? Help! Confused readings

Discussion in 'Lantus / Levemir / Biosimilars' started by Mimis mom, Oct 19, 2019.

  1. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    My cats last 4 blood sugar readings (every 12 hrs) was 474, 390, 230 and now 50
    I do it at 9:30 am and 9:30 pm

    I can’t seem to figure out her numbers.
    I want to try and dose her an hour early because I have to leave and she’s only 50.

    current dose is 1.5

    because of her elevated levels I went just a teensy bit more towards 2 units today because of how high it was the last two times.
    She’s also not eaten a ton today...
    I can’t feed her 4-6 times a day, I don’t know how anyone can, and I’m feeling like a bad fur mom...

    should I dose her?
     
  2. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Rosa, 68 is the take action number for the AlphaTrak2 meter. Would you please get another test right now? Do you have medium carb food and high carb food, as well as some Karo syrup or honey on hand?
     
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  3. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Do not dose early tonight. 50 is too low. On an AlphaTrak, the take action number is 68.

    I realize that DKA is in Mimi's recent past, and am hoping that someone with DKA experience comes along before your usual shot time of 9:30pm EST.

    I am assuming that the test of 50 was around 7:30 pm which would be +10.
     
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  4. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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  5. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Yes, you do not want to shoot one hour earlier with a 50 on an Alpha track. You need to made sure she is up over 68. Since you don’t have a Spread sheet with data attached to your signature, it’s hard to give you dosing advice , but I can say with absolute certainty, please don’t dose her when she is this low.

    I’m assuming she was diagnosed sometimes around your member fate? I would not give her any insulin until she comes up over 150. That would mean you would dose her 12 hours later.

    could you set up a spread sheet and attach to your signature? If you need help , please yell and someone will help you.

    AND she had earned a reduction. To 1.25 units with that 50 drop. Using an alpha track the reduction point is 68.
     
  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    PS. when she had come up over 150 please do give her insulin. With the reduction. ( new dose 1.25). Skipping insulin, Is not a good idea for kitties recently DKA. The recipe for DKA is :

    not enough insulin + a systemic infection + in appetence.

    Remember, If you shoot late, the next insulin shot is 12 hours later.
     
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  7. Idjit's mom

    Idjit's mom Well-Known Member

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    Rosa, where did you go? You posted a 911, which is an emergency beacon, and we jumped to help you out because you were getting an unusually low BG number that you needed help with. We are concerned for Mimi.

    Regarding feeding smaller more frequent meals, get a timed feeder. PetSafe and CatMate both make 2 and 5 dish feeders just for this purpose. Many members manage those frequent feedings in this way.
     
  8. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    You are given good advice here. Please keep Mimi safe and us updated!
     
  9. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Also, when you move the dosing time, you can only safely move 15 minutes per cycle or 30 minutes in 1 day, not an hour. Also, Please do not leave the house with your cat showing a 50 on the glucomètre, that is not safe!
     
  10. Mimis mom

    Mimis mom Well-Known Member

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    Hi I was waiting to test again before I had to leave for a little bit. She was 50 but also hadn’t eaten in 7-8 hours. I fed her, she was starving, she devoured all of the food, and I tested her bout 15 later and she went up to 60.
    She’s acting completely normal, not hypo at all, and never acts hypo even when she is that low. She’s hit 34, 43, before, and then will hit 474. Yes I know in need to make a spread sheet- I attempted to and it says I need permission to through google docs
     
  11. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Rosa, how is Mimi doing?
     
  12. Mimis mom

    Mimis mom Well-Known Member

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    I know I shouldn’t have left but she’s acting normal and I have friends in town visiting.. I know I sound irresponsible but I also don’t want to act overly paranoid, especially when the vets instructions from the beginning were not to test her (not necessary) and to only respond if she’s not eating or acting “drunk” which she’s acting totally fine and hungry.
     
  13. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Some cats show no symptoms whatsoever and then when they do, it might be too late. Rover never showed symptoms either, then one day at he did, and it wasn't the lowest number he'd ever had. It was as if he was blind. We loaded him up with corn syrup and drove like crazy to the ER vet. Please be vigilant.

    @Marje and Gracie said she would help you with the spreadsheet if you have problems. Click on her name or photo, then click "start a conversation"

    Spreadsheet instructions are here. You have to make a copy of the spreadsheet template and then work on the copy.
     
