Newly Diagnosed also w/DKA,etc. - Day 5/6

Good morning (5AM here),

Baby is in the blues this morning and I'm just wondering about when to test next? I'm starting to realize she has her low way, way later than my last kitty did with Lantus, so I guess I need to adjust when I'm testing! I've been doing it way too early I think and maybe not getting good data to see what her cycles really look like.

Should I be testing sooner than 1 hour from now as she's maybe coming down fast?
PMPS: 301, +3: 261, +5: 169, +6: 140 and now +7: 101.
She's agreed to have some LC food at the moment.

 

Levemir has a later onset and nadir than Lantus.
If you look at the last 3 hours of this cycle…there are about 30 to 40 point drops inbetween the hours so she is not dropping fast but fairly sedately. If think test at +8 would be fine.
Any ketone test results today?

 

Ok, still trying to know what's good and whats bad and not panic all the time! She was negative for ketones.
She's at 79 now, is that still an ok number?
When should I test again?

 

Great no ketones.
79 is a safe number. I’d give her a snack of low carb and test in 30 minutes…mainly because you are fairly new to green numbers and it would be good to catch the nadir.

 

She's at 92 at +8.5.
Been up most of the night, would it be safe to sleep for awhile?

 

It looks like nadir was at +8.
I think you could give her a good snack now and have a sleep.
BTW the +8 column should be green not blue.
Are you getting back to a better time schedule yet?

 

Ok, she's snacking away and I'm off for a nap, thank you!
I switched it to green
Slowly getting it to a better time, although I'm unclear on what point in the cycle I need to test for her low so I'm not sure what's the best time yet to do her insulin. With her nadir being later, should I push back her first test to +4 or +5? Or is it still better to do early tests to keep gathering data for now?

 

I think you probably need more data. And the nadir can move around. As she settles down you will be able to see when onset is which is very useful. She will most likely bounce from the greens tonight. And as she eats more low carb food and less HC treats, the cycles will look a bit different. But she is doing so well.
For now try and get some sleep.

 

Ok, I'll keep going with the first test at +3?

She is at 133 PS this morning, do I stall and re-test?? She's never been this low before an insulin dose

 

I'm stalling at the moment, didn't feed and will test again twenty minutes after.

 

She's going up; she's at 149 after a 20 minute stall, feed and shoot 1 unit?

 

I was trying to move her shot ahead by 30 minutes, maybe I shouldn't attempt a move this cycle? 12 hours would be in 15 minutes.

 

I kept her original time (not 30 min sooner as planned) and gave 1 unit, hope this was right to do!
She didn't eat a full amount (ate about 1/8-1/4 can) so gave 5 temptations.
Test at +1?

 

Got a +1 184

 

at +2 she is at 140; do I keep testing hourly as she has never been in the blues before a PS??? Help please.

 

She's gone down to 77 at +3... I don't have much data yet but she usually hits her lowest at +6-8 so should I be concerned she's gone this low so early? I've tried to read everything I can... If she goes below 50 I will give her HC or honey? Any advice/reassurance would be much appreciated. Trying to not allow my anxiety disorder to freak me out; maybe these numbers are a good thing and mean she's responding well to the insulin already?

 

So she's floating in the 50s and seems ok but a bit sleepy. She did get a dose of anti-nausea and appetite stimulant so maybe that makes her drowsy? I've also been annoying her for lots of tests so maybe she's as sleep deprived as I am lol.
If her numbers stay low, do I consider a decrease or is it too soon to do that? She is negative again for ketones.

 

These are lovely healing numbers. Are you feeding her a tsp or so of food after each test? That'll help keep her floating (we call it surfing) around those numbers. Sometimes cats will nadir earlier if they are heading for lower numbers that cycle.

If she goes below 50, and that's definitely reduction territory, you can give her either high carb wet food or HC/honey/syrup - a drop mixed with her regular food would work. As for when a reduction is earned, that's a more complicated question. Over on the Lantus / Levemir / Biosimilars forum we have some yellow starred Sticky Notes. One of those describes our dosing methods, people typically will pick one of the two there. The point when a reduction is "earned" depends on the dosing method being used.

As for feeling sleepy, it could be she's just used to higher numbers. I like to think of it as someone who drinks a lot of coffee (high blood sugar). When you reduce the coffee (blood sugar), they feel tired. Eventually she'll get used to the new and better blood sugars and feel good there.

 

You can feed her a bit of low carb or a few temptations but not too much or many. I can't quite figure out what her usual nadir is yet and I never used Levemir (which can have a later nadir if I remember correctly).
If you can, you want to keep her in the greens. Surfing the greens (above 50, of course) is good. It helps the pancreas heal.

I cannot stay online. The changing weather has given me a terrible migraine. At least it's not bitterly cold anymore.

 

Thank you for the response! So sorry to hear about your migraine, I get them too and they can be brutal! I hope rest and some relaxing helps it calm down

Ok, I've been testing pretty regularly and giving a few temptations each time to keep her from going down. I'll keep doing what I'm doing and hope she just stays green. Healing her pancreas sounds good to me!!

 

Hi Emily, well done shooting the 149.
Baby is having a lovely cycle.
I think you could start posting over on the Lantus page from tomorrow and you will get quicker responses over there.
Here is the link to the Lantus page. People who use Levemir also post here as the two insulins are very similar.
When you post over there make sure you mention Baby is just a week post DKA.
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
And here is the link to THE BASICS…NEW TO THE GROUP…START HERE
This link will give you all sorts of information about posting on the Lantus page.

 

It has been quite a nice cycle! I was nervous seeing these numbers for the first time but we got through lol.
Ok, I will start posting there tomorrow, thank you!
Would you suggest I keep the dose at 1 unit for the next cycle, at least, or should I be increasing or decreasing it? Also, if her numbers are similar tonight to today's and last night's, do I need to test as much as I have been or can I do every 2 hours? Just want to make sure I'm doing the best I can for Baby!

Thanks again!

 

Yes stay with the same dose. She hasn’t earned a reduction and she doesn’t need an increase in dose.
With testing, it all depends on what the BGs are and what you are feeding. I would test more if the numbers get lower or are dropping faster.

 

Great, thank you!

 

Hi Emily and Baby, (she is a beautiful girl!) Well done today! (I've been watching ) .
I too was in a bit of a panic (to put it mildly) over these lower blue and green numbers when they started with Kitkat, and needed a gentle reminder (again and again) from Bron and others that this is exactly what the insulin is supposed to do! and that it's a good thing! ( they have such patience with us ) With the careful vigilant monitoring you are doing, you can control her safe numbers.
Try not to get TOO hung up on just the numbers themselves (I see you have asked a few times about what the numbers all mean) higher is not so good, mid-range and lower is better, green is healing. You may find, as I did, that the trends you see as the days go by, are much more indicative of Baby's progress than any one single test result.
deep breathe, you got this, and you're in very good hands

 

Thank you so much for this Melinda! Anxiety and lack of sleep sure don't go hand in hand when worrying over our furbaby's well being! I think I've learned that the blues and greens don't have to be scary now that I've lived it, and survived lol. Trying to do lots of deep breathing and remembering to be grateful for all the amazing support here! Hopefully I can get some sleep tonight and rebalance my nerves