Chloe2

Just tested at 366. Forgot to put the Prozinc back in the fridge this morning. It's almost used up anyway. Should I just start a new one? Oh yeah, I wanted to mention how Chico loves to play with the syringe caps (from the top). Do any of your cats like playing with them?

 

I think it might be a good idea to try the new bottle. Prozinc can survive being left out a bit, but you mentioned the bottle was a bit old anyway, right? As long as you have the new one might be a good time to switch. Just make sure you clearly label which one is which so you don't get them mixed up in the fridge.

And yes, my other cat loves batting them around. If I don't toss them right away, they're on the floor getting batted around before I get back from giving Sam his shot.

 

Actually not a bad time to switch so you can monitor when starting the new bottle. Sometimes new bottles are a bit more potent. You could put that older bottle back in the fridge and just hang on to it in case something happens and the new bottle breaks...then you'll still have some even if it's a bit older and less potent while waiting for a new one.

 

Glad to see that pre-shot was a little lower this evening! Can you remind me....are you using u40, or u100 syringes?

 

I'm now using u-40 syringes which makes things a lot simpler.

 

Make sure you put a note on your spreadsheet if you change to a new vial of ProZinc. That way you can see if the fresher insulin has an effect on BG.

 

Also, if you still have any of the U-100 syringes, put them in another room, far away from the U-40 syringes

 

Are you going to be around today to get some mid-cycle tests? It would be really helpful to see what's going on during the day today to determine if the dose needs to change again. You did a great job with that on 4/1/17!

 

I did.

 

No, I have to go to a conference. I'll do it tomorrow. Besides, I just started a new bottle. I'd forgotten to put the old one in the fridge several times, the latest being yesterday.

 

Done. I put them so far away, I forgot where I put them. I probably won't find them for a few years.

 

Lol....oh how I can relate to that!

 

If there are any extra tests you can get this afternoon or this evening, it would really be helpful. As well as getting the tests tomorrow. Having the pre-shot tests is really important to keeping Chloe safe, but it's the mid-cycles that help us know if her dose needs to go up or down.

 

Nice job with the mid-cycle test! Plus a 255 at +8 indicates a really nice response to the insulin, so that's great!

 

What a lovely +8. Looking forward to seeing your PMPS!

 

Your evening pre-shot numbers are looking really good right now. There are only two recent mid-cycles, so it's hard to know for sure, but I think it would be good to raise the dose to 1.25u since you said you'll be able to get in a few mid-cycle tests tomorrow. What do you think? Ready to try the next step?

 

Yes, I agree her dosage should be raised. She hasn't been in the blue for a long time. What damage happens when numbers are overly high for too long? Doesn't it damage her pancreas?

 

When the numbers are high for too long, cats will start to experience neuropathy - when that happens they will have difficulty walking and lose strength particularly in their back legs. They will also lose a lot of weight, drink and pee excessively. And yes, the pancreas will struggle to recover the longer they are unregulated. Cats can also experience DKA which can be deadly if not treated right away.

So yes, it's important that we keep working to find a dose for Chloe that is both safe, and that will start to bring her numbers down into a healthier range. However, the increases need to be careful because sometimes it takes a few cycles for the cat to start responding to the new dose, so if increases are too large or to fast, you can end up missing a good dose and end up giving too much insulin. And as you've seen, that can result in hypo numbers which can also be very dangerous.

It's a tricky dance to find the right dose, and even once it's found, it will still move around from time to time. That's why monitoring with the tests is so important. You're doing a great job with the pre-shot tests, and as you're able to start adding in those mid-cycles are you have the past couple of days, it will really help.

So in the morning, assuming Chloe is above 200, go ahead and give 1.25u, and then aim to get tests every 2-3 hours until the evening pre-shot test. I'm so glad you'll be able to monitor tomorrow, those numbers will help a lot.

 

Isn't 1.25 the same as a fat one?

 

Well, that depends on how fat your 1u has been. Generally a fat or skinny is just on one side or other of the line, but still touching the line. It's only like a drop of insulin different.

A 1.25, you would look at the space between the 1 and 2, and then eyeball about 1/4 of the way down into that space. So there would be a tiny bit of room between the plunger and the line for the 1.

When you listed 1u on your spreadsheet, were you giving a fat 1u?

 

No, it was right on the line.