  14. Idjit's mom

    Idjit's mom Well-Known Member

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    Many cats are not symptomatic....until they are and then it's a rush to the ER vet. 60 still isn't a great number, and now you can expect a "bounce" later. You will see high numbers from her body releasing stored sugar and hormones to save her life when she hit the low number. Do not be surprised or upset about this. Better high than too low. Please test again in about 20 minutes.
     
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  15. Idjit's mom

    Idjit's mom Well-Known Member

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    Rosa, your vet was wrong. It is necessary and it's critical that we all test our diabetic pets. If you were diabetic, you would be told to test before every shot and then during the cycle between shots. If you were diabetic and your blood sugar dropped, you would be aware of it and take action, you would eat or drink something to bring your blood sugar up. Your cat is aware but can't tell you. That's why she ate ravenously...trying to bring her blood sugar up.
     
  16. Mimis mom

    Mimis mom Well-Known Member

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    So if she ate it’s a good sign that she’s getting her BS up and should be ok right? I am not home at the moment. She’s been lower than this before and been fine. So what does this mean? Her dose blood sugar is regulating? I’m so confused. I know I need to do a spread sheet
     
  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Again, please read the instructions because you do not need permission through google to make a copy of the template. I’ve set it up so members don’t need permission otherwise, I wouldn’t have a life :):p I’ve offered my help a couple times. There’s not much I can do for you insofar as the SS if you don’t contact me and our ability to help you with dosing is also limited without one.

    Please understand that watching your cat to see if she is ok does not mean her BG won’t be low. My kitty was in the 20s several times and appeared totally normal. We also had a very long-time member here whose cat was very steady and predictable for years. Until he wasn’t and he died from a hypo. I’m not trying to scare you but just want to pass on lessons learned here.
     
  18. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    so the “bounce” could explain why it’s going SOOOO high? Just a few days ago it was 34 at the nadar then 337 right before her night dose. The vets were all confused why she jumps like that. But it could also be because they don’t understand diabetes
    She’s also on raw now- a different one then before because the one before I had her on had squash, carrots, and apples!!!! It made up 8 percent of the food!! The brand is Primal
    I switched to Vital essentials which is only turkey, turkey heart, turkey liver, goats milk, herring oil
     
  19. Mimis mom

    Mimis mom Well-Known Member

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    So I shouldn’t have left? I don’t know what to do, Im currently out to dinner... :( I know how that sounds..
     
  20. Mimis mom

    Mimis mom Well-Known Member

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    Why is she too low? What could have been a reason!??
     
  21. Mimis mom

    Mimis mom Well-Known Member

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    What did you do when your kitty hit the 20s - also what causes that????
     
  22. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Rosa – very important. Did you give Mimi a shot early before you left the house?
     
  23. Mimis mom

    Mimis mom Well-Known Member

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    Another question- she was 50 before she ate anything and hadn’t had anything in 7 hours so could that mean her body would have gotten the spike from the food not her fat stores? Does that make sense
     
  24. Idjit's mom

    Idjit's mom Well-Known Member

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    Here's an explanation of "bouncing". It explains why a kitty's BG can go from low to sky high:
    BG goes low OR lower than usual OR drops too quickly.
    Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode.

    No one can recommend better dosing until we can see a history of the BG numbers.

    Doesn't sound at all like the vets understand feline diabetes. If you want to help Mimi, you will listen to the advice you get here, read the recommendations and the information, get the spreadsheet set up and the data recorded. When Mimi has those dangerously low numbers, you will be prepared to intervene and prevent a critical hypo which may cost her life or impair her for life. What is it that you want to do here?
     
  25. Idjit's mom

    Idjit's mom Well-Known Member

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    Maybe, who knows? You didn't stay to see what effect the food had on her.
     
  26. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I wouldn’t have left even if I had skipped the shot. Lantus is a depot insulin which means the previous shot can continue to affect subsequent cycles and she could still hypo if the dose is too high. Because she dropped to 50 on an AT, we already know the dose is too much for her.

    If a cat drops into the 20s, the dose is too much and you have to lower the dose. Immediately, if my Gracie dropped into the 30s or lower, I gave her karo and retested in 15 mins. If she wasn’t up into the 40s//50s on a human meter, I fed her what would be necessary to further get the numbers up.

