Help- numbers dropping too fast?

Today Mellows numbers started out at 26.6 AMPS so I gave the usual 2.5 of Caninsulin. His numbers after were;
+4 21.1

+6 22.2

+4.45 22.8

PMPS 21.9 This seemed low so I reduced the Insulin to 2.0 but at + 3 he's dropped to 13.1

Is this too fast?

We have been changing him to wet food (Butchers classic Meat about 8% carbs) but may have done it too fast though he seemed fine yesterday.

I gave him some Go Cat kibbles with honey on them and some Gourmet Gold Chicken and Liver in gravy at + 3.40.

 

Hi, I understand your panic when you are not used to seeing that big of a drop at once. You reduced his dose for PM and gave him some honey, so I am sure he is going to come up a lot. Get another test in 20 from the time you gave him the honey and kibble then post.

 

He probably would have been fine at 238, it's just that you aren't use to seeing him in the pinks or yellows. With the Alphatrak hypo starts somewhere around 69 so he did have a ways to go. Next time keep testing to monitor and when he get nearer 69 then you can give the higher carb food and honey. Again, I understand how anxiety producing it is when you see a drop and a lower color that you are not use to seeing. How is he now?

 

Just tested and he's 8.3 at +4.33. Yikes. I hope he goes up next test. He's eating more kibbles and Gourmet with a little honey at the moment and seems ok in himself. I am so glad this site exist. Its re-assuring to have you guys around.

 

I'm sure he is going to be fine. He is still a far away from a hypo event and you have your finger on the pulse of everything. Keep testing 20 minutes from the +4.33 test. He's probably loving all the extra food right now.

 

I don't know the formula to convert your numbers to the ones we use, so I can't help on that front, but as a Vetsulin (Caninsulin) user I can tell you that sharp, fast drops like the one you experienced after your PM shot are typical of this insulin. It would be a good idea to talk to your vet about it, and show him/her your numbers, he may want to reduce your kitty's dose a little bit.

 

It can take up to 30 mins after eating for it to show in the BG testing. Stay with it and I am sure he will come up. Do you have any higher carb wet food with gravy? Bet he is enjoying the extra food.

 

If his numbers indicate that he's at risk of hypoglycemia, gravy from high carb canned food is most helpful, it will bring his BG up but won't fill him up in case you need to feed more. When my cat had a problem, I mixed the gravy with some Karo or honey, and he ate it right up. Kibble takes much longer to bring BG up. After you feed him test again in about 15-20 minutes and repeat if necessary. Keep us posted!

 

His numbers have been quite high recently but started to come down since I started a new bottle of insulin on 1/10. We also started him on wet food recently but he likes to lick the jelly off and not eat the meat as quick. I dont have any higher carb than the Gourmet Gold- thats supposed to be 25%. Doesnt seem to have much gravy though.
I'll test again now.

 

25% is high, we suggest that for carb stay 10% and under.

 

10.7 at +5.14. Should I give more gravy and honey?

 

Can you plug it into the Spread Sheet so it equates it? I am not that familiar with the AT codes.

 

@Robin&BB , @Sue and Oliver (GA) are either of you around, need help with an Alphatrak numbers.

 

@Squalliesmom , don't you have an alphatrak?

 

It appears that your SS equates your AT readings with human meters, please plug in the last reading you got so I can see what the number is.

 

I do, Bobbie, but I use it so infrequently that those numbers don't really mean anything to me; I usually use my Relion, sorry.

 

NO problem, I ask Orangey to plug the number into the SS. If you look at his SS it equates the AT reading she gets to one that I understand. Apparently, he dropped again....

 

Okay, I just looked at your spreadsheet and if I'm reading it right, he is not currently hypo. Hypo on an Alphatrak is 68 or below (our numbers, don't know what Orangey's equivalent is).

 

The US equivalent numbers are
236 + 3 (uk 13.1)
149 +4 (uk 8.3)
193 +5 (uk 10.7)

So last one a bit higher. Whew.

 

His last reading at 10.7 at +5.14. so he is actually coming up. Yes, he is not in hypo, he had a big drop from PMPS at +3, bigger that she has seen and in lower colors and got a bit anxious.

 

I use Alpha Trak and anything under 4.5 I start to give extra food, only LC to start with.

