High Glucose, 9 units on Vetsulin

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Sammy's G-ma, May 17, 2017.

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  1. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Hello. My cat is Sammy. He is a mix between a Tabby and a Siamese, which makes a beautiful grey striped tiger look. Sammy is 6 years old.

    History

    We started Sammy out on Vetsulin. He stabilized at 7 units. But unbeknownst to me he was showing the early warning signs of Pancreatitis. He stopped eating his wet food and was only licking away the gravy. This was going on for months.

    At some point I decided to switch Sammy to a less expensive insulin. I switched him to Novelin, the long lasting type, N I think.

    Sammy had a Pancreatitis attack and was hospitalized for three days while he got intravenous Novelin and Water. His Ketones were very high. His pancreas recovered fast while he was on intravenous Novelin R. They put him on Antibiotics and on Antacid's and something else to help with nausea. These were all short term prescriptions.

    Sammy had lost weight and was about 9 pounds

    We brought Sammy home on Novelin N at 3 units and took him back in about every 3 days to measure his insulin. They uped his dose one unit each visit because he was running between 300 to 500, normally in the 400's. When we got Sammy up to Novelin N 10 units, he still ran in about the 400's. But Sammy was gaining weight and got back to 10 pounds. I believe Sammy is best when he is at 11 pounds.

    For food we feed him a measured amount of Science Diet WD

    Last week we did a Glucose Curve. Sammy responded to the insulin within the first 30 mins with a dip but in a short time after that he spiked back up and stayed high.

    Since we were not getting results on Novelin we switched back to Vetsulin. They had me start at 6 units. Now we are all the way back up to 9 units. Still Sammy is still running in the 400's. We are using the U-100 syringes so we do the 2.5 conversion in order to get the right dose amount.

    Today we did a Frutosamine test, it was high and did not seem to give the vet any ideas on what to do next.

    He is a indoor and outdoor cat. We ended up finding out he was sneaking the neighbors food at night, so we do not let him out at night. If Sammy is throwing up I would not know, he hides it from me.

    The good thing is Sammy is not acting like he is starving any more. His water and urine are high, but not extreme. He is gaining weight, he has a good apatite and eats all his food eagerly. But the bad thing is he is not responding to insulin he runs in the mid 400's. I would love ideas from you on what you suggest we do next. I have a human glucose meter at home. I have tested his blood at home, mainly to see if he is high or low.

    Thank you for your insights!!!
     
    Last edited: Jun 23, 2017
  2. Sharon14

    Sharon14 Well-Known Member

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    Hi Jeanine, welcome. Good that you have a meter and know how to test! To find out what's going and to keep Sammy safe, you should test him before you feed and give insulin and then try to get a test or two during his cycle. The Science Diet W/D is a very high carb food, and if you start testing as stated above, then you can gradually switch him to a lower carb food. This may bring his glucose down significantly, so you must be home testing before the switch. We recommend a wet food over a dry and there's no need for the expensive vet foods, plain old Fancy Feast Classic or Friskies pate will do. If you can start the testing and record the numbers in our spreadsheet that will make it easier for us and your vet to help you.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    If you need help setting it up let us know and we'll get someone to do it for you. Please keep asking questions
     
    Last edited: May 17, 2017
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  3. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Welcome Jeanine and Sammy!
    To add on to what Sharon said with home testing, we can help you figure out Sammy's better dose. I can also help set up the spreadsheet as Sharon mentioned;). It sounds like the Vet has been increasing in terms of whole units, something very common but not practical. We prefer to recommend increases made in 0.25U or 0.5U increments. :)

    If you could also setup your Signature with some information in the instructions, it's super helpful: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/ Also, helps those of us with bad memories :smuggrin:

    As a new member to the forum I will also leave you this link: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
     
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  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    What are you feeding?

    Are you testing at home?
     
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  5. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Hello! Sorry I have not replied sooner. Thank you everyone for your information. I have had several demands on my time, but I just got a window in my life to try these new things with Sammy.

    Today I put Sammy on Friskies wet food with a little of the old food mixed in. I moved his does down to 8 units because I strongly feel the 9 units is WAY to high!! I plan to move his dosage from here in small increments as suggested here and in other threads.

    I am astonished at the immediate results this simple change has made!!! For the first time in over a month Sammy tested below 330!!! Four hours after feeding today Sammy was at 117 on my human tester. Which seemed low, Sammy was looking for food. I gave him as much canned Friskies as he wanted. Sammy tends to eat what he needs, not over eat. If he acts hungry and scrounges for food it is unusual, and I believe it is because he needs food.

    All I did was change the food!! What the HECK with that Science Diet stuff!!???? Was that really the problem?? Because EVERY vet highly recommended it!! Frustrated at that. But glad for this forum and all of your expertise!! I was skeptical to take your food change suggestions.

    I still need to set up a google docs. I know google docs quite well so I think I will be able to set it up. If I have questions I will let you know. The suggestion to put important information in my signature makes sense. I will look into that too.

    I plan to check Sammy's levels several times today, and going forward.

    I am glad to have this resource, and for your help and insights.
     
    Last edited: Jun 23, 2017
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  6. JanetNJ

    JanetNJ Well-Known Member

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    Good job testing and switching food....it makes a HUGE difference.

    When you get A chance set up a signature as well. Click on your name in the upper right hand corner and choose signature. Add info such as your pets name, date of diagnosis, type of insulin, food, type of meter, and any other health concerns. Then hit save.
     
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  7. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I was feeding Sammy 4 times a day on Science Diet WD. Two larger meals when I gave him his shot. He was on 2 to 2.5 cans of wet or 1 to 1.25 cup of dry on Science diet.

    I am thinking I will have Sammy on 2 cans of Friskies a day. Feed him 1/2 a can 4 times a day. Now that I think about it, I did have one vet who had a diabetic cat, he suggested to NOT use Science Diet WD. This vet suggested Sammy eat several times a day, smaller meals, to avoid spikes in blood sugar.

    Do you have suggestions on how much I feed Sammy and when?

    Look! I have a signature and a spreadsheet. :) Thanks for the help.
     
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  8. Yong

    Yong Well-Known Member

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    How is Sammy's weight?
     
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  9. Sammy's G-ma

    Sammy's G-ma Member

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    He was down to 9lbs and constantly hungry when I started giving him .5 cans extra a day. He is now just over 10 again I believe. He should be about 11lbs. He runs thin in the Summer and chubby in the Winter.
     
  10. Yong

    Yong Well-Known Member

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    *I'm not an expert* but I did some research for maintaining, gaining, losing weight on kitties. With what I've found, I take an average of a couple formulas. If you are interested, I calculated you want Sammy to eat around 191.7 calories per day, so divide that by how many meals you feed time. Dr. Pierson's Food chart has calories per can for most foods :)
     
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  11. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Wow! I would have been WAY over feeding him!! Thanks for this info.
     
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  12. Yong

    Yong Well-Known Member

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    Forgot to mention I calculated that based on a 10.5lb kitty, so if he needs to get closer to 11lbs, you can round up to 200 calories / day :) until he reaches goal weight. Then just go back to lower end to maintain :smuggrin:
     
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  13. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Good to know. Thx
     
  14. JanetNJ

    JanetNJ Well-Known Member

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    While cats are unregulated they require more food because their body doesn't utilize the nutrients properly. Esp while he needs to gain, if he's hungry, feed him.
     
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  15. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Janet this helps, thanks. Sammy did ask for more food then the 3/4 can I planned to give him this morning, so I gave it to him.
     
