12/29 Butters AMBG 32/..+0.33 106/+1 162/+2 166/+3 110/+5 155/PMPS 203/+2.5 302

Yesterday...a long night...

Today, Butters is the poster cat for why you always need to get a pre-shot BG test. She was surfing when I went to sleep four hours ago. And during those four hours, she had snacks with 16%. When I woke up she was beside me having a grooming session and purring away happily.

I retested the low BG number and it is accurate. I gave her 1 tsp of HC gravy + 1/2 tsp syrup. I'll be testing again at +12.5

Any other ideas or suggestions are welcome.

I was planning to shoot a BCS of 2U this morning. Obviously I haven't shot anything right now.

Have a great day, all.

 

I'd test in 20 minutes, not 30 just to be safe. Up Butters, up.

 

I'll be leaving for work in about 20 minutes, but I'll try to check in once I get there. Glad she isn't showing any hypo symptoms.

 

Will do. Thank you for checking on us, Carla. Will test @+12.3. If you can't check in from work, please don't worry. I'll keep giving her syrup if necessary.
She never gives me any signs when she goes lower.

 

The way Butters is coming down the dosing scale so fast you may want to consider skipping the shot this morning to help drain the depot. Others may have different advice.

 

Please skip the shot. That is one monster depot! You can shoot the reduced dose at your normal time this evening.

She will get back on track.

 

Well that brought her up to 106 @+12.33. Maybe a bounce starting too. Whew. Will recheck in 30 minutes.

I'm thinking of skipping. I'd love to hear if anyone has other advice. @Bron and Sheba (GA) and/or @Gill & George if you're around, would you mind giving me some advice, too please. I can't think of who else I've seen on the board at this time who offers advice in this situation. @Sue and Luci not sure if you do.

 

That could be the effects of the syrup and HC. Please get another test in 30 minutes to be safe.

 

Will tag @Sienne and Gabby (GA) too

Lyla - could edit the thread title to add the "?" prefix and "SKIP SHOT?" - so if folks aren't getting tags but see the question if they are looking at the forum.

 

That's a strange number! Whatever is she up to today? I'd be interested in seeing what her BG looks like without food/syrup. After the night you've had and all that shark chasing and lagoon surfing, I might be inclined to give it a rest too...let's see what happens in a bit.

 

I am sure people will be here soon.

I would not give insulin. In my mind there is always a risk/benefit analysis & it is risk with absolutely no benefit with regards to a cats health in these situations .

 

btw, I didn't have a single 'alert' when I logged in this morning...I just happened to open them up and saw that you tagged me...I wonder why the 'tagging no longer seems to work???

 

Yes, that's happening pretty often now. No alerts for tags.

 

Thanks. @Tomlin I didn't know you were on this early.
Even that 32 didn't really get my brain to wake up.

I can't imagine what I'd need to hear from someone that would compel me to shoot any insulin until PMPS, but I do want to hear if anyone has a dissenting opinion.

 

What would the advantage or benefit to health be?

Worst case scenario, BG increases and you adjust later as needed. No harm at all—no risk!

 

100%. I'm not going to shoot. I'm tired. Maybe not thinking straight. But I don't see any upside to shooting. This is getting a little ridiculous. She never used to have these drops into the 30s.

 

Butters that was not polite. Fwiw, I’m on team skip. I’ve skipped for Jax before in the 40s when I didn’t have time to stall. Butters will get back on track.

 

She is 162 @+13. This is most definitely a bounce now.
I slept well for maybe one hour...I don't have the brainpower or the experience to know what the consequences of a skipped shot will be for her down the line. I just don't see an upside to shooting. She was in the low 30s! For the second time in three days, and following two reductions and a BCS.

 

Give yourself and Butters a pokie break. Catch up on sleep for the next 2-3 days and get ready for the next round! Because she ain't done yet!

 

There won’t be any.....other than Butters will be safe and you will have actually slept! Again, you will just adjust dosing based on trends you are seeing as the BG stabilizes on a lower dose.

