Corn Litter = Carbohydrates? (And other Q's.)

Discussion in 'Feline Health - (Welcome & Main Forum)' started by billr, Aug 3, 2013.

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  1. billr

    billr Member

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    Jul 29, 2013
    A newbie here. We use Worlds' Best Cat litter, which is corn based. From what I've read on this board, corn is generally a bad thing for food because it's high in carbohydrates. The corn litter is kind of dusty, so I know he gets some on his fur and feet, which he eventually licks off. Do you think there's any significant amount of carbs in the litter? Should we switch to something else?
     
  2. Re: Corn Litter = Carbohydrates?

    Bill,
    I can recall a couple of people who found that their cats were eating the World's Best which explained the higher numbers they were getting since switching.
    If you think it might be a cause of higher BGs, you can try switching as an experiment.

    Maybe a pine/ceder style?
     
  3. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Re: Corn Litter = Carbohydrates?

    If there is a Tractor Supply Store, or similar, near you, you might try inexpensive compressed wood pellet bedding. It disintegrates when wet so you do need to scoop regularly.
     
  4. billr

    billr Member

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    Jul 29, 2013
    Re: Corn Litter = Carbohydrates?

    Thanks for the replies. It answered my question that if he ate enough it could affect his BG readings. We'll checkout some other types of litter. (I don't he actually sits and eats it or anything, so he's probably not ingesting much. Still, corn is fairly high is sugar, so probably best to avoid the potential problems.)
     
  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Re: Corn Litter = Carbohydrates?

    Welcome Bill and Gizmo to the FDMB, the best little message board in the universe to help you with your newly diagnosed sugarcat.

    Let us know what other questions you may have. Keeping them all here in your first post helps with continuity for those of us helping you.
     
  6. billr

    billr Member

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    Re: Corn Litter = Carbohydrates?

    Thanks, Deb! Gizmo was started by the Vet on 2U of Lantis, 2x daily, not quite 2 weeks ago. At the same time we switched him from a mostly dry kibble diet (Professional brand) with some FF as a treat, to dry and wet DM per the Vet's recommendation. A few days later, I found the board here and starting reading. We dumped the DM wet and dry and started transitioning him to all low carb wet food. After trying a bunch of different brands and flavors, the only one he really consistently likes is FF Classic Turkey & Giblets. We also made a transition from the Professional to Nutrisca Dry food. The Nutrisca was recommended by our locally owned pet food store for its very low glycemic index (8 for Salmon, 9 for Chicken). Grain free and made with free range chickens. No carbohydrate listing though, and not on any of the pet food charts. (Transitioning to all wet food has been very hard, so that's the reason for continuing to feed some dry.) He did like the Nutrisca, but subsequently I called the company to ask the carb percentage and they told me it was 23-25%. Still too high, so we have ordered some Young and Alive 0 carb, which should be here this week.

    In the meantime, he has been on an all wet food diet, so we may not need that YA except maybe to put out when we'll be gone during the day. He's also a nibbler and doesn't like the two or three time a day feeding schedule.

    Doing a BG on him was initially very difficult. He was a feral kitten when adopted and didn't like his ears touched, so sometimes we would only get an PM BG reading. He has been getting better about, which is good.

    Shortly after diagnosis, the Vet went on vacation and my wife didn't feel comfortable giving him 2U so we dropped it back to 1U 2x daily. (After reading more on the start low and slow procedure, I found 2U was kind of high for a starting point. In the Vet's defense, when we brought him in he was in ketoacidosis, so she probably wanted to bring him down quickly.) Anyway, after about a week, with his AMPS and PMBS BG readings in the high 200's we dropped him to 3/4U 2x. Yesterday, he was at 275 +6.5 from AM shot and 225 at PMPS. We gave him about 1/4U last night. This morning he was at 156 AMPS, so based on the advice of don't shoot if below 200, we skipped the AM shot. Are we doing the right thing? Is it too much to hope for that his pancreas could be turning around so soon, with the low card diet?

    He was overweight before being diagnosed (and lost weight from not eating much during the ketoacidosis). Another contributing factor is that our original Vet (not the one we're working with now) gave him a steroid shot a month or so ago to treat what he said was an allergy causing him to cough a lot. So, all those factors (dry kibble, overweight, steroid shot) obviously contributed to his diabetes. In addition, I think his BG was probably on the high side even before the steroid shot.