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  16. JanetNJ

    JanetNJ Well-Known Member

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    Sounds good... Just no food 2 hours prior to preshot testing.
     
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  17. JanetNJ

    JanetNJ Well-Known Member

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    I noticed he got down to 89 last night at +4... While a safe number he still had two hours of drop time. Now that he's eating lower carb food you may need to reduce the dose a bit esp when the preshots are lower. You may want to do 7-7.5 when the preshots are under 450

    I think you may see the numbers gradually come down over the next week.
     
  18. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I am feeling good about this process so far, feeling in more control. Thank you for looking at my spread sheet. I was thinking I would bring him down to 7.5 today, until I saw his high pre shot levels this morning. I will bring him down to 7.5 for his evening shot today. I think that is a good idea. I have been reading more on the forum about HYPO etc. When ever I took Sammy into the vet we tested his blood at 4+. So right now my goal is to have Sammy in the Blue range on the spread sheet at 4+. Does that sound about right?

    Notes

    5/27
    11:45pm Sammy looked groggy, would not jump up on his table, His eyes looked droopy and his movements slow and kind of drunk. He had a low level of 89. I gave him two spoonfulls of food. He licked the gravy and looked better.

    5/28
    Sammy stayed in last night. Was high first thing with no food. Seems strange. I am going to keep him in at night for a while to establish a pattern. Maybe Sammy's snack from late last night, that he only licked the gravy off of was still in his bowl this morning? Maybe Sammy ate that before I tested him this morning? Sammy normally is not hungry when he is high, he normally regulates his own food intake. But today he seemed hungry, so I let him eat more. I have a lot of confidence in Sammy knowing what he needs.
     
  19. JanetNJ

    JanetNJ Well-Known Member

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    In response to your notes.... While 89 is not technically hypo, since it's so far from his norm of 500+ it felt low to him. Another reason to ease up a little on the dose. If you ever want a second (or third or fourth) opinion on a particular dose, just ask on here.
     
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  20. JanetNJ

    JanetNJ Well-Known Member

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    BTW, while some cats peek at +4 on vetsulin, many don't hit the lowest until 5 or six hours post shot. One day when you can, try catching a 4,5,6 test to see what is happening to see the nadir (lowest) point.
     
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  21. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    oh ok.... Good to know. Thanks!
     
  22. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I just found this image that helps me understand better what Sammy's blood sugar should ideally look like. This helps these blood sugar levels make a lot more sense!!

    I continued to give Sammy 8 Units because the #'s seemed high. Now that I understand the curve, the numbers do not seem as high. I will go down to 7.5 tomorrow.

    http://www.vetsulin.com/vet/Cats_Monitoring_About.aspx

    [​IMG]
     
    Last edited: May 28, 2017
  23. JanetNJ

    JanetNJ Well-Known Member

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    If the preshot is over 450 do I'd do. 8, if under do 7.5
     
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  24. Sammy's G-ma

    Sammy's G-ma Member

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    Thank you for this guide! That helps a lot. I gave him 8 units again because he was over 450.
     
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  25. Yong

    Yong Well-Known Member

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    Jeanine, just curious about a couple things.
    1. Are you testing for ketones?
    2. Would you be willing to try a start-over? My understanding is you got to current dose, and previous ones, via whole unit increases? @JanetNJ and @MrWorfMen's Mom can maybe chime in on their thoughts on this as well.
    I know I have not used Vetsulin or Novolin N and if it could work the same as Prozinc and Jeanine was up for it, go ahead and go back to 1.0U, hold for 3 cycles and increase by 0.25U at a time?

    *I am not trying to give dosing advice* Just a thought I had, of course it is very possible Sammy needs the higher dose.
     
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  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think a good part of the reason for those high pre-shot numbers is the massive drops Sammy is getting on the 8u.
    27May he dropped from 396 at +1 to 89 at +4, a difference of 307 points
    28May he dropped from 601 at AMPS to 146 at +5, a difference of 455 points
    then he dropped from 480 PMPS to 187 at + 4, a difference of 293 points​
    These drops are more than 50% of the starting BG and a recipe for bouncing.

    With a history of ketones I wouldn't recommend starting over from scratch but I think it would be prudent to back off the dose slowly and do so by at least 0.5u or even 1u given the large dose he is on. The recent diet change is likely impacting his need for insulin. Purely speculating, it's also possible Sammy has a low grade asymptomatic chronic pancreatitis which can contribute to the need for higher doses of insulin than expected or there could be another high dose condition involved but right now it's impossible to determine an ideal dose or whether either of those secondary possibilities have any merit when he is going up and down so dramatically.

    Sammy has become accustomed to high BG levels and any substantial lowering of his BG is foreign to him now and makes his system panic and release hormones to raise his BG to even higher levels. The goal is to try to keep kitty in optimal numbers for as long as possible in each 12 hour cycle hopefully keeping the bouncing to a minimum. You can't force the issue with huge amounts of insulin but also don't want to give too little particularly when there is a history of ketones. Bouncing once in motion takes a few cycles to clear and if the dose is too high and it keeps getting raised based on high pre-shot numbers, it becomes a perpetual problem that is going to take some time to get past. Dosing should be based on both pre-shot levels and how low the dose is taking him. Right now the doses are taking him to safe but drastically lower levels so as long as he is high enough pre-shot to receive insulin, I'd pay more attention to how low he is going to determine how to proceed dose wise.

    If Sammy were my guy, I'd back off to 7 or 7.5u for a period of 2 or 3 days no matter how high the pre-shots are and pay more attention to the amount of drop occurring mid cycle. When the bouncing clears, I'd expect the pre-shots to come down on their own. If he is still showing drastic drops after a few days on the lower dose, lower it again.
     
  27. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    This is a lot of good info. I have a lot of things I am not sure about....

    We diagnosed Sammy late. I believe he had mild diabetes for 2 to 3 years before we caught it. Sammy gets more thin in the summer when he is more active. We took him into the vet, concerned he was a little under weight. Because he is a big boned cat, the vet would not be as concerned with Sammy's weight. The vet would scratch his head, think everything looked good. At the next summers dip in weight we would be concerned again. It took an increase in symptoms for us to catch the issue.

    Because Sammy was diagnosed late I think his pancreas and his ketons had been building up for a while. Sammy's recent hospitalization was able to flush them clean. The hospital recommended strongly Science Diet WD to avoid another pancreas attack. But that switch created what looks like was 1.5 months of severe deregulation. At every turn I expected I would need to take Sammy back in again for pancreas and ketons. Then I found this forum.

    I think it is likely Sammy has a build up in pancreas and ketons issues now because of this severe dis-regulation he has been under this last 1.5 months. I think testing for Ketons is a good idea and will be the next thing I add to his care regiment.

    I am impressed with the level of knowledge in this forum. I think the concerns about Sammy bouncing make sense! When I look at what a normal glucose curve looks like it looks like the highs and lows have a difference of about 200. Sammy, as noted above, has been running 300 to 450. So that does sound like a bounce.

    Quite honestly I was excited to see ANY dip below 330 from Sammy with the food switch. When the vet recently did Sammy's glucose curve he only dipped for a short time.

    I feel like 8 is too High. I am much more comfortable with 7 because that is the one place Sammy was regulated at in the past. We always moved in whole units. And this was after years of undiagnosed diabetes. Even 7 seemed high, I would much rather have Sammy on lower units like I see in the other charts here.

    This is what I think I will do....

    Learn to measure Ketones.

    Drop Sammy by .5 units every 2-3 days as long as his lows are more then 250 below the highs.

