12/24 Checkers PMPS 306, +1 306, +2 226 +3 97, +5 49

Pretty uneventful night and i slept well. I think one of my cats is constipated and trying to figure out if its checkers or my other one.

Looking for advice on his morning dose so if anyone can help that would be great.




previous post

 

Morin! What is his BG?

 

'morning Luke, glad you slept well, Happy Christmas Eve
Hope someone can give you some insight on a new dose.
Don't forget, unless Checkers goes under 50, we need to keep giving the same dose for at least 3 days now.

 

around 137 @ 10.5+, 149 @ 11.1+

 

do you mean stick to his old dose of 1.25 or the one i gave him last night of 0.75?

 

No whatever you shoot this morning you should stick to after this.
You're never going to get anywhere if you keep changing the dose.

 

I get that I just have no clue what to shoot this morning since he has no real stable dose anymore. I want something stable i just don't know which way to go.

 

As you're looking at spreadsheets the one thing you should notice is that we don't jump around on the dose with Lantus. It doesn't work properly when you do. We shoot the same dose for no less than 6 cycles unless kitty goes under 50. After 6 cycles, if the dose needs to be increased, it can be done safely.
Read about the depot again.

 

You'll need to update your subject line to be "DATE Checkers AMPS etc" for people to be able to help.

 

Looking at his spreadsheet, he got under 50 during the AM cycle, and I am assuming since you just joined Saturday, he is a new diabetic, so he earned a reduction during his AM cycle, from 1.25 to 1.00. It looks like you shot a little later than normal last night and did a reduced dose of .75. This would be true if you are following TR or SLGS as 90 is the magic number for earning a reduction on SLGS.

If you want to play it a little safer, you could keep the .75 to see what happens with that. I know that the message boards tend to be a bit more quiet on the holidays, so people are not as available to help out if it is needed. Normally if giving dosing advice, the person would stick around and make sure all is well, and unfortunately, I will be heading out in about an hour, so I will not be around to help out.

I am sure that is clear as mud, but hopefully others will chime in soon. If it were me I would be inclined to stick with the .75 for the time being.

 

Right

Gotcha. Hopefully someone has a good dose suggestion for you.

 

Most kitties have no stable dose until the beans find it. That's where you are. Hopefully, someone who is very data experienced will take a look at your situation and be able to offer an observation or two.

 

staying at 0.75 would be fine with me and is a dose i'm comfortable with giving him and not pulling my hair out over

 

I'll agree with Molly

 

Unfortunatley because he is so newly dx'd, there is not a lot of data to be looked at, just because he is so newly diagnosed.....

@Lukewithcats do you have a "hypo kit" yet? It would have some medium carb food, some high carb food, some karo syrup and such in it.....

 

He's set

 

yes i have 10 cans of fancy feast extra gravy and a new bottle of syrup and some honey as well as some larger tipless syringes i could use to force food in either end lol. Not sure about medium carb food, i will look into that. i had been using dryfood basicly in that function but everyone agrees thats a bad idea so i will have to check lists to see what would work well.

 

I'm comfortable with .75 if you are, let's stick with that for a few days and see where Checkers goes.

 

as long as you have high carb food, which the fancy feast with gravy is, you are good......as you go through this process you will start noticing a lot of things. One thing that I learned is Skooter is a bit carb sensitive, which means if he goes too low, I can normally bring him back up with medium carb food instead of high carb food....that is why it is important to keep track of what you are feeding, when you are feeding as well...

Have you read the sticky on how to handle low numbers? This will be something to keep handy, especially during holiday times when people might not be around as often.....

 

just did his amps reading and its 146

 

I was going to suggest trying 1.00 unit, but trying 0.75 is fine. Just try your hardest as long as he is in safe numbers and you will be around to monitor to keep with the same dose for 3 days (6 cycles).
I see that you shot at +13 last night. Are you shooting about 12 hours after that this morning?
Can you change your remark in your PMPS column yesterday from "dosed at +1" to "dosed at +13"?

 

If shooting, I would try and get a +2 if you can as that is gonna be a pretty good indicator of what your cycle will look like....

