BG in the 300's

Well I haven't been on in a little bit, Brady is doing ok, wish he was a little better....His numbers are pretty much hanging in the 300's so I adjusted his insulin (Prozinc) up to 1.5 U from 1.25 U. His bowels were a little funky yesterday, diarrhea, put him back on probiotics to help him. Not going to lie getting a little worried with his bowels, they did firm up today a little bit, a little clay colored and a little greasy. He only went once. Still has a good appetite for the most part. I check his ketones as much as I can when I catch him heading to the bathroom, he has trace ketones according to the ketone sticks from CVS. But that has pretty much been the same all along. He seems ok as far as mood and attention. Wondering if I should move him up to 1.75 or 2U?

Hope everyone is staying safe!!

 

I think that was a good call to move the dose up to 1.5. Right now, I would leave it there for at least 3-6 12-hour cycles to give Brady's body a chance to adjust before making any further changes to dose. Keep watch on his mid-cycle tests to see how it goes. If he continues in yellows and pinks mid-cycle, then you might consider an increase after waiting 3-6 cycles. If he hits some blues, you might hold at 1.5. If he dips under 90 in the green, go back to 1.25.

Patience is your friend. Brady's pancreas has shown signs of healing, but it doesn't happen all at once. He might need a touch more insulin right now, and then have to get less again. Or, he might need another small increase. The trick is to give each dose adjustment time to work itself in so you can see what the next move should be.

 

Clay colored, like the grayish color of clay kitty litter?
Picture please? Break open the poop, and let us see the color.
Thinking about EPI.

He may need some sort of antibiotic, if his feces remain too loose.
Canned pumpkin can help with both constipation and with diarrhea.
But you need to find the underlying cause.

 

Spoke to the vet about it, giving him the probiotics one daily for the next couple days, if he doesn't improve she wants to know. I don't have a poop to show you right now, I will try to get you a picture as soon as I can....Thank you for the information....so so scared, I don't want finances stepping in the way of our babies care!!!

 

Thank you for the information Juls, God I do wish this wasn't so hard on him, we are not used to seeing our baby like this......I keep praying for some healing time.....

 

I will add my prayers!

 

481 pre shot, I just feel like something is going on, this has been the worst week yet, I guess im just flat out worried...again!!

 

Just remind yourself that pre-shot numbers are the ones you can least trust. They can be influenced by bounce, food, etc. Don't fret the high pre-shot numbers. The lowest mid-cycle numbers will tell what move to make next. Never change dose because of the pre-shot numbers.

And also remind yourself that Brady doesn't have to be perfectly regulated or in remission to feel better. I bet you he is already feeling much better than he felt before his diagnosis and treatment. Pay attention to how he acts and how his attitude is. That's the best proof of your treatment. It's not all about the numbers.

 

I know and truly appreciate all your comments....he isn't having a good day today, not acting himself at all....The cost just a short month ago was so much, im really worried about all this now......I cant even talk about it.....prayers, please, prayers

 

All the prayers. With my Billy, he had good days and bad ones too, but overall I could tell he was doing better.

Have you tested for ketones? You haven't had to skip any insulin doses, so it's not likely, but it might be worth doing.

How exactly is he acting?

 

He had ketones when this all started, he has trace amounts but those sticks im testing him with pretty much show the same thing every time, like just on the trace amount color.....He just isn't himself, he is just sleeping a lot, he usually likes to stroll around our patio and today he just pretty much stayed under the chair....just not himself at all...moving slowly...he did eat, which is always good...but I know my buddy, and he just isn't himself today.

 

That sounds more like my Billy on one of his off days during treatment. Some days he was just really low key and sleeping a lot. Who knows, maybe they sometimes need extra rest to do all that healing. Hopefully Brady will perk back up soon. Is he eating enough? Not getting enough calories could also make him feel logy.

 

Yes he is eating ok, today, so far he seems a little better...He bugged us this morning starting about 430 am for his food, so that's what I like to see....but I have to see how the day goes....He still had soft stool this morning....I had a lot to do running around and getting signed in for work an he covered his poop...I know @Deb & Wink wanted a picture, I will get that, hopefully the next time he goes....I reached that EPI that Deb talked about and if his stools don't get better im going to talk to the vet about it....Deb is one heck of a good contact on here, as are you.....Thanks girls

 

No rush on the picture. When you get the chance. Work and other family and life responsibilities come first.

