? To Shoot or Not to Shoot.

Good morning,

Hoping someone is as crazy as me and up this early on a Sunday morning.

I was hoping someone could take a look at Melty's SS and give me a better idea if I should be shooting or not this morning. Historically, he's been in the mid 20's before every shot, and swings quite low at nadir. Last night, however, he stayed fairly even, and is still lower than normal this morning. (Praying to the kitty gods that this is the start of a trend!)

I'll be home all day to monitor, but I was just hoping for some guidance.

 

Hey Nikki, sorry I didn't see this sooner. I see you went ahead and shot and I'm sure Melty will be fine. I know you buffer his drop with food and his +1 isn't tanking quite like it did yesterday at the same time. I would just watch him and take a +3. If he's under 4.5 or so then take every half hour - not because I'm super concerned but because I know you'll worry! It's a good time to see how low he goes so don't feed any emergency treats. Just watch for the signs of hypo. I'm learning that peak can happen at +3 so that reading might just be as low as he goes. Take as many readings as you feel comfortable doing. By then you will have nice curve data to give to your vet. You're doing great.

 

I forgot one thing. If you look at the colours and use them and not purely the readings to interpret anything, note that the World sheet has 6 "ranges and colours" whereas the U.S. Only sheet a lot of people are using has 7. There is an additional range marked with dark green field and white text of what I interpret as "safe but caution" whereas the world sheet gives a bright green at any reading under 5.6. I changed my SS to mimic the U.S. Only one so if someone in the U.S. were to look "by colour" we were looking at the same thing. It isn't critical, but I thought I would mention the difference.

 

Good Morning Melanie

I did go ahead and shoot. He was lower and even last night so I feel comfortable. I'm here all day and to be honest he's a dream to test so I'll probably do every hour or two unless he gets low!

He's on strictly low carb wet and a little Orijen dry when feeding the curve, now. I can tell his tummy is still a bit off, but his numbers look great.

Didn't drop very low at all this morning so gave dry meal at +2 instead of +1.

I'm praying his numbers stay like this and that it's the food that's making all the difference

Hope you and the fur family have a nice relaxing day!

 

P.s. Genghis is looking good!

 

Hey just checked in on Melty - wow, nice numbers. You go, girl!

 

He is staying low and constant all of a sudden. I can't believe my luck!

 

So...Melty's AMPS this morning is 18.4.
I'm thinking I should only give 1.5u again?

 

Good Morning Nikki,

Are you going to be around to monitor for awhile (4 or 5 hours or longer if need be)? Melty's starting number is a bit lower again today so unless you can monitor, I think I'd reduce even more maybe back to 1u. It still looks to me like Melty is on his way off insulin, so I'd be conservative if you can't monitor.

 

I have already given his 1.5u, but I'm leaving for work. :S Will leave out extra dry food for him, and have my boyfriend (works just across the road) check on him every couple of hours to make sure there's no signs of hypo.

15.4 drop already in 1 hour. I'd be lying if I said I wasn't a little anxious about that number.

 

As long as someone can monitor and knows how to deal with low numbers, he'll be fine. We are all so anxious when we get the diagnosis, but when kitty decides he might want off the juice it's just as anxiety provoking. Can your boyfriend check around 3 hours and if Melty is way down give him some moderate carb canned food to slow down his drop? Dry food takes longer to boost the sugar. And if Melty is dropping, he should be monitored closely until he starts rising again (no less than every 30 minutes).

 

Crap. 11.3 at +1.5. Should I be giving him anything now. He just ate a dry meal about 15 minutes ago.

 

The dry will be kicking in when the Caninsulin is kicking in.
Give him a few teaspoons of canned food to help slow the drop.

Tonight, you might give some of the dry at shot time, since it takes longer to have an effect, and use the canned at +1.5

 

Will see if I can get him to eat the wet food and check again at +2.

 

Hey Nikki, I'm no dosing expert but I will say based on his numbers yesterday when you got all that info he was higher yesterday by a bit and didn't drop into "green" numbers on 2.0u - basing it on just that, and that he has food available and has just eaten, and if he can have a check at +3 he should be okay riding through the drop. This whole thing can be very unpredictable so I'm glad your boyfriend can check on him - keep us posted!

 

He suddenly appears to be on a hunger strike (probably scarfed down a bunch of kibble and is full).

I did manage to get him to eat some of the juices out of the wet food can.

Testing again in 10.

 

Ack!!! 5.4. He's eating right now because I put temptations in his wet food.

 

Ok take another reading and if he is still dropping I think a little corn syrup on his gums would help. you only need a little!

