Kitty Cat post hypo gameplan

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Christina & Kitty Cat

Christina & Kitty Cat

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New thread after Kitty Cat's hypoglycemia scare last night
Context:
Kitty cat had hypoglycemic episode last night, got numbers up with high carb dry food + honey, trying to figure out game plan for today. insulin dose reduced from 1u to 0.5u. Switching to human meter because not enough alphatrak strips.

Sept 15 (Last night)
PMPS 56/106/121 AlphaTrak
1 unit Lantus
Fed just under 2 cans FF.
Shot 1 unit Lantus.
+1 134
+2 80 Fancy Feast + ondanestron + famotidine
+3 55 Purina dry (27%-35%?) + honey
+3.5 72 Purina dry + honey
+4 143
+4.5 158
+5 176
+5.5 254
+6.5 267
+7.5 keytones: negative

Sept 16 (Today)
PM +11 ondanestron + tiny bit of FF
AMPS 431 with alphatrak at usual AM dose time
held off on insulin
AMPS keytones: negative
AMPS 525 (1.25 hr after normal) with one touch ultra HUMAN METER
gave 0.5u lantus (half of normal dose)

History:
Ketones: small
Vomitting
Admitted to clinic Monday 14 Sept
Vet said not in DKA "yet"
Given fluids and cerenia.
Ultrasound showed pancreatits and GI inflammation.
Sent home Monday (14 Sept) same day with ondanestron and famotidine.
 
Carry over from previous post:

Mogs:
For today's shopping list:

* Definitely get more test strips for the human meter you're now using.
Ideally, keep 3 pods in the house
* Pod 1: Currently in use:
* Pod 2: Open when pod 1 is finished. Order a new pod when you open this one.
* Pod 3: For use in emergencies (like last night).
Date rotate the pods so they don't expire (pod 2 becomes pod 1, pod 3 becomes pod 2, new pod becomes pod three).
Grandma has A LOT of test strips and she said I can have her meter for today. I have relion coming in the mail tomorrow because the monitor and strips are cheaper. Will make sure to order more as well.

Other things for the list:
* Check that you've got enough lancets and ketone strips.
I have about 150 lancets right now, grandma also has but I will order more of my own.
Keytone strips I have ~45 but for next bottle I will get the ones with glucose test

* Check that you have enough honey/karo.
I have honey.

Also, foods for your hypo toolkit (suggest a couple of cans of each):
* Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy / 20% High Carbs
* Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. / 15% Med Carbs
* Fancy Feast Gravy Lovers Turkey Feast in Gravy. / 15% Med Carbs
* Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy / 15% Med Carbs
* Temptations Treats
Will do
 
(((Grandma))) :bighug:

I added the following suggestions to the list on the other thread, so I'm just copying them over here now:

Additions to Shopping List:

* Neosporin OINTMENT with pain relief, or Vaseline, for Kitty Cat's ears.

ALSO:

* Something nice for you, your mom, and your grandma. :)
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Mogs
.
 
carryover from previous post:

Is it normal to go through these episodes in the beginning?
He was diagnosed on 9/1/20 but I'm not sure how long he really had it. My family is in the boat of "he's suffering and this is no way to live" so they will disagree with me but said they'll still be here to support for my sake. My thinking is that I need to at least try to get over the beginning hump before resorting to the extreme. I told them it's not like I hadn't thought about the possibility that I would need to putting him to sleep, but it's my absolute LAST resort and I must at least try to do this. I don't need to convince my family since I'm paying for everything, doing all the shots myself, etc. but I do want to know that I'm doing right by him.

Did you guys have these thoughts? I feel so guilty for even thinking about giving up because I know it's not what I want to do and just thought it out of frustration.

you are all such an incredible support system. definitely giving me lots of power and hope.

testing again in 5 min. he's currently hiding in his castle.
 
Here is the testing method I used. Perhaps it might give you some ideas to add to your own testing technique, e.g. freehanding the pokes.

