12/22 Ballonee AMPS 205, +4 56, +6 94

I just checked Ballonees Gluc at +4 even though she was acting normal just incase and it was 54 So gave her corn syrup and fed her some high carb food. Re-checking soon. I really think she needs to be on an even lower dose. I am constantly worried about her hypoglycemia. Last night she didn't get insulin because she was 94 and I know she drops so suddenly. This morning it was 205 so I thought she'd be fine but apparently not

Also I noticed all the posts here are dated in the title. Should I be doing this? I don't know the routine.

 

Oh, gosh!

Good job on the corn syrup and HC food. Post as soon as you get a re-check.

A lower dose is a possibility, there's just that darn DKA. The other way to go is to really up the carbs in her normal food, and feed her more at key points in the cycle. We can discuss these possibilities when the dust settles on these low numbers-- time to move back up, Ballonee!!!

You can edit your post title at any time-- basic format is name, date, numbers (and you can see people put brief notes). It's described in the "New to the Group" sticky up top. If you edit the current title to include the BG numbers, be sure to mention it's a pet-specific meter you are using.

 

54 is a normal blood sugar number on a human meter. Our take action number is 50. I haven't heard of the Accucheck pet meter before. Where do you get it? On an AT pet meter, the action number is 68. I hope she comes up soon. I would test again in 20-30 minutes.

We have a Sticky Note on drawing fine doses, you might want to look at how to dose 0.25 units.

 

I would test her again in 30 minutes. Syrup can wear off quickly. At least, hopefully, she'll be reaching her nadir soon.
I don't know how an AccuCheck compares to an Alpha Trak but I assume they are close to the same, so a dose reduction would be in order. I would try to practice measuring 0.25 units when you have some time later. For the next hour or two, you might be a little busy testing and feeding. Remember don't feed her too much, as you don't want her to vomit. Post your next test number.
Because she's had DKA recently (very recently), it is important that she gets insulin. It's just finding the right dose that will keep her safe.

 

Not much luck.. 60 now.. Gave her more corn syrup (am I not giving enough?) I was told to take a swab and rub it on her gums. and she ate a bit more for me but I dont know how much she'll eat for me.. shes not a big eater.

I will edit the title as soon as I get her okay. Thank you! I have to edit that in my signature. It's definitely AlphaTrack meter. Not sure what I was thinking :/

 

and yes I think her nadir should be really soon.

I took about a table spoon of some high carb food the vet gave me for these situations and she hasn't even gotten through that yet.. just little bits she'll eat for me

 

The hypoglycemia has literally been an every day thing for her since she was started on Lantus. Yesterday was the first day she was okay on it and I ended up not giving it in the evening otherwise my bet is she would have dropped.

 

Does the high carb food have gravy in it?

 

60 is better, but still low on an AT. Test again in 30.

You don't want to give too much of the corn syrup at once, as Dyana mentioned, because she might throw it up.

Do you have any other high-carb food around? Any gravy-containing cat food?

She's a bit of a puzzle-- she has the DKA just last week, but she doesn't really seem to need much insulin. Maybe because she is so tiny?

 

I don't think it does. I'm assuming the gravy is an important part? Can you recommend a brand? Just anything with gravy? I'll get some tonight.

she has another test in 10 mins.. crossing my fingers

 

You may have to find a higher carb food that she likes, and will eat well, just to be able to give her the insulin she needs.
Are you checking for ketones daily?

 

I know right? super confusing.

 

Yes and so far shes been okay

 

Good.

 

very tricky. Perhaps some high-ish LC food can help - as a regular meals?

I am in the US and I use Fancy Feast Grilled - 13-15% carbs, or Fancy Feast Gravy Lovers - ~20%, do you have it available?

 

I always fed Fancy Feast and used the Medleys varieties for a MC and the ones with gravy for HC. There is also variety called Gravy Lovers, I think, although I have never fed them. Yes, the gravy is where most of the carbs are.

 

Where are you located? It can make a difference as to what foods are available if you're outside of the US.

Also did you see Wendy's question about your meter? AccuChek makes both a human and (apparently) a pet meter. The dose reduction point is different on a human vs a pet meter. Also, you may want to review the two dosing strategies we use -- Tight Regulation Protocol vs Start Low Go Slow.