    Once I get below a 250 difference in lows and highs I will make a new plan.

    Thanks for reading. Sorry so Long. LMK what you think.
     
    Last edited: May 29, 2017
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  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Jeanine, glucose curves done at the vet are not reliable. Most cats get stressed out and that causes their BG to go up. In some cases, that elevation can be 100 points or more so vets are really not doing their clients & caregivers or themselves any favours basing dosing on in office readings. Insulin is a hormone not a drug like an antibiotic so every day is different for every cat and too many vets seem to ignore this fact.

    I'd definitely start checking Sammy for ketones given his history. Anything over a trace is cause for some action and if trace shows up, checking more frequently will be required because ketones have already been present for awhile by the time they show up in the urine.

    Bounces can take up to 6 cycles (3 days) to clear so holding a dose for that long is generally suggested so as to be sure that any bouncing has cleared before making dose changes. Some cats bounce very little, others bounce a lot and dramatically. The trick is to figure out what Sammy is up to, how he responds and go from there. Getting his cycles to smooth out a bit will help. This is a marathon not a sprint so patience is key.

    I'd aim for drops no more than 50% of the pre-shot reading rather than setting a "hard" number of points but not below 90 or so mid cycle. That gives you a bit more wiggle room to deal with any impending low BG readings.

    From one big gulper Mom to another (my girl was on 16u twice daily for awhile:eek:), decreasing doses can be a little more confusing than increasing so keep posting and we'll help you get Sammy back on the right track.
     
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  29. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I am glad to find another "gulper". I think waiting 3 days is good. Thanks for the information about the 50% drops. Your spreadsheets are hopeful! I loved seeing how low you were able to get the insulin units!
     
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  30. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    The Bouncing range was bigger yesterday. And seems to have been bigger today.

    Sammy disappeared into the basement for his nap, he did not come when I called, and resisted the kids trying to get him. They said he looked fine.

    With a human tester, how do I know what is too low?

    I have been giving Sammy a snack 1/2 way between his shot. I am thinking I will start giving Sammy a snack at +3 hours, before the dip, instead of at +6 hours has I have been doing. Moving up the snack might help his bouncing from high to low be less extreme?

    LMK what you think.
     
    Last edited: Jun 23, 2017
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  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Technically speaking any reading under 50 on a human meter is cause for action to bring BG up to safer levels. That said, when using an insulin like Vetsulin, we generally recommend 90 as the point at which to start intervening because drops can be sudden and dramatic so a little extra wiggle room makes the process easier and safer.

    Giving Sammy a snack earlier in the cycle (between +2 and+3 roughly) may be the ticket to smoothing out the cycles and lessening the big drops. Feeding in the earlier part of the cycle rather than later often helps smooth out the cycle.

    I'd be inclined to reduce his dose to 7u given that 53 he got yesterday at +6, particularly if you are unable to monitor him closely. It's better to have him running a bit high and getting used to slightly lower numbers than having his BG go that low because it just sets off more bouncing and could become an unsafe situation.
     
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  32. Sammy's G-ma

    Sammy's G-ma Member

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    Thank you. This makes sense. I am concerned about how low the lows are. I am going to go down to 7 units.
     
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  33. Sammy's G-ma

    Sammy's G-ma Member

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    Tonight my daughter is graduating. All our family will be at the graduation. Our friends close by are out of town. No one is available to come in and give Sammy his shot, Our plan is to give Sammy 1/2 of his shot 2.5 hours early and the other 1/2 his shot when we get home, Which will be about 2.5 hours late. I hope this is a good plan..... Seems like the best option available to us.
     
  34. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Jeanine, I'd be inclined to just skip the shot for tonight if it's going to mess up your shot schedule to shoot 2.5 hours late. While you have some shot time flexibility with Vetsulin, shooting twice will create two nadirs. Neither may be low enough to cause a problem but it does muddy the waters and these furkids can sometimes surprise us. I'd want to try out a technique like that ahead of time to see how it works with Sammy when I could monitor. If you can swing it, I'm thinking just giving the shot on your return home and then shooting an hour or so earlier tomorrow morning assuming pre-shot number is safe,to gradually work your way back to your usual schedule. Or just skip the shot and start fresh tomorrow morning. Sammy will be fine and you will regain ground in short order.
     
  35. JanetNJ

    JanetNJ Well-Known Member

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    Just skip it
     
  36. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    I think skipping is the way to go tonight too. The insulin you're using works on the glucose that's there so it will be easy to get a handle on that again.

    Ketones develop when there's not enough food for the insulin to work on, the body begins using it's fat stores which don't 'burn clean'. It can also be not enough insulin to use the food correctly. Either way, ketones are the result. Testing ketones isn't a big deal - just dip the little strip in fresh urine and compare against the colors on the bottle at 15 seconds. Ignore anything that develops after that 15 seconds, it's no longer accurate.

    HUGS!
     
  37. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Thank you for this information. And so quickly!

    The Vets have told me that if my shot is late to give 1/2 a shot.

    What do I do when I get home tonight? Feed Sammy? And give him half a shot?

    Is it dangerous to feed him without a shot?

    I will not give him 1/2 a shot before I go tonight. I will check back in here after I get home to see what you suggest I do when I get home.

    Thanks for the info.
     
  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You have choices and have to pick what works best for you.
    1. Just skip the shot and get back on schedule tomorrow morning.
    2. Shoot when you get home but this will mean shooting later tomorrow morning and then gradually over the next couple of days getting back to your original schedule by backing up shot times by 3o minutes to an hour as long as pre-shot tests permit. I wouldn't back up by more than an hour and only do a one hour adjustment per day so it will take you a couple of days to get back to your original schedule.
    3. You could shoot 1/2 dose tonight when you get home and just be careful about pre-shot and cycle tomorrow due to the possibility of some carry over from the late shot tonight if you shoot on original schedule tomorrow (i.e 2.5 hours early).

    The caveats to all of this is Sammy's history of ketones. I'd opt for option 2 or 3 rather than skipping for this reason. Have you checked him for ketones lately?
     
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  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Was just peaking in to see how you and Sammy are doing. I see you chose option 2 above and that's great. Hope you enjoyed your daughter's graduation! Congrats to her BTW!

    I see Sammy got down to 71 yesterday from a lower pre-shot of 426 but then he scurried right back up again. If he were my guy, I'd lower the insulin down to 6u and try that for a few cycles to see if that doesn't even him out somewhat. Looking back at how the dosing was upped in the beginning, I am even more convinced that Sammy needs less rather than more insulin and it's quite possible you skipped right over the best dose for him due to the vet upping doses by full units at a time.

    It's nice to see a reading of 71 for a change and while that it a safe number it's low enough to warrant a bit of steering to ensure Sammy does not drop too low with Vetsulin. It also sets off more bouncing and that's what he looks like he's doing right now. The only way to break the cycle of bouncing is to ease his BG down gradually so his body can get re-acquainted with more normal BG levels without panicking and that means less insulin so his numbers don't get pushed as far down mid cycle. :)
     
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  40. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Hello. Thank you for checking in!!
    I planned to give him a 1/2 dose but my daughter misunderstood and gave him a full dose.... So we have been readjusting his dosage time.
    Sammy's pattern seems changed by this schedule changed so it has me scratching my head. I am glad you have a suggestion.

    So, maybe I will back it down by .5 units every 3 days?? Does this seem decent?
     
