12/31 Chianti amps 318 pmps 99 ack!

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itzj

itzj

Member Since 2014
We are at shot time, don't know what to do. We are super relaxed on data, usually only testing at pre-shots. I know, bad, but it is what it is.

He had been begging for food. This week he has not been eating much in comparison. We took him in yesterday. They ran a fructosamine and a uti among other things to be safe, but we won't know anything till Friday because of the holiday.

We don't want to not shoot, because I don't want to jack up the depot and the vet thinks we are close to getting the right dose. But I don't know what to do. Dh already fed him, now we're just trying to decide what to do. He had a low number last week, 138, we shot and he was fine. But he's been high in the morning since, we suspect from stealing some chow (other cats have access to it, it is a high protein no grain food).

How do we handle a low preshot? Like out of the blue low preshot.
 
Crap, dh decided to shoot him. How often do I test him now? What's the we screwed up protocol?
 
OK.
+2 is when you might see if any food spike will happen.
Nadir is likely between +5 to +7.
Got coffee?
 
Testing overnight is no problem. Dh is fine with setting alarms to test. If he is fine at +5 and +7 can he stop after that or should he do more?
 
If he is dropping at +2, chances are good you'll want to monitor him up through +7 unless he seems to level off in safe numbers.
 
I'm on the west coast so up for a while and will keep on eye on your condo. It's usually best to suggest the next test time based on how the cycle goes. For all you know, Chianti may bounce. When you are shooting your lowest number ever, I'd definitely get early tests. A +2 for sure and sometimes even a +1. Post your +2 and that'll help suggest when the next test should be.

I'm a little worried that Chianti went even lower today and needs a reduction. No matter what protocol you are following, it's best to get some mid cycle tests before doing an increase. Here's the relevant bit from the start low go slow protocol, which I presume you are following:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Click to expand...

Dose decisions are based on nadirs, and Chianti got very close to 90 today which is the reduction point for SLGS.
 
Are there cats who remain in the 200s for preshots but then swing low and that is their new normal?

I'll test at +2 and report in.
 
Neko earned her first reduction (below 50 via TR protocol) with a preshot of 430 and was back in yellow by the end of the cycle. She also earned reductions over 450. Often when cats start lower, the cycle is flatter, so paws crossed that's what you'll see tonight.
 
Good thing he's eating. Don't let him fill up, maybe a couple tsp, you may need him hungry later. You got high carb food or karo around in case you need it later? I'd get a +3 for sure. If you are nervous, you could get +2.5.
 
He ate a little, not as much as I wanted him to. I have honey and karo on hand at the ready. I have some high carb on hand but he doesn't like the high carb wet so I'd probably have to syringe the gravy. He has never been wild about anything other than tuna.

He is perky still, playing.
 
+3 57

Just reread the sheet on hypo for the millionth time. At what point do I start high carbing him?

He seems to want food but is only kind of licking it or taking a bite or two.
 
Also, if he is back at a "normal" number in the morning, how much of a dose reduction should I do? .25 or .5? If he's at a low number, I skip the shot, right?
 
He's below the reduction point of SLGS. It says to reduce by .25U tomorrow. Congrats on the reduction. Since he's earned his reduction, you might as well give him high carb or a couple drops of karo or honey as BJM suggests.

ETA: You'll have to keep testing him for a while tonight. Might want to put on the :coffee:
 
And then re-check in about 30 minutes.
With +/- 20% meter variance (because the number could be lower than you actually tested), I'd go with the
test
feed
wait 30 min
repeat
until you are sure he is past nadir and will remain in safe numbers.
 
Well someone just shot off fireworks which scared the mess out of him, that'll raise his blood sugar, right ;) ?

Ok, will carb/honey him. And continue testing. Dh will stay up with him till he is past nadir and rising numbers. If he is at a safe number at +7 can he sleep between testing? (I am about to go to bed with the sick 2 yr old human baby).

For his reduced morning shot, can we shoot if he is over 150? Or should he be at 200?
 
Lets wait and see how it goes before making a decision for morning.
Sometimes, decisions are altered based on what happens.
He might bounce high as a kite; he might not.

I'm about to go out and feed the garage cats; I should be back in an hour.
 
He should. I'm too keyed up to sleep. I'm in bed with the toddler talking to him via messenger. He is in the basement with Chianti. If I go to sleep I will make him post.
 
OK. That's the syrup (& maybe fireworks) kicking in.
It wears off quickly, so feed 20 tsp low carb with maybe 1 drop of syrup, wait 30 min and re-test.
 
Great news! See if he'll eat a little of his regular low carb food, maybe a couple teaspoons. I'd test again in an hour. High carb food can wear off and the numbers could go down again.
 
He rejected the high carb. But he ate tons of his regular. Dh says he is acting normal and perky. And is now shooting him looks wondering why he is looking at him so much.
 
OK. Wait another 30 minutes and check on him.Tell DH you don't want Chianti to eat so much at one time that he can't eat if he's gone lower in 30 minutes. In other words, only feed 1-2 teaspoons each test period. He also could vomit if he eats too much ,too fast ,with the syrup on it, which will set him back.
 
Thank goodness for both of you helping. I am learning a lot here. And am so thankful, our vet would have no clue here.
 
Your vet might put him on an IV drip of dextrose overnight .. because they don't learn this stuff on home care.

I will note that a real overdose - like the time a friend misread a syringe and gave 10 units, not 1 - is not something to attempt to manage without IV dextrose and lots of it. Not to mention a healthy credit card ($$$$$)
 
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He's been in safe numbers all night. Cats not on insulin test down to 40, but we want them higher than that cause there's no margin for safety. Chianti's probably feeling great. If he's only eaten regular food and no high carb or karo, then this is a great cycle.

We had one member here whose vet started the cat on 10U! Fortunately the cat survived but it was a rough way to learn home testing.
 
+5 124

Food spike or are we maybe out of the woods?

Yikes 10U!? Even I know that is crazy.
 
Could still be the food spike. Get past 3 rising numbers and past nadir, then breathe!
 
+6.5 160

He is acting totally normal. I feel like we've passed the danger zone.

Thank you both so much for guiding me through this.

I am turning in. I'm sure I'll have more questions tomorrow.
 
You're probably right that he's ok now. Might be smart to leave him some canned low carb out just in case his bgs wobble, but i suspect he is ok for tonight. You did great tonight. Kudos!!

Go by test numbers though, rather than behavior. By the time a cat has hypo symptoms it's really serious.

If you're following SLGS don't forget to take your dose reduction in the morning.

I
 
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