    The issue here is your kitty has had DKA. We typically do not recommend skipping shots when a cat has recently had DKA. We could have helped you stall and feed correctly so the numbers could come up without a food spike and you could get “some” insulin into her.


    Exactly. And sometimes it doesn’t matter if they eat....the numbers can still keep dropping. Each meter can vary by 20% from reading to reading so a 60 is still basically a 50.
     
    Last edited: Oct 19, 2019
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  27. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Lowering the carb content of what one feeds a cat has an effect on the blood glucose levels. Another thing that points to the current dose being too high.

    Did you shoot tonight?
     
  28. Mimis mom

    Mimis mom Well-Known Member

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    I’m going to test her when I get home and I plan on shooting her then. It will be an hour later than normal but at least I’ll try to get it in... Yoh know I notice when I shoot her in the flank her blood sugar is lower than if I do it in the scruff?
     
  29. Mimis mom

    Mimis mom Well-Known Member

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    No I did not.. she ate all of her dinner and I left. My friends I’m with are telling me I’m being overly paranoid.. I tend to get that way too.
     
  30. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Please test, then ask for guidance as regards to the dose. It is obvious that the current dose is too high but with DKA in the frame, it is not wise to give no insulin at all. I do not have enough experience to advise you on the dose and it is hard for anyone to advise without having a spreadsheet which contains a history of all the numbers to look at (sorry to be a pain about this).

    If you shoot one hour late tonight, then tomorrow morning you will need to shoot 15 minutes earlier than tonight's shot time.
    Say tonight's shot is at 11:00 your time, then you would shoot at 10:45 tomorrow morning.
    Then tomorrow night, you shoot fifteen minutes earlier again at 10:30, and so on until you get back on track.

    Shooting any earlier than this will act like double dosing and an increase – and that is not at all what you want to happen.

    You are not being paranoid at all. It is up to you to keep your cat safe. Would any of them give a child insulin without testing?
     
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  31. Mimis mom

    Mimis mom Well-Known Member

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    What number should she be at to dose her- say I test her and she’s 115, or something like that should I dose her?
     
  32. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    It's dependent on the cat, how long kitty has been on insulin, how much data you have, and your ability to monitor. If I saw 115 for a new member with no data, I might advise something different for a cat who has been on insulin for months with lots and lots of data.

    Right now, I think your priority is to eventually go home and test your cat. Then please please contact @Marje and Gracie to get your SS set up. We really can't help you completely without data. It's hard for us to piece info together and give GOOD advice.

    As for being paranoid, non-sugarcat caregivers most likely will not understand. Many of us have had to change the way we go about our days because of our cats. It's unfortunate and some are not always able to make this change. But it's one all of us have done because of how much we love our cats. Everything is very overwhelming right now but try to breathe, read everyone's advice here carefully and try your best.
     
  33. Mimis mom

    Mimis mom Well-Known Member

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    She’s newly diagnosed 8/28/19
    Can you see that in my profile? Did I set that part up correctly?
     
  34. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    When my cat was diagnosed with diabetes, a few people asked me “why don’t you put your cat to sleep”? You will encounter many, many people who do not understand your love and commitment for your baby. You are not paranoid, you’re being worried and cautious. With diabetes you need to be cautious and also your life changes, it’s going to revolve around your cat, the BG tests, the shot time, etc... it’s demanding but necessary to keep them safe and heathy (enough). You’ll get used to it :) it’s a luck for you and Mimi to have found this forum because people here are so knowledgeable and committed. They will help you navigate the disease and become an expert yourself. For that, you need to create your spreadsheet (lol, I had to say it), it takes two minutes honestly, and people will be able to help you with dosing etc. Also, please take a look at other people s spreadsheet and you’ll see that it’s not uncommon to go from 300s to 50s during a cycle. You’ll notice bounces and other patterns. But do not copy their dosing! Every one needs a different dose. Right now I believe Mimi earned a reduction tonight! Good luck :)
     
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  35. Crista & Ming

    Crista & Ming Well-Known Member

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    Yes I do see that.

    I was talking hypothetical situations. I would give very different advice to people whose cats were newly diagnosed vs. experienced. So your question of whether you can give insulin with a BG of 115 will depend on what the readings were like in the past few days/hours prior. Does that make sense?
     
