Help with Elmo Hypo

Discussion in 'Feline Health - (The Main Forum)' started by Beth 73, Dec 8, 2016.

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  1. Beth 73

    Beth 73 Well-Known Member

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    Hello all Elmo guardian angels....PMPS at + 11 is 156..... advise please ...
     
  2. Beth 73

    Beth 73 Well-Known Member

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    FYI ...will be feeding in 15 minutes and insulin in 45 minutes...
     
  3. Beth 73

    Beth 73 Well-Known Member

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    PMPS at +11...156...... feeding in 15 minutes....insulin 30 minutes after that
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Two choices: 1. more brave: give 0.25 u; 2. less brave: no shot. :)
    He'll probably be more insulin sensitive after today's hypo so 0.25 u might have a bigger effect than it normally would.
     
  5. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    I agree with Kris's take on the number. A lot of that is going to depend if you are able to monitor the next 4 or 5 hours after the shot. If you can you could give the 1/4 unit reduced dose Elmo earned today. If you don't feel you are up for a potential pajama party, then a skip would be in order. Elmo certainly surfed those blues nicely today.
     
  6. Beth 73

    Beth 73 Well-Known Member

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    Hmmmmm....pros and cons on both....gotta think on this ...:bookworm:
     
  7. Beth 73

    Beth 73 Well-Known Member

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    I definitely will be up and can monitor...just what would be safest is my initial thot...
     
  8. Beth 73

    Beth 73 Well-Known Member

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    Maybe also feed a bit higher carb food ?? Core beef is 5 carb while Core chicken/Turk/ liver is 8....
     
  9. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    If you are feeling brave you could give a skinny, skinny 0.25 unit and watch him. The one nice thing is Elmo seems to be carb sensitive and did well with the higher carb foods you gave him today.
     
  10. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    What would you normally be giving him for his prehot meal?
     
  11. Beth 73

    Beth 73 Well-Known Member

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    Usually right now the Wellness Core Beef venison lamb and Wellness chicken and beef....that's what he currently likes....
     
  12. Beth 73

    Beth 73 Well-Known Member

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    That's what he is eating right now
     
  13. Beth 73

    Beth 73 Well-Known Member

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    If he lags eating those I throw in some FF chunky turkey or chicken.....he REALLY likes those...they r my bribe foods currently
     
  14. Critter Mom

    Critter Mom Well-Known Member

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    I don't often suggest anything dose-wise except to articulate things that are fairly obvious but nevertheless important not to assume, so:

    1. The 0.5 dose is definitely too high. Given the data you've recorded I think it would be dangerous to give this dose to Elmo at this point. A somewhat higher nadir in the normal range would be safer for a Vetsulin kitty.

    2. Make sure to check Elmo for ketones daily because of his history - especially when a dose reduction is made.

    3. If you do give insulin tonight I would advocate a very conservative approach plus I would strongly recommend starting to test at +2 (or even earlier if Elmo starts looking for grub - appetite uptick usually signals dose onset) and keep testing until confident that nadir is passed safely (you've got very little recent PM cycle data to help so testing's the safest thing to do).


    Mogs
    .
     
  15. Critter Mom

    Critter Mom Well-Known Member

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    Word of caution:

    It doesn't always follow that higher carbs produce higher BG levels; sometimes a slightly higher carb food may result in better BGs (depends on the cat and how functional their pancreas may be).

    At these BG numbers plus Elmo's BG patterns of late plus using Vetsulin it's safer to test than take a chance that a carbier food will keep him in safe numbers (IMHO).


    Mogs
    .
     
  16. Beth 73

    Beth 73 Well-Known Member

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    I routinely check ketones and did so twice today...he balances on edge of litter box to go so makes it easy to catch....and yes , being extra hungry has been one of his signals..I will test at +2 and monitor til at least + 5
     
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  17. Cathie and Shaak Ti (GA)

    Cathie and Shaak Ti (GA) Well-Known Member

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    WOW!!! you guys had some day!! Congratulations on hard earned kudos to all of you!:bighug::bighug::coffee::coffee::coffee::coffee::coffee::coffee::coffee::coffee:
     
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  18. Beth 73

    Beth 73 Well-Known Member

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    Mogs....thank u, thank u for ur insight and wisdom and caring.....praying for extra restful sleep to u this night:bighug:
     
  19. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm on board with everyone else. Back on the 1st of Dec, when Elmo got the 0.25u after a 73 earlier in the day cycle, he nicely surfed in the 160 range through the night ...possibly a bit of a bounce and wasn't much higher the next morning. He went much lower today and then surfed nicely. Doesn't look like he bounced so I'd be inclined to go with the skinny 0.25u and monitoring up to at least +5 if that's doable. Aren't PJ parties fun! ?
     