 

Still at 3.4 he's not pleased but there is corn syrup on his gums.

 

Nikki, do you mean 5.4? Take another reading in about 10 minutes to see if he is holding.

 

No sorry, I shouldn't have said "still".

I moreso meant he's still dropping.

We are at 2.9 now, but he's eaten wet food, dry food, temptations, and had a little corn syrup.

Still no signs of hypo as far as I can tell.

 

I'd give him some more syrup on his gums. we need to hold him where he's at and get him rising.

 

Hi Nikki,

Just saw your 911.

2.9!!! I think your little guy needs some carbs. Give a little honey or syrup now. Have you got any wet food with gravy?

IMPORTANT: Don't give Melty too much food at a time - we don't want him getting too full. He's very early in the cycle and you'll probably need to feed him again.

Take another test in about 10 minutes and post the result here straight away.

 

NB - You need to stay with Melty. It's not safe to leave him at these numbers.

 

@Critter Mom Thanks for coming to the rescue. I've been trying to help but admit I am out of my element here.

 

No worries, Linda.

I had a few white knuckle rides with Saoirse when she was on Caninsulin but she had a much earlier typical nadir than Melty. Given that Melty's doing a food transition I was concerned that he might start racing down the dosing scale given how strongly he has responded to the insulin over the last few cycles. The plus side is that it's an in-out so once Nikki and Melty are through the peak period of insulin action there won't be a shed to worry about.

EDITED TO ADD:

This is a classic example of why it's so important to be home testing before starting a transition from dry to wet food.

 

@Critter Mom and @MrWorfMen's Mom

THANK YOU THANK YOU THANK YOU

I probably did feed him a bit too much (I'd be lying if I said I wasn't a bit panicked).

Held at 2.9 for about 25 minutes, now up to 3.4.

And no worries about leaving him. I wouldn't do so unless I know he's out of the woods. 3.4 is a good start.

 

That's a bit better, Nikki! I'm very relieved to hear that you can stay with your bestest pal.

Can you post the readings with the +?? numbers so that we can follow how far along in the cycle they were taken, please?

e.g.
+2.5 - <BG value>
+3.0 - <BG value>

We need to know how far along in the cycle we are to keep Melty safe, and also to make decisions on what to feed and when.

 

@Critter Mom Absolutely agree. I could never imagine giving insulin without home testing and my vet laughs and tells me I'm a bit OCD but she thinks it's great.
My concern with Melty is his usual nadir is about +4 hours and if my calculations are right he got his shot about 7am. so he's only at +3 now. He's already had dry food and may be getting full and reluctant to eat.

@MeltyCat Good to hear he is rising! I think though we have to still keep monitoring closely and maybe more corn syrup because he's still not at his usual nadir at +4 if my assumption he got insulin at 7am is correct..

 

@Critter Mom Can you stay with Nikki for a bit? I need to run out for about an hour but will hold off if you can't stay with her.

 

@MrWorfMen's Mom -

Melty has had nadirs at +6 - see yesterday's AM cycle on his spreadsheet. He also seems to have quite a long run at the lower numbers. The other thing is that the crystalline portion of the Caninsulin reaches peak effect around the +7 mark so we need to make sure Melty's past that and in good numbers. It may take a while for the dry food carbs to kick in. The rise we're seeing now is probably down to the corn syrup, and that can wear off fairly quickly.

EDITED TO ADD:

Cross-post!

Yep. I can stay with Nikki for a few hours.

I'd appreciate it if you could check back in with us on your return. I had a very rough night last night (PTSD sleep probs) and I'm worried that I might not be able to last out the full cycle. I want to make sure Nikki and Melty have someone keeping an eye out for them.

 

Sorry it's all a bit jumbled because I took SO MANY READINGS.

Here it is:

PMPS - 18.4
6:30am - wet meal
7:00am - insulin (1.5u Caninsulin)

+1 - 15.4
+1.5 - 11.3
+1.75 - 5.4
+2 - 4.0
+2.25 - 3.8
+2.5 - 3.4
+2.75 - 2.9
+3 - 2.9
+3.25 - 3.4

About to take a +3.5 test to see if we are still increasing (fingers crossed!!)

 

That's a great help, Nikki!

At what time did you give the syrup, temptations, etc., and have you fed anything since?

You're doing brilliantly, BTW.

 

Have you got plenty of test strips for the meter?

 

I am watching this thread and relieved Melty is on the way up. Way to go Nikki.