USUALLY (but remember we are full of "exceptions" with this sugar dance)....if the numbe is similar to your preshot than it might be a quiet cycle, if there is a drop, it could indicate an active cycle....normally I will try to get a +2 and +3, as I have learned Skooter is HORRIBLE about reading the stickies, IE where is says the +2 is a good indicator and his indicator is anywhere from +2 to +3 most of the time....

I am heading out now, but hopefully others will be able to keep an eye on ya...

Originally 1.00 was what I was going to suggest as that really is what the earned redcution was, but I was just worried if people would not be around today and tomorrow to help out if his numbers went too low....

 

I gave him 0.75, I had to run out the door right after I did it so will fix the SS when I get back to home base.

 

Luke, my opinion for what's it's worth I'd stick with the .75 since you gave that last night if your uncomfortable over the holidays.

I will be around all day today and tomorrow.

However, I'm not familiar with the ranges human meters use.

 

Hi. When you fix the ss it would be a good idea to post your BG results in tiur subject line too. That way if there's a big drop it will be seen quickly.

 

well i thought his level would be on the higher side today but here we go again lol. I did a reading at around +3.2 which was 56 so i got him to eat just some regular food as i know hes been eating and his dose should be low enough not to drop him lower. It has gone up abit to 61 @ +4 so hopefully it will stay up. i'll test again in 30 mins or so.

 

Definitely check in 30.. You are doing great.

 

just broke out some gravy after he dropped to 52. @ +4.5

 

Nice surf going on. I would feed a little regular food and see if the surf continues.

 

i just tried but he wasnt interested so i gave him some of the unused high carb food that was leftover in the can from earlier. he seems to really like fancy feast, normally food with gravy he just licks the gravy and leaves the meat but he seems to actually like the meat in this stuff.

checkers just refuses to stop surfing the line. it's like his body has figured out how to get sweet sweet gravy by screwing with me. I thought today would be a blue day not a green one. i'm determined to stick at this dose but he's really frustrating me.

 

Are you following SLGS or TR ? He is in safe numbers right now either way and in a good place if TR. You might want to find a food he will eat that's middle carb. Tanya's CRF site has a more recent food list than the one people use around here and does have tge carbs for many foods. Some of the fancy feast are in between as well. I'd look for foods around 12-15%. It takes experimenting to find what they like. That being said dropping the dry like you have just might make him food controlled. It's too hard to say at this point since he was getting 3 units which is a lot. Max is around 16 pounds and he never went that high. Weight is only one part of the puzzle but I point this out because I think that your vet took Checkers up way too fast and in increments way too big. It's scary at first to see those numbers but this board will keep him safe.

 

@tiffmaxee Hey Elise, Luke's been doing pretty well actually!
I think he's doing TR?
Did you figure it out, Luke ? I think you monitor enough to do TR, and it does give the best chance of remission.

 

Checkers still has quite a large depot working in comparison to today's dose of 0.75
He should start staying a bit higher soon.

 

He is doing great! He said he was frustrated though. I'm thinking if he can keep him surfing on mc he will reach his finish line sooner.

 

I would have done go slow but i went too fast due to vet prescription prior to finding this site. That's one of the reasons i've been so frustrated as i keep thinking i can get him on a low dose and then go slow to find him a good dose but no matter what i do i seem to end up at TR lol. I guess maybe thats what he wants although he doesnt seem to enjoy lowish numbers. i think checkers preferrs to be in the blue then greens. He has another test coming up in around 10 mins so we will see where he is at then.

 

I agree 100%. Checkers is pretty close already. I think he might just need some support while his pancreas sputters back to life.

 

it's just frustrating how little effect dose changes has had. Every assumption i make turns out wrong. I assumed a 0.75U dose would lead to blue/yellow numbers for the full cycle yet here we are, it frustrates me because last night i hardly tested him because i assumed 0.75 would be low enough that i could basicly take the night off but now i realize he was probably low last night too based off todays numbers.
If i had known how he would react to 0.75U I wouldn't have dosed him last night. I am determined to stick to 0.75 but that means i will probably not be having the best night tonight thanks to him needing testing and me having his dose time pushed back an hour doesnt help lol.

 

Ah, but what a gift it would be if he could get off the insulin and become diet controlled. It would make it all worth while. I have been here a long time, and have seen many many many cats become OTJ. Not all do, but I would work for that.

 

Luke I think you may not yet fully understand the depot...