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  20. Beth 73

    Beth 73 Well-Known Member

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    Oh , yes, love me some pj party time :joyful:.... getting ready to give a skinny .25 and will take BG probably hourly starting at +2 til at least + 5....sooner or longer if needed....thank u :bighug:thank u:bighug:thank u:bighug:Linda and of course Menace ;)
     
  21. Critter Mom

    Critter Mom Well-Known Member

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    Thank you, Beth. Fingers and paws crossed for a safe and uneventful PM cycle.

    :bighug:


    Mogs
    .
     
  22. Beth 73

    Beth 73 Well-Known Member

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    Amen and thank you, Mogs....I receive your words gladly :bighug:
     
  23. Beth 73

    Beth 73 Well-Known Member

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    One last question before it is bedtime for many of you on east coast time.......thots on tomorrow morning dose? Stay with reduced 0.25 depending on tonight and AMPS ???
     
  24. Beth 73

    Beth 73 Well-Known Member

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    Also will only be posting my BGs on SS tonight unless there is a problem....which there will be none:)
     
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, that makes sense to me.
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I agree with sticking to the 0.25u for now. I'm with Mogs re: aiming to keep Elmo's nadirs in very low 100's range and absolutely no lower than 90 on the pet meter so you always leave yourself a little extra room for drops. It may take a few cycles to see exactly how the 0.25u is working for him so even if you see slightly higher readings over the next few days, I'd hold the lower dose unless of course Elmo is too low to get his shot.
     
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  27. Beth 73

    Beth 73 Well-Known Member

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    With PM reads of 133 +3 and just 134 +5 (was acting hungry at +5 so fed him) , believe I will pj party til +7 to see what we get...would rather stay up than get alarm woke up :coffee:
     
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  28. Beth 73

    Beth 73 Well-Known Member

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    167 at +7 PM....
     
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  29. Beth 73

    Beth 73 Well-Known Member

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    Encouraging morning Elmo update to the Kitty Cavalry:)...Elmo AMPS 165...gave 0.25 unit vetsulin. BG at +2 126........will be testing at +2, +4 and +7 today and then +2 and +4 this evening.....again a HUGE thank u to all the Cavalry who pulled Elmo and I thru yesterday...words don't adequately express:bighug::bighug::bighug:
     
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  30. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Elmo is looking good so far on the reduced dose. You did a great job yesterday with that hypo number. :bighug:
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Elmo wasn't too high this morning and he's had a good drop at +2 so you might want to test at +3 just to make sure he is not going to quickly so you can steer him if need be. Elmo is definitely progressing well and in the right direction but he's also a little less predictable than they are at higher ranges.
     
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  32. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree. Looking good but predictability might suffer right now.
     
  33. Beth 73

    Beth 73 Well-Known Member

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    Thank u , Linda...+3.5 just taken was 144...monitoring extra thru out next few days..taking ketone check several times a day..his balancing act on edge of litter box aids that ...eating and acting normal
     
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  34. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Well isn't Elmo full of surprises! I thought he'd be down not up at +3.5. Oh well, we all know, our kitties are all doing slightly different steps and they change them up just to keep us on our toes.
    As for the ketones, I think checking once a day is more than sufficient unless there are any ketones showing up. He's not running high BG, is healthy otherwise and eating well so chances of ketones right now are low. You are a wonderful kitty Mom Beth, but take a break when you can so you are in good shape when Elmo really does need extra attention.:bighug:
     
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  35. Beth 73

    Beth 73 Well-Known Member

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    :bighug::bighug::bighug:
     
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  36. Critter Mom

    Critter Mom Well-Known Member

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    He seems to be like Saoirse; metabolising the dose really quickly at the beginning of the cycle. FWIW Saoirse's nadirs started getting earlier and earlier when she started heading for remission.

    Beth, a bit of an advanced heads-up for you to think about: if you find that you can't nudge Elmo into regular nadirs in the low 100s on 0.25 IU Vetsulin but also find that the 0.5 IU dose continues to be unsafe (and I really do think it is taking Elmo too low for comfort on this particular insulin, even on days when he hasn't dipped below the hypo threshold) it might be worth sounding your vet out now about possibly using Lantus or Levemir to continue Elmo's treatment.

    The L insulins typically don't produce wide variations in BG levels over the course of a cycle (provided a good dose is established!) and because of this they can provide a means to keep a kitty in healing numbers for more of the day while allowing treatment to continue safely for a longer period of time. This allows the pancreas to rest for longer and hopefully recover more beta cell function.