Áine you have experience with Caninsulin and I have seen some of this unpredictability with Genghis. In no way am I saying Nikki did anything wrong - you can't find a more devoted owner - but do you think the mix of insulins contributes to the harsh drop? Of course in addition to diet but I wonder myself sometimes if I have mixed it enough.

 

Hi Nikki,

Gosh, a scary drop there! And well done for handling it so well.
From looking at Melty's SS it looks like he sometimes reaches the peak (lowest point) of the cycle at around +6. So you may want to continue to test until that point at least, and until you've seen three rising numbers in succession.

You're doing a great job!

 

@Critter Mom Thanks Aine. I just didn't want to leave Nikki on her own with this. I will check in as soon as I get back and take over for you.

@MeltyCat Nikki, I second Aine's comment....you are doing a terrific job. Melty's a lucky guy!

 

@Brashworks - Hi Melanie. Plenty of room for company here!

I'm not sure what you mean by "mix of insulins". Can you elaborate?

 

Hi Aine, I'm guessing Melanie may be referring to Caninsulin being comprised of some shorter acting insulin and some longer acting insulin (but, Melanie, please correct me if I'm wrong!)

 

That's what I thought she might be angling at, Eliz, but I'd rather be sure I understand her query properly so that I might answer it better.

 

Hi Nikki,

What's the latest BG reading?

Also, what foods do you have available (and do you know their carb calorie %)? Any wet food with gravy, by any chance?

 

Melanie,
Cats have a fast metabolism, so insulins made for dogs (like Caninsulin) and insulins made for humans usually have an earlier onset and a shorter 'speeded up' cycle in cats. That can cause some steep drops with some insulins.
If you are rolling the insulin a few times (and tipping it up and down also) before using then it is very likely that you are mixing it just fine.
.

 

Wow you guys are absolutely amazing.

Here's an updated list with feeding times, etc.

PMPS - 18.4
6:30am - wet meal
7:00am - insulin (1.5u Caninsulin)

+1 - 15.4
+1.5 - 11.3
+1.75 - 5.4
- attempted to give wet food, would only eat the gravy
+2 - 4.0
+2.25 - 3.8
- gave a little corn syrup (about 1/4 tsp)
+2.5 - 3.4
+2.75 - 2.9
gave wet food with pumpkin, with kibble and temptations mixed in (I was panicking and it did the trick)
+3 - 2.9
+3.25 - 3.4
+3.5 - 3.8
+4 - 5.0

He is doing great! Thank you to all of you for so much support.

@Critter Mom We are fully stocked on strips!
We're also stocked for food. Have a couple of can with gravy on standby, corn syrup (for emergencies), higher card treats, and I've kept a little of his high carb wet food.

The vet thinks the extra pumpkin may be causing a bit of an issue, suggested I remove it and pick up some Fortiflora for the diarrhea.

 

Great job, Nikki. Much better at +4/5.0. (And another good job on the 'story so far'!) I see you've got a textbook perfect hypo kit.

Melty has a while to go before we can be sure the insulin is past its period of peak effect. I'd recommend testing again in about 30 minutes. Don't feed in the meantime just in case his numbers might dip again in which case you would need to give him a little food (the choice will depend on the number at the next test - we don't want to give Melty higher carbs than is actually necessary).

 

@Elizabeth and Bertie thank you for that. It's exactly what I do so I feel better. No doubt it is me trying to make the unpredictable predictable. I should just get used to thinking long term and big picture!

@MeltyCat isn't this place great? I'm glad Melty is on the up.

 

It's good to see that '5', Nikki.
I second all Aine's comments/suggestions about testing/feeding etc.

Some of us also use Slippery Elm powder for runny tums. It can be mixed with water to make a kind of 'syrup' (for feeding/syringing on it's own), or mixed directly into food along with a little extra water.
.

 

@Critter Mom ...I'm back and will continue monitoring with Nikki so you can go take a break. Looks like things are ok for now but needing ongoing vigilance. Thanks so much.

 

Hi Linda,

Thanks for letting me know you're back. I'll wait with you for a little bit to see what Nikki's next test result is just in case there are any queries about what and when to feed. After that if you could keep an eye out, that'd be great (I'm hanging).

 

@MeltyCat -

Nikki, have you tested yet? Please can you let us know the result.

 

Yes, I'm so sorry to keep you ladies waiting.
I did test once more at about +4.75, and he is up to 7.2.

My boss became rather testy so I've had to run away to work (shhhh).

Phil (my boyfriend) works just across the road and will be testing again at +6.