  36. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    I cannot stay up any longer.
    The dose is too high. If you get a high test number tonight, that will be the bounce talking. It does not mean that you can give the 1.5 unit dose. Bounces are temporary and you do not know how long the bounce will last. The dose still needs to be reduced. Please ask for guidance before you shoot tonight.

    Edit: We really want to help you find a good dose for Mimi. With DKA in the recent past, it is imperative that the dose is the correct one so that she doesn't fall back into a DKA state. The only way to find that good dose is to test and be vigilant. All the work will pay off.
     
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  37. Idjit's mom

    Idjit's mom Well-Known Member

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    Off to bed too, wrenched my back today and I need to lay down. Good luck, and I hope that Mimi is and will be ok.
     
  38. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Hi Rosa,
    I am around for the next several hours.
    Please post and tell me what the blood test result is when you test the blood sugar.
    Don't give the insulin until you have spoken to someone here.

    None of your friends, who are telling you you are paranoid have any idea at what cat diabetes is so they are talking nonsense!

    It is imperative that you continue to test Mimi and if she is in a low number like under 68, you must stay with her until she is up into higher number and feed her some honey or Karo and some high carb food to get the numbers up. To leave her and go out is putting her life in danger.

    Just because she looks ok does not mean she will continue to be OK when the number is low. That is why we test.

    Recently there was a cat who we thought was coming up and he was around 48 when he suddenly dropped lower (even though he was being fed food) and he became unconscious. The caregiver put honey on his gums and he was seen by the vet. He was very lucky to survive.

    Another cat I read about yesterday (not on this site) was found unconscious and was rushed to the vet. He is now blind and is having a lot of trouble getting his balance and trying to walk again from the hypo event. He is not out of the woods.
    So you can see that things can go wrong if you are not vigilant. I am not trying to frighten you, just make you aware of what can happen with a hypo

    You are not a bad Mom......there is a lot to learn when you have a diabetic cat.
    In regards to the food. Can you buy a timed feeder so you can leave food out for Mimi while you are not there?

    Please post as soon as you are home and have tested.
    Bron
     
    Last edited: Oct 19, 2019
  39. Mimis mom

    Mimis mom Well-Known Member

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  40. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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  41. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Just tested her and she’s 528
     
  42. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    I am 2 hours behind because I couldn’t get a ride home earlier, I feel like a bad mom
     
  43. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    You skipped the last shot didn't you?

    If so you really need to give Mimi some insulin.

    Can you draw up 1.25 units of Lantus and give it to her now?
    It will mean you are not going to be able to give the insulin at the normal time tomorrow but she needs to have it now.

    I will wait here for your response so please answer me:)
     
  44. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Ohhh bouncing big time! Don’t worry this is normal. It can take a few cycles to calm down and doesn’t mean you have to increase. Please stick with the reduction tonight! Tomorrow, you can start going back to the original shooting time, 15 minutes per cycle. So if you shoot now at 22:15, tomorrow morning it’s going to be 10:00, tomorrow evening 21:45, Monday morning 9:30, etc...
     
  45. Sandi&Maxine&Whispy(GA)

    Sandi&Maxine&Whispy(GA) Well-Known Member

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    Rosa, if you go to post #2 in http://www.felinediabetes.com/FDMB/threads/how-to-make-a-spread-sheet.220621/ you will see that the first link has instructions for creating the spreadsheet (which Marje has kindly offered to do for you if you'll contact her directly), and the second link tells you what all of the columns in the spreadsheet mean.

    Please take the time to contact Marje and also read the second link that explains each of the columns. Then if you still have questions, we'd be happy to help.

    Please help us help you and Mimi. :bighug:
     
    Mimis mom likes this.
  46. Mimis mom

    Mimis mom Well-Known Member

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    So shoot 1 unit. If she’s been 1.5
     
  47. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    No. I want you to shoot 1.25 units.

    That is half way between the 1 unit mark and the 1.5 unit mark.

    She earned a reduction in dose when she dropped to 50.

    So now she needs 1.25 units.
    Do you think you can do that amount ok.?
     
  48. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Rosa.
    Have you managed to draw up 1.25 units?
     
