Teddy's first home curve

Good morning all,
I'm doing Ted's first at home glucose curve testing today.
My question - since I'm doing the curve should I only feed today after am and pm shots, twelve hours apart?
I am going to be doing every two hour tests....so I wasn't sure if I could give him any other food....if that would change his numbers?
On previous days I do give him extra food because I'm worried he is losing too much. But today I am testing every two hours -- so what do I do about the food situation? And if it's fine to just feel him twice today please let me know that too.


Thank you!

 

When I used to do curves for my vet, I would fit in Teasel's lunch just after a mid day BG test so that it was 2 hours before the next curve test. You could do that more than once over the day if needed.

 

I'd say go with what Kris suggested, Teddy still needs to get the calories and the curve lets you know how the dose is doing with his diet but don't want every number food influenced

 

Hey shawna, just read your notes (I forget to read those a lot) and found an older thread you might want to read about Tramadol. Has some similar side effects like Teddy is having on it
http://www.felinediabetes.com/FDMB/threads/buprinex-vs-tramadol-after-dental.44641/

 

If hes still having trouble with the tramadol, ask for bupe for pain. Other than getting sleepy none of my cats have ever had trouble with bupe or lost their appetite.

 

I always just fed how I normally would... Although most days last summer were curve days because I was home. Ha

 

Getting a little low at that +4 with time to drop.... I would feed a little low carb food right now to steer it up.

 

I agree. He needs a little LC snack right now. Don't worry about the effect on your curve.

 

Definitely time for a snack for him!

 

Can you rest him again at 5+ to make sure he's still in safe numbers

 

He won't eat. He's growling at me. I called the vet.
I gave him some honey.
This is too hard and I don't even think I can do this.
I'm so sad. Can I delete this thread, I don't know where to delete it. I appreciate you all but I'm just having a mini meltdown and I just can't do it. And my sweet Theodore is always in pain. And I thought I was hopeful for a couple days and now today I just feel tired and I don't know if I can keep him alive and without pain. It's just so hard.

 

Woah Shawna, it's okay! You CAN do this. We've all had meltdowns here, and that's what we're here for.

One step at a time...what did the vet say?

 

Hey hes going to be fine... Take it easy. If you are worked up its just gunna stress you both out.... It's OK......

He's been doing really good and is making progress.

Play some calming music... Take some deep breaths.... It's OK.

 

It's down to 43 and I've been giving him honey. Is he going to die. Should I bring him to some other vet

My vet closed at noon. She said don't let alpha tracker get below 50 or to give him sugar. I am just using people one since I know it better.
How much honey? He won't eat any food like last time this happened. i don't want him to die

Between the Metamucil and Meloxidyl and tramadol and insulin and I don't know what's wrong and he's just staring off and I don't know what to do anymore

 

Ok so is the 43 on the alpha track? If you have a vet open it might be a good idea. On a human meter it's just a bit low, but it's quite low on an alpha track meter. No it doesn't mean he's going to die, but at the vet they can get his numbers up quickly. Honey wears off after a short time, so every 10-15 min test and put more honey. Stay calm though so you don't freak him out

 

Do you have any high carb food with gravy?

 

He is NOT going to die. Yes, that's low, but he can pull through it. How long ago did you give him honey?

 

Other than growling at you does he seem normal?

 

don't delete this thread. Listen... you aren't alone at all... we are here with you, ok? You can do this... take some deep breaths, he's going to be ok. If you don't think you can handle it, put more honey in him, and bring him to a vet. They will put him on a glucose drip for a while and he'll be ok.

 

Yep, exactly! The honey will keep him up while you get to the vet and from there, they can handle it so you can know he is safe.

 

Janet, I have to leave soon...are you able to hang around? @JanetNJ

 

No the 43 was on the human one and I'm just only using the human one for rest of time

 

yes... I'll tag whoever I can as back up.
@Djamila @Dyana @Barbara & Uncle

 

oooooh ok. well that's a lot better. hahaha still low but managable. If it was on the alphatrak it's really low. OK we'll get through it.

 

Hi Shawna. I just read your notes on your spreadsheet. 97 on an alphatrak means he's still in safe numbers. Anything above 68 is fine.

You are not alone. We're going to be with you the whole way. If you take him to the vet, please let us know. If you want to get him through this at home, that's fine too.

He isn't going to die. The numbers we list as 'take action' numbers leave a safety buffer. He's still okay.