  1. Fold a sheet of kitchen paper in four lengthwise and cut it up into 1" strips. You will use these to cushion and support the ear during the test.

  2. Put a thin film of Vaseline or Neosporin ointment (not the cream!) onto the edge of the ear to help the blood sample bead up instead of wicking into the fur. (Wipe off any excess.)

  3. To get a blood sample you need to increase the blood flow to the ear, so make sure the ear is really, really, really warm (but not hot) - especially in the early days of testing. (Note: With repeated 'poking', more capillaries form in the test area, so it becomes easier to get samples reliably.)

  4. Once you have the testing area of the ear well warmed, wrap a strip of folded kitchen paper round your index finger then place finger under the sweet spot area of the ear you're testing to support it during the poke.

  5. Use your thumb and middle finger to lightly but firmly grip the ear and paper strip in place so that the edge of the ear is taut but not overstretched; the little bit of tension will make it easier for the lancet to break the skin surface (and it helps to keep kitty's head from moving around too much).

  6. When using a lancet 'freehand, make sure the bevelled side of the lancet is facing upwards. Hold the lancet at a slight angle to the ear similar to the way you hold a pen when writing, not perpendicular (easier to see where you're aiming and also makes skin prick easier).

  7. When it comes to the actual poke, prick the sweet spot on the edge of the ear in a similar way to how you might quickly prick a balloon with the tip of a needle to make it pop.

  8. When using the glucometer, bring the test strip to where it j-u-s-t comes into contact with the blood droplet and hold it there. The strip should then 'sip up' the amount it needs to run a valid test. Most meters beep or give a visual cue to let you know that enough blood has been collected on the strip.

    If your cat is a wriggler, try collecting the blood sample on the back of your (clean) fingernail and test it from there.

  9. After the test, fold the paper strip over the edge of the ear and apply gentle pressure to the test area for about 15-20 seconds to minimise bruising.

Mogs
.
 
he lost a little bit of weight. ideal weight according to vet is 10lbs
yesterday 8:13AM 7.5lbs | today 10:46 AM 6.9lbs

His heart was beating like crazy last night when I went to sleep, I'm assuming all the tests got it worked up. Trying to listen now but he keeps purring so I can't tell...

Am I testing every hour today?
 
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jt and trouble (GA) said:
Actually no but its completely NORMAL! Dont beat yourself up. I too was told it would be kinder to just PTS I laughed at that suggestion and Trouble was off insulin in a year. YOU CAN DO THIS!
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This helps. My brother had a long talk with me last night about other animals he's known that were put down and explained how taking care of kitty cat has caused me to be unfairly resentful towards my family and his thoughts are that keeping kitty cat alive this way with treatment will be ultimately bad for our family. So when I went to bed last night, I was so exhausted and frustrated. What he said was valid so I thought about it more. But I had a dream that me and kitty cat were fighting through this so I feel like I know what I ultimately want to do and can't let the frustration cloud my judgment.
 
Awwwwwww:bighug: I didnt have family nagging at me it was people at work. so called friends. Well we showed them!
lol especially when it was my manager that dumped him on me. He just wanted ME to do HIS dirty work.
 
jt and trouble (GA) said:
Awwwwwww:bighug: I didnt have family nagging at me it was people at work. so called friends. Well we showed them!
lol especially when it was my manager that dumped him on me. He just wanted ME to do HIS dirty work.
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The resentment comes from me never actually wanting pets and saying to not bring the cat home because I was allergic. longstoryshort, my brother is the one who brought the cat home but ultimately he became my cat because I was home the most and he now lives with me in my solo apartment. So I felt like I was the only one who cared about this health crisis but I have to acknowledge that how my brother and mom feel (about letting the cat go because he's sick and needs treatment to survive) isn't unique to the cat, and they feel the same about their own lives. So just a difference of perspective on life and I need to learn to not hold it against them. I am the one who wants to keep trying for Kitty Cat so it's 100% my responsibility and I cannot get mad at anyone for not helping.
 