  49. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Rosa are you still there?
    Please let us know what is happening.
     
  50. Mimis mom

    Mimis mom Well-Known Member

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    My phone died- I drew up as close to 1.25 as I could- just a touch about 1 unit and dosed her
     
  51. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Well done!!!
    Did you get her to eat first?
     
  52. Mimis mom

    Mimis mom Well-Known Member

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    A touch below... I really appreciate all the help and diligence Everyone has put forth..: it means a real lot to me... this whole thing with her has been depressing me a ton..
     
  53. Mimis mom

    Mimis mom Well-Known Member

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    No I did not because she ate at 8:30...
     
  54. Mimis mom

    Mimis mom Well-Known Member

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    Why does she need to eat if she’s over 500? This disease is so confusing
     
  55. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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  56. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I just posted. It has got caught up in the yellow bit. Click to expand.
     
  57. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    How did Mimi go Rosa?
    Did she eat a good amount for you.
     
  58. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    She just ate all of the food I gave her. It was about half of what I normally give her twice a day.
    I’m going to make a spread sheet soon. Just confused what the numbers mean- like AMPS- or 1+ 2+, etc
     
  59. Mimis mom

    Mimis mom Well-Known Member

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    What do you mean the “reduction point is 68” ?
     
  60. Mimis mom

    Mimis mom Well-Known Member

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    Got it

    - I’m still having a really hard time catching her when she pees to test the ketones! I have the strips right by the boxes! I have 3 now instead of 2 because 6 months ago she had a struvite stone and needed surgery to remove it. I was hoping to encourage the litter box more.
     
  61. Mimis mom

    Mimis mom Well-Known Member

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    So is she not over the DKA? When they released her they said she didn’t have ketones anymore.
    How quickly can the ketones come back, and what exactly is the treatment for ketones? Like what are they doing exactly?
     
  62. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Great!

    First about the food.
    After DKA it is really important that Mimi gets enough food every day to fight any ketones that may be lurking around. Food and insulin is what fights to keep the ketones away. Ketones develop if Mimi is not getting enough to eat and not enough insulin.

    So I would like you to give Mimi extra to eat please.
    Feed her before her insulin every time...no matter what the BG level is.
    Then give her food inbetween the shots. That is really important
    Can you do that please?

    APMS is am (morning ) preshot and the +1 is 1 hour after the insulin.
    The +2 is 2 hours after the insulin.
    +7 is 7 hours after insulin

    PMPS is the pm (evening shot) and the +1 is 1 hour after the preshot just like the morning one.

    Does that make sense?

    With the Alphatrak meter the number you need to take action with...that is give some honey or Karo and high carb food is 68.
    Anything below that number is too low and we need to bring it up higher.

    So if it gets below 68 Mimi earns a reduction in dose.

    If you get low numbers like that you must ALWAYS stay with Mimi and test her 20 minutes later to see she has risen in numbers..
    even then she is not safe and you need to keep testing until she can stay up higher with out any feed for 2 hours. Otherwise you risk a hypo and I know you would not want that.

    Try and test every day for ketones if you can. It is an insurance against DKA returning

    Yes she has got over the DKA but the care after DKA is really important to ensure that ketones don't return.
    Ketones can come back when there is NOT ENOUGH FOOD, NOT ENOUGH INSULIN, AND AN INFECTION OR INFLAMMATION IS PRESENT.

    So to treat it ( stop ketones returning) we make sure Mimi is getting enough to eat ( this is really important as food is like medicine when recovering from DKA), make sure she is getting enough insulin and enough water and any infection is being treated.

    So your job is to
    • make sure Mimi gets plenty to eat. Offer her food throughout the day and the evening. I know you work....can you buy a timed feeder?
    • Make sure she gets her insulin
    • Try mixing a small amount of warm water in her food if she will have it so she gets extra to drink.
    • Test daily for ketones
     
  63. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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  64. Mimis mom

    Mimis mom Well-Known Member

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    Testing for ketones daily is nearly impossible. I don’t know when she pees. Can I express her bladder?
     
  65. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    What about the other cat?
     
  66. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    During the day, I separate the cats now, if I have to leave.
     
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  67. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Can you follow her when she goes to the litter box?
     