 

I'm really looking forward to seeing what this dose does for Chloe today, and how low she gets during the cycle!

 

Just did the +3 and she had 302. Going down. Let's see what the 1:00 test is. That would be her nadir, right?

 

We aren't really sure when her nadir is yet. Most cats hit nadir sometime between +5 and +7, but some hit earlier or later. If you could get a +5 and a +7 that would help to figure it out.

How is the testing going? Are you feeling good about it? Is Chloe doing alright? Ears bleeding well?

 

The testing is much easier now. I usually get it on the first try. The warm rice sock helps. It even makes her purr.

 

That's great! I'm so glad to hear it's going well!

 

157! I have a very soft cloth that she lays on when I'm testing her. And I give her some treats afterwards.

 

Wow! It's so great to see that the insulin is working, isn't it?!

 

BEAUTIFUL!

 

I think you spoke too soon. She's back at 296. I left some food out and I'm sure she grazed a bit, but why is there such a variance? I will stay at 1.25 for a couple more cycles, but I think her dose should be 1.5.

 

Whenever a cat's BG goes lower than they are used to, their body will release stored glucose into the blood stream. I would guess that, since you just raised the dose, the 157 may be lower than Chloe has seen in awhile. So the 296 is a pretty normal response. And she will likely give you an icky number for your PMPS, so don't be surprised.

This is what we call bouncing, and it's totally normal. If you go back to your old thread, there are a couple posts that explain more about bounces.

This is why when we raise the dose, it's so important to monitor (so you can see that low number), and also why it's so important to hold the dose steady for a while.

Chloe will need a few cycles at this dose to balance out, and then yes, you will likely need to raise it again. But it's really important to do that slowly (usually about every six cycles), and again, only during days when you can monitor. Since you can't monitor during the week, you have to hold the dose a little longer than that.

 

445. Chloe's SS has a smile. Isn't that how it should be?

 

Yes, that's the correct shape. The goal is to slowly increase the dose so that the whole smile shape shifts downward into lower numbers. That includes the pre shots and the nadir. That's why it's so important to get these extra tests in on days off. That's the only way to be able to judge how well the dose is working.

 

Yup, that's how it should be.

So this smile shows us that she's reacting well to the insulin. It will just take some time to find the dose that will start to bring the whole smile lower, and into safer numbers. Good job today.

So for now, hold the dose and give her some time to adjust to this. Sometimes cats will get an even better reaction a few days into a dose, so keep getting mid-cycle numbers whenever you can.

You're a teacher, aren't you? Are you on spring break this week? or did you already have it?

 

Lol....oops. Looks like Kris and I posted at the same time. Sorry for being repetitive!

 

I have tomorrow off and also Friday. Friday would be a good day to increase the dose to 1.5.

 

As of now, that seems like a good plan. Please do try to get tests when you can during the week so that you can be sure the increase on Friday is the best idea. A lot can change in a week.

I'll be gone hiking all week, but there are lots of other great people here who can give you advice as the week goes. Have a great week!

 

Have a good time hiking and thanks for all your help.
Roberta

 

Definitely keep posting here and one of us will jump in and help you out when you need some advice or support. Getting in as many test you can between shots will show how she's adjusting to the dose. Can never have too much data on your spreadsheet!

 

So you're off today? It would be great if you could get a mid cycle number today as well and then continue to get what you can throughout the week before Friday.

 

DAMNDAMNDAMN!!!!! I went to my pottery class and lost track of time. Didn't get home until after 8 pm and realized I'd forgotten my purse at the studio. So no shot for Chloe tonight and no food. I'm afraid to do her blood test, so I'll just wait until tomorrow.
omg. my professor just called and said he found it. whew. Uh oh- Chloe is on the arm of my chair. I feel so guilty. Should I feed her?

 

Why aren't you feeding her? You can skip the shot but still feed her. She'll be a bit higher for her next test but that's expected.

 

The test is still good data. You'll see where she started with no shot and where she ends up.

 

I'm imagining what would happen if I didn't feed Frank. 1, he would sing the song of his people alllllll night or 2. He would eat me in my sleep.
Please feed Chloe, so she doesn't nibble on your face when you're sleeping.

 

I fed her. Her appetite doesn't seem so good, but maybe it's because I ran out of Fancy Feast.

 

204 is a great preshot with food and no shot. Did she eat the whole 3oz listed on the spreadsheet? If not maybe note how much she ate and what kind. Sometimes a sudden change of food can upset their belly. Did she eat any this morning?

