7/20 Max - no more Hypo. AMPS 176; +2 80, +3 43. Feeding gravy and testing! +6 he’s at 85!

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Took what I learned from last time but please advise if I need to do more!
AMPS 176 knew he could go low so tested...

+2 80 Fed 1 tsp 5.6% Weruva carb food to try and keep him up.

+3 43 Fed FF gravy lovers mostly gravy, some pieces

+3.5 49 (soonest I could get blood!) Fed a bit more gravy and a few pieces of boiled chicken (ear stick treat) as I retested +3.5 and one minute 53.

+4 58 Gave gravy

That's where I'm at now! We have 2 hours to nadir. Is Karo necessary, or keep going? One he reached mids 60s can I go to every 30 min? He is REALLY not happy with ear sticks.

 

This is what I'm trying my best to follow:

If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

• Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
• Test again in 15 – 20 min. Depending on the numbers, give more HC food.
• Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
• Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
• Test in an hour and follow the same steps.

My only concern is he's still 2 hrs away from nadir. At least he gets a dose DECREASE tonight. Looks like 2U is just too high for Max.

 

HC(20%+) food should suffice. So feed re-test in 30min and we'll go from there.
Once you hit a rising #(60s would be considered rising) don't feed and re-test in 30 min

 

Thank you! Our 30 min is almost up, and I will retest. I am also removing the 911 tag now.

 

Just don't panic. you have the idea of how you're going to handle this situation. You're not alone

 

I will add that from what I found we have 15% carb food (FF chicken gravy lovers), and we started tagging my CKD cat's food with carb levels. They range from 13-15%, but I also have a Hills non-Rx food that's 25% but no gravy, so that's my emergency stash. My daughter had given him some more gravy while I was typing up my post, so I will test him in 15 min. (which would be the 30 min).

 

How's Max acting?

 

Thank you! It's a bit intense, but I do know what to do from the site, yay. It's only my second true hypo (on the 16th he hit 53, but back, in the beginning, he hit 50 on the AT I was using), and that was closer to nadir than this. I guess it was that he tanked at +3 that freaked me out. Glad I knew to test him.

 

Just as mentioned above in the how to handle low #s post....don't overfeed. You want him to maintain an appetite so he eats when you really need him to eat
Depending how carb sensitive he is, a couple of tsp usually will do the trick(it did for my boys anywho).

 

Quite happy, and pretty normal! He's very unhappy with ear sticks and I had to pull out the sweatshirt to protect my arms!

 

We've been trying to give only gravy, for that reason, which he had enjoyed quite immensely! FF is his new crack.

 

Good job momma! I'm sorry Max is not very happy with the ear pokes. Maybe he'll warm up to it oneday

 

Not trying to be a fuss pot but, in between everything when you get a chance update your SS. That way other peeps just popping in can see what all the fuss is about

 

+4.5 68

 

Nice. Try not feeding and re-test again in 30 min. We'll go from there.

 

Done!

 

Max seems like a typical mid cycle nadir type of cat. Hopefully that was enough of a food bump to get him to nadir. After nadir he should be coming up on his own as the insulin weakens. Paws crossed

 

Max has earned a reduction of .25u since he went under 50 and he's a newly diagnosed sugar sweetie

 

76 @ +5 ! Looking good. SS updated too.

 

That was my plan. I think his sweet spot is somewhere between 1.75U & 2U, but time will tell.

 

Lookin good Max! Great job Rebecca. Looks like he's going to sail into nadir pretty smoothly. If you want you can wait an hour and re-test. If he's still on the up and up resume your normal schedule.


ETA just be sure to get a test before bedtime to make sure he's not going to be sneaky

 

At least I give him credit for that . I will test him again in 1 hour - giving his ears a bit of a break - and him too. Thank you for for staying with us.
It's one of those things of do I post or not post, you know?

 

You're most certainly welcome. I'll keep checking in to make sure nothing's changed(I go to bed late). I totally understand the post or not post thing. You can always try the main health forum or even the FB group associated with the FDMB if you don't get a quick reply here. It's hit and miss on the forum somedays. That's why it's good to know where the appropriate stickies are to help guide you through things when no one is around to help. Gotta give the forum HUGE proprs for that. And you made GREAT use of the stickies. You've got this diabetes thing and you're going to kick it's butt!