  68. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Test whoever you can..
    There is no reason why you can't express her bladde I guess.. ...have you done that before?
    yes, as Penelope says a good idea would be to seperate the cats while you are not there....at least for a while.
    Can you do that?
     
  69. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Keep asking us lots questions
    We are hpaito help you.
    We are all lost in the beginning .....we understand how you feel.

    With expressing the bladder...if you haven't done it before I wouldn't do it...it may hurt Mimi.
     
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  70. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Because you have the insulin 2 hours late, you are not going to be able to give Mimi her next dose at the normal time.
    Is that going to be a problem?

    You are going to have to work your way back to the original shooting time by either 1/4 hour each cycle or 1/2 hour each day.
    So whatever time you gave the shot tonight, you will have to take that time tomorrow morning and go back either 1/4 or 1/2 hour.
    Does that make sense?
     
  71. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019

    Ok I was afraid of that answer... they both love watching the birds and squirrels in a sunny spot in my apartment. I’m trying to keep it a stress free as possible too and they sleep with each other during the day.. :(
     
  72. Mimis mom

    Mimis mom Well-Known Member

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    Yes it does
     
  73. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Ok so, what if you left a lot of food out?
     
  74. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    well I’m speaking as far as the automatic feeder goes. You know what’s funny is I have very specific instructions from the vet to not feed her more than twice a day.. why are they so uninformed??
     
  75. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Jun 13, 2019
    Because they are old school. They learn it a certain way, and then they apply what they learnt without updating the knowledge to recent studies. Also, I think that the x2 day feeding applies to other types of insulin, but not the slow ones like Lantus and Levemir.
     
  76. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Vets do not get a lot of training in cat diabetes and it has changed a lot in the last 10 years and most have not kept up with the later treatments.
    You are not the first one to come here and ask that question!

    I can promise you that the best thing you can do for Mimi is feed her several times a day.
    It is not only better for her pancreas, it is better for her dealing with the insulin and most important of all at the moment it is so important that she is getting enough food to keep away the ketones.
     
  77. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    When do you have to leave for work?
    Is it not possible for you to give the insulin at the time needed for the next few days?
     
  78. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    Which is funny because I worry about her overeating in general because that is what I though might have caused the weight gain.. ok so if I purchase two automatic feeders and they open at the same time- if he “shoves” her head out of the way (which he usually does) she can move over to the next one.. so smaller meals just more often? Every what- 4 hours? Is this going to be ok for my other cat too? Is this a better way for cats to eat?
     
  79. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    I’ll make it possible.
    I did 1 am tonight, so 12:30 pm tomorrow? And then 12 that night then 11:30 am the following?
     
  80. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Sorry you probably do 24 hour clocks
     
  81. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Spreadsheet question Back to the 1 hour after, then 2 etc, are you saying I test her blood sugar every hour?!
     
  82. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Did she lose any weight when she was in the hospital?

    We don't want her putting on too much weight, but we want her to eat enough at the moment.

    I would divide food up into say preshot meal, +3 meal, +5 meal +7 meal and then you could leave it until the next preshot time.
    They don't have to be a large amount of food. I would give her a third of the food at preshot and then divide the rest up into the other three meals/snacks. Just small amounts say a tablespoon each time.

    Hopefully your other kitty won't eat it all. You can buy ones that have a chip in them that only let the one cat eat out of the container but they are more expensive.
     
  83. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    No we don't.
    We all talk in +1 + 2 etc.
    Because I have no idea what time it is at your place. I am in Australia and it is 6 pm here on Sunday afternoon
     
  84. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Jun 13, 2019
    You can only back up by 30 minutes/day, so tonight was 1am, tomorrow morning will be 12:45pm, tomorrow evening 00:30am, then Monday morning 12:15pm, Monday evening Midnight...
     
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  85. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    No not at all
    You only have to test that frequently if the numbers are near hypo numbers

    Test at preshot ALWAYS to see it is safe to shoot
    Then if you can get some tests in during the cycles to see how low the insulin is taking Mimi that would be great.
    The more the better but try and get at least one test in during each cycle.
    If you go to work and can't get one in before you leave, get one when you get home.
    At the weekend if you can get some tests in around +4 to around +7 that will help.. different times each day.
    And get a before bed test every night to see she will be safe. If she is lower than the preshot at the before bed test, then you will have to set the alarm andget up later to test again to keep her safe..

