PM Pre-Shot = 96. After feeding = 59?

I'm just a little confused as to what's going on with Ziggy's numbers right now. He was way up in the high 500s this morning and my cousin, who was taking care of him while I was away, gave him a dose of 3.25 U after feeding, as I instructed. So when I got home tonight, Ziggy's pre-shot numbers were 96! That's usually a nadir number for him.

I waited 20 minutes. He dropped to 80. Then it was feedie times.

Half an hour after feeding him a can of Fancy Feast, he's down to 59!

I'm definitely not giving him a shot, and I'm too scared to even think about doing a reduced dose. Does anyone have any idea what might be causing him to drop like this? In terms of behavior he is currently running around the house batting his toy mice and just being as friendly as can be.

 

I don't know much about vetsulin so no advice there but do test him again in a few minutes just to make sure he isn't still going down if he is you may need to give him some food with higher carbs, and keep your hypo kit readuy

 

I agree skipping tonight's dose is the right move. How many hours ago was the last shot given? As Veronica said, test again and make sure he is not continuing to drop and if he is, take action to stop the drop.

It appears to me that Ziggy has been bouncing big time. Drops of more than 100 points can set off a bounce and some of Ziggy's bounces have been far greater than 100 points... some have been around 300 points. When a bounce occurs, the glucagon stores in the liver are used to counter act what Ziggy perceives as his BG dropping too fast or too low. There is only so much glucagon stored and if enough bouncing takes place, those stores get depleted. It's possible Ziggy's glucagon stores are getting depleted and that suggests that the dose of insulin is too high. A slower acting insulin would perhaps be more suitable for Ziggy and I see you have been considering a change. In the meantime, I'd suggest trying to ease Ziggy's BG down so he gets re-acquainted with lower and more normal BG levels a little more slowly.

See where he's at tomorrow AM. If there is no history of DKA (sorry I didn't go back through whole history), and his pre-shot BG is high enough to shoot, I'd be inclined to back him off to at least 2.5u or maybe even 2u. Better to run high for a few days than to go too low.

Looks to me like Ziggy is not yet ready for sliding scale dosing based solely on pre-shot numbers. If it's possible to get any extra mid cycle tests in, it would help immensely to figure out the best plan for Ziggy.

 

I'll do my best to get some more mid-cycle tests in for sure. He has no history of DKA. I think I might drop him down from 3.25 U to 3 U, since he's been on 3.25 for a couple of days and he's really low right now.

So he's at 46 at the moment, so I'll give him a little bit of honey to perk up his numbers. He gets half a can of Fancy Feast before bedtime, so some extra food should help.

EDIT: Figured it'd be best not to wait and gave him his food now.

 

I'd ask your cousin to show you what syringe he used and what line on the syringe he drew the insulin up to, just as a precaution. More than one caretaker has inadvertently grabbed the wrong syringe or drawn to the wrong line.

 

Assuming his last shot was more than 12 hours ago now and if you are sure the dose given was correct, you should not be needing honey to get Ziggy's numbers up at this point in time. 46 is actually a perfectly normal BG for a cat NOT getting insulin shots.

I'd check his BG again 2 hours after eating. If the BG is still down or not rising, it may indicate his pancreas is working and giving 3u tomorrow may be way way too much insulin and very dangerous. Given his numbers tonight, I would definitely not give him more than 2u tomorrow and even that I'd be cautious about given how long he's been surfing in normal range despite eating. I cannot stress enough that it's better to let Ziggy run a little high than for him to drop too low especially if you will not be there to monitor him through the day tomorrow.

I strongly suggest you post tomorrow AM for recommendations as to what IF ANY insulin to give based on his AMPS and what has transpired tonight.

 

I actually held off on the honey at the last second, since I do know that he’s within a normal range right now. I should have said so in my edit.

I will post tomorrow morning!

 

Ziggy is at 576 this morning after receiving no shot last PM.

 

That high reading is not unexpected. With the low of 46 last night, that 576 is no doubt bounce influenced. Can you monitor at all during this cycle? I still would reduce his dose today as he may be a little more sensitive to the insulin after going so low last night. If you can monitor, I'd be inclined to try 2.5u. If not, then maybe 2u. If you can get the bounce to settle down, then it will be easier to determine exactly how the dose is really working for Ziggy. Right now he's bouncing so figuring out just how effective a dose is, can be a bit of a guessing game. I'd definitely err on the side of caution for a few days after last night but I'd also be monitoring for ketones. Better for him to run high for a couple of days than go too low when you are not there to monitor.