 

I would leave food out for her if you're not going to be home so she doesn't go too low. Are you able to get a test in today or not?

 

She did eat breakfast, but when I got home a half hour ago, she tested at 30. She refused to eat that sardine wet food even with bonito flakes on top. Then I gave her the Nutro soft loaf duck and she dug in. I also put honey on her gums. I will test again in a few minutes.

 

woah.
You did good with the honey. Test in 20 minutes to see if she's going up.
Do you have high carb gravy type food? Or high carb anything? She needs a small bite like a teaspoon of it to help bring up her numbers. 30 is very low and honey will help her spike for a few minutes but it doesn't last too long.

 

No shot tonight. And I suggest reducing in the morning. She will most likely bounce but she will be sensitive to the insulin after this hypo.
Please post her numbers once you test again. I'll be here waiting to see what they are. Please give High carb food you can mix some honey in food if you don't have high carb. At this point feed her what she will eat.
If she's not eating keep going with the honey. If you can't get her numbers going up soon she might need to go to the ER vet.

 

I just read you tested the 30 thirty minutes ago.
PLEASE test now. See where she is... she might need more food or honey.
How is her behavior?

 

@srk3cats You should post a "911" thread on the main health forum too. You will get more eyes on it and more people to help out.
Did you get another test yet?

 

I agree with what Steph has said. This is a seriously low number and if you can't get her BG moving up she'll need vet attention. Please post on the main health forum with a 911 icon on your thread title. You need to catch the attention of people who are in another time zone who can help.

 

Was this BG test result of 30 at +12 or later than +12? What is Chloe's demeanour - acting normal or acting strange?

 

@srk3cats it's been 25 minutes PLEASE update us... what was her test and did you give any more food or honey and if so how long before or after the test?

 

I tested her again and it's 45. She seems a bit lethargic, but otherwise fine. It was +12.

 

Ok give her a little more food and maybe a drop of honey and test again in 20 minutes. 30 is a dangerous low. She could start rising then go back down- depends on how much insulin is left in her system.
Did she eat any food?
Please come back in 20 and update us.

 

That might only be a short lasting increase from the honey. You're not out of the woods yet. Do you have any gravy style high carb food? If so, give her a teaspoon of gravy and test again in 20 minutes.

I see that Steph has given similar advice.

 

How can anyone help? I'll put more honey on her gums.

 

Kris will be heading to bed soon. I should be in bed but I will stick around and help you through this. When you post in the main health forum more people from other time zones will see it and be able to stay longer if those of us on the East coast can't stay on.

 

Pro Plan True Nature, don't know if it's high carb, but she's going at it with vigor.

 

People can help by following what's happening to Chloe's BG numbers and suggesting what to feed, how much to feed, when to test and when you've reached BG safety. Until you've gone through a few hypos it can be hard to maintain presence of mind. Having others "with" you is reassuring.

 

Your goal is to get her ABOVE 50 and stay there for 3 tests after you're done giving her spoons of food. Don't overload her with food too quick. If she gets full and won't eat anymore then drops again you could have a problem raising it again.

 

Once she is staying above 50 for 3 consecutive tests without food you can feed her what's left of her meal or what would be her normal meal. She might not eat it all right away.
Very important to NOT give her a shot tonight.

 

That is good that she wants to eat.

 

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

This is for later. It's a good idea to have a hypo kit prepared ahead of time.

Also this :
http://felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

 

@srk3cats did you get another test yet? Kris has great advice. I have a hypo kit even though I never really needed it til I switched.

 

Any new data ?

 

She started a new thread
http://www.felinediabetes.com/FDMB/threads/chloe-is-too-low.176210/

 

Yes, we suggested that she post on the main health forum to get more eyes on it. She's in Arizona while StephG is in NY state and I'm in Ontario, Canada. I'm well past my bedtime.

 

Me too. Running on 3-4 hours of sleep and need to be up in 6 hours.
Hoping to see an update soon!

 

I know, just didn't know if you'd seen it.

 

Just updated her SS with 31

 

Now what? back down to 31.

 

Give her another spoon of food with a drop of honey in it.
It's very important to test again in 20 to 30 minutes max.
You'll know if she's still dropping before getting too much lower before giving more food or honey.

