Help Please, testing advice and dosing questions

So, obviously I will give him the 1.75u tonight. And since you said you'd check in around 9, I will ask you now when you recommend I test him during the night? I don't want to over-test or miss a test at a time that I should be testing him. I'll set my alarm and probably get a better night's sleep based on his performance today...

 

Not sure when you turn in for bed but it's a good idea to get a test in either around +3 or before you go to bed if that is before +3. Then based on what BG is at that time, you can decide when to test. If the cycle looks somewhat like the day cycle, then I'd do the before bed/+3 test and one more around +6/7. If BG has dropped off a lot, feed him and retest in a couple of hours. If BG gets down below 100 then I'd give some Medium carb food or LC with a drip of honey to push number up and retest in about an hour.

 

Thanks, I'll write that on a note for myself. These past few days I don't go to bed anymore, just take cat-naps! couldn't resist saying that...
Seriously, tho, thanks for sticking with me on the marathon. Of course I will be recording his numbers on the spreadsheet and hope for something much like the day went.

 

Cats often go lower at night than they do during the day so getting the before bed or +3 test gives you and idea where things are heading. Once you are surer about the dose, you can sleep better and not be taking cat naps. You need to look after you just as well if not better than you are looking after Clarence. He's counting on you so don't get yourself exhausted.

 

Thank You. Yes, I will stay strong and look after myself a little better. I stress out easily and worry a lot (always been that way). I'm working on that...

 

Clarence started out the night much like the day. His numbers were high this morning, tho. I continued with the 1.75u this morning. He was hungry in the wee hours this morning, coming in to my room and knocking items on the floor to try and get me to wake up and feed him. I don't know if he was stressed cause he was hungry and maybe that is why he went higher than he had been.
On the plus side, I got some good rest last night and kitty didn't have to get stuck much.

 

You gotta love them. They may not speak "hooman" but they sure do get their point across. Sounds like Clarence is a bit of a character. His BG could have been a bit elevated by hunger stress but I think he's probably bouncing from going into the blue range. This should settle with time but he's become unfamiliar with those lower BGs and his body is basically defending itself against them unnecessarily. He has to get use to being in those lower numbers again.

 

Cats love being in control, don't they? He is definitely a character, but, yep, gotta love them! They are smarter than a lot of people think, really, which is super cool to observe.

I thought maybe he was 'bouncing' some. I'm hoping it settles and thinking it will. I'll test him later today to see what he's up to...

 

I tested Clarence at +4 and he was 322. At +7 he is 208. He doesn't seem to be dropping fast, but I'm hoping that I'm interpreting his numbers or pattern correctly. I'm hoping he doesn't go back up super high and figuring that I should still give him the 1.75 and monitor tonight similar to last night and today.

 

He'll probably start rising anytime now but how high he goes is anybody's guess. That 208 isn't bad given where he started today. Possible the bounce is starting to settle.

 

I need to begin using ReliOn and recording readings for it. I can start that tomorrow morning. Help with changing my spreadsheet would be greatly appreciated. I can easily add a row that says I'm using a Human Meter, or whatever it needs to say. As for the conditional formatting, I made the changes to a copy of my sheet (called Test Spreadsheet) and will publish that to my signature if you wouldn't mind taking a look at it for me?

 

PMPS was 289 (still using AT2 at this point)

 

Your spreadsheet looks absolutely wonderful!

Looks like the bounce is clearing now and you are going to have to monitor Clarence a little more closely early on tonight or if sleep is a necessity due to work tomorrow, I's be inclined to reduce the dose tonight to 1.5u to avoid a potential PJ party.

 

Thank you.

I got some good sleep last night and I also had a cat-nap today, so I should be able to set some alarms and monitor him. I'm retired, so work won't be an issue (and its a good thing because this would be even more stressful for me if I was still workin').

Couple of questions:

I have a can of Friskies - the gravy kind - is that adequate for medium carb food? - he really will mostly just lick the gravy and that's what he would need to do.

You already told me not to let him go below 90 on the vetsulin, what would that number be using the ReliOn (in case I run out of AT2 strips)

Am I off base in thinking that it would be better to keep him on the 1.75 because it might end up being his dose and is consistent? I can give him 1.5 but I worry about so much fluctuation, is that unnecessary worry?