 

Wow! Well-trained boyfriend! (Must be love..... )

Nikki, it's clear that another dose reduction is in order here (it's definitely an improving picture for your boy!). But the next pre-shot number you see might be inflated by any higher carb food that you've given (especially if you've given dry food...?) so don't be thrown by that.
If it were my kitty I'd be thinking of dropping back to one unit or even halving the dose (ie, between .75 to 1 unit) to see how that works out. But I'm going to tag BJ @BJM to see what her suggestions are regarding dosage.
.

 

Thanks for the update. 7.2 is good for now.

It's fantastic news that Phil works so close to home and that he's helping you with the testing. (Not all members here are that lucky! )

I'd suggest that if he drops back again at +6 to maybe feed some medium carb and check again in 30-60 minutes depending on how low Melty's numbers are. I think that if he is still rising at +6 maybe give him some of his regular lower carb food - enough to keep him going but not to completely fill him up - and check his BG again an hour later.

IMPORTANT: I strongly recommend you reduce the dose tonight even if he's a bit higher on the PMPS test because he has had some high carb food. Once that wears off you could find Melty in low numbers again later on. Cats can really race down the dosing scale with the changeover to lower carb wet food and Melty is showing every sign of doing so.

 

Linda and Eliz,

Are you OK to keep an eye on Nikki and Phil from here on in? I'm really struggling at this end with the sleep deprivation.

 

@Critter Mom

I can't thank you enough for all of the advice. I will definitely pass the instructions along to Phil as well to make sure we are doing what is best for Melty.
Please don't deprive yourself of sleep any longer! I think he is on the rise, and we will be careful to monitor to make sure.

Thank you again.

 

Great news about Melty's BG! Not so good with the boss! My only concern would be whether some of that number is still from the corn syrup. Let us know what the next reading is @+6! Fingers crossed Melty'll be over the hump soon!

@Critter Mom I will keep monitoring until they are over the hump. Thanks so much for your help and the education I am getting from your experience!

 

@MeltyCat - Nikki, only too glad to do something to help. You did a great job today.

@MrWorfMen's Mom - Linda, thanks for taking over. If you get stuck and there's no-one else around, post a request for help on the Lantus board with a link to Nikki's thread.


Blessings to beans and scritches to kittehs.




Moggers

 

@MeltyCat ...Did Phil get a +6 reading? I'm standing by to see if Melty is holding, rising or (hope not) going down at all. Please let us know.

 

Just heard back from Phil. He has apparently spiked to 14.7 (say he tested twice to be sure). Not ideal...but better than another low dip.

I can't thank everyone enough for the support through this. It really is a HUGE comfort.

 

Thanks for letting me know. It's likely the high carb food clicking in at this point. Not to worry. It happens.

You did a great job today! I'll check in later this evening to see how Melty is doing.

 

Hi Nikki,

Just checking in. Glad to see that Melty's numbers went to safer levels. I'm assuming that all is OK now. Yourself and Phil did a great job helping Melty get through the low.

@MrWorfMen's Mom - Thanks for helping Nikki.

 

@Brashworks , @Critter Mom, @MrWorfMen's Mom , @Elizabeth and Bertie, and @BJM

Thank you all so much for the support this morning

Melty is back up to 22.5, but I'm not surprised at all. I have him all kinds of treats and food to try to keep his level up, and left him dry food to munch on all day (since no one was consistently available).

I'm hoping to draw upon your knowledge once more today.

I spoke with my vet and he said it would be fine to skip Melty's insulin completely tonight if I needed to.
What do you wonderful people think?

 

Hey Nikki - wish I could have been more there for you but you were in far more experienced hands.

When I had that situation with Genghis she cranked up to a 26 I think. She had been on 2.0u prescribed from the vet and I gave her a reduced dose and continued with that 1.0u until now. Sort of the same situation but Melty's numbers might be that much more pronounced because of his more drastic food change.

That said, Genghis never fell so hard and fast as Melty did today - well managed and must have given you quite a fright but you and Phil did great!!

I'm not sure if you can monitor him tonight as much as you did today - maybe a token dose but I am really really not comfortable making any definitive suggestions.

I hope someone with more experience can guide you!!

 

(please ignore - posting problem)

 

@Brashworks I appreciate any help I can get, and your support has been really lovely

I thought 1.5u this morning was a safe dose, just a little slice of humble pie to let me know that my dosing instincts aren't quite there....yet!
Phil is heaven sent on most days! I'd better put a ring on it soon hahaha

I can monitor FOR SURE until +4 tonight, and of course am always willing to stay of late if the numbers bid me to do so, hah.

