6/25 Henry AMPS 319 +1 265 +2 198 +3 163 +4 151 +5 126 +6 125 +7 133 +8 145 +9 155 +11 187 PMPS 235

Previous: https://felinediabetes.com/FDMB/threads/6-24-henry-pmps-355.265038/#post-2968243

Well, Henry is finally living in the blues! Hoping those ketones will start to clear out now and we don't get a bounce from that fast drop. Anyone know how long it would take for the bounce to become apparent from a fast drop?

Giving subQ fluids shortly.

A big thanks to everyone who has been so helpful in making it through this stressful time. You're all amazing!

 

Sorry, I don't know how long it would take but we'll have a good indication by PMPS. If he bounces, it's not necessarily just because of the fast drop but also from the run of low (for him) numbers.

After the fluids might be a good opportunity to get a few hours of sleep in before PMPS. When is your shot time?

I know it's very early to guess what might happen at PMPS but if @Sandy and Black Kitty are still around, can you give any advance guidance?

I'm tagging in Bhooma @Bandit's Mom who is always there doing our night shift along with Bron. They'll be around after I go to bed, but I'm here for a while yet.

 

@John & Henry are you still shooting at 2am/pm or have you been able to move it forward over the last couple of cycles?

 

It's slowly moved from 1am and yeah, we're at 2am/pm now.

 

You could move it up to 1:30 in the next shot. And you might want to get some sleep till then

 

AGREE ON THE SLEEP!

Just because I'm confused...are you trying to get to better shot times by
moving back from 2am to 230 to 3 etc
or
moving forward from 2am to 130 to 1 etc?

It doesn't matter which, I'm just curious.

 

He was shooting at 10am/pm and we had to stall 3-4 hours the night Henry came back from the hospital, waiting for his numbers to rise. The shot was delayed to 2am/pm. He could get back to 10am/pm, if he would like to.

 

Just finished subQ fluids and managed to get my first accidental needle stick and of course it was from the 18g needle. Got the back of my finger pretty good & bleed for a bit. I figured it was a good opportunity to check my own BG which is sitting pretty at 100 and that was just after a meal

The subQ didn't go very smooth tonight. I didn't shoot through like last night, but he decided he was going to leave (luckily wife was there to keep him but -- IDK how I would ever pull this off on my own) but when he moved the needle DID go out the other side of his skin getting me wet again. Had to poke him twice because he moved again after that and pulled it out. I only had about 5ml left when he moved enough to pull it out the 3rd time, so I figured that was enough. I've been trying to feed him immediately after the subQ as a reward for enduring it. It seems the sensation of the cool water running in their is more distressing to him then the actual needle poke. Does anyone ever warm up their fluids first? Maybe he wouldn't mind the sensation as much if it wasn't as cool?

 

Yes. It could be and you do want to warm fluids before giving them. This is a great video:
How to Give Subcutaneous Fluids (Video)

And this site/page has a ton of info on SubQ fluids:
Tips on Giving Subcutaneous Fluids.

 

Well, the vet had set it at 9am/pm. Then we had the stall to 1am/pm a couple days ago. I was at 1am/pm before he went to the vet. It slowly moved forward to 2am/pm. I'm fine staying at 2am/pm for now. I'm up late. It may be good to adjust it in the future tho, if I need to shoot R so I could monitor it for the first few hours. But we're fine for now. I rarely am asleep before 3:30-4am normally.

 

Yeah, I'll probably lay down for a bit after this next check in 20 minutes. Finger crossed everything stays steady/not red tonight.

 

Thanks for those links, very helpful.

All the videos I've seen and your comment talk about/show using bags. Well, they gave me a bag, but they also gave me a bunch of 60ml syringes and needles and told me to draw the water from the bag and give it from the syringe. Also also gave some butterfly needles and said they may be easier than doing it straight from the syringe, but it seems easier/quicker to just attach the needles to the syringe to go straight into the cat. Guess I'll try a butterfly next time and see if that might be easier. Looking into ordering some Terumo needles. Chewy has 18g Terumo thin wall needles, I thought I saw someone else say 20 or 21g? Certainly want to get the smallest needle possible but I also want it to be over quick, especially since its not coming directly from the bag. Guess I can't have both.

 

John, if you see the site I sent it has a lot of information on needle sizes and also using the syringe method vs the giving set method. The syringe method goes much faster.

18G needles are really fat and are therefore called kitty harpoons! There is a tradeoff between thickness of the needle and speed of fluid administration. Fatter the needle, faster the flow. I use 21G needles to give Bandit fluids.