  41. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I don't think the timing worked against you at all (that is being two hours later with his shot the other night) and you are gradually working it back so that shouldn't be causing any particularly different numbers. It's up to you whether you reduce by 0.5u or 1u but the difference in readings between 7 and 7.5 has been negligible so I think you can safely take it down a whole unit and it might get those pre-shot numbers down a bit more. Both 7 and 7.5u have caused Sammy to dip to low normal numbers bordering on becoming unsafe from fairly high pre-shots and while I normally wouldn't suggest decreasing by a full unit, when the dose is that high to start with, a 1 unit change really isn't that large. Different story when kitty's normal dose is below 5 units. If per chance 6u proved to be too little, which I seriously doubt, you can always take him up by 0.5u again.

    Just noticed he's gone down to 149 today at +6. That seems great but he's dropping so much (441 points which is almost a 75% drop) that it is just perpetuating bounces giving you those high pre-shot readings. He'll likely be high at pre-shot again tonight. Yesterday he dropped 83%. It would be easier on him and lessen the bouncing if you can get him to drop no more than 50% and keep his mid cycle numbers around 90 to low hundreds. To be honest, I am worried he is going to go too low one of these days unless you get the dose down. Better to have him getting slightly higher mid cycle numbers to be safe and that will lead to lower pre-shots and give him some time to get used to having lower numbers.
     
  42. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Ok, this makes sense. Thank you. I will go down to 6. I am concerned about the big differences and the lows too. Also since I have quite a busy life. I try to test him often, but even as often as I test him it does not seem often enough. So if I go down lower that will reduce the risks, I can see that.
     
  43. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Jeanine, lowering the dose will reduce the risks but monitoring when trying to get a bouncy kitty under control is key so until you find that right dose for Sammy, a little more caution is advised. If you're in for a busy day, test earlier in the cycle say between +2 and +3 and see what Sammy is up to. If need be, you can always feed him to slow him down if he seems to be dropping quickly. Those early readings can be very telling much of the time so testing early gives you a head start at warding off any potentially too low numbers. It's a good idea to make sure you have some high carb food, and karo or honey around too just to be safe. Do you have a hypo kit set up? Not that you'll need it but having one helps hold Murphy at bay! ;)
     
  44. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Can you help me understand what testing at 2+ and 3+ would help me see? How would it help me know how low he is going? Should it be at 2+ and 3+ that I see less difference in numbers from the preshot number? And if the difference is high then the low will be lower? Is that what I am looking for?
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Jeanine, with Vetsulin, cats generally hit their nadir (lowest cycle reading) between +4 and +6 however nadirs can move and might be a bit earlier or later on any given day. Sammy appears to often have his around +4 so if you took a reading at +2 or +3, you will already be able to see the drop starting. Today, I am wondering what his reading would have been earlier and whether at that 149, he was at nadir or on his way back up. Getting that extra test in the morning while you are trying to get Sammy sorted out would be helpful to answer that question when he is now getting some considerably lower readings.

    If he's already dropped 100 points or more by +2 or +3, chances are good he's going to drop considerably more. If his pre-shot was way up, then a drop of 100 points that early might not be an issue but if his pre-shot was lower, say around 300, a further drop of another 100 points until he reaches nadir, could potentially take him low enough to need monitoring and steering. Today he dropped over 400 points in 6 hours. The trick is to get some more tests in those early hours and keep testing around nadir to get a sense of how fast and how swiftly he really is dropping. The other thing to be aware of is that cats often go lower overnight than they do during the day. You've been getting some earlier cycle tests at night but he's had some low readings during the day that cause him to bounce and that probably explains why you have not seen much of a drop early at night. Every cat is different and the trick is to learn how your cat reacts.

    It's a lot harder backing up the dose than it is to start low and work up slowly so a little more monitoring right now will help get Sammy on the right track ASAP while helping to avoid any scary situations. I'll keep an eye on Sammy's spreadsheet and you can holler anytime if you have questions or need help. We'll help you get your furry friend figured out! :)
     
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  46. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Thank you for your support and information.

    So should I be focusing my efforts on testing him most in the +2 +3 +4 +5 +6 hours?

    I think if I understood the best hours to be testing I could stay more focused on what is the most important.
     
  47. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    I have been testing about 6 times a day. To me this feels like a lot. But I understand what you are saying about me not getting enough information about Sammy's curve.

    So. What if I try to test 8 times a day.
    AMPS, PMPS
    And 3 times, switching every other day between odds or evens in the hours of +2 +3 +4 +5 +6 +7, twice a day.

    Would this give me/ you/ others the information that is needed?
     
  48. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good grief, I am not suggesting you test that often day and night. I don't know about you but I need my beauty sleep :woot: (not that it's really helping) and I don't want you turning Sammy into a pin cushion. LOL!

    I am suggesting adding in one additional day test randomly with that test being sometime in the earlier hours of the cycle unless he throws you a surprise of a large drop early on, in which case for that cycle a little more monitoring may be needed. You are already getting some earlier tests at night and sometimes into the wee hours. So if you test at +2 and +5 one day, then +3 and +6 the next, then +2 and +4. Randomly right now will give you enough data to figure out when he starts dropping and to see how much. The earlier test will also give you the ability to steer Sammy up a bit if he seems to be dropping quickly.
     
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  49. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Oh! Lol! I had not even considered how late that would be keeping me up at night. Thanks for pointing that out.

    What you are saying makes sense.

    I will put in more focus on testing Sammy in the Morning in order to help me have more information about his cycle.
     
  50. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Those extra tests at different times can help spot a pattern in the spreadsheet without testing him 24/7 :). You need sleep and Sammy's ears will appreciate the no constant daily testing :cat:.
     
  51. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Sammy woke me up last night at 2 am to go outside, so I tested him then.

    His AMPS was 522 which is lower then average so that is good. By 10 am he was at 321, so he is already having a 60% drop. So it looks like he will have an extreme drop this curve.

    I have been thinking about Sammy's physical symptoms. Sammy has not been scavenging for food. In my experience Sammy does this when he is extremely low. I have not seen Sammy walking lethargic or drunk. I have not seen Sammy with droopy eyes. These are other symptoms of him being low. Granted I am quite busy and I do not see him all hours of the day. But when I do see Sammy I am not seeing symptoms of extreme low BG in his actions. This leaves me hopeful that he is not bouncing as low now as he use to when I would see these symptoms from time to time. When I did see these symptoms I would immediately respond with giving him more food or milk. I think bringing down his dose is reducing his bounce, his physical symptoms have been reducing for sure.

    I have been very busy with the Graduation, Birthdays and other things. I have not read up on ketones or considered a kit for if Sammy is extremely low. Is there some section here that is full of good things to read? Should I be reading more informative stuff on this page? My vet told me that if Sammy was extremely low to rub something sugary into his gums. I have explained this to all my older children too. This is what we have planned to do if we find him extremely low.

    The times in the day that I might miss Sammy being extremely low could be his afternoon nap. When I have sent the kids to bring him up for testing in the +7-+11 afternoon hours he has been really groggy, but has tested higher. I think testing him more often in the mornings will help me catch this.

    Thanks for reading and supporting!
     
  52. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    I found the list of the best articles on the homepage and will start reading through any I have not already read.

    I only got to test Sammy twice before his snack today. But his BG levels are improving.
     
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  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Sorry Jeanine. Had to run some errands and am just seeing this now.