Could I give him a 'skinny' 1.75 just for a little caution???

Okay, that was more than a couple questions, but, I always have questions!!

Thanks!

 

decided to play it safe with 1.5 and this was not one of my best shots - he jumped when I started to inject the insulin. I couldn't really tell whether I got any in him or not, so I tried another spot (same needle, same insulin - or what was left of it) -- is it okay to do that? He has been pretty good lately, but he has started to tense up when he knows I'm giving him his shot. Once He jumped when I was just about to insert the needle, he jumped before it even touched him. I think I must be doing something wrong. Other times he doesn't even flinch. I don't expect him to like it, I just always wonder if others have experienced that.

 

For simplicity purposes, we generally just use 90 as the goal for Vetsulin for either meter but with the Relion, I think you could safely use 80 instead. There is no way to equate the readings from the two meters and the goal is simply to allow for enough of a cushion to be able to prop BG up if it is dropping quickly in lower range.

Gravy foods in general are Medium to high carb. Not sure what the Friskies you have is, but it should be on THIS FOOD LIST.

While I agree it's ideal to be able to stick to one dose, there is the safety of Clarence and your well being to be considered. When kitty is coming out of a bounce and when monitoring is/may be a bit more problematic or not possible, it's better to err on the side of caution. Clarence's pre-shot was way down last night so I suggested the slight reduction just to prevent a PJ party. If you look at how much the 1.75u dose has been dropping his BG, if he dropped that much at a pre-shot of 289, you might have been chasing numbers for a few hours last night. This is of course all speculation but it's based on what Clarence has done so far. When kitty is bouncing, there is no way to know how much of the BG is bounce related, when it will clear and how much is what his body does normally at this time.

Clarence got down to 121 last night which was good but still allowed a comfortable cushion so you might have been OK with a skinny 1.75u but hindsight is always 20/20.

As for the shot issues, what some folks find helps is to give the shot while kitty is eating. You could withhold a couple of tsps. of food from his pre-shot meal, then give that last bit to Clarence when you shoot. Most kitties are so intent on eating they don't even notice the shot. Some low carb treats would also work. I'd also double check your needles. There have been instances where folks have found the needles a bit dull causing shots to be a little more problematic.

 

Gosh. AMPS is 294 on the ReliOn - that is pretty high, I think, but it is in the yellow, so it will take me a little while to get used to the difference, maybe.

 

The link to your spreadsheet isn't in your signature anymore. The words are there but it's no longer a link. When you have a second can you fix it. You may need to re-establish the share options.

Yes it looks like AMPS is up a bit but there is also meter variance that comes into play when comparing the meter readings so just go with the flow.

 

So, with this reading, I'm unsure of whether I should go ahead and give 1.75 or less? Just a little unsure of myself.

I'll go fix that link.

 

You can safely assume that the AMPS is at least higher than last night's 289 on the AT2....the only question is how much? Since it appears Clarence only went down to 121 (if memory serves) then if you can monitor, I think 1.75u will be just fine.

 

Ok, thanks. I fed after I got that reading of 121 (on the AT2 meter) last night -- wee small hours of the morning, I mean.

 

When I first starting giving the shots, I did it while he was eating, but he caught on to that right away and the minute I touch him when he's eating, he tries to leave. He is a food motivated kitty and has never ever liked to be disturbed when he is eating.

 

They all have their own "thing". My girl loves her food and I could shoot her while she was eating without her ever lifting her head. Maybe some bribery.......give him a treat before and after after each shot (whether he stays still or not) so he knows he gets a treat for just being there and another once you are done? Or coms catnip or a brushing....whatever might work for Clarence as an incentive to co-operate.

 

Good suggestions. I will look for a treat that is low carb that he might like.

I'm reviewing the Beginner's Guide to Vetsulin again (3rd time, I think) and finding it helpful to try and get the info stuck in my head, especially since the meter swap. I'm sure I'll need to review it again. I need to work on finding a different vet, I think, which I really don't want to do. My vet doesn't advocate home testing, though, and after monitoring Clarence for the past week, it is clear that it will be in Clarence's best interest to do the monitoring. I need to find a vet that is happy to have me testing and being diligent about his care. And willing to work with me to get him as regulated as possible.

