Checkers PMPS 130

well not the funnest night on record. Checkers really seemed off so I only gave him a token dose last night. i think i'm running into problems with the insulin and the BG reduction from switching to wetfood both hitting at the same time as it seems to be driving back towards a possible 1 unit dose. I'm hoping last night gave him some time to clear out his system abit. He does seem somewhat better this morning but i just got up so we will see how it goes.

I know i shouldnt be jumping around on my dose but last night the numbers i was getting were considerably lower then normaly even at pmps+2 he had not raised up to normal levels. it seems like he actually stayed in somewhat decent levels all night so he doesnt seem to have missed most of his dose. Hopefully i can now stabalize him but we will see. It was a hard choice last night, i tried waiting and that didnt help, I got up every 2 hours last night to check on him until his BG raised to a point i was comfortable enough to leave him until morning.

last thread

 

You'll probably see the effects of that reduced dose today or tonight. Glad Check is feeling a bit better today.

 

The beginning is tough but it does get easier especially as you get to know how Checker's does. The flat blues last night were wonderful but you have to do what your comfortable with. With Checkers being newly diagnosed and making the change to wet food he'll likely come down the dosing scale pretty quickly. You're in the right place here with the L&LL family. Keep asking questions and I found it very helpful to look at other kitties spreadsheets with gaining the comfort level of seeing those "normal" numbers. Hang in there.

 

i must admit i'm finding it hard, everything was fine and then its almost like his pancreas just randomly woke up from hibernation. All of a sudden his BG is staying low and his dose was too high. I'm wondering if at this point I should just reset back to 1 unit and restart everything. I don't want to be messing with his dose but looking at his numbers it's hard to say i made the wrong choice lowering his dose, although he wasnt happy yesterday his BG was actually pretty damn good all day. If i had stayed at the 2 unit dose i think he would have been in deep trouble by now, since its only been 2 weeks or so since diagnoses i hope i have a litte flexibility with his dose. I have spent time looking at other peoples sheets and they in general seem to have a slower effect then chcekers is having. i've seen alot of sheets where it took over a month to get anywhere near checkers current numbers so something is working, i may be going about it in a nonideal way but still it seems to be working.

 

I'm not experienced or comfortable giving any dosing advise. It may be beneficial for you to put "dosing advise" in your title with the "?" prefix just to get some others feedback. You're doing great!

 

Wow, 40's again?
Hopefully you've given him some high carb food, preferably with syrup or honey on it.

Let us know how Checkers is doing.

 

yep did 2 tests both 45 exactly. gave him about 2 spoons of gravy with some dry food on the side to hopefully keep him up alittle longer then the gravy would on his own. I just can't keep him in good levels now. I would say that lowering his dose is causing him to go low but surely it should do the opposite? Looks like i will be going down to 1 unit after this.

No idea whats going on anymore. losing my mind lol. i did not expect him to even be this low. he was pretty high when i gave him his dose and the dose he's on is the suggested starter dose for his size i think so it shouldnt be too much and he didnt seem too off other then he was sleeping a fair bit.

 

At this point I feel that some may suggest holding off insulin for a few days and seeing how he does.
Removing dry food from his diet may have been enough to control BG's alone.
Please, wait for others' opinions. But if he were mine, I would see if he can keep himself under 150 120 without insulin.

 

he just ate alot. i guess when i woke him up for his test he realized he was low also. he ate a good mix of gravy, wetfood and dryfood so I think he will be ok in an hour or so. i will do 30 min tests until then and if he shows any signs of being worse i'll get out the syrup/honey.

I have no idea what is going on anymore but thank god i decided to hometest and lower his dose when i felt like it. him being on nearly double the dose hes on now is scary to think about. pretty sure this forum saved him since i would never have thought he was just bouncing for that first week and a half.

 

Starting insulin therapy is usually reserved for after a diet change in a newly diagnosed kitty, unless they're DKA.
Our vet had us change diet before starting insulin, as sometimes diet change can control BG's alone. It is so good that you were testing him at home.
I think what you are seeing is the dry food leaving his system slowly and his insulin requirement is becoming very little to none. Some cats can be diet controlled from the beginning and Checkers may be one of the lucky ones.