Christina & Kitty Cat said:
Is it normal to go through these episodes in the beginning?
Click to expand...

Ketone production is a complication of feline diabetes, but it is only temporary provided it is treated promptly and any underlying issues are addressed (e.g. cat not eating). The 'formula' for conditions under which there is a greater risk of ketones forming is:

"Not enough food + not enough insuiln + underlying condition or systemic stressor"

When the cat's not getting enough food and insulin the body starts metabolising other resources, most notably fats, to provide energy to support normal cell functions. Once normal caloric intake and adequate insulin are restored, ketones are flushed from the system, and any underlying problem is addressed then ketone levels should drop back to normal (negative or trace).


Christina & Kitty Cat said:
My family is in the boat of "he's suffering and this is no way to live" so they will disagree with me but said they'll still be here to support for my sake. My thinking is that I need to at least try to get over the beginning hump before resorting to the extreme.
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Correct. You two have unfortunately had a real baptism of fire because Kitty Cat had the digestive system hiccup, but you caught the first ketones early ( :) ) and you've now got the treatments he needs to help him eat properly again.
I do want to know that I'm doing right by him.
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None of us here would be working so hard to help the two of you if we thought for one minute that you were doing anything that would harm Kitty Cat or be bad for him.

Did you guys have these thoughts? I feel so guilty for even thinking about giving up because I know it's not what I want to do and just thought it out of frustration.
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You've had a couple of big scares, and you're tired. Things will look much better when you've had some sleep.

(((Christina)))


you are all such an incredible support system. definitely giving me lots of power and hope.
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We are here to help you both as you learn. And yes, there is most definitely hope. :) You've got Kitty Cat, and we've got your back.

:bighug:


Mogs
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Saoirse looked worse than this when she became diabetic and I took her to our then vets for help:



IMG_20150812_154140.jpg





I had to fight them to get the help she needed: the first vet gave her a diagnosis of 'old lady' who had 'had a good innings' and she REFUSED POINT BLANK to run any tests. Saoirse's BG levels were through the roof by the time I got them to finally help her. I could have lost her...


Mogs
.
 

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This is how Saoirse looked a couple of months later after switching to a new vet practice and to Lantus insulin:


X1Wj6jt-Cy1UltZqJa4oPjuCMixFNQZH7pgbd-BCSn8DCsiCyF8LI_KqS_5EEkUIIMMrH5eTUrLddKAeGsRHYhXRqij6hWHtM2GatJd5BdLBhvlnhEWl0w11phm55LWpSh81tFg



Saoirse had the added complication of chronic pancreatitis on top of the diabetes. A few weeks before she looked like this she was having great difficulty eating. She was very ill indeed - very severely lethargic and depressed-looking. Her recovery was greatly helped by the members here letting me know about the right treatments to ask the vets for. (H/T Elise! :bighug:).

So, Christina, indeed there is hope! :) And Saoirse is far from unique: effective insulin treatment can transform a diabetic kitty and bring them back to wellness. Maybe show your family her pictures to let them see what's possible?

I'm really glad Kitty Cat has you in his corner. :)


Mogs
.
 
Christina & Kitty Cat said:
+2 474 HUMAN METER
down 11 from last hour

Is it going to drop very slowly like this today because of the reduced insulin dose?
Should I keep testing every hour or do I have room for a 2 hr break?
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Could you hang on till the +3 test before taking your break, Christina? The insulin dose will only just be kicking in right now and because you've only got a few days of insulin treatment under your belt we're all still learning about how Kitty Cat is going to respond to his Lantus. At +3 we'd have a better feel for how the cycle will go. (Fingers and paws crossed things will be fine then.)


Mogs
.
 
