shot this morning. His BG was 160 so he didn't go up too far... yet.

 

Smoky PMPS 264, may be influenced by food. I left a small amount in his bowl and went to the store for an hour. I cld have texted my roommate to pick up his bowl had I known it was down. I don't have any idea if he ate some food or not. I cld not have picked a worse time to do this. I'm still thinking about giving him the 1.75u since I don't know how much food played a role in his higher BG.

 

Yeah I think that would be fine. If he ate some it could have caused those numbers.

Don't beat yourself up...it happens. We've ALL done that.

 

I gave him the 1.75u tonight so hopefully he will have a high enough BG in morning for his am shot.

 

Don't be too hard on yourself, Lisa. He adjusts quickly.

 

You're right Kris, I didn't think about how fast he seems to adjust to changes in dose.

 

Thanks for all the encouragement

 

Smoky was 166 for AMPS, a nice blue but I'm not sure what is a safe dose to give him for am. Maybe 1 unit? I can't do a midday test today.

 

I drew up 1u of insulin foe smoky, he shld be safe with that

 

I agree, Lisa. You're in really good BG territory with him right now and it's getting better. Safety is paramount when you can't monitor.

 

I thought about giving him 1.5 u but decided on 1u since I can't be there. I'm still trying to decide on my no shot dose, was thinking if it's under 140.

 

The no shot BG cut off point is tricky, especially when you can't be around to monitor. If monitoring is possible it's better to do the stall thing and/or token dose. My personal guideline for a token dose is 30 - 50% of the regular dose at that time. However, I'm able to monitor.

The main goal is always safety so it has to guide dosing decisions. I know you know this. Good to be thinking about this, though, because Mr. Smoky is doing extremely well!

 

My current vet doesn't think that Smoky has much of a chance to go into remission since he is an older cat. I have more faith in my boy than that.

 

That's what counts. I pretty sure that getting him regulated is in the cards. Remission is a possibility regardless of what your current vet thinks.

 

Smoky is looking really good, Lisa! True, deciding how much less to give is always tricky, but it is a good problem to have!

 

I'll be starting a new thread on Thursday as this part is getting a little long. It's on to part 4 tomorrow. I gave 1 unit for am but think I need to give either 1.5u or 1.75u tonight. Smoky was 294 for PMPS. Is going from 1 unit to 1.75 too much of a jump in dose? Any suggestions wld be appreciated.
I have about 20 minutes before shot time.

 

Smoky is a little higher than last night so am thinking 1.75u wld be good. I am home from work tomorrow to keep an eye on him.

 

I agree with the 1.75 u. He should be OK because he doesn't really bounce. Maybe a mini curve tomorrow?

 

Good idea. I think maybe a +4 and +8 would be good. He has been growling at me here and there so he is stressed from all the testing. He only does it when I am testing him.

 

I know it can be annoying to them sometimes. It's what keeps him safe though. Do you give a treat with each test?

 

Yep I give him turkey meat. He doesn't like most freeze dried snacks. I bought him some orijen treats to try but waiting to get them

 

I'll start part 4 after I wake up a little bit Smoky was nearly the same for am as pm last night. I don't know if pm dose was too much or not. AMPS was 282 and last night was 294. It's a bit higher this morning than last several days. I'm trying to decide what dose to give for am.

Just to use as a reference point for am:
Relion: 282
AT2: 379

 

Maybe 2.25 u? If you want to go to 2.5 u because you're home to check him, that could work.

 

Is it normal to up the dose by that much?
1.75 to 2.25?

 

I don't know what happened to those nice lower numbers

 

You can do that especially when you're there to monitor. You have lots of data that shows Smoky isn't really a bouncy cat. As for higher numbers, he had two AM no shots in a row on 12/26 and 12/27 plus a low dose of 1 u for AM yesterday. He's had a fair bit less insulin the last three days.

 

That's true, he did not really have a lot of insulin lately. His appetite is really good and he us gaining weight. Darn, I was getting used to those lower numbers.
It's time for his am shot.

 

I gave him 2.1u for am, I'll check him a few times today to see how low he is dropping. I need to pick up more syringes with half unit markings on them later.
I didn't sleep well last night so was too tired to eyeball the 2.25u this morning.
I'm setting my alarm for a few hours from now to get a +4 test in there.

 

Those numbers will be back, Lisa. He's responding very well to the I'm very glad he has a good appetite and is gaining weight.

 

Are you still using U40 syringes, Lisa? I highly recommend that you try U100 syringes with the conversion table so that you can split Smoky's doses into small fractions without doing so much eyeballing. It's much easier to do than you might be thinking and I'm here to help. You'll probably get into lower dose territory soon and these syringes would be very helpful. You can get them at Walmart for a low price. Just make sure they're o.30 cc/mL with half unit marks on them in whatever gauge you like.

 

Smoky- BG at 145 at +4 on 2.1 units.
I still have a whole box of u40 syringes in whole units and a box of same in half units that came in mail today. I wanted to use those first. They don't have u100 syringes in Walmart by me in half unit markings. I would have to order them online.

 

You might was well use what you have then. So far so good with BG.

 

I'm continuing on with thread switching from vetsulin to prozinc, part 4.