    One thing to be aware of is that by the time you see symptoms of hypo, it can be a bit of a battle to get them back up to reasonable BG levels and in some cases require a trip to the vet to get them on a glucose drip. Some cats will get frantic for food at low BG levels, some get frantic for food at very high levels and some do it in both cases. Some will get frantic when they get to lower numbers than they are used to but nothing concerning. I used to be able to tell the difference between my girl's low and high frantic episodes but not so much any more. There are also cats, like some humans, who do not display hypo symptoms until they are severe. So any time kitty is acting a bit different, it never hurts to do a quick test to just be sure.

    I see you found some reading material so you have probably already seen these How to Treat Hypos and Hypo Tool Box. but I'm including links to them here for easy access. Good idea to post the "How to Treat Hypo" on your fridge or keep a copy in the Hypo Tool Box.

    Sammy hasn't dropped as much today but that drop is much better for reducing the bouncing. It will take a few cycles to see exactly how the lower dose is working for him. He is definitely looking better and hopefully the lower dose will smooth him out even more in the coming days. :)
     
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  54. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Thank you for the Hypo info. I had read the information there and discussed it with my family. I love the idea of posting it on my fridge. Now that I look at the Toll Box I can see how useful that is. I will make one of these and have my family learn about it. Thanks for posting that.

    I am curious, in the case of Hypo, how often would I retest? Clearly if he was low with sever symptoms I would have a helper giving him sugar stuff on his gums or rectally while I am driving to the nearest ER. So besides the initial test I am not sure there will be much testing as one person would be driving and the other would be rubbing gums etc... But if the symptoms are not severe how quickly could one expect to see change in the BG levels?

    No problem MR WorfMen's Mom :) We all have busy lives! Thanks for fitting in replies as often as you do.
     
  55. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you are just feeding to bring numbers up to a safer level, then retest every 20 minutes after each food offering. Once numbers are up and /or holding then you want 3 consecutive safe readings that have not been food influenced and you can spread those out to 30 minutes to an hour apart depending on each of those readings. So if each of those non-food influenced readings is higher than the last, waiting an hour to retest is fine. I would use 90 to 100 as your goal for a safe number with Vetsulin and start steering at that point with low carb food to avoid having to deal with lower numbers.

    If you get a reading of 50 or below, go straight for the sugar stuff. You can mix it into high carb food if he will take it that way or rub it on his gums. The sugar stuff alone wears off quickly so using it with High carb food will give him a quick boost and last a bit longer. If there are any symptoms or numbers continue to fall, it's time to scoot to the vet. If your vet office is close, you may not need to test again on the way, but if it's a long drive, then pull over and test and give sugary syrup/honey as needed to keep him at a safe reading.
     
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  56. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Great info! Thanks
     
  57. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Today Sammy was at Hi at o, then at +3 he was down to 227, and at +5 he was back up to 598. This curve seems abnormal. I am planning on testing him every other hour to keep a closer watch on him today.

    Sammy started licking the gravy off of his food, which is what he did last time before the pancreatitis attack. He did end up eating most of his food. But left some of it uneaten. Maybe a lower glucose means he needs less food? Or maybe this is early indicators of problems with his pancreatitis?

    We are going to be watching him closely for the symptoms listed in this article.
    http://www.petmd.com/cat/conditions/endocrine/c_ct_pancreatitis
     
  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Jeanine, are you checking Sammy for ketones? If not you should just to be on the safe side with his history. If he has a chronic pancreatitis, that could explain his high numbers and the difficulty getting him regulated. Keep an eye on him and get some ketone tests strips from the pharmacy or Walmart and check his urine. Some folks can hold a ladle under their kitty's butt and others put plastic wrap scrunched up in the cat's favourite pee corner of the litter box. You only need a tiny bit of pee to do a test but it is time sensitive so read the bottle for instructions.
     
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  59. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Thank you. I can see how that would be a good indicator of his pancreas health. I just read up on Ketons last night, and planned to get test strips on our way home from my daughters school event tonight. Sound like I need to get right on it.
     
  60. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Just reinforcing the time sensitivity for the ketone test strip and looking at it in really good light :). Most seem to be about 15 seconds but even after a minute or so the colour will darken. Has Sammy been on Vetsulin since diagnosis in September 2016? And have you only been home testing since 27 may or did you have some older data? :woot:
     
  61. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    So I am telling my husband on the way home from my daughters art show. "I am concerned about Sammy..."
    From the back of the van my 6 year old pipes in "Yes, I think that foxtail in his eye hurts!"
    Me "Sammy has a foxtail in his eye?"
    6yo "Yes I think it hurts!"
    I was able to easily pull the foxtail out, his eye looks irritated but fine at this point.

    High BG solved, it was caused by stress. Because "that foxtail in his eye hurts!" Lol
    Other then a low dip to 72 at +5, that I watched closely. Sammy seems back to normal.

    Hello Yong. My Vet had us doing something totally different!!! I did not test at home. I took Sammy in once every 3 days for 1 test and dosage adjusted by full units. It is AMAZING they ever get a cat regulated like that. When Sammy became a tough case I got a tester just to tell me, when he looked drunken, weather he was high or low. He started on Vetsulin, he "stabilized" at 7 units. I then switched him to Novelin N (I believe it was N not R) because it was cheaper. Sammy had a pancreatitis/ ketone attack and was hospitalized for 3 days about 2 months back. We went up to 11 units on Noveline with no good BG levels. Then switched back to Vetsulin. When we were back up to 9 units on Vetsulin I finally found this forum. Now my life has changed with testing all the time. But I feel so much better about how Sammy is doing and am glad to know how to help him manage his BG better.

    I missed Sammy's urine tonight. Will try to test Ketones again tomorrow.
     
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  62. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Wow, adjusting by full units and getting kitties regulated with that method! They were lucky! Most kitties don't adjust well with full unit increases. It works better with humans because we're bigger animals! :p. That's why small increases work well for our fur creatures kids :cat:. Since Sammy had ketones before with pancreatitis, you may want to try to test for ketones 2 - 3 times a week, just to stay safe ;). Time flies when getting these tests though, maybe it's just me :rolleyes:. I feel like I try to get Maury's sample every few days and when I do, I realize on my notes it's been a week :facepalm::smuggrin:. And yes, if you were on Novolin it was N not R. Novolin R is used in emergency rooms when a kitty's BG needs to come down fast like with DKA. However, it is also used for some high dose kitties (we're talking like slow increases and still getting up to 18+ units twice a day). Anyways enough of my babbling :D.

    It's great how much better you feel knowing how kitty's BG is doing and if they act weird, we can just test their BG instead of trying to analyze their behaviour in a situation and go full "hawk mode"!:woot:

    I am wondering if you should try another reduction with Sammy but just by 0.25U or 0.5U this time. While those blue and green numbers are beautiful, they are big drops for him right now. Just thinking more on what Linda was saying about softening his drops so he doesn't bounce back up as high. I do see his PS numbers trying to come down, so that is a good sign! Most of this section is just me thinking out loud, you don't need to take it to heart but feel free to think on it too :).
     
  63. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    OMG! Poor Sammy! I am so glad the mystery of the higher numbers has seemingly been solved. That must have been driving the poor guy nuts!

    With that 72 last night, he may bounce a little but I'm wondering if taking him back to 5.5u might be a good idea. We don't want him hitting numbers that low until the pre-shots come down a bit more and even then, that is low enough for a cat on Vetsulin. I'm suggesting a 0.5u reduction because at a dose of 6u, a quarter unit dose change is a drop in a bucket. Even the half unit is a small change. I'm assuming that foxtail may have been influencing his numbers for the past couple of days so we may not have an accurate picture of what the 6u was doing for him until last night. Even at 5.5u I'd monitor him closely today.

