Please Help should I give Phoenix some dry food for carbs? He doesn't eat dry food unless he drops too low. I checked his BG at +8 it was 175. I gave him a snack and checked again at +9 122 and gave him another snack. Now, at +10 he is at 73. I know you are not supposed to feed after +10 . What should I do?
Sorry no one answered you sooner. What did you do? Did you feed him a low carb snack? It would have been fine to feed him a snack at +10. Then no food after that. However if he continued to drop low, you would have to feed him to keep him safe It looks like he is coming off the bounce after bouncing from all those lovely green numbers yesterday morning cycle. Have you tested again?
No, I didn't feed him. That was my question. It was +10 and you are not supposed to feed after that. I don't have any clue what to do about his upcomi ng shot but this is these second time this week I haven't received a response from a 911. Phoenix dropped to 51 a few days ago. I didn't receive an answer about what to do as far as his p.m. shot so I gave him half a dose. This is why his numbers were high.The next day, I received a response to lower his insulin to 8.5. He has only been on this dose for a day and a half and is dropping again. I checked his BG again this morning after 20 minutes. He was up to 106 but after another 20 minutes, he is back down to 83. I have no clue what to do about his AMPS. He is due his insulin in another hour. I guess I will just have to give him another half dose since no one responds. Thank you for your concern.
Bron replied? Are you waiting for someone special to respond? You tag people by doing the @ and write their name straight after, and pick their name from the list. It's usually slow this time a day, if you don't get a response here, try the Main Health forum instead.
Hi Susan, was the 83 at +11? When did he last eat? Link to previous post: https://www.felinediabetes.com/FDMB...g-dropping-to-low-for-my-comfort-zone.244041/
You can feed at +10. You then have the 2 hours after that that you don’t feed so the preshot is not food influenced. I think you will find the higher numbers after you gave the half dose were from a bounce from the green numbers rather than the half dose you gave as they went up at +1 before the half dose had kicked in. See what the preshot number is. You have shot green numbers before with the full dose. You will need to do what you are comfortable with doing. Do you have plenty of test strips and high carb food and can test during the cycle? Unfortunately it is very late her...after midnight and I am heading to bed so won’t be around for a the preshot number. I am not sure who else Is around at this time of day. It is a time when the board is fairly quiet. Ah I see @Bandit's Mom is around.
If the BG still low at preshot you can stall, dont feed and test again after 20 minutes to see if it is rising
Oh thank goodness you are up. I know you are in a different time zone. No, the 83 was at +10.5 I checked his BG again at +11 it was 79. He last ate at +9. He is due his AMPS is another 15 minutes. I have no clue what to due about his insulin. We just lowered to 8.5 one day ago. He is still getting low numbers. This is not like him. I will stall giving his injection until I can get a response. Thank you for your help.
Let us see where he is at AMPS. Do you feel comfortable shooting the full dose? Will you be able to monitor him if you do? (Whether you shoot the full or a token dose, the depot will continue to influence the cycle, so monitoring will be needed).
I usually rely on Bandit's Mom and Marge and Gracie. They are great but they are both in different time zones from me. Thank you for your advice. Next time, I will try the main forum.
It was too early in the morning for anyone in the US. But you can tag or PM any of us who are usually around: @Bron and Sheba (GA) @Gill & George @Bandit's Mom
@Scdal I don’t give dosing advice ... and won’t be online long ... but wanted to address your comments in your last thread regarding the difficulty it presents you with seeing such low low numbers and wondering if you might change dosing in order to achieve higher nadirs. I’m wondering if going to SLGS (or perhaps a modified version of it) might work better for you. There’s absolutely nothing wrong with choosing it over TR and it might give you the “cushion” you’re craving. It might seem there’s a lot of pressure to use TR or that it’s what’s “best” for our cats, but honestly, sometimes what’s best is what we can realistically do given the realities of life, whether it’s living alone on an acreage or being hours from the nearest ER or simply needing to sleep. So don’t feel guilty if that’s what works for you. I’ve been there and completely understand. If you use SLGS, you’d reduce dose at 90 rather than waiting to see something beneath 50ish. Just a thought. Cat insulin needs can change over time, and it can be really stressful to see and shoot lower numbers on a higher dose cat. Again, been there. I’ll leave the dosing advice to Bhooma and others who will take good care of you and I will continue to follow quietly from the sidelines. Just wanted you to know you’re not alone. Hang in there and best wishes.
