Exciting. . .no scary, night ahead!

VanGogh tested at 34 tonight at +3! This did happen once before with him at +3 on Oct 24-2013 with him never showing any symptoms & he did okay, but it still scares the crap outta me! Not knowing any better, I got rid of all high carb food on diagnosis, but did buy just a few cans of mc food. . .Friskies Prime Filets which he loves! I gave him some of the prime filets as well as a small handful of Royal Canin Protein Preference dry. How often should I test him the rest of the night? I'm open to phone calls anytime. ***-***-****. After he ate, he cleaned himself & is curled up sleeping right now. I do have raw honey in The Fridge. . .Thanks in advance, Renee

 

Feed 1-2 teaspoons higher carb - Karo, dissolved sugar, jelly, etc.
Wait 20-30 min
Test
Repeat until rising and over 100

Gravy/carbs wear off fast. You'll be up for several hours with Lantus's long action, so put on the caffeine.

If you have flour, mix it with some water over heat and and mash in some of the medium carb. Cooled, it is gravy like.

No more dry food - it expands and may provoke vomiting.

 

Here are the instructions for dealing with low numbers. You don't want to use dry food to raise numbers. It takes a while for the dry stuff to work and it takes even longer for the effects to clear our. You can always add several drops of corn syrup (Karo), honey, maple syrup, or even sugar water to Van Gogh's food to get the numbers to come up.

Please remove your phone # from your post. It's likely that you will get a ton of phone spam (and who knows what else). Members of this community are not the only ones who read this Board.

 

Hi Renee,

I removed the phone number from your post. If you want to share it, please do so by PM to any other member you want to share it with. But to protect you from unwanted phone calls, (like Sienne said, anyone can read this board), I thought it best to remove it.

Carl

Have you gotten any other numbers since the 34?

 

Thank you Carl for removing phone number. Someone else had told me they once spent 4 hours on the phone with an FDMB member, so i thought it was okay.

I rubbed some raw honey on his gums. . .no way he wanted it. Also mixed flour/water with some mc food & he ate that. Now quite sated, he is cleaning himself. Will test again in a few more minutes. Mad at myself I only have 1 more can of mc food! Maybe have to run to Walgreens to see if they have any. I think they're open 24/7. . .

 

What does mixing the food with flour & food accomplish? Digest quicker?

 

I think it is just to make a gravy if you don't have any at home.

I'd use the karo, honey, or syrup with his regular food.

 

OMG! Don't know how it's possible so quickly, but after rubbing raw honey on gums, & giving mc food mixed with water & honey, I got a reading of 92! Should I feed again now & test again in 20 minutes? Thank you ALL for your help & patience!

 

Yes. Keep monitoring - Lantus lasts a very long time in the body. You're going to be up at least until you're past +7 (nadir).

Mashing it together is so it tastes good enough he eats it more readily.

 

Thanks, Marje. I'll see if he'll eat his reg food with some honey in it. He sure didn't want it by itself warmed up!

 

The honey/karo wont last long and yes it can bump it up pretty quick.

 

You are feeding small amounts right...a teaspoon or so at a time? Remember you don't want to overfeed as you will likely need to keep feeding and don't want him too full so that he won't want to eat if you need him to.

How far apart are you testing?

 

Okay, I'm feeding him too much. . .testing every 20-30 minutes. Just took the food away from him & the look on his face! Well if looks could kill! Going off to sulk in his "cube". Will test in about 10 minutes. . .

 

If you had gravy food you would be feeding a couple of teaspoons of gravy which is where the most carbs are...and not much food.
Does your medium carb food have gravy?

Which variety of Prime filets is it? I just checked and some of them are pretty high..up to 19%.
Looks like several sauce and gravy varieties. If so, work mostly with the gravy which will help most with bumping your numbers up
Maybe a teeny bit of the food...but save the most and can decide when best to use that. Karo alone wears off quickly...but a couple drops mixed in with food will last longer.
The one more can you have is probably plenty.

