Moving over here, as I was having the discussion on the main Feline Health page, oops https://felinediabetes.com/FDMB/threads/footfoots-bg-spreadsheet.269546/ Footfoot was on an all-kibble dry diet when she was diagnosed in early September. I then introduced low-carb wet food (HiLife tuna flavours, Blink chicken) but kept giving her a bit of kibble too, so as not to change her diet too fast. So she's getting a mixture now. Probably on average about 70/30 wet to dry. Her BG readings are dipping quite low at the moment, so I should probably wait till they even out a bit before reducing the kibble further? It's Hills d/d, which is stupidly high in carbs, about 30%, and a smidgeon of LoveBug, which is also high, in the 20s, I think. I was attempting to follow the Modified Prozinc method, but I've been sticking too long at each dose, I think - I'll admit, I'm quite confused as to how it works... She did have some worrying ketone readings earlier in the process, but I haven't tested for a while since her BG has not gone high and she seems really well. Thoughts and guidance gratefully received!
First, can you get a ketone check in please? My next piece of advice is really going to be based on that. Secondly, I would reduce to 1.75U, you're losing your diet change cushion and I'd like to have a little more wiggle room. 1.5U would be better, but only if ketones are ok. I would pause any diet change, try the new dose for a few days, and see if she keeps dropping. What to do after that really depends on what her BGs and ketones are doing.
Thanks Melissa. I'll check her ketones before her evening shot, and go down to 1.75U or 1.5U, depending on ketones.
OMG! I've just realised that I gave her a shot last night even though her BG was reading 6.8 (123); below 11 (200), it's a no-shoot number, isn't it? Yikes! What should I do if it's below 11 tonight? @Hendrick Cuddleclaw @FrostD @Shelley & Jess @tiffmaxee @Virginie
I'm not really on top of things right now as I'm ill, mostly in bed - that's why there are fewer BG tests on the spreadsheet. Clearly my brain isn't doing too well either :-/
Oh for some reason that hadn't loaded when I looked earlier. At this point I would go down to 1.5U either way, you're getting some pretty good downward movement overall. Give the 1.5U about 3 days and see what she does...if you get numbers below 80 please tag me (I try to check in each day but I don't always get to people in time) The 200 is a no shoot number. But it looks like it turned out ok, perhaps. I think you'll soon be in the position of having to shoot below 200 anyway...last night I'd have said 0.25U-0.5U *if* you could monitor.
If you can monitor, I would try 0.75U. Monitor meaning start with about a +3, then perhaps another one a little later depending.. If you can't monitor, 0.25U is a pretty safe bet. I am SO SO glad about those ketones!!
Thanks Melissa - apologies, my brain is really not functioning well - should I give her I.5U now, with her 10.1 (183) BG reading?
No - sorry we're posting at same time and got a little muddled 1.5U above 200. Tonight, give 0.75U if you can get the few tests I mentioned. Otherwise, give 0.25U. Shooting below 200 is a lite bit of a guessing game, especially with diet transition. So we start conservative to see what happens.
I'm so relieved about the ketones too, I'm mortified that I gave her a full shot last night with such low BG! Could have ended tragically :-o
It happens... thankfully they're usually pretty resilient when it's not too much of an overdose and it doesn't happen often. (Also note for anyone lurking - the advice in this thread is strictly for Footfoot; we did not follow standard protocols/methods due to ketone risk)
She's now at a BG reading of 13.5 (242 mg/dl), at PM shot +4. I could set the alarm to wake up later in the night and test again - unless we think she's now safely rising?
Thanks Melissa! That was my reckoning, too. It would be surprising for her to plummet at this point. Mind you, some other night, I ought to do a curve, to see what does happen between +4 and +12, at night. Am lacking data there.
Looking pretty good, the lower blues are encouraging! This is her first reduction - we haven't seen how she handles a reduction yet. Hopefully she only needs 3 days/6 cycles at the most to settle in and show us what this dose can really do.
This was the 4th day on 1.5U - I haven't been able to do as much testing as I'd like, as there have been other things going on. Tomorrow I'm going to try to do a full day's curve, testing every 1 or 2 hours.
The full curve didn't work out anyway, I had an appointment and some shopping to do this afternoon! Her diet is probably about 70/30 wet food to dry food, though it's a bit hard to gauge. Wet: HiLife tuna & mackerel, and Blink chicken with turkey/duck/salmon. With it, a bit of kibble, which is a blend of Hills d/d and Lovebug (both are high carb). I've haven't changed it really since I added the wet food to the dry, which is all she was eating before she was diagnosed. I'd like to phase out the kibble but I'm keeping it steady for the moment. She's not as monstrously ravenous as she was, but she still has a big appetite. I'm feeding her up to 8 meals a day! Some of those are a fair bit smaller than the main shot-time meals which are around 10am and 10pm. One of the other meals is at about 5am (I set a timed feeder). It stops her from being so ravenous in the morning that she'll wake me up early! I'd like to set up a camera so I can see when she eats that one, but I think now she knows there will be one, she'll find it pretty promptly after it becomes available. Only one scarf'n'barf incident in the past week.
@FrostD @Shelley & Jess - does it look good to you so far, for her to go overnight with her usual 5am meal and no shot?
Spreadsheet says 1.5, did you give 1.5? I might have tried something a little smaller like 1U, but depends if you can monitor. If.yoi can phase out the kibble she should fall into a really nice range
Oops my mistake, I filled in that cell out of habit. No, I didn't give her a shot at all. Corrected now!