Do you have his AMPS? Phoenix seems to drop at the end of the cycle. I don't know what your feeding schedule is, but feeding him in the second half of the cycle, might help with those drops.
I just took his AMPS It is 81. I do feed him usually around + 7 or + 8. I did this morning as well and he still kept dropping. I will be home today to monitor and will delay his injection until I hear back from you. I have fed him.
He seems to have flattened out from +10 till AMPS so you can shoot the full dose if you can monitor. Do you have MC and HC and honey and enough strips? If you shoot, get a +1 and tests every half hour after? So we catch any dips as soon as possible? If he is still flat at +1, you want to feed him slightly higher carbs He does look like he is headed for another reduction at some point. Like Bron said, next time you can feed till +10 if he is dropping.
I have no clue what is going on lately. Phoenix was diagnosed almost a year ago. His BG always went up at least 100 points after eating and stayed up for several hours. He has a late nadir. The last couple of weeks all this has changed. He has been remaining low all day which is a good thing. I can no longer predict when he is going to be low or high I do have errands to run tomorrow so I will be unable to monitor for about 4 hours. I don't know what to do if his numbers are low again. I will cancel all my errands but I need to pick up his Lantus refill at the pharmacy.
I will give his full dose since I can monitor. I don't want to get his numbers too low ,though . I live in a rural area. It is an hour and a half drive to the vet for an emergency. I know I can feed to + 10 but what if he continues to drop after that? Should I feed and delay his shot or what? I am going to go and give him his insulin. Thank you for responding.
His insulin needs have reduced. Even though he is high for a couple of cycles after a skipped shot or BCS shot, he recover quickly. He is just going down the dosing ladder and that is often a scary ride for the caregiver. It is safer to skip the shot if you cannot monitor and he is running low. Let us see where he is tomorrow AM. Please get a +1 and post it here. What is the % of LC, MC and HC that you have?
I don't know how to measure the LC, MC HC. Phoenix has always been on a raw meat diet. I have a sandwich bag full of dry cat food that I keep in my refrigerator for an emergency. I took it out of a large bag of dry food that I feed my barn cats. I do have honey and karo syrup as well.
So you have raw food and honey/karo, right? Let's try and avoid the dry food. Please get a +1 and post it here? Thanks! ETA: Could you also please update the thread title and his SS with the latest numbers?
Yes, I have honey and karo. I will get a + 1 in 30 minutes. Thank you for your help. I have updated his spreadsheet and will now update his title.
Add a drop of honey to the raw. (if you keep track of how much you can figure out what works for Phoenix). You feed at +10, don't feed after unless he drops below 50. If he does, he has earned a reduction. Today wasn't a typical lantus cycle, what you saw was a combo of bounce breaking and the effect of the larger depot of the 9u (that is still affecting the cycle, even with the depot draining reduced dose) He was flat coming into that PS as @Bandit's Mom noted. From the becoming data ready to shoot sticky Becoming Data Ready: Are you data ready to handle a lower preshot number? Everyone focuses on the +6 spot check to find the cat’s nadir, but there is a reason to collect data in the very early and very late part of the cycle. The +10s and +11s and +1s and +2s are often the “neglected spot checks,” but they can be almost as important as the nadir. Why the +1s and +2s? Let’s say you have a lower than usual preshot. If you have collected the data to know what usually happens after you shoot and how long it usually takes for the insulin to start having an effect (onset), you may see that shooting low is actually very safe for your cat. If your cat typically rises through +1 and +2 before the insulin starts to work between +2 and +3, then you can feel comfortable knowing that your cat will actually be much higher before the insulin starts to work. If your cat typically has little to no food spike or an early onset, then you may need to be more conservative with low preshots. You are not shooting the number your cat is at now – you are shooting the number your cat will be at when the insulin kicks in. You need to know what that number will be. You are then using the lag time (aka overlap and carryover) to your advantage. It is important to note that while Levemir may typically have a later onset than Lantus or Basaglar, that is not true for every cat. Know thy cat. Why the +10s and +11s? These spot checks will help keep you out of trouble. Again, let’s