    I'm going to be out most of the day but will check in again when I can, to see what Sammy is up to.
     
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  64. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I know right! Young. I do not know how the Vets think they will ever get a cat regulated that way. The next time we go in I am going to ask for Sammy's medical records so I can put them in his document.

    Today will be his third day at 6 units. Why don't I switch him to 5.5 units starting tomorrow?

    The foxtail was stuck between his eye lid and the eye ball. Sammy's eye still looks a little irritated today, but much better. I am sure it did hurt!

    I had a cat sitter today while I was off playing with cousins and kids at a splash pad. We did not get as many tests as I had hoped.

    I tested Sammy's Ketones this morning. He measured at only Trace. I am glad it is that low!!! I was fearing the worst.... But... Someone on here said I needed to act even if it was at trace. I am making sure to keep him in supply of good fresh water. Other then that I do not know what to do. I will have to read up on that.

    I have another kid event today. Not sure how much testing we will fit in today.

    Thank you all so much for your reading and suggestions!
     
  65. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Jeanine, try your hardest to get another ketone test this evening. The reason we say to act even if it's trace is because ketones can build up kind of fast, the earlier you catch them and get them cleared, the better. We don't want you to have to take Sammy for another hospital visit :)
     
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Another way to keep him well-flushed is to add enough water to each wet food meal to make a sort of "kitty stew". Test for ketones often right now.
     
  67. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Agree you need to keep an eye on those ketones. May be a product of those higher numbers the last few days, the inflammation from the foxtail and his lack of appetite. I take he is eating better again now? Keep an watch on his eye too. Seems foxtail is a member of the lily family and has toxic berries. Not sure if what got in Sammy's eye was prickly and could have scratched his eye or not, but if the inflammation isn't gone by tomorrow, I wonder if it might be a good idea to have the vet look at it just to be on the safe side.
     
  68. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I am always so impressed with how well you guys keep up with some random persons cat!! Thank you.

    Today Sammy's eye is looking normal. I do not see anything wrong with it. Which is good. I plan to keep an eye on it for a few more days to make sure.

    I have a large family and manage my various family members testing him and taking care of him. My instructions do not always get followed, or I forget and miss an instruction to give them. But we do our best. This morning I had to be away so I had my husband be in charge of his morning shot, but I forgot to tell him to take Sammy down to 5.5.

    I am happy to report that Sammy's appetite has returned. Which is such a relief. He is eating all of his food eagerly again. Sammy's looks normal and healthy, I do not see any of the symptoms I would be concerned with. So that is a relief too.

    We have a concert tonight. So we are floating his shots back so that we can give him his shot a little later tonight when we get back.

    On 06/04 his PMPS was 355.
    On 06/05 PMPS was 486.
    On 06/06 PMPS was 515 (this is the day Sammy had a faxtail in his eye).
    On 06/07 his PMPS was 425.

    I am encouraged by this. It seems the over all pattern is that Sammy's PMPS is floating down. All of these days were below 490 except for the foxtail incident. Today his AMPS was 438 so I hope to start to see a trend in that floating down too.

    On 06/06 his BG took a deep dip in the evening at +5 down to 72. I think this was in response to how high his BG was that day because of the stress of the Foxtail in his eye.

    Looking at the last 4 days, other then the foxtail incident, the lowest Sammy has been is 151. Again I see this as encouraging. It seems that overall his bouncing is becoming less extreme. He is not bouncing as high or as low as a trend. I find this encouraging.

    It seems like every summer Sammy gets a foxtail in his eye at least once. We live near a nasty field of foxtails. We often comb out foxtails out of his fur. I was super worried the first summer, but now I just know to watch him closely. There is always a chance this time might have scratched it worse then last time, but so far he has recovered well.

    I just got a chance to test Sammy's ketones. He is at trace again.

    Thanks for reading
     
    Last edited: Jun 8, 2017
  69. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Good suggestion on the Kitty stew. Sammy has really liked that in the past when we did it after his hospital visit. I can start doing that again.
     
  70. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Definitely :). Sometimes I forget to suggest these things because they are part of my normal routine now :smuggrin:. Like telling someone, "go get ready" I would probably forget to mention something simple in one of those steps lol.

    Anyways, still try to test him for ketones daily :cat:
     
  71. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I was hoping those BG's over 500 at +5 and +8 were abnormal on 06/06 because of the foxtail. But then Sammy had over 500 at +6 and +7 on the 06/08. I need more information about his cycle so I am planning on testing him every other hour. I will be home most all of the day and not have sitters taking over so today is a good day to do that. Also I will try to get a ketone test in.

    Last nights concert went late so we called in a family member to give Sammy his shot. But this person was not trained on testing BG so we did not get a pre shot test.
     
    Last edited: Jun 9, 2017
  72. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    The hospital did not tell us the Kitty Stew would help increase water intake, we were told it helped with upset stomach. I am going to do that now to help with the water. Also Sammy drinks every time his water dish is refreshed, so I plan to refresh his water often.

    In the hypo kit article I learned that the Fancy Feast should have been the classics because the gravy ones are high in Carbs. Ooppss.... We have been feeding Sammy gravy's. I have switched to classics and saved some of the gravy's for his hypo kit. Making Kitty Stew is helping him transition from the gravy cans, because he likes those much more then the pate.
     
    Last edited: Jun 9, 2017
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  73. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Oh! Good that you discovered the gravy food is considered high carb. While it is not super high like dry food it's enough of a difference that it could effect Sammy's insulin requirements. Keep a good eye on him today while switching to the pate. You are already reducing his insulin and trying to see if less insulin is needed and lowering the carbs will likely mean even less insulin. Some cats are more carb sensitive than others but it's something to be aware of and monitor closely when making food changes.
     
  74. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    I think I figured the abnormal highs out. I started giving Sammy his snack earlier to try to avoid the lows, Looks like the snacks have turned into those irregular highs.

    Good to know about the food change, thanks.
     
  75. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Let's see how the lower carb food helps avoid those irregular highs :)
     
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  76. Sammy's G-ma

    Sammy's G-ma Member

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    May 17, 2017
    Towards the end of yesterday I was excited to get a chance to tell you guys that Sammy was not in the black for 2 days straight (500 or higher). But just after he started having abnormal black readings...... Based on the readings I am wondering if I forgot the shot?? Maybe I entered the test time and not the shot time? IDK

    But. Overall I am seeing an improvement. Most of the highs for a while were red or lower. The lows never got into the greens, all stayed in the blues. So that seems like things are getting much better.

    The difference in the highs and lows on two recent days was a 40% difference, which is much closer to that 50% I am shooting for. This is also an improvement over the 9% to 29% difference I have been getting on other days. Since I am still not at a 50% difference between highs and lows it seems like the thing to do next is go down another 1/2 a unit?

    So, my plan right now is to take Sammy down to 5 units tomorrow, for three days. LMK what you think of this.

    Ketones. OMGoodness! Sammy has been difficult to test. Maybe he has caught on to the fact that I am going to stick something under his but while he pees, so he is trying to avoid me?? I have been watching his litter box usage closely for the last two days, and he has not peed when I can see him.
     
    Last edited: Jun 11, 2017
  77. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    A 40% drop in BG is fine. You are aiming to have him drop NO MORE than 50% but he doesn't have to go down that much. :) The best case scenario would be to get pre-shots down and then the drops won't be so dramatic especially when he is bouncing. Looks to me like he's still pretending to be a trampoline artist but he's not jumping as high for the most part. You can try taking him down to 5u and see what he does. While it looks like you may have forgotten to give the shot last night (it happens! :banghead: ;)), it doesn't look like a furshot this morning to me. Why do you think it was? Was his fur wet after the shot?

