Help For Molly #8

continued from previous threads

 

Found you!

 

Seems I'm forever apologizing for not being around. My 93 year old mother has some health challenges that have needed extra attention recently and there are long phone calls with my sister involved. It takes me away from the forum.

Molly certainly had some action from that 0.10 u dose last night! I agree with Linda that this is a good time to push the envelope to see how she does in those lovely lower numbers.

 

That’s ok Kris I understand. Molly jumped from a green to a yellow what’s going on

 

She's got a food bump combined with a bounce from the lower green pre-shot. Let's test her again at +4 and see if she has started coming down a bit.

@Kris & Teasel Been in that boat all too many times with parents and in-laws so no worries. We understand. I'll keep an eye on things here.

 

Thanks, Linda.

 

Well I was hoping she would have at the very least have leveled off but Molly seems to have other plans. No point in over testing but can you grab another test around +8 or +9 which might show us if she's possibly hitting nadir later than most cats do.

 

This maybe a stupid question but what’s Nadir? Been meaning to ask you that. Would the .10 this morning been too much?

 

Nadir is the point where the insulin reaches it's peak action and the BG reaches the lowest point in the cycle.

While the .10u might have been fine, I thought it better to track the drop dose at that low AMPS this morning because you've always skipped when she was that low previously so we have no history to know what she would do with either dose from that low a BG. Better to start with the lower dose since she was there already from the reductions she earned.

 

Sorry was unable to get a test done this afternoon. What should I give for insulin tonight?

 

If you haven't fed Molly yet, hold off for 15 minutes and retest her to see if she is rising or not. I think she is showing us she is a late nadir kitty.

 

If you have fed Molly then we have to make a decision and the question is how much monitoring are you prepared/able to do tonight. We can try the drop again or the 0.10u. Given how late she seems to be hitting nadir, if we opt for the higher 0.10 dose, I think it would be wise to get a test in sometime in the middle of the night and perhaps very early in the morning. Otherwise it looks like she is Ok on the drop dose. It would however still be helpful to get a couple of tests later into the night cycle.

 

She jumped quite a bit. What should I do? Hubby has to get up at 4am I can get up then to test?

 

Give her the 0.10u again. Let's see if we can't get her back to more of those blue and green readings.

 

Holy cow! That was quite the rise. And you had not fed her yet? Even with food I would not expect a food bump of that magnitude. HMMMM??!!

 

When do you want me to test?

 

I gave her very little food. But just fed her just now and she’s looking for more. Why the big jump?

 

Let's get a +3 tonight and see what she is up to. If she is just coasting in yellow, then test again when DH gets up. If she has dropped more like to blue, get a +6.
As for why she is jumping like that, I have no idea other than perhaps she was lower and she is bouncing again. That is why I suggested getting the other test in today.....we need to figure out when she starts dropping to see how low she is really going.

 

She probably was lower this afternoon. Feel bad now I didn’t get a test done.

 

Hey we all have lives and when you're working you have other things needing attention on the weekend. I get it.....no harm done. Main thing is to keep Molly safe and she is just fine.

 

What does DH mean? Never mind I got it lol

 

Adrienne, Molly appears to be starting to drop a bit now. I know it's a PIA but if you could get a test around +6 anyway and again when DH (dear husband) gets up for work, (I think that will be around +10) it would be really helpful to see what Molly is doing overnight. Please try to get at least one test at a minimum. She is really a mystery right now and I think this is the only way we are going to figure her out.

 

Sorry just read the message. She’s 16.1 this morning while I’m up with DH.

 

How about trying to do a curve today, Adrienne (test every 2 hours after AMPS). Its a hassle but, as Linda said, it's hard to know what's going and we need that info so good decisions about dosing can be made. She's doing well and has been in safe numbers. The ups and downs aren't unusual in a kitty who has a pancreas that's working off and on.

 

I can do a curve today. I’m just a little upset with her numbers lately.

