Cadmium BG thread cont.: AMPS: 383, +4: 108, PMPS: 438, +7.5: 189

PREVIOUS THREAD: https://www.felinediabetes.com/FDMB...amps-364-6-369-pmps-411-2-390-5-5-346.272492/

01/19/2023
AMPS: 435, 0.5F, whole can. I gave him a fattened dose as his eye is still giving him issues, and to help his body use the energy to fight it off.
+2.5: 341
+5.5: 227
PMPS: 441, 0.5F, whole can
+4: 308. I'm going to try shifting his mealtimes and insulin doses from 30 minutes apart to 15 minutes apart.
+7: incredible level of zoomies!!!

01/20/2023
AMPS: 449, 0.5F, whole can. Trying giving his dose closer to mealtime (15 minutes) and addressing his activity levels before I mess with his dose much more.
+1: zoomies
+2: 303
PMPS: 457, 0.75S, whole can
+1: zoomies

01/21/2023
AMPS: 440, 0.75S, whole can
+3: 358
+4: 336
+6: 363
+8: 386
PMPS: 415, 0.75, whole can
+2.5: 285. FINALLY broke 300s!!
+4.5: 221

01/22/2023
AMPS: 431, 0.75, whole can. Scarf and barfed before his insulin dose. Made sure he still had an appetite before giving it. Keeping an eye on him.
+3.5: 256
+6: 212
PMPS: 480, 0.75, whole can. Had dose of miralax as he is straining again.
+2.5: 381
+6: 286

01/23/2023
AMPS: 363, 0.75, whole can
+4: 222
+6: 218
Cleaned his ears earlier after AMPS, unsure if results after that are entirely accurate. Attempted to wipe his ear off for PMPS, dont know how well it worked.
PMPS: 468, 0.75, whole can
[finished food]
+2: 354
+5: 343

01/24/2023
AMPS: 440, whole can. I think he needs to go back up to 1 unit for a bit, and have things settle down. I haven't seen any reading below the 200s in a while.
+2.5: 351
+4: 293
+6: 240
PMPS: 280, immediate retest of 269, 15 minute stall 340. Really wanted his dinner and was scolding me for it lol. Whole can, gave 0.75F as he was coming out of his really high preshots.
+2: 384, has finished food by this point
+4: 309

01/25/2023
AMPS: 315, 1u, whole can
+6: 263
PMPS: 355, 1u, whole can
+3.5: 204
+6: 158

01/26/2023
AMPS: 377, 1u, whole can
Unable to get midpoint AM reading as I was at doctors office for longer than I expected today, by the time we got home we were all pretty exhausted and fell asleep after seeing that Cadmium was awake and alert.
PMPS: 423, 1u, whole can
+2: 355
+6: 258

01/27/2023
AMPS: 397, 1u, whole can
+5: 211
PMPS: 416, 1u, whole can
+3: 361, might be food and stress influenced. Finished dinner before reading, and had a difficult time getting a large enough sample for BG. Zoomies though!!

01/28/2023
AMPS: 244, scarf and barfed shortly after reading and before insulin. I might want to split his meals up a bit. 1u, whole can
+4.5: 98, giving him more of a snack. I gave him snacks to supplement the food he threw up, but looks like he will need a bit more to soften this drop.
+6: 119
PMPS: 370, 1u, whole can
+3: 267

01/29/2023
AMPS: 436, 1u, whole can
+1: zoomies
+6: 194
PMPS: 415, 1u, whole can
+4: 146

01/30/2023
AMPS: 438, 1u, whole can
+1: zoomies!
+8: 337
PMPS: 389, 1u, whole can
+6: 149

01/31/2023
AMPS: 288, 1u, whole can
+8: 277
PMPS: 434, 1u, whole can
+1: zoomies
+3.5: 298

02/01/2023
AMPS: 382, 1u, whole can
Gave AM dose too quickly, vomited some of his breakfast. I gave a couple of pre-cooked shrimp to replace the food he threw up. Ate the shrimp happily, so still has appetite.
+3.5: 299
+6.5: 280
PMPS: 366, 1u, whole can

