Cadmium BG (new years ed.!) AMPS: 364, +6: 369, PMPS: 411, +2: 390, +5.5: 346

PREV THREAD: https://www.felinediabetes.com/FDMB/threads/cadmium-bg-cont-amps-387-4-5-135-6-201-pmps-487.271842/

01/01/2023
AMPS: 412, 1U, whole can. I gave his insulin too early for his stomach again... He vomited his breakfast.
+2: 310
+6: 135
+7.5: 186
PMPS: 444, 1U, whole can
+6: 120

01/02/2023
AMPS: 360, 1U, whole can
+4: zoomies, had a play session
+6: 336?? I have. no idea how that happened. After his reading he walked off with a wobbly gait, so maybe he bounced from a low?
+8: 407. No signs of ear infection, only a little bit of wax buildup. Going to keep an eye on his ears though, plan on cleaning them with his ear solution tonight.
+8.5: ketones- negative
+10.5: 446
PMPS: 465, 1U, whole can
+2: 348
+5.5: 136. Huh.... Guess it was a particularly hard bounce.

01/03/2023
AMPS: 381, 1U, whole can
+2: 311
PMPS: 463, 1U, whole can
+1.5: 426
+5.5: 266
+6: 290

01/04/2024
AMPS: 404, 1U, whole can
+3.5: 275
PMPS: 371, 1U, whole can
+3: 291
+6: 208

01/05/2023
AMPS: 454, 1F unit, whole can. Gave him a fattened dose to hopefully push him into more blues and possibly some greens. Will make sure hes more active today, as I wasn't able to play with him all that much yesterday.
+4: 227
+6.5: 197
PMPS: 456, 1F, whole can
+6: 303. Thinking of returning his dose to one unit.

01/06/2023
AMPS: 371, 1F unit, whole can. Depending on how he does today I might lower his dose back to 1 unit.
+1: ZOOMY
+4: 154!! Yay!
+6: 115!!!! I'm so excited and happy about this!!!
PMPS: 453, 1F unit, whole can.
+1: EXTREMELY zoomies
+3: 242
+6: 165

01/07/2023
AMPS: 471, 1F unit, whole can. Extremely excited for his meal, wonder if that plays a factor into his reading? Gave dasuquin with his food. Zoomies!!
+4.5: 168
PMPS: 456 >: (, 1F unit, whole can. Zoomies after food and insulin again!
+3: 261
+6.5: 199

01/08/2023
AMPS: 446, 1F, whole can, ketones- negative
+3: 293, zoomies
+5.5: 168
+6: 148
+7: 159
PMPS: 360, 1F, whole can
+3.5: 237
+6: 169. He is feeling well enough to chase after a fly, but was meowing in frustration when he misses it! So we had a play session to help him work out his frustration/help him feel better.

01/09/2023
AMPS: 411, 1F, whole can. I overslept again.
+4.5: 261
PMPS: 353, 1F, whole can
+3: 242

01/10/2023
AMPS: 264, whole can. Called vets office and we decided to give him 1U dose and to have me watch and monitor his glucose, agreed that if it doesn't seem to help manage his BG then his evening dose will be returned to 1F. Possible furshot or partial furshot as I could smell a faint hint of insulin after his injection.
+1: zoomies
+2: 306, taken shortly after he finished eating his breakfast.
+3: 257
+4: 208. Depending on his PMPS tonight, I might return him to 1F. Just didnt want to risk a hypo this morning with his BG being lower than his usual.
+7.5: 246
PMPS: 268! Huh! 1F, whole can
+3: 208
+6: 101

01/11/2023
AMPS: 391, 1F, whole can
+3: 291
PMPS: 302, 1F, whole can
+4: 286. Finished his dinner around PM+3.