    Sorry for running on, but I know sometimes having all the background information can help.

    If he is still at or below 200 tonight, do we skip the PM shot, too? What if he is in the low 200's (e.g., 210-220)? I would guess if he's back up in the mid 200's or higher, we would shoot 1/2U or so.
     
  7. Deb & Wink

    Deb & Wink Well-Known Member

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    That's the only food my foster cat Wink would eat at first when I switched him from dry to wet food!!!!! :shock: :eek: :shock:

    With the history of ketoacidosis, you need to be doing ketone testing daily. Do you have ketone urine testing strips from the drugstore or pharmacy counter? Here are some urine catching ideas that might work... https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

    Dosing changes for Lantus insulin are made on the nadir or lowest point in the 12 hour cycle. The tests at pre-shot are to make sure your cat Gizmo has a high enough BG to shoot the insulin. The pre-shot tests are not used for dosing adjustments.

    With the ketone risk and past issues with ketones with Gizmo, I think we need to teach you to shoot low. I would not reduce the dose again at this point. I think your cat will need some insulin for tonight. In fact, I think you need to go back to the 0.75U or even the 1U dose. That is based on the 1 nadir number you gave us.

    Do you have more mid-cycle test BG numbers you can share with us?

    It's a little early after only 2 weeks for the pancreas to have healed. We want to see normal numbers in the 50-130 range before we would stop the insulin. The fact that you have changed to a low carb diet is a big factor in controlling the diabetes. Also, since this case of diabetes may, only may be steroid induced, once the steroid is out of Gizmo's system, he may go OTJ (off-the-juice, insulin being the juice) into a diet controlled remission.

    Do you have plenty of test strips on hand, some HC (high carb) food, karo or honey or another simple sugar, willing to stay up to monitor if needed? What is your usual shot time?

    We can help guide you through shooting those low numbers if you would like.

    Thank you for all that info. It helped me to see more of the situation and make some better suggestions.
     
  8. billr

    billr Member

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    Jul 29, 2013
    Thanks, for the advice, Deb. Unfortunately, we have no more mid-cycle numbers. Until just the last few tests, he was difficult to test. We will try and get some more, now that he is calmer about having his ears handled and poked.

    We had no idea we should be continually checking for ketones, even when the BG is not above 300. We do have some of the combo ketone + glucose test strips and have checked a couple of times and ketones have been negative.

    We do have some emergency supplies on hand - plenty of glucometer test strips, some gravy wet food and some Karo syrup.

    You think he will be high tonight, and I suspect you are correct. In that case we would give the 3/4U he was getting. But what do we do if he isn't? What if he is still in the 150 region? Given that we don't have more than one nadir reading and we don't want to send him into shock. I know having a complete profile is best, but we will at least try and get some more mid cycle numbers to have more information to go on. That's also really interesting about determining dosage based on the nadir reading. That wasn't completely clear from the information I had read.

    P.S. We actually had another sugar cat quite a few years ago (2000). At the time the Vet had him Humulin (don't remember the variety; it might have been N). I remember doing a little research at the time about insulin for cats, but don't remember reading anything about Lantis. For whatever reason, I did not find this discussion board either. I wish we had all this great information when Neo was alive. He was difficult to keep at a stable BG level. Anyway, we have learned a lot from this website and really appreciate all the advice the members provide.
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    My kitty was one of those that loved to snack on World's Best corn litter. We switched to Blue Buffalo walnut clumping. Very similar size, texture and clumping and she has no interest in eating it at all. :D
     
  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Are you giving him a low-carb treat for being so good about being tested?

    The shoot/no shoot threshold of 200 is a general guideline used with new members here on the Feline Health forum. They may be struggling with testing, switching to lower carb food, learning to deal with the newness of the diagnosis and the stress of caring for a newly diagnosed sugarkitty.

