? 9/14 Henri PMPS 166, +3 282, +4 269 +5 214, +6 212, +7 168, +8 149 AM hypo, hypo again tonight?

https://www.felinediabetes.com/FDMB...-286-bounce-high-numbers.235147/#post-2633526

So, I was advised on here to raise Henri's dose back up to 1 unit of Lantus on 9/12 PM shot. I was warned about potential high numbers for the first 24 hours but now I am in to +2 of her morning shot (36 hours from increasing her dose) and her numbers are down to 125. Should I be concerned of a hypo event? She ate about an 80 calorie breakfast at dosing time and gets lunch in 3 hours (at +5).

I'm sure I'm just being a nervous momma and I know I want those healing blues and greens everyone keeps talking about but I guess I just need a little reassurance that everything is OK? I'm not used to her being in those healing numbers and even though they are healing, they make me nervous.

So I'm thinking I should keep a close eye on her bc of her low numbers so early in the cycle.

Am I right in this is how I should handle the drop?
Once she tests at 50, I should feed her MC-HC food 1 tsp every 20 min and test? Once she is showing an upward trend (2 consecutive increases) I can monitor every half hour and once she reaches 70 she's safe again?

and with dosing her with her PMPS if she is in an upward trend, whats the lowest number that it's safe to dose at? and if she's not in an upward trend, what number should I not dose at and use the "stall" thing

I know a lot can happen in just a few hours but I am compiling a notebook of facts and things to remember lol

https://docs.google.com/spreadsheets/d/1OG2DE6K4Qn7i8E1vlvwgISq4hp_Pv9_8b-80OdX7zts/edit?usp=sharing

 

Someone else with more experience may weigh in (I don't see many online right now) - but my two cents are below (short answer is you and Henri are doing great ).

Looking at your SS, looks like Henri bounced up a little bit from those healing numbers yesterday and is back to the healing numbers today - this is a great thing 126 on a Human meter is a safe healing number but you are right to keep an eye on her since this is new territory.

Sounds like you have been reading the sticky on low numbers - great job Generally, HC is saved for <50 so you can try MC first in the 50s. Every cat is different (ECID) so there is some learning of how your cat and how Henri will react to the carbs. Remember, it takes 20-30 minutes for the carbs to register in the blood glucose so patience is key (I have none lol).

And I'm still new here but every new color number freaked me out the first time I saw it. You will get used to it And you are keeping Henri safe with your testing and can intervene with food if needed!

Keep posting questions and updates. You are doing great!

 

She dropped to 47! I have her 1 tsp of fancy feast gravy lovers. She is ravenous. I don't want to feed her too much too fast. I'll test her in a few min and I think continue to giver her 1 tsp of gravy lovers every 20 min?

I'm not sure what number i'm trying to get up to before I stop with the food

 

and at what number should I start giving her some low calorie food?

 

Thanks! I'm waiting for someone to respond. She is officially HYPO and i'm trying not to panic. She just ate 1 tsp of HC fancy feast gravy lovers. I test her again in a few min. I'm not sure what number i'm trying to get her back up to and when I should start giving her LC foods. Lunch for her isnt until 2 more hours

 

You can try linking your thread on the fb page and then ask if someone can look.

I wish I could help, I'm just sending hugs!

 

thanks! I'll do that

 

Is she symptomatic? Let me see who is online. Give her a t of HC (20% or higher).

 

@Sue and Luci @tiffmaxee Can you help Henri and Katie?

 

Did you test again? I think you want to get her up over 50 then keep feeding her small amounts after that and keep repeating till she has 2 tests over 50...Then keep feeding small amounts...and test again. I think you're doing everything right. Hopefully you'll get help soon!

 

She was ravenous and restless. Just tested her 20 min after 1 tsp of HC food and she's up to 69. Still hungry but no longer restless. Should I give her any more HC food, or should I giver LC food? Or nothing and test in 20to see if she is on an upward trend

 

so feed her another tsp of HC food and test again? or should I do low carb food now that shes tested at 69

 

I think you want a 2nd test over 50...per the guideline sticky. Is it time for a 2nd test yet?