 

Okay, he's coming up. Maybe another 2 test 20 minutes apart to make sure he continues to come up so that you will be able to know he isn't going to plummet on you. I don't think I would give anymore honey or kibble at this point unless 20 minutes from now he started to drop but I don't think that will happen

 

Your reading at 149 is not a bad number at all on an AT meter.

 

Post again when you get the next number. I'm staying here with you.

 

I agree, I don't think you need to give any more right now. I think you are well out of the dangerous range. Those hard, fast Caninsulin drops in BG can be very scary, I know, I've been there, too. That is how that particular insulin functions, though; it has a fast-acting component, which can cause drops like the one you had today, usually around the +3 to +4 time frame, and it also has a longer acting component that kicks in to try and get optimum duration. This second component can cause another drop but usually not as sharp or as fast, sometime around +7 hrs, give or take.

Just remember, with your Alphatrak meter, he's safe unless he hits a BG of 68 or less. If he starts to get close to that number, I would recommend testing him fairly frequently so you can make sure he doesn't cross that line.

I know it's nerve wracking! Good job being alert to his numbers and asking for advice, you're a very good kitty Mom!

 

Ok . Thanks Bobbie, Squalliesmum and Sue484. I was just worrying at the speed he was dropping and wanted to prevent a hypo. I have enough strips for a few more tests tonight- I have 7 left but I need to keep at least 2 for tomorrow and 2 for Monday. I may have to buy more from the vet on Monday. I only ordered some online earlier today as I thought I was getting low! (And I wasted one on the last test as Mel shook his head so I didnt get enough! )

 

You did great! I understand your panic when you saw that first big drop. What is your name by the way?

 

Maybe ration out those few strips for the +7 +8 tonight for when Lucy said another more gentle drop can occur. And right now, he is in a good number to be able to go down some without concern.

 

Thanks! I'm Tracey.

 

Hi Tracey! Did you see my last post about saving your few strips for the +7 +8 tonight?

 

And good instincts that you lowered his PM dose!

 

Ok- good idea. Thank goodness its Sunday tomorrow and I can catch up on my sleep!

 

I hear you! I think you'll be okay now if I sign off. It was nice to meet you and I will follow up on you tomorrow.

 

I saw it , I just cant type fast enough to keep up, lol.

I wonder whether I should have given him any at all now though
.

 

Ok, Thanks for all your help and support. And everyone else who posted too.Nice to meet you all. Sweet dreams.

 

You did the right thing giving him his dose because of his preshot number. How much? I don't know because I am not familiar with caninsulin. Maybe post o that forum and let them guide you.

 

I wonder whether I should have given him any at all now though
.[/QUOTE]
How long ago did you give him his shot?

 

Hi Tracey. How long ago did you give him his shot?

 

It was at 8 pm so 6 and a half hours ago for me.

 

He's probably not going to drop a whole lot more, but it would be a good idea to check him a few times just to be sure, every cat is different (ECID, you'll hear that a lot here, lol). I would suggest you may want to reduce his dose tomorrow, if you are short on test strips. Better one day with higher numbers than risk a hypo.

I'll be checking in on and off, if you have any more questions, although I imagine it's well past bedtime in your part of the world!

 

Latest reading 23.6 (US 424) at + 7 !! Must be the Honey and Gourmet Gold finally kicking in. Well I feel safe enough to go to bed now. I will test him again before his 8am shot. Thanks for your help Lucy. Goodnight.

 

Good night, hope you get some good sleep, now!

 

Don't forget to enter your numbers in his spreadsheet!

 

Also, I just have to mention that 424 is actually pretty high. You probably need to talk to your vet about the numbers he'd like to see your kitty start to come down to.

 

Hi there, Tracey! (I realize you may not read this for awhile, given the time difference between you and southwest U.S.)
I'm a longtime AlphaTrak2 user. You did just fine with Mellow, and I totally understand your concern about the hard & fast BG drops that may occur when using Caninsulin. That said, those yellow and two blue BG# you saw in tonight's cycle are actually very good numbers; not so low as to cause concern about an impending hypogycemic event. But it's great that you're staying on top of the monitoring - good job!

