yesterday Still trying to get his food right. I don't think he's getting enough to match need + insulin dose so after last night's skid and after gravy+karo, I gave him a bunch of FF pate - to stabilize and so we could sleep! This morning I gave him more food than he's been getting and he seems more content. Will see how long it takes to blow out the bounce. Considering taking the reduction he almost earned 7/28. Not sure if simultaneous extra food + lower insulin makes sense as far as understanding bg readings that will likely be upended. Jeebus.
Butternut had a great night last night! it looks like this dose works well for him I hope he clears the bounce soon Have a great day
The dose is the question. He was heading south at +3 with the rest of the night ahead of him. If I have to feed him repeatedly to keep him from bonking during the night then he either needs more food @ shot time or less insulin. Micro-managing him like that doesn't make sense to me and can't continue. His last reduction failed so here we are pondering a another reduction. Maybe by PMPS I'll know what to do. Thanks.
Mowgli is the same way... he jumps off a damn cliff at +1.5 - +2, depending on the numbers I might try a less hovering approach next time... while testing of course. Fingers crossed you figure it out.
Sometimes it takes a little time to settle down - you might want to take a poke break this morning...test him in a couple or three hours...he's bouncing from his low numbers last night... Hope he comes down by this afternoon/evening...
am trying to poke less and do some pad care - (as I poke him again and see he's already in blue) I suspect he's bounced from lots more food last night and this morning too. Oink. Lately it seems like the food+insulin balance is enough for lazy days and sleeping-basal metabolism. Now that he feels better and moves around he bonks more, like he outstrips his supply of glucose and can't generate enough to keep up, or his tissues suck it up and his numbers plummet. I see how his body sucks up the karo and moves right along with green and blue after that. eye-opening. Doesn't take much to deplete his tissues right now - small walks. A couple nights ago I just watched the green numbers develop and didn't feed... just watched in case I needed to provide food. All was great that night. Not so much on a couple other nights that he had walks. what I want to try and do is head off the deep dives and hours of followup. If I don't check I won't know if he's going hypo either. Right now it seems more food is the answer if he continues with 1.5. I suppose it could be possible to have good numbers and be semi-starving at the cellular level? Gotta find some balance for him. my brain hurts. lol
Perry had minor neuropathy at dx and it continued until we got him on insulin, but I know that's not the case with all cats. How bad is Butternut's?
My vet has said numerous times that he does not have neuropathy because he walks up on his toes. He doesn't have hock drop though he has in the past. B12 shots helped. He has leg rear leg weakness so Id think that IS part of his diabetes = neuropathy or lack of glucose or all of it. He's compensated by using his front legs more...shifts his weight forward and pulls himself up stairs. He's had the same level of weakness until this spring when he got pancreatitis and his bg was not regulated. Then he wasn't up to taking his usual walk outside. Since Levemir he's gotten so much better I didn't recognize him. He's taken more walks, longer walks, and with gusto -- for him. Even this morning once he hit yellow he wanted to go outside for a second stroll. I didn't allow it. He's also been worse in the past two weeks, today being the first time since levemir I've seen him weak like that. Early this afternoon just after he hit blue he couldn't push himself up in the back end,... was slipping on the floor and looked hypo. I didn't know which it was, slippery floor or what, but I gave him a gob of food to eat. He walked better on the rug than the floor. His BG was down to 170 by then. It's only up to 222 after a big bowl of FF pate with some karo drops-yep I freaked out. It's like his body is starved for glucose due to months of dysregulation and any extra movement creates demand beyond what I am/was feeding him. Plus his better regulation with Levemir, glucose receptors, starved cells... I don't know what to think except that he needs to eat frequently and a lot... that's my gut speaking. He looked Hypo at 170. After his meal he was happy as a pig in poop... bathing, purring, responding to me...... normal. He didn't walk around so not sure where he is with that... he's been sleeping and I had to leave once I felt he was stable. I think I want to cut his dose down a bit and let him eat what he needs. hope that made sense. I"m overwhelmed and tired don't want to cause more harm than good. I got him zobaline recently.
Once again late in the cycle he's on the down swing, even after extra food. +10 = 187 How can I tell if his pancreas is working and sputtering or not?
