05/16 - Small Kitty amps : 412 psps drop to 88 pmps +1.5 191 +2 328 +3 284 +5.5 304

Not so bad this morning, seen worst. Home it will come down in the few days at 2.25.

Yesterday :
http://www.felinediabetes.com/FDMB/...248-9-495-pmps-491-2-328.157805/#post-1677482

There was a very close call this day (yesterday). I had let Small Kitty go out on the mezzanine with
a close watch on what he was doing. All of a sudden I saw him jump the fence and go out in the open.
Luckily I was able to catch him in the neighbor's backward. Still missing the time wen this was normal
and fun. Now on I'll do that only when I'm there with SK on my knees.

One thing interesting about this experience is that when he was at the bottom of the staircase
I saw him roll on it's back with lets pointed to the sky. I think I'm not the only one missing
running and hunting outside as this morning he sounds as being less depress as usually.

Maybe one day..

Have a nice one all.

 

Good Morning Sebastien and Small Kitty. That was a close call with SK almost escaping! It's hard not to let them outside anymore when they are used to it. I had to confine Bubba inside once his numbers were starting to get into lower ranges. He has adjusted for the most part. Sometimes he stares out the window and cries.

Sebastien, is there anyway you can get a test 1/2 through the cycle in the PM cycle? It would be really good information to see how low the insulin took him through the cycle. And that information would help to know if his AM higher number is a bounce from the lower number the night before. Otherwise, it will be hard to know how to guide you with dosing. For example, the night before last he hit 191 at +4. And the next morning his BG was 556. That was quite a bounce and it is possible that he went even lower that the 191. I know it is hard because you work two jobs and need your sleep. If you could set your alarm at the alarm at the 1/2 way point and grab a quick test if would be good.

You have a nice day today too.

 

Lots of good wishes that those numbers come down for you.

I had an outside kitty, left behind by the previous owners of a house I bought. He kept getting beat up by other neighborhood cats. So. In he came. It took a while, and he always looked longingly through the windows at the great outside, but in time he settled down and became a very content house cat. And no more wounds or injury caused vet visits!

Marilyn and Polly

 

Wow Bobbie, you're in a different world then my Vet (who has never returned one of my calls).

I'm at the office right now, pretty happy you're interested in our health (this thing, might be affecting mine as well.

What about giving the new dose a 3 days like Julie explained yesterday, to see how what it can give ?
At the same time it will allow me to have full night of sleep (although Big Brother started pushing on my
chest with his front legs last night to show me his affection).

Might see the middle cycle on Wednesday, what do you think ?

 

Hi Marylin, there was some fights with my cats and others and I was pretty proud, war injuries were always repaired by me and they were back
to the battle front again a few days later. What I liked the most was them bringing me mice and birds, sometime still alive . When there was
no pray they would bring me small kids toys . I'll manage something, a harness of something that will keep them on the mezzanine.
Big Brother is peeing somewhere in the apartment every night, sure it's because of that. At least it's on carpets so I put them in water and
there can be dried, just sad for them to be confined...

 

Hi Sébastien!!

Bobbie wasn't suggesting you change the dose in SK....We do want to keep him on the 2.25 for at least 6 cycles (3 days) and see how he does

What she was saying (I think) was that on the PM cycle on 5/14/16, SK dropped to 193 at +4 according to your spreadsheet.....It would have been really helpful if you'd been able to get one more test in later in that cycle (like at +6 or +7) to see if he kept dropping

Going from 518 to 320 in two hours and then dropping to 193 in another two hours is a HUGE and FAST drop....He could have continued to drop that night even lower.

All that being said, I realize that with your health (and I believe that was the night after your seizure?) that it's very important for you to get your sleep.

Can you set an alarm, get up and get back to sleep fairly quickly or are you one of those that once you're awake, it takes you a long time to get back to sleep?

 

Thanks Christine, I's a good idea but there is a change in scenario now..

Dont know what is happening, kind a strange, really strange.

Small kitty has dropped 412 to 88 within 12h and there was diarrhea on the floor when I arrived.
With urine normal.

Should I be nervous about such a drop ? I'm really concern this is not normal.

Please give my your opinion, not even sure if I should shoot tonight

 

First thing is to do another test. Sometimes a strip can be "off" or a reading can be "off".

If the number is still in the same range, then see how Small kitty is doing otherwise. How bad was the diarrhea ? Have you been feeding a different food? Is there any chance SK got into something bad...garbage..plants etc?