Here's another great video on giving SubQs. See how fast he does with the syringe method:
http://www.iwillhelpyourcat.com/blog/givesqfluidslikeapro

 

....and we're still in the blue 155 (nova) 180 (libre) @ +9. Henry has been acting a little weird all day/last night. Not lethargic, but doesn't want to sit on my lap which is unusual (maybe its because I'm constantly sticking him whenever he's on my lap lately) and laying in front of the front door. It's just not a normal place I've ever seen him hang out before. Just not being his normal purry self. I'm wondering if he's in pain or something. I still have lots of bup left, maybe I'll give him some and see if it lightens his mood at all.

 

Minnie also sat by the front door when she was out of the hospital! It was as if she was trying to get as far away from me as possible. She came back as she was feeling better. As long as he keeps eating! He's going through a lot, it can't feel great.

 

If I remember correctly, last time you gave him bupe he was lethargic and wouldn’t eat much. Not sure I would give him any at the moment unless you are sure he is in pain. We want him alert and eating lots.

 

So we're ticking up but still in the blue. 187 (nova) and 219 (libre). Boy, that libre really makes my phone go crazy when he gets over 200 or under 70. While the numbers on the libre have been quite a bit different than the Nova and is mostly useless in the 300s, it does seem to be very good for seeing which way the BG is trending without poking and getting alerts when things are going into dangerous terrority. They seem like a good deal too, it was only $30 at the pharmacy. 22 minutes to PMPS

Interesting. Seems our ketone prone multi-DKA kitties have a lot in common. The first day or two after he has gotten out of the hospital he's been super clingy, always on me purring at full strength. Now I guess my brain is just looking for any sign something isn't right. And yeah, I guess high BGs make humans feel crummy, I'm sure it's probably similar for cats, not to mention the hospital.

I believe you're thinking about when I was worried about giving him bup afraid it would cause nausea. I've never actually seen that happen with him. I did give him some about 2 hours ago right after I wrote that post, and 5 minutes ago just ate a whole can of FF in record time, so I guess it doesn't bother him too much. I'm not sure it's very easy to assess if a cat is in pain or not other than by their demeanor or maybe yeowing if you pick them up or touch the wrong spot. Before he was in hospital the second time him he didn't want to stay on my lap either (he usually lives on my lap), we guessed it may had been due to the suspected pancreatitis which is why the vet sent him with the bup in the first place.

 

Just so we're all on the same page: I'm planning on giving just the 1.75U L in 15 minutes and no R of course.

 

Mindreader. I can't be bothered to delete what I already wrote below, but we are on the same page

Started writing this before your last post! With any luck he'll hang onto the blues til PMPS but I wouldn't be shocked if it sneaked into yellow, especially since he ate. I'm heading to bed, but you'll have @Bandit's Mom and I think @Bron and Sheba (GA). [ok, I will probably check in 15min]

At PMPS stick with 1.75uL No R. You could check his blood ketones too but this would be data gathering only - whatever his ketones, don't do anything different. Feed him LC at PMPS. Post and ask for help if you have questions!

I would check again at +2 to see where his numbers are headed. Post and check in with @Bandit's Mom for guidance on next steps/test time and whether to feed LC or MC.

I'm hopeful that you will be able to get a good night's sleep after +2, if he doesn't drop. If you get up for a mid-cycle test, remember to stick to Wendy's advice of
no R below 300
0.1U R if 300-349
0.25U R if above 350

Hmm, at that point the East Coasters should be back to help too!

 

Thank you Liz, have a good slumber.

 

0.3!!!! Don't get too hung up on the 235, that is certainly food influenced. Usually we recommend newbies withhold food 2 hours before shot time for just that reason, though it's more significant with low readings where you have to decide whether to shoot or not.

Check in with Bhooma at +2 for how long you get to sleep. Try not to overthink his BG numbers, there are so many things at play. A good day's work today.

 

PS don't forget to update your title!

ETA and put in your s/s when you gave bup and fluids I'm really going now

 

Alright @AMPS we're sitting at 235 (nova) & 297 (libre) and best news of all: ketones are down to .3! yay!

I'm thinking it would be a good idea for me to try and head to bed soon, and catch a +2 in 2 hours and re-assess from there. Hopefully we're outta the woods, for tonight at least.

Thank you team FDMB, you guys rock!

 

You are doing a great job, John. Not many people would be able to sustain this level of caregiving. See you at +2. Hope you get some sleep.

 

I think you may have solved my problem! I think pushing the plunger down and rotating it was the ticket! No strange bubbles anymore!