Lantus does not show its immediate full effect in dose changes.
The numbers you're seeing today are from the dose that you shot up to 3 days ago. Take your pick, there were plenty of different ones.
Lantus is not an "in-and-out" insulin like most others. Some of it works right away and some gets saved for later - Up to 3 days later.
As you shoot .75 for a few days, you should see his numbers come up a bit. If they don't, then it's time to drop to 0.5, and then 0.25, and then 0.1....until Checkers is off the juice.

 

the way i've been picturing it is the depot is based on previous cycles up to 6. That would mean though that his depot should have shrank a fair bit over the last few days as the lasy 6 cycles were alot smaller then say 2-3 days ago. Is this it or am i wrong? the reason i assumed the 0.75 would have an effect is because i figured the high doses would have finally left the depot so the depot should have shrank a fair bit over the last few days.

Am i crazy and the depot is like a set figure and i've been replenishing a high depot even with lower doses over the last 6 cycles and the only way for me to lower it is to not give him insulin for a cycle or 2?

 

No, I think you're close on the way you're picturing it. But you shot 1.25 3 doses ago and 1.4 5 doses ago, so those are still in the mix.
If he doesn't give you more comfortable numbers in the next 2-3 cycles then I would decrease again.

 

You've had a beautiful surf today.....And Checkers pancreas has had a nice long run of green numbers in which to continue to heal!!

Cycles like today are what we wish for....keeping their numbers between 50-120 as much as possible!!

I'd hold the .75 for at least 6 cycles (total) and see how he does....since Checkers is so new and you recently got the dry out of the picture, we just have to let his numbers tell us what dose is best for him

If he drops below 50, he'd earn a reduction to .5 (or if he stayed in normal numbers for 7 days on .75)

 

I think he would have gone under 50 if i hadn't brought out the highcarb food, does that matter?

I'm really concerned he has a bowel blockage or is super constipated. I have 2 cats and in the last 3 days between the 2 of them their has been 2 small BM's. I took my other cat to the vet today specifically because I figured it must have been him that was blocked up but the vet looked him over and thought he didnt show any signs. So that leaves me with Checkers. I'm concerned he's blocked up and his numbers are going to be extremely erratic due to it. he hasn't been very happy today and feel like his belly is swollen although i thought that about my other cat so certainly i'm not a good judge lol.

I checked his BG a few ago and its finally raised up so he's probably good to go i'm just so paranoid with how often he surfs so close to the line. I'm ok during the day but when it comes to night i get worried because i just can't keep my eye on him the same way.

Is there any thing with lantus or being diabetic that could caus a major constipation issue?

 

If you look at Skooter's 2015 spreadsheet (link in my signature), and look at the end of Feb/beginning of March....that is when Skoots was constipated and blocked. He ended up with two ER visits, each with an enema....it was an icky time, but we got through it! His numbers don't necessarily indicate something is hugely wrong (his numbers going so high was the way I figured out something was wrong)....not to say there can't be something blocking him.....They found Skooter's with an x-ray....

A lot of people will use pumpkin or I think squash to help with constipation, unfortunately I found like the ONE thing this cat won't eat. Before doing this, I would definitely discuss with vet as it may not be an issue, but Skooter got 1/4 teaspoon of miralax twice a day for about a week and now he is on a maintance dose of 1/8 teaspoon twice a day. Again, ECID and I would discuss with vet before adding the miralax to the mix.....but I think most people try the pumpkin (not the pie filling kind), or a baby food variety....

I remember that feeling all too well.....I was scared to death of greens....now I crave greens like nobody's business lol....It does get easier, I promise and the lower numbers will not always be so scary.....a lot of people think that if their cat starts out at like 90 and they give insulin, they will drop by half, because that is how it works with the higher numbers.....Lantus is best dosed with lower numbers as it holds them steady most of the time....Feel free to peruse Skooter's 2014 or 2015 spreadsheets (great way to learn, reading other people's sheets)....it shows how once he got used to the lower numbers, he would surf them when he started out with them....

You are doing a beyond amazing job with your baby!!!!!