01/12/2023
AMPS: 274, 1F, whole can
+1: zoomies
+5.5: 170
Yellow thick discharge from left eye again, giving him his antibiotic non-steroid eye ointment, will monitor to see if condition changes. Contacted vets for advice
PMPS: 327, 1F, whole can
+6: 158

01/13/2023
AMPS: 437, 1F, whole can. ketones- negative
+2.5: 334
Condition has been improving since using antibiotic ointment. Prescribed to used 7-10 days, every 8-12 hours. Drainage output has vastly improved and his eye look brighter and doesn't squint as much after a dose. Wearing inflatable e-collar to prevent him from scratching at it and making it worse. Vet asked that if there is no continued improvement over the weekend to contact them.
+6: 238
PMPS: 441, 1.25S, whole can. Miralax given in meal. Gave boosted dose to accommodate his infection (conjunctivitis) ketones- negative
+1/shortly after dose: zoomies!!
+2: 316
+5: 234

01/14/2023
AMPS: 388, 1.25S, whole can. No noticable drainage from his eye this morning!
+4.5: 193
+6.5: 162
PMPS: 163, stalling without food for 15 minutes. STALL: 174. 1U, whole can.
+2: 128
+4: 66, heard what sounded like meowing and went to check on him. After seeing reading I fed him a couple of spoonfuls of highcarb food, and he was suddenly ravenous. Tagging it as 911 for mild hypoglycemia symptoms.
+4.5: 97, removing 911
+5: 101
+6: 128
+9: 219

01/15/2022
AMPS: 365, whole can. Waiting for dosing advice, contemplating on 0.5u considering he earned a reduction and may be extra sensitive to insulin after his low episode. Vet is closed today, will send a message asking them to call me tomorrow morning.
+3: 354, guess 0.5 is too little?
+7: 416, very zoomy
PMPS: 449, 0.75, whole can
+2: 411, has so much energy! zoomies
+5.5: 399

01/16/2023
AMPS: 357, 0.75, whole can, miralax.
+2.5: 225
+6: 111!!!!! WOOHOO
PMPS: 446, 0.75, whole can. ketones- negative.
+3: 415, constipated? Had miralax with AM food though...
+6: 444. I would be putting a grimacing emoji here.

01/17/2023
AMPS: 396, 0.75, whole can. I think last night's dose might have been a furshot.
+3.5: 102. I think this confirms my theory about last night being a furshot!
+5: 70. Symptoms: refusal to get up on his own, excessive sleepiness, only perks up with food. Gave churu, about to give spoonful of 15% carb food.
Perked up after having snacks!
+5.5: 102
+7: 184
PMPS: 420, 0.5u, whole can
+3: 233

01/18/2023
AMPS: 364, 0.5u, whole can
+6: 369, his eye still seems to be irritating him. I think hes going to need the antibiotics course to be a bit on the longer end. Lets see how he responds to his PM dose tonight, in case this is a bounce.
PMPS: 411, 0.5, whole can
[finished dinner around +1.5]
+2: 390
+5.5: 346, eye discharge returned. I had removed his e-collar for yesterday, and it seems he scratched at it again.

 

Started a new thread @FrostD @Suzanne & Darcy

 

Steady as she (he) goes!

 

I do think he is probably bouncing from those blues. I am a little concerned about the wobbly gait, but perhaps it was a passing thing.

 

I think I missed the reason why you reduced from 1f over the holiday. It does look like he was doing better at 1f than after the reduction.

 

I dunno... He hasn't really done that before with previous bounces is the thing that concerns me. And its different from when his back legs were acting weak at the beginning of treatment. Hes a little clumsy normally from repeated ear infections and is often wobbly when he first wakes up, which is understandable. So I'll go see if his ears look like an ear infection is flaring up, but he was for sure awake when he got up and walked away from me. I almost thought he was trying to flop down in order to scratch an itch but that didnt happen.
Maybe I could try shaving his PM dose down tonight and keep a close eye on him, making sure to check his glucose more frequently?

 

Reduced due to vet request because she had the impression he was having an insulin overdose and went lower than that 97, especially because he had zoomies but then got very worn out, followed by a massive spike. Nadir was very early too.

 

Oh

wow, then this could be the early stages of an ear thing then? Poor boy!

 

Which day was that?

 

I do not think that you are missing an “overdose” because you do so much testing on most days. We would see it in the data. If you have serious quAlms about the dose, consider the Libre for Cadmium.