 

I'm liking that pink PMPS. I was going over your spreadsheet and wonder if switching your feeder to dish out a meal/snack at +3, +5 and +7 might slow down his drop a bit and help stabilize him a bit more. Just a thought.

 

I could give him food through the feeder throughout the day, sure. I’d have to use Friskies for that, though, since using more Fancy Feast than he’s been getting would be financially unreasonable for me. I thought for sure that Friskies was making his BG skyrocket recently, but maybe he’s just been bouncing?

He also gets extremely stressed out when he’s hungry — he’s been meowing and begging for food starting at 5am every day (I get up at 7) and his morning numbers have been consistently high. I have been very sleep-deprived this month.

 

As long as it's low carb food, it doesn't matter what brand you use. That said, some cats are more carb sensitive than others so if the Friskies is a bit higher but still under 10% carbs, it could be elevating Ziggy's BG a bit but I seriously doubt it would be causing anything as dramatic as the highs and lows Ziggy's been having lately.
If you normally feed 2 snacks each cycle, I'd try the +3 and +5 timeframe as that's when the drop starts and sometimes peaks. If you can slow down the initial drop, it should level off some of the bouncing.

 

Okay, I will try giving him 1/6 of a can at +3 and the same at +5.

 

Hi Natalie,

Doesn't look like moving the snack times helped much yesterday and Ziggy is still bouncing. Is there any way to get a few tests during the day cycle today and/or tomorrow to track when he starts dropping/how much he is dropping and when nadir occurs? Depending on your availability, if you could run a curve of either +2, +4 ,+6 and +8 or +1, +3, +5 and +7, it should shed some light on what he's up to. I'm still wondering if he is dropping off a lot sometime in the cycle causing those high pre-shots. When you have tested mid cycle he's definitely been dropping significantly and some kitties have to be nudged down to lower numbers.

 

Sure, I can do a curve tomorrow to see how he's reacting to his current dose.

I just checked his nadir number and he's at 370. That's after feeding him 1/3 can of Friskies a couple hours before. I'm definitely taking him off Friskies again. I just know something's wrong with it that's causing his numbers to shoot up — there's way too much gravy in it. His nadir shouldn't be that high, and I know I didn't give him a fur shot. But I don't know what I can give him for a snack if not Friskies or Fancy Feast.

 

Is the Friskies the pate variety? There are all sorts of different Friskies flavours and textures etc. and those with gravy are generally higher carb than ideal. The gravy foods are great when you need to bump up BG but not for everyday meals/snacks. Fancy Feast pate is ideal.

The pre-shots are coming down a bit and nadir yesterday day cycle was not bad. Still a good drop but a bit more gentle. That 370 @ +6 last night could very well be from higher carb food.

 

It's Friskies pate, yes. I'd been feeding him the same kind — Poultry Favorites — for the past few months with no problems, but this last batch I bought him caused his numbers to skyrocket. There's a lot more gravy in the food now. I know they came out with an "Extra Gravy" version of Friskies and I've seen that in the store, but I've made it a point to avoid gravy and stick with the classic pate. But even then, it looks like they changed the formula for the normal pates, too. That's part of the reason why I switched him to Fancy Feast.

 

I recall seeing some threads about the "changes". It's frustrating when you find something suitable and then they go messing with the formula. I am in Canada and Friskies options and even the naming on FF is different here. We found a good economical option in one of our large supermarket chain brands here. Don't know if your supermarkets carry their own exclusive brands but if they do, it might be worth investigating by writing them for dry matter breakdown to determine carb levels. FF, while not an excessively expensive brand, can get pricy. I always wait till PetSmart has it on sale and then I load up. My girl is so picky, she will eat only one flavour of FF.

 

Ziggy was at 198 at AM +4, and I fed him half a can of Fancy Feast at +5. I just took his +6 test and he's rocketed up to 407! Either the Fancy Feast really screwed up his numbers or the current dose just isn't holding his numbers down long enough.

It's looking a bit like he holds a low of high-100s around +4, then the dose wears off and he creeps back up to high numbers at +6, then remains there until shot time.

 

I'm not totally convinced it's the food causing those numbers. I think he was on his way back up already when you fed the FF and now you are seeing both a bounce and food influence in that 407. Unfortunately, with Vetsulin, nadir sometimes is at +4 and then kitty zooms right back up but the other issue and possibly the bigger one is the range of the drop Ziggy is experiencing. Today's drop was still almost 300 points in 4 hours...that's huge. Believe me I know how hard it is to be patient with these numbers but Ziggy has become so accustomed to high BG levels that as soon as his BG starts to drop from the insulin, his defences go up and his body basically goes into panic mode because it no longer knows Ziggy is quite safe at a BG of 198.