The biggest thing here is getting that dry food out of the picture, completely, for good. You can use high carb canned if he gets too low, it raises BG's much faster than dry.
You may see his BG's spike high for the next 2 days and then come down again as this food today leaves his system, so keep monitoring closely if you continue to give insulin.


Edited to add:
FDMB definitely saved Pimp. We were going up and up on the vet's advice until I came here. You can see where everything changed on his spreadsheet. I have learned sooo much from this wonderful place in such a short time.

This is the best place you never wanted to be

 

the dryfood was cut out his diet cold turkey but i've given it to him 2 or 3 times to raise his BG. My only concern with the gravy is i've seen peoples charts and it seems to only boost BG for an hour or 2. Dryfood seems to raise it for the entire cycle but if its doing damage in the long run i'll cut it out. i need to go buy more high carb wetfood today after he gets in a good place. Any suggestions on a specific type? anything with extra gravy I imagine?

thanks for always being here for me. i do appreciate it andy!

i told my vet the day he was diagnosed that I would be switching him to wetfood immediately but the vet didnt seem to care. She certainly didnt tell me to hold off on insulin for awhile due to it. i'm constantly saddened by just how bad of advice my vet gave me, she also never did xrays or anything so I'm tempted to go get his thyroid checked and check his pancreas for tumors also.

 

You're welcome Luke. There was always someone here for me the first few weeks when I was in your shoes. I'm just paying it forward.

Many here use fancy feast gravy lover's for their emergency HC. All the flavors are around 20% carbs, and we usually pop the top and press it in to squeeze out the gravy. Then you just feed the gravy(about a tsp at a time), not the meat. It raises BG's pretty quickly that way, and you're not filling kitty up, in case we need him to eat more HC.
The beauty of HC wet food is the short life of it...so you can make sure kitty can hold their BG up without food influence.
The damage from the dry food comes when it wears off days later, and BG's drop out like that.

eta: you're in canada? Not sure if the same foods are available there or not. Lots of canadian members here though could help out i'm sure.

 

Do you have holiday plans, would it be a good time to see how Checkers does without insulin? That way you could enjoy your holiday without worrying about him tanking out on you again.

 

...and I wouldn't worry about x-rays (i think it would actually be ultrasound) or other expensive tests just yet. If the rest of his bloodwork was normal, he most likely is diabetic. He may just be one of the lucky ones that doesn't need insulin.

 

dont get my hopes up lol I don't tend to have the best luck so it wouldn't fit but i sure would be happy to have a remission sugar kitty although i would feel bad not having to give him shots after seeing all the care people here are giving their cats lol.

I'm now seeing how much more accurate my meter is at low levels. i did 2 tests in a row nearly an hour ago and both results were identical and i just did another 2 tests and those 2 tests were identical too. definitely alot more accurate with low levels.

i have no plans for the holiday other then a few hours work and getting checkers under control.

 

I tend to agree about the food change having a major impact. BTW, my vets have almost killed Doodles previously so I understand your sadness/disappointment with the vet. FDMB has been our only savior.

One thing to consider is that these lows are likely still a result of the depot from the 1.75u and the 1.4u. It could take a full 4-6 cycles for the depot drain so lowering the dose does not always immediately show results in higher BG's. This is the trickiest part of Lantus. Here is the sticky http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

Add "Dosing Advise" to your title please so it catches the eyes for others scanning. Surely they will take a look and provide good guidance. Skipping a shot or 2 to drain the depot and taking out the dry food all together might be a good idea to see where he really is.

 

Feel lucky/grateful....it's OK and we all have our fingers crossed for you!

 

This is not really true. We have had kitties come on here that were on dry, they started insulin and numbers came down but they did not go off insulin. It's a fine line because a caregiver can't wait too long to start insulin or it puts the kitty at risk for insulin resistance (and potentially DKA if infection is also in the picture).

If you have gotten Checkers off dry food, I would suggest that you don't use it for raising the BG if canned food will work. Dry food doesn't hang around for days if you just gave a little to bring numbers up but why give it if he will eat canned? It's certainly an option to control low numbers for members whose cat hasn't made the transition and won't eat higher carbed (which can be anything higher than what they normally eat) can food.

Checkers might not need something really HC....my Gracie responded to just 12%....you will have to figure out what percent carbs brings him up as cats have different carb sensitivity. The bottom line is keeping him safe.

