? 7/23 Velcro AM +5=Hypo level; PMPS=427; +2 =453; +3.5=hi

Heading towards an active day :/

 

Nice start for Velcro! Surf on the beach Velcro! you can visit the lagoon but no diving

 

Oh boy he’s down to 59 at +4.

 

Active indeed. Are you feeding him?

 

Yes, he had a planned snack at +2 and now I am giving him another LC snack.

 

I have honey and HC if needed

 

+4.5 = 36, broke out the HC food. No symptoms of hypo luckily.

 

I would give honey too at this stage.

Your last post so we can all follow along: http://www.felinediabetes.com/FDMB/posts/2412156/

 

Also test in half an hour and see where Velcro is.

Also it's reduction time! 0.5 units tonight if the rest of the cycle goes well It's scary what Velcro is doing but it means the insulin is working and Velcro is healing Hang in there. You're doing a great job!

 

Thank you will test again at +5. Not getting much done today.

 

From The Hypo Toolbox. Testing should be every 20 minutes.
TREATMENT

During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

Can you test now? Concerned since Velcro had problems at the ER hospital with insulin.

I cannot stay on. On my way out the door. @Crista & Ming have you got this?

 

@Red & Rover (GA) yes I can stay on. And thank you for the reminder.

I know there's some debate about testing every 15 or 30 minutes because some say food takes about 30 minutes to work. Of course, it doesn't hurt to test sooner than 30 minutes.

 

Retested and it says lo. No symptoms.

 

Feed Honey + HC please.

He may need a bigger reduction tonight but I'm not sure. I'll tag some others: @Chris & China (GA) @Sienne and Gabby (GA)

 

Vet wants him to come in for emergency.

 

Please rub honey on his gums

 

Now he bounced to 92.

 

Did that

 

Glad he's up to 92. That's definitely the honey and HC. Are you still planning to take Velcro to the vet?

I would test in another half an hour and see if he's trending up or down.

 

He bounced up so I am going to avoid the vet and monitor every 20 minutes.

 

Good plan!

 

No I just called them back and said I was going to keep testing at home rather than add stress of a car ride and vet if I can avoid it.

 

Good job!

The rule of thumb is two hours of testing where values are going up without HC/Glucose intervention If Velcro even goes down to 80 the 2hr clock starts again! we want to be very vigilant on this

great catch today

 

How did you even realize he was low? Did he show any signs while being on Lo according to the meter?

 

Ok he fell to 51. Now what?

 

At his +2 I was afraid this would happen based on previous days numbers so I’ve been testing all morning.

 

FWIW, I'd give syrup/honey and gravy and head to the vet's. Take your meter and syrup with you.

 

I would feed 1 tsp of HC and test in half an hour. Help keep him up. He does seem to reach nadir around +4 to +6 (with that one time at +9).

Edit: @Jill & Alex (GA) is much more experienced so I would follow their advice.

 

More HC food maybe? is he hungry? You can put a drop of honey in the food too.

 

Yes you are right about the nadir. I do think today could be more like the +9 day because of the honey.

 

No he isn’t really hungry at this point because I keep giving him food to try and get his number up. I can syringe feed him a bit, he does ok with that.

 

If that's what you think, you'll be fighting these kind of lows for the next 3-4 hours if you don't go to the vet.
Not saying it can't be done, but it's very risky.

 

177... I didn’t give him any more honey just HC food. I am going to try and avoid the emergency vet. They did absolutely save his life, but I’m not sure they are really the best place to treat him.

 

Early this morning Butternut dove... I tested at 30 minute intervals at first then 15 for an hour, then 30 again. I put the feeding schedule in the remarks so it looks like it took ~45 minutes for the bg uptick to stick and then climb. I used only FF - most of the can.

 

That's quite a jump.

I understand. I just don't want you to get in over your head. It can happen quickly... in a blink of an eye. It's why I don't hesitate suggesting vet intervention when a caregiver is having trouble keeping the numbers up... especially when they're low. Even an inept vet/clinic can put a cat on a glucose drip...

Keep testing in case he bobbles around or drops again.

 

His last reading was 210. So perhaps I over corrected . I am going to continue to test every 20 minutes. Starting to think about tonight - if he’s over 150 do I dose? Do I lower it? I think he will probably have a reduced appetite when it’s time - I could syringe feed him, but I’ve already done that once today with the HC food. I will need to run out for more supplies if I’m going to give him insulin tonight.

 

Yes, but no frowns. This is a learning experience. Next time you'll give less. That's good to know!!!

That's a bit much. Every 30 - 45 minutes should be enough. If he stays high go to an hour or more. See how it goes.

See how the rest of the cycle plays out and then post for help before the next shot time.

You'll have to take that into consideration when making a decision tonight.

Probably a good idea if for no other reason than you never want to run out of supplies with a diabetic kitty.

 

Still up, 233. Will test at +7 and if high run out to get some more supplies. Thanks for the advice.

 

Sounds good.
Nice work today!

 

Well, the little guy made it easy to decide to shoot. PMPS=427. I was definitely aggressive in bringing his BG up from hypo levels.

 

Did you shoot 0.75 u? I suspect he'll bounce tonight but in the rare chance, he goes back down, you'll have to be on the look out again.