    When a cat is prone to ketones, has had ketones in the blood or urine tests, has been hospitalized for DKA (diabetic ketoacidosis) then the general guidelines do not apply. For special situations like with your cat, it's more important that your cat get insulin to prevent those ketones. It's also very important to keep a ketone prone cat hydrated because fluids help to flush out the ketones in the urine. One situation that sets a cat up for ketones is not eating enough, not enough insulin and an infection ( can be hidden, think teeth).

    Over in our Lantus TR forum, the shoot/no shoot threshold is 150. As you gather data, you learn to shoot lower and lower and hopefully get your cat OTJ.

    I think you need to give insulin tonight, even if the evening BG pre-shot, what we call the PMPS, is around that 150 mark. We need you to hold off on feeding, hold off on insulin and retest in 30 minutes if the number is below 150. We want to see if the number is a rising or a falling number. You could also test at +11.5 (30 minutes before your normal pre-shot test) and then again at PMPS to see if the BG number is a rising number.

    We need you to take up all food, 2 hours before your pre-shot tests. We want a BG reading that is not influenced by food.

    I'd like you to tell me when your regular test, shoot, feed time is for this evening. I think you need to be guided in testing and managing the low numbers.
     
  11. billr

    billr Member

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    Jul 29, 2013
    We don't have any low carb treats (yet). For the AMPS and PMPS, we let him have something to eat after the test and shot.

    We have been testing and shooting around 7am/7pm PDT. Food time is after shot and again when he's hungry (usually around +3 and +8 +/-). The last two readings I gave (last night's PMPS and today's AMPS) were with no food at least 2 hours prior, per your instructions to someone else.

    Is it ok to give him extra water directly (like via a 3mL needle-less syring) if he hasn't been drinking a lot of water? We do add water to his wet food.

    BTW, his ketoacidosis was (so far) a one-time thing at initial diagnosis and he did have an infection and temperature at that time, which has since cleared up with a treatment regime of Clavamox.

    The website is still acting squirrely for me with timeouts and such, but I will try and post his +11.5 and PMPS numbers when we have them.
     
  12. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, it's ok to syringe small quantities of water.

    A lot of times, the extra water added to the wet food as well as the water already in the wet food, cause kitties to stop drinking water from a water dish. That is because, they are getting all the water they need from their food.

    I've seen 2 of my 3 cats take one drink of water from a water dish in the last 7 months. They are getting all they need from their canned food.

    You can check for dehydration by lifting up the scruff. Does it return back to normal quickly? (not dehydrated) Or does it stay tented or slowly go back down? (dehydrated)

    You can also press on the gums with a finger and release. How long does it take to pink back up with blood again?
     
  13. billr

    billr Member

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    Jul 29, 2013
    Thanks, again, Deb for your help and encouragement. As you suspected he was way tonight with 415 at +11.5.
     
  14. Deb & Wink

    Deb & Wink Well-Known Member

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    Let's see where he is in another 30 minutes at PMPS.
     
  15. billr

    billr Member

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    Jul 29, 2013
    My wife let him eat after the test because he was hungry (since it was high), so a PMPS BG at this point would be invalid.
     
  16. billr

    billr Member

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    Jul 29, 2013
    We went ahead and gave him 3/4U. Will see if we can get BG before bed (it would only be about +3.5).
     
  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok, understood. You gave him food after the +11.5, did not test again at PMPS. Will get another test at +3.5. If that numbers is much lower, like 50% or more lower than the +11.5, you should put up the 911 post icon on your very first post in this thread and ask for help.

    I'm not expecting that he'll drop real low, not with this high number, but cats can do the unexpected.

    If you can get a +2, that may tell us which direction Gizmo is headed. If it's going to be an active cycle, normal cycle, or very active cycle.

    I'd love it if you would be willing to set up a spreadsheet and link it into your signature. Gives us a way to follow along with the BG numbers from cycle to cycle and make suggestions.

    This post from the Tech Support forum tells you how. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

    If you need help, ask. There are a couple of us here in Feline Health that set them up for people. You do need a Google account first though.
     
  18. billr

    billr Member

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    Ok, will try and do a +2. Can you elaborate a bit more on the different cycle types you mentioned (or point me to a link). I realize it's getting late back in MA. Your last posting has a timestamp of 6:58pm PDT, but it just showed up for me between 7:45pm and 8:10pm. I had the browser open to this page doing occasional page refreshes.