    If you can't get a ladle under Sammy's bum, you could try putting bunched up plastic wrap in the box in an area he prefers to pee in, to hopefully catch a small sample when he does go.
     
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  78. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Sorry. I think my numbers are backwards. I should figure out how to rework my spreadsheet. The lows are only 40% of the highs.... so... That is like a 60% difference between the Highs and the Lows... I will have my husband look at my math today so I can get my numbers to look right, so we are talking about the same numbers.

    Loved that emogi! :banghead: That is totally how I feel!!

    Lol! Trampoline artist! That he still is!

    I am going to get out the plastic wrap and rig up his litter box, thanks for the tip.

    On the fur shot. Looks like most of it made it in, so that is good! I normally stick him, then rub the skin in the area afterwards. When I rubbed the fur was somewhat wet.
     
  79. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Love love love that fox video. Glad I visited the ladies before viewing! :woot:

    Just a warning. Don't rub the injection site. You can apply light pressure for a moment and lightly brush the area to check for wetness but rubbing can cause the absorption of the insulin to speed up. I know you were probably told to do so by the vet or vet tech but it's not advised with insulin. :)
     
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  80. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    OMG!! The vets get EVERYTHING wrong!! Good to know. We will do our best to break this habit.
     
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  81. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Just had another member mention they did this :smuggrin: so you are not the first or only :bighug:.
     
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  82. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Scratching my head today?

    Yesterday his AMPS was abnormally high, 599. This was three days after the switch from high carb Gravy to Classics.... Could it be that his insulin was too high, since he was on lower carb food and he was starting to bounce more? IDK I do not have an explanation for it.

    Today his AMPS was abnormally low, 243. I was curious to see what that low reading would mean. In hind sight I should have been like "Oh no here comes a potential Hypo spell! Baby him and watch him closely!" Because he later dipped into the Hypo area.

    Once I was aware he was Hypo I started feeding him and retesting about every 20 to 30 mins. A little over 2 hours later and he was back above 100.

    Sammy did not eat all of his breakfast this morning... That could have been another indication he might go hypo.... But.... I was thinking at the time that he was more regulated so he might need less food. We technically are over feeding him right now. I figure his need for food will come down and he gets more regulated. I assumed that him eating less was an indication he was better regulated.

    I have two test strips left before I get the car again later tonight. So I will test him twice more, once for his PMPS. Assuming his curve looks mostly normal... I think I will still feed him 1/2 a can... But... Should I still give him 5 units? Or should my units come down? IDK what to think

    Ketones update - Sammy continues to avoid peeing in the litter box up by me. He will poop in it, but he wont pee up here any more.... At least when I am around. He did end up peeing in it when the plastic wrap was in the litter box, but he peed beside the plastic wrap so I caught nothing. :S Kids suggest I plastic wrap the whole litter box. I don't think Sammy will even go in it then.... Maybe it is time for me to schedule another vet visit and get a blood work up? IDK
     
  83. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    P.S. Did some more reading today to try to guess more at what might be going on with Sammy.

    Found this "Diabetes with Ketone Bodies in Cats" a possible symptom is "Rough hair coat". Sammy's fur has been getting more and more luxurious, soft and fluffy! When we pet him we are astonished how nice his fur is getting. His soft fur makes us feel like he is getting better and more healthy.
     
  84. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Wow Sammy gave you some excitement today but you handled it well :cat:. I still think 5.0U is too high for him in general, especially if his preshot numbers start coming down. I wanted to try to explain/say more but my brain clocked out a few hours ago and I can't convince it to get overtime :smuggrin:
     
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  85. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Thank you for your opinion on this! And your compliment. I am going to go down to 4.5. Have a good night!
     
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  86. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    HOLY COW! What a ride Sammy took you on today! Sammy didn't go hypo but he was right on the edge of going hypo and with Vetsulin, you don't want him that low. I'd aim to keep him no lower than about 90 or so at nadir and intervene if he drops under 90 to prevent close calls! That said, they throw surprises at us every so often but you caught him in plenty of time and handled it like a pro! KUDOS! :cool:

    Your decision to reduce the dose is right on. I'd still keep an eye on him tomorrow. Tonight he's bounced and may still be up some tomorrow but they can be a bit more sensitive when go that low. Your analysis is spot on and he will need less food once he's regulated. Diabetics cannot efficiently use the food they take in, thus the extra hunger. The interesting thing is that often cats will be frantic for food if they are high or going very low but even that pattern can change with time. Some cats like some humans can be unaware of their BG dropping toward unsafe levels. Every cat if different. His AMPS this morning was much lower and that was probably because some or all of the bouncing had cleared. That could have reduced his appetite and less food could have in turn, contributed to the low BG.

    Sorry I am so late to the party and glad Yong was around to confirm your decision. My girl had me testing her every few hours last night so I've been grabbing cat naps all day and now finally, when I should be hitting the sack again, I am awake. :arghh:.
     
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  87. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Thank you for coming by to look!

    I just looked at your girls chart. Looks like she kept you quite busy! I am tired for you! I am glad she came back up for you eventually.

    Thank you for clarifying about hypo and 90.

    I think your theory about him bouncing makes sense.

    I hope you can get some sleep!
     
  88. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Thanks Jeanine. I'm glad Menace's BG came back up but she went too far now!:banghead: She's now busy on her trampoline :woot: so at least I'll get some shut eye tonight if I can make myself tired enough to sleep! :rolleyes: I'll keep popping by to see how Sammy and you are doing.
     
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  89. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Lol! This does not get old :banghead:

    Dream of kittens jumping on the tramp like those two cute little foxes. :cat:
     
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  90. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Sammy is back to his trampoline, bouncing with highs and lows. So I am taking him down 1/2 a unit to 4 units.
    [​IMG]
     
  91. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Good decision Jeanine! You're figuring out your little man slowly but surely! Hopefully he'll smooth out a bit more very soon.

    LOVE LOVE LOVE the trampoline kittens! :joyful:
     
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  92. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Jeanine, I see Sammy has a very steep drop early in the cycle last night and I am just wondering how you guys are doing? Concerned! :bighug:
     
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  93. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Thank you for checking in on us. Sorry to scare you. We have not been putting in his numbers on the spread sheet because we have been test driving new vans all day. My kids have been the ones taking care of Sammy.

    So last night late I tested Sammy, I was concerned about how low he had already gotten. But I planned to be getting up at 6 am the next morning to drive out and test drive a car an hour away before that family went to church. So I piled food in front of him. I gave him extra canned food, extra treats, and milk. When I saw that he had eaten good I went to sleep, feeling pretty confident that all that food, before the low dip, would carry him through. Maybe that was too big of a gamble?

    In the last two pre-shot tests Sammy stayed out of the black, so that was good.