 

The side by side I did on that test last night where he was 121 on the AT2, he was 79 on the ReliOn Prime.

 

for a treat at shot time (or test time) -- try dried bonito flakes/curls -- can get more cheaply at stores that cater to those cooking Oriental style

can be fed by themselves or sprinkled over something else -- pure protein no carbs

several cat food mfg's produce these too -- CatManDoo is one -- smaller packages bigger price, but available online

if you are avoiding fish in regular canned food, as many do, it works well to use something fishy as a treat

 

I think I have some of those, usually keep them in stock for my son 'cause he loves Asian food. I haven't been avoiding fish for him at this point, he loves it and gets it daily. For a time I was giving him the fish & shrimp directly after a shot like a little reward. I bet the bonito flakes would be great for him as a little treat! Thanks.

 

Don't be hard on your vet. Nor do you have to switch vets necessarily. If you like your vet for other things, continue with him/her but what you do at home is your business so just continue testing. I think most vets come around when they see the results and if that doesn't work ask the vet if they would give insulin to a baby without knowing what the baby's BG was? Give the vet some food for thought to quell any argument about home testing. Dosing wise, you can always listen to suggestions and nod your head and then follow your gut instincts given the knowledge you have accumulated about Clarence and his patterns. Vets can have several reasons for not advocating home testing. While some may be interested in padding their pockets by requiring useless in office curves and fructosamine tests, most just don't advocate it because they fear their human clients will not want to treat at all if they make things too complicated. Of course there are also control freaks but how much control do they have when they only see the cat periodically?
Most of us here do not consult our vets about the diabetes. We handle that aspect of kitty's care and let the vet handle those things we really need their help for.
Another option for treats would be freeze dried meat treats such as Purebites but buy the dog ones and break them into kitty size pieces. they charge a premium for the cats ones I guess because they had to cut them smaller.

 

My vet is the one that I am getting the insulin from, and I need a Rx to get that, don't I? I don't have a problem with it other than I feel like I am being deceitful when he is telling me (and thinking that I am doing it) to give him 3u.

 

You have the spreadsheet showing Clarence is getting good results on far less than 3u. I dare say 3u could have sent Clarence hypo. The one day you dosed 3u Clarence's pre-shot was in the 400s and he dropped to 88 which I think your vet would probably agree is plenty low enough. When Clarence starts a cycle at a lower pre-shot, 3u would be nothing short of dangerous. Most vets try to keep cats above the BG levels we aim for here so I think if your vet sees the results, he/she won't be able to argue that more insulin is needed. You can always say you were uncomfortable with raising the dose that much.
If your vet is not willing to work with you, that is a problem. As long as you are not endangering your cat, hopefully your vet would be willing to be a partner rather than a dictator and continue to prescribe insulin based on results rather than ego. If they refuse, as far as I am concerned, they are endangering your cat.

 

I have been using the same vet's office for many years. There are other vets operating in his clinic as well and I have always been happy with the care my animals get from him or any of them there.

Testing update: This morning I tested at +2 it was 229 and at +3 it is 135 (ReliOn Prime meter readings)

 

The actual lowest he went to on that day was 79 (this info is in the remarks section). When I called the vet's office, I gave all the numbers to the person answering the phone. She called me later and reported that the vet had said to continue with the 3u and not test again until Friday (this was on a Tuesday). Part of the problem I have is whether or not the vet actually said that and even whether or not she gave the information to him at all. He might have also thought I was using a human meter. I want to discuss this with him but I'm not the confrontational type. I was totally blown away by all of that and there was no way I was going to give him 3u again after he had gone so low on it. That was when and why I started this post in the first place.

 

When Clarence went for his initial curve, his first injection was 3u and he went really low, so they brought him back up again and no more insulin that day. Next day they started him on .5u and the day after that I picked him up and his dose was 1.5u.