Critter Mom said:
This is how Saoirse looked a couple of months later after switching to a new vet practice and to Lantus insulin:


X1Wj6jt-Cy1UltZqJa4oPjuCMixFNQZH7pgbd-BCSn8DCsiCyF8LI_KqS_5EEkUIIMMrH5eTUrLddKAeGsRHYhXRqij6hWHtM2GatJd5BdLBhvlnhEWl0w11phm55LWpSh81tFg



Saoirse had the added complication of chronic pancreatitis on top of the diabetes. A few weeks before she looked like this she was having great difficulty eating. She was very ill indeed - very severely lethargic and depressed-looking. Her recovery was greatly helped by the members here letting me know about the right treatments to ask the vets for. (H/T Elise! :bighug:).

So, Christina, indeed there is hope! :) And Saoirse is far from unique: effective insulin treatment can transform a diabetic kitty and bring them back to wellness. Maybe show your family her pictures to let them see what's possible?

I'm really glad Kitty Cat has you in his corner. :)


Mogs
.
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Awwwwwwwwwwww what a sweet face smoooshable :bighug:
 
Critter Mom said:
None of us here would be working so hard to help the two of you if we thought for one minute that you were doing anything that would harm Kitty Cat or be bad for him.
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Can't say enough how amazing this group is. a group we "never want to be in" but am so incredibly thankful for.
Critter Mom said:
You've had a couple of big scares, and you're tired. Things will look much better when you've had some sleep.
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yes, I think I just need some rest to get over this crazy week. I felt so relieved after taking him home from the hospital the same day and got a decent rest that night, otherwise I wouldn't have been able to handle last night's episode.
Critter Mom said:
This is how Saoirse looked a couple of months later after switching to a new vet practice and to Lantus insulin:
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she is absolutely beautiful.
tiffmaxee said:
You have had a rocky start but it will get better. How fast did she lose that weight? She’s going to be eating as much as she wants to get back to her 10 pound weight.
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He was 16lbs at his heaviest last year from overfeeding living with my parents. So he shouldve been 14-15lbs when I took him to live with me in the new apartment in March. He ate a healthier amount of food without much fuss, 2x a day on a schedule. Then around 2-3 months ago he stopped finishing his food but was always whining for more. He's been avg 7.5lbs lately. He lost weight over the weekend from all the vomiting but went back up to 7.5 after the vet visit. today I weighed him at 6.9 but could just be fluctuation of the day. He also started pooping again normally.
Critter Mom said:
So, Christina, indeed there is hope! :) And Saoirse is far from unique: effective insulin treatment can transform a diabetic kitty and bring them back to wellness. Maybe show your family her pictures to let them see what's possible?
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Told my mom it's possible cats can get off insulin. I'm fully aware this is not definite and even if it does happen, it could take years, but I'm telling her that because she's very against drugs of any kind and has expressed that if she ever needs medication to survive, she won't take it and will die "naturally". So when I told her it's possible to get off insulin she said that was very good and she hopes that happens.
Critter Mom said:
Could you hang on till the +3 test before taking your break, Christina. The insulin dose will only just be kicking in right now and because you've only got a few days of insulin treatment under your belt we're all still learning about how Kitty Cat is going to respond to his Lantus. At +3 we'd have a better feel for how the cycle will go. (Fingers and paws crossed things will be fine then.)
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Yes! I am here and ready to take a +3 when it's time. Mom is here the whole day with me as well to help me with all the housework I've neglected.
 
Even if remission doesn’t happen he can become a controlled diabetic and live years very happy. You won’t be going through what is happening now. That was way too fast a drop in weight which is why some of these complications have hit so hard but that all will change.
 
jt and trouble (GA) said:
My hubby is a controlled diabetic and hes VERY happy:p
Trouble was too ;):coffee:
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my dad and grandma (his mom) are actually diabetic, not the hereditary type. they've been on insulin for years. to my family, animal and human cannot be compared, but seeing how they are able to live and function normally with just the added need for shots, that's something I can work towards for my Kitty Cat.
 
There's a +/- 20% variance between any meter reading and the 'true' blood glucose level at the time the reading was taken, so essentially all the test results you've taken on the human meter for this AM cycle are showing essentially the same BG level.

@tiffmaxee - I think it should be OK for Christina to take a couple of hours' break for now. What do you think?