say that you have a lower than usual preshot. If your preshot is higher than +10 or +11, you know the insulin from that cycle is waning, the cat is on his way up, and the number is probably shootable. If you have a preshot that is much lower than your +10 or +11, knowing why will help you decide whether or not to shoot. Some Lantus, Basaglar, and Levemir users notice a dip at the end of the cycle, meaning that the preshot is always a bit lower than +10 or +11 (but usually still higher than the nadir – the cat dips to a nadir at mid-cycle, then rises, then dips again). If this is your cat’s pattern, then this type of dip is not a reason to delay a shot. On the other hand, if your cat has a bounce clearing and is still careening downhill at shot time (usually characterized by numbers that drop for the whole cycle, without a clear nadir), then you will want to take that into consideration as you make a decision about shooting. Know thy cat. Knowing whether your cat is one that dips at the end of the cycle can also help you with dose increases. If your nadirs are not that great and you are considering an increase, but then he dips again at the end of the cycle, you might be tempted to delay the increase. If you know that this is a usual pattern for your cat, you will know that you can ignore that dip and go ahead with the increase. Do not forget the “neglected spot checks.” They are more useful than most realize. Know thy cat. Be data ready to handle the situation. ~ written by jojo and bunny(GA) and Y, edited to update and clarify by Libby and Lucy Although it was a bounce clearing cycle, he had stopped dropping by PS, he arrived at PS having been flat for two hours, so it makes me think that he is less likely to give you a hard time in the morning cycle. However with the large depot of the 9u still governing his cycles, he may still be quite active. I really liked getting a +11 and/or +10 especially when I started seeing green PS because it gave me an idea of what to expect with the cycle if I shot the full dose. As phoenix is flat, you may still get some carryover/overlap with this dose (the last dose is still impacting his numbers, though keeping him steady) with the food you may see him come up at +1 but if he is the same or dropping you need to take note and feed accordingly to manage those numbers. See how he does, paws crossed.
Phoenix ate 1 cup of cornish hen for breakfast. That is his normal meal. I just gave him 1/4 cup of beef kidney. You are making him a very happy cat. I will get a + 2 . It is due in about 20 minutes. Thank you again for your help.
Lovely numbers showing up on that SS lately! Looks like Phoenix might be rounding the corner on getting less insulin. Only time will tell. Nice job Susan Have a great day!
I think she needs to modify TR and take reductions at a higher number. She’s clearly scared and it’s crazy to live like this. Thoughts?
Great idea, like what @JL and Chip detailed nicely above somewhere I agree even more, since Phoenix looks to be heading down in dosing needs.
Yes. You can’t modify SLGS according to guidelines but you can modify TR. We just need to decide on a reduction number. Maybe 70?
Another thought. Would you consider getting some canned mc and hc food for when he needs. To be propped up instead of the dry? Using dry is usually a very last resort with TR if ever. If not perhaps SLGS would be a better choice.
I haven't found any canned food that Phoenix will eat. When he was younger, he would eat the canned DM. Then, they changed the formula and made it quite mushy. Every time he ate it, he immediately threw it back up. I had to syringe feed him when he was sick. That was pouches of broth and gravy for elderly cats. He will not eat it on his own. I do have a lot of it left over. The next time his BG drops, I will try and see if he will eat it. As far as SLGS, he was on that up until a few months ago. His numbers seemed to stay in the yellow. I was gradually having to increase his insulin. He got up to 10 units. Since I switched to TR, his numbers have really come down. Within about 6 weeks, he has come down from 10 units to 8.5.
I like the idea of sticking with TR and taking reductions at 70. If he fails one we can go right back up. You are feeding raw. What about looking for a raw that’s higher carb to use if he drops? Some are higher carb than others. Is that possible? Maybe try Ziwipeake canned? I believe it contains some carbs but not sure. Tanya’scrf food list includes some raw and she has the carbs listed for some. It’s up to date so worth looking at. We don’t want him vomiting.
Also feeding in the second half of cycles where he clears bounces and keeps heading lower till PS. You may have to feed every hour right up to +9.5 or even +10. Will keep him from going too low at pre-shot for you to shoot.