 

Huh....BG went down to 20 all by itself, about 30 minutes after having a meal of wet food. I think I'm going to skip dosing tonight.

Please feel free (anyone) to chime in if you think that's a bad idea!

 

Hi Nikki,

First off kudos to you and Phil for your efforts today! It's tough work! I'm a little tired from the anxiety of "looking in from the outside" and can only imagine what you feel like. Glad to be of any help although I'm grateful Aine and Elizabeth were there to help due to my lack of experience. It was a learning experience for me too!

I don't think I'd make a decision based only on that 20 now. That is within meter variance (+-20%) allowance so it's virtually the same as the 22.5 from before. If he drops more, then reconsider. It's not always the best answer to skip the dose rather than reducing.

If Melty were my guy, given my conservative nature and what I perceive as either a wonderful response to the diet change or Melty's body trying to go OTJ or both, I'd give no more than the 0.75u tonight as suggested by Elizabeth and Bertie. Even 0.5u if you are more comfortable with that. Or you can skip, it but he will probably be high tomorrow.

Melty was going lower at night anyway and is going lower every day now. Today has been tough on all of you so I'd suggest taking a middle of the road approach. You'll still need to monitor for that first few hours after the shot to see where Melty is headed and how fast but hopefully the reduced dose will get him surfing in some nice numbers instead of diving and you can get some much needed shut eye.

 

Hi Nikki,

Glad to hear that Melty's well and truly out of the danger zone. No surprise about the number tonight after all the contraband earlier. That said, he hasn't gone crazy high. Nice going, Melty!

One thing I do know is that Melty needs a dose reduction going forward. That 1.5 is way too much now that he's eating more low carb wet food.

I'm naturally extremely cautious so I would be inclined to skip and get some rest. Other members may recommend a conservative Big Chicken Shot. (I wouldn't even attempt that unless I knew I could monitor all night should the need arise.) I'd suggest waiting for opinions from other members.

Based on my experience of transitioning Saoirse to wet food, I'd be inclined to post for advice at each preshot over the next few days as the dose requirement may need reduction on every cycle. Even if Melty's preshot is high in the morning I'd still urge caution: it may take a little while for the carbs from today's dry food to work out of his system. Once they're gone, he could go low unexpectedly if you're just basing dosing decisions on preshot readings. Will Phil be able to get mid-cycle tests over the next few daytime cycles? With such a strong response on such a low dose, to keep Melty safe you really need to know what his nadirs are because Caninsulin can still produce fairly sharp drops even at tiny doses. (Maybe have a look at the early part of Saoirse's spreadsheet from last year to see a real-world example - the food transition started on 10.07.14.)

 

Nikki,
Aine makes some good points and has experience with Caninsulin so on reconsideration, this seem like one of those times when skipping the shot may be the right move. With the Lantus I use, you don't generally get those sharp drops so token doses are less of a potential problem.

 

Indeed, Linda. Another difference between the two is that skipping a dose on Lantus or Lev can muck up the depot. Skipping a dose of an in-out insulin doesn't lose the same ground. Possibly the most important thing to consider when choosing whether or not to skip is whether a kitty is ketone-prone. If yes, then skipping carries a greater risk.

 

@Critter Mom and @MrWorfMen's Mom,

All suggestions greatly appreciated

I did end up skipping, simply because both Melty and I need a break from all the testing.
I just checked him again at +1 (from no shot at all) and he is at 17.1 now.

The drop isn't really surprising at all, but will make sure to check him before bed to make sure his body isn't somehow phantom dosing itself. He's also eating more and more of the wet food meals, and just free feeding on the dry a little bit throughout the day/overnight.

I definitely agree that a dose reduction is in order, as did the vet when I spoke to him this morning.

I will post his pre-shot numbers for better advice before shooting. Linda would have saved me this morning, had I waited until she posted and not just gone full steam ahead.

I asked Phil today if he'd be willing to do +3 and +5 readings for me the next few days. He has no problem doing it (I'll even leave him a chart with food options incase the numbers are lower than expected). Would love some suggestions for working that out. Like...>6, give x amount of wet food and so forth.

On the subject of Ketones, I did order some strips so I can spot-test, but they haven't arrived yet. So I'm unsure if that is a factor or not at this point.

I just want to say thanks again for all of the kind words. Despite being scary and stressful, today has been a huge learning experience, and given me more confidence about dealing with his low swings.