 

Numbers so far:
82 pmps; 0.25 U Lantus
119 +1
34 ~ +3, about10:50-ish pm
94 ~ +3.5

 

Sorry. . .my phone won't hold charge & this old computer keeps freezing!

I have Friskies Prime Filets with Ocean Whitefish & gravy. 1 unopened can & probably 1-2 teaspoons in opened can. Going to do another test now. (12:07 am)

180! Should I keep feeding? His regular numbers aren't usually this high?

 

That's the high carb kicking in; it wears off quickly.

Feed 1-2 teaspoons of low carb w/ a bit of syrup or gravy.

Stay vigilant; you've got to stay on this until past nadir.

Numbers so far:
82 pmps; 0.25 U Lantus
119 +1
34 ~ +3, about10:50-ish pm
94 ~ +3.5
180 ~ +4 about midnight

 

Ok. . .will go back to low carb.

 

MIX, please. The High carb will wear off fast!

 

Mix the hc & lc together with some honey? Or just low carb with honey? Sorry,I'm a bit confused now. . .

 

Either is fine.

The HC will help sustain the higher glucose.
The LC will start building a protein base to support it later.

 

Okay, I'll do lc with honey & see what kind of number I get. Thank you soooo much for your patience & help to a worried Momma!

 

Just keep going nice and steady. Be calm so your kitty doesn't stress out.

Snag another test on the half hour, please.

 

I'm staying pretty calm & VanGogh. . .just thinks I'm nuts as he's trying to sleep & wonders wth is wrong with ME!

 

Yeah. I spent a night like this with Spitzer the first week.

BTW - its always a good idea to repeat a test any time you get one that is unusually low or unusually high. That 34 might have been incorrect. Better safe than sorry, though. And better too high for a day, than too low for a moment.

 

Well if this had happened the 1st week, I either would've been stupidly/blissfully ignorant . . .or crazy!

12:30 = +5 & we're now at 187. . .I assume that's good that he's holding a little more steady now?

 

Numbers so far:
82 pmps; 0.25 U Lantus
119 +1
34 ~ +3, about10:50-ish pm
94 ~ +3.5
180 ~ +4 about midnight
187 ~ +5

Looks OK; I'd go with the low carb at this point and check in another 30 min.

Or do what Marje suggests below.

 

I wouldn't keep feeding him at 180. Yes, the carbs will wear off but this is pretty high for it to be attributable totally to food. I'd also let him go for an hour on the tests.

 

I just reduced his dose to .25 as of yesterday. Should I continue with that in the morning. . .even if his numbers are low? Say 50-100? Or should I think about skipping a dose? We've skipped 2 PM doses in the recent past. (Recent? Only dx Sept 13, 2013!)

 

FYI:
I don't see the exact name you mentioned on the food chart.
The one I saw that is close is: Prime Filets With Whitefish & Tuna in Sauce. That one is 18%.
Probably still considered MC but on the high end.

easily HC with Karo mixed in. You will have plenty of food if you are feeding small amounts and not overfeeding.
At some point you will be able to go back to LC.

You need to get past nadir and have at least 2 consecutive rising numbers that are not food influenced.

I have barely looked at your chart to see when Van Gogh's usually nadirs.

 

He may be rather high at his shot time tomorrow from the higher carbs tonight, so you'll have to wait and see.

There isn't a lot of mid-cycle data to know where his 'usual' nadir would be (to me), so I'd plan on staying up to +7 and the 2 rising, non-food influenced tests.

 

Thanks bettyandhank, yes that is the food I have. Ocean whitefish & Tuna in sauce.

VanGogh was diagnosed 9/13/13, but I didn't get ss til 9/30/13 & it took me some time to get hang of testing, so not a lot of numbers. I don't see the rhyme or reason it in myself, but it does seem his nadir is around +3? I thought most cats experience nadir at around +7? Sometimes I feel like I'm wading thru heavy mud trying to understand all these numbers. . .certainly NOT MY strong point!

I'm confused as to how I should proceed in the morning with dosing. . .we just reduced to .25 yesterday We did skip 2 pm doses in the past day or two. But I'm thinking that's not good, either. . .cause of the need to build reserves?