 

Molly's been pretty flat all night. It will be interesting to see where she is at AMPS. I agree it may be her pancreas is now sputtering into more action at times and then dropping off again.
I know it's frustrating but it's more common to see this kind of pattern so take some deep breathes and let Molly lead the way.
What I am finding very interesting is those sharp climbs seemingly right after she eats? I know I keep harping on the food.......she is eating FF Pates and not some other variety of FF right?

 

Adrienne, can you move this morning's reading over to the AMPS column please. You've put it in the PMPS slot. Anxious to go back to bed are we? I know that feeling!

 

I just seen I did that . I’m up for the day now. I was up with DH. Tested Molly and went back to bed. I’m only feeding her chicken and Beef pate FF. Freeze dried treats.

 

Ok you are going to think I am crazy but I seem to remember someone saying their cat's BG went up when eating beef. Not sure if it was FF or not but it's worth a shot to see if Molly is reacting the same way. Can you keep track of what you feed her, when you feed and the amount for each feeding today so we can see what her BG is doing in relation to the food she is eating. Just feed her as you usually do.

 

Ok there was half a can left over from last night. So she finished that for her breakfast. Do I open a new can of the beef or chicken? For lunch

 

So if the can from last night/this AM was beef, give her chicken next and we'll see if her numbers come down at all.

 

What should I do for the shot tonight? She’s been eating the chicken more then the beef. So for supper I gave her the beef pate. Maybe it’s the chicken raising her BG. I don’t know just getting frustrated.

 

Sorry Adrienne. I was out tonight and just got home a little later than I expected. I agree with the dose of 0.10u and would make sure you get the usual test before bed. If at possible, it would be a good idea to get another test sometime around +6 too just because those flat yellow cycles can sometimes be a signal that the next cycle will be an active one. I'll check back in late to see what the before bed test is.

 

That’s ok I’ll get a bedtime test. But the +6 I won’t be able to do. I need my brain working for tomorrow at work. It’s year end and payroll

 

That's fine but leave a bit of LC food out for her to munch on if she needs it overnight then.

 

It'll be interesting to see what her AMPS is. On Feb 22, Mar 18 and Mar 20 she had a lower AMPS after a streak of flat yellow the day before. This is why the spreadsheet is so helpful. You have a history to look at to make better predictions of how she might behave. If she's lower this AM than you're comfortable with try a drop dose and leave food out for her.

 

She’s a pink this morning

 

Don't be sad - it's just part of this back and forth process. Give her 0.10 u this AM. If the higher numbers continue over the next few days you might have to put her up to 0.25 u. It's very rare for the dosing to stay the same for a long time or even to trend steadily downward. Up and down over a long time is far more typical. Molly gave you some glimpses of good progress and now is being an unpredictable kitty. That's not at all unusual - just take it as it comes. It'll be much better for you mentally and emotionally.

Is she feeling and acting like a happy kitty?

 

I agree with Kris. Molly is doing what most kitties do and not taking a straight path. Our kitties tend to change their steps to the sugar dance along the way and all we can do is follow. Take it one reading and one day at a time but don't get hung up on one or a few higher readings.

 

She’s hungrier and slept with me all night. She still is happy and playful. She doesn’t like Mondays where we go back to work.
It just frustrating DH is getting upset also. Went from blues and greens. To a few pinks and more yellow.

 

As long as she is eating and playful and happy, she is fine and you don't need to worry. I found my kitty was actually more active and less lethargic in the yellows than she was in blue or green for the longest time. It boggles the mind but they get so used to sitting in higher numbers that it takes them some time to start realizing the lower numbers can feel good too.

 

Tell hubby not to worry - Molly is doing well.

 

.10 for tonight @Kris & Teasel @MrWorfMen's Mom?

 

Molly was sick this morning. I got up to test her she was 3.7 I gave her some high carb SO wet food.

 

I suggest skipping the shot this AM even though you fed her. You'll be at work and would worry if you gave her insulin. If you were at home I'd have suggested a drop dose. Was it a "normal" vomit from a furball developing or does she seem to feel ill? Was she willing to eat the wet S/O?

