My brother's cat - Murderface [I did not name him] - was diagnosed in November. Everything was going well, then he threw-up one morning and dropped to 50. Luckily, I'd been through all the help files and brought him out. He stayed level without insulin for about a week. When his numbers rose, I restarted him on 1 unit, but hit days where he was just too low for me to be comfortable giving him a shot. I lowered the units, but he still drops to an amount I can't shoot. If I stop for a day, he'll start going up. If I try as little as .25, he drops too low to shoot. I need guidance. I thought I had this! I don't have a Google account, so I'm going to link to the image of the SS on my domain. I hope that will work. I have the current month at the top, then pasted the end of March at the bottom for reference. http://www.sendcoffee.com/MurderCurrent04122021.jpg
These numbers don't seem too low to shoot? Are you going off the sticky that says don't shoot under 200? That's just for newer people who don't have a lot of data, but you do. Is he on a completely low carb diet? No other health issues? No chance he's sneaking higher carb food?
I'm not comfortable shooting under 150, and especially not 122. Ekk! For example, I didn't give him anything the 4th - the 9th because he was getting low numbers. On the 9th I restarted with .5, but on the 10th at his night shot, he was only 138 - that means I pace a bit and try to decide. Since it was night, I decided against it. Morning, he's 260, so I gave him .25 - but then by night he's down to 122. I can't shoot that. Today, I let him cruise, did a curve to see where he's headed. All highs. If he's high in the morning, I'll likely do .25 and see how he does. I don't get the dose taking him so low that I can't shoot at night. He's eating the same. Acting the same, but the numbers seem odd. He's on Blue Buffalo Wilderness no grain. He's a crunchy kitty. No other health issues. That one 302 looks like he ate a donut, but no. He was 3 units and a nice curve before he crashed. Now it's crazy numbers.
Oh one other major question - do you withhold the food for 2 hrs before testing? So I have a couple of thoughts.... The dry food is relatively high in carbs, almost what we'd consider a medium carb food. Dry food that's higher in carbs almost always makes BGs a bit more unpredictable. There are two lower carb kibbles, Young Again and Dr Elsey's. It may be worth looking into a switch. The flexible dosing also makes things a bit more difficult. ProZinc can last beyond the standard 12 hrs and you get overlap...so although he may be at say 122, you skip a shot, and then the insulin may wear off at +14 and he just continues to go up. It's often better to pick a dose and do your best to stick with it, instead of skipping and changing. Was there anything different about that week in March when he was below 100 without insulin? It looks like his pancreas is sputtering back to life, in which case the best thing you can do is keep him in the lower ranges. Ideally less than 150. Is there a history of DKA or ketones? That's a primary concern when there's inconsistent insulin dosing. What's his eating schedule? Do you by chance have a timed feeder? It may help in keeping him a little flatter by feeding him at certain times - for example, he tends to drop later in the cycle. I'm guessing he eats all his food early on, but if you were to feed smaller amounts a bit later it may keep him high enough to give a dose. I certainly understand comfort level! My two cents - if it were me, I'd restart at 0.5U and do my best to give that at every shot time. Based on the data you have, I'd say 140 is a pretty good cutoff (so below that, skip or perhaps try 0.25, you know him best). Again, the food makes things more difficult to predict. When you get a number close to the cutoff, say in the 130s, that's the time to "experiment" if you can stick around to monitor. The only way to know if you can shoot the full dose at lower numbers is to try and then get the data, but again it's all comfort level and making sure you can monitor and keep him safe.
He had gone down to 50 in March, after throwing up his breakfast. Then, I guess, he 'honeymooned' for a bit. I never skipped around with the dosing before that. He was steady on. Nothing changed with his food. My brother even counts the treats he gets. I try to keep everything the same, so the data is straight forward for me. The 14 hour length is good to know. I probably read it and forgot it. I will remember now.
The 14 was just an example of what could be happening, just to be clear. More than likely it's a combination of the dry food, pancreas starting to fire up, changing insulin, and perhaps not withholding food for 2 hrs before testing
He's been on the same food since diagnosed and he never eats before I test, unless there's a nibble left from the bowl I leave a tiny bit in for overnight or over day. But all that has been the same since November. He's always ready for breakfast or dinner, and knows he has to left me check him first. I've been blessed by his reasonable nature.