While Ballonee was in lower than desirable numbers previously, the 54 is not panic worthy -- although it's lower than desirable if you're using a glucometer calibrated for a pet.

As for the DKA/insulin, it may be that you're going to have to bump up the numbers by using food. Generally, swabbing syrup on your cat's gums may not be sufficient. I would add a couple (2 - 4) drops of corn syrup or honey to Gabby's food. (She couldn't tolerate the gluten in most gravy based foods.) Many people here use Fancy Feast Gravy Lovers which is around +15% carb.

 

Found some cat food with gravy (my other baby had some). Got Ballonee up to 5.1 (90) sorry! Im used to mmol

 

do you feel that if we try the 0.25 units it may not be enough to keep her out of DKA even if her numbers stay lower?

I read the meter it is defintely AlphaTrack

 

Yes! It was the fancy feast gravy lovers my other kitten had available

 

At this point, with that 5.1 (92), you can hold off on giving any more food/syrup. Let's see if she can hold these numbers!

I don't have enough experience with DKA to be able to answer the question about the 0.25U dose. Hopefully others will know, but I suspect that no matter what you'll be bumping up carbs for everyday meals for a while. Maybe that will help her put on some weight, too, which will probably help make her more robust and resilient to these issues.

 

Great! The gravy acts like Karo or Honey and bumps the BG up quickly - 10-20 min but also wears off fast and the BG goes down again.
I used to feed the gravy alone - not the whole thing meat and gravy because it is HC and may stay and affect the BG longer than necessary and also fill up their tummies too quickly..
I am glad that you have it at home - real savior in case of a hypo but feeding your other ones - even if non diabetics -with it daily may not be very best option.
FF Classic pate are below 10% could be much better choice for daily feeding (or Friskies) at he same price.
Again, I am in the US and speak of our FF and Friskies formula - it could be different at your place. Sorry I do not know where you are.

 

Tested again and shes 94 so it's looking up. Thank you so much to everyone for helping me manage the situation

 

i would take another test later on to be sure the BG stays up after the gravy effect is gone.

 

With the 50’s on an Alphatrak meter the dose needs reduced to .25u. She might go a bit high with a bounce so don’t panic if she does. It can take up to 6 cycles to clear a bounce so be patient before going back up in dose. Who knows, she may not bounce at all! Good job today

 

Gravy/karo can wear off in a couple hours, so make sure you test a couple hours after her carb fest to make sure her numbers don't come back down.

Good job today.

 

Does anyone notice that their kitty is particularly sleepy after a low? She just seems so off right now but I checked her gluc on both ears just to be sure cause I'm an anxious mommy and she is 122. If I were to look at her and guess a number Id say like 40..

I also called the vet and asked if anything could be wrong in addition to the diabetes and he's pretty adamant that she's okay otherwise based on blood work and tests. He said she might be recovering from the low and to check again in two hours and call if Im concerned

Update: She's a lot better now. Acting like herself. Wow am I over concerned

 

If she was running in high numbers for a while before the DKA/hypo incidents, her body may just not be used to how low (currently, pretty "normal") numbers feel. As long as she's behaving normally otherwise and ketones are negative, I wouldn't worry too much about some sleepiness. She's had a busy week, after all!

 

Yes I think thats what it is and I just need to remind myself of this! haha I am just looking for the littlest things right now so I don't miss anything

 

Understandably! She's had multiple very serious health conditions in the last week!

 

Saoirse was a bit wiped out after her one and only hypo, but ECID.

Did you manage to talk to the vet about how Ballonee's being underweight is possibly complicating her insulin therapy (per recent 'brittle' diabetes discussion in your thread on Feline Health)?


Mogs
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Yes, we lowered her insulin dose to 0.25 and she is already eating high-ish carb food (1/4 recovery formula, and 1/4 diabetic formula) so he is wanting to stick to that for now and see how she does. It's so weird though because today in general she went hypo twice and had gravy food ..and had some high carb food around +9 after her AM dose as well. Got up to 266 for her PMPS, gave her 0.25 units (less than usual) and she still dropped to 68 by +4. Ill keep working on it with my vet but I'm just pretty confused. Maybe we will just have to keep managing the hypo's until she gains some weight back.

But I don't think I'd want her numbers to go much higher than 266 before her insulin, right? Regardless of what they are she just drops low with the insulin.

