Update on Chloe

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Chloe'sMom (GA)

Chloe'sMom (GA)

Member Since 2015
Hello everyone -

Some of you will remember me from only a month ago when Chloe and I had our first experience with the scary DKA. It was thanks to this forum and eventually the help of our local vet that got us through. I truly credit this forum and the valuable assets here that saved her life. We are SOOOOO grateful.

You haven't heard much from me because she's been doing so well and we had returned to our normal busy lives. She still has her occasional "shudders" or "shakes", so that is still alarming, but they have subsided somewhat. I had intended to come on here yesterday to tell you that everything was A-OK and to thank the wonderful people for their attentiveness and assistance, but we've been noticing a turn towards the DKA route again and so I am here once again asking for advice. I feel like I should send each of you a check or gift or something for your time and for those that stayed up with me for that 2 nights getting Chloe through this. I'm just so grateful for all that each of you did, so again, thank you. Please help me keep her out of DKA again. I hope I'm just over-worried and that nothing is wrong, and I'd love to bashfully "sit in the corner" and say "Oops, it was just a fluke", but I'm not sure...

Here is what we have been doing:
* Up until yesterday she was eating a combo of the dry high-carb food and the Purina DM canned food. I'd put both out and let her take her pick. When she was coming out of DKA, the carb foods were helping, so I continued with those, and started introducing the wet again. (Ideally, I'd love to pull her out of this diabetic state and have heard/read here that some are successfully able to do that.)
* I have NOT been checking her glucose regularly. Up until 3-4 days ago, she was back to her loving self that wasn't getting into mischief (we hadn't seen this in months or even a year +, my husband thinks she just knows how close to death she came and is grateful to still be alive - could be true.) I check her glucose only every several days at best. She had been in the low 200's.
* Insulin - still Lantus and still the 3/4-1.5 unit twice a day. Admittedly, 2-3 days ago she missed a couple of doses (not consecutively).
* Food/Water - she was pretty normal on this until the last few days again and has been eating an entire bowl of food + in a day, where as before these last few days, she was grazing and eating maybe half or so a day. She is urinating more as well, but not as bad as her pre-DKA days.
* Unlike prior to DKA - she has NOT retreated, hidden, distanced herself or what not. She is used to sleeping with me, and she does every night. She follows me around as normal and seems to be her normal kitty self.

BUT - as of yesterday morning, I took away her dry cat food - attempting to get that carb-rich food out of her diet. And when I checked her glucose this AM - it was 56. I froze in my steps, my husband and I just stared at the number a bit shocked. Her last few glucose readings are as follows (sorry, no chart...) All times are in Eastern.

6/9: 7am = 123
6/11: 7am = 284
6/13: 7am = 56 - put out dry food again, still eating the wet and administered 1/2 ml of karo. NO insulin given as of yet...

(somewhere between dates of 6/9 and 6/12 she missed a couple of doses of insulin - our fault due to late schedules or forgetfulness)

So, my question is (and thank you for taking the time to read this to get a thorough update - I figured since I hadn't posted for a while, I wanted to give as much info as possible) - do I need to take her to the vet? We're trying to bounce back from the $1500+ that we spent last month and yes she was worth it, but I know he will want to run a much of tests (or I fear it) and not sure the bank account can handle too much of that with other expenditures...

Please and thank you for the advice. As always it's much appreciated.

Chloe'sMom
 
On a human meter, 56 mg/dL is just above the threshold where we start intervening with high carb foods. For a pre-shot, though, and limited test data, absolutely no shot. See my signature link Glucometer Notes for some feline-specific reference ranges. Its a d*mn good thing you were testing and caught that!

With Lantus, consistency in dose amount and schedule is key to optimal use. Once she is back up over 200 mg/dL on a human meter, you may resume insulin. Dose adjustments are based on the lowest glucose post-shot, called the nadir. This is about +5 to +7 hours after giving it, with Lantus.

Sudden food changes can have sudden results, as you discovered this morning. Ditch the high carb dry food keeping her numbers up, and you may get her to a diet-controlled state in a couple weeks. If you must use dry food, Evo Cat and Kitten (pet supply stores) or Young Again 0 Carb (internet only) are available in the US. Pop over to Cat Info for some feline nutrition reading.
 