 

I'll add @Kris & Teasel and @StephG

 

That's a relief! You'll be OK. Breathe deep and gather your thoughts. We're here. Do you have an empty feeding syringe? If so, mix up a warm water slurry of a bit of HC food laced with honey and gently, slowly squeeze it into the side of his mouth. Kitty burrito and extra towels required - it can be messy.

 

I just saw your notes... 97 on an alphatrack is a safe number. he's going to be fine. I used to aim for 85-90 on alphatracks. Just give it another test when you can.

 

Except the side effects of the tramadol that the vet said should wear off.
He only growls if I try to give him food
Right now he's just staring off.
I'll give him more honey and test him again - I'm only using the people one now - and then if it does get higher I'll bring him to an open vet.

Thanks for the help xoxoxoxox

 

You have a bottle of wine for later? Hahahaha it's really ok. he probably isn't eating because of the constipation.

 

How long has it been since he pooped? Janet may be right about the reason he isn't eating. Will he drink any water?

Shawna, you're doing great. Sending you and Teddy lots of love and reassurance!

 

Do you have an empty feeding syringe? If so, mix up a warm water slurry of a bit of HC food laced with honey and gently, slowly squeeze it into the side of his mouth. Kitty burrito and extra towels required - it can be messy.

 

More than likely the constipation is why he isn't hungry...we wouldn't be either! You're doing wonderfully and there is tons of support for you...you aren't alone, remember that!

 

I'm on as well. Yes good thing the 43 is on the human meter. Uncle had a 44 the other night and he's sitting here right beside me. We're here to help!

 

what about some kibble... will he eat that? or party mix/temptations? My cat was a little low and I gave like 5 temptations and that number was up like 70 points in 15 min. haha

 

On another note: Meloxidyl is a generic version of Metacam I see and there are safer pain meds for kitties. Tramadol is a narcotic but I don't know how often it's used in cats. Buprenorphine is much more common. All narcotics can cause constipation, hence the Metamucil. Maybe plain pumpkin would be better? Also, if you don't already do this, add warm water to every meal.

Just a few things to distract you while you wait to get the next test.

 

Oh, isnt' Metacam the one that people say makes their cats act a bit nutty? Like yowling and pacing?
Yeah, maybe get it switched to Bupe if the vet will let you. If he's still not pooping, have the vet give him an enema.

 

Actually, that's mirtazapine, the appetite stimulant. I think metacam is hard on the kidneys.

 

What's his BG now, Shawna?

 

I feel like I can breathe now....I am sorry I just couldn't think straight and I really panicked. Embarrassing...I wish I hadn't reacted like that but thank you for understanding. I am rereading the comments now that I can think and I am going to do the things mentioned.
Thank you from the bottom of my heart.

 

I'm going to check it now and thanks for the blanket and syringe idea, I'm doing that too.

 

Don't apologize! We all know how scary this can be at times. Getting out all the anxiety is good. Teddy will be fine.

 

Oh man, I've been there! No apologies or embarrassment accepted here

 

ahh ok... I know it started with an M. lol

 

Yes to what Kris and Barbara said! This can be a stressful process which is why this community is so incredible! We've all been there and understand!

 

You are not the first to freak out on here, and you certainly won't be the last. No worries.

 

50
I'll keep syringing food/water/honey mix...

 

Shawna, do you know how long since his last poop?

 

ok... that's better. 50 is a safe number, but because it's honey influenced, keep going a bit more. Then we will have you hold off on food/honey and see if the numbers go up on their own. once you have 3 rises that aren't food influenced we can determine he's out of the woods. You're doing awesome!

 

Excellent! Don't give too much because you don't want him to throw up.

 

Thank you!

 

Thanks for your help and kindness, xoxoxoxo

 

Ok thanks, when do I know to stop giving the honey. I need to look up some other sugar syrup the vet had mentioned last time.

 

Lol
And yes I keep thinking all the food he has eaten and the food I have syringed the last week and nothing is coming out! I wouldn't want to eat either!

 

Pretty much since he stopped moving around...Since 4-28 he has only pooped once! And it wasn't a lot. He went on 5-2, so this past Tuesday was the last time he went.
My vet told me to just keep doing Metamucil until he goes. But I think it's making teddy sick.

 

xoxoxo

 

also in between tests if you could add all these numbers to his spreadsheet that would be awesome. we need to know all this so in the future we can refer to it. Did he eat significantly less this morning? I wonder if that's why the dose is suddenly too much.

yeah, it's probably impacted. Kitty needs an enema. that should be fun. I wouldn't wanna eat if i hadn't taken a dump in a week either.