    I was able to get Saoirse switched from Caninsulin to Lantus because it became unsafe to give her even a tiny dose of Caninsulin but she was not in remission. I was able to help her into much better BG levels and because I was able to safely extend the period of her insulin treatment she did achieve remission. It's certainly worth running the idea past your vet if you run into a Vetsulin dosing 'brick wall'.

    :bighug:


    Mogs
    .
     
  37. Beth 73

    Beth 73 Well-Known Member

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  38. Critter Mom

    Critter Mom Well-Known Member

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    I'll do what I can to help, Beth. :bighug:
     
  39. Beth 73

    Beth 73 Well-Known Member

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    Mogs,,,sorry i am often techy deficient and today sleep deprived...posted a reply on ur previous post...how i manage to do it correctly one day and not the next is beyond me:nailbiting:
     
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  40. Beth 73

    Beth 73 Well-Known Member

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    Thank u, Linda..u r truly one of Elmo's guardian angels :)
     
  41. Critter Mom

    Critter Mom Well-Known Member

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    Don't worry, Beth; I found it. And boy, oh boy! can I relate on the sleep deprivation side of things.

    :bighug:


    Mogs
    .
     
  42. Critter Mom

    Critter Mom Well-Known Member

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    Linda?!! (Teasing. :p)

    Wow! You really are punchy tonight, Beth. Sending you an extra big batch of :bighug::bighug::bighug::bighug::bighug::bighug:. I hope you'll get a good sleep tonight.


    Mogs
    .
     
  43. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    :DThose sleepless nights do take their toll! We've all been there. Hopefully Elmo will let you get a good night's sleep tonight Beth!:bighug:
     
  44. Beth 73

    Beth 73 Well-Known Member

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    Ahhhhhhhhhhh:nailbiting::nailbiting::nailbiting:......shoots holes in my "I'm doing ok on 3 hours sleep" mantra;).........seriously tho, when/if Elmo and i do hit the vetsulin wall, please feel totally free to give me a nudge in the changing insulin direction...i tend to overthink things and will be depending on u and others to urge me on...hopefully on a day where ive had more than 2.5 hours sleep :p:eek::joyful::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::woot:
     
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  45. Beth 73

    Beth 73 Well-Known Member

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  46. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    "Both of ur precious black kitty pics thru my bleary mind for a loop!! At least that's my story and i'm sticking to it:nailbiting::nailbiting::nailbiting::coffee::coffee::coffee:;););):bighug:"

    I believe ya! The pics are quite similar AND beautiful! :p
     
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  47. Critter Mom

    Critter Mom Well-Known Member

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    There's a pair of us in it! ;)


    Mogs
    .
     
  48. Critter Mom

    Critter Mom Well-Known Member

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    Indeed they are, Linda. Indeed they are ...

    :bighug:


    Mogs
    .
     
  49. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Whatever would we do without those emoticons to convey what's going on mentally??!!
     
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  50. Beth 73

    Beth 73 Well-Known Member

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    Linda...PMPS just now at 202.... what dose to give in 30 minutes ???
     
  51. Beth 73

    Beth 73 Well-Known Member

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    Linda....PMPS at 202...what dose to give in 30 minutes ?
     
  52. Beth 73

    Beth 73 Well-Known Member

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    Did it again ...
     
  53. Beth 73

    Beth 73 Well-Known Member

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    Sorry I am all over the place...just got PMPS of 202....scares me....what dose to give in 30 minutes ????
     
  54. Chris & China

    Chris & China Well-Known Member

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    I think it's probably time for a new thread Beth....this one's getting pretty long

    You shot .25 this morning at 165.....I'd hold that dose tonight too
     
  55. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hi Beth,
    Can you eyeball 0.25 u and then let out a small drop to estimate 0.125? Or you can go with what Chris and China has suggested.
     
  56. Beth 73

    Beth 73 Well-Known Member

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    Can try... scary to give such tiny amount with number so high for him....
     
  57. Beth 73

    Beth 73 Well-Known Member

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    Will do after get thru this ....no sleep magnifies...I know u all know
     
  58. Beth 73

    Beth 73 Well-Known Member

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    Still have 15 minutes before the 30 minute eating period...he is eating ok....what do I need to watch for tonight???
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Same as what you had to watch for yesterday: too rapid a drop, too low a nadir, too early a nadir, etc. You could always test hourly up to +6 or +7 and be ready with small amounts food to steer. Don't feed too much at once and avoid using syrup if you can.
     