    If you have a low test, always test again to check it is coming up. Never just assume it will be ok.
     
  86. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    You can do 1/2 an hour a day to get back to the best time. So either 1/2 an hour once a day or 15 minutes twice a day.
    For 1/2 hour a day :
    If you shot at 1am tonight you can do 12.30 pm tomorrow and 12.30 tomorrow night.
    Then the next day will be 12md then 12mn.
    Next day will be 11.30am then 11.30 pm.
    Etc. only 1/2 an hour a day to get back to your best shot time.
     
    Last edited: Oct 20, 2019
  87. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019

    I have to admit- I do not shoot her at exact 12 hour intervals.. it’s more like 9:30 pm then 10:40 am then 10:20 pm then 9:15 am- do you see what I’m saying? I didn’t know it had to be exact every 12 hours..:

    sometimes it’s 13, then 11, then 12 and a half...

    and then at times I might be late at getting home from something and it’s 15 hours.. that doesn’t happen a lot but has definitely happened... am I killing my cat??
     
  88. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019

    Ok, thank you so much.
    How about feeding? Does that have to be super specific? How often? Every 4-6 hours? She seems to be hungry every time I give her any food.
     
  89. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    How many times a day? Specifically this many or just as often as she’ll want to eat (which seems to be very often)
    Also, I am terrible at getting her shot exactly 12 hours apart- sometimes it’s 14, sometimes it’s 11, but I always test before
     
  90. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    There is a huge amount of information in this thread. I'm going to try to consolidate that information so you can keep things straight (hopefully). Given some of your comments, I'd suggest you read the post linked in my signature -- Gabby's legacy. There are a few comments before mine (see the 7th message), but it may help you to put some of the diabetes experience in perspective.
    • Spreadsheet: It is hugely important that you get Mimi's spreadsheet set up. I'm wondering if you have a Google account which may be why you may be getting the odd note. If you have't set up a Google account, you need to do so. If you do have a Google account, please send Marje a PM. (Click on the "Inbox" at the top right of the page and send Marje a note.) We are very numbers driven here and I'm not the only experienced member here who will not give dosing help without benefit of a spreadsheet. We could give poor advice without knowing what's going on with Mimi.
    • Shot times: Lantus is a depot-type of insulin. You need to shoot as close to every 12-hours as humanly possible. This may mean you need to give some consideration to your shot times to accommodate your schedule. (I moved my shot times to 5:00 AM/PM so I could give shots on time and it gave me 2.5 hrs in the morning to see what was going on before I left the house.) If you do not shoot close to every 12 hours, your irregular shot times have an effect on the depot: an early shot acts like a dose increase whereas a late shot acts like a dose reduction. If you think of this as a pool, you want to see an even surface. If you don't shoot every 12 hours, you keep disturbing the pool. The result is wonky numbers. Please ask if you need help getting Mimi back on schedule.
    • Feeding: It is fine to give multiple small meals. You do NOT want to feed Mimi 2 hours prior to shot time since you don't want the food to influence your pre-shot number. Beyond that particular rule, you can feed whenever you want. My personal opinion is that I think it's best to feed your cat prior to nadir. (Since you don't have a spreadsheet, we don't know when this is for your cat. With Lantus, many cats' nadirs are around +6 but not all cats play by the rules.) If you are worried about your other cat poaching Mimi's food, there are feeders that are activated by a microchip. Mimi would need to wear a collar and the chip on the collar would open the feeder. These types of feeders are expensive. With the more traditional feeders, you could always separate the feeders and see if that will keep your other cat out of Mimi's food.
    • Ketones: If you are finding it difficult to test for urinary ketones, you can always purchase a blood ketone meter. The ketone meter is more accurate than testing for urinary ketones. NovaMax and Precision Xtra are two brands people here often use but there are other brands around, as well. The only down side of blood ketone testing is that the strips for the meter are expensive. As others have explained, with a cat that has recently gone through an episode of DKA, we strongly encourage ketone testing since it is the best way to prevent another (expensive) hospitalization.
    • Low numbers: @Bron and Sheba (GA) have provided you with the rationale for why how your cat may be acting is not a good means for not being VERY attentive to low numbers. Please do not become complacent. While there is a difference between low numbers and symptomatic hypoglycemia, low numbers can become hypoglycemia in a heartbeat. Please see this sticky note on managing low numbers from the top of the Board. I'd encourage you to print this out so you have it handy if you need it.
    • FD and food: Diabetic cats are. usually hungry until they are better regulated. Since your cat's pancreas isn't producing insulin in a normal way, the results of metabolizing food (i.e., glucose) isn't getting into cells. So while a diabetic cat may be eating a lot, not all of the food is getting where it's supposed to go, the glucose is floating around in the blood vs getting into the cells, and your cat is starving. Getting your cat back to more normal numbers will help to reduce appetite since you don't want to get your cat to be too "fluffy." Please make sure you are giving Mimi low carbohydrate (below 10% carb -- usually much below) canned food.
    Please let. us know if you have questions. The beginning stages of this process can be overwhelming. There's a huge volume of information to assimilate. No one expects you to become an expert in 5 minute but these's a huge amount of expertise here on the Board and many people who donate their time and knowledge.
     
