7/26 KT pm+11-27 +11.5-41 AMPS 62 LEVEMIR HELP PLEASE

Good afternoon World! Welcome to our home!

KT - TODAY
pm+11 - 27! (NOT symptomatic for hypo)
pm+11.5 - 41 (half FF can of gravy food right after above test)
AMPS 62
+2 - 147

7/25 AMPS 51
7/24 AMPS 68
7/23 pm+11 - 39
.......pm+11.5 - 54
.......AMPS 77

HELP! I'm at a loss and don't know what to do now. KT is down to .1 unit - literally just enough to feel the plunger push a tiny bit. almost just a 'squish'. He's doing a LOT better on levemir but now he's throwing me these extreme lows. He still doesn't eat overnight, that's not going to change - well, it would if I'd just open him a can of gravy food or hand him a bowl of dry food but anything else, no, he's going back to sleep.

Suggestions PLEASE!!!

 

27? Yikes! :shock: :shock: I don't know, Lyresa, it will be interesting to see what the wise ones suggest. Maybe only shoot when he's above a certain number, like 100?
Liz

 

Thank you Liz! Yep that 27 wasn't a typo - first test handed me a 23, the 27 was a retest as I didn't believe it. Needless to say he got fed first before I even started coffee or let any dogs out to potty.

BIG HUGS too!!

 

I'm definitely shooting from the hip with this suggestion. I don't have anything to base it on. I am remembering Shai's Fitz and they developed a protocol for only shooting when Fitz was above a certain number. I think Fitz was on Lantus, not Levemir. It's great to see KT on such a low dose! Hugs to you, too.
Liz

 

I don't know. That 23 came from shooting 0.10 on a 219 last night. He won't eat (LC) at night at all?
Maybe you should try for one drop by pressing the empty syringe in tightly and holding it tight while you put the needle into the insulin and then releasing the plunger. Pull the needle out and check to see the size of the drop, then do it again. That's what I do with R insulin.
Lets see what other suggestions people come up with.

 

Thanks again Liz and thanks Dyana!

No he won't eat at night even if I wake him up and stand beside him with lots of encouragement - he just gives me sleepy eyes and goes back to sleep. That .1 is almost that needlefull - when I measure it with my magnifying eyes, there's not even hardly a visible gap between the plunger and the end....a 'silk' straight pin (very thin) wouldn't even fit in that space, I'm not sure that more than 1 sheet of paper would even fit!

I've emailed Marje, Jill and Libby asking that they visit and share any ideas they might have too.

HUGS AGAIN!!!

 

KT - TODAY
pm+11 - 27! (NOT symptomatic for hypo)
pm+11.5 - 41 (half FF can of gravy food right after above test)
AMPS 62
+2 - 147
+6 - 91
+9 - 62
+10.75 - 168
+12 - 249

I'm just skipping tonight's shot even tho' he's way above what anyone would say is a 'no shoot'. So was last night's... :roll: I'm just lost....are these high numbers all bounces? I believe they are but I don't trust myself here. He's eating well during the day, poops are mostly good. He's not playing much, kind of hissy but everything else is in place.

HUGS to all!!!

 

Lyresa, you said he won't eat LC at night. Would he eat a little MC? You might try that, if you did want to shoot. Or could you take most of the gravy out of some lower HC and give him that? Just throwing these out there. I'm sure someone much smarter will be along with better suggestions.

Meanwhile, hugs for the stressed out bean headed your way, and some nigthtime appy vines for KT. I hope your Rock Doc is doing well. :YMHUG: :YMHUG:

 

Lyresa

I would suggest you take a look at Jill's Alex's SS.

I hope Jill will have a chance to pop in and explain better than I can but she seems to be following Alex's lead. She either shoots half a drop every 12 or every 18 hours. Alex is not doing what KT is but it seems to me you have a couple choices:

---give him six or so cycles without insulin and see if he just comes down into normal numbers; he's at 0.1u and getting into really low numbers which is causing him to bounce. See what he does without insulin but you have to give some time for all the bouncing to stop

--if you think he needs insulin, shoot a tiny tiny amount every 18 hours and see what happens.

As you can see from Alex's SS, Jill has been trying different things. Her comments might help you understand her thought process.

As to why he's doing this.....possibly he's done with insulin, possibly he's not eating enough to work with the insulin.

I'm not sure if that helps. I definitely think Libby and/or Jill would have some great insight and thoughts.

 

Lyresa,

responding to your PM... I would first give it a try without insulin to see if he really needs it. He may just be bouncing because he is fighting to keep the numbers up. I would try withholding insulin to see where he levels out.