    Last edited: Dec 9, 2016
  60. Beth 73

    Beth 73 Well-Known Member

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    Mercy....how u all have done this for as long as u have amazes me
     
  61. Kris & Teasel

    Kris & Teasel Well-Known Member

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    We get used to the routine, Beth, and we aren't always having the excitement you've had recently. Baptism by fire for you ... :)
     
  62. Chris & China

    Chris & China Well-Known Member

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    We're all a bunch of crazy cat ladies!! (with a few gents thrown in)

    But seriously, all this testing now helps you to learn how your cat reacts.....as you get more experience under your belt, you'll learn what signs to watch for and will learn when it's probably going to be OK to take a pokey break and when you need to keep a closer eye on things
     
  63. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm on board with the 0.25u again. 202 isn't that high and it could just be Elmo reacting to the low numbers of late. Beth you are doing fine and while we all know how panicky this can make you, take deep breathes. You've got this. The trick here is to let Elmo direct you without immediately getting aggressive about dosing. It's tough and we all go through it but it does get easier with time. I find myself almost complacent (perhaps too strong a word) when my sugar throws me a low number now. It's become more of a routine than a panic.
     
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  64. Beth 73

    Beth 73 Well-Known Member

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    The BEST...that's what you all are :bighug:
     
  65. Critter Mom

    Critter Mom Well-Known Member

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    Hi Beth,

    Just saw this. I would stick with the 0.25 IU dose, even with the 202 preshot; the 0.5 IU dose is IMO too high and unsafe.

    Is all well on the ketone side of things today?


    Mogs
    .
     
  66. Beth 73

    Beth 73 Well-Known Member

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    Ketones negative ....I think I may be too old for this :nailbiting:
     
  67. Critter Mom

    Critter Mom Well-Known Member

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    Lethal Weapon fan, perchance? ;)

    Good news on the negative ketones. :cool:

    You're doing a grand job, Beth.

    :bighug:


    Mogs
    .
     
  68. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Beth, you are obviously NOT too old for this! You should be very proud of yourself woman! You are doing a grand job of looking after your beloved Elmo! :bighug::bighug::bighug:
     
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  69. Beth 73

    Beth 73 Well-Known Member

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    Will test hourly mostly for my comfort... be ready to steer up with 1teaspoon low carb food if goes below what number ???
     
  70. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Any green, just in case.
     
  71. Beth 73

    Beth 73 Well-Known Member

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    So keep him in blues??
     
  72. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Beth, I think MamaBean needs a little rest so if I were you, I'd test at +2 and see where your little sugar is headed and then again at +3. As Kris says, any green is time to steer. Then hopefully Elmo will let MamaBean grabs some ZZZZZ's. It would be ideal to keep him in the blues but low blues. I wagering bets that Elmo will behave himself tonight. Elmo, please don't call my bluff! :)
     
  73. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aim for that, Beth. I said any green because of what you've been through and blue gives you that margin of safety that will give you peace of mind after your ordeal. You'd be erring on the side of caution. I wouldn't panic if he gives you a high green at or post nadir though. Just dose with food.

    Meanwhile look at that Elmo face! He's saying, "Who? Me? Cause trouble for my mom? Never!" :)
     
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  74. Beth 73

    Beth 73 Well-Known Member

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    I am starting a new thread entitled " I may be losing my post menapausal mind !!"...... nah, just kidding ;)
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

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    They keep us sharp!
     
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  76. Critter Mom

    Critter Mom Well-Known Member

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    It could end up being very well-subscribed! ;)


    .
     
  77. Beth 73

    Beth 73 Well-Known Member

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    You, dear Mogs, are a comedian :D:D:D
     
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  78. Critter Mom

    Critter Mom Well-Known Member

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    FYI peeps, I've got sleep meds on board so I won't be around tonight.

    Hope all goes well and safely, Beth, and that you get some quality rest once you're sure his nibs is in good numbers for the rest of the cycle.

    :bighug:

    Oiche mhaith, a chairde, agus codladh sámh!


    Mogs
     
    Last edited: Dec 9, 2016
  79. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sweet dreams Mogs! I hope you get a very restful and restorative sleep! :bighug::bighug::bighug::bighug:
     
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  80. Critter Mom

    Critter Mom Well-Known Member

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    You bring it out in me, Beth! :woot: (No mean feat, these days ...)


    Mogs
    .
     
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  81. Marlena

    Marlena Well-Known Member

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    Oh blame, I know how it feels!;):p
     
  82. Marlena

    Marlena Well-Known Member

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    Oh blimey, my spelling's gone horribly wrong!!!
     
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  83. Beth 73

    Beth 73 Well-Known Member

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    :bighug::bighug::bighug:
     
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