 

@Critter Mom ......Wonderful info I shall add to my "depot". Thank you Aine for sharing and for staying with Nikki today. I'm at that point where I don't want to leave anyone "stranded" but having never dealt with Caninsulin or low numbers yet for that matter (DARN!) I am so grateful you saw the post and came to the rescue. It's been a great learning experience for me!

 

OH! I also swapped out the pumpkin in his wet food for FortiFlora tonight.
Just incase that has any effect on anything.

 

Nikki,

The trick to using food to steer the numbers if they start dropping is to feed small amounts at a time to avoid ending up with Melty so full he won't eat at all. I've seen suggestions of giving a teaspoon or 2 and then retesting after 20-30 minutes. Repeat as needed. I don't know of any reference docs that can tell you how much at what number. I think it becomes a judgment call based on ongoing testing if numbers are dropping and what your testing availability is.

If Melty is dropping sharply then higher carb food would be appropriate. If there is a slow drop, low carb might do the trick. If he dives corn syrup or honey is a quick sugar boost but won't last long so it needs to be accompanied by some food. Canned food will get into his system faster than dry so while dry can be left for him to nibble on, it also will fill him up faster so it's not ideal and especially not when his numbers are dropping as he may become reluctant to eat faster acting canned food.

Not exactly what you were looking for I'm sure but I don't think anyone can give you a "formula". Hope that helps a bit.

 

Looks like skipping that shot was the right call, Nikki. Well done.
Melty was already starting to drop by the end of the cycle (and it's generally not a good idea to shoot on a falling number.)

Very encouraging that he has dropped without insulin. (Those carbs should be wearing off now, but hopefully his little pancreas is weighing in also).
It'll be interesting to see how Melty's numbers are by the time of the next shot....

Ironically, it can be challenging when a kitty's numbers start to improve! You can find yourself back-peddling on the dose fast; sometimes cycle by cycle. Fortunately, one of Caninsulin's good points is that its shorter duration makes it easier to change doses as needed.

You've worked very hard, Nikki. I do hope you managed to get some good rest afterwards. You deserve it!
.

 

Sounds like a good summary, Linda.

It really does depend on the situation. Sometimes low carb food is all that's needed to 'steer the drop'. Sometimes higher carb food is needed.
The gravy from higher carb food is particularly useful as it adds carbs without bulk. Syrup/karo acts really fast, but doesn't last as long as food. So, you may often see the advice to give a little syrup and a little food.

And as Linda says, it also depends on your testing availability: If a caregiver isn't going to be around to test much then just getting carbs on board to raise the numbers (and 'abort the cycle') may sometimes be the safest option. Some folks would use dry food if they need a longer acting carb source (but there was one memorable instance here where a member used potatoes because that was all she had available! (It worked well as I recall...))

We often tell caregivers to try not to let the cat drop below 50/2.8 (on a human meter) in order to give some buffer of safety. But for some cats (and in some situations) it may be better to try to keep them at a higher level than that, especially if they're using a shorter acting insulin and the cat is prone to dropping fast. (There have been caregivers who've tried to keep their kitties BG above 90/5 for example.) When numbers are dropping fast things can change very quickly.
A brief story of Bertie's first hypo:
I'd given a shot at a BG of 200/11. Two hours later he was 47/2.6. It was obvious I needed to take some action to stop the numbers dropping further, although Bertie looked completely normal. In the time it took me to run downstairs and get syrup everything had changed though. His eyes were like black saucers. He was staggering and falling over, and kept swatting at the air in front of him as if he could see something that wasn't there. And he was aggressive; so it was really hard to get the syrup into him. I couldn't believe that the situation could change so fast...
And I recall a member here (a couple of years ago) whose cat was just sitting with her watching TV. He then jumped down from the couch, keeled over on the floor and had a full hypoglycemic seizure.

Some cats show hypo symptoms early on (increased/ravenous hunger for instance). Some cats show symptoms when the hypo is moderately advanced (like Bertie does). And some cats do not show symptoms until the hypo is severe (as in the seizure example above). 'Absence of symptoms does not mean absence of hypo'.

For more advice on handling low numbers do see the FDMB hypo document linked to below for general information/guidelines. It is an extremely helpful document; well worth reading and then printing out and keeping with your hypo kit (especially for times when there is nobody online to help you with advice tailored to your particular situation) :
How to treat HYPOS - THEY CAN KILL! Print this Out!!

(Sorry, I hadn't meant to go off into my usual 'hypo spiel'. But I've not said it for a while so it probably doesn't hurt to give it a little airing. )
.

 

Every bit of information is useful and you ladies have been so wonderful. Melty and are are indebted to you.

I woke up a bit late this morning. So I've just tested him (while he was eating his yet food) and he is at 19.0.