 

If she'll eat, give her a little more food and retest. You're using a human meter, correct? So you want to get her up and hold her above 50.
Is there any signs of confusion, lethargy, glazed eyes, stumbling when she walks, etc?
Oh, and don't forget to take a second and update your spreadsheet with the latest numbers.

 

I think the high carb because she'll get a boost from the food, then maybe go back down. I think the idea is to keep her steadily going up.

 

OK, so she jumped up on the kitchen table and found the can of HC food I had opened. probably ate 1-2 more tsp of food. She is definitely hungry. I'm wondering if I should switch her to LC food if her next test is up? I test again in 10 min

 

I think I'd not let her have any more food and retest again when it's time. But I have no idea if that's what you should do!

 

I updated my spreadsheet although I'm not sure how to do the "in between the hours" numbers. I test again in 2 min. her +3.3 test was 69

 

she tested up again. so her +3.6 is 72

 

Good number. Now we'll see if she is stable, and you can switch her to lower carb food. After all, you don't want her sky high at her next shot time.
And I think you've already guessed that this means you back down again in her dose.

 

That was my next question. I had backed down on her dose but then was told her numbers weren't good at that dose and I only just raised it the other day. It's OK to be going up and down like that?
Should I wait for her next test to give her LC food or do it now

 

I think you did it right, you have to manually put in the color though when you add the extra numbers. The little paint can looking icon for fill color.

 

You can do a spoon of LC. Don't let her fill up, in case the high carb food wears off later on and her numbers come back down.

For "in between" numbers, you can do fractions. 1/2 hour after would 3.5. You can put multiple entries in a cell, but you will have to manually colour them with the paintcan tool. So in the +3, put 47; 69@3.3; 72@3.6.

Couple of housekeeping requests. Since she's above 50 and you have help, please remove the 911, which we save for medical emergencies. Please keep the subject line up to date, so we know she's safe now. Sounds like this was low numbers, but no other hypo symptoms?

I'm glad Karen popped in!

 

Hi. You have had an exciting morning. Feed her a little lc now. I’m going to read through the thread. The first under 50 Is scary. I’m glad for you it happened during a day cycle. Wendy and I cross posted.

 

It’s definitely ok to be going up and down. That’s why it’s called the sugar dance. Sounds like she was not having a symptomatic hypo but rather low numbers. Max was in the 30’s more than once but never had symptoms. Under 50 is the take action time when you feed hc or a few drops of honey or syrup with the hc. It takes 20-30 minutes for it to kick in and then you test again. Rinse, lather, repeat until 2 tests over 50 and then switch to lc. You want her staying up into at least 60’s or 70’s without food for two hours before it’s safe to leave her alone. Someone will keep checking and guiding you to let you know what to do.

Congrtats on the reduction. Her dose is now .75 again.

 

Thank you all for your help! I'll change out the 911 and fix up my spreadsheet. her +4 is 75 so I just gave her some LC food that she is going to town on.

 

You can check her again in an hour. She cleared that bounce in a dramatic way.

 

Is it OK to lower it again when it was just raised a day ago? Is that dangerous to be going up and down so frequently with insulin? and what dose should I lower to? .75 again?

 

Will do. Should I be expecting very high numbers again like the last time when she went low and then we lowered her dose? I think that was a bounce too?

 

S

so should I hold off on food then? I just gave her a little LC food. She normally eats in 1 hour but I can feed her again in 2 hours if need be

 

nope..other than being ravenous and restless and vocal (which is always what happens when she's hungry) She was a little of balance but that's how shes been since coming back from the vet. I think she got a little weak being cooped up in the cage for a week. It's mainly when she's jumping down from things that you see it. Like her back legs are a little weak maybe?

 

You can feed her lc as normal. I just wanted you to know you shouldn’t plan on stopping the testing until she’s good for 2 hours without food.

 

The weak legs could be neuropathy. I need to find the video of it to show you. They often get ravenous when their numbers get low. That’s good for us because we need them to eat carbs to bring the bg back up. It’s more difficult to do that without an appetite.