For future reference: On an Alpha Trak2, although the usual "be careful" BG # is anything less than 69 (between less than 3.8-3.9 in U.K. #s) , I'd say that if you see your kitty starts dropping to around a BG of 80 (4.4 in U.K #s) on your AlphaTrak - giving you an added measure of safety here - that's when you'd want to start steering with a some food to bring the BG number up.

You may see a bit higher AMPS in the morning as result of dropping at nadir more than 50% from his PMPS (& the syrup + higher carb food could factor in, as well) - but that's ok. If this were my kitty: I would probably stay the course with that 2.0U again in the morning, just to see where he goes mid-cycle during the day - since Mellow did experience a nice drop in the p.m. cycle 3/10/15 after you lowered the dose. And in taking a look at his daytime cycle 3/10/15, I have to wonder if the reason Mellow was staying high and flat through his daytime mid cycle could have been that the dose was a little too high? As sometimes a kitty's #s will stay high and flat when getting a bit too much insulin: This may provoke compensatory hormones to release stored glucose (glycogen), which raises the blood glucose level high - making it appear like more insulin is needed when it is not.

Just some thoughts here ... hope these may be helpful to you. - Robin

 

Good morning all. Thank you Robin. I did wonder why the numbers were a bit 'flat" yesterday in the day. This mornings AMPS reading at 7.18 am was 31.7. (I inject at 8am) Its a new bottle of Insulin that I started on 1/10 so dont know if the previous one was not the same strength or if it was the change to wet food, but his numbers began to come down out of the 'blacks' into the 'reds' .

I think I will stick at 2.0 u this morning. I havent many strips left and Mellow is beginning to struggle when I test. I nearly didnt get enough blood this morning as he flicked his ear and I had to stab him again poor thing.

 

I'm going to try and sleep for a few hours now and test again between + 4 and +6.

 

Hi Tracey, hope you got some rest and.I am glad that Robin weighed in as she also uses the AT. Keep us posted.

 

I slept for a few hours so didnt test until +7.15 He was at 39.6 (712) !!! Mellow was sleeping on the bed with me so I dont think he ate between 7.30 am and 2 o'clock.(+6). He had eaten a bit of low carb wet food ( Butchers Classic- 8% carb) and a few kibbles at 7.30 ( WHY did I give him kibbles- I dont know what I was thinking!!! Still in panic mode from last night I expect as he didnt seem to want much of the wet food and I knew he needed to eat before I gave him his AM shot.). Then he slept from 11 am until 1.30 and then ate some low carb wet food -no more kibbles.
I am making a real mess of things. I feel like I dont know what I'm doing or why .
I dont have enough strips to test again before his PM shot now. Should I withold any more food until then?

 

How far away in hours is his PM shot? Don't beat yourself up, we have all been there.

 

Shortly after my last post to you last night, I tested my cat and he had a big drop! And being night time and me needed sleep, I might have oversteered him with food. It is a learning curve for all of us. Is it possible for you to buy an inexpensive human meter and strips today until you can get more AT strips on Monday?

 

Its 3 hours to his PM shot at 8PM. He's sleeping now and doesn't seem too fussed about eating. I know he needs to eat before I give another shot.

I already have an Accuchek Aviva human meter and strips that I bought originally. The numbers on Mellows SS up to 24/9 are with that meter (except for the first line on 18/9- a curve done at the vets.) I know it reads a lot lower than the Alphatrak which is why I switched over.
I do have some Alphatrak strips but only enough for the PM shot tonight and the AM and PM shots tomorrow. I dont really want to buy them from the vet tomorrow as they charge the earth and I dont have pet insurance. But I may have to as I dont think the ones I ordered online will be delivered until later in the week. I need to make an appointment tomorrow to see the vet in the evening anyway, to discuss the curve I did on 27/9/15. Trying to save money by doing it myself and then the vet advising me on dosage etc.

 

Perhaps you could use the Accucheck if you need to until you get more AT strips. Do you happen to know the difference between the two?

 

Glad he's not chomping at the bit to eat.

 

You're not making a mess of things! You're still new to this, and it's very easy to feel overwhelmed, I know. You're trying very hard to do all the right things for your kitty. We all have those "Oops!" moments when we wonder why we did something and are afraid we made the wrong decision, you just learn to roll with it and try to remember not to do it again.

If you're only 3 hours away from his PM shot I would hold off on food until then, you want to make sure he eats before he gets his shot.