    Iv'e got a Google account, so will fill out the spreadsheet.
     
  19. Deb & Wink

    Deb & Wink Well-Known Member

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    There isn't a link to the active cycle types. It's just one of the benchmarks that often works to predict where a kitty might be headed based on the +2 number and how it differs from the pre-shot number. It hasn't been formalized anywhere that I know of. Just something I learned in my time here and made some notes about.

    General Guideline regarding pre-shot number and +2 relationship.

    If +2 is a lot more than the pre-shot, it's probably going to be an inactive cycle. You probably can head off to sleep or work.
    If +2 is similar to pre-shot, it's likely to be a normal, active cycle Lantus cycle. You probably want to get a +4 and a +6. Leave out some extra food if you go to work.
    If +2 is much less than pre-shot, it's likely to be a very active cycle, with possibly an early drop. More testing and monitoring required. Definitely leave out some extra food, maybe even some higher carb food, so your cat has something to eat if they drop really low.

    ECID. Every Cat is Different. ECID Every Cycle is different. ECID. Every Caregiver is Different.

    So although these guidelines work in a lot of cases, they may not hold true for your cat or hold true for every cycle.
     
  20. billr

    billr Member

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    Jul 29, 2013
    So, his +2 (more like +2.25) reading was 310. From your description, that sounds like either an active cycle or between normal and active (not knowing when his nadir is actually occurring). Will try for a +4, but don't know if it will happen as my wife (primary poker and care giver) is very tired and may not be able to stay up another two hours. In any case, we will leave out some extra food for him.

    If we don't get a +4, any general guidelines for the AM shot based on his AMPS level (150/200/250/300/350)? We can try for a PM +11.5, as well as the AMPS (both with no food). I'll make an effort to come home from work around his AM +6 time, too, so we can get a BG to help determine the pattern.
     
  21. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Set the alarm to wake you/wife up for a test?

    +11.5 415
    PMPS n/a 0.75U
    +2.25 310

    So a 105 point drop or roughly 50 points an hour. Lantus usually has onset by +2 so we are seeing the effects of this shot. There is still a lot of room to drop, but that is a fast drop. I'd feel safer if you were able to get one more test before bed. Is that possible?

    As far as a dose for tomorrow, I'd suggest staying with the 0.75U dose for a full 6 cycles. We will probably need to increase but only time and some more BG readings will tell us that. Unless we catch a BG under 50 tonight. That would be a reduction.
     
  22. billr

    billr Member

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    Good morning. Unfortunately, no mid-cycle reading last night. This morning, at PM +11.5 he is 115. My wife is uncomfortable giving 0.75U and wants to do 0.50U or even 0.25U. We will check again at AMPS to see what the trend is.
     
  23. billr

    billr Member

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    Jul 29, 2013
    97 at AMPS. I will get all the numbers into a spreadsheet today.
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

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    Ok, I'd suggest 0.5U if you haven't already shot. Good to get another test if you have not fed yet. So we know if it's a rising or falling number.
     
  25. billr

    billr Member

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    Jul 29, 2013
    We shot at 0.25U. We plan to get a +6 BG today.

    As I mentioned in the background post, we had another sugar cat quite a few years ago and he had several incidents of symptomatic hypoglycemic shock where we had to rush him to the Vet. I know Lantis acts differently then the Humulin we used back then, but it's hard, especially for my wife, to overcome that fear of shooting too low.

    What she wants to do now is start over and go low and slow, with 0.25U consistently for 6 cycles and see what his BG is like, then bump him up to 0.50U for 6 cycles, if necessary, etc. That will help build consistency and confidence. Gizmo's behavior (the 5 P's and his overall activity level), seem to be best when he's in the mid-100's even into the low 200's - even though I know that is on the high side of typical.
     
  26. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Ok, SLGS protocol it is. We'll have other people that use that protocol. SLGS Protocol

    Hypos with clinical symptoms on Lantus insulin are rare but they do occur. We understand your caution and concern. Our number 1 goal here is to help keep your kitty safe. I kept a copy of the hypo instructions in with my hypo kit.