 

Mix a little honey in with the food she'll eat and give her about 2 teaspoons, no more. You might have to keep doing this and you don't want to fill her up. Test again in 20 minutes. Please post right away.

 

31 is a dangerous low. She still has active insulin in her system or she wouldn't be going back down after eating. You need to keep feeding her and testing after 20-30 minutes. I like to test in 25 minute increments but chuck has never been this low. You could rub some honey on her gums too. You need to get her up into safer numbers. She could start having hypo symptoms. Seizures, coma-- the deadly ones.

 

Pro Plan True Nature, unless it is gravy-style, is not high carb. I feed it regularly and it is very low carb.

 

@srk3cats Just to be clear- did you give her insulin tonight? Or was her last shot over 12 hours ago?
If she had any insulin within the last 6 hours she might need to go to the ER vet no matter what you do at home.

 

There's a zero in the PM dose column.

 

I must go now. If she is not above 50 keep giving food with some honey in it.
If she's over 50 wait 20 minutes and test again.
You have others here to help I think. If you don't get an answer on your main Health thread you can try here too. Keep testing until she's going up for 3 tests without food.

 

I'm keeping an eye on both threads, for the time being. I think Kris & Teasel are, too.

 

Thank you, I hope you have a good sleep.

 

Her last dose was in the morning. I won't give her insulin if she's under 200.

 

32. She's eating though.

 

32, after an hour of eating, is still dangerously low. I'm nervous for you!

 

@srk3cats I am truly puzzled as to why her bg is so low if she has had no insulin within 12+ hours. I think you should take her to the ER vet, for safety's sake. She has been too low too long and is not coming up appreciably. She could be fine, but it could also turn into a deadly situation in the blink of an eye.

ETA: Just looking back over the earlier posts - it's been over three hours since she first tested below 50, time to go to the ER.

 

Chloe has dropped dangerously low before. I agree that this is time to call in the vet and have her seen. I think @srk3cats looked up vet info in case of an emergency the last time this happened with Chloe.

 

What will they do at the ER that I can't do here?

 

They can put her on a glucose drip, if she needs one. Theoretically, with no insulin on board, these numbers, while low, wouldn't be too worrisome; however, I have never seen any cat go from needing insulin regularly to just dropping into such low numbers so suddenly. I am concerned that there is something else going on here that we are not seeing. And I am very uncomfortable that you can't get her numbers up and keep them up over 50.

 

I'm speaking to an animal hospital right now and he said they don't recomend human glucometers.

 

I don't really see that that has a lot of bearing on the situation at hand. Yes, they will read lower than pet meters, but I think even on a pet meter Chloe would be dangerously low!

ETA: There is only an 18 point difference between the "take action now!" numbers on the two meters - 50 on a human meter vs 68 on a pet meter.

 

Test it on yourself. See if it gives you a normal number.
Try giving more honey.
Do they want you to bring her in?
(I can't sleep yet so I decided to check in)

 

Does it really matter what meter they recommend at this point? On a pet meter Chloe would be even more dangerously low. The 'take action now' number on a pet meter is at 68...as compared to the 50 on a human meter. It seems that, for whatever reason, Chloe is not able to bring her number back up even now when the insulin should be wearing off. That, to me, indicates that she needs to be seen urgently by an ER vet so they can raise her number back into the safe zone.

 

She doesn't want to go and I'm exhausted. Maybe it's just her time.

 

Who doesn't want to go, Chloe?!

 

That's an awful way to die!!!!!

Give her a tablespoon of honey mixed with enough food that she'll eat it. Rub some on her gums too. If that doesn't move her numbers then at least take her and get her humanely put to sleep.

 

It really is. Death from hypo is not a peaceful way to go. I know you're tired, but please do the right thing by Chloe, even if that does finish up being pts. Although there is honestly no reason why any cat should die from a hypo episode...not when you know the numbers and can have them brought back up at the ER if you can't get them back up on your own.

 

Just want to add one thing.....she's going to fill up on food and not want to eat

I would stop mixing so much food in (unless it's just the "gravy" from a "Gravy Lovers" type food) and increase the syrup/honey/karo until she's well above 50....a drop or two isn't cutting it tonight

At this point, it doesn't matter if we send her too high....she needs to get UP

 

Please take her to the vet, even if it is only to have her humanely pts. Letting her die from hypoglycemia would be incredibly cruel.