 

I tested her at 3.5 and she went down from 75 to 73. I'm continuing to give her LC food but she only eats a little but at a time. That is normal for her though. Is her dropping down 2 points anything to worry about? Is she on her way back down or could that just be that 20% difference thing i keep hearing about

 

Meter variance is 20% so she is surfing now. Just what you want to see. This is good. Not a drop at all.

 

Ok whew! Good to know lol shes still eating her LC food bc its lunch time now. I Isuzu pick it up between 1 & 2

 

She can graze all day if that is normal for her. Just pick up the food two hours before pmps.

 

My goal is to eventually let her graze but with the fly situation right now it's just not an option. Im in the process of updating my SS but she dropped a little.
I guess I'll continue to offer her food based on her numbers? What is a safe low number to give her, her insulin shot this evening?
+5@85
+5.5@73
fed some more LC food
+6@ 95

 

since I've been giving food to help keep her numbers up until they rise on their own, and I will be doing a dose reduction tonight (down to .75) my new question is, what low number is it safe for me to dose her with insulin tonight

 

If under 200, post for guidance. Being new if over 150 it’s probably safe to shoot but you want to make sure someone will be able to stay with you. If you feel at all nervous, stall, don’t feed and ask for help. A +11 will be helpful to see if she’s on her way back up.

I’d print out the sticky in handling low preshots. I used to read it a lot.

 

You don't really have much of a choice. She went too low, and you can't let that happen, so that means the dose was too high.
Really good catch, by the way. Well done!

 

I printed out a bunch of stickys. I'm going to read through and highlight them. I'm going to make a shortened simplified cheat sheet for my husband with how to handle the hypo. I shot a few days ago with the lowered dose of .75 U at 152 and she was fine so I guess I'll use 150 as my safe to shoot number but I'll probably still post for guidance lol I'll take a look at the stickys to make sure I printed that one out. Thank you!
Can I ask you another question? I'm feeding her a little LC food since he numbers got into the 70's. Ive been testing her every 30 min (which she only minded the once when I couldnt get blood lol) but her numbers have been going up and down from 73-96 from her +4 to her +7. Is that all part of that 20% meter variance still? or are the numbers changing bc I'm feeding little bits in between. It's all in my SS with how much I fed in between. I think the numbers are going down and back up again bc possibly of the food I am giving her? Is that OK? I think she should be on her way up within the next hour or 2 based on her numbers from other days.

 

Thank you!

 

She’s probably dropping a little but not too much. This is a pancreas healing cycle. Normal bg for a cat is roughly 50-120 on a human meter. It’s exact What you want to see. In fact another way to earn a reduction is being between 50-100 for a week.

You really don’t need to test every 30 minutes. Try an hour next time.

 

On this forum, we use a preshot value of under 150 as the number where you stop, do not feed or shoot, and post for help, if you are following TR.

Here is a post on Neuropathy, with links to videos.

Note that a cat's insulin needs can vary over time. Their pancreatic beta cells have the unique ability to heal, provided they spend enough time in healing numbers to give those beta cells a chance to recover. That does mean dose needs can change. With healing, the beta cells produce more insulin on their own, and less injected insulin is needed. And if the cat stays at a dose that is just resulting in high numbers for too long, their body gets used to it, and it can cause glucose toxicity that results in beta cell loss. Glucose toxicity is a type of insulin resistance and needs more insulin to break through it.

Printing out the sticky notes is an excellent idea. There could even be a time when the power goes out and you lose connection to the internet. I had to test and shoot a couple times by flashlight.

 

I have to second that...PRINT out the notes on how to handle lower numbers as suggested by Elise and Wendy earlier today.

I'm sorry I wasn't available...work is always in the way! Glad you were able to get her numbers up.

 

Thanks! I just get so nervous. I told my husband if her +1 and +2 tomorrow morning are worrisome like they were today, that I'm taking off of the 2nd job lol

I updated her chart and i'll update the post title,but I gave her the .75 dose when her PS was 166. She ate well though (77 calories). I've dosed 152 before I think?