 

Just did a test with the Alphatrack II with the only strip I had left (I calibrate the meter to use human strips)
and I got the very same thing or something very close: 100

Food is the same, Fancy Feast Classic or Paté. He's feeling great, urine was usual, I think but
it's hard to say as I have to cats.

Small Kitty is doing great, mewing and looking fine

 

Dia

diarrhea was not that bad, 2 inches spot on the floor.

 

As Mary Ann suggested double check the number, if it's still in the same range perhaps stalling without food for 20 min to see if she is coming up on her own.
With SK history of dka skipping altogether may not be
advisable, but that said 88/100 is low to shoot with relatively little data.
Not sure what is the best thing to do.

Whatever you do shoot you would need to be prepared to stay up and monitor freqiently, it could turn into a long night. Do you have enough supplies?

 

Could Small Kitty have found it's right dose with the new 2.25 U 2X, compared to it's 2.0 we had for a week, giving high sugar level ?
Find it strange that it drop so quickly..

 

Good....it is possible that Small Kitty went lower during the day and the diarrhea could have been from being in low numbers. Where he is right now is not a worry, but with that sort of drop I would not shoot the evening shot. I know you need to keep on schedule and can't change the times you are shooting so my suggestion would be to skip the evening shot and shoot again in the morning.

But let's see what other people have to suggest first. Could you change your title and add a question mark and "dosing advice needed" and let's see what others have to say.

That is such a strange cycle with the numbers having dropped so much and being that low at the PMPS time

 

He is also using an Alpha Trak 2 meter. I forgot about the DKA, but with other health issues I don't know if he is going to be able to stay up. His sleep is really important for his health concerns

 

Yes, I've testing strips, the human ones, I've order the ones for the Alphatrak today but downt know when it's gonna come.

This Small Kitty has a load of surprise in reserve.

 

Sebastian are you able to stay up late if you do shoot?

@Gill & George what would you suggest as a dose for the evening....if SK is still rising after testing again with no food. Although "officially" SK did not earn a reduction, with that strange of a cycle I would not suggest shooting the 2.25 units. What do you think Gill?


ETA: According to the SLGS SK would have had a reduction with a human meter, so definitely with an AT2 he earned one. Since Sebastian is not testing during the day except on weekends I would say this is the SLGS approach

 

A crazy theory :

You'll blame me of negligence on this but I'll assume.

I dont know if it's my memory who's falling, but I'm sure I had put the fence on the mezzanine back
in place yesterday. When I arrive from the office, here was not only the fence dismantled but also the cat
trap ''lock'' been dismantled. Ok for the fence, but the cat trap I'm sure I didn,t let that open, both of
them might have been playing so much that they dismantled it. I think they might have spend the day
Outside...

Could some air and fun have brought the sugar level to normal ?????

 

Yeah, I could but I will need to learn something that was way off topic in my case, what to do in low sugar cases, like
putting honey or something on the teeth in case of number getting too low.. This was far from a possibility as we speak.

What kind of interval should I test in the advent I feel I can ? Until when ?

 

You're all marvelous btw, thanks

 

Exercise will definitely help with lowering glucose levels. The main question in my mind is why did the numbers drop so much over 12 hours.

Do you have some higher carb food...something with gravy would be good. Also you will need to have honey or maple syrup/pancake syrup...something like that. This link has information on dealing with hypos:

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/


Right now you need to NOT feed SK and retest again about 20-30 minutes after your last test to see if the numbers are going up and how much.

 

He's now full food, I didn't thought about that and he's washing himelf, big brother licking hijm, now they are fighting.. not the kind of mood a sad cat would be in..

I'll weight him now.

 

If you have already fed him then any test you do will be influenced by the food. Even if the numbers are rising it would be impossible to know if that is from the food or not so it would not be safe to shoot. If you are able to wait about 2 hours with no more feeding then the numbers will be more "normal" without the food influencing them. HOWEVER...if you wait and shoot 2 hours from now that would change your morning time 2 hours later as well. IS this possible or would that be too big a time difference for you getting to work?

If shooting later will not work for your schedule, then my suggestion would be to skip this dose. The only thing worrisome about skipping is SK's history of DKA.

 

Mary Ann it's the first time I have visited SK's condo, my first thought was to skip until I saw the dka history.

Maybe a bcs would be appropriate, draining the depot, the lack of data makes it difficult to judge.

When you test again the number you get may be food influenced, so we won't be able to tell if his numbers are rising due to food or not and therefore impossible to tell if it will be safe to shoot.

 

2 days ago : 4.166 kg
Now : 4.24kg
Weighted with food balance

 

Thanks for the reply. This morning's cycle was such a strange cycle and now with food on board it makes it difficult to know what to suggest for the evening.