 

For now you need to give your vet the benefit of the doubt although I think the dosing methods/instructions have been very questionable. You don't know if the info you relayed the day you had the low readings got conveyed to the vet properly, whether you got his response accurately AND/OR whether the vet could have been distracted when responding to the tech/receptionist. This is a prime example of why the vet cannot take on the care of a diabetic cat from arms length. You hold the needle and if anything adverse happens, the vet is free and clear of any guilt because they have no way of knowing if you really followed their instructions or overdosed the cat accidently.

Vets do not get a lot of training on diabetes in school. They also don't usually have a lot of feline diabetics in their practice. Many see more diabetic dogs than cats and treat cats like dogs. Since they often have very few feline patients, they don't stay up to date on current practice which encourages home testing.
I don't think you have to confront the vet. I think you need to make the vet aware of what you are and are not comfortable with and the vet needs to co-operate with you because you are the one who is giving the insulin and having to deal with the outcome.

Unfortunately, what you are describing is all too familiar and time and time again, the caregiver either gets a baptism by fire (hypo or close situation) or the cat manages to keep their BG up but is running in very seriously high numbers because they are in one long continuous bounce. This not only slows down progress but because too much insulin can look identical to too little, it makes it very difficult to get the cat back onto the right path dose wise. I think most vets come around when they see the proof that you know what you are doing and are making good decisions about how much insulin to give.

 

Liking those readings today so far. I'd test again by +4. If he suddenly gets hungry, check him then as that is often a sign BG is going down.

 

Oh my goodness, it is amazing that what you have said here is exactly what has been going through my mind since this whole thing started. So Thank You! He is very good with dogs and I know that because I've been taking my dogs to him for 30 years. I very much want to give him the benefit of the doubt on this because I respect him. He is old school and because of that there is a lot of great practical knowledge from him. He is spread thin, I think, and would love to take more time with his patients but the time isn't always there. I also don't know what else could be going on in his life that could impact his decisions/actions without him even realizing it.

 

Okay, I will test him at +4 or if hunger ensues. He was pestering me for food before the +3, so I fed him a little right after the test. He is used to getting food whenever he asks for it, he is a 'grazer' outside of his regular breakfast and dinner.

 

+4 was 125 (the food I gave him after his +3 probably influenced this reading).

 

Ok give him a break. While some of that 125 may be food, it wasn't a full meal so his drop seems to be slowing down now. How about grabbing a +6 snce his nadir has seemed to be around that time in the cycle.

 

You are probably correct about that. I have to keep reminding myself this is the HUMAN METER...

 

Yes switching meters can be a bit mind boggling for the first few days but you'll get used to it soon enough!

 

Clarence's +6 reading: 166 ReliOn Prime Meter

 

Because I was going to be working on a little project outside, I tested Clarence at the +7 1/2 hour mark. He was at 273, so I feel fine to wait until the PMPS to test him again. I'm thinking since there is still almost 3 hours before his PMPS that he will be high enough for me to give him the 1.75u tonight, probably.

 

PMPS was high - 396

 

Ok. I'd stick with 1.75u tonight and if Clarence is still up tomorrow morning, then you could try 2u as long as you can monitor to see if we can get him down just a wee bit more.

 

Okay, thank you.

I was a little early getting his pre-test and he was quicker to eat, so I managed to give his injection about a half hour earlier than usual. I think hat should be okay and will actually let me do a +3 earlier as well.

 

No problem shooting 30 minutes sooner with Vetsulin especially when BG is high enough.

 

+3 was 290 on the ReliOn Meter (btw, I keep saying that mostly to remind myself if/when I go back and reference these posts, which I have been doing when I need to). Test again at +5 or +6 or +7 ?? This morning his lowest tested was at +4, but prior to that, the nadir was around +6 or +7 (maybe more so at night?)

 

After looking at his numbers and noting his behavior around +5 1/2 hours, I will check in on him again around +6 1/2 and if he seems to be dropping fast or anything, then I will test him. Otherwise, I'm gonna leave him be until is AMPS tomorrow. He started out pretty high and hadn't dropped much by his +3.

 

Nadir will not always be at the same time. With some cats you can set your watch by their nadir while others can move around constantly to some degree. It looks like Clarence's nadir was early during the day yesterday but later again, as it has usually been, on the night cycle. You were quite right to give yourself and Clarence a break when his +3 hadn't moved much last night. It will be interesting to see where his BG is at AMPS.