 

The larger depot can influence 4-6 cycles after a reduction, could have been that tonight.

Recovery formula is low carb food.

 

Just a word about terminology...

With an AlphaTrack meter, the point where your cat's dose is reduced is 68 (50 on a human meter). For many of us who have cats that like to give us panic attacks, numbers even in the 30s don't produce a symptomatic hypoglycemic event. When you're referring to a "hypo," I interpret this as your cat having symptoms of hypoglycemia. The symptoms to be concerned about include but are not limited to:

• staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
• ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
• disorientation (yowling, walking in circles, etc.)
• twitching
• stupor
• convulsions or seizures
• coma

If your cat's numbers are not producing symptoms, it's not "hypo" - your cat is dropping into low numbers. You want to be concerned because you don't want your cat sitting in a low range overly long but low numbers are not necessarily equivalent to symptomatic hypoglycemia.

Since Ballonee wants to keep you on your toes, you may want to read over/print out the sticky on Shooting & Handling Low Numbers.

 

Thank you for your reply and clarification! Usually when she gets to the lower numbers she doesn't really experience the symptoms mentioned above but she will sit there with her little head hanging and be less reactive to me. She just gets pretty lethargic. But definitely nothing like seizures or any of those thank gosh. I'm glad to hear it takes really low numbers to produce those though.

Just reading through the information now. Thank you.

 

Yes, that could have been. Thank you. When I mentioned it to him he basically just said to keep feeding her the recovery and diabetes formula. He did suggest a decrease in insulin though. Maybe he isn't familiar with the brittle diabetes or hasnt worked with it a lot? He did mention he's never worked with a cat who needed less that 0.5 units of insulin. Also, I myself wasn't aware that recovery was low carb so thank you for this information.

 

Your observations are as important as what you see on the glucometer. When Gabby's numbers were running low, she would sit and stare at me -- I'm convinced she assumed I could mind read that she was telling me she needed food!

 

It's interesting because just about an hour ago she seemed so off.. just lethargic and no energy it seemed. She was 63 on the OneTouchVerio meter so not "take action" number yet but I gave her some food and she gobbled it, sprang up after and started cleaning herself.. the change was like night and day :/

She was recommend by the vet to eat 1/2 a can (1/4 can of recovery and 1/4 can of diabetic formula) 2x a day. But it seems like it's just not enough for her.. I think especially because shes like 1.98kg and has no stores.. and the low carb doesn't help the energy. Any recommendations? I remember in a former post it was mentioned that many members on this form feed many small meals to their cats over the day.. any suggestions for a change in diet that will give my little one more energy?

 

Jones free feeds. He has always done that and I haven't tried to change that with his FD diagnosis.

I have noticed when he goes lower - he gets cold! He always comes to eat when his numbers are dropping and if I see several trips I do a test. But his ears and body seems to get cold.

I have noticed that he will sleep a lot after hitting into the blue zone lately. I figure that if he hit the healing zone his body needs a rest!

 

Thank you for your reply! ^^ I think I'm going to have to do something like that. I just don't really know how to go about it with another cat in the house who eats everything :/

Also I think that might be a bit true for Ballonee as well with the body temp! I've also noticed that when she reads high on the monitor it's easier to get blood from her because her ears are so warm

 

Most of us feed our cats more than twice a day. There are a couple of reasons. First, when a cat is newly diagnosed and numbers are still high, glucose is floating around in the blood vs getting into the cells. Since glucose is the end product of metabolism, your cat isn't getting the benefit of what she's eating. Many unregulated diabetic cats are hungry all the time and actually need to eat more to keep their weight up. Also, feeding only twice a day forces the pancreas to work hard since insulin is released by the pancreas in response to food. Rather that overwhelming the pancreas, frequent smaller meals is easier on a healing pancreas.

When Gabby was first diagnosed, Gizmo was a kitten. I was also attempting to feed them different foods. Gabby was not fond of "diabetic" food and was convinced Gizmo's food was better. I ended up feeding one of them in the bathroom. It was the only way to make sure they were both eating. Once someone here pointed out that there was nothing magical about diabetic food and I could give both cats the same food, life was easier. However, Gabby was ravenous and Gizmo would graze. (Gizmo learned to not graze if he wanted to eat!).