 

Shooting time is in 30min. Changing shooting schedule would be hard, I've to leave at 7h max. + I've already called
sick lately for epilepsy..

 

OK. When it will be the usual shot time (in 30 minutes) how long will that have been since he ate?

 

That is for tomorrow

 

Just short of 1h.

 

For tonight when are you supposed to give SK his shot?

You posted at the same time I was posting. If it is only 1 hour since he ate when he is supposed to get his next shot then the glucose number will still be affected by the food.

Let's do another test about 10 minutes before his shot time and see what the numbers are.

 

What about a lower shooting dose, like .5 ?

 

When do you usually shoot?

The way it looks on your spreadsheet, you got that 88 at his usual shot time tonight

 

Something like in 30 min

Now big brother is mad about getting outside... I'll let them free on the balcony

 

OK.....if his USUAL shot time isn't for 30 minutes, retest then and let's see where he's at

The way it looks on your spreadsheet, his blood glucose was 88 at shot time and you fed him.

If your usual shot time is in about 30 minutes, how long ago did he get food?

 

It's now 18h40 here and shooting is usually between 18h and 19h. Is injection timed by the minutes ?

 

He got his food exactly 1h ago 17.30min,

 

Usually we do it this way

TEST....to make sure they're high enough for insulin....FEED to make sure they're eating.....SHOOT......all in about 5-10 minutes

You should be shooting as close to every 12 hours as possible

 

Seems he's asking for food like mad now, think 'll test

 

Thanks for coming on board Chris.

My concern is that SK may have dropped much lower during the day, which could possibly make him more insulin sensitive.

ETA Since Sebastian is using AT2 meter and I believe he is doing SLGS then SK has earned a reduction back to 2.0 units, BUT if there was a bigger drop earlier then insulin sensitivity may be a factor, even if the numbers show it is okay to shoot???

 

If the Pre-shot number is too low to shoot, you should "STALL", don't feed and test again in about 20-30 minutes to see if he's coming up on his own (for future times)

Use that time to ask for help

 

Before feed : 88 pmps
1h after feed : 191

Is this useful

 

Mary Ann, Gill, Chris...

Unfortunately, I cannot stay online and I have NOT followed or read the history here (do know about DKA history), but throwing a few ideas out there (depending on where he is at shot time): What about shooting at +18 and then again at +18 tomorrow?

Following an 18/18 shot schedule will also help since kitty has been fed. It should also help alleviate concerns of possible insulin sensitivity from dropping so low today.

BTW, I'm pretty sure the drop was the bounce breaking.

• "If" BG numbers are sky high @+18 (bounce started), I would shoot the full dose.
• "If" the bounce hasn't begun @ +18, I would reduce the dose depending on how much of a rise you're seeing.
• "If" you're not seeing any rise by +18, I would either skip or shoot a token dose.
• "If" the shot is skipped tonight, shoot at the normal shot time in the morning.

 

OK....that's a pretty high "food bump", but we really don't know how much of a food spike he usually has since you don't have any tests in during those hours

Is it POSSIBLE for you to wait and shoot at 2400 tonight? With your health problems, I'm not sure that's something you can do

 

Sebastian has Epilepsy and needs regular sleep. If he shot an 18 hour he would still need to monitor some, which would keep him up very late. I thought about that but was not sure how he could work that without getting worn down and maybe sick

 

Gotcha.

 

Just a thought Chris. If Sebastian cannot manage a time change or 18/18 change what about doing a 1 unit shot for one time. This would have some insulin on board but shouldn't create another drop??? Thoughts???

 

That's what I'm considering too Mary Ann....just waiting to hear back on the question I asked

Having SK go up 100+ points in an hour with low carb food kind of looks like there may be a bounce starting but without having any +1 tests on SK, I'm just guessing

 

Testing at midnight is not a problem, Big Brother woke me up last night walking on my chest asking
for affection. I gave him what he wanted but returned to sleep after.

 

Yes this is a real puzzler right now. I think part of it was doing a 1/2 unit increase 2 days ago which took SK into the blues Saturday night. definitely not a colour he is used to. Today's drop is boggling

 

If I shoot 1 unit now, what would be a concern at +3 and +6 ?

 

Just curious about how you use the AlphaTrak 2 meter with human test strips. You said that you calibrate the meter to do this. I use an AlphaTrak 2 meter also but I have no idea how you change the meter settings so the it is accurate using human test strips.