 

As we say in the part of Queens where I grew up, "Oy vey!" Sounds like the decision not to shoot is a wise one. Hope you can get a nap in soon, Lyla!

 

She might be a little higher tonight, but she'll come back down. You have to take care of yourself too.

 

No dosing advice here - but what people are saying about skipping makes sense given how low Butters has dropped. And then there's the sleep thing - you need some. Hope you can get some napping in today.

You are doing an amazing job looking after Butters and all these complex pieces of the puzzle. Hugs Lyla

 

Thanks! I truly did not see an upside to shooting this morning. I'd rather deal with some higher numbers than worry about those low lows. I know 32 isn't a number in the 20s, but it's lower than I personally care to see for Butters.

As for sleep, well, I tried to go back to sleep. No can do. Naps aren't my thing, either. I wish I could nap though.

 

I did not expect to see that bg this morning! I’m glad you skipped.. She ate all the food in the auto feeder? I am not one to nap either. We have to make sure that you can sleep tonight.

 

Yep, she ate all of the food in the auto feeder. I put it right next to her on my bed to make sure. I figured she'd continue to surf or even go higher because of the extra food.
Maybe the skip will let me get some sleep tonight!

 

I hope so. She’s already coming down some today I see. How’s her belly? Nice and soft?

 

She is coming down without insulin???!!! Mother of God!!!

 

Yes. It's still nice and soft. I worry about the HC foods potentially aggravating her since she has been doing well with just being on pork. I hope the skipped shot means she can go back to eating just the raw!

 

What makes you think the hc is a problem? Carbs don’t usually cause pancreatitis and it’s been shown that for most cats even fat is not the cause like it is for dogs and humans.

 

It was wise to skip for many reasons including your health, welfare, and sanity and draining the depot a bit more. Any decision that is done for safety reasons is always one we should all support. Well done!

Elise is correct that carbs and fat have not been shown to cause pancreatitis in cats but we’ve had cats here that could not tolerate gravy well including Sienne’s Gabby and my Gracie. Because the intestines, liver, pancreas, and gallbladder are so proximal to each other and closely associated in function, I wonder if the gravy could set off some upset in the intestines and perhaps trigger something more in the line of triaditis instead of just pancreatitis? Just brainstorming.

 

On 12/27 I asked for advice on whether to feed another raw protein to her and we all agreed it was best to stick with the same one for now. I've been giving her other foods lately that she isn't used to. My worry wasn't about giving her carbs or fat specifically; it was more about it being a different type of food. Her vet hasn't ruled out IBD just yet, so I guess I worry about that too.

ETA: Just to clarify, she seems fine. She does. I was just looking back at my spreadsheet when she ended up in the hospital. The evening before, I had fed her lower Phosphorus foods that she was not used to. Maybe a coincidence but I always felt guilty about that like I could have caused the panc flare. I don't think it was a coincidence.

 

Yes. I remember that conversation. @Marje and Gracie what might work for hc if that’s the case? Mc plus syrup?

 

Afternoon Lyla, I thought I was seeing things. Butters that wasn't very nice.
I hope you get another good nights sleep again . ♥

 

glad to see that butters came up for you, lyla.
dear butters, there are only so many episodes of schitt’s creek, so watch your manners, k?

 

Sienne used LC and karo....or maybe it was honey. I found that Gracie did well when in low numbers with MC and a tiny bit of Karo.

 

Don't worry about the skip, just pretend it was a fur shot.

Neko couldn't handle gravy from wheat either, so I bought some of the Weruva products that made gravy with potato flour. In the 30's the corn syrup (which is called karo in the US) came out. We did have one member who gave maple syrup on bacon for HC treats. yumm! Another member who made her own gravy, can't remember if it was potato flour or rice flour.

 

Unfortunately, many cats are being & have been diagnosed with pancreatitis when often, there is also IBD & other organ involvement. There is also that pesky shared bile duct which makes it all the more interesting .