 

It takes roughly 3-5 days for a dose change to stabilize at the new level.
eta: if its going too low, though, you get to reduce again.

Tonight's low could have been a bad test or it could have been a real value; too late to tell.

Think of it like walking up a down escalator.
Go too fast, and you walk off the top.
Go too slow and you're back at the bottom.
Start with a little burst of speed to get up part way, then keep a steady pace and you'll stay at roughly the same level.
Slow down a smidge, then resume the steady pace and you maintain at a slightly lower level.

The later is what a dose reduction is like.

 

Renee

I'd like to summarize the approach to low numbers for you. If you get a number in the 30s like tonight, the goal is to get him up above 50 as quickly as possible. So you might want to give a tsp of HC GRAVY with a couple drops of karo, honey, or syrup. If you have no HC Gravy, then just put a few drops of karo/honey/syrup in a tsp of LC food.

It takes about 30 mins for food & karo to affect the BG. If he's in the 30s, You can test in 20 just to see if he heads up. If, next test, he's in the 40s, give him a tsp of HC gravy. There is no reason to give more karo if you have the HC gravy and he's coming up. If you don't have the HC gravy, give 1 tsp of LC with a drop of karo (again, if you don't have HC gravy). When he gets above 50, then try 1 tsp of LC food, test in 30. Once you get him up above 80, you can, generally, stop feeding and test in an hour.

Even if he's up around 100, don't get complacent until he's been without food/gravy for at least two hours and is still rising.

That is all a very general summary but we really tailor it to the cat and the caregiver as we go. If you got stuck alone, though, that should help you.

On the dose, I would go ahead and reduce him to 0.1u in the morning and see how he does. We don't mess around with 30s and the fact that he got into the 30s on only two shots, tells me we need to listen. You can always go back up if the reduction fails. I'll find a pic for you on what 0.1u looks like.

BTW, we don't wait for a dose to stabilize on a reduction.

 

Do you want to get a +6 or wait to the +6.5?

 

Depends on the last feeding. If Renee fed at +5, I'd let him go until +6.5....I'll be up.

If she didn't feed at +5, I'd check at +6.

Renee...did you feed and +5 and, if so, what and how much?

 

Thanks MarjeandGracie! Gonna print up your suggestions, as that's pretty much what I've done tonight & it seems to be working. I'm going to test him again in another 20 minutes, & 1:30 a.m. will = +6 test. I imagine most, if not all of you have been in my shoes at some point & hope you have an idea of how grateful I am for all the support!

 

I did NOT feed at +5.

 

Ok..good that you didn't feed and it will be good to test at +6 to see if he's going up or down.

The depot from a higher dose can affect up to six subsequent cycles and so you may see him come down and run low even for another cycle or two even when you reduce the dose. Normally, that is the reason we wouldn't take back to back reductions. But, as I explained, you had a skipped shot which drains the depot. So a 34 in the 2nd cycle of a dose after a skipped shot requires reduction.

 

Looking OK for the moment. Apologies, but I need to crash before I fall asleep on my keyboard (!@#$ sleep disorder)

Thanks Marje and the others who stopped by.

 

And here's the 0.1u image:



Thanks, BJ. Good job. Sleep well.

 

Thanx for that image Marje! Going to test again in a few minutes.

 

And thank you BJ for "rallying The Troops"!

 

Renee

Also...when you get back, could you please take down the 911? Thanks!

Waiting for the +6 test.

 

Just got a 194 for the +6 test! Think it's safe for me to go to bed & set alarm for TWO hours?

 

I was planning on doing a Curve tomorrow. Should I still go ahead & do that?

 

Yes...I think you can do that but please be sure you are able to get up. I wouldn't be surprised if he's back down tomorrow.

It's up to you if you do a curve. We generally recommend spot checks as more effective but if you want to see what he does, it's if, by any chance, he bounces up, it's not a good idea to do a curve. You want to do it when his numbers are more like what they've been.