 

His ears look fine, only a bit of earwax but nothing like when he gets ear infections. I'll continue to keep an eye on it though just in case.

New Years Eve. I played it safe and reduced it the night before, but when the vet called me the next day she told me to continue at that dose.

Would love to, but even with access to the readers we need to use the sensors, too... Out of pocket is out of my budget
If we have surplus then maybe. Where does it get installed for cats?

 

The numbers could be a hard bounce, but the ears could also explain that (infections raise BG as I'm sure you know).

 

His ears look normal, just some earwax. I'm going to monitor it though just in case. I don't know what I'm going to do for tonight's dose, though...

 

I'm going to talk to his vet tomorrow and ask them to look at his sheet. If we're lucky his readings might calm down- but I want to ask about the possibility of him having an infection... I can try and pick up some of the multi-test urine dipsticks while out and about tomorrow to see if signs of a UTI are present, and clean his ears more often. I have been forgetting to do that lately with my hypoglycemia episodes being really bad, I had 5 in the span of 3 days. Today was the first day where I stayed in range the entire day.

Depending on how things go and what the vet thinks, I might bring him in for an appointment. He isn't showing much of the warning signs for UTIs, main symptoms he is having is stupid high level glucose and losing his balance. Maybe his ears were being deceptive about the wax buildup and had an infection set in? He gets yeasty ears very, very easily. If he ate anything with grains long before his diagnosis, like, since I first adopted him- he almost always had a flareup. Figured that out after it happened three times, each one of them a yeast infection. For now, I am maintaining the same dose of 1 unit, because it is too early to mess around with it.

 

Update!
I spoke with the vet, and the impression is that the one cycle that acted really weird was as if he didn't receive any insulin whatsoever. We know it's working and still good based on the cycles surrounding it, so the theories are:

1. He got a good snack of kitty contraband somehow
2. The needle went in and back through his skin (or he jumped when receiving his shot) so he didn't receive the dose as he should

Vet said based on the curve, his period of effect is approximately 8 hours, sometimes longer, and is pleased with how he's responding to 1 unit- with minor fluctuations in dose to accommodate his glucose. Said to treat that cycle like an outlier, and to keep doing what we're doing.
Did get more ear cleaning solution while I was there, as last night I couldn't find where the bottle ran off to!

 

Dr J. called me on the 6th and said to keep him on 1F for now, and will reevaluate on Monday if his diet or insulin dose needs to be altered to get him into better numbers. She said she is comfortable with him increasing all the way up to 1.5u but I would do this slowly due to how sensitive he is. I am wondering if his spikes at the end of his cycles are due to well, obviously needing his insulin- but also being really excited for food. When his insulin becomes less effective (around +8) is when the other cats get fed too.
I am getting suspicious of his urine output and water intake rate, but I think constipation might be playing a part in that? He got miralax recently but I dont think all of it is out of his system just yet.
On top of that I need to clean his ears.... oy. Good thing I have a lot of time on my hands, due to being unemployed and disabled!

 

Hey everyone, his pre-shot readings were really good! He has started eating and I know I need to reduce his dose to accommodate his glucose, just not entirely sure by how much? Is going from 1F to 1S okay? Realized in retrospect I should have stalled and retested him without feeding, but too late now. @FrostD @Suzanne & Darcy

 

I don't think you need to reduce? Unless I'm missing something on spreadsheet. We only reduce under 90 (or possibly 75 in your case). If anything he needs a slight increase to nudge nadirs down.

 

I reduced due to how much the insulin brings his blood sugar down, and this felt safer to me. He's no stranger to having cycles where suddenly he dropped approx 200 points or so whenever his insulin kicks in. Especially because I believe the higher numbers lately wrere due to him being really constipated, I noticed that it can raise his glucose readings

 

That's a lower than expected preshot, but (in hindsight) it looks like you would have been safe giving the 1F. I hope the constipation will get better/has improved. You should probably make a note for yourself on his spreadsheet about when he poops.

 

Hindsight is a hell of a thing, ain't it?