I also would not stop insulin at this point. Karen is correct that this could be the depot. I think it's a little early in the cycle yet to tell what you should do tonight. I think if he is still running lower or you need rest, skip tonight's shot and drain the depot a little and then restart tomorrow. The dose would depend on what he does tonight. If he starts to come up and stays up without food, check him at +11 at the latest and post for dose help. We can then decide if he would do better at 1.25u or 1u.

 

No someone who is qualified to give any definitive advice, but I am on my second cat doing this. I think the dry should go. Just go. Throw it away so you won't be tempted.

If your cat will eat wet food, feed wet and don't mess with the dry. Diabetic humans, if they are having a low sugar incident, don't eat two doughnuts. Or they shouldn't anyway. LOL!

My first kitty was brought into remission without ever using syrup, honey or any dry food. When he hit high 30s to mid-40s, we gave him 1teaspoon--literally 1 tsp--of 15%-25% carb wet food. And not all gravy because the carbs are concentrated there. Of course, we watched him carefully and would have revised that behavior if we needed to. And your kitty seems to want OTJ soon.

We want to keep our cats safe but not overreact either and that's not always easy, I know, especially in the heat of the moment. I find myself thinking, even now. uh oh. Should I or shouldn't I? I trust someone will correct me if I am wrong, but a couple of tsps of gravy and some dry food is a lot of carbs and not what you are after.

Another thing to think about is that you are here to benefit from the experience of others. The old timers who have seen a lot base their advice on what happens under certain conditions, so jumping around on the dose means your situation does not match those conditions.

You might want to scroll down in this, my condo from the other day, for a long post by Marje. It is something to think about. I think you are doing great. Such quick progress is wonderful!

 

@Marje and Gracie thanks for clearing that up. That was just my personal experience with my vet. Edited to avoid misinforming future readers

 

Just one other thought....if you could please note on his SS when you converted to canned and then, as you did on 12/21, when you used dry to control numbers, that would be very helpful.

Check out Scooter's SS when Linda totally dropped the dry on 2/18/14.

 

Very impressive

 

looking at my SS from last night I think maybe I should just drop down to that 0.5 that i tried last night and use that as a starting point. It's starting to look like his ideal dose may be closer to there then i realized and it looks like a pretty safe number. I was really worried about him last night so was setting my alarm clock for every 2 hours and his BG stayed fairly stable and best of all safe.

i also think their may be some benefit to not just stopping cold turkey and I think that dose is low enough to be a good middle ground if i do end up needing to take him off.

 

There's no way to know that based on just that cycle.

 

What Marje said. You've got to understand the depot is all wonky right now from all the dose changes. The dose doesn't do its proper job until it has been shot 4-6 times consistently.

 

sorry i hadnt noticed your recommendation, i've been stressing out abit and must have overlooked the second paragraph you wrote. I'm fine with waiting it out and seeing where he is at at PMPS. I take sleeping meds at night which makes testing hard during that cycle so maybe just not dosing will be best but i'm cool waiting. thanks for the advice.

 

Looking at a single cycle and making a decision can be like looking at a single frame from a movie, you know? Is it a comedy? A drama? You may be able to say it probably isn't a musical but you need a bunch of frames before and after for context. good luck with your decision.

 

Hello fellow Canuck - the Fancy Feast Gravy Lovers are available here. As an aside, we have another Maritimer here, @ShelleyP and her kitty Tip. He also started out too high and has been seeing a lot of green lately.

As f0r dose, I agree with Marje. What Karen (@Doodles & Sour Pea ) said about the depot is so true. The higher dose can affect 4-6 cycles after the reduction and that means the 2.0 U (almost twice what you are giving now), could still have an influence today. Skipping one dose is a way to help get rid of the depot, if you are exhausted and need to sleep tonight.

 

I was cursing the depot today with Doodles 48 saying....time to drain depot as no reducie happening yet! Once I learned and understood the depot it made things a lot easier. Thanks to Wendy, Marje, Julie and so many others!

 

just did his pmps and it had raised up to 130, if anyone has any suggestions based on that it would be great, i will read through thread also and see what people suggested.

 

I think i'm just going to skip tonights dose and hopefully it will help to drain the depot as many have suggested. I'll post in the morning before i give him his morning dose to see what people are thinking.