Rainy days, BG's running in the high range, slight UTI infections, upset tummy are all reasons our diabetic cats feel less well and sleep more than usual. If your cat lays all tucked up, like a lump of meat, we call that "meatloafing". Sometimes cats with pancreatitis will do that "meatloafing" pose. Plus, their belly is tender if you try and touch it.

Do try to at least get a call into your vet for some feedback from them about the soft stool. Maybe ask about an antibiotic, like metronidazole for the diarrhea.

Wink was on that several times, including when I first fostered him. That medication is bitter, so hiding it in a gel cap or a tiny piece of meat, and then putting it way back in your cat's mouth may help. Wink would foam at the mouth and drool something awful. But when he had liquid poo, softer than pudding poo, he needed the antibiotic to help him.

We always worry so much when our cats are not feeling well. I know that I worry, when my civie cat Dancer turns her nose up at her mid-day snack, like she did a couple of days ago. She's a former feral colony cat, always eager for food, so if she refuses to eat, I know she isn't feeling well. But, it's likely to be an upset stomach or her gut is acting up with the megacolon, so I usually give it one day before I really worry.

Please keep testing for ketones every day, and make sure that Brady eats enough. As long as it's only a trace, it's not as worrisome. More than a trace, that is a vet visit needed. Possibly some fluids, some anti-nausea meds, some appetite stimulant, some pain meds. All this, including giving the fluids you can learn to do at home.

But if the ketone levels get too high, then Brady would need more supportive care at the vet for them to balance the electrolytes and such in his body. That could be a several overnight stay for him, at an emergency clinic.

Let's prevent that, and keep Brady eating. That yellow AMPS was nice to see this morning. Hope his blood glucose levels stay down a bit more today and his appetite stays up.

 

Couple things @Deb & Wink a lot of mucus and quite a bit of hair in his poop. I actually have some metronidazole on hand from when this all started expires on 7/6/2020 so im going to call now to see if I should give him some and if it is ok with the probiotics and cerenia meds he is on. His numbers climbed back up in the 300's but just took it again and its on its way down but still in the 300's...Sorry I use numbers because im color blind, I can see colors but a couple different categories look blue to me. I do test often for ketones, sometimes its hard to catch him heading to the litter box and I miss it.....

 

So the mucus says his gut, his intestinal tract is really upset. A bit of hair in the poop is pretty normal, especially since it's shedding season, and cats will pass hair through their intestinal tract to eliminate it.

More brushing? Does Brady like to be brushed at all? I use a slicker brush, which my cat loves.

No problem with the color blindness. Did not inherit the red/green color blind issue from my dad, but my brother had it. Makes driving challenging for you I bet. Which colors are a problem for you?

I'll try to remember not to talk about only the colors on the SS, the "pinks" or the "greens", and instead try and talk about the ranges as well. So this morning, Brady came down from the pinks (300-399) to the yellows (200-299) and then went back up to the 300 range (the pinks).

I think we may need to increase the insulin dose again, to get him out of those 300's (pinks) and back down to the low 200's (yellows) and even down into the 100-199 range (the blues).

Anything over 500 is bouncing. Black (500 and up) = bouncing.
Anything over 400 is too high and probably bouncing. Reds (400-499) = bouncing or not enough insulin.

Does that help a bit?

I'm anticipating you needing to increase the dose to 1.75U for PMPS tonight, 4/8/20.

 

Brady does like to be brushed, we do brush him quite a bit, he has slowed down on the shedding somewhat...just brushed him last night, hardly anything on the brush, we have to kinds of brushes......

Color blind sucks in some things I do, doesn't really come into play with driving, Red up top, yellow in the middle, green on the bottom, lol...and its ok if you use the colors in your responses just makes me read it over a couple times hahaha...by the way, males are more dominant with color blindness, its a dang guy thing....some women have it but mostly the good ole boys tend to be the ones....

I am thinking the same thing about an increase, but im trying to take the SLOW approach, but if his numbers are still up at PMPS I will adjust to 1.75U

Spoke to the vet, going to start giving him the metronidazole to help clear this up...they said the same thing about the hair, not much to worry about there.....hopefully the meds get him back on track.