Mogs
.
 
+6 is 442.
How are we doing? Is it okay that it's not really moving today?
Should I test again before PMPS?
This morning, vet said 0.5u insulin for AM and PM today.
Since his insulin was late today by 1hr15m, is it okay to move the PM shot 15 min earlier? so ex: morning shot was 10:15am, PM shot can be 10:00am?
 
Hi Christina,

I hope you feel the better for your nap.

It would have been preferable to see a little downward movement in BG levels today, but you've got two potential issues affecting today's high numbers:

1. Possible influence from the high carb dry food Kitty Cat needed to eat last night to keep his numbers up. (It can take a little while for the effects of high carb dry food to work their way out of a cat's system.)

2. Possible 'bounce' up to high numbers caused by the body signalling the liver to release more glucose into the bloodstream after last night's low. Bounces, too, can take time to clear.

Because Kitty Cat's only recently started treatment, it will take a little bit of time for you to learn his 'style' of responding to insulin. Without much data, it's a case of proceeding with caution while getting him stabilised. Keeping him clear of ketones is also key, and additional caution is needed there too.

Christina & Kitty Cat said:
Since his insulin was late today by 1hr15m, is it okay to move the PM shot 15 min earlier? so ex: morning shot was 10:15am, PM shot can be 10:00am?
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That should be fine, but not by any more than 15 minutes.

Things to do:

* Keep visually monitoring Kitty Cat for now.

* Get another ketone test as soon as possible.

* Lift all food 2 hours before your planned shot time.

* Take a BG reading 1 hour before your planned shot time.

* Post the results for the above when you get them.



You will still need to get a PMPS reading, but I've asked you to get an additional reading so that you'll have time to ask for help before tonight's dose is due. You can change your thread title to reflect this as follows:

* Go to your opening post in the thread.

* Above the post, click on Thread Tools and then choose the option to Edit Title. (I suggest changing it to something like "PMPS due shortly - Help Needed ASAP".)


In the meantime, it would be helpful if you could confirm below whether your mom has been able to pick up some of the Fancy Feast Gravy Lovers foods and the Temptations treats, so that anyone who might be helping you tonight will know what foods you have available in addition to the FF chicken paté and the Purina Cat Chow (c. 26% carbs, per the info from Chewy that Diane posted on your previous thread).

Unfortunately I won't be able to help this evening (been doing my best to hang on for your +6 result before signing off for the day).

I am tagging @Panic and @Sue and Luci to ask if they could keep an eye out for your updated thread (hope you don't mind, ladies!) and assist you before tonight's PM cycle or find other members who can.

NB:

If you are waiting for assistance and don't get a timely answer on Feline Health - especially if the need is urgent - I suggest going to the Lantus, Basaglar, and Levemir support board and posting a thread there requesting help. (There is usually more traffic on that board.)

* Set the question mark icon next to the thread title to attract more attention to your LBL post (more people post there than on Feline Health).

* Should you require emergency assistance (if Kitty Cat were to go low again) then set the 911 icon against the thread title.

-------------------------------------------

IMPORTANT SAFETY INFORMATION:

Now that you are using a human meter, you need to make sure that Kitty Cat's BG does not drop below 50. (Normal range for cat BG on a human meter is 50-120mg/dL.)

If in any doubt about anything don't hesitate to seek help from a vet.

-------------------------------------------

Fingers and paws crossed that all will go well tonight. I'll check in with you tomorrow.

(((Christina and Kitty Cat)))


Mogs
.
 