 

Is this your shot time, right now?
Edit:looks like an hour ago

 

could be. its been around 12.5 hours since last dose

 

just trying to figure out what time you'll need eyes in the morning. There aren't likely to be a lot of peeps online.

 

worst comes to worst i'll just give him a slight decrease and go with 1 unit, thats what he started at so it should be ok. I think at this point i may preferr a couple high days then more low days. I think he would appreciate it too, these low days are certainly getting him down.

 

Hi Luke I just wanted to pop in and say hi! Thanks @Wendy&Neko for introductions! I'm from New Brunswick and Tip and I have been visiting the forum for just a couple of weeks. Tip and I had a similar experience to what you are seeing. We didn't go into the 40's but that's only because I freaked out and fed him before he did, but he came down from really high numbers super fast once we got him properly treated and off dry food. Had I been checking every 2 weeks as suggested we would have been in big trouble! I think the biggest thing that was really hard for me was learning to look at the big picture and not react to just one reading. My experiences may be different than yours, and you are in great hands here. so really I really just wanted to say "hey there neighbor".

Where are you located?

Shelley

 

That sounds like a good plan. I agree with the others that he would probably be better off with some insulin...I just wanted to give you the opportunity to de-stress if you needed to. I should be around in the morning if you have questions.

And yes, there is another mantra around here:
"Better too high for a day, than too low for a minute."

 

I think you hit the nail right on the head with this one, @ShelleyP .....I remember when Skooter was first diagnosed, learning not to react to the one snapshot was difficult. Once I started getting more tests in (and at different points in his cycle), I started to be able to see the bigger picture and it made those quick, scary snapshots not so scary and I learned not to have a knee-jerk reaction to that....

I SUCK at patience, but I suck a lot less after about a year and a half of this dance

 

hello shelly, it is nice to see a local maritimer here. Hopefully both our cats will get off the juice and have good winters next to a heater. Mines been hanging by the heater for about a week now, i think he loves it more then me lol. It sounds like you have the same vet expierence i did. I think my vet wasnt aware of the depot effect, she didnt even want me using my own syringes which ment no half units let alone quarter units.
I'm located in south coast new brunswick

I could still give him a token dose if you think I should, i can make up the time over the next couple days.

 

I like the idea of letting the depot drain for a night.

 

I did another BG and decided to give him 0.75 dose for tonight an hour late. I agree he should get some but I'm wary of giving a full dose. Hopefully this is a middle ground while the depot runs out. I have plenty of time over the holidays to make up the time if i want.

 

That's fine, you hold the syringe

His next shot will be due 12 hrs from now. No less.

 

sounds good, hopefully he will have good numbers tonight like last night and we can have a happy night together before getting back on the crazy train tomorrow. Have a good night, hopefully i will do the same

 

Shooting late is fine....just remember that you need to wait 12 hours before shooting again

You can work your way back to your "chosen" shot time by shooting 15 minutes early per cycle for the next few days until you're back on the schedule you want to be at

 

for your spreadsheet...
you shot at +13, the count always starts from the last shot.

Have a good night Luke.

 

Luke

Just for future reference, if we stall, we usually shoot the full dose because stalling can act like a dose reduction. So stalling + a reduced dose can give a bit of a double whammy. The other thing to remember is that when you shoot a reduced dose, you might not see the results u til later in the cycle...or tomorrow's cycle.

I am absolutely not criticizing what you did, just giving you information for the future. I hope you rest.

 

Hi!!
I am pretty new here but I went thru some similar issues as you--take a look at Drevons ss and you can see where we increased and the first few days were great -safe greens then he tanked…the depot kicked in. (We were on tight reg and I am now going slow--I thought I was prepared …. I wasn't)

I ended up skipping a few shots and starting over at 1 unit BID-Not saying this is what you should do as I am not qualified to give advice for others but I do know my boy very well and I knew (and was pointed out to me) that we needed to find a dose that worked for both of us. I know it is overwhelming .. I really do -- but thank goodness (and these wonderful people) that we have found a dose that seems to be working and I can get some sleep-I found it very helpful reading other posts and taking it in as so much wisdom is floating around in this forum. Be nice to yourself --we all do the best we can and want the best for our kittys-

 

Crikey checkers has been keeping you busy! Hope you get some sleep and he surfs safely. Diving kitties sure are scary.