The only way to overcome this reaction is to slow down/decrease those drops and allow Ziggy to become re-acquainted with lower BG levels more slowly. This means, aiming for higher nadirs which should in turn bring down the pre-shot numbers. His pre-shots seem to be coming down a bit and his nadir is not dangerously low as it has been in the past.

I know how frustrating this can be and how desperately you want to see better numbers. Your instinct says you should throw more insulin at the problem but insulin works differently from medicine and sometimes too much looks exactly the same as too little. If I were you, I'd reduce his dose to 2.25 or even 2 units for a few cycles to see if he doesn't level out a bit more. Once he levels out a bit, then you can slowly increase by .25u at a time as needed. Patience is key here. This is a marathon not a sprint.

Some kitties tend to be far more bouncy than others and it may just be that Ziggy needs a longer acting, gentler insulin to get his numbers under control. In the meantime, I'd try to decrease his bouncing by easing his numbers down.

 

You're right, and everything you said makes sense. I don't think Ziggy will be happy just on a diet of Fancy Feast, since it's far less food than he's used to, so I'll try to integrate some Friskies back into his diet (he enjoys it and it's far more financially reasonable for me). I am probably overreacting to the idea that it's his food when it really could just be his massive drops. And I definitely see what you're saying about how it's easy to assume that more insulin is needed — I had been trying to slightly lower his dose a few weeks ago, but for some reason his pre-shot numbers skyrocketed and I was looking for explanations as to why that was happening.

I'll keep easing his numbers down little by little. I am, again, looking into switching over to Lantus maybe next month or the month after.

 

Pink pre-shot again YEAH! I'd hold that 2.25 units for a few cycles and then re-evaluate his dose. Have you been checking ketones at all? It's a good idea to do so while they are running in higher numbers.

If Ziggy is eating a variety of flavours, the carb % could be different between flavours even though they are all under the recommended 10%. Some cats are more carb sensitive than others. For instance, some do well on very very low carb (0-2%) and others do better on 4-6%. It could be that Ziggy reacts more to some flavours than others so when you are noting "Friskies" or "FF" in the comments, jot down the flavor too so you can look back and see if any flavour seems to take his numbers up more than others.

 

I have been testing for ketones, but he hasn’t shown any trace, so that’s good. Also a good idea to note down the flavors of Friskies he’s getting. Thanks for the suggestion!

I’m a little frustrated because my coworker is keeping me here at work three hours late to work on a rush project and I’m going to be late for Ziggy’s supper and shot.

 

So I needed to go buy kitty litter after work today, because Ziggy is out, but my debit card got hacked and now I don’t have any money. Until I get a new card I can’t buy him litter.

I do have a bag of World’s Best Cat Litter I can use in the meantime, but Ziggy eats it. So his numbers are going to be extremely high until I get my new card.

 

Didn't get any notification of your last 2 posts. Bummer about your card and a real PIA! Hopefully Ziggy behaves this time and doesn't eat too much of the litter.
Have you checked for ketones lately? Good idea to keep on top of that when he is still throwing you some HI readings.

 

I managed to get access to my account that day, so plenty of new litter for Ziggy!

I've checked for ketones and Ziggy is all clear so far!

 

So I opened up Ziggy's automatic feeder today after getting home from work, and all of the food I'd set out for him (with ice cubes) had turned red, and there were fruit flies swarming all over it! We've have a big fruit fly infestation over the past week and I turned the house upside down cleaning everything, but it seems they might be getting to Ziggy's food and spoiling it. They gross me out so much — I've been on edge all week.

Ziggy definitely doesn't like his Friskies as much as the Fancy Feast, but he's still eating most of it and his behavior continues to be great. Just have to make sure I'm not serving him spoiled food.

 

Fruit fly infestation is a major bummer! Would they turn the food red? What about freezing the food itself and letting it thaw instead of food with ice cubes? Might make it a little less attractive to the flies at least until it's fully thawed and hopefully Ziggy will get into it before the flies get interested.

Looks like Ziggy may need a dose increase. He's been running high and that could be some glucose toxicity. Maybe this weekend, if you will be around to test mid cycle, you could bump his dose up to 2.5 or even 2.75u and see if that at brings his numbers down a bit.

At those high readings, I'd make sure you check him for ketones regularly. They can develop quickly so checking daily or at minimum a couple of times per week is a good idea.