Hi again BJM - thanks for the reply. After seeing the 56 this morning, I set out the dry again hoping to boost her up. So, you definitely think we should remove it altogether? I'm happy to do so, but the low #s are scaring me. My sister suggested that I transition slowly, as anything abrupt may cause issues. That abruptness honestly could have been what sent her into DKA last month (just my assuming though). I don't have to feed her the high carb dry food, but I had set it out as she was coming out of the DKA per my vet's recommendations. He wanted her eating anything and everything she would and she does love it, so I put it out. For fear of her regressing, I hadn't taken it away until yesterday. But, maybe my approach was too much too fast - wonder if I should transition gradually?
 
Honestly, because she has had DKA (ketones twice now?) the top way to prevent this from happening again and save yourself a lot of $ at the vet is to test daily. The ability to monitor her sugars closely will show you patterns where you can intervene before it gets to a point where she is sick and where you have to spend thousands at the vet. There is a great spreadsheet tool that you can download from this site that helps you track BS.

Likely, the ketones right now are due to missing doses, so you want to try not to miss any more. You may want to transition her first to a medium carb (10%-15%) wet food so she doesn't go so low that you skip doses. Then gradually switch that for lower carb wet food. You will have to track bloodsugars more closely with food changes, and you may end up reducing insulin.

For right now, add a bunch of extra fluids to her food if possible. The ketones can be flushed out early if you increase fluids and maintain her insulin doses, if she is still eating fine.
 
Its a high carb dry (about 35% calories from carbohydrates) and is keeping her numbers elevated.

Maybe phase out the dry per Meya, and see how the numbers shake out.

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
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Meya14 said:
Honestly, because she has had DKA (ketones twice now?) the top way to prevent this from happening again and save yourself a lot of $ at the vet is to test daily. The ability to monitor her sugars closely will show you patterns where you can intervene before it gets to a point where she is sick and where you have to spend thousands at the vet. There is a great spreadsheet tool that you can download from this site that helps you track BS.

Likely, the ketones right now are due to missing doses, so you want to try not to miss any more. You may want to transition her first to a medium carb (10%-15%) wet food so she doesn't go so low that you skip doses. Then gradually switch that for lower carb wet food. You will have to track bloodsugars more closely with food changes, and you may end up reducing insulin.

For right now, add a bunch of extra fluids to her food if possible. The ketones can be flushed out early if you increase fluids and maintain her insulin doses, if she is still eating fine.
Click to expand...


Thanks Meya. No, she doesn't have ketones that I am aware of, but just that her glucose took s nose dive to 56. Just checked her 20 mins ago and she's at 186. She's eating the Purina DM wet food which seems to be highly recommended for diabetic cats, but also had been eating the above dry food too. Her food consumption has been elevated quite a bit lately and she's drinking a lot more again too.
 
BJM said:
Its a medium-high carb dry and is keeping her numbers elevated.
Maybe phase out the dry per Meya, and see how the numbers shake out.

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
Click to expand...

BJM yes. I promise I will work on that later today.

I was fazing - though maybe too drastically - the dry food when she plummeted to 56 earlier this AM. Still haven't given her insulin yet ad suggested above.
 
If you haven't given insulin yet, and you are seeing symptoms (excessive urination), ditch the dry since she is eating a canned food OK. Test her today and tomorrow to see how the numbers go - before feeding, about 2 hours after eating (probably food spike), and then 2 hours after that (to see if pancreas brought it down).

And no, prescription food for diabetics isn't really any better than Fancy Feast Classic pates. It just has better marketing to vets.

A test of 56 without insulin on board is terrific!
 
In that case (no current ketones) she's probably been running high and so you're seeing the general symptoms of diabetes (increased hunger, thirst, excessive urination). I agree, you can ditch the dry, and monitor her sugars carefully until they stabilize.
 