    You might want to print a copy of these instructions, in case you think your cat may be hypoglycemic. Sometimes the board is having issues and you can't get help here or the experienced folks are just not around. There is a Facebook group also. https://www.facebook.com/groups/62167000201/ It's more social but can give advice in an emergency also.

    It's not until a cat drops under 40 that you need to be concerned. We try to keep a cat at 50 or above, for a safety margin. We know how to feed and when to test to bring those BG numbers back up. Most people on this board can walk you through a low numbers situation and prevent those hypos. Edit your very first post in the thread, put that 911 icon on your very first post and yell for help. Those 911's really catch our attention.

    If you do not see anyone here on the Health forum, look over in the Insulin Support Group Lantus TR for some help. There are often folks on over there later at night when Health has become quiet.

    If someone answers your post and suggests you shoot with low numbers, that person has committed to staying with you until you are out of danger, or they have found someone else that can take over and give you the support you need. If the person answering your post says they are going to find someone else to help, they have either sent a PM or posted over in Lantus TR to get some eyes over here to help you out. That's the way we work here. You are not left to twist in the wind or manage this on your own. We are here to support you all the way.

    Hope that information will help you in the event of any low number situation.
     
  27. billr

    billr Member

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    Thanks, I really appreciate your patience and all you and the others do here. I already printed out the Hypo checklist and have it posted. :) Both my wife and I feel the postings and assistance on this board have saved Gizmo's life and put him on the right track, even if we may still be a little overly cautious. :)
     
  28. Hi Bill,
    Any chance you could get an earlier test, like +2 or +3?
    Here's why - as you know, Lantus and Humulin are quite different. And I can certainly understand any hesitation to shoot low numbers given your history with Humulin. And Lantus can be shot on lower numbers, as the dose is determined primarily by the nadir rather than on the preshot number....

    My concern today is the trend of the numbers. Gizmo went from 400+ last night and dropped to 97 this morning, and it looks like it was still dropping at AMPS.

    Even though you only gave .25u, with Lantus there is still the "depot" to consider. A prior, larger dose can still have residual effects on the BG even when you reduce the dose. There usually isn't an "instant" reduction in the effect of a dose like you would expect with an insulin like Humulin. So you could see more drop in the BG even from a tiny dose than you might logically assume would happen.

    A +2 or +3 test is a great "early warning system" to catch falling numbers early.
     
  29. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    I second getting another test before you head off to work. You shot on a dropping number. Gizmo may be headed even lower.

    If you can't get another test, leave out plenty of HC (high carb) food for him to eat during the day.

    We usually recommend you stall and not feed or shoot until the number is rising, especially with those low numbers and not much history to know how low Gizmo may drop.
     
  30. billr

    billr Member

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    Jul 29, 2013
    Thanks Carl & Deb. I can't do a +2, but +2.5 or +3 is doable. He was ravenous this morning, so ate quite a bit after his shot, which should help. I just updated my signature with his SS (such as it is) and will post again after his next BG test (between +2.5 and +3).
     
  31. Deb & Wink

    Deb & Wink Well-Known Member

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    We'll take the +2.5 or +3 then. If it's a lot lower, you may need to carb him up, i.e. feed HC (high carb) food to raise the numbers.

    I have read only access to your SS now. Looks good.
     
  32. billr

    billr Member

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    Jul 29, 2013
    His +2.5 is at 57. We fed him some high carb dry kibble which he ate, although not sure how much to give.
     
  33. Do you have any higher carb gravy style canned food on hand? This serving of dry is OK, but it takes dry longer to take effect.
    57 is still fine, and you did the right thing feeding him. Can you test again in 30 minutes?
     
  34. billr

    billr Member

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    Jul 29, 2013
    Yes we have some gravy wet and are feeding it to him now. Will retest in 30 minutes.
     
  35. Deb & Wink

    Deb & Wink Well-Known Member

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    Only about a teaspoon of the gravy only. We do not want him to fill up too quickly.
     
  36. Good:)
    Don't go overboard with the food. Just a tsp or so. You want to slow a drop down, but you don't want him to "scarf and barf".
     
  37. billr

    billr Member

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    Retest at 30 minutes from previous test or from now when we fed him?
     
  38. 30 after the gravy is fine.
     
  39. billr

    billr Member

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    Thanks!
     