In a worst case scenario, if you have to use your human meter, folks here who also use a human meter may be able to help you understand those numbers, but I'm not familiar with the Aviva Accu-check so I don't want to swear to it. I'm guessing, though, that it's the same as any other human meter.

Keep us posted, please!

 

I need to make an appointment tomorrow to see the vet in the evening anyway, to discuss the curve I did on 27/9/15. Trying to save money by doing it myself and then the vet advising me on dosage etc.[/QUOTE]

Next time you go to vet ask him if you can send him your ss by email on a regular basis (weekly, by weekly) . That way he can look at it and just call you if a change needs to done. It will save a visit to the vet.

 

No idea. Mellow doesn't like having his ears pricked even for one test so I've never tried to do two readings at a time.. The Accucheck needs more blood so my early attempts had more failures than successes. I may try a comparison at the PM shot.

Thanks for the encouragement, Lucy. And Bobbie.

 

Next time you go to vet ask him if you can send him your ss by email on a regular basis (weekly, by weekly) . That way he can look at it and just call you if a change needs to done. It will save a visit to the vet.[/QUOTE]
You can email your vet the link for your spreadsheet, that way you won't have to remember to email it every week, and he has immediate access to it if you have a problem and need a phone consult!

 

Next time you go to vet ask him if you can send him your ss by email on a regular basis (weekly, by weekly) . That way he can look at it and just call you if a change needs to done. It will save a visit to the vet.[/QUOTE]

Good idea. Although they probably want me to go in as I still have to pay for them to interpret the curve, though not as much as if Mel goes to them to do one.

 

You can email your vet the link for your spreadsheet, that way you won't have to remember to email it every week, and he has immediate access to it if you have a problem and need a phone consult!

 

I' ll find out if thats possible. Its a great idea.

I must go and eat now. I'll check back later. Thanks again all.

 

It's easy to do, I can probably talk you through it if you need help. If I can't, there are lots of others here who can!

 

Hello again folks. Mellow woke about half an hour ago (7. pm) and is looking for food now. Am I right that I should test, feed then shoot or can I feed him now then test straight after he's eaten then shoot at 8pm? It takes me about half an hour to warm his ear, do a test , get food out for him plus fill a syringe ( I like to do the syringe about 15 mins before the shot for it to lose the chill.) I know the dose will depend on the BG number.

 

No, don't feed now; you're right about test/ THEN feed & shoot. We try to avoid feeing in the 2-hr. window* before an AMPS or PMPS test.

ETA: *The only time you'd deviate from this would be either an active hypo event going on OR if your kitty had some type of other health problem that would require you feed then.

 

Just so you know ... the reason we avoid feeding in the two hours prior to a pre-shot test is that you don't want food artificially raising his BG #, as when you test at AMPS/PMPS, you're trying to see what his actual BG level is all on its own (without food raising it). This helps you in determining proper dosage.

 

ok tested and he at 38.7 (696). I should probably stick to 2 units now as he definitely wont be getting any more kibbles only low carb food. He's eating now.

 

Sounds good, Tracey!

 

Forgot to ask: Do you routinely check for ketones? As is always good practice to do that.

 

Got the Keto- Diastix strips but havent used them yet. Hard to catch Mellow in mid pee. Usually he has pee'd in the night before I get up. He also goes out a few times a day so probably pees then too. I will try to catch him as I know if his numbers are high theres a danger of ketones. There were no ketones when he was first diagnosed on 10/9/15 but the numbers have been high a lot since then.

I am exhausted now so will watch Downton Abbey and then go to bed.

 

Glad to hear you're getting into a good routine with Mellow! It would definitely be a good idea to get a ketone test in when you can (I have to stalk Squallie to get one!).

You have no idea how jealous I am that you guys have Downton Abbey now, and we won't get it here until January, lol!!!

 

Hey Tracey ~ I have the same problem as you, Bubba spends some outside time. Something that helped me to get the ketones checked was to crumble up some saran wrap and put it each corner of the box (cats usually aim for a corner, and hopefully some of the pee lands on the saran wrap for you to dip your strip in. Hope this helps.