    Sammy seems to have an ear infection in his left ear. Yesterday he held his ear bent forward a lot, and did not want it touched. Today, Sammy seems to be less irritated in that ear today, but still irritated. Yesterday Sammy had not cleaned the burs out of his fur form his recent romp outside. Normally unclean fur is a sign Sammy does not feel good. Today Sammy has cleaned himself. Sammy is eating less. He licks up the "gravy" water from his "stew" and leaves the chunks. Concerned he is not eating enough I re-hydrate the chunks, he drinks the water again and leaves the chunks again. Sammy is still avoiding peeing where I can't see him. Wow, I guess me waiving test strips under his bum was rather upsetting to him. He pees around the plastic wrap, but I will keep trying. I feel like his eating patterns are abnormal. I called the vet on Saturday. They could not get him in until the 27th. Sammy still asks to go outside, and his movements seem normal. My plan has been to watch him closely over the weekend and call the vet first thing Monday to see if they have any cancellations. If I can not get Sammy into the normal vet, and if I am still concerned about him, I will try to get him into another vet. But I would really rather deal with the same vet I have been dealing with. Because, when I was having Sammy's blood being tested every three days I saw several vets. They are all so convinced that there is one only right way to do things. Only one vet I have taken Sammy too can think outside the box at all. So I would like to get in with him, show him Sammy's chart, and give him a flyer for this group. I am pretty sure he will be eager and glad to know about this group. Though if Sammy seems to need help tomorrow it is more important I get him into anywhere.

    Thanks for asking. Plugging along, mostly good, we will see how Sammy continues to do.
     
  94. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Ok. I think Sammy is doing good. Here is some more information.

    I left extra food out last night. That could be why he ate less tonight.

    When I called Sammy to come eat he came bouncing and bounding across the back yard grass full of energy. His Eyes ere bright, his fur was clean and in good condition.

    Last Ketones attack we were told dehydration was a symptom to watch for. I watched these videos




    By all indicators Sammy is not dehydrated. So I am feeling better about Sammy at this point.

    Also his ears are straight, and he is not scratching them, but I will keep watching that.
     
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  95. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    So happy to hear you and Sammy are safe and sound. :D I saw that huge drop on the SS for last night and then no reading this morning and that just wasn't normal for you so I started wondering if he had continued to drop and you'd had to take him to emerg for a hypo situation. I think you might want to consider taking his insulin dose down a bit more yet again. I don't think it would be unreasonable to drop him back to 3 units. His drops are so huge that it's causing a lot of what appears to be bouncing and that alone can make Sammy feel poorly. It would be better to try to get his BG down a bit slower to give him some time to get reacquainted with the lower BGs. He's dropping more than 50% from pre-shot to lowest point (aka nadir) and that causes the bouncing. Once the pre-shots come down, so too will his mid cycle numbers. That said, be sure to monitor him when you reduce the dose because when the bouncing breaks, he could go lower still and need some steering with food to keep him safe.

    Sounds like he may just have been off yesterday due to the big drop in BG. Not eating and drinking enough and high BGs are a recipe for ketones so as long as he is eating well, getting lots of fluids while you are working on getting his BG down, he should be fine. Amazing how they will pee right in front of you until you want a test! Hopefully the ear is not a problem. I can't believe you couldn't get an appt. until the 27th though! o_O. That's worse than human doctor's offices! That vet must be very popular. If the ear problem returns, I'd try to get Sammy in to see whatever vet you can ASAP because infections can play havoc with BG levels.

    I hope your test drives were a success and you found something you liked! :D
     
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  96. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    [​IMG]

    Hello. I have been MIA for a few days. Been working through some difficult things here. My daughter was in a car wreck, she was not injured. Our car was totaled. So after several test drives we ended up getting a new car that was an upgrade. Which is good. In addition to all that we had some other drama.

    The testing of Sammy has been spotty at best these last few days. I try to remind myself that I am testing on average of 6 times a day, giving 2 shots, and feeding 4 times a day. So as much as sometimes I feel like I am neglecting Sammy, I really am a highly involved pet owner. Sammy seems to be surviving, and getting healthier, so hopefully it is enough.

    Guess what we found in Sammy's ear?? A foxtail. Took four people holding him down, one with a flash light and me with q-tips to finally get it out. Once out Sammy went instantly from mad to relaxed and relieved. I think in Sammy's perfect world there would be no foxtails!

    I have changed my name to Sammy's G-ma. Technically Sammy belongs to my oldest daughter. As I have been taking care of Sammy's medical condition I have gotten to spend so much more quality cat time with him, it has been enjoyable.

    The jumping cat at the top is in honor of Sammy's large bounce yesterday. According to your suggestions Mr WorfMen's Mom I did bring him down to 3.5 units. Then when I saw his big bounce yesterday I brought him down again to 3 units. I am going to do my best and watch Sammy closely today so that I can get back in touch with his curve patterns.

    My oldest teens are off to camp this week, and my younger teen has been assigned a few times to take care of Sammy. Unfortunately the younger teen did not follow instructions. I think the low BG yesterday was a lot because Sammy was not fed when he was suppose to be fed. This teen seems to have learned the importance of taking care of Sammy. I expect this teen will respect the need to feed Sammy at the right time more now.

    Thank you once again to coming in and keeping up to date on Sammy's care and needs. I think I may try to find time to join in the conversations more here in the future. Is there an area of the forum that is more interesting then the others?
     
  97. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    That is so sweet that you are looking after Sammy for your daughter. Seems you and Sammy are forging a great Grandma/Grandson relationship! Not many G-ma's would take this on! Hope your daughter knows how lucky she and Sammy are to have you!

    Boy you've had some excitement going on! So sorry to hear about the accident but so glad to hear your daughter was not hurt and you've got some new wheels. As far as the foxtails are concerned, Sammy's having a real problem with them isn't he? I can just imagine how irritating that must have been. How did you discover it? Was he pawing at his ear or shaking his head? Oh that they could just tell us what's bothering them! Probably had some effect on his numbers the last few days. That 159 was a great number...right in the normal range and not too low so he's looking pretty good. Looks like his numbers are improving now that the nasty foxtail is out of his ear.

    I'll keep checking in to see how Sammy is doing on the new dose. :D
     
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  98. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Glad to hear your daughter was OK and one of your teens is learning about caring for Sammy :). At least with the foxtails, you'll know if his numbers are higher to look for them ;). I would be curious to see the 3.5U dose again sans foxtail :cat:
     
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  99. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Thank you Young. If I don't get good numbers at 3 I can go back up to 3.5.

    Looks like, based on my earlier posts, Sammy had the foxtail in his ear from the 17th to about the 20th. His ear scratching dramatically died down after the first day. I think eventually the foxtail was coated in goo so that reduced the irritation. But I still would see him scratch from time to time, the irritation became much more mild so it did not really stick out to me. I finally realized he was still scratching and that it could be a foxtail in his ear so I went looking.

    The 12th through the 16th Sammy's numbers were higher. I stopped rubbing the injection sight on the 12th, interesting.

    Glad to know both of your insights on the 159, I thought at that point in the curve it should be higher.

    My oldest is a great cat mother. She was his primary care giver until I decided to try the new methods here. This was much too demanding for her to take on when she was still in high school. I rely a lot on her to make sure we keep up with his rigorous schedule. Which is why it is harder to keep up with her gone. When Sammy was hospitalized she paid half of his medical bill. I took over Sammy's care with this method because I wanted to avoid any more hospital bills. It has been a good experience getting to spend more time with Sammy. My daughter keeps up to date a lot with the changes I make to his dosing etc. If/ when I get Sammy more regulated, with less changes, I will start to transition her back to taking over more of his care again. She is more of a cat person then me, I am more of a bird person.

    Thanks for checking in and giving me advice.
     
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  100. Sammy's G-ma

    Sammy's G-ma Member

    Joined:
    May 17, 2017
    Lol. I woke up at 2:30 am last night to try to catch the dip in Sammy's curve. He came said hello, ate a snack, then ran away outside from me before I could test him! lol I normally test before he snacks, but I was moving slow and he beat me to his snack.
     
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