 

I think you could go ahead and shoot the 1 Unit now....but you'd need to get a +1 and +2 to make sure he stays safe (and have high carb food and plenty of test strips).....and since it's 1900 now, you'd want to hold his morning shot off until 0645

 

Recommandation of the vet (an idiot) was to skip if withing rage. Guess he was not that bad, think is how much.
I know my cat and seems he's doing great. Would be so nice if my mother from above had given him a magic virtual shot

 

If you shoot 1u now the biggest consideration is the possibility (not probability) that you'd have to continue monitoring. It's not likely, but it *could* happen.

 

Have to go give China her shot

 

Any example of high carb food ?

 

Friskies or Fancy Feast with GRAVY Any food with gravy is higher carb.

 

I have these things :


I remember having a sky high sugar level the next day I gave him that, he loves these thing.

 

Could that be a good boost to bring SL to ''normal''

 

If not for the fact that SK has had DKA skipping is not a bad option if you can't change the times. But with DKA history it is best not to skip insulin unless the numbers are just too low to shoot and don't come up.

 

What about that ?

I'll go buy gravy cat food and give him 1 unit and keep monitoring.

 

If you shot 1 u,
I would strongly suggest getting a + 1 test done, is that something you can do?
As Jill says there is the possibility that you may need to monitor more through the night. The +1 can give you an indication of the cycle will be active.

Whilst high in carb being dry they take longer to work out of the system the food Mary Ann suggested would be better, or a drop of honey in you regular LC to make it high carb.

 

Temptations are high carb. You can also add a drop or two of karo or other sweet syrup (honey, maple syrup, etc) to regular wet food to make a high carb food which will help sugar levels rise.

That works.

 

Temptations are high carb but because they are hard shelled they can take longer to bring up glucose levels if they are too low. You have syrup and it can be mixed in with a bit of regular food IF NEEDED. Something to put on your shopping list is a few cans of Friskies or Fancy Feast with gravy, just so you have them if needed.

 

Good luck with whatever you decide!
I really have to run...

 

Thanks for your help Jill

 

Back shortly..I have to deal with my 2 furballs

 

If you can monitor and can run and get some "Gravy" food, I think shooting the 1 Unit is the way to go tonight

 

Should I start giving the high carb now or wait to see if gets down ?

 

If you can find some "Fancy Feast Gravy Lovers", that's what most of us use when we need to feed something high carb

Just look for the words "Gravy Lovers" on the label....If you can't find them, find a canned food that says "In Gravy"

No, if his last test was 191, you don't give high carb food now

You give high carb food if he drops below 68 on the Alpha Trak

 

Go ahead and TEST....feed him a snack of low carb food if he's really hungry and SHOOT the 1 unit if you're going to shoot tonight

We'll also have to change some of the entries on your spreadsheet but that can wait a few

 

Ok, back from the store, got Friskies Turkey and cheese in gravy, with temptation added should be fine.

 

@Chris & China

One more "fly in the ointment".

If Sebastian shoots now..it is about 7:30PM where he is, the normal morning shot time is around 6:30 AM, since he has to leave the house at 7:00AM and he is not able to change that. Any thoughts on whether shooting one hour early in the morning will be a problem?

 

SS updated, shot given at regular time : 1 unit at 19.00h

 

He can shoot up to 30 minutes early to get back on schedule, so he can shoot at 0700 tomorrow morning

 

Thanks Chris. He is actually at 7:00PM not 7:30 (Quebec has different time zones)so he can still shoot at 6:30AM and be out of the house by 7:00AM. However that does not leave time for a testing before he goes.

 

OK...you need to make some changes to your spreadsheet (I THINK)

What are your NORMAL shot times? 0630 and 1830?? Or 0600/1800? Or 0700/1900??

When did you shoot this morning??

 

Heck, that's a nonesens, he's back to his typical numbers :434
That 10 min after 1 unit injection. He seems to be feeling great also

 

That's probably due to him "bouncing" from being low earlier. Bounces happen for three reasons

1. Going too low (below 68 on the AT)
2. Dropping too much, too fast
3. Dropping to a number their body isn't used to being at anymore (or any mix of all 3 reasons)

When that happens, the liver responds by dumping stored sugar and hormones into the bloodstream to bring them back up quickly....they "bounce" up

It's normal, especially for newly diagnosed cats and there's nothing you can do about it but wait for it to clear (up to 3 days)

The good news is it looks like you'll probably be able to go to bed at a reasonable hour and sleep well!!

