Dosing Advice 1/25 MooCAT+23 309 Should I go ahead with drop dose?

I feel like I should give drop dose to Moo since he hasn't eaten in 6 hours and BG is 309. He stayed in the Blue until +15 178. If I give it to him now I can monitor until +6

 

Yesterday's condo

I linked it for you.

If you shoot, do you have the ability to monitor? Did you pick up more HC foods?

 

I can monitor until +5.5 then I have to leave. I'm stalling him for food right now and the time I have to monitor is getting shorter. Just tested him for preshot again 290- ETA-No higher carb foods I could not get to the store. Also he needs pate that is higher carb or he won't eat much at all. I can't find anything on Dr. Pierson list that is pate and high carb

 

Can you give him higher carbs when you feed and shoot? Then he will start higher before the onset.

@MrWorfMen's Mom

 

I do have 7% carb food

 

I see Mandy has already provided a link to yesterday's condo.
For future reference, copy the URL of your previous thread. Then on the new thread, click on the little paperclip in the tool bar and paste the URL into the box and click on Insert.

Mandy, I'm concerned that giving him insulin today might result in a repeat of yesterday. AMPS is virtually the same and part of it could be a bounce from yesterday's shark hunting. Unless I could monitor him through the cycle, I don't think I'd chance it. I'd really like to see what he does without insulin for a bit longer.

 

I agree. That's why I also suggested giving higher carb (MC or HC).

If you have just the 7%, I wouldn't shoot. Do grab a couple more tests before you leave for data then post for advice at PMPS.

 

Okay, just fed him. He was driving me nuts for his breakfast. So i'll skip and get some tests in.

 

In my opinion, this continues to happen, and you struggle to get Moocat up, with very low numbers on an AT2. Back on this post, it was suggested to withhold insulin for a couple of cycles, and I think since the pattern of dropping continues to occur, you should not give insulin and see what you have for numbers over the next few cycles. http://www.felinediabetes.com/FDMB/...ocat-amps294-2-226-4-99-5-75-6-57-at2.209604/

It was asked whether you are testing for ketones, not sure if you provided an answer to that.

 

I tested back when you asked on another thread. No ketones.

 

I can't afford the expense of dka.eta and I don't think moo could handle it and recovery.

 

Thx for the link instructions!

 

That is certainly something to experiment with but even that scares me a bit because he didn't seem to be particularly sensitive to the carbs and BG barely moved with honey or 17% gravy yesterday so I'd still want to be able to monitor a cycle with the combo of insulin & higher carb food.

 

I understand your concern, and taken from one of the information stickies, "The basic recipe for developing DKA = an insufficient supply of insulin + inappetance + infection OR other systemic stresses." That is why testing for ketones is important.

I was trying to highlight that consistently getting down to low 40s on AT2 can be quite serious, my thoughts about trying to see how things work without insulin for a few cycles were as a result of my concern that at some point consistent low numbers like this, combined with the fact that it has been hard for you to keep the numbers up in a safe range, which could actually put you in a position where you will need to go to the vet. I had linked a previous post so that others who are here today like Mandy and Linda can get a broader picture of the history.

I feel like I have I offended you in some way, so I apologize if that is the case.

 

Hey there , what a day yesterday
Just checking to see if Moo has had any previous DKA episodes.
If not, and he is eating well and doesn't have any underlying infections he should be okay to hang out in higher numbers for a bit until this bounce clears so we can see what he's doing off the one drop of insulin. That being said, for peace of mind I would test him for ketones. I understand your fear of Moo getting DKA, it's no joke.

 

Looks like Christie and I "cross-posted". Hi Christie

 

I still vote for a short trial of no insulin.

 

I threw the idea out there yesterday because of what I saw on Moo's spreadsheet.
I thought it would be a good idea for people more experienced then me to check out Moo's spreadsheet and take into consideration yesterday's events.
Maybe @Marje and Gracie can take a look as well...

Here is my original post:
"I might be totally crazy, but I'm wondering if Moo needs insulin. I was looking at his spreadsheet a lot today and wondering if the high numbers he's had lately are all bounces from going too low on the one drop. This would be a scenario I have never seen before, but it I think it would be worth asking someone very experienced about.
I will reach out to a couple of people when I see that they are on the board and ask them what they see/think."

 

Oh My Gosh! No! You haven't offended me at all! I appreciate your input!

 

There was a cat here a few years back who was somewhat similar and they played around with meal/snack times, carb level, you name it and the CG was finding it difficult due to the constant monitoring required and unpredictability. Last I remember she had stopped shooting unless BG was up significantly but she stopped posting so don't know if cat went OTJ or not. I'll see if I can find the SS.

 

Can you see if there are any science diet non prescription foods that fit for high carb? I know the pate I used to feed was pretty high.

 

Interesting!
The other thing I was wondering was if there has been a change up of food for Moo -post-diagnosis.
We've definitely seen cats get off insulin very quickly from time to time with just a change in diet. I.E. switching to wet, low carb only from previosly eating higher carb food for most of their lives

 

Hi, yes I can check that- So if it is, would this be the emergency boost food or his regular diet?

 

He used to eat Blue Freedom Indoor Chicken it has 7% carb. Then he had a spurt of inappetance when diagnosed so I tried the fancy feast which is 3-4% carbs- have to put phosphorous binders in all of his foods. Vet told me to stick with poultry. He eats the FF most of the time now - (likes it more) but on occasion I do crack open a Blue Freedom - he seems to like it for a few meals and then doesn't want it.