He tends to eat his leftover dry food really early in the morning. So the number may be a bit inflated.

My gut says only to shoot .5u, but I'm hoping someone can assist

 

Hey Nikki,

I'm late to the party but for what it's worth, 0.5u sounds reasonable to me as long as Phil is able to test/feed if Melty starts dropping too much. He's not THAT high considering what he took in yesterday.

I know Phil was going to check him at +3 and +6 and you probably took another reading before leaving for work. If so what was that reading?

Looking forward, can you measure .25u on your syringes? I wouldn't be surprised if you are going to need to drop the dose back even more over the next few days.

 

Good Morning Linda,

Thanks for the response!
I did test him at almost +2 (am I that predictable? hah) and he was at 14.7, which is consistent with his more even days.

I am absolutely thrilled that his dose is dropping, but he is still peeing an awful lot. I've e-mailed the vet to ask if I should be testing for Ketones at this point. What do you think?
There's no weight loss, in fact, I think he's actually gained a little bit of weight, but it's something that I still want to be wary of.

Phil will be testing him at +3, and then again as needed. I might have to buy him a new video game or book as thanks. He has been really wonderful about helping.

I've instructed to give Melty a little bit of wet food (a moderate carb food), if he is below 7 at +3. Is that too cautious? Not cautious enough?
I'm not sure about .25? Sometimes I'm not even confident with my .50 readings...

 

Update: +3 reading popped up on my phone at 9:59 and is 12.3. Looks like we are having a nice even drop today. Phil will test again at +5.

 

I think if he is below 7 @ +3 I would go with the high carb food but just a few teaspoons. If he did get to 7, will Phil be able to stay and monitor to see if Melty is holding steady or continuing to drop? That is the main factor you need to consider.... your testing availabilty.

Melty has been throwing you some punches (albeit good but tough ones) so if he gets down to 7, I'd be intervening a little more aggressively to slow the drop and hopefully avoid another situation like yesterday.

Are you using U40 or U100 syringes? I know your insulin is U40 but some people use the U100 syringes so they can adjust doses easier. There is a conversion chart for doing this.

 

Cross post!

Beautiful! Whoo Hoo! Looks like your 0.5u was a great decision for today but that doesn't mean that Melty is going to continue needing that dose. I think you are now in a position of having to make the call as you go based on his numbers and your availability. I can only imagine how tough this is on you and Phil but you are a great team. And yes I think a treat for Phil is in order. Sounds like a keeper to me!
I'll check back in to see how things are going @+5 (around noon).

 

Just checking in quickly to see how things are going. Looks like a much smoother ride today.

Nikki, bearing in mind that you skipped a dose last night Melty might have a stronger response on this evening's PM cycle. If he were mine I would not go above 0.5 IU. Indeed, if his PMPS is low I might think about lowering the dose further. As always, be sure to ask for support when PMPS comes around.

Going forward, should the need arise to microdose the Caninsulin using the conversion chart and U100 syringes, you need to get the 0.3ml U100 demi syringes. These have narrow barrels and half-unit markings, both of which make it a little easier to measure tiny amounts of insulin.

 

Can't edit post above (I have problems drafting posts using this forum's software for some reason ).

Just wanted to add that this evening's cycle has the potential to be affected by some 'carry over' from this morning's dose. Also, when some cats have their levels go down to the hypo threshold it can make them more sensitive to insulin. Just some things to be aware of.

 

I think we are up to the challenge of the dose reductions. Phil's boss has a diabetic cat, so if Phil needed to check in every 15 minutes (or stay for an hour), he'd have free reign. We are in an incredibly lucky situation for Melty.

I do use U40 syringes for his dosing, so doing .5 is even a bit sketchy. I suppose it's time to pick up some U100 syringes.
Does anyone have the conversion chart that they could link me to?

Good to see you Aine, thank you for the wonderful advise, as always. <3
I will definitely be posting his PMPS around 6:15-6:30 to give a little time for responses.

 

Ask and you shall receive:

Conversion Chart

Bit of a blessing that Phil's boss has a sugar cat and understands the tricky bits! (Although I wouldn't wish diabetes on any kitty!)

 

I will bookmark this and print out a copy for our fridge. Thanks again, Aine.

Combine (her sugar kitty) has been regulated for about 6-7 years now. Darilyn is a pro, and is even willing to catsit herself when we are away.
Melty and I couldn't be more lucky with our current support system, FDMB included.

 

You've got a FD-ready catsitter? You'll be the envy of the board, Nikki.