The 56 is a great pre-shot number and definitely means no shot for Chloe this morning so you did the right thing there. :) And while it's important that she gets insulin because of her recent DKA, you can only deal with the number you've got at the time and this morning that meant your only safe option was to skip a dose. I think that is telling you that getting the dry food out of her diet is most likely going to reduce her insulin needs - maybe even to the point of her going OTJ over time. And while it's important that she gets insulin because of her recent DKA, you can only deal with the number you've got at the time and this morning that meant your only safe option was to skip a dose. But because she's on insulin, as Meya said, testing her daily is going to be really important to make sure she's safe while you transition her to wet food as it sounds as though that alone is going to bring her numbers down significantly.

If you can gradually get rid of the dry food, possibly even switch her wet food to one of the cheaper options (Friskies or Fancy Feast pate varieties) and test her daily to make sure she's not dropping low, you shouldn't need to go back to the vet at this point especially if you can test for ketones as well. :)
 
I'm working on updating the chart. But checked glucose throughout the day yesterday and in the afternoon when she went to 310, I gave her a shot (3/4 unit) of insulin. Still eating a lot, giving mostly wet food with a few crumbles of the dry (so she doesn't have a belly ache) and as of 7:15am she was at 277 before I fed her. Gave her 1 unit again and had to leave for several hours as of 11am. She still had food and I didn't check her before leaving (glucose) and when I came home at 3pmEST (just 20 mins ag0), I saw she had thrown up all over the place and her food was gone. I'm cleaning that up now (Spot Bots are amazing) and checked her glucose before more food (she's eating like a horse and drinking as much as one again) and it was 37. I thought it was a fluke and tested again immediately and it was 36. I administered 1.5mg of karo and gave her wet food (the Purina DM). I will add this to the chart and see if I can share it here. I don't know how she can go nearly 250 points from one direction to the other in a matter of several hours. I have NOOOOOO idea what is causing this? I'm so scared of another DKA episode!!!!!!
 
I will also start testing for ketones ASAP. Feeling quite overwhelmed again. She's got a great attitude and is playful, cleaning herself, and normal Chloe self, but the eating and water intake is really really excessive again.
 
manxcat419 said:
The 56 is a great pre-shot number and definitely means no shot for Chloe this morning so you did the right thing there. :) And while it's important that she gets insulin because of her recent DKA, you can only deal with the number you've got at the time and this morning that meant your only safe option was to skip a dose. I think that is telling you that getting the dry food out of her diet is most likely going to reduce her insulin needs - maybe even to the point of her going OTJ over time. And while it's important that she gets insulin because of her recent DKA, you can only deal with the number you've got at the time and this morning that meant your only safe option was to skip a dose. But because she's on insulin, as Meya said, testing her daily is going to be really important to make sure she's safe while you transition her to wet food as it sounds as though that alone is going to bring her numbers down significantly.

If you can gradually get rid of the dry food, possibly even switch her wet food to one of the cheaper options (Friskies or Fancy Feast pate varieties) and test her daily to make sure she's not dropping low, you shouldn't need to go back to the vet at this point especially if you can test for ketones as well. :)
Click to expand...

Manxcat - OTJ? Isn't 56 and now today's 37/36 extremely low though?? And then after her 56 yesterday, she shot up into the 300's. Now granted, I gave her karo for fear of her getting into some diabetic coma. I just gave her some now too for fear of the same.

Do you think it's ok to just withhold the dry food cold turkey? The wet is a diabetic food - Purina DM. I've heard great things and while it is EXPENSIVE, it's worth it. I also know she'll eat the Friskies Salmon Pate which is low carb too.

This is her now. She seems happy... being extremely rotten laying on Mommy's crafty things! :)
 

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I, too, would have intervened upon getting a number below 50 mg/dL on a human glucometer or below 68 mg/dL on a pet glucometer. And as noted, that earns a reduction in dose.
See my signature link Glucometer Notes for some feline-specific reference ranges using various meter types.

The spreadsheet is coming up great. If you have any past numbers and can fill in any prior tests, that'll help us see any patterns.

Ketones result as a by-product from fat breakdown for calories. Generally, you need lack of insulin, infection, and high glucose levels for fat breakdown to start happening. Usually, 1 day of elevated glucose isn't going to do it, although each cat is different.

