? 11/28;Sushi PMPS 408 +2 245 +3.5 245 +5 232 ~ New, went low on first dose

Continuation of:

http://www.felinediabetes.com/FDMB/threads/911-hypo.207142/#post-2296089

Spoiler: Quick Reference

Last insulin injection yesterday 11/27 ~ 5 pm
4:45 am BG 42
6:43 am BG 39
7:14 am BG 49
8:23 am BG 64
8:55 am BG 90
10:52 am BG 198
2:18 pm BG 343
5:15pm BG 408
5:35 1u
+2 245

 

I didn't do much research, but I might have pricking his ears wrong. Was it the wrong area? I was trying to do it right on the vein. Also, I didn't use a lancing pen, but I feel I don't need a pen.

update 8:55am BG90

 

Well done this morning! That was quite the baptism you got and you handled it very well. How are you feeling now? A bit exhausted I'm sure.

90 is a great safe BG for now but I'd get another test now to make sure he is staying in safe range. Please let us know what the reading is now.

You want to aim for the area between the edge of the ear and the vein rather than right into the vein. Whether you use the lancing pen or not is entirely up to you.



In the meantime, I'm going to ask you to do a bit of homework so that the folks here on the Lantus board can help you in the best way possible.
At the bottom of our posts, you will see some light grey text called a "Signature". This is where we put information about our kitties and ourselves so that anyone assisting you has pertinent information to ensure you get the best help possible. It also means we won't keep asking you for the same information over and over again.

To set up your signature, click on your screen name up in the upper right hand corner of your screen. A menu will drop down and on the left side you will see Signature. Click on Signature and you will get a text box to type in. Include your cat's name, age, sex, date of diagnosis, any other medical conditions including history of DKA, the type of insulin, the type of glucometer you use, any dietary issues. You can also include your general location and your name and a link to your spreadsheet.

The signature can only be 3 lines long so abbreviations are fine and info can be separated with "|" or semi-colons. When you are finished entering your info, scroll down and click on the button Save Changes.

The other bit of homework is to set up the spreadsheet. It's easy to use and it lives on Google Drive and is viewable by anyone with the link. You will need a Google account and if you are using a tablet or phone, you will need to have Google drive and Google sheets installed on your device. The instructions for setting up the spreadsheet are HERE and THIS document will explain how to use it. Once this is set up, you will need to add the link to your signature.

If you need any assistance with setting any of this up, just holler and we'll get you sorted.

 

Wow! Welcome. So sorry you got such a crazy intro to feline diabetes.

 

Yes, it was exhausting so I had to take a nap. I will work on doc today. I'm so happy I bought the meter and strips yesterday while getting his insulin.

10:52am BC 198

 

Sushi is fine for now but obviously his BG is rising and with the history of DKA, it would be best to try not to let it skyrocket.
Are you home all day and able to monitor? Any recommendations re: dosing have to take into consideration your ability to monitor (especially given the dramatic morning you just had) and getting you onto a shot schedule that will work for you going forward if you do work during the day.

 

Yes, I'm home all day today. I work 6am to 2/3pm.

Sushi is feeling better. He just ate some food and went to the litterbox, #2 runny. Now he's grooming. I have to give him his Ursldiol 30mg.

 

Welcome, sorry about the crazy start to FD. A couple of questions to start off with. Did Sushi show any signs of hypo, or did he just have low numbers? I think I read he slept through most of it, the trooper.

How much does Sushi weigh? Is that his ideal weight or is he under weight? One of our dosing methods uses weight as a guideline for starting dose.

 

OK, I keep thinking of more things to ask.

What is your ideal 12 hour shooting schedule? We can always work back to it if we aren’t there today.

How many test strips do you have on hand and how many cans of high carb food? I want to make sure you have supplies on hand.

 

No problem, I think he didn't felt great. I woke up at 4:15 am and he was in the carrier. He struggled to get out, meowed, and was wobbler.
Sushi is very thin now at 8.5lbs, last year he was 13lbs.

I want to be able to observe sushi after his insulin dose before I go to work, so ~4:30am. My mom and brother are home but I don't think they are confident enough to test and give insulin.
Than the PM dose can be ~4:30pm

I bought a box of 100 yesterday, so I have 50+ on hand.

I don't know which wet foods are high carb yet, but I have 24+cans of FF grilled (turkey/ beef/chicken)

 

What time zone are you in? Just wondering what 4:30 is relative to now. We are from all over the world here.