As quickly as she'll let you at a 70/30 split I'd say a week max? Just watch BG as always. You have some wiggle room right now, just not a ton.
Thanks Melissa! I reduced it today, so it's about a (large) teaspoonful of kibble in each meal now. Though, there are a lot of meals... she was markedly ravenous all day today; campaigning for more food right after every meal. I've given her as much as I thought she could handle without barfing (it's a fine line!). She was mainly in the pinks today. Every time I tested her, I also fed her, which is more or less the pattern. In fact she recognises the sound of the microwave (when I warm the little rice bag) as a cue for food, now!
I would go up to 1.75U. Glad she's not fighting the food transition too much! Right now she's in a combo of bouncing and the effects of that skipped shot...should settle back down a bit.
@FrostD, @Shelley & Jess - she was so close to a no-shoot number tonight (12 / 216mmol/L) that I went back to 1.5U, hope that was the right thing to do? It's been a bit of a day; her breathing rate was up, between 30 to 40 per minute at times. With help from the UK FB group that I'm on, and a vet who posts there, I managed not to have to take her in to the emergency vets. I found some furosemide tablets from the last time she had respiratory distress, and have given her 3 of those at 4-hr intervals, and she seems much better now. Tomorrow morning, if her breathing rate is still up, I'll take her to the vet - to get more furosemide, apart from anything else. It's almost certainly connected with her heart complaint (thickening of the atrial wall, for which I give her clopidogrel daily, and fortekor, though the vet I spoke to today says that the latter doesn't really do anything). They will probably want to scan her heart again, but I'm penniless, and hoping it won't be strictly necessary, if the furosemide can get her back to normal. :-/ Intending to go back to 1.75U of Prozinc tomorrow morning if her BG is OK.
Definitely ok to ease into the lower numbers! I can't speak much to the furosemide or heart issues, but my only concern with breathing issues would be any effusion due to heart issue.
Panic over! Today her breathing is back to normal (24 per minute, both times I checked). I did take her to the vet, so I have more furosemide for today and tomorrow* and that should be plenty, as we don't want her on diuretics long. Her heart sounded the same as when last checked (number 4 on whatever scale it is they use for monitoring a heart murmur) and her lungs sounded clear. Her BG is a bit high, is that common when there's some medical stress going on? She's back to her hungry, active self, anyway. THANK GOODNESS!! * and some for future emergencies
Yes BG does tend to go up when stressed, not feeling well etc. But I actually think this is a bounce...I suspect she saw green or close to it last night. Glad she's feeling better!
Yes, with a caveat - when you get that big of a drop in 2 hours, it's a good idea to test again later in the cycle. For last night specifically, I'd have said again around +4. It's possible she went lower than we'd like overnight but hard to say. Same thing if you get mid/low blue before bed - if it's a fairly gradual drop, then maybe a +5. Big drop, test earlier.
Yikes - from a day of reds, to yellow, blue and green! I hope it won't be too low later, and need overnight monitoring: I'm starting my new job tomorrow, a job with a hefty learning curve. Not ideal if I have to watch out for hypos overnight, but of course I will if I have to! What do you think about the dosage? @FrostD @Shelley & Jess
That was a really nice cycle. I'm guessing she's going to bounce though! Will you still be able to get daytime tests with the new job?
I did give her 1.5U - will check in 2hrs to see how she's doing. If it's low, I'll set the alarm to check at +4. Fingers crossed!
14 / 252 at +2, thank goodness, not bad. Unfortunately, with the new job, I'll be out of the house for 8hrs at a time, and I haven't tried to train my husband to do the testing because I think it's too fiddly for him. I do need to make sure he can recognise, and act upon, a hypo, though. Oh lordy, this is all very fraught. What a time to start a new job! :-/
My recommendation then would be to reduce to 1.5U and switch to SLGS for a little while. Gives a nice cushion. The problem with symptomatic hypos is that BG is usually quite low, and can be a bit difficult to bring up. In my opinion, better to err on the side of caution for a little while.
A sudden 2.8 (50) for Footfoot this morning. What's going on here, do you think? I gave her a slightly higher carb food (Applaws, it's about 9.5%) and a few Wainwright's treats (47%), not sure if that was the right thing to do but she seemed absolutely starving and I wanted to make sure her BG would rise a bit. Or is 2.8 fine, and I had no need to respond that way? @FrostD @Shelley & Jess Also - should I start another thread now? I can't remember if it's here or elsewhere that you're supposed to do that after a thread reaches about 50 posts.
Yes.please do start a new thread and tag us in it. Hmm. Did you by chance retest? When you get an unexpected number it's good to retest to see if it was maybe a bad strip. The prudent thing to do now is reduce by 0.25U. It was likely a late nadir from breaking the bounce, but we don't know if the 50 was nadir, or if nadir was earlier (and therefore lower). Any recent changes you think might be responsible?
Thanks @FrostD . Yes, I did indeed retest and got the exact same result. Nope, can't think of anything that would explain it! I tested her again at +3 but since then, I've been out at work all day, just back now. It will be time for her evening shot soon. I'll drop to 1.25U unless she's gone back up high again...
I would still do the reduction...she was high last night and came down all that way. I assume she'll be high from a combination of a bounce from lows and a skipped shot