So an hour ago after he time to digest all that food, Nut was recharged and raring to go outside again. Legs working as they usually do. He had a little walk but since he was and still is in the 2 hr preshot window and I don't want him to eat, or bonk, I brought him inside. He complained somewhat loudly and poked at the screen door! He's outta control.... what is this miracle juice, Levemir? I wonder about reduced insulin resistance, pancreas coming to life, tissues demanding a re-feed, general healing. Jeebus, Butternut, I'm flummoxed. I shut down Google and rebooted. SS is working again
Have you tried logging out of Google apps and then back in? If that fails, shut your computer down and then start it up again. It sounds as if something in your login is hung. I was able to view Butternut's SS. If you're following TR, it looks to me like it's time for an increase. His numbers are a little wonky for sure - but when you see them coming down it's time to lay on the higher carb foods. It's a tricky game and Luci and I have been playing it for nearly two years...insulin will bring his BG's down and the food will prop them up - it's just a see-saw of trying to find the right balance - you're doing a great job ... but it does require a lot of hands on...hang in there! It also seems he likes to do his going low thing at night - so typical of many cats...nocturnal creatures I suppose... Luci and I are waiting for the Levemir to kick in -you and I started at about the same time - it's suppose to level off the highs and lows...but it does take time. Look at @Amanda and a Loudogg and @JoyBee&Ravan - SS's. Ravan is a great example of hitting the high places for quite a while before he 'caught on'...and Loudogg has ACRO issues...so he was a high flyer and his numbers were all over the road... You're just getting started on this sugar dance - try to be patient...this stuff takes time
we crossed each other. I just logged out and in again. it worked. Increase?? I'm not ready for that. I am willing to stick with 1.5u tonight and give him more carbs to see what happens. I have patience to work this out but I cannot continue to stay up at night watching for hypos. I'm going to crash. Ill check the other SS after PMPS, food and shot. Thanks.
I really think vets' definition of neuropathy is different from a cat guardian's. They're looking for cats who can't jump onto anything and hock-walk. We're seeing little differences (and sometimes big differences) that are really upsetting, because you don't know where it's going, but you know it isn't how it used to be, or right. Sigh.
Can @Sue and Luci or somebody explain why Butternut might need a dose increase at this time vs completing a few more cycles at 1.5u? I'm open to it for tomorrow AM but I need to understand it too. And by increase would that be .25 units more or a fat 1.5? His numbers will surely be wonky now due to me feeding him more carbs, making it even more difficult for me to know what to do for him. The pumpkin and/or addition of FF and less raw food helped a bit.
He surprises me at times with the stuff he can jump up onto or climb. I find him in the arubacat tree sometimes. Getting down is more of a challenge because he can't hold himself back with those rear legs. He hopped up the deck stairs this morning with no problem. Walking is more awkward sometimes... his legs look like they go different speeds. He has arthritis in his lumbosacral spine, his rear left knee and I wonder about the front legs. He doesn't seem to be in pain but am curious whether a test of pain med would be worthwhile. Gabapentin is NOT for him so not sure what he'd be given. He does get glucosamine injections. He LOVES bone broth but now I worry about the Phos. What irks me a bit is not being instructed to do something for his legs long ago. The best thing I can do for all of his body is get him regulated and nourish him as deeply as possible. Figuring out his insulin dose is next on the to do list, I guess. Thanks for your input.
My general thinking about an increase was from looking at Nutty's SS - he's been on this dose for 11 cycles now and hasn't seen any really low numbers - low blues or greens at all...so I refer to the Stickie: http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/ In particular this paragraph: Increasing the dose: Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit. if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing. when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing. Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300. Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300. It's not a hard and fast rule but a good suggestion if you're following TR and you'd like to see some improvement in his numbers. On the topic of his legs - I'm still leaning toward diabetic neuropathy - it's the first thing I'd try to eliminate with the insulin treatment. It's a common thread around here to hear of weakness in the limbs when the blood glucose is and has been wonky. My opinion only comes because I too have such a hard time trying to figure out when to increase...it seems like all we do is go up and down the dosing ladder...so I'm in the same boat as you with that...just gotta keep trying to move forward and hit the sweet spot...you're certainly not alone in your efforts to find it. I hope this is helpful
all his nadirs for those 11 cycles are under 200? 5 are under 100. Most of his blue and green occur in the evening and are so low I have to feed him. Mornings are all colors. Confused. Holding AM dose until I get this figured out. He's much improved this morning... walking all over. Thanks. I'll do more reading too.