Your new dose should be 0.5 units.

 

I did give him the 0.75 dose. So tomorrow AM I should do 0.5 (assuming I shoot)?

 

Yes, 0.5 units for the next dose. I encourage you to re-read the SLGS protocol. It's a lot of info and re-reading helps us all and gives us refreshers Reductions in doses are made when BGs go under 90.

There's also a thing called "shooting through the bounce". It's done when cats earn a reduction but bounce because they went too low. And because they're bouncing, their numbers will be elevated for a cycle or more and not giving the reduced dose for one more cycle could help kitty not bounce as high. But I would be wary to do it unless I had more data and/or knew my cat is a bouncer.

 

Ok I will reread it (I’ve read it every day, but thought I had to have a pattern to reduce).

 

We reduce based on how low the dose takes the kitty. In this case, 0.75 takes him too low, so we reduce.

Good job on noting the times and types of food/honey when you had to give to intervene on the spreadsheet. If you add the quantities too, next time you’ll know how to tweak the amounts. One other thing, I always retested a Lo to make sure it wasn’t a strip error or too little blood. The first time I saw a Lo, Neko got some HC she didn’t really need. Ah well, you can never be too cautious. After that I did retest low numbers. As for frequency of testing, I always tested a little sooner when numbers were below 40, didn’t want to wait 1/2 an hour.

 

Nice job handling the lime greens. I hope Velcro relaxes tonight and stays safe.

 

Thank you. Velcro is all chill eyeing his brothers’ hard food and looking for an “in”. He was totally fine through it all. He didn’t eat quite as much tonight, probably because I have him so much this afternoon, so I will be extra alert.

 

+2 was up to 453. Usually his numbers are falling by +2. Just test at +3 and see what happens? Not giving him is +2 meal. I don’t think he’s hungry anyway.

 

As Crista observed above, he is bouncing. I would just feed him normally. Sure test him at +3. I doubt he will go low from that 450.

 

I’ll give him a break for +3 too, I agree he probably isn’t going to fall low. But can he go too high? Hyperglycemia is what got him to the hospital.

 

You could do a before bed test if you want to gather data, or you could go to bed early and save a strip tonight.

 

Neko registered “Hi” several times. Felt icky due to high BG, but it was just an ugly bounce. Take a ketones test when you can, but don’t worry about short term high numbers otherwise. They will pass.

 

Velcro is now recording “hi”. Again, that’s where he was when he was hospitalized. We have SubQ fluids for him daily right now, should I give him an extra dose to try and flush out his glucose? Should I take him to the emergency vet? A 0.25 insulin dose (guessing this is the worst option).

 

I don't think this is an emergency unless Velcro starts developing ketones or not eating/vomiting/etc. How is he doing right now?

High numbers are typical after going low or diving. It's what we call a bounce and should only be temporary. it's also called a panicky liver. The body released extra sugars when Velcro went low in order to combat it. Like Wendy said, don't worry about the short term high numbers.

Do you have a way of testing for ketones? Either with ketone urine strips or a ketone meter?

 

Also it's not recommended to give another insulin shot - even when you accidentally shoot insulin in the fur. You never know what went into the body and how the insulin will work. Insulin is a hormone and works differently than a drug. A more experienced member might be able to explain better than me.

In special circumstances, with much guided help, a kitty might receive short acting insulin to bring high numbers down. But this is not the case right now imo.

 

I do not have a way to test for ketones yet. Velcro isn’t really acting any different except drinking water a little more frequently. I haven’t offered any food because of the high BG and because he ate more earlier in the day than usual. He does definitely want some of his brothers’ hard food. No vomiting.

 

Thank you - that is what I expected but thought I’d check. I just feel so bad about today for him.

 

When BGs are high, they usually want to eat and drink and pee more. Maybe seem lethargic. Depends on the cat. When Ming was used to high numbers, he would not feel so great when he went to low numbers but when he went back up, he'd be playing. It's because his body thought that high = normal. That's changed a lot now. He acts much better in lower numbers.

I think you can give him an LC snack if you want. It's a balancing act. You don't want their BG to go up but you also want them to eat enough when they're high to avoid ketones. Ketones develop when there's not enough insulin + not enough calories + high BG.

You can get ketone measuring sticks from the pharmacy or online. It's a good tool to have but don't feel like you have to go out now to get it. It can wait and you can get some much needed sleep.

It's great to ask questions And you're doing great. It's just unfortunate our cats have FD and all these reactions are typical of the disease. You're doing your best to make him feel better and that's what counts. The positive is he's not acting very different despite the low and the highs today.

 

Yes it sure is. I hate that for our sweet kitties. Thank you for the help.

 

I gave him some baked chicken, his favorite.

 

Worth repeating - Crista's great advice.
Don't ever provide a second dose within 12 hours.
If you do a furshot - no second dose. (just cuss a lot and pet your kitteh)
If they are high, no second dose.

Additional dosing with a second insulin, or within 12 hours is a very advanced prototol and not appropriate for Velcro.

Next time you are shopping get Ketostix from Walgreens. $20 and you will probably never use all 100.
https://www.walgreens.com/store/c/k...urinalysis-ketone-test/ID=prod6144848-product