Does bringing her up more slowly like I did today decrease the chance of her bouncing? A few weeks ago was my first low number (66) and I panicked and gave her a ton of food lol I didnt realize at the time that only 1 tsp every 15-20 min was needed. She came up quickly and much higher and then was bouncing like crazy

 

I printed them out last night and had basically studied them lol
I was in panic mode though and going off memory lol
No worries...everyone has gotta work lol I told my husband that I may take off the 2nd job if her +1 and +2 in the morning are worrisome like today. They have been VERY sympathetic about my kitty being sick and i'm babysitting to give the mom a break which means they can survive without me. The morning babysitting job needs me bc they both work

 

I dosed her today at 166 so I feel a bit better knowing that.Her +1 is 271. She also ate a 77 cal meal right after her dose. That's very interesting about the healing process! And that makes sense about why you want to get low without getting too low...so things can heal. It's also interesting that my vet wants higher numbers than TR calls for. My vet doesn't ever want to see anything below 80 but Ideally she says kitty should stay between 100 and 225 for 18 hours a day. I know from personal experience that although vets mean well, they don't always know what's best...and just like human Dr's there are good ones and bad ones. I learned this the hard way with my epileptic kitty. This forum is truly amazing and so helpful!

 

Does bringing her up more slowly like I did today decrease the chance of her bouncing? A few weeks ago was my first low number (66) and I panicked and gave her a ton of food lol I didnt realize at the time that only 1 tsp every 15-20 min was needed. She came up quickly and much higher and then was bouncing like crazy[/QUOTE]

Sometimes brining them up slowly prevents a high bounce, sometimes it doesn’t. It does allow a better chance to keep them in normal numbers longer which means fewer bounces and quicker clearing. For most. Some cats bounce all the way to OTJ!

You were fine to shoot. I told you to post more for your benefit than his. With TR people shoot with bg of 50 when they have enough data and feel confident.

 

Her PMPS was 166 (down from +11 184) but I dosed her with her new lower dose of .75. Her +1 is 271 but she already ate dinner (77 cals) I do have a probiotic treat and an L-lysine treat that she usually gets late night to early morning hours bc it seems to hold her off for breakfast without her getting too upset. I have no idea of the carb content on those.

 

Many of us feed several small meals instead of one large one, for a couple reasons. One, it's easier on the healing pancreas not to have to deal with a huge amount of food at once. Human diabetics (who don't heal), also do more smaller meals. Two, you can use food strategically to influence how the numbers change. If you have a kitty that likes to drop hard at onset (when the insulin takes effect), it can help slow the drop to give them a small meal before onset to slow the drop. See how Henri dropped about 80 points at onset today? A small meal about +1 or +1.5 might have slowed that drop a bit.

Plus with my girl, she would chew my toes off if she had to wait an entire 12 hour before her next meal! Even before diabetes, she got multiple meals a day. Cats hunt prey several times a day. I once read that about one mouse worth at a time was good.

Which L-lysine and probiotic treats are you giving? I just give them as powders mixed in with the food.

 

Thanks for the info on neuropathy! Her back legs are definitely affected and they do slip out from her bit but I think she is still walking up on her toes. I'll have to take a closer look when she wakes up lol
When she was in the ER she was also being treated for low potassium levels which the article said has similar symptoms to the neuropathy. I', going to order some of the Methyl B-12 and also look into a potasium supplement for her. I cant seem to find out if it's water or fat soluble in cats. She has an appointment with the vet tech to get an antibiotic shot and I may also ask for them to check her Potassium levels as well. I have to wait until next week to talk to my vet though since she is away on vacation.

Thanks for all this fantastic info! I've been printing everything out. Im going to have to turn my Henri folder into a Henri binder lol

 

Don't give a potassium supplement without advice of the vet. There are dangers for being too high. They should be taking her bloodwork regularly if you start to supplement potassium.