 

Okay, his AMPS was 232 so not nearly as high as last night or even yesterday morning.

 

Yeah! Ok so don't increase and let's see what Clarence does today.

 

I'm happy it wasn't super high this morning. He is acting as tho he is feeling 'good' today. It isn't nearly as hot and I let him stay outside for most of the night. I think he is a bit depressed by all of this and because I won't let him out unless it is in the fenced yard. We have spotted a fox around here and last year he got in a scrap with a fox and was injured badly, so I don't want to risk something happening to him.

Would you suggest a +3 ?

 

Yes I think +3 is a good idea. Glad to hear he is feeling good today. I think like us, sometimes the weather does have an effect on them too.

Are you sure when he goes out that he doesn't get into some "grub" left out for ferals or catch mice (good protein!). Either one could account for higher BGs if he is eating more than you are offering.

 

If I let him out the back (no fence), he would definitely be catching rodents/birds and eating them, I haven't been doing that for about a month or more. In the front, it is fenced. The dogs are out there. He could possibly catch the occasional critter, but mostly when I have looked out there he is just sleeping somewhere or looking longingly outside the fence. I did see him catch a baby bird out front but the dog quickly grabbed it as soon as Clarence set it down to do his playing with his prey thing. It could happen that he would catch something and eat it, but lately all he has wanted to do is sleep - it has been hot and his BG has been wonky. We don't put food out for ferals (don't really have them right here anyway). I do feed one of the dogs out there but always look to make sure he has finished his dinner before I let the cat out. I hope that answers your question. Basically I'm pretty sure this past week he hasn't been catching and eating and I have kept him inside mostly so I could keep an eye on him. One thing, he hasn't been too happy that I have been making him stay inside so much.

 

+3 is 167 (ReliOn Meter)

 

Looking good. Keep working that juice Clarence!

 

I feel like I should test him in an hour because I don't want him going lower than 90. Is that unreasonable?

 

He's not dropping off that fast or a huge amount so I think you can hold off till +5.

 

Really? Okay. I did give him a treat of some roasted turkey (home cooked, not processed) after the testing as a little reward. That's okay, right?

 

Of course. Bet he loved that treat!

 

+5 on ReliOn Meter: 79
Do I give honey with food at this level or just food, LC?

 

I gave a small drop of honey with his regular food. He ate it up.

 

77

 

Is that 20 minutes after he finished eating? That's basically the same reading. Retest in 20 minutes again.

 

Okay. When I gave him food, he ate it right up, then I gave him a small bit more with the honey on it and he ate that up, too. I was mostly referencing the time of my post to determine the 20 minutes, since I was back and forth from him to my laptop and forgot to look at the time.

 

Are you having fun yet? The first time my little one blessed me with a green number I ran around my coffee table several times mumbling to myself like a crazy person (thank goodness no neighbours walked by!) and then went running for the high carb treats which certainly weren't needed but I thought they were!
Test him again 20 minutes after the food.

 

75

 

should I give him a little more food? Arghh!

 

Still about the same. You can give Clarence a teensy bit more food with honey to keep him surfing and test again 20 to 30 minutes after the food.

 

And by now it is +6, so I'm using that last test as his +6

 

Ok, will do, just a drop of honey...

 

That's a great story! Makes me feel a little better about grabbing him up and running to his food dish, then dashing back to my desk to look at stuff and post, trying to calm myself down.

 

Okay, 87 so on the rise.

 

While we don't aim for BGs in the 70s that was one very nice cycle today. He'll probably bounce up higher after those beautiful numbers but that is totally normal. Looks like threatening to up the dose worked!

 

Looks like it! As far as bouncing back up, when will that likely occur? I'm trying to understand the bouncing thing. The more often they hit the lower numbers are they less likely to bounce back up high? Looking at my note when I was using both meters for some of his testing, he had been at 79 on the ReliOn meter before - on AM cycle of 7/27 the reading of 124 on the spreadsheet - the next AMPS after that was quite high.

