Walter AMPS 87 (97 at +0.45)

I am still nervous about giving Insulin at lower numbers - especially since Walter's BG has been running pretty high in general. 87 at AMPS seemed very low and I won't be home to monitor him this morning/afternoon. I waited half an hour (without feeding) to retest. He was agitated, hungry and almost impossible to test, but he was still under 100. So I decided to skip this shot.

I am fully expecting a bounce tonight... so where do I go from here? Continue with 1.5 units?

To make matters worse, he is also getting worse about testing. Last night, he wiggled so much that I managed to hit a vein in his ear and he bled profusely. This morning, he was even more agitated and I was more nervous about hurting him... and everything went downhill from there. I briefly debated on testing his paw instead, but he for sure wanted nothing to do with that. Just an all around frustrating day...

 

Aww so sorry to hear about the testing. I know how it feels to get frustrated at them for not cooperating. Don't they know it's for their own good?? Lol still new here so I can't give advice about dosing.. But I know if you're not going to be home to monitor him then it's better he's a little high tonight, then really low.
Hope your day gets better!

 

Have you tried singing to him while you test? That can work well to keep both the kitty and the bean calm. If you're feeling stressed when you try and test it's likely that Walter will pick up on that and be stressed too. I assume you are giving a LC treat each time.

Your signature doesn't say if you're following TR or SLGS. You are testing enough for TR, if that's what you're doing I would hold the dose until you get a test below 50. You will get another chance to shoot green when you can be home to monitor (I think it was a good call skipping today since you couldn't and don't have too much data yet) and your nerves will settle as you get more of those opportunities and see what he does.

If you're following SLGS that 87 earned him a .25 reduction.

 

I agree with Serryn (Vyktor's Mum) - it was a good call to skip this morning. When you are going to be home and can monitor, that's the time to try shooting low. People often move their "no shot" line down gradually. If you do want to try shooting low (ie, shooting the regular dose into normal range) post here and ask for advice. Our tradition is that if someone encourages you to shoot, they will also stay with you in case you have to deal with low numbers.

Until now you've only shot in the 200's or higher, so perhaps your first step would be to shoot something in the 100's before you try something under 100. Ultimately, you'll want to work up to shooting lower because that is the path to getting a cat regulated and if possible, to becoming diet-controlled. But don't do it when you're not going to be home afterwards to test and keep him safe. And definitely post and hopefully someone will look at the spreadsheet and see if it's a good time to try it.

Are you using Neosporin ointment with pain relief on his ears? That will get rid of any owie - I put it on generously every night and punkin's ears were healed by morning. Wiped off any remaining in the morning before the first test and he was good to go for the day with a like-new ear.

Also always give him a treat to soothe his feelings after you've poked him. That can help him learn to associate testing with treats. I do better with treats too.

 

Thank you, everyone! I spent most of our faculty meetings yesterday staring at my cell phone app where I can see Walter on the web cam. When he laid down next to the water bowl and didn't move for a few minutes, I just about ran out to check on him. When I came home and tested him, his numbers were really high and I am sure he didn't feel well due to that - but I guess I am glad that his number was too high rather than too low. Last night, I did a pre-shot test and then let him be for the rest of the night.

I figured we would just start back up with our regular routine in the morning. Everything went much better today (probably mostly due to the fact that I was more relaxed). I am still working on finding a treat that he really likes. Walter's teeth are horrible (and he will need a dental once he is a bit more regulated) - so he wants nothing to do with any of the low-carb freeze-dried treats I have. Right now, I feed him some turkey breast when I test and he loves that.

I think the most nerve-wracking thing is that I don't really know him that well yet. When Mandarin became diabetic, I knew exactly what was "normal" behavior for him. Walter was already diabetic when I took him into foster 2 weeks ago and we are still getting to know each other. I was planning on following TR, but I am terrified that I will not recognize when he goes too low. Luckily, my schedule is pretty flexible most days... so I think I just have to work up the nerve to shoot lower numbers.

 

You and Walter will get into a routine and it will be less stressful - always remember the treats. Even my civies have figured out that if they hang around during Hyde's tests, they will get treats

 

Not sure if you already know this or not, but getting a dental done can often improve blood sugar dramatically. Infection, inflammation and pain can all increase blood sugar, so if his teeth are so bad that you know it and it makes him not want to eat some treats, that's probably pretty bad. Some vets don't want to do a dental until the cat is regulated, but it's a chicken and the egg kind of thing - which comes first? I'd get the dental done as soon as possible.

 

I agree with Julie about the dental. You might discuss whether an antibiotic will help with the dental situation.

I also suspect that with Mandarin, your kitty already trusted you. With a foster, you and your home are all new territory and Walter was scared. Add having to poke his ear and give shots and no wonder he's not always cooperative. I also agree that if you're calmer, Walter will be calmer, as well.

 

Hm, I was always under the impression that a diabetic cat has to be regulated first before they do a dental. At least that's what I was told by our shelter vet. In Mandarin's case, he was able to go OTJ before he had a dental, but I am not sure if that will ever be the case with Walter (esp. since his diabetes was left untreated for so long). There's no doubt that Walter's mouth is painful and infected, but I don't want to risk putting him under if his Glucose might drop too low. So when is he regulated "enough" that the vet might attempt to do a dental? Or what other precautions would they take?

 

His spreadsheet looks better than some cats that I've seen have a dental. Punkin had acromegaly and wasn't particularly regulated, but he had 2 dentals done. There are always risks with anesthesia - one is that it often lowers blood sugar. So people either skip the morning shot (and maybe even the pm shot), or give a 1/2 dose, depending on what the vet wants.

A second risk is to the heart, so if you have a delicate guy, you might want a veterinary dentist. On the "Where Can I Find?" post, in the second half, there is a link to find accredited veterinary dentists. I was lucky to have a local regular vet be on that list, so I took punkin to her. I would want to look at the whole health picture for the cat, not just the blood sugar, and if it seemed like overall the cat could tolerate it, then I'd try to get one done.

I'm not a vet - just sharing what I've seen here, so it's something you'd want to ask your vet about. They can be very expensive, but if the cat's mouth is bad I think, just based upon what I've seen here, that it can prevent regulation.