  91. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    I hate to confuse the matter but if she’s high at +11 this morning, you can shoot an hour early.

    As an example, if you shot last night at 12:30 then +11 would be 11:30 this morning....if she’s 300 or higher. That will get you one hour closer to your regular shot time. Then tomorrow morning, if you can check her at 10:30 and she’s still above 300, shoot then. That should get you back on schedule if your shot two hours late last night.

    Does that make sense?
     
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  92. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    another alternative that I have seen some folk used is to feed in another room, or dog crate which can only be accessed by the diabetic cat via a cat flap, the cat flap being activated by microchip or magnet that Mimi would wear on her collar.
     
  93. Zelda & Walter

    Zelda & Walter Well-Known Member

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  94. Zelda & Walter

    Zelda & Walter Well-Known Member

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    Sep 8, 2019
    This is very helpful. Thank you!
     
  95. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Thank you very much!!!
    I am having a really hard time knowing when she’s going to pee, so i might have to check out the blood ones..
    I didn’t know I shouldn’t feed her close to her night time dose- good to know!!
    I’m going to work on the spread sheet now- I have lots of information to enter and I’m still not entirely clear how it works- and I know someone has mentioned it somewhere but there’s been so many threads I’ve lost track..
     
  96. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Also, testing her BG, I shouldn’t test after she’s eaten even. Like I just gave her a snack of sardines.
    And she’s at the nadar as well.
    I did the snack before reading this
     
  97. Mimis mom

    Mimis mom Well-Known Member

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  98. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Perhaps try putting her in the box when you both first get up. That usually always worked for Gracie and it works if I need urine from my other two.

    Also, unless she is low in the two hours before shot time, you don’t want to feed her. Typically at shot time, you’ll want to test first and then you can feed/shoot. Most of us test and then shoot while feeding to distract the cat.

    Yes, at any time during the cycle, if you plan on getting a test or need to get a test because the BG warrants it, you’ll want to test before you feed.
     
  99. Mimis mom

    Mimis mom Well-Known Member

    Joined:
    Oct 12, 2019
    I've tried putting her in the litter box but she just hops out. what does in the morning have to do with it do you think? she's not always sleeping when i am. its funny because I can hear my other cat go, Mimi is silent.

    what do you mean when you say shoot them while feeding, so you'll do the test, then put food in from of them and then while they are eating shoot?
    Ive been shooting her on the flank with a shorter thinner needle and I think its been easier for me because her fur is white, shorter and curly and I can see what I am doing better. Her fur there reminds me of a Maltese fur- it like doesn't shed like the rest- it feels more like "hair"
     
  100. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Well, my cats usually wake up with a full bladder because they sleep all night:joyful:;)

    Everyone has their own methods when it comes to shot time. What is most important is that you test first. Then if you want to feed her and then give insulin, fine. Or if you want to give insulin and then feed, that’s ok, too. It’s whatever works best for you all as long as you, at least, test and feed in a 15 min window. You can feed within a 30 min window after testing and be fine.

    Because you asked me in a PM about dosing methods since I set up the SS and we now have a box for it, you can read about the two dosing methods we use for Lantus in this post. At some point soon, you will need to let us know which you’d like to do and add it to your signature block but it’s best to get some basics down first.
     
    Last edited: Oct 20, 2019

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