 

Every cat is different. Some will zoom up to higher numbers quickly and some will take a few hours or even till the next cycle. Bounces can last up to 6 cycles and sometimes longer but usually dissipate relatively quickly. The goal is to get kitty into good numbers and get them to surf in those good numbers as long as possible to get them re-acquainted with more normal BG. Most will have less bouncing over time but each cat is different and some just seem to bounce even with less than great numbers. You can sometimes see when a bounce is about to clear by a fairly flat cycle occurring before numbers come back down to kitty's normal.

That comparison testing gives you a feel for how different the numbers can be between the pet and human meters. While the numbers tend to look better on the human meter, they are also seem scarier when they get down to the lower ranges.

 

Thank you for that explanation and for your patience as I try to process everything and, hopefully, get my kitty somewhat regulated. I tend to be someone who wants more of an understanding of what is going on and that generates lots of questions. The more I know and understand, the better for me and my cat in the long run.

When the 79 reading showed up, I referenced the Sticky on the Guide to Vetsulin for help. BUT, in my state of excitement, and my own desire to act quickly, my mind raced ahead to what to do if he was 50 or below instead of simply staying calm and giving him a little food and testing in 20 minutes or so. Such a wonderful thing that I have this forum. I can't imagine what I would have felt like with having this resource. Thanks for your time and doing such good for all of us out here and our kitties.

 

My pleasure. Knowledge is power and this dance gets much easier as you gain experience and learn how your cat reacts to the insulin. You are doing great and Clarence is one lucky kitty to have you as his person.

FYI I think it would be a good idea to reduce the dose to 1.5u given that lower BG today. Don't want him flirting with even lower readings!

 

So do you mean just for tonight or altogether?

 

For now I would say reduce it down for tonight and revisit that question in the morning depending on his AMPS.

 

His PMPS is 203 - should I use the 'stall' technique I read about in the Sticky, do you think?

 

Okay, I retested after waiting for a half hour. 243 - so I should go ahead with the 1.5u as you suggested earlier?

 

Sorry DeeDee. Wasn't on the board as late last night. You were fine to give the 1.5u. While you obviously want to pay attention to the pre-shot number you also need to make sure Clarence is not dropping too low and since many cats go lower over night, I think the 1.5u dose was absolutely the right one. You've got this!

 

That is perfectly fine. You have been so great about assisting me, basically mentoring me on this adventure and I really appreciate it. I cannot expect you to be sitting here all the time just waiting to assist me. I figured you weren't there and I was fairly certain it was good to give the 1.5 at his PMPS number. With the time difference, you've got to be having your sleep schedule and homelife responsibilities impacted. I hope you know how much I appreciate all of this.

 

Clarence was 331 this morning, so should I go back to the usual 1.75?

 

I'd hold him at 1.5u for now. That higher AMPS is part bounce. He doesn't seem to be bouncing as high now and we have no idea when that will clear so I'd stick with the lower dose for the next few cycles just to avoid having Clarence suddenly go down too low.

 

Okay, that makes sense. I'll give him 1.5u. I need to go to town and pick up some more insulin for him anyway, so the lower dose will help me feel a bit better about him while I'm out.

 

quick spreadsheet question:
The freeze pane on the sheet makes it so when you scroll down the sheet, the heading saying that I'm using a pet meter is visible, the line I added saying I switched isn't visible (or soon won't be after more lines are added). I don't want any confusion when someone is viewing his spreadsheet. Is it safe to add a note in the heading or will that screw up the sheet? Any other suggestions for this? Should I post the Q somewhere else, like in the spreadsheet help forum?

 

His shot this morning was a fiasco! First, I 'wasted' 2 needles missing the correct place on the membrane of the vial and putting it through a thicker spot. Then, Clarence jumped a little when I started injecting, which pulled the needle out (and there was a droplet that for sure didn't make it in). I managed to calm him down a little and injected the amount remaining in the syringe (which I hate to do because I know the needle was a little dull by now). I should be able to see by his numbers if I didn't even get close to getting the majority of it in, shouldn't I?