02/02/2023
AMPS: 351, 1u, whole can
+6.5: 157
PMPS: 440. Might be stress influenced as one of our other cats tried to tackle him
1u, whole can
+4: 359, he is still finishing his food at this point- might also be a potential furshot at this rate.
+5: zoomies

02/03/2023
AMPS: 361, 1u, whole can
+5: 128
PMPS: 408, 1u, whole can

02/04/2023
AMPS: 342, 1u, whole can
+1: zoomies!! He even did a butt wiggle and his classic "maow-wow"s when he runs around!
Intermittent zooming for most of the day
+6: 271, woken up from a nap
PMPS: 433, 1u, whole can. I suspect a bounce from the high energy levels earlier
+4.5: 213

02/05/2023
AMPS: 432, 1u, whole can
+6: 225
PMPS: 394, 1u, whole can
+5: 282, really didn't want to sit still for this test so I think his ear is feeling sore from repeated testing still.

02/06/2023
AMPS: 302, 1u, whole can
+7: 259
PMPS: 430, 1u, whole can
+5: 254, depending on his preshots tomorrow I am thinking of bumping up his dose to 1F.

02/07/2023
AMPS: 380, 1F, whole can. Attempting breakthrough dose to break this pattern, how he responds will determine if he continues on 1u or 1F.
+4: 168
+6: 107
PMPS: 366, 1F, whole can
+5.5: 150

02/08/2023
AMPS: 384, 1F, whole can
+6: 102
PMPS: 381, 1F, whole can
+3: 349

02/09/2023
AMPS: 334, 1F, whole can
+6: 111
PMPS: 368, 1F, whole can

02/10/2023
AMPS: 295, 1F, whole can
+6: 139
PMPS: 310, 1F, whole can

02/11/2023
AMPS: 285, 1F, whole can
+7: 137
PMPS: 266, 1F, whole can

02/12/2023
AMPS: 228, 1F, whole can
+6: 89, low carb snack (churu) to make sure that he didn't dip lower
+6.5: 121
PMPS: 468, 1F, whole can. Bounced rather hard, which unfortunately doesn't surprise me considering this is the first green number he has seen in a good while.

02/13/2023
AMPS: 209, 1F, whole can
+6: 68, giving him some snacks. Guess he has earned a reduction for tonight!
20m later: 73, giving more snacks
+6.5: 79
+8: 155
PMPS: 307, 1u, whole can

02/14/2023
AMPS: 322, 1u, whole can
+6: 142
PMPS: 219, 1u, whole can

02/15/2023
AMPS: 466, 1u, whole can. This reading makes me suspect a bounce and if he had a low number last night. We didn't test because he was acting completely normal, so I will need to monitor how he is responding to it today.
+1: zoomies
+6: 223. So far I preferred his numbers on his old dose, but I will wait and see what his PMPS winds up being.
PMPS: 228! So sticking with 1u, whole can for right now!
+4: 87, snack time
20m later: 123
+6: 416, I didn't give THAT many snacks in order to cause that kind of reading, so I'm pretty confident this is a bounce!

02/16/2023
AMPS: 470, 1S, whole can. Giving 1S dose as my interpretation of his readings last night is that he had really severe rebound hyperglycemia. I will see how he responds and go from there.
+1: zoomies
+5: 281
+6: 245, zoomy
PMPS: 208, 1S, whole can
+2.5: 216

02/17/2023
AMPS: 379, 1S, whole can
He scarf and barfed a portion of his breakfast before receiving insulin. Giving extra treats today.
+6: 103
PMPS: 421, 1S, whole can
+7.5: 188

02/18/2023
AMPS: 254, 1S, whole can, ketones- negative
He scarf and barfed before receiving insulin again, this time it was almost the entire can!! He still has appetite (ate 3 precooked shrimps) and checked his ketones, everything looked fine. Then he passed a stool that was almost 2-3 times the size of his normal ones, so I guess his gut was just dealing with too much!! He got a replacement can about 15 minutes after the shrimp and insulin injection.
+5: 192, likely from the extra food.
PMPS: 427, 1S, whole can
+4: 144

02/19/2023
AMPS: 400, 1S, whole can. Bounce.
+3: zoomies!!
+3.5: 260
+6: 234
PMPS: 495, 1u, whole can. Increasing insulin due to #s.