As long as she is OK eating canned food, I would drop the dry and monitor her glucose to see if it alters. ETA: IF you aren't giving any insulin, there is no risk she'll hypo.
 
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The 56 is fine - it's anything below 50 that we want to treat to bring them back up. However, although I did once shoot a dose with a reading of 57, that came from knowing 100% that it was safe for me to do that and that I could handle any low number that it caused, so skipping was absolutely the right thing to do.

The 37/36 on the other hand is very low. You do definitely want to treat that with karo and keep monitoring to make sure she comes back up and stays up! Unfortunately, I'm not going to be here this afternoon - I'm pretty much on my way out for a few hours now - but I'm sure there are people around who can help you keep an eye on those numbers.

I wouldn't take the dry food away cold turkey, especially when she's dropping low...removing that could very well make her go even lower so I'd phase it out gradually at this point. The Purina DM isn't a bad food (as far as I know), but it also isn't necessary to buy anything more expensive than the Friskies or Fancy Feast.

What is is with cats and covering crafty things with their fur? My 2 do that as well - and have done since they were kittens. It's like a magnet for them - the craft stuff comes out and they have to sleep on it! :P Love your picture though - she looks so happy. :)

Oh, and OTJ is Off The Juice (also known as diet controlled or in remission).
 
BJM said:
I would have intervened upon getting a number below 50 mg/dL on a human glucometer or below 68 mg/dL on a pet glucometer. And as noted, that earns a reduction in dose.
See my signature link Glucometer Notes for some feline-specific reference ranges using various meter types.

The spreadsheet is coming up great. If you have any past numbers and can fill in any prior tests, that'll help us see any patterns.

Ketones result as a by-product from fat breakdown for calories. Generally, you need lack of insulin, infection, and high glucose levels for fat breakdown to start happening. Usually, 1 day of elevated glucose isn't going to do it, although each cat is different.

As long as she is OK eating canned food, I would drop the dry and monitor her glucose to see if it alters. ETA: IF you aren't giving any insulin, there is no risk she'll hypo.
Click to expand...

BJM - I wasn't home to know that she had dropped that low. I checked her immediately upon coming home, but I can't be here 24/7 to watch her. I can fill in the sheet some more, but it will be from approximately a month ago. I didn't notice any change in her until a few days ago. I only gave her glucose yesterday afternoon when she shot above the 300's and this morning when she was in the 270's.
 
I'm confused - who got the test when she was that low, then?

Never mind - you got that when you got home, and gave Karo, which was good.

She's really taking you for a ride right now.
 
manxcat419 said:
The 56 is fine - it's anything below 50 that we want to treat to bring them back up. However, although I did once shoot a dose with a reading of 57, that came from knowing 100% that it was safe for me to do that and that I could handle any low number that it caused, so skipping was absolutely the right thing to do.

The 37/36 on the other hand is very low. You do definitely want to treat that with karo and keep monitoring to make sure she comes back up and stays up! Unfortunately, I'm not going to be here this afternoon - I'm pretty much on my way out for a few hours now - but I'm sure there are people around who can help you keep an eye on those numbers.

I wouldn't take the dry food away cold turkey, especially when she's dropping low...removing that could very well make her go even lower so I'd phase it out gradually at this point. The Purina DM isn't a bad food (as far as I know), but it also isn't necessary to buy anything more expensive than the Friskies or Fancy Feast.

What is is with cats and covering crafty things with their fur? My 2 do that as well - and have done since they were kittens. It's like a magnet for them - the craft stuff comes out and they have to sleep on it! :p Love your picture though - she looks so happy. :)

Oh, and OTJ is Off The Juice (also known as diet controlled or in remission).
Click to expand...


Manxcat - I understand! I was out earlier at an airport and couldn't be home - we all have lives, so please, your thoughtfulness is noted and appreciated.