Phoenix eats just raw meat. It is not canned. I have looked at the Ziwipeake on Chewy.com. I don't believe Phoenix will eat it. I have multiple cans of prescription food that the vet gave me to try. He would not touch them. I hate to buy a whole case when I know he will turn his nose up at it. He does like milk and it doesn't upset his stomach. Is that an option? I am trying to think of foods he will eat.
If he refuses canned just add honey or karo. Marj adds maple syrup. Dry takes longer to work and sticks around longer. It’s trial and error as to how much to add and I’d only do it if under whatever number you choose as a reduction number. What are you thoughts on reducing at 70 instead of 50?
Though I agree that you need to ditch the dry, unless in an absolute emergency. I think a better choice than SLGS would be to increase the carbs in the raw using some honey mixed in, if he won't eat canned. With notes on how much honey is used per couple of teaspoons of food, it should be possible to figure out how much to use when. I think I even remember someone adding potato flakes to increase carbs, I don't know if that would be a good idea or not? Skips and token doses can be used to drain the depot, it's just that the depot is big, I have seen this many times with kitties on the higher doses, they get back to good numbers pretty quickly after a skip or a half dose, the depot helps with that, it doesn't necessarily mean they are racing down the dosing ladder. With him having had problems getting into good numbers, and being on a high dose I think SLGS would be a set back for Phoenix IMO I agree, when we test and get a number, we need to ask ourselves What does this number tell me about this cycle Is it a normal cycle is it a bounce breaking cycle And then take action. Sometimes you are going to get caught out and may need to skip take a half dose to drain the depot if it's all getting too much. Today that +10 and +11 showed he'd stopped dropping, that told us that he had most likely stopped the dive and this mornings cycle turned out to be a non event (BTW did you get that +3) How often have you been using the dry? I can't see it noted on the SS??
That's a good idea to add the honey or Karo to his meat. He scarfs it down so fast, he probably wouldn't even taste it. Potato flakes are another good idea. I could just roll his meat in it as long as they didn't just disintegrate. As far as reducing at 70 instead of 50, I would like to see what Bhooma thinks. I am willing to give it a try.
I have only used the the dry on 2 occasions. Both when Phoenix dropped into the 30's. I have been a bad mama. I went outside to feed my animals and took Phoenix with me. I forgot all about the +3. I did get a +4, it was 206.
that's good, I think if you find yourself in an emergency where he is not coming up and getting full you could use the dry, especially as you are so rural, we are an hour from our vets, no ER, so I get how that can give anxiety, but steer clear of it otherwise, it makes it harder to read his numbers. I was concerned it might be more regular than that, and we would have to keep that in mind going forward. Looks like shooting the full dose was a good decision, isn't hind sight great If this was me I would probably see what happens over the next few days of cycles, and see if it becomes necessary, see if you can hold the dose long enough to see the depot settle. You have reduced by 1u already this week, coming down too fast can back fire. See how he settles into this 8.5u dose. I just don't want to see your hard work undone.
That all sounds good to me. I am a little concerned about tomorrow. I have some errands to run and will be gone for about 3 hours. I can wait until the afternoon when his BG usually rises. Unless he pulls another stunt on me like earlier this week. He remained in the blue numbers almost all day. I will not leave him if his BG is not above 120.
I want to thank all of you for your help this morning. You are amazing and I truly appreciate all your advice !!!
I believe you had the tests for acro and IAA done but we never saw the results. I am wondering if he had IAA which is self-limiting after a year and the BG can drop quickly with several reductions earned one after the other. He’s been diabetic about a year so, if he did have IAA, it would be about the time it would break.
His vet phoned me with the results. I believe you asked me previously what lab he sent the blood work to. I do not know. I feel he would be offended if I called him up and started questioning him. My previous vet that I had used for 40 years retired. It took going to several vets before I found my new vet. He was recommended to me and I am extremely pleased with him. I don't want to ruin our relationship. The next time I take Phoenix back to him, I will ask. Phoenix has no signs of acromalagy. I do believe he may have been diabetic for a couple of years before being diagnosed. His eyes had gotten cloudy and he was very lethargic. This has since cleared up. They have always had to sedate him to get blood work. The raised glucose was always regarded as stress reaction from the visit.
Susan You paid for those tests and I cannot imagine any reputable vet that would deny you access or be offended. Those test results belong to you. It ties our hands in trying to help you. The advice I’d give you if he was IAA positive is very different than if he wasn’t.