02/20/2023
AMPS: 340, 1u, whole can
+6: 115
PMPS: 346, 1u, whole can. Has a lot of energy after his dose!
+5: 167

02/21/2023
AMPS: 353, 1u, whole can. My phone died overnight so his morning dose was 30 minutes late.
+5.5: 146
PMPS: 218, 1u, whole can
+6: 84

02/22/2023
AMPS: 236, 1u, whole can. His AMPS reading and dose were an hour late today, so a reading of 236 is absolutely amazing all things considered.
+6: 263. I wonder if he might have had a furshot and I didn't notice? I checked this morning and didnt notice anything. Its either that or how he stepped on a greasy plate a while ago!
PMPS: 444, 1u, whole can
+5: 217

02/23/2023
AMPS: 206, 1u, whole can
+6: 76, snacks.
+8: 88, more snacks
PMPS: 195, 0.75u, whole can. I am lowering his dose as I know I am not going to be able to stay up all night with him, as I have a very important doctors appointment tomorrow. I am being officially fitted for a wheelchair! Plus he was extremely close to hitting his hard reduction point. Depending on how he responds to the reduction will determine what his dose will be in the morning.
+2: 204

02/24/2023
AMPS: 212, 0.75u, whole can
+4: 117
+6: 134
PMPS: 430, 0.75u, whole can. He threw up a portion of his dinner before his insulin, which was due to him being constipated again. He has passed a bit of stool, but looks like he needs more miralax soon.
+4: 204

02/25/2023
AMPS: 428, 1u, whole can. He scarf and barfed again, and is still having some mild constipation. He did pass more stool at some point between his PMPS and +4 reading the previous night.
+5: 174
PMPS: 179, stall 15m later: 189. 1u, whole can
+5.5: 69, snacks. Will check again soon.
+6: 85, bit more snacks
+7: 103

02/26/2023
AMPS: 406, 1S, whole can. Bounce. Reducing dose slower as it seems to be easier on him and makes it more likely for his reduction to be successful.
+7: 207
PMPS: 449, 1S, whole can
+5: 241

02/27/2023
AMPS: 303
+6: 97
PMPS: 198, 1S, whole can
+4.5: 77, snacks
+5: 81, some more snacks

02/28/2023
AMPS: 407, 0.75F, whole can. Bounce- reduced dose due to him getting really really close to his reduction point last night.
+3.5: 347
+6: 338
PMPS: 409, 0.75F, whole can
+5: 115

03/01/2023
AMPS: 451, 0.75F, whole can
+6: 295
PMPS: 267, 0.75F, whole can
+5: 94

03/02/2023
AMPS: 424, 0.75F, whole can
+3.5: 135
+6: 215
PMPS: 471, 1S, whole can. Tweaked his dose because I do not like that preshot.
+3: 364

03/03/2023
AMPS: 414, 1S, whole can
+5.5: 353, thats concerning...
PMPS: 403, 1S, whole can
+3.5: 163
+5.5: 81

03/04/2023
AMPS: 416, 1S, whole can. He did jump while getting insulin, so hopefully it was injected into the right spot.
+5.5: 169
PMPS: 474, 1S, whole can. This might have bounced up so high bc of separation anxiety.
+2: 399

03/05/2023
AMPS: 383, 1S, whole can. I will start a new thread soon because I realize its getting rather long to read this main post!
+4: 108
PMPS: 438, 1S, whole can
+7.5: 189

 

New thread @Suzanne & Darcy @FrostD !
His left eye had some discharge return last night, I think he scratched at it again while he had his e-collar off. I think I need to keep it on as much as possible and only remove it while he is supervised in order to keep his recovery going smooth.

 

I am only speculating here, but what you are describing as mild symptoms with the BG of 70, excessive sleepiness, refusal to get up, etc. may be the fact that he is not used to being in low-normal numbers. We do see that quite a bit on this Board. Some cats act so energetic and content in high numbers because their bodies are just used to it. Some will even act sick or hide when they are in greens... until they get used to it. Anyway, let's see what Cadmium can do on .5 units, right? I'm very optimistic!