 

Next problem (lol)- Mellows AMPS is only 12.4 (217)! I dont want to give a shot at all but is that right? My syringes dont have measurements less than one unit, so anything under a half would be hard to do accurately. I wont be here to monitor him (work) and dont have the strips to spare anyway. My husband will be at home so can keep an eye on him but hasnt done any BG monitoring himself..
Mel didnt eat a whole lot yesterday- he just licks the jelly off the meat and eats only little bits of the meat. He didnt seem to have eaten anything much overnight. I think the wet catfood is having a good effect on his numbers though- other than when I panic and give the wrong food.

 

The number you saw @ AMPS (217) is A VERY good number! (Go, Mellow!)
I know this can feel quite alarming the first time it happens, as this is an amazing drop from the very high AMPS/PMPS numbers Mellow had just the day before. As you had no way to monitor, I think it was just fine that you skipped the dose this time, because you'd have had no way of know what he'd do at mid-cycle - and you do want to make sure Mellow stays within safe BG #s when you're not available to step in and feed if he were to drop too low. So ... you're doing fine, Tracey! It may well be that the lower carb wet food is helping his numbers drop; we see this happen quite a lot, actually. Can't be certain about what kind of # you may see at PMPS, so we can cross that bridge when you get to it as relates to a reasonable dose tonight.

I'd highly recommend that you get some U100 syringes marked on the half unit if at all possible. This would help you immensely! (@Elizabeth and Bertie - Can you weigh in here? Are these available in the U.K.?)

 

Hi Robin, yes they are indeed available here in the UK. I get mine online from VetUK.co.uk here:
http://www.vetuk.co.uk/insulin-syri...-0-3ml-u100-insulin-syringes-box-of-100-p-296

But Tracey, if you'd like to try some out before you buy a box I can send you some of mine. Just PM me your address if you're interested.

In order to use them you'll also need to feel OK with using a conversion chart that shows you how much U40 insulin to draw up into a U100 syringe. As an example, a unit of U40 insulin will come to the 2.5 mark on a U100 syringe. It seems a bit odd at first, but using U1oo syringes (especially with half-unit markings) can make it so much easier to measure small doses of Caninsulin/Vetsulin.
Here's a link to the conversion chart:
http://www.felinediabetes.com/insulin-conversions.htm

Eliz

 

@Elizabeth and Bertie Thanks, Elizabeth! Hope all is going well with you?
@Orangey - Tracey, just wanted to add: At first, I was really nervous about using the conversion chart and U100 syringes - even kept the U100s in a box with a red lid, on which I wrote in huge black letters: "MUST USE CONVERSION CHART!" (I'm not exactly what would be known as a math wizard.) But it's actually quite easy to do & I'm happy I switched over, because this really helps so much in being more accurate when you get down to these small doses.

 

Sorry to be so long in responding. I saw the vet again (I didnt take Mellow) on Tuesday evening to discuss the first curve I had done about 9 days previously and to give her info on the readings since then. She wants me to do another curve on Sunday for her to see along with Mel next Tuesday. Overall the numbers are coming down nicely.

Funnily enough, today I've just received syringes I ordered from VETUK. They are still for u40 but have markings for half units.

 

Oh, that's great news!
And am glad to hear you've got U40 syringes marked on the half-unit. That'll probably make your life a little bit easier.
Please keep us posted on how things go with Mellow - will keep fingers, toes & paws crossed that those numbers just keep going down!

 

Thought I'd give an update on Mellow. Its been over a month since I posted last but its all good news. His numbers have continued to drop steadily and I began to reduce and eventually stop giving insulin. Its been just over a month since his last dose and although he's more in the low blues than greens I feel he has levelled out to acceptable figures, averaging in the 6's. He is back to his old self now- playing with string/straws/pens/unwary fingers and with the 5 P's in evidence. He is on very low carb wet food now (Sheba Fine Flakes Poultry-under 2% ) which I am sure played a big part in the reduction of his BG .

I want to thank everyone who helped me previously- this forum is such a blessing and an invaluable resource.

 

Tracey, this is the most MARVELOUS news - you just made my day!!! HOORAY!
CONGRATULATIONS to you & Mellow! My best wishes for many more happy, healthy (& insulin-free) years ahead!

 

Hip Hip Horray!! Awesome news and continued low blues and safe green to Mellow!

 

So happy for Mellow and you!!! Congratulations!!!