These drops after a run of high numbers are confusing but it's likely the 0.10 u dose depot got filled and that 3.7 is Molly's response to it. They don't always respond consistently to a dose day to day either. My guy is like that. This morning, for example, his AMPS was only 4.1 after days of mostly yellow. I know that about him so I hold a dose longer than many other people would.

 

It was a fur ball vomit. She seemed fine and was waiting to be fed. I hope I did the right thing? By feeding her SO food. Do I still test her this morning? Even though no shot?

 

Yes I'd still test her just to see what she is doing without her shot. The depot from the insulin will still be in play so she may stay in lower numbers (not too low) for a bit. Any data is good data. Just mark the dose this AM as a "skip" so we know what was effecting those numbers. As yucky as it is to deal with vomiting, it did give you some useful data that suggests Molly has been going lower overnight. Good to know.

 

She’s back to yellow this morning. Probably still from the SO food?
Her being sick got me up real quick. I had a gut feeling last night. Her BG was going to drop!

 

FYI ladies - I'm leaving soon for a dentist appointment.

 

Those strings of yellows often forewarn of a drop coming. Something to tuck away for future reference. I'm not surprised she is back to yellow. This too shall pass.

I know how scary it is to suddenly see a low number after the long string of yellow and pink, but unless Molly is below 3mmol, just give her the LC food and then retest her to see that she has come up again. If it's early in the night cycle and you need to go to bed, it's ok to give her the higher carb but when it's in the latter half of the night cycle and you know you'll be testing again in a couple of hours, better to hold off on the higher carb unless the LC doesn't bring her up a bit.

@Kris & Teasel Have fun!

 

Her vomiting scared me. The lower dose so that why I thought the SO was the right thing to do. I tester her 30 min later to see where she was at. Then went back to bed. Will her numbers ever stay in blues and greens? Or just stay in yellows?

 

No harm done giving the higher carb and Molly is safe which is the main thing. Every cat is different. Some bounce more than others and while Molly doesn't bounce to the moon and back like Teasel does (he's a champ at bouncing!) she does bounce. With time if you can keep her in the blues and greens more the bouncing should ease off but it's early days yet. Molly quickly sped down on dose and it just didn't hold which is all too common. She will get back to the blues and greens but she has to recognize them as Ok numbers.

You also have to be prepared to not overreact to those low numbers as hard as that is to do. No need to go for the high carb unless Molly drops below 3mmol (2.8mmol to be exact) and even then there is a little cushion built into that reading. Having used the Freestyle meter myself, it tends to read low at lower BG so you probably have even more cushion than you might have with a different meter. That doesn't mean you ignore low readings but rather that panic is not needed when numbers are in the 3 mmol range and giving her LC instead of HC in that situation would be more likely to keep her surfing in healing numbers which will help her get used to the lower BG and help ease off some of the bouncing.

 

Ok, from now on I won't be scared if I see lower numbers. If it's below 2.8 than I'll be concerned.

 

Just here to check in. Don't get discouraged by the ups and downs. It's all part of the process. Numbers permitting you might want to try 0.25 u this weekend to jump start her into lower BGs again.

 

Thanks for checking in Kris. Do I skip a dose this morning? Or just a drop?

 

Have you fed Molly yet? If not don't.

 

She’s been fed

 

Ok. If she finished eating 15 minutes ago or less, test her again now and see if her BG is up at all. If she finished eating more than 15 minutes ago, then give her the drop dose.

 

6.3 still give her a drop?

 

Yes.... looks like she is not coming up on her own so I'd go with the drop.

 

Well son of a gun! Those days on 0.10 u booted her up! A drop sounds good. Typical kitty: when you think they might need an increase they surprise you with a lower PS.

 

I gave her the drop, she went back to bed. But she looked depressed. She'll be ok til lunch time? I left food out for her but I doubt she'll eat it. She always waits til I'm home to eat her food.