This is really the double edge sword of an easy blood test like the Spec fPLI. Even with an ultrasound added to the initial diagnostics, depending on the level of inflammation at the time, organs, including the pancreas & intestines, may not appear thickened or changed on the initial ultrasound done. As a result, cats leave with a diagnosis of pancreatitis. Vets are becoming more aware of this issue & when they see the history, are making pet parents aware that there is more than likely more to the situation with added differential diagnosis.

With respect to fat, the one recommendation that has changed in more recent years, is that instead of the nutritionists & specialists stating that fat is a non issue for cats with pancreatitis (if that truly is the only issue), they now recommend a true moderate fat diet. This is key because many of the canned foods, especially lower carb cat foods, have a high fat content vs a true moderate fat content (especially when you calculate actual grams based on calories fed to a specific cat). This turns out to be a problem for a decent percentage of cats with pancreatitis &/or inflammation of the GI, gall bladder &/or liver.

In addition, some of these cats cannot & will not tolerate having to eat a lot at one feeding or even eating too many small meals across several hours to bring BG up &/or tolerate a mix of foods/ingredients .

For this reason, management of insulin dosing vs management of BG using various foods/multiple feedings/testing (aka “feeding the curve”) becomes the preferred strategy for some of these cats.

This just simply means not taking the risk and shooting lower #s at times &/or taking some dose reductions earlier or by a greater amount in order to to avoid being forced into the situation where you need to increase BG with food. Obviously, there will be some instances (hopefully not too many!) when a situation may happen & using honey, syrup or maybe a particular food you have found that will work without causing an issue, is fine . However, the goal is, to the best of ones ability, avoid dosing that results in these situations.

You are definitely still able to get to where you are going.....the same exact place....it is just an alternative way of getting there based on the specific needs of & what is best for your cat . Win/win. Again, strategy & management that is based on risk/benefit .

 

Well, you had a bit of excitement!!

Gabby couldn't tolerate gluten. Most of the HC food, at least at the time, had gluten in it. She was also a champ at vomiting up beef. I used either a drop or two of either corn syrup or honey to bump up her numbers.

If there's a possibility of IBD, you may want to consider novel proteins. Gizmo who does have IBD gets fed a combination of raw and ZiiwPeak canned food (either venison or rabbit and lamb). The ZiwiPeak has no gums or carageenan. If Butters is sensitive to fish/seafood, it does use green-lipped mussels for omega-3, though.

The issue with tagging may be that you need to make a list vs type out the people you're tagging in a row. The board is sometimes finicky. (It's about cats -- of course it's finicky!)

 

Oh -- and remember to take the dose reduction at PMPS.

 

Butters is certainly keeping things interesting. Congrats on reducie.

 

Looks like you will get some much needed sleep. ANTI-JINX!

 

She is 302 @+2.5. I'm excited for sleep. But I hate seeing that number. I hope this is just a mega bounce from the 32 this morning and that I didn't ruin her beautiful numbers with that skip.
I did a 60 minute spin class this afternoon. I think being overly tired made me more determined to do something productive.

 

This evening is cycle one of the new dose: 3.5U. Thank you for all of the information to chew on. I will have to think it all through tomorrow as I just don't have the brain power today. But I appreciate everyone who stopped by to make a comment and share their knowledge.

Last night did exhaust me. It is what it is. I could barely think straight this morning (pro-tip sidebar: I always adjust my calipers immediately after a reduction is earned. I would've forgotten to do that this morning). It was the right decision to do that "fur shot" from a safety perspective. Hopefully she gets back on track soon.

I am thankful to those who were around this morning to ensure that I made the decision with safety in mind first.

 

A bounce was expected with that 32. She will rebound! Get some sleep and cuddles.

 

Thank you for this! Comforting. I am taking butters to bed with me now. Goodnight.

 

I did a 60 minute yesterday, a feel good ride. It’s still hard. I’ve done 26 days in a row so far. Good night.

 

Oh Butters, what the heck are you doing to Mama!? You sure like to keep her on her toes, you silly goose. Really hope she keeps things less exciting for you Lyla and that you get some sleep. Take care of yourself. You're doing a wonderful job.

Schitt's Creek is amazing, right?! Best show when you can't handle anything heavy. I think I should re-watch it