  40. No problem, Bill. I'll be here until you don't need any help. If you have any questions, don't hesitate to ask.
     
  41. billr

    billr Member

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    Jul 29, 2013
    81 at 1 hr after previous test, 30 minutes after a bit of dry and 20 minutes after gravy.
     
  42. Good, so it worked! ;-)

    AMPS ~ 97
    +2.5 ~ 57
    +3.5 ~ 81

    At this point, you can put away the gravy and the dry.

    A tsp of low-carb is okay if you want. And a test in an hour. You just want to try to keep the numbers from dropping back down, while at the same time, not make them rise up "artificially" from higher carbs.
     
  43. billr

    billr Member

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    Jul 29, 2013
    He's alert and seems to be doing well, so out plan is to skip the +4.5 and test at +5.5. Is that ok? My wife doesn't want to overdo the poking.
     
  44. Has he eaten since the gravy a while back?

    If not, then maybe a spoon of low-carb and then you can wait another hour.

    I understand not wanting to overdo the pokes. But also keep in mind that most of the time, you can't judge where his BGs are at just by looking. I've seen people post here that got 30s on their meter and had no clue before the test that kitty was that low. I don't think that's the case right now with Gizmo, but just something to keep in mind.
     
  45. billr

    billr Member

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    Understood. Yes, he did eat some more after the gravy. His +5.5 will be in 25 minutes. (1:05pm PDT).
     
  46. OK, good. I would think you'll see a number like the last test or higher at 5.5. If so, he should be okay for a while, and not need more pokes. But let's see what the number is first.
     
  47. billr

    billr Member

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    Jul 29, 2013
    Now 113 at +5.5. When do you recommend the next test?
     
  48. I think you're good until +11. The reason I think that test might be useful - it looks like he's climbing. If you get a +11 and a PMPS, you should see the same trend, and that's what would be logical (as opposed to this morning where he seemed to be falling at shot time). Getting both the +11 and PMPS will let you know for sure.

    You handled all of this great, Bill. And let your wife know she has good instincts. :smile:
     
  49. Oh, one other thing. You can go up to your first post in this thread and change that "911" to one of these - :mrgreen:
     
  50. billr

    billr Member

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    Jul 29, 2013
    Thanks for hanging in there Carl. Should we still observe the 2 hour fast prior to PM shot? You don't think it will continue dropping at this point?
     
  51. billr

    billr Member

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    Jul 29, 2013
    Any ideas on how long we need to be concerned and closely monitoring? The 12 hour cycle, 24 hours, other?

    P. S: my wife said thanks for the compliment, Carl, it made her feel better.
     
  52. billr

    billr Member

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    Jul 29, 2013
    SS updated. BG 135 at +8.
     
  53. Just got back home from a photo-taking trip. ;-)

    AMPS ~ 97
    +2.5 ~ 57
    +3.5 ~ 81
    +5.5 ~ 113
    +8 ~ 135

    Very nice numbers!

    Yes, I would still withhold food for the 2 hours prior to the PM test, but he can eat up until then. No, I don't think dropping back down at this point is likely. He might not climb much more either.

    Well, I think that if you decide to go from this point with a logical dose and one that you are able to stick with for 3-4 days at a time, your concerns won't be as high. Lantus works best if you can do that.
    Going forward, of course you would test at every shot time, just before feeding. And on days when it works with your schedule, you would want to test around +6 if possible, as that is the "typical" time for nadir. And the nadir is how the dose is adjusted.

    In my opinion, good times to test besides shot times are
    Either +2 or +3. So that if you are going to see a good bit of drop from the insulin, you get an "early warning". Like today. He didn't go like "dangerously low" on that 57, but had you not seen it, and not fed him, he most likely would have dropped into the 40's I think.

    And around +6 to try to see the "low point" that typically happens around then.

    Other than that, the tests you get will pretty much indicate if more testing makes sense.

    Another great time to test is just before you go to bed. You'll sleep better knowing where the BG is at that time.
     
  54. billr

    billr Member

    Joined:
    Jul 29, 2013
    Any theories (with little information) on why he was still dropping this morning? Would that have been from the PM shot the night before being too much or just ECID?
     