 

If Moo still needs insulin it will be very important for you to have a higher high carb (at least 20% and above) around to help steer/ pull numbers up when need, like yesterday.
Honey & Karo are important of course as well for emergency's and times when you need an immediate bump up in numbers but their influence wears off very fast.
It is also helpful to mix in with your low carb 3% & 7% foods to keep Moo from dropping super fast. You can play around with the mixture to make something more like medium carbs 11% - 16%

ETA: These are the carb ranges according to info I got early on from Chris & China:
Low is under 10%
Medium is 11-16'ish
High is 16+

*Please keep trying to find some HC food in the (20% and over) range for situations I've discussed above.
I just wanted to correct my post so I don't give out wrong carb range info to others who may be reading along to learn something

 

I just checked the spreadsheet for the other kitty but it wasn't exactly the same situation. MooCat's swings are far more dramatic. The other kitty was staying mostly in blue/green/odd yellow pre-shots while MooCat is going into pinks at times and has far more yellow in the picture. Perhaps Moo Cat just has a super reactive defense system and a darn good store of glucose reserves?

 

Okay, well, that blows my theory about the change in diet being a new factor in him going low. Both those foods are low carb.

 

Hi Barbara and Uncle,
Moo has not had previous DKA episodes. He has an appetite. No infections that I know of, has IBD and takes budesonide daily. Also needs sub-q fluds (systemic stressors IBD and CKD?)
Yes! yesterday was stressful and I still feel like I haven't recovered, Moo seems to feel just fine. I think I would be bouncing off walls if I didn't have you all responding.

 

I see you skipped this AM. That's what I would have done in your place. It'll be interesting to see where he is through today.

 

That's great news and important info moving forward in crafting a plan and maybe having to experiment with not giving Moo insulin.

 

Early on, before I became a member of FDMB - I asked my vet if this might the case (reactive defense system and glucose reserves kicking in) she said she didn't think he would have that much reserve. But she now is baffled by what I have reported since and told me she can't advise me anymore.

 

LOL!!!! All the theories presented are helpful, thx!

 

Most of us have been where you were yesterday or pretty close to it. I wouldn't have gotten a whole extra year with my sweet kitty Uncle if not for the FDMB
Thanks wonderful FDMB friends

 

I like a Vet who can admit they haven't seen EVERYTHING and knows when they may not be able to be helpful for certain things.
My vet told me I knew more about FD than she did (she had not heard of the TR Protocol) and was very interested in working with me. I was very lucky.

 

Just a curiosity....do you have a good supply of AT2 strips? The reason I ask is because while the FS lite strips do work, they are not as accurate as the AT2 strips with the right code. Yesterday the FS strips read higher than the AT2 strips and that is the last thing you need with a cat that is so prone to diving and then hard to get back to safe numbers. I know the AT2 strips are expensive but not as expensive as a trip to the vet so for safety sake right now, I strongly suggest you use the proper AT2 strips if and when insulin is resumed.

@Majan Moo Cat is on Lantus.

 

He won't eat the honey in food mix. But I just checked @majandra suggestion regarding high carb food (science diet) - they have between 22 and 33-34-35 carb food. now i'm checking where to get it.

 

I have about 45 strips left of the AT2 and 49 FSL strips- I agree with this. I don't want to chance it considering he is predicatably unpredictable these days. I'll order some more AT2 strips.

 

You were lucky- My vet seems to have retreated a bit from me because she was pushing for me to increase to a unit early on and I told her that the protocol indicates that I should decrease. Since then I have reported the decreases in insulin by email and she does not respond, only responds to non-diabetes questions.

 

Hmmm not ideal...

 

It will be interesting to see how Moocat does without the insulin from yesterday's AM cycle. Hope you got a good night's sleep last night.

 

Still pretty tired but doing better than yesterday. I have taken a few tests today. And I was happy to see a drop from 290 to 235 but just tested him when I got here and he was@287. Wondering if I should wait one more cycle or not.

 

I would wait. Moocat is still bouncing from the few hours in lime greens yesterday.

 

You think so? ETA It probably would be better to see more before I mess with giving him insulin. He's only been on insulin for about 10 weeks and I haven't enough experience.

 

I guess the BIG question is, Are you going to experiment with not giving Moo insulin for enough cycles to see what happens when he clears this (probable) bounce
OR keep trying to figure out how to give him some insulin safely?
I was hoping you would get a few more opinions from some of the most experienced people on the board for their take on the sitch!!!
ETA
I would probably wait if it was my cat (who had no DKA history) and I was testing for ketones

 

I think I'm going with you on this. I'm going to skip tonight and do some more tests. I think moomoo and I are in a tricky situation. So tonight no shot and see what comes up. I'm probably going to be asking for help with whatever comes up. I don't have any high carb pate yet. I have to check that out tomorrow. Went to a pet store by my house and they didn't have science diet. He's been running on 200s and 300s with the bouncing on insulin. Are those values more dangerous off insulin even if they are the same numbers? I was curious about that.

 

I don't think you need to worry about the high numbers. I'm sure we will discuss what to do tomorrow after seeing what Moocat does with no insulin for over a day. Do you have a Petco near you? I think I've seen Science Diet in their store.

 

Yes, that's where they have it. I have to go there tomorrow. It's about 20 miles away. Thanks for your input on the high numbers.