 

Which is understandable! I had that thought too, but the thing that concerned me was he was acting like he wasn't fully... there? Like incredibly groggy and he did respond to stimuli still, but not like he normally would. It's very possible that his body thought it was a hypo, but it wasn't a true hypo. But caution was warranted in my eyes because he fit 2/3 of Whipple's triad and the third condition was debatable! Also considering how my reduction point is 75, he still earned it. Just need him to stop annoying his eye, damnit!

 

I most definitely understand and approve of your caution! And he was lower than his reduction point. So I am saying you did just right, but just trying to figure out what is going on with him. He is not going to hypo on your watch!

 

I am gently bumping up his dose to 0.75S, as his preshots and patterns regarding nadir have been far too high. Even a fattened dose of 0.5 hasn't really worked for him. His vet called me yesterday and told me that I might want to consider bringing him up to 0.75u again, as she also thinks 0.5 is too low. Looks like it was too much of a reduction for him for right now, but that he's making his way down still.

 

A lot of times back to back reductions don’t work. His spreadsheet does look like he needs to go back to .75.

 

Yeah.... I figured this was a failed reduction. He will get 0.75u for his dose tonight then.

 

Increased dose to 1u due to the fact that I haven't seen a reading below the 200s in days.

 

PMPS readings of 280 and double check reading of 269?????

 

HI! Since you have been getting those blue nadirs (mid to lower blues, too) for the last few days, I would hold this dose for a bit longer and see how it goes. Are his eyes all cleared up? Anything else going on?

 

Eyes are completely clear now. I give him normal OTC eye drops to help prevent any inflammation or irritation, we think he might have dry eye and that's what led to conjunctivitis! He's been playful, but doesn't want to hang out in the rest of the house because of the younger cats being bullies. He prefers to stay in his room for the most part, so I've been trying to hang out with him more so he doesn't get lonely. I've noticed some scaling/hardened plaque on his back teeth that I'll need to figure out what to do to address it considering his toothpaste makes his sugar spike like crazy. Answer is probably another expensive cleaning

 

I hope you aren't using these eye drops. I just heard this morning about a recall of these artificial tears due to them causing antibiotic resistant infections and also some blindness (and it says death?)

 

How awful is that! I understand about younger cats being bullies. You might want to try rotating cats in different spaces... I mean putting the bullies away and letting Cadmium out for a few hours into a different part of the house.

 

I'm using a different brand, I'll check and see if there's any recalls on it to make sure!

Yeah we try something along those lines, it's just J'zargo constantly wants to play and will run in or yell until he's included! We also try to make sure we don't let them interact when anyone is feeling particularly hangry either. Or at the very least if there's a skirmish, we take the offending cat and put them in "timeout" in the downstairs bathroom!

 

Don't like how the CDC says: Patients reported over 10 different brands of artificial tears and some patients used multiple brands. EzriCare Artificial Tears, a preservative-free, over-the-counter product packaged in multidose bottles, was the brand most commonly reported.
Especially now that another brand has been recalled (Delsam Pharma) so I guess I will be stopping his eye drops to be safe!

 

How's it going with Cadmium?

 

He's doing alright! Has a lot of energy, strong appetite, and is acting about half his age! The main concern is getting these numbers into consistent ranges. It seems any time he approaches being in the low blues/high greens he will have a bounce starting with the next cycle.
Depending on how his preshot numbers are doing later today, I'm thinking his dose might need to be 1F for a bit? Guess we will see.

 

His preshot today was 380, so I am attempting a 1F dose to try and be a "breakthrough dose" and get him out of this pattern. I haven't seen any numbers below 200 for a decent while- and the ones that were may have been influenced due to thinks like scarf and barf. So depending on how he responds to this dose, that will determine if he will continue on 1u or 1F!

 

Cadmium has earned a reduction, I tested him for his +6 and he is at 68! Going to give him some snacks to help his glucose get back up to 75+

 

Posthing this observation as a comment too:
Giving 1S dose as my interpretation of his readings last night is that he had really severe rebound hyperglycemia. I will see how he responds and go from there.