 

Eventually I want her to free feed but I'm having a fly problem. She also only recently started eating enough calories regularly...I'm thinking I will continue with the appetite stimulant and anti-nausea for 1 more round just to be on the safe side. So it will be out of her system in about 3 more days. Right now I try to get 70-90 calories into her at 7 am after her AMPS and her insulin dose, then when my husband takes his lunch break at noon, he can usually get about 20-30 calories into her. He usually picks her food up around 2pm bc of the fly problem...so from 12-2 she has access. Then when I get home I do he PMPS, dose her with insulin and try to get 60-80 calories into her. I'll also offer her food around 10 or 11 before I usually go to bed (bedtime...whats that lol) and she'll eat another 20 calories or so. I keep her lysine treat and probiotic near me so when she does he late night nibbling I can just give her those. I use the treats and not the powder bc 1...she loves them and even if she's not hungry she will ALWAYS eat them...so at times when I need her to eat I can crumble one and put it on top of her food and she goes for it every time. I use the "Pet Naturals of Vermont" brand. Even my picky girl with stomatitis bc of the feline herpes virus...will eat these. which is so helpful bc L-lysine is shown to stop the replication of the virus in a flare up event. So dosing daily as soon as you notice a flare up and 4 days until it's gone.

 

yes, definitely. That why I was trying to find out if its water or fat soluble. If it's water soluble they can't overdose on it. But yes, I'm definitely going to speak to the vet about it and ask that they check her levels before giving anything to her. I would just rather have it on hand in case I need it for some reason.
It would be helpfull to know if her potassium levels were low and that could be whats causing the weak legs, or if it's the neuropathy

 

Have you tried an autofeeder? They should seal in the food from the flies. If you get a rotating one, you can set it to rotate to another empty slot after a period of time.

 

Sometimes brining them up slowly prevents a high bounce, sometimes it doesn’t. It does allow a better chance to keep them in normal numbers longer which means fewer bounces and quicker clearing. For most. Some cats bounce all the way to OTJ!

You were fine to shoot. I told you to post more for your benefit than his. With TR people shoot with bg of 50 when they have enough data and feel confident.[/QUOTE]
ah...ok lol Yeah total nervous momma here

I think she might be bouncing? her +1 was 271 and her +2 was 321. I'm just hoping she doesn't go back into the reds again

 

I do have one that has ice packs for wet food..to keep it fresh. We used to use it for our epi kitty when we traveled bc it made it easier for others to medicate her. unfortunately it doesn't seal tight enough. These flies are tiny like fruit flies but they are something else. My husband turned over an empty can of cat food the other day on a flat dish (so the opening was down) so he could show me what food he fed her. When I picked it up, a swarm of flies came out They seem to be attracted to our garbage, sink, the litter box and the cat food. Garbage now has a lid and goes out every night, pooped is picked up throughout the day, no wet food left out unsupervised and no dishes left in the sink at all for any amount of time. I had the exterminator here and he gave us this foam stuff to put in the drains at night to kill any eggs/larvae. Fingers crossed this works bc it's driving me nuts. Other people I know are having the same problem so it must just be a bad year for flies I guess

 

Her PMPS 166, +1 271, +2 321. Is this another bounce bc we reduced her dose back from 1 unit to .75? Is there anything I should expect other than high numbers and bouncing being that she was raised back to 1 unit only a couple days ago

 

She dropped to a lower bg than she is used to, the 47, so her body caused a bounce. It happens either when they drop too quickly or if they see a bg a lot lower than they have seen in a long time. She’s bouncing for sure. It can are as many as 6 cycles to clear. Some cats clear them quicker than others. You won’t have to test more than a before bed test.

 

I just tested her again and she's headed back down again. Her number isn't super low or anything though. It's +3 282. Its a little early I think though in the cycle to be heading down for her...no? Her +3 this morning was a big drop but I don't think she typically hits her nadir until around +6 to +8?

 

Looks like last night. I would get a +4 or +5 and then go to sleep if pink or yellow. If not sure ask. Yes should know by +6 for sure.

 

Check the ingredients on those lysine treats. I'm seeing a lot of carbs and sugar... oat flour, maltodextrin, etc. Possibly those treats could be affecting her numbers.