 

I am learning so much here, thank you!

@MeltyCat Linda gave me a link for some diabetic supplies - they seem to have the best prices for test strips and syringes I have found. These 3/10 100u syringes have a nice short, thin needle and the half unit markings for fine doses.

Way to go with Melty!

 

@Brashworks Hi Melanie!!
Genghis' numbers look good, kudos to both of you.
Looks like your dosing instincts are pretty spot on for her.
I will bookmark those needles for later, but probably stop at the vet for convenience and time's sake.

I'm finding this place to be a WEALTH of knowledge, and a huge comfort.
It's quite heartwarming to have access to such a big group of great, like-minded people who are devoted to their sugar kitties.

 

Nikki, how did Melty get his name...?

 

Well, I had a lot of help from the folks here, just like you!

I could not agree more!

Lastly, if you want, we can work something out to combine our order and get free shipping from that site. I can order them and ship them to you for a lot less -- if you want to PM me an address you feel comfortable with we can work that out, just let me know! I plan on placing an order later this week - they do free shipping for orders over $150 or $9.00 flat rate under that and I know I can tag off my work Purolator account to ship for less than half that. $9.00 to me equals nearly 9 test strips or 15 cans of FF!!

PS Did anyone else here notice the "black cat" trend? I'm outnumbered and my black cat Jet isn't diabetic but his photo would certainly fit in better!

 

Nikki,

I somehow doubt the vet will have the syringes you need so I would at least call before making the trip there. If you can get to a Walmart, they have them at close to the same price. Those syringes come in several needle lengths so make sure to get the 8mm rather than the 6mm. I made that mistake once because they didn't have the 8's and it was harder to make sure I got/kept the needle in far enough so I now have almost a whole box of useless syringes.

 

I had noticed, Melanie, but was too polite to mention that Genghis was an interloper!

 

Hello Ladies!

@Brashworks - I will definitely PM you when I get home, and we can work out a way to possibly order together.
Any opportunity to save money without cutting corners for the kitty is a good one.

I also noticed the black cat trend! I have such a soft spot for black kitties, so love seeing everyone's pictures on here.

@Elizabeth and Bertie

Welllllll...his name is actually Junior.
However, when I started dating my boyfriend, his then three year old son called him "The melty cat" because he was rather fat and it looked like he was melting when he laid down.
I started using Melty as a nickname and it just stuck. He comes running when I call so I don't think he minds.

Edited to Update: +5 reading was 11.2, so he is having a slow and steady day today!

 

Much smoother. And probably easier on his glucose regulation system. Really wondering what PMPS will be like.

Me, too. It makes me so sad to think that people are so reluctant to adopt black rescue cats. They were always my first choice.

@Brashworks -

I propose that we grant Genghis honorary Black Cat Status.

 

Jet says, "Genghis has been endorsed by the Black Cat Authority"

This is my boy about 2 weeks after I got him from the rescue folks. He was part of a feral colony, full of ear mites but otherwise healthy. Still a bit skittish but getting there!

@Critter Mom LOL your endorsement rings far truer - we were doing this at the same time! I'm like you - they are my first choice and I don't understand why people have such a reluctance to adopt.

 

I was reading through the posts and I totally missed the discussion on "mix of insulins" yesterday - sorry - I wasn't ignoring the questions. Yes, Elizabeth was correct, I meant because it was made of two types, short and longer acting. Thank you both for your wisdom and knowledge. I am thankful for this thread as I have learned so much.

Curious as well to see Melty's PMPS #. Go Melty!!

 

@Critter Mom and @Brashworks

I am also very curious to see what his PMPS will be. I'll try to make sure I post it by 6:15 or 6:30 so I can get some advice before shooting.
BJM suggested giving dry food before the shot and then wet food after (which is the opposite of what I've been doing). Do you think that would make a difference?

I'm very thankful for this thread as well, it has been very informative and full of support from all of you wonderful people. If Melty could reach you I'm sure he'd give you all a boop of the nose

My sister has black cats as well and insists they are good luck (contrary to popular belief).

 

The dry food would possibly cushion the drop and prepare Melty for onset of the amorphous part of the Caninsulin (first to kick in). The usual drill with Caninsulin/Vetsulin is to 'front load' the cycle with carbs and give less as the cycle progresses and the dose starts to lose strength. The crystalline part doesn't have as much welly.

I'm all for nose boops!

Saoirse has been lucky for me. She saved my life.

 

Welcome Genghis to the Black Cat Club!

Melty is having a great cycle and I too am anxious to see what his PMPS is.