I know you have been part of this forum for a very long time, but you are a very educated woman when it comes to the feline world. Im actually extremely impressed....you have been right on with your information

 

I know about feline diabetes pretty well. There are other people here, some of the Lantus ISG forum users that eclipse me in their knowledge level. They blow me away with their level of expertise. Well, one of them is a professor at a medical school. Another is a trained biologist with many decades of experience in that field.

I know about some other feline diseases, because I've had cats with things like HyperT, CKD, stomatitis, etc. To me, knowledge is power. So I like to share what I know with others, so they can learn too.

I will never know everything, but like to always keep learning. I will never know as much as a vet has to know about multiple types of animals or about all the other symptoms and conditions that pets can have. But I will know some things that vets do not know about feline diabetes and will happily share vet journal research that people can pass along to their vets.

Thanks for the compliment Perry.

 

this is such an important reminder. i lost count of the times we "reacted" to the pre-shot numbers at the beginning.

we use the remarks part of the spreadsheet for tracking this kind of thing, in addition to the food. things like if kit initiated play today or if she chatted w the birds. oh, and about the food part of remarks we also try to capture times when she needed more encouragement to "finish her plate."
it's really helpful to look back and realize that there are a lot of good days. it's easy to "over remember" the more trying ones.

 

adding prayers!

 

Don't want to jinx it but im a little happier today, Brady seemed to be in good spirits, ate very well, bugged to go outside, played on the patio, good day, now if we can just get his bowels in order, that's the part that has me worried...he is back on the metronidazole twice a day. Slow and steady hopefully wins the race!! His numbers got down a little bit, but then back up to the low 400's. So took Debs advice and he is now on 1.75U. Hopefully that does something, I just hope we find that right dose.

 

You WILL find it! Its a marathon not a sprint and since Brady has other issues it may take a little longer. You are doing a great job for Brady KEEP UP THE GOOD WORK!

 

Thank you so much we are trying so very hard....

 

All paws crossed here for Brady.

Sometimes, it's 2 steps forward, 1 step back dealing with sick kitties.

 

Pretty much the same numbers as yesterday...Let me know if I should probably jump up to 2U

 

Patience Pat. You want to hold that 1.75U dose for a few more cycles, to see if it is working for Brady.
Brady has only been on this dose for 2 cycles. You want to hold it for at least 6 cycles, 3-4 days, to see if it's effective. Rushing the dose changes may mean you bypass the proper dose.

Do try to get at least 1 test in the PM cycle, after the pre-shot test. A before bed test can be a good one to get every night.

 

Sorry Deb, forgot to put that in this morning, I updated his PM number I took last evening...

 

Hey, I chalk things up like that to "senior moments." Have enough of those types of forgetfulness constantly.

I'm in the over 60 "baby boomer" generation.

 

LOL, im headed to 57 so not far behind....I needed that laugh today....All this between the virus, my kitty, not seeing family and friends, especially my grandson is taking its toll....

 

Do you use Skype or Zoom or something else, so you can at least have visuals with your children and grandson, family and friends?

I'm doing a daily email with 2 good friends, and we call each other once a week. Not the same, but at least some contact back and forth. It's so hard not being able to see each other in person though.

 

Oh yes we all facetime and talk, but obviously not nearly the same....Vacations have been cancelled, camping trips have been cancelled and it looks like future family vacations are quite possibly going to be cancelled. We have a big family trip planned mid June to NC beach area, first one we ever really planned and it doesn't look promising.

 

@Deb & Wink @JOJI and Kit @jt and trouble (GA)

Ok guys, someone please help me out....Could this be a misread on my ReliOn prime, didn't post on the SS just yet...So I took his BG and it was 102, went out and played on the patio, Brady chased around some stuff cause the wind is blowing, hung out there for a while, he was trying to chase birds...Waited like 40 minutes and retook, it jumped way up to 346...I know he was very hungry but Im not sure what to think of that 102 reading....HELP!!!

 

Ok, please test one more time Pat.
Could have been a bad test, that 102, could have been a bad test that 346.

We want to double check before you give him insulin.

