When she is low like that I ALWAYS retest to ensure it is accurate. When she is in that state, I am rushing to take action because a few times she’d drop into the low 40’s. I can tell something is off because she looks “ stoned”.
Yesterday, I grabbed a few kibbles of dry food to jump her sugar. Corn syrup or honey usually takes 30 minutes but dry food has an almost instant impact on her.
I will get the SS updated when she’s out of danger.
As for feeding- she is only on Fancy Feast pate right now with aluminum hydroxide to help with phosphorus. I started trying to switch but vet said to work on diabetes regulation first as changing foods was changing a big variable. Besides, she’s wasting away and I need to ensure she eats.
She free feeds. Not ideal but when I tried scheduling meals, she would eat a lot and vomit. So I keep food out all day and refresh often. I do encourage eating in the morning, midday and evening by putting the bowl near her bed. She will get up and eat for about 5 minutes at those times.
So based on the data I have, why is she suddenly dropping like that? She’s been on .5units for a time and when I see 6 hours of 200+, I would not have expected a 59 BG.
what am I missing?
When you retest, you need to also put in the same cell RT so for example when you got the 59 and retested, you would put, in the same cell “59 RT 62” or whatever the BG was on the retest so we understand you did it. Knowledge is power and data is knowledge.
We don’t use dry food to bring up lower numbers and one reason is because it stays in the system a very long time and causes the BG to remain high so on top of the bounce she experienced, getting a high carb food that stays in the system after nadir completely put the brakes on any insulin she might have had left between +8 and +12.
We recommend corn syrup to bring up low numbers and it usually works within 15 minutes. As Maria said, giving 1 ml orally in a needless syringe is the best way to go but some people will mix it with HC gravy. HC food and syrup usually only affect the BG a few hours so the dry food could be one reason you are seeing her go so high if that is what you’ve been using to bring up her BG.
I don’t know what % calories from carbs the FF pates you use are but I hope you do. It’s very smart, if you want to figure this out, to record in the “Remarks” section of the SS, how much food you feed her when & what the carbs are. You can look at my Gracie’s SS as an example.
If you have a set amount of food you allow her to eat in a day….say one can….that would be 1/2 can per cycle. You want to divide that up into four “mini meals” (MM) to start and you’ll feed one after you have done her PS and while you are shooting, one MM at +1, one at +2, and one at +3. That’s where we start and then we see what effects it has on her curve. If you feed after +6 which is typically the nadir, then you are slamming the breaks on her insulin as it begins to wane.
I’ll give you an example of what it looks like when the insulin wears off because of short duration (usually feeding after +6). Look at her a.m. data on 11/25. She went from 146 to 314 in three hours. That is a sure sign of loss of duration especially since she came back down that night.
On 11/18 a.m. cycle, clear bounce breaking cycle. she had been low on 11/17, bounced, and then cleared it the next day in the a.m. cycle. Classic. And she signalled what we call “ the high before the break” because at PMPS on 11/17, she was in pink, came down to yellow, and then was pink again before she cleared the bounce on the 18th. Once you learn these patterns, you’ll know on a bounce-clearing day, you need to test early and guide her down with food instead of letting her come crashing down.
IMHO, Bella is no different than the hundreds of other cats we’ve seen in regard to her diabetes. You just aren’t working the insulin correctly by feeding when she needs to be fed to flatten the curve….and by learning to anticipate the pattern and when you need to test. I can’t urge you enough to be sure you always get a +2 when you are home and at night you should always get a +2 and a before bed test even if you think she’s high.
I’d like to suggest you start posting daily on the Lantus, Levemir, and Biosimilar insulin support group (ISG). There are more eyes there with a lot of experienced depot insulin users (I am not on the board very often these days). The posting guidelines are
here and it’s important to read them and post accordingly. We have many members there and our method allows us to quickly scan BGs and triage who needs help first. It’s also important to read all the Stickys there but most important would be the one for
dosing methods. Since you are feeding some dry food, you will have to do Start Low Go Slow until all the dry food is out of her system and you aren’t giving her any. Then you can switch to the Tight Regulation Protocol which most cats do better on. I think part of the issue is you haven’t apparently had any specific dosing methods and your vet has just been reactionary likely to preshots and also some to nadirs. Doses have been held longer than they should have been.
I just want you to understand we can help you and Bella but it will take work on your part in a different manner than you have been doing. What do you think?
sorry, I was referring to, as expert members, (as well knowledgeable) sorry, I am done, this time I mean it, I am not going to advise any longer, apparently my expression of language is not appropriate to do so