  55. billr

    billr Member

    Joined:
    Jul 29, 2013
    What I meant to say was, for today episode, are we definitely past the danger zone and the need to do bi-hourly testing? You seemed to imply that in your earlier comment about testing at +11 and PMPS, but just wanted to confirm that.
     
  56. Well, you have three tests in a row showing a climbing number (food helped of course). But now you are past nadir, so the number should be on the way up (typically). You can use that 135 as a benchmark this cycle. I would expect a higher number than that at PMPS if he doesn't eat after +10.

    I think that the dose should remain small. Like maybe .5u or less. I know the data is limited to this point. But I just have a feeling that Gizmo isn't going to need too much insulin. The low carb diet has made a big difference, in my opinion.
     
  57. billr

    billr Member

    Joined:
    Jul 29, 2013
    Thanks. My wife's instinct at this point is to skip the shot tonight, regardless of reading and see if maybe he actually can be controlled with diet only, since he seems to need such a small dose. If that does not work, then start with 0.25 U and work up from there.
     
  58. Okay, that sounds like a plan. Stick with low-carb canned only. And just because he has a history that includes DKA, try to test for ketones daily. Your wife's instincts have been good so far. :D

    If he gives you numbers in the 200 range, or several numbers above 120, that would indicate that he needs at least tiny doses of insulin. You just don't want to let things "get away from you".
     
  59. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Well, I wouldn't call 50's the danger zone. More like "be on the alert zone".

    Once you have 2 rising numbers, without food influence for an hour and the numbers are over 100, you are usually ok.

    Once you are past nadir, the insulin is not going to keep pushing the numbers back down.

    There are always exceptions of course. That is why we tell people ECID (Every cat is different) and to "Know thy cat"

    He should be fine now. Don't think you need to test until the +11 and then the PMPS. Carl probably suggested the +11 so you know if your PMPS is a rising or falling number.

    We don't suggest you shoot on a falling number until you have more data on how your kitty will react. The usual suggestion on a falling low number is to stall if you can. Stalling is withholding food and insulin and retesting in 20-30 minutes to see if the number is rising yet. Stall as long as you can to fit your schedule. With Lantus, you need to be able to shoot 12 hours later if you stall. Not everyone's work and life schedule will accommodate that schedule change.

    You can always skip a shot if you need to. One of our sayings here is "Better too high for a day, than too low for a minute". Meaning, the high numbers do damage over the long term and are not as dangerous, whereas the low numbers, under 40 could mean hypoglycemia and hypos are more dangerous in the short term. You already had some possible hypo situations with your other diabetic cat it sounds like.

    Carl had you pull out the HC food because you had already given some dry high carb food and the low numbers were pretty early in the cycle, several hours before nadir. If the lows had been later in the cycle, say at +4, LC (low carb) food may have been enough. It depends on how carb sensitive your cat is also. You might have been ok with LC early in the cycle too.

    Lots of good information here for you today. Are you following what we are telling you or do you need some clarification on anything?
     
  60. mtncat58

    mtncat58 Well-Known Member

    Joined:
    Feb 8, 2013
    About the litter I stopped using it the Ants loved it, they carried piece by piece one by one down the wall board and out the house. To Funny!!!
     
  61. billr

    billr Member

    Joined:
    Jul 29, 2013
    Yes, thanks, Deb. I did learn a lot today that I will remember. We really, really appreciate all the help. There were some good reminders here for other noobies, as well. What I learned was:

    1) Do no shoot when the BG is still dropping. Wait until it starts rising or skip altogether.
    2) It really is very important to get those nadir readings when adjusting dosing. Doing anything else is just guessing.
    3) Don't panic if you do get a low or falling readings; follow the helpful hints about feeding a little hi-carb food and he/she will probably pull out of it (especially when giving Lantus).
    4) When the advice givers say they will stick by you during a crisis, it is not just lip service. They really are there to support and advise and comfort the care giver.

    Thanks again to Deb and Carl for helping Gizmo today (and everyday).

    And, on the original topic, thanks for the cat littler suggestions, too!
     
  62. Priss

    Priss Member

    Joined:
    May 4, 2012
    Hi, I bought that litter too and put it in the tray, my Priss thought it was dinner...walked up and started scarfing it by the mouthful!
     
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