 

I'd love to be able to help but I cant give dosing advice. I think it might depend on what it ate before that 120 reading. When I use to get an "off" reading I would retest immediately (but youre past that point now). Once in a while it would be off. Hang on the others will chime in.

Ahhh ty DEB!

 

Retook again 381

 

I wonder if I have a bad meter, now im really going to be a mess.....UGGGGH

 

Test yourself. Fresh lancet, fresh strip. It's a really quick way to test your meter. Side of the finger, it will sting, trust me I've done it plenty of times. Lots of nerve endings in our fingers.

If you have not eaten, it should be <120 or so. In the mid 150's if you have eaten and are not diabetic.

Go with the 381, it's closer to the last test you got. Correct for this time. Go ahead and give Brady the insulin dose.

 

My wife volunteered, lol....it was 109 so that was right....Ok but my thing is, could he jump that high in 40 minutes...He didn't eat anything....I did give him his insulin so I will test later to be safe....

 

428 at +2 here we go...Will check before I go to bed

 

Three cheers for your wife volunteering to be the test subject and verify that your meter was accurate. That 109 is a very good reading for a human. Tell your wife (name?) that she is not diabetic.

Pat, it's more likely that the first test, that low BG test was a "bad" test.
That can happen if you get too little blood on the test strip.
That can happen if you get too much blood on the test strip, and smear it on the end of the strip.

Yes, the number could go up that fast, without food. Some cats BG levels rise very quickly at the end of the 12 hour cycle. It's possible that Brady is a cat that gets slightly longer duration from the Prozinc insulin. The duration can vary from 10 to 14 hours in cats.

If you ever get a BG test that seems out of line, test again right away. For future reference.

 

not sure if it's the same with your meter, but our alphatrak2 came with a "control" solution. since the solution expires in a few months once open, we just test the meter using the solution every couple of weeks. somebody told me that a new bottle of control solution is stupid expensive, so once ours expires we might resort to the human test protocol from time-to-time.

eventually you'll probably want a backup meter. i think that's an idea we got from the hypo kit checklist.

^jw

 

Another day of change, good changes...Brady had a very nice bowel movement today, solid, light brown, a little greasy, but im very happy, lets hope it stays that way. This is day 2.5 since starting the probiotics and metronidazole, im thinking its helping. Now today his BG was also encouraging, he just tested at 73, I checked and then rechecked his numbers to make sure the meter is correct, I got 73-71-77. All in the 70's....Not sure what color or what you guys think of that. Thoughts??

@Deb & Wink

 

Yeah for good poop news! We cheer about the strangest things here sometimes, but that is good news.

Those BG numbers are all in the normal non-diabetic cat range <99 (the greens). Nice safe numbers for +8.

Normally, if you were following the SLGS Prozinc dosing methods, those 70's would mean a dose decrease for Brady. But you test enough, that I think you could use the MPM (Modified Prozinc Method) and hold that 1.75U dose for a bit longer. Until you see more BG numbers < 99 (the greens). I'd like to see more than 1 mid-cycle number <99 (green) before reducing the dose.

Would you be able to test the same amounts that you are doing now? Do you have enough test strips on hand?
Are you willing to try that other MPM dosing protocol?

 

Im assuming what you mean by MPM is stay on the 1.75 U, the only time I really don't get a lot of testing is at night, last night I passed out in the chair and crawled up to bed exhausted.....But yes I do test pretty good.....

Maybe if you could explain that a little better to me since its a new term that I haven't really seen used before? That may help me out better...Im sure its somewhere in all the notes from all the different pages on this forum but if you could explain it to me it would really help.

The one thing I did notice, he has been drinking a little more today, not sure if that is something with the medications or what.....low BG shouldn't make him thirsty right?

 

Yes, I mean stay on the 1.75U dose for a bit longer. The BG levels would be allowed to drop lower at mid-cycle. You would "feed the curve" to keep the mid-cycle numbers more steady. Dose adjustments are made based on different criteria than the SLGS method.

MPM (Modified Prozinc Method) is explained in the
Prozinc / PZI Insulin Support Group (ISG) in the Sticky PROZINC DOSING METHODS

If you print that out and read it, it explains it very well. About 1/3 of the way through that link is where it starts to talk about the Modified Prozinc Method (MPM for short).


No, low BG's should not make Brady thirsty. But warmer weather can make a cat drink more.