 

It would be helpful if you entered all these BG readings on your SS in the appropriate cell: for example "43 @ +___, 50 @ + ___. After your next test, try not feeding, wait 20 minutes and retest to see if he can hold his BG up without food/honey.

 

I agree that he might need an enema. Then I'd try plain pumpkin added to all meals - not sure how much though. Warm water added increases their hydration and also helps constipation.

ETA: @Beth 73 has had success treating Elmo's constipation with something else.

 

Ok, can you test again? It's been 30 mintutes...

 

Here is some information for later (after the BG is stabilized) http://www.felineconstipation.org/acutetreatment.html

It looks like you can do an enema at home, but if there's anyway you can go to the vet, that might be less stressful for both of you!

 

seriously though, no one wants to clean up after that. hahahaha some things are worth paying for. haha

 

That does sound like a long time to go without pooping. I used 1/8 teaspoon BID of Miralax for J.D. He would get constipated from Bupe. I would also mix a little baby food squash into his food. I would sometimes go up as high as 1/4 teaspoon of Miralax, and if he still went too long without pooing, I used Lactulose and that would work, but you should consult with your vet before trying any meds. I'd suggest getting him to the vet to do the enema.

 

that's actually a really helpful link!

 

I agree about the vet doing an enema. Not something I'd try at home and, at this point, he probably needs one to get things moving. Then you can address it daily with pumpkin, etc.

 

Went from 50 to 49...
But now I just was able to get him to eat temptation treats!! So I'm hoping that works?

 

Not to pile on with too much info/advice but I agree about the enema. I have been dealing with constipation issues with Uncle off and on for a while. I believe it's time for an enema and I would NOT try to do it at home. Pumpkin, Miralax and Lactulose can all be helpful when kitty is not already too impacted. I've only had to take Uncle in once for an enema and since then I've been able to keep things on track with adding pumpkin and/or Lactulose as needed. I agree about the warm water with food. Miralax and Lactulose need that added water to work well.

 

Yes I think you are right! He did eat much less than normal this morning. I didn't realize it would cause a problem though, I just figured he still ate enough. But he did only eat a little bit of his am food this morning.

Ok i added the numbers to the spreadsheet

 

Ok I'll definitely call about that!

 

He just ate temptations, should I wait 20 minutes now and test?

 

Shawna, is there any way you can get him into a vet today? Is there another clinic or pet hospital that might be open. They could give him some relief from the constipation, and as an added bonus, give you a break from the BG as well. I'm just thinking that Sunday is even harder to find a clinic that's open, and I'm not sure he should wait much longer to get treated. I know this is already stressful and don't want to add to your stress, but I'm just thinking if you can get him in somewhere it might actually lower your stress a little to see him feeling better.

 

Thank you! I will definitely do that and I will definitely have a vet do it.

 

Oops. just saw your response that you're calling! Sorry for the cross-post!

 

Yep

 

Thanks, I will!

 

banfield pet hospital is opening my house tomorrow. That's isn't his normal vet, but they are good there. Good idea - I think I need to get him in there for the enema

 

I will post what his test is in 20 minutes. Xoxoxoxox

 

83

The temptation treats worked he used to be so addicted to those.

 

Is the Banfield hospital open today?

 

Ok, great! I am going to take the dog out for a half an hour walk. I'll be back to check on my own kitty who went from 154 at PMPS to 72 at +2.5 this morning. Gave him 13% carb food and will need to check him at his +3.5. will look in on you as well.
I am no expert at know how long dry food affects BG and not a prozinc user either so not sure about Teddy's normal nadir time.

 

The temptations worked and plus now he is purring instead of growling

 

I hope your kitty is doing ok too! xoxox have fun on your walk with your dog...I love dogs too.
I don't know teddys normal nadir time yet either. But thank you from the bottom of my heart for your kindness and care! xoxoxo

 

Ok well now you know how to buy his cooperation. Lol. That was CC'S addiction too

 

Yes until 7pm, they have good hours. I will probably go there for the enema, thhey are good with walk one if I have to go today otherwise I'll go in the morning.
or if he does go I am going to email my vet to see what she thinks.

 

Yes earlier during all this he even growled when I held out the temptations!! So I'm glad he came around and was able to eat some! Im going to make sure to keep those on hand. He's still purring so I hope so much it means he is at least feeling better. I wonder if they get nauseated when they have low bs, or just weak and tired...I need to read about that.