If he does need insulin, then you'll need to figure out a way to give it to him. With KK, I found that changing his food to 12% allowed me to give insulin safely for a while. Eventually he got to a point where he didn't need insulin every day even with 12% food, so I just gave shots sometimes. I skipped whenever he was lowish and I wouldn't be able to monitor (he was also eating dry food so I didn't want to run him any lower, plus he didn't digest his food well so I could never be 100% sure that high carb would work in a low number situation). Increasing carbs doesn't work for Alex, so Jill has been experimenting with ways to keep giving insulin, but less of it. In theory, giving insulin at intervals greater than 12 hours should allow the depot to deplete partially each time, so each dose will have less impact than it would if given with a full depot.

eta: I should add that most cats probably wouldn't need to go all the way to 12% to see a difference. KK's digestive issues meant that most food went right through him, plus there was dry food in the picture, so I had to be fairly extreme. I remember one cat for whom switching from EVO to a 3-4% Wellness made all the difference. ECID.

 

Thank you Marje and Libby!!!

 

I hope that one of the suggestions gives KT nice steady surfs! :mrgreen: :mrgreen: :mrgreen: Not sayin' nuttin', but looking good!

One MC food I've found is MaxCat. The small cans " with duck" or "with venison" are only 8% and they have gravy! Tess always will eat those!

 

sorry i'm late to the party. i'm one of those who hasn't received email notifications when a PM arrives since Robert changed the board over to a new server. :roll:

in response to your PM...

i don't have much to add to the advice libby and marje have given. if i were in your shoes i would try these things in this order:

• withhold insulin immediately... regardless of the numbers you're seeing. it's possible KT is telling you he's done with insulin and is simply stuck in a vicious circle of dropping and bouncing. trust me, it happens. when withholding insulin you'll want to withhold for a minimum of 3 days (6 cycles) to allow the bounce to clear and the insulin depot to deplete. fyi: not too long ago we saw a cat take around 5 days to clear a bounce before going otj. trust your gut and use what you know about KT to help in making decisions.

• try feeding higher carb low carb foods. the extra % of carbs could help him tolerate even that small dose you're giving him. don't be afraid to experiment to find a food that works!

• try to measure even smaller doses of insulin to give consistently. it doesn't matter what you call it as long as you know what it is. for example, right now alex is getting the smallest dose i can consistently measure with any semblance of accuracy. i'm calling it "half a drop" which is absurd because any drop is still a drop. lol! the important thing is i know what it means... it's the smallest dose i can possibly measure... a dose that's smaller than 0.1u, 0.05u, or "some" insulin.

• skip shots whenever you're not comfortable shooting. you can try shooting at more than 12 hour intervals intervals. after shooting quite a few 18/18s, i've pretty much come to the conclusion that alex would do best on a 15/15 schedule. i'll switch to it if i have to, but a schedule like that is a killer.

• another option not yet brought up...
  it's possible to dilute the insulin in order to make measuring a smaller dose easier. i haven't gone this route and probably won't because to me it sounds like more trouble than it's worth. i know nothing about it and the big turn off for me is the diluted insulin only lasts a few days before you have to throw it out and start over. if you choose to go this route, please work closely with your vet and your pharmacist. i don't think there's anyone who posts here any more who has hands on experience when it comes to diluting insulin.

the only way i've been able to make sure alex gets as much food as she needs every day is to supplement by assist feeding whenever necessary. in the past, syringe feeding was always a chore, but i think i've found the secret to syringe feeding effortlessly... i don't use any liquid when preparing the syringes. i only put canned food in my Ninja when making up a mixture for syringes. adding liquid to the mixture tends to make it splatter all over me, on alex, and everything within 5 feet of where i'm feeding her. syringing small amounts of food only tends to stay in her mouth. i now syringe solids and liquids separately. it's made syringe feeding so much easier. alex is so comfortable with it now that she'll eat the solids off the top of my hand! :mrgreen:

is there any chance you could syringe food sometime between +6 and +8 at night? feeding then might be enough to stop those late cycle drops at night. i can syringe 20 - 30 ml and be back in bed within 10 minutes now. i take the syringes up with me when i go to bed, set an alarm, feed her, and hop right back into bed.



most of all, you want to keep KT safe. when any kitty gets to where KT is now and there are other circumstances to consider... throw "the protocol" out the window. only shoot when you feel comfortable shooting. it doesn't mater if no one else understands what you're doing. you know your cat better than anyone else. you know the consideration you have to give to real life events when it comes to monitoring KT. if you can't monitor, no one can fault you for not shooting. weigh your options with what KT is doing and proceed accordingly. what i'm trying to say is follow KT's lead and don't become discouraged if it takes awhile to make it all come together.

good luck!


Edited to add:
Always check for ketones at least once a day when withholding insulin.

 

Great info! I'm so glad Jill had a chance to stop by and give some thoughts and expand upon the ones Libby and I suggested.