See the thing is, he was pooping either once or twice daily during all of this, and would usually occur after he started eating his meals. Either just before insulin, or right after. Gave miralax because I noticed he was straining a bit. The thing that surprised me was the fact that he was more backed up than I thought! He passed what would have been his normal amount, but surprise, he actually had double the amount and the second half was giving him trouble. His poor butt. However, I think the worst of that bout is done.
His stomach doesn't look bloated/"rotund" now so thats good. Has more energy too. Vet suggested giving miralax on a more regular basis to help him out instead of as needed, and that there are some cats they have as patients who need it twice weekly!

 

We have people here whose cats get a little each day. I have one kitty who gets a pinch every other day, but then he takes a med that tends to be a little constipating. Also, if their kidneys start to fail then constipation is usually a problem.

Hindsight is wonderful!

 

URGENT: PMPS reading was 163, stalling for 15 minutes.

 

Wow. He had a really good cycle today. You may want to go back to his former dose tonight. But let’s see what he’s doing after the stall.

 

After 15 min stall from previous reading hes at 174, token dose or previous dose do you think?

 

Waiting for confirmation that it's safe to go ahead and feed him or if I'll need to do another stall reading. What should I do about his dose for tonight?

 

What was the stall number?

 

Oh 174 I see

 

I think I might go bCk to his previous dose if he were my cat. He is on the rise without food though. And I know that you do such a good job of monitoring him that I believe you can take care of him if you choose to do the slightly larger dose.

 

I don’t see that he’s ever had this low of a preshot. Has he? Am I missing it?

 

Sounds good. I was thinking it might have been due to him getting upset about being poked again or the fact that he still got a small pinch of bonito flakes as a treat for putting up with me for PMPS. He was also real annoyed about not being fed yet, he was saying all his swear words! I'll get him fed now.

 

I think he had a preshot of 100 back in November

 

But he wasn’t on this dose, was he? It was lower? I would feed and maybe even just give a straight one unit and not fatten it. As long as I was able to test him and feed/intervene if necessary.

 

Yeah he was on 0.75, just confirmed.

I was thinking of doing just 1 unit straight too! Want to make sure hes eaten at least half of his can/had food for about 15 min before his dose. Learned the hard way that he gets nauseous and vomits otherwise.

 

Good idea about waiting. Give his BG a chance to go up as well. And we don’t want him vomiting if you can help it.

 

Yeahhhhhh. Whenever he does vomit from me messing up I always make sure to give extra food/treats so he doesnt get too low as the insulin kicks in. But rather have him not vomit in the first place if I can help it.

Otherwise guess this is really definitive confirmation that he's recovering from his eye infection! Going to have him finish the full antibiotic course to (hopefully) make sure it doesn't come back!!

 

That’s what I was hoping as I was looking at his spreadsheet… that his eyes are recovering

 

All right. Keep a good eye on him tonight. You know what to do.

 

Bumping due to reading of 66 + mild symptoms (meowing, ravenous hunger) and marked as 911 as it was right on the border of what is considered hypo? Unsure if 65 or below is for pet meter or human meter specifically. Gave two spoonfuls of chicken gravy lovers FF already, monitoring his condition.

 

bumping, contemplating giving him 0.5u as he definitely earned a reduction last night and i know he might be extra sensitive to insulin today. i also need to run an errand and hopefully my partner can keep an eye on him while im away, but i want to be cautious after that wake-up call last night.

 

I guess you decided on .5. I am happy that he didn’t get into true hypo territory (under 50 in the lime greens). That is a human meter you have, right? By the way, 15 percent carb food is considered medium carb food. (I just read the notes on your spreadsheet about the percentage.). So you only needed a bit of that medium carb food to bring him up. That is good to know. I’m sorry about your lack of sleep!

Below 10 percent is low carb
10-19 is medium carb, and
20 percent and above is high carb

 

Yes its a human meter, its my old AccuChek Guide Me. I think I was mixing up the pet meter numbers and human meter numbers!