Good job tonight. Hope you rest. I won't be up in two hours but some of the east coast people might be on.

 

Thanks for advice on Curve. I hated the thought of having to poke him again every 2 hours tomorrow. Maybe next week when he's hopefully stabilized again.

I hope I removed 911 Icon. Went to edit & put NONE for icon. . .not too Sugar Cat savvy & definitely not computer savvy!

You ladies were all a calming lifeline tonight. Thanks to ALL of you!

 

It's what we do we all pay it forward.

In order to take the 911 down, you have to go back to the very FIRST post in this string, open it by clicking edit, then click on the none, then submit

Thank you! :smile:

 

Thanks again. I hadn't hit sumbit! I'm ready for bed & VanGogh is playing! Something he's done VERY LITTLE of since I found him!

 

I think you mean West Coast...No?

This southern CST girl is going to bed. Marje you are still around for awhile, yes?

Renee Van Gogh is on mission. Not interested in being on insulin much is he?

great job tonight!

 

whoops,,,,,,,duplicate!

 

I'm also going to bed. . .for two hours at least! No, VanGogh doesn't seem interested in being on drugs! I've fallen so deeply in love with him the 4 months that I've had the honour of being his Momma! I don't care if he's OTJ or On TJ! He'll ALWAYS be my Sugar Cat!!!

Thanks again to all for being my calm in The Storm!

 

911 gone Thank you!

He's one lucky guy that's for sure. Glad he's happy

Betty...I did mean east coast cause some of them are up early sometimes. We west coasters usually hit the sack about midnight or so unless someone needs help.

Good night ladies. Sleep tight.

 

At +8, I went to bed with a reading of 199.

I did get up around 6:15 am (Eastern Time) just to check & he was fine & wondering wth all the fuss was about.

This morning AMPS was 88, so I'm going to shoot 0.1. ( Or as close to that as I can, lol!) I was going to do Curve today, but I think I'll eithre put that off another week if he remains stable, or just do 3-4 spot checks during the day whenever possible.

 

Wow didn't you guys have fun last night....a PJ party!!!! :lol:

I bet you need a lot of this this morning!

He is looking great - 0.1 units is a hair away from OTJ.. keeping my paws crossed!

 

Yeah, too bad I don't drink anything with caffeine! Just got 104 at +3 & only did that csues that's when he usually seemed to drop. . .but rising slowly for now! I'm gonna give us both a break & run out to do some errands for a coupla hours!

 

Morning Renee. Glad you got at least a LITTLE sleep.
I see you shot this morning..that 88 PS is a low one so be sure to keep an eye out since he has sure shown he can respond to these itty bitty doses.
This kitty is on a mission. Hopefully he will have an easy surf.

 

He seems to be climbing up slowly & hopefully safely! Thanks!!!

 

So glad to hear that!! And I'm so thankful for the caring folks on here who helped take care of you & VG!

 

Looks like VG is doing great after his exciting night! (Who came up with THAT term!? Scary is more fitting!) lol!!!

AMPS = 88
+2 = 96
+3 = 104
+6 = 92

Probably checking a little more than I need to? Just being at bit cautious as he dropped a bit at +6. Maybe wait til + 9 to test again. Poor baby. I so hate poking him so much! But he's SUCH a Trooper!

 

YOU did!

Actually these are all pretty much the same number allowing for meter variance. He is having a nice little surf in beautiful numbers.

Data never hurts...you can always learn something. He surely hasn't bounced...lucky you.

looks great!

 

Lovely!!!!

I think you are NOT being too cautious. With that 34 last night, his depot is full and that effect can last a few cycles. So I believe it's good for you to watch him as you are.

 

Here's a question: do you think the 34 was a valid test initially? ie was his glucose in the +/- 20% range?

 

I don't know BJM. I did get a 34 reading the previous week. . .again, with no symptoms. I don't understand/know how to answer the 2nd part of question about +/- 20% range. . .we're staying with 0.1 dosage & see what happens. . .

VanGogh NEVER showed ANY kinds of symptoms. Relaxed, sleeping. . .next day even playing a bit.