I'm sorry if I took up a lot of your time...I know how precious weekends are especially for teachers lol
I'll keep posting his tests. But thank you...........xoxoxoxoxoxoxo

 

Exciting afternoon!
Maury gave me some excitement one time when he didn't eat his "lunch". It's another reason why I usually do my routine the way I do it . Hope the enema helps Teddy get some relief

 

He's fine, just checked and he's holding steady at 72. I will stay vigilant about testing till I can see that he is holding his own above 5o without medium or high carb food for at least 2 hours. I just fed him some 0% carb so that won't count!

 

any new readings?

 

Any new news?

 

Let's talk about moving forward with doses. Clearly Teddy has earned a reduction. What does everyone thing about this for the next few days while he's hopefully getting his appetite back:
(Human meter readings)

175-250 .25
250-350 .5
350+ .75

 

Theodore is at 75.

He was at 83 at +9 and I had given him a few more temptations after that. And I wanted to do more checks before pm preshot because of everything....well I guess i must have felt a tiny relief to know his blood sugar was going up and I passed out sleeping....if it makes it any better Teddy was sleeping too....No not better I know!! I feel bad and why do I have to share everything lol but I didn't intend to fall asleep and I guess all that crazy crying wore me out! well I woke up at preshot pm time thankfully.

I'm going to keep trying to get him to eat...he's just still not interested in eating. I'll be home all night and I'll watch him like a hawk...and I'll even set my phone alarm for a ton of times in case I fall asleep!

xoxoxoxo
Thank you to everyone who helped me today....from the bottom of my heart....sincerely...each of your advice and reassurances made me feel so much better. No one could ever understand like you all do. Thanks for caring, xoxoxox, Much love <3

 

Aw I'm glad to hear Uncle is doing ok...how did you come up with that name? It's adorable. Is that meter you use a human one?

 

No shame in a nap. If my son didn't make me play kickball half the day I would have taken one too! lolol Well you can sleep fine tonight, and no need to test tonight since no insulin. You might as well enjoy it. hahaha but do try to get him to eat and poop. Maybe crush 2-3 temptations onto his food. Really it sounds like the food has no where to go. Big guy needs a you-know-what.

 

Shawna... You did so good today. I know you had a freak out, but you got yourself together and did everything you needed to do to keep Teddy safe. He really didn't drop too low because you did a fantastic job steering him up. now that he's not getting an insulin shot tonight, you can open that bottle of wine. hahaha

 

Shawna you did GREAT today. We've all had meltdowns before and we know how you feel...but you handled it like a pro!!!! Teddy is super lucky to have you!

 

Honestly, I would not suggest a sliding scale on Prozinc with this little data to recommend it. I understand that's the best way to dose vetsulin, but prozinc behaves differently, and the protocol is pretty clear that a sliding scale should only be used if consistent dosing has been shown to be "dangerous or ineffective". It had already been suggested a few days ago that one unit was too much, and I think today confirmed that.

I would recommend either 0.25 or 0.5u above 200, and No Shot for anything below 200. Teddy has had two hypos in nine days. If it was my kitty, I would want to give him some time to recover his stored glucose reserves. In addition, he's constipated which often causes higher than normal BG. So if this is "higher than normal" for him, then I think that Shawna needs to be very very cautious about dosing right now which is why of the two options (0.25 or 0.5), I would probably lean toward the smaller dose. It may cause him to run a little higher for a few days, but none of his numbers are really that bad, and I'd much rather err on the side of safety at this point.

That is a conservative opinion, but if it was my cat, that's the approach I would take at this point. Aggressive dosing can be tried later when Teddy is healthier and when Shawna has had a break from all of this drama.

Hopefully when you take him in tomorrow, the vet can help with the pain medication choice and his immobility, along with getting him that enema. After that is resolved, the dosing can be figured out. Please keep us updated on how it goes tomorrow.

We all care very much about how both you and Teddy are doing. Janet is right, you did a great job getting through all of this today, monitoring, syringe feeding, getting the right treats to entice him....you did everything right. And since he had no shot tonight, you can take the evening to rest and heal your own spirits after all of this. You've had quite the start to your FD journey! I promise it isn't always this stressful! It's going to get better, and you're getting to be quite a pro at it already! Sending you hugs and hope for a peaceful evening for you both!

 

If a diabetic cat does not get insulin at the pm 12+ time, can the blood sugar still drop or does it just get higher?

 

It should get higher. Or stay the same. Cats don't go hypo without an injection of insulin.

 

Thanks Janet. I probably didn't do so good, but thank you for your support and reassurance. It made all the difference. And thanks for your help with dosing going forward too.
And yes wine lol

 

Ok thank you, that makes sense I just didn't know.