 

Diabetics are often dehydrated, which can contribute to constipation. Are you adding lots of water to his wet food? I also give my Neko 1/4 tsp of pure plain pumpkin in the AM and PM meals to add a bit of fiber. One of her other medicines can cause constipation. Can you give his belly a little soft massage in circles?
Constipated cats usually have higher numbers. The Miralax that Molly mentions above is Restoralax in Canada. Discuss using it with your vet.

It's hard to know without actually seeing the under 50 whether he would have gone there. We usually wait until we see the number. Which is why we wait for an under 50 number to pull out the high carb food, unless we have to go out and can't monitor. If you are worried about tonight, test as late as you are comfortable doing so, then leave lots of food out for him so he has something to eat if he goes lower.

 

is squash the other option if a cat doesn't like pumpkin?

 

Yes, some kitties prefer squash, or even baby food squash as an alternative. I find I have to give more babyfood squash to get the same effect as pumpkin.

 

just did his pmps and his BG is much higher then i expected (306). its doubled each hour for the last 2 hours. worried its the blockage. any ideas?

 

The rapidly rising BG could be a bounce kicking in, from the nice green numbers today. His body isn't used to it yet and his liver will panic and send out extra stored glucose (glycogen).
Here is a diagram of the digestive system if you want to try to feel for a mass. The colon runs under the spine from behind the ribcage, it's higher up than you'd expect. It should be pretty easy to tell if his colon is empty, unless he's really overweight, but just because you can feel something in there doesn't necessarily mean it's blocked.
Massaging the area gently from front to back can also help get things moving.
I hope you get some poop

 

The only definitive way to tell, is to take him in and get an x-ray done.

 

Oh and shoot that .75!
Don't be thinking he needs more because his number is higher

Might be a good idea to separate the 2 cats with their own litter boxes so you know who's pooing and who's not.

 

i gave him his shot when i did his high reading and raising his dose wasn't something i considered even for a second. I'm just concerend about his constipation.

After i gave him his shot i tried to get him to eat as normal and he refused. the vet gave me some hairball meds with petrolatum/mineral oil in it but the damn stuff is sugar cane flavored or some stupid ****, no idea why they would give me that for a diabetic cat and he absolutely hates the taste and smell of this stuff (i hate the smell too) so its useless. i tried mixing it with gravy and still no dice, its smell is so damn strong i wouldnt be amazed if its flavor was too. I'm hoping the reason he isnt eating is because he can still smell that stuff, i can smell it when i get near him as i touched a bit to his nose like the directions said and somehow its led to him having a face that stinks of this horrible burnt sugar cane/caramel smell.

I'm not worried about dose or anything just his bowels and ofcourse its christmas eve so if he ends up in trouble I will have very few options. i dont think my vet is even open until mid next week.

 

Well, as @Wendy&Neko suggested, you can try some pure pumpkin mixed in to see if that helps.....I know Skooter had no appy when he had his obstruction....

Are there any ER vets that might be open?

Good catch on the hairball meds!

 

I believe you can put a little petroleum jelly on their nose or in their mouth for a laxative effect. Hopefully someone else can confirm.

I'll copy and paste this in case you missed it....
The rapidly rising BG could be a bounce kicking in, from the nice green numbers today. His body isn't used to it yet and his liver will panic and send out extra stored glucose (glycogen).
Here is a diagram of the digestive system if you want to try to feel for a mass. The colon runs under the spine from behind the ribcage, it's higher up than you'd expect. It should be pretty easy to tell if his colon is empty, unless he's really overweight, but just because you can feel something in there doesn't necessarily mean it's blocked.
Massaging the area gently from front to back can also help get things moving.
I hope you get some poop

 

Another substitute for petroleum jelly (Yuck - Neko loves it ) is a little olive oil, plain unsalted butter if he can do dairy, or virgin cold pressed coconut oil.

 

I give Max 1/8 teaspoon miralax most days. I have used pure pumpkin and baby food squash mixed in the canned food as well. Pumpkin does have more fiber than tge squash. My cats wouldn't eat organic canned pumpkin. So brands do matter, LOL.

 

I don't have any pumpkin and its a couple hours away from christmas, i can't think of anywhere i could get any. perhaps baby food or something would work? I could maybe dig some up tomorrow from a pharmacy or something.