 

Thanks! I set an alarm for the +5 so I can at least get an hour abd a half of sleep in

 

Yeah...i wasn't sure how to figure out the carbs in those treats. I was original using them to entice her to eat abd the probiotic she needs right now anyway. Lately I've been using them in the middle of the night when she's begging for food.

 

Freeze dried 100% protein treats work great and no carbs.

 

Shes a snob lol she turns her nose up at them lol

I use them for the immune boosting properties and the probiotic she needs bc of the antibiotic...for the time being. Im a bit concerned about the covenia shot now though bc of what im hearing about it :-/

We did the injection bc the oral was causing nsusea and vomiting

 

+4 269 shes still headed down.

I was supposed to sleep until her +5 /+6 but of course now I can't lol so I figured I might as well test. She has been sleeping through it anyway lol

 

+5 214 shes still headed down

I guess ill be up all night testing?
Should i be worried about another hypo event tonight?

 

She is likely almost at nadir.. I’d give her a little food and maybe get one more test in an hour. Then go to bed. When she dropped low it was much earlier in the cycle.

Something that will make it easier for you is to get an auto feeder. You can set it to open while you sleep or go to work ad to close 2 hours before shot time.

 

I do have an automatic feeder but we're having a fly situation at the house right now and the flies can get into it :-(
Hopefully I get it under control...the exterminator came the other day and gave us some stuff to put in the drain that should help
Her +6 was 212 only slightly lower than her +5. Its probably that 20% meter variance

 

Henri is still dropping at +7 168. I don't know how I'm going to be able to work tomorrow.

 

He’s not going to go hypo this late in the cycle.

 

She is still dropping though +8 149 should I feed her low carb or let her body handle it herself? This is all new territory for me :/
oh and she is definitely hungry right now

 

she is still dropping though +8 149 should I feed her low carb or let her body handle it herself? This is all new territory for me :/
oh and she is definitely hungry right now

 

yes, please feed her is she is hungry and asking for food. don't worry - these are safe numbers!

 

I just fed her. She ate about 14 calories which isn't much but I'm sure it'll help since she's nearing the end of her cycle

 

Oh my goodness looking at your SS... you must be exhausted!
A couple little things I wanted to add: I have had those same weird fruit fly things plenty of times. They move slower don’t they? Like fat dumb fruit flies. They will hang out by the litter boxes or the food if they come visiting my house. They are deeply annoying and I feel your pain! Keep your drains covered when not in use, this will help too.


And about the back legs, I know you’re searching for an explanation and maybe a fix from that, but with DKA that means kitty had muscle loss. And where there is the most muscle is where the body will take it from first. It’s true that low potassium can cause hind weakness, I have experienced that with Alice, but that comes with other complexities. My honest guess would be that there is just a bit of muscle loss and therefore hind weakness. Give it some time. Even if it is low potassium, that can improve with feeding, and feeding, and more feeding. So food is your answer either way unless you do bloodwork and find low potassium then. Alice was weak on her back legs and couldn’t even crouch to pee, after DKA. It would shoot straight behind her made it easy to catch urine samples to test for ketones though!

I hope you are getting some sleep now.

 

Oh my goodness I am tired...she continued to gradually go down until +11 lol

thanks for all that great info.
I'll start a new thread with this link after I get myself together this morning lol

 

I know you worry and I fully understand, but you could definitely have cut yourself a break over the night! By +4 I would have taken at least maybe a two hour break. I know Henri likes to dive for you but that 269 after a trend of yellow and pink... I would consider that a safe number to skip an hour or two of testing (or more depending on the cat), especially if you have food on board. I’ll keep an eye out for your new post later.

 

I think I tried to but I cant always fall asleep when I want to and I figured, since I was up and she was sleeping through my testing, I might as well
continue lol

My husband did the +11 for me so I got about an our and a half lol

 

Same. I thought I would sleep after my +7 but I just laid there for ages first. I can be dead tired but not sleep on command.

It will get easier as you get things more regulated.

 

I may elicit the help of an excedrin PM tonight if she's still in the yellows