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Critter Mom said:
Get another ketone test as soon as possible.
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Just took a keytone test AM+7 and it's negative!
Critter Mom said:
In the meantime, it would be helpful if you could confirm below whether your mom has been able to pick up some of the Fancy Feast Gravy Lovers foods and the Temptations treats, so that anyone who might be helping you tonight will know what foods you have available in addition to the FF chicken paté and the Purina Cat Chow (c. 26% carbs, per the info from Chewy that Diane posted on your previous thread).
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Mom still shopping now, couldn't find at the wholesaler so she's going to the regular supermarket which definitely has it.
Critter Mom said:
Unfortunately I won't be able to help this evening (been doing my best to hang on for your +6 result before signing off for the day).
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HUGE THANK YOU <3
Critter Mom said:
* Take a BG reading 1 hour before your planned shot time.
* Post the results for the above when you get them.
You will still need to get a PMPS reading, but I've asked you to get an additional reading so that you'll have time to ask for help before tonight's dose is due. You can change your thread title to reflect this as follows:
* Go to your opening post in the thread.
*Above the post, click on Thread Tools and then choose the option to Edit Title. (I suggest changing it to something like "PMPS due shortly - Help Needed ASAP".)
Click to expand...
Okay, we are ready for this!!
 
Critter Mom said:
I am tagging @Panic and @Sue and Luci to ask if they could keep an eye out for your updated thread (hope you don't mind, ladies!) and assist you before tonight's PM cycle or find other members who can.
Click to expand...

@Bandit's Mom will probably be on the forums around 10 p.m. Eastern Daylight Savings time...however I will not...I'm an early riser/early to bed gal...sorry I can't be around later to help.

Hopefully there won't be too much drama...others from the west coast may be on the forum as well at that hour.

Good luck to you! Hope to see some declining numbers at any rate :)
 
Sue and Luci said:
@Bandit's Mom will probably be on the forums around 10 p.m. Eastern Daylight Savings time...however I will not...I'm an early riser/early to bed gal...sorry I can't be around later to help.

Hopefully there won't be too much drama...others from the west coast may be on the forum as well at that hour.

Good luck to you! Hope to see some declining numbers at any rate :)
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tiffmaxee said:
I can check in but I might fade early. I got very little sleep last night
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thank you all so much for staying on with us so late last night <3 I have hope tonight will be okay. I wrote out everything I need to do with times to help me in a panic.
 
Animals have value. Some people think animals have more value than people, others think animals have value up until they become an inconvenience to people. I just remind them that "the righteous man cares for his animals". Period. My dad asked me multiple times if the kinder thing to do wasn't to put Panic to sleep when she was sick, down to 4 lbs and starving all the time. I just kept telling him she will get BETTER she just needs time. And she did!

I will be on till at least midnight EST ... got a little kitten who needs eye ointment every 8 hours so that falls on midnight time. Oh well. Tag me if you need anything, I'll be around!
 
hour before PMPS he's at 482!

So we haven't gone down today and are almost the same as AM+1. Should I still give the reduced dose of 0.5u lantus tonight? He would usually eat now but have to delay an hour due to this morning's insulin delay
 
That’s fine. He’s still bouncing. I’d be worried if he was low. After the hypo I didn’t t want to see you shoot more as you might not get the help needed if he drops too low. Bounces can take up to 6 cycles to clear. Is your vet open? You could call them and ask if you should shoot a larger dose.
 
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tiffmaxee said:
That’s fine. He’s still bouncing. I’d be worried if he was low. After the hypo I dint want to see you shoot more as you might not get the help needed if he drops too low. Bounces can take up to 6 cycles to clear. Is your vet open? You could call them and ask if you should shoot a larger dose.
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vet not open but I'll call them first thing tomorrow morning so I just need to get through tonight. Would it be safer to underdose than overdose tonight? I know he's in the high range today though. With the 0.5 from this morning, he basically stayed the same all day.
 
We just don’t know if he’s just bouncing from the hypo or needs more insulin. Keep him eating enough and enough water. Check for ketones.
 
tiffmaxee said:
We just don’t know if he’s just bouncing from the hypo or needs more insulin. Keep him eating enough and enough water. Check for ketones.
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oh i see okay so he might actually need the full 1u tonight... hmm. I will take another test in 20 mins and start feeding him to see how much he gets in him. Then I have a 15 min buffer to decide what to do about insulin
last keytone check was AM+7 so 4 hours ago, definitely negative.
 
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