 

Shooting time used to be at 0630 / 1930 but I catched in a post that shooting before food is ''setting a break'' on
the insulin. So I started shooting after food, at 0700 / 1900. Been a week like that. So the 1 unit dose what
given at the usual time.

No junk food given so far :434

 

That was totally to be expected. After the low number he hit today and with the food still affecting his numbers the BG was bound to be high. You still need to monitor some more tonight though.

Also in the morning if you could test and NOT FEED about 1/2 hour before his usual test time and post the numbers here we can see how you should proceed. I am up very early and others are also on early.

But you need to test at +2 and +3 for sure tonite. He could well be bouncing, but the food is still affecting his numbers

 

I think you mis-understood this......What Julie was talking about (I think it was Julie) was that a lot of times if we feed after nadir, it's like putting the brakes on....After nadir, the insulin is already starting to wear off, so if you feed then, you're adding carbs as the insulin is it's weakest so it can cause the numbers to go up quickly

You want to TEST/FEED/SHOOT.....all within about 5-10 minutes

TEST....to make sure they're high enough for insulin....FEED to make sure they're eating.....SHOOT

The 2 hours before shot times you want to make sure SK doesn't have any food (unless he's running low of course) so that when you do the Pre-shot test, you get a number that's not influenced by food

 

I'lll do that, so no junk for now I guess, with that kind of number ? Just testing at +2, +3 to make sure no junk (Friskies) is needed ?

 

That's one of the thing I've understood well, to test without food in the blood. Last test that was normal in numbers is 30min old so I guess I can
breath again and test at +2. He got his shot 1h. ago.

 

NO junk food unless he drops below 68 on the Alpha Trak....and I would NOT use the Temptations at all. They are dry food and aren't good to use when SK is running too low. Dry food takes too long to break down and get into the bloodstream to be a good choice

If SK is too low, you want to use the "gravy" off the high carb food

 

Yeah, temptation gave me quite a lesson, I'll remember it.

 

That's a more practical solution, waiting after is just a way to forget.

 

Now he's asking for food like mad. Just gave the minimum when I arrived. They usually have a shared
portion of Special Kitty for the evening. They eat it later. This is low carb food but fat.

 

I never thought shooting schedule was as tight. Was sure Lantus was a long acting and that you had a good margin.

 

You can give SK some regular low carb food, the same as you would normally have done.

Lantus works best if you try to keep the shots 12 hours apart.

 

I would like to thanks all of you. My vet would have spoke to me like if I was affected with intellectual disabilities

 

Small Kitty would like to says thanks, he's enjoying his Special Kitty low carb food

 

All of us here care about everyone's kitties. Most of us were scared and worried when we first had our kitties diagnosed and there was always someone to help, so we all try to help others. You have had such a rough start with SK, with the DKA and all and you did a wonderful job dealing with it.

Not to be unkind, but many vets have no where near the experience in dealing with diabetic kitties that the people here do.

 

Was what happened something to be concerned about (AMPS 412 and PMPS 88) or I was just freaking out ?

 

You weren't freaking out....It WAS something to take notice of!!

 

Without all of you I would have had to face the humiliation of having my vet treating me like a kid.

I HATE THIS GUY !!

Problem is that he's the best of the worst and close to the house in case of immediate intervention needed.

I think everything is alright now, I'll keep on testing.

Should I resume the 2.25 if numbers are fine at +6 and amps ? Small Kitty has had a 1.0 unit shot pmps.

 

With the low number SK reached today he earned a reduction. Your dose is now at 2.0 units. Of course that will also depend on what his numbers are in the morning. If they are high...which they really should be with the bounce from the low number...then you would shoot 2 units. It can take up to 3 days for a bounce to clear. With having had DKA if the numbers stay high you might not want to wait a full 3 days, but let's see how the numbers go.


ETA You need to change the dose on your spreadsheet to 1.0 unit for the PM dose. If others come in to help they need to know that he was given a reduced dose this evening.

 

I think what happned is that he had an adrenaline rush of being free outside since quite a while. Who know if this is
not the remedy to all diabetic cats ? (Big Brother is mad at me now because the cat trap is solidly closed)

So let's go with 2.0U and see.

 

It's best if you give Lantus as close to every 12 hours as possible. Giving the shot early can act like an increase in dose....giving a shot late can act like a dose reduction

Since you are unable to get any tests on the AM cycle during the week, it might be best for you to stick to the SLGS method instead of Tight Regulation. Under that method, he earned a reduction in dose down to 2 units

 

2.0 units is the morning dose....UNLESS SK has low numbers in the morning. I really doubt that he will, but our kitties like to keep us guessing