Regardless considering he was showing mild symptoms, I figured today his insulin dose(s) would be based out of caution until I can speak with vets tomorrow. That's why I went ahead with 0.5 to keep him relatively close to schedule, hes a bit behind now but oh well. He's safe and thats what matters.

Thank you for clarifying the carb count scale!

 

50 or below on a human meter is the take action number. It’s 68 on a pet meter such as the Alpha Trak. But it is always a nail biter when you are not used to seeing those numbers that are getting closer to the take action number. But, as I write this, if you are following the SLGS method (although yours is kind of customized by your vet) then you want to keep them above 90 - or in your case I believe you chose 75? I’m only saying that he wasn’t going to hypo. I’m not surprised he became super hungry and meowing for food though since he’s not used to being in those middle green numbers.

 

He wasn't meowing for food, he was laying on the bed very sleepy and meowing for help/us to come check on him (his meows for food sound different). He only got extremely hungry once we introduced food to him, and was low energy- not quite lethargic? but definitely excessively sleepy. Poor guy.

 

Update: his +3 reading was 354. I'm guessing the 0.5 unit dose is too low?

 

Yeah.... It was really scary
Kinda why I kept spamming the forum, sorry if you got like 50 notifications from me alone!!

 

I’ve not seen a cat behave like that when at 66 on a human meter. Up and hungry and meowing for food yes …. But lying down like you describe… no. I now question whether he was really lower than 66 (bad strip?) because mid 60s are the kind of numbers that lots of cats see in their day to day lives (both lots of cats here who are diabetic but also cats who do not have diabetes.) So I am not sure what to make of that - except to make a note that Cadmium is different.

 

It’s all good. But I knew that you could handle anything that came up. You watch him so closely.

 

I wonder if him feeling crummy from his eye infection may have been part of it, if it wasn't the strip at fault? It's also part of the reason why I removed his inflatable e-collar (we call it the donut) because I know he's less likely to want to do much. He would follow us with his eyes but little interest in playing. Even with his favorite toy.

Maybe I should try and get some control solution soon... For now, once I get home, I'll do a test with my blood and see if it's reading correctly.

 

I am just glad he is safe. A little bit high today. That is probably a combo of a reaction to last night’s low and the temporary reduction today. How are his eyes today?

 

His eye was irritating him a little earlier, I think he scratched above it a little too vigorously. He has a tendency to be excessively itchy, dunno why! But no discharge, and looks bright and clear. Antibiotic ointment seems most effective if I'm able to lift his lower eyelid to apply it there- he has either a clogged gland, rogue eyelash, or stye there. We found it around the same time as his diagnosis! It had swelled up again and that's why I thought it was the culprit when he started being gooey lol

I am very glad he's safe, too. Got my partner a present while at the pharmacy as a Valentine's Day/"thank you for staying up all night with me and letting me get some sleep" gift

 

Either way, he for sure earned a reduction! So the potential max dose for next shot would be 0.75, I guess it depends on what his PMPS winds up being like tonight. If it seems fairly settled bounce wise, prrrrrobably 0.5? Dunno. Guess we will see.

 

Hopefully he will have a better day today.

 

His AM+6 was 111 today!! So I think he's doing a bit better!

 

I like it!

 

following his reading of 70 i gave him snacks, called vet to discuss reduction (it was approved), and after eating a spoonful of 15% carb + churu hes at 102

 

Wow. Cadmium seems determined to get reductions. Good! He would have earned a reduction per SLGS anyway, but I am glad your vet is on board with you.

 

He’ll probably be high this evening so maybe it’s a good time to give his ears a break or give yourself a break (and sleep if you want to.)

 

When I told him his readings for this cycle, Dr K said "I don't understand how he went from almost 400 to 70 with not even a full unit of insulin! He's so dramatic!" lol.

Was wanting to make sure the vets were on board after how Dr J initially wanted him back on 1F due to the highs following the 66. To which I said "absolutely not."

Yeah, still will get his PMPS and maybe a +3 to make sure he's still having the insulin take hold considering how his PM cycle yesterday was likely a furshot. Otherwise its rest time for everyone!