 

Its freaking cold here today...but did have the heat on....ugggghhhh

 

Cold here in coastal MA too, plus very windy all day and the rain has started again. Hope my internet connection doesn't flake out on me.

 

heyhey @Irish Pat haven't seen you or brady around lately and no spreadsheet updates last few cycles.
hope you are doing ok
^jw

 

Im here, thanks for checking in on me....I updated Brady's SS last evening....Going good I guess...Vet apt on the 15th went ok...Vet recommended a fructosamine level check, it came back at 575, she said that's high but we are working on it...His pancreatitis numbers came back as well, 4.4, she still wants him on cerenia to hopefully get that lowered to below 3.5 which is the normal range....I looked it up and that 4.4 is in a gray zone area indicating not positive or negative....so I don't know....Im just glad its not real high. He is holding his weight at about 16 1/2 lbs which im very happy about. His bowels have been good. He is only on the cerenia and fortiflora probiotics as far as medications, other than the insulin....

Did have a bad day the other day, dropped the prozinc on a tile floor...and yes it busted so had to run quick to the vets to get another bottle...not what I needed at this stage of the game.....cant have that happen again.

I am making a change, both cats are only going to be getting fed twice, once in the morning and once at night right, both times before Brady's shot times. I think it will take a little time until they adjust to this but I tired that yesterday and his numbers were really good, not exceptional but good....We are doing are best to get the hang of this and I hope this will help him. I have to get over the fear of giving him a shot with low numbers he started out at 137 PMPS and jumped up to 437 at +4, I only gave him 1U instead of the 2U. Im just so scared about that and the hypo situation.

Again, thanks for checking in on me and Brady, hope everyone is doing great!!

 

Any comments on any of this would be appreciated, lol

 

Pat, I cat sit for people. I dropped an almost full vial of Lantus insulin on the tile floor in their kitchen. It shattered and I did not have any spare insulin for their cat. They said "no worries" and I still pet sit for them all the time, for the last 7 years. (Not during this covid crisis. Not comfortable doing cat sitting for people yet.) I felt so guilty, and waved my usual cat sitting fee, but they paid me anyway!

Try putting some bubble wrap around your vial. Or a piece of that foam pipe insulation, cut down to fit. Or even lots of layers of plastic wrap.

Yes, shooting those low numbers can be scary. But you know how to home test, you have your hypo kit al lready to go, you have the support of members here to help you out during a low numbers situation. You have your vet on call so you can call and ask them what to do.

You've got your support network.

As long as you are able to monitor, you can keep Brady safe. As long as you know when to use the low carb food, the medium carb food and when to reach for the high carb food and maybe some corn syrup and honey, you're good to go.

Part of the reason Brady is running high, is that skipped shot prior to the vet appointment on 4/15. Not sure why you skipped the shot. Did the vet suggest that?

p.s. Was composing my reply, when you did your reply, asking for comments. See above.

 

i saw that too in the ss and was curious about the reasoning. i see the shot at +5 that day and a normal PM shot schedule following.

 

Yes the vet told me to hold off on the shot and no food due to the blood work being completed, only thing that thru me off, which I didn't do, was they said to give him a shot when we got home and then his regular PM shot at his normal time in the evening....There was no way I could do that, that would have been only like 7 hours apart or so I held off on giving him a full dose and only gave him .5U.....

 

See my reply to Deb....I was confused by the vets orders, but didn't follow them to scared

 

You know the funny thing about this Pancreatitis diagnosis is his numbers were never really high, the high end of that test is 3.5, the highest he was, was like 5.2, then the next test was 4.5, and now he is at 4.4.....The vet said they see cats as high as 20 or better, so that has me a little baffled as well....

 

I think I would have suggested that you give a half dose of insulin in the morning, before the vet appointment.
Then you could have given Brady the full insulin dose in the PM cycle.

I can understand why the vet may have requested no food if there was anesthesia involved for the appointment.
Fructosamine does not require fasting.
For the pancreatitis tests, fasting is preferred but it's not essential.
Not sure what other bloodwork was done, that required fasting.
Even a simple CBC is better done fasting for 6 hours before.

p.s. Pat, this thread is getting long. Would you please start a new one and link this old one in at the top.