I read most of it but ended up chasing after checkers as he did something. I have been feeling his stomach area allday. yesterday i looked at alot of diagrams and even disections to really try to get the feel for what i should be feeling but if its anywhere its not in the colon/sphincter its probably where the large intestine meets the colon which i think is over near the spleen so its basicly impossible for me to know if i'm feeling organs or blockage over there, I'm just not trained enough. i've been just rubbing his belly and vibrating it and massaging it all day.

My vet did say something about emergency hours over the holiday so if tomorrow is looking bad I will try to get him in somewhere, so frustrated i probably took the wrong cat to the vet today. my other cat is oldish and big boned/muscular and has been having some back leg arthritis so taking him in seemed the better bet and let me get that looked at while i was at it.

i will just keep my eye on him and see how he is tonight.

 

Looks like he is bouncing. Is he eating? Are you going to give him any insulin?

 

i gave him his scheduled dose just under an hour ago

i havent got him to eat yet

 

If you have some petroleum jelly, unsalted butter, coconut or olive oil, you can put a little on the top of his paws...most cats will lick it off even if they don't "like" it just to get it off their paws

 

I don't know what you can do tonight and I don't know the area you are in. Stores like Kmart and Wal-Mart will have some hours tomorrow and some groceries open later in the day. If you have the ones that sell food you might be able to get a can of Libby pumpkin. Not the pumpkin pie kind, just plain pumpkin. I put a small amount in each feeding every day for all my cats. It took about 24 hrs to see any effect. I open the can split into 3 and freeze 2 containers until I need it. I'm trying miralax now but don't like it. I prefer the pumpkin and will go back when miralax is finished. I use it to prevent constipation.

 

how do you use the miralax? Just mix it in with food or put it in the water or what?

pretty sure all stores around my way other then gas stations and a big box pharmacy store will be closed but the pharmacy sells very very basic groceries so may have something, pumpkin babyfood i would think at a minimum. How does the pumpkin you are talking about come? In a can or what? is it just pure pumpkin?

 

It's a tasteless powder, so most of us just add it to food (it really is tasteless!)

Yes, just plain pumpkin...not pumpkin pie filling (which contains sugar)....it comes in a can ...which is why we suggest that once you open it, you put the "leftover" in ice cube trays and freeze it....so you don't end up throwing a bunch of it away (since you can't leave it in a can forever)

 

Pharmacy might have miralax. I just sprinkle very little in the food for every meal. The pumpkin is in a can. Usually in the baking aisle where pie filling is. Make sure the only ingredient is pumpkin. I mix that in there food same way as the miralax.

 

I use the plastic take along containers because I have so many of them. When you freeze it and it thaws it has quite a bit more liquid in it which is good.

 

If I want to make sure Max gets it all, I mix the miralax in some all meat baby food. I recently read it's best to put a little in each meal but with just 1/8 a teaspoon I've always given it at one time. It takes a few days to kick in though. The site mentioned earlier is really good (felineconstipation.org).

 

just woke up to check on checkers, doesntseem like hes eaten, low BG and no BM. Not good. I did manage to get some gravy in him and abit of fancy feast bits that came with the gravy but he didnt want to eat it, deffinetly lost his appetite. i will test again soon. If any advice it would be appreciated.

 

Will he eat from a spoon, or from your fingers? Gross, but sometimes cats will eat from there if not the dish.

Do you have a larger syringe that you could try syringing food in him? In the Where Can I Find post, there is a link to a video on assist feeding. And here is a post on How to Stimulate Kitty's Appetite.

You can't get all meat babyfood in Canada, so that option is out. But you can get butternut squash babyfood. Any open pharmacy will likely have Restoralax.

 

And here is a video Liz posted of her vet giving her cat Zener a tummy massage to help him feel more like eating.
http://www.felinediabetes.com/FDMB/threads/12-14-gabby-amps-267-pmps-119-2-5-43.149236/#post-1557680

 

got up and gave him some more gravy and he ate alttle meat too. Someone has had a big BM but i dont think its him but we will see. I may have felt something in his colon but not 100%, going back to bed for a few before getting up to test again, merry christmas lol

 

How is he doing? Any tests to report? If you are awake please post them or test if you haven't yet. That 49 last night means you need to watch carefully this cycle, especially if he's not eating well.

 

I just posted a new thread, his spreadsheet should be up to date. he did eat this morning but is right back to surfing the greens.