Many thanks for that tip!

 

Awesome! So glad it worked for you. I noticed the plunger would get sticky in that area and just tried a few things and that twisting and pushing motion seemed to lubricate better. Then the bubbles went away. Try setting up that hands free rig, you will thank me later. Also I thought you were gonna get some zzz’s. Remember sleep? Lol

 

Down a bit to 162 (nova) 228 (libre) so back in the blues. Think I'll be good til +6? The libre beeping my phone will wake me up if it gets too low.

 

That is a bit of a dip at onset. WOuld be better to get a +4 than wait till +6.
Did you feed his usual LC at +2?

 

Yeah, I can do +4, he just ate a whole can of FF LC @ +2

 

Good to see he is eating well. Hope he won't be too full to eat later, if we need him to. See you at +4. I hope you are napping in between tests!

 

I am. We're 105 (nova) 185 (libre). The libre is reporting we're currently in an uptrend, so maybe we're passed nadir. see you at +6?

 

OK, starting to run a bit low @ +8 92 (nova) 101 (libre). I just gave him a MC snack. Shall we go to +10 or sooner now that we're low?

 

92 is pretty flat - within meter variance of 106. The MC would have given him a good bump. Can you get a +9 or has it been too many pokes? Can wait till +10 then.

 

I can do +9, he didn't eat much MC, he's not a fan of friskes anymore for some reason (probably because he loves the FF so much)

 

You need to get your hands on some 20 gauge terumo needles for fluids. They are the best and very sharp. I poked myself a few times too. I thought I would never be able to do fluids on my own but was forced to when my neighbor got tired of helping. I think thrivingpets.com has them and a few other online sites.

I found 19g and they will be much better than the vet ones. I’ll keep looking.
https://thrivingpets.com/products/t...ch-box-of-100?_pos=2&_psq=terumo&_ss=e&_v=1.0

I think Amazon has 20g.

 

You can turn all of them off except the urgent low, and the lowest you can adjust that to is 55. Not sure how far the high one goes, I only started using the Libre when Cinna was already green/blue so never adjusted it. I found it really useful for when I wanted to get some sleep but still be alerted to possible problems.

You'll want to get some Uni-Solve to get that thing off with when it dies. Hopefully, they didn't use vet glue to stick it on there, that stuff is like concrete and took forever to get the Uni-solve to disolve. The last one I placed with just some SkinTac for extra stick, and it stayed on the full 14 days. I think as long as you shave very close and prep the skin well, they stay on pretty well.

 

Hmmm, in my last post my + was off, it should have been +6 not +8 (it was actually +6.5.. the SS has always been correct -- sorry half asleep). I thought my alarm was set for +7 but I must have just nope'd it while in the middle of a dream of something, because I don't remember hearing it..

Anyway we are definitely at +8 right now and lower still we slide 75 (nova) & 69 (libre). He just ate 1/2-1/3 of a can of 18%, hopefully that'll spike the numbers up a bit. I'll get +9 in a half hour.

Huh, not sure what the vet used, but he doesn't seem to mind it and hasn't messed with it once. Thanks for the tip with the uni-solve. Do you have to shave when putting on a new one every 14 days? I was just looking in the settings and it seems 55 - 240 are the high and low alarms. I was confusing the alarm numbers with the "report" numbers of 70 and 200.

Oh good, I'll prime some of those 20g. I hate to go much smaller because I want it over with quick. I also don't wanna use the "kitty harpoon". He doesn't mind the jab as much as the water being cold I guess. I keep wondering if that's why he's been sitting at the door lately. He has always had such a huge trust in me because he knows I'd never purposely hurt him so its been easy to get away with the occasional things most can't don't like over the years with him, but last night he just wasn't digging those fluids. Will definitely warm them up today. Thanks for the tip

 

So I was just looking on Amazon and they have both 18g and 20g. The 20g won't make it til Wednesday but they can have the 18g here tomorrow so I'm leaning towards the 18g. One curious thing tho. That link @Bandit's Mom sent me said to get the "ultra thin wall" types of terumo, but none of the ones on Amazon say that either in the ad or on the boxes. Are they all ultra thin wall? Here's the 18g I can have tomorrow if I order in the next 5 hours: https://www.amazon.com/Terumo-18G-1-20x38mm-Each-Pack/dp/B088PYNVDM

 

What was the MC% he had at +6/+6.5? 18% might be a bit much this late in the cycle. Hope you are ready to shoot green one of these days!