 

Missing the right spot in the vial and fur shots happen to all of us from time to time so don't fret over it. Just make a note to yourself in the remarks or in the dose cell so you have that info for reference. I'll peak at the spreadsheet later today and see what I can suggest. You can certainly add a notation in the heading or on the line with the pet meter declaration about switching on July 29th. Got to think about how to best do this. We can freeze rows but which ones is the question.
Eventually, while you may look back on the AT2 readings to see your progress, you won't need to use them for reference anymore once you get a bit more human meter data as they will be ancient history.

 

Just tested him after I got home from town (which is +5 and he was at 51 on the human meter. I gave him a little gravy from Friskies/with a little honey and will test again in about 20 minutes.) I tested him before I left and he was at 150.

 

Sorry just seeing this now. I see Clarence is back up to 88 now. Looks like another dose reduction is in order to 1.25u. That little monkey seems to be on a mission right now which is good except for your nerves. Good job giving him the gravy. Now that he's up and in a good place, just double check again to make sure he is maintaining a good BG level. Hopefully he is just surfing along in the same range now or up a bit higher. Don't feed him more carbs unless his BG is dropping again. You want to see if he can maintain it himself.

I can't stay online to monitor right now but you've got this and I'm sure Clarence will behave now. If you do happen to need any help, put a 911 on a post in Health and someone will assist you.

I'll check in when I get back home.

 

Today was rough on Clarence and on me. I really need to get better at this fast! I should have known that he was dropping a little quickly when I got the +3 reading and insisted that my son test him at +4 and call me to report. I did feed him a little of his regular food after his +3 thinking it would be enough to keep him from low numbers until I returned home. But maybe I should have given him a little more since I often feed him a little at that time. In retrospect should maybe not have fed him the honey with the gravy friskies and given him the gravy twice...I need to work on my response to the readings I get. He was feeling pretty good when he was at the 51, but was hungry. I'm sure the gravy was the right thing to do (not sure about the honey with the first round of gravy tho), there was no way of knowing how low he was going to go and with still a couple hours before his usual nadir I didn't want to chance anything. Are there amount guidelines for this, like give him a couple tablespoons of the medium carb food? And how much honey?

What might tonight be like?

 

I think tonight you reduce again down to 1.25u. If you are worried and Clarence isn't terribly high, then back off to 1u for tonight and resume with 1.25u tomorrow. Clarence is obviously getting extremely, almost too, good drops out of the 1.5u especially given he looked to be in a bounce this morning.

I think you did exactly what you needed to do and you kept him safe and that is what counts. Until you go through this a couple of times and figure out what works for your cat, it's hard to say do X,Y or Z exactly. You do what you need to do to get numbers up when they are that low and try not to shoot BG to the moon but if you do it's no big deal. I'd say you hit the nail on the head.

As for foreseeing what he might do, you gave a lower dose than yesterday and BG at +3 was a tad higher than yesterday so you had no way of expecting/predicting that 50 reading. The important thing is that you handled it like a pro and didn't shoot him to the moon. Remember, when he goes into low numbers, his defences kick in too so while 176 may seem high to you, believe me, I've seen kitties go up a lot more than that. Safety first. BG will come back down if you boost a bit too much. Far better safe than too low.

 

Well, he is at 252 for his PMPS. Since I gave the injection a little later this morning do I need to do the same tonight? I would usually just feed him now, wait 20-30 minutes after he is done eating as has been advised and then inject (which has taken me a little longer these past few days - haha). Anyway, would you think 1.25 would be okay to give?

 

If by a little later you mean up to an hour, then you can shoot whenever you want to. You can shoot up to an hour early as long as BG is high enough which it is. Although Clarence was a bit lower last night and didn't do much dropping, I think tonight I'd err on the conservative side and give 1u just to be on the safe side and to allow you to get some sleep after this emotionally charged day.

 

BTW, I will set alarms and monitor him a little closer tonight unless he looks like he isn't going down much. And I'm still getting used to the pre-shot numbers with this human meter...

 

Well, maybe it is server slowness somewhere, but I checked for a response right before I gave him his shot and didn't see any response, so I gave him 1.25. I see that you sent it not that long after I asked it, tho. Hope I don't regret that decision. I will check him at +3 or maybe a little later and see what he's like and then I can also give him a snack of his usual food. I'll be fine with sleep. I'll have extra coffee tomorrow!