 

Sorry, Eastern Time (ET)

 

No worries, the time zone differences were to your advantage last night when Liz from the UK was able to help you. Looks like shot time is in a couple hours from now. I'm leaning towards something like 1.0 units dose. Our Tight Regulation protocol method for dosing would have you use that as a starting dose provided he is on an all low carb wet food or raw diet.

What food is Sushi eating normally? The FF grilled are what we call medium carb food. Anything 15% and over on this list is high carb. The gravy lovers are a one option.

Are you testing regularly for urinary ketones? With DKA in the recent past, that's a must. And the presence of ketones would influence my dose suggestion.

 

update: 2:18 pm BG 343

He's such a picky eater esp. being sick. Today he had FF grilled "assisted" and He ate WHISKAS® PURRFECTLY® CHICKEn ENTRÉE by himself (mostly the sauce) today.

I'm giving him an all wet diet with a few temptation treats (not every day). I have the Wellness complete health in chicken & chicken and herring. He ate WHISKAS® PURRFECTLY® CHICKEn ENTRÉE today.

I do have the ketones test strips. I did not see him urinate yet but could have when I was sleeping.

 

With DKA in the recent past, eating anything trumps not eating at all. It's important to get calories in him. Instead of Temptations treats, which are high carb, next time you are in a pet food store, see if you can find a freeze dried all meat treat. Economy or larger sizes are in the dog section. You can get all sorts of proteins freeze dried. If he can handle chicken, most cats seem to love the freeze dried chicken breast, Purebites is one brand.

Here is a post on understanding the spreadsheet grid.
We use one line per day and count the number of hours after a shot. Take a look at my Neko's or other spreadsheets to get an idea. You are now about 21.5 hours since his shot?

 

~23 hrs since his last shot. (11/27 5 pm)

I'll look out for those the next time I out.
Sushi prefers eating small meals throughout the day. Would that be an issue with controlling his BG?

 

Multiple small meals are fine.

 

5:15pm BG 408

Can /Should I give hime his insulin now? and how much?

He has eating the Wellness complete health in chicken and herring

 

Yes on the insulin. If you can monitor tonight, By which I mean get few spot checks, I would try one unit. Start with a +2 test. And try to get a ketone test when you can.

 

Did 1unit and will spot check.
Thank you your help

 

Hi and Welcome. It sounds like you got your feet held to the fire this morning.

Love Sushi's avatar. He blends right into the environment!

 

Yea, it was something.

+2 BG 245

 

That’s quite a drop to the +2 test. Could you get a +3.5 or +4 test next? The +2 test often gives you a heads up on what the cycle looks like. If there is a big drop from preshot, the it’s likely to be a cycle needing more monitoring.

Just to confirm, you are using half unit marked syringes and drew insulin to the second line after the zero line? Just asking cause we’ve had a few people use the wrong line. There are pictures in the Sticky Note about dosing that might help.

 

Perhaps you can take a picture of the insulin needle with the dose you gave?

 

https://photos.app.goo.gl/3pxcRPjfEfdEcrKL6

Sushi like to eat smaller meals and he ate some before +2

Added: I will get a +3.5 or +4 test.

 

Ok good, that looks like 1u to me with the right U-100 syringe.

 

Perfect on the dose.

Sushi may have felt himself dropping, so helped himself to a snack. Snacking is OK at this point,we just dom’t want him full. In case you need to feed later.

 

A favour to ask of you, could you update the subject line with his latest blood glucose data. Something like “11/28;Sushi PMPS 408 +2 245, New, went low on first dose” or something like that. That way anyone taking a glance at the subject headings can see if you need help. To the top right, there is an Edit Title button that is visible on your first post of the day. There is a prefix there you can also use if you need help. The question mark will bring eyes on you.

 

+3.5 245

 

That’s good, looks like he has stopped the drop. How much later until you typically go to bed?

 

I'm getting tired but I can set an alarm to test. I have work tomorrow, so i rather test for my peace of mind.

 

Why don’t you wait until an hour after the last test. Then if he is flat or rising you can go to bed and wait until morning to test again.

 

okay

 

+5 232

 

I think you're good to go to bed (if you're still awake)

What a lot of us do is drink a large glass of water in the evening so we "have" to get up later in the night.....as long as we're up, we'll grab a test!

You will get to the point where you can test without being fully awake!