 

We are still on a really crappy shot schedule due to a stall about a month ago and then issues getting ear sticks (sometimes up to 45 min to get a drop of blood). His PM shot is around 12:15 AM, so I try and set an alarm for +2, +3, or +4 (depending on his PMPS read) to test him - he's usually meowing for food around those times anyway (recently its been 2:30 AM, ugh). Because of today, I will definitely check him at +2. Each time I bump him back, we run into an issue that keeps us between 12-12:30. A 6 AM nadir is great, but not so much for +2 reads. I went to bed at 1:30 AM only to toss and turn, so was wide awake for a +2 test.

 

Oh wow. I didn't even put 2 and 2 together with the time and nadir. Geez you guys really are on a crappy shot schedule. I thought Moey's 10am/10pm was bad.
I'm sorry y'all can't seem to get back to a better time for everyone. I'm sure you've tried all the tricks to get Max to be more compliant when it comes to ear sticks. Some cats just never fully appreciate that we are trying to help them. Well I hope he improves his behavior and can learn to accept the process. It is still "new". Some take longer to adjust to the whole process. But it sounds like you're really trying to bribe him with all of the yummies Keep up the resilience and patience

 

85 at +6!!
Oh, I have tried going back 15 min each cycle or then 30 min per day, but something always brings us back to around 12 AM for a PMPS and 12 pm for an AMPS - guess we just like to be the weird ones, lol. I'm a night owl and a stay at home mom/caregiver to my elderly dad, so it's doable...and glad this all hit with COVID as homeschooling was easy for us to slide into with the charter school my teen twins attend (not that any of this matters, ugh!) and not having to get up for a job and such. Max has been a stinker with ear sticks from the start, but he's my grouchy cat of the two. The Libre sensor was a Godsend a few times, but I am determined to get ear sticks down. I can attach the Libre myself, so it's my safety net (if it only worked the full 14 days...). We have the rice sock, my heavy gardening glove (i got tired of him getting me with claws and teeth), and the boiled chicken treats to get us through. He's 16, so even if remission is not in his future, I know this isn't a forever thing.

 

Good job today, with Briere's excellent help. Good luck with the reduction.

One more housekeeping nag. Do you mind going up to your subject line and putting the latest numbers in. Always good to keep it up to date so we know Max is no longer in dangerous waters when we scan the forum for who needs help.

 

I changed that he’s no longer hypo and added his +6 read. Hope that’s okay.

 

Out of curiosity, did Max exhibit any hypo symptoms? If not, we just call it a low numbers event. It's less common (and more urgent) if seeing actual hypo symptoms, which is why I'm asking.

 

I did not notice any major symptoms- aside from some twitching. He also wanted to sleep, but got very angry (kept trying to bite and scratch me) when I had to do the multiple ear sticks. So, I guess it was a low numbers event, then.
I think my biggest fear is that I will not catch something quick enough. I don’t want to become ‘complacent with low numbers’ but I also don’t know how low he can go before I really need to worry/ when he exhibits the symptoms listed on the sticky. My vet keeps telling me that cats can tolerate being low/hypo a lot better than many think. While I don’t necessarily agree, perhaps Max is just fine in the high 40s/ low 50s. The drop from 80 to 43 in one hour was a bit alarming for me- he just wanted to sleep.
When I shot him at 155 (PMPS 7/15), I had a feeling he’d drop. The PMPS read was lower than his +7, which was totally out of character for Max. This time, his AMPS was 176 (and a bit higher than his last read), so I figured I had a bit more ‘wiggle room’, dare I say. BUT, he was also only 3 cycles into a dose increase. I know we don’t go back to previous numbers/doses, as they are in the past, but I do remember that Max dropped pretty low on 2U back in May. I’d like to think I’m closing in on his best dose- somewhere between 1.75U and 2U, but maybe I’m also jumping the gun?
Gotta go read up on my next step after his dose reduction...I know I have it in my head somewhere, but it can be overwhelming and I want to keep him heading in the right direction. For so long he had a panicky liver, so I hope he’s on his way to being regulated. Right now that’s my goal. Remission would be great, but I’m taking one step at a time.