Don't know if you will find anything useful here:
https://felinecrf.org/cheap_supplies_usa.htm

 

Get 20g or even 19 if buying terumo. My first cat would not stay still so I used 28. They glued in. Much better tgss as n cry harpoons.

 

Do you know if all the terumo's are considered "ultra thin wall"? Guess I'll order the 20g from amazon, too bad they won't make it til Wednesday tho.

 

The 19g are not utw but honestly they work fine and you really don’t need them. I’ve used both without issues.

I used their 25g for ear pricks because my vet preferred needles to lancets.

 

The one at +6.5 was just the DM which I believe is 8%. Not sure if that's considered MC or not, but it's much more than his normal FF at <3%. He didn't eat all that much of it anyway. Oh, I've already joined the "shoot in the green" club the other day when you and Bron had me do it at 70 (and got that subsequent 37). After night before last, I think I'm about ready for anything

Just did +9 and we're back in the blue at 128. Hopefully we don't spike up too much.

 

DM is 6% so it's low carb. DM savory selects is 10% so MC.

I'm off to bed so I'll see you on the other side. Tag @tiffmaxee if you need help. She's on the West Coast.

I really hope you are getting snatches of sleep. Fingers crossed that Henry's numbers stabilize soon and you're able to rest and relax!

 

Morning!

LC 0-10%
MC 11-15%
HC >16%

DM pate is 6%, DM savory selects 10% (Bhooma taught me well - our messages crossed but at least we're saying the same thing! Sleep well)

 

I got some good rest last night. Feeling much better. Thanks for all your help Bhooma!

 

Good morning,

Thanks for the carb info. I'm going to do a shopping trip today and stock up on both some MC & HC.

We're back up to 144 @ +10, so we should be in good range for a shot in 2 hours.

 

If it's not too late, don't give him any food until shot time. Will be interesting to compare with last night's PS.

ETA or if he's really hungry and you can't resist, try to stick with LC and don't give after +11

 

He polished off some 3% FF in the last hour so no more til after AMPS, got it.

 

Ugh, Well we're escalating quickly I hope we're not starting a bounce

Reading at +11 is up to 272 (nova) from 144 at +11. 128 point jump in an hour? Good thing I got some rest last night, looks like it may be bumpy ahead.

 

What did @Sandy and Black Kitty say yesterday - keep the faith? I wouldn't get too hung up on the rapid increase, it's the rapid decreases that worry me. This could be a bounce after the greens. I know there are more experienced people out there who can advise better. @tiffmaxee @FrostD

I will be out this afternoon but hopefully Sandy will check in and answer questions about R at shot time. If not, I would err on the side of caution. Remember your R rules. Cross paws his ketones will still be low.

 

Yes, that was my next question. With all the good numbers the last day, I wasn't expecting needing to use the R again Guess I'll just stick to the rules. Shot time is in half hour

 

Get 20s! Or 19/. The others are too big

 

Don’t worry. You’ve had an absolutely beautiful cycle today.

 

I think I sent this to you before but it may have been buried.
Needle Flow Rate Comparison
APRIL 4, 2022
Share
The most common gauges of needles for cats and small dogs in order of popularity are: 20 gauge, 21 gauge, 19 gauge, 22 gauge. Most vets use the same Monoject 18 gauge for 200 pound dogs and 5 pounds cats. Using the same large needles may be fine for veterinary clinics because they often give fluids in emergency situations and typically only 1 time. When giving fluids on a regular basis it is important to use the optimal needle gauge. ThrivingPets does not recommend 18 gauge needles for pets under 50 pounds. ThrivingPets stocks Terumo needles, McKesson / Nipro needles, and Nipro Needles. Please contact ThrivingPets if you have any questions on needles, IV sets, or fluids online, email- service@thrivingpets.com, or phone 303-333-1899.

 

Please listen to Sandy about when to use R. She’s the pro and not anybody else posting right now.

As I already said terumo 19 or 20 are both good even though the 19 are not utw. Both worked great fir my cat who needed it dine quickly and both glide right in.

The higher bg could be a bounce. How are ketones?

 

Hi there

What’s the ketone situation today?

 

alright AMPS is 290 so won't be using any R. Haven't checked ketones, but I expect they haven't went up with all the good numbers today, but I will check in a minute.

Thanks for the flow chart @Suzanne & Darcy seems like the 20ga UTW is a good compromise between speed and not being too big. I'll order some. Thank you

 

Hi Sandy!

Just checked ketones and they're holding steady at 0.3 Fingers crossed for the next 12 hours they stay that way.

edit: new thread here: https://felinediabetes.com/FDMB/threads/6-26-henry-wc-amps-290.265099/