 

She'll eat if she really needs it so don't worry. She is obviously bouncing more than we are seeing and that no doubt has her feeling a bit off. She'll be fine. She has to get reacquainted with the "good" range and that can take some time. Went through the same thing with my girl. When I expected her to be frisky, she seemed off but when her numbers went back up to what she was used too (too high but not horrible) she got very frisky. It's confounding but it's common.

 

For some reason my reply went on Molly #7.
I see your reply

 

She’s 10.4 a drop or .10 for insulin? @MrWorfMen's Mom @Kris & Teasel

 

I'd go back to 0.10u tonight and get that +3 or +4 test to see what she is up to .

 

Ok, I won’t be home til later. Probably at +6 for a test.

 

Ok just leave her some LC Fancy Feast to munch on in your absence. She will be fine.

 

Ok that’s what I did thanks

 

I'd stick to the 0.10 this AM if you are going to be able to monitor a couple of times today. She is getting back into some great numbers!

 

.10 this morning for insulin?

 

Yes as long as you can monitor her a couple of times because that is the lowest pre-shot we've tried that dose.

 

I'd get a +3 to start to see if she is starting to drop at all by then.

 

Ok, I think she maybe constipated?

 

When did she last move her bowels? Is this a problem she's had before? You could get some plain pumpkin and mix some into her food to help. Just make sure it's plain pumpkin and not the pie filling with additives. Other folks here use Miralax (not sure if that's what it's called here or in the US) but I'd start with the pumpkin.

 

She had a little BM this morning. But not much she’s never had a problem before.

 

She's probably not drinking as much water as she was. Maybe a bit more water mixed into her food would help too. Just keep an eye on her.

 

Looks like she is sitting pretty flat right now. That might still be a wee bit of a food bump. I'd test again around +7 to see what she is up to.

 

Loving those blue cycles!

 

Me and hubby both are pretty happy. Molly was a little upset tonight. I took out the S/O bag of dry food. Put it in the truck for the SPCA.

 

LOL! I'm sure she will forgive you!

 

A yellow this morning

 

It's not a high yellow. With meter variance it might be a high blue. Not to worry. She may have gone down a bit more later last night and is bouncing a tiny bit.

 

You're moving in the right direction even if it doesn't feel that way - less yellow and more blue with the 0.10 u dose.

 

I like seeing the blues hopefully it’ll continue.

 

4.5 skip a dose tonight? @MrWorfMen's Mom @Kris & Teasel

 

I'd give her the drop dose tonight and check at +3. We want to try to keep her those healing numbers as much as possible.

 

Ok

 

Gave her some FF. Bedtime snack

 

Congratulations! You're getting braver with dosing on lower numbers.

 

Worried about her all night. Should I give her .10 this morning?

 

What is her BG?

 

12.4

 

Ok she is bouncing today from those lows.......totally expected. She earned the reduction to a drop again last night so I'd stick to that since you can't test before +6 today.

 

Just a reminder, Adrienne: if Molly drops below 5 (90) that means a reduction in dose to whatever the previous lower dose was. Linda is using a general rule from the Lantus guidelines. We haven't bogged you down with that long list of rules. Just keep that 5 in your mind.

 

She went like this before. Then had to increase her insulin. When her BG went higher. Just don’t understand why she can’t stay consistent.
She didn’t eat much this morning.

 

Leave her some food to munch on. It's common to wobble up and down dose wise like this. She's still getting re-acquainted with those beautiful green readings. She'll get back there but it may take a couple of days for the bounce to clear. You can't force it. All you can do is follow her lead.

 

Do I continue with the drop dose tonight? @Kris & Teasel @MrWorfMen's Mom

 

As long as her BG is around 5mmol or above, yes. She may be higher for up to 6 cycles because of the bounce but bounces just have to be allowed to clear on their own. If you dose higher during a bounce (reacting to the higher BGs immediately) and the bounce breaks suddenly, Molly could drop further than we want her to.

 

Ok, that answered my question. One cycle is 12 hours I'm assuming?