Ok, so I will incorporate some of the dry and taper off. I mean, I'm giving her less than 1/4 cup now that this has popped up, but did take it away due to other suggestions. I'm SO confused! lol I think I will give her a few small pieces here and there, but ideally, I'd like for her to be on the wet. The problem is when we leave for hours and her wet food gets gross. I don't want to give her secondary problems, so the dry is there to keep her balanced. I will need to look into a low carb dry though so that if we are gone all day, she can eat ok. I don't think it's a good idea for us to leave her at home overnight anymore. I think she'll have to be boarded unless she gets OTJ as you say! ;)

I know, she climbs in the Christmas decor, or my husbands suitcase, and even on our good clothes. She never bothers the old things, lol!!!
 
BJM said:
I'm confused - who got the test when she was that low, then?
Click to expand...

I took the test, but like I mentioned above, she was at 277 this AM. I gave her 1 unit and food and when I came back the food was gone and her glucose was 37. That was just in a matter of 7 hours. :(
 
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback without having to go look in all your past posts.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name,
cat's name,
date of Dx (diagnosis)
insulin
meter
general location
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
 
BJM said:
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback without having to go look in all your past posts.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name,
cat's name,
date of Dx (diagnosis)
insulin
meter
general location
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
Click to expand...


Is that date of diabetes diagnosis? Hmm... I'd have to dig around for that. It's been about 2 years though.
 
Approximate is fine - its more about whether it has been going on for more than a year (long term vs short term)
 
I always, always go for safety above giving the shot regardless as do most people here - look at how many shots Rosa missed in her last 2 or 3 weeks because I had to be out for the day and she wouldn't let my husband test her. Sure, I didn't like doing it - but it was the only safe thing to do, and in the end it didn't cause her any real problems. There's nothing you can do about the times you can't be home - you have to have a life yourself (and even if you chose not to, there would be things you HAD to do anyway). And there's no way you could predict a dive like she pulled today - a number in the higher 200s should have been completely safe to shoot...Chloe just obviously had other ideas this time!! I do think it's likely that Chloe is trying for another reduction already, so with that and reducing the dry food, the only thing you can do is play it safe - if that means skipping an occasional shot then so be it. Though I agree on not leaving her alone overnight while she's tending to run low numbers like that. If she'll eat the low carb dry, that could be a good choice for now - especially in the warmer weather, I've noticed the wet food getting a bit icky looking by the end of the day (not that it seems to bother the cats, but I've been trying to replace it slightly more often than every 12 hours just in case).

And agreed on the climbing in and onto things - if we're trying to pack for a trip, I can guarantee there'll be at least one cat in the suitcase on top of the clean clothes we just packed within seconds! If only they'd go for the old stuff instead. ;)

I'll check back on this thread when I get home later to make sure you're doing OK and that you've got any help you need. :)
 
Karo wears off pretty quickly. If you're past nadir, she'll start gently climbing as the Lantus wears off.
 
What is nadir? yeah, I'm sure it is the karo buzz. ;) It wore off quickly during DKA, but if she does what she did yesterday, she'll climb into the 300's and then I'll give her a shot. I might only go for 1/2-3/4 unit this time.
 
Nadir is the lowest glucose post-shot. It is used to evaluate the dose. For Lantus, the nadir period is roughly between +5 to +7 hours after insulin is given. It isn't a set time, just a general period. Testing then allows you to see if the dose needs adjusting.
We have 2 protocols for using Lantus
Tight Regulation
Start Low, Go Slow
Check them out and see what may work best for you.

Also, when you intervene for low numbers, it doesn't take a lot. Just 1-2 teaspoons of gravy from something like Fancy Feast Gravy Lovers can help bring up the numbers without over doing it.
 
Thanks Manxcat as always.

This is right now... You'd never know she was so low! She wasn't like this at all during DKA. It just makes me smile!!
 

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She's at 203 right now. Still eating, though sleeping a lot the last few hours. Should I give insulin? Went from 37 four hours ago to 101 two hours ago and just moments ago is at 203.
 
If you include the reduction of 0.25 units off the dose for going so low, yes. She is rising pretty fast, so she may be starting to bounce. Compensatory hormones release stored glucose (glycogen) when the glucose drops suddenly or to an unfamiliar number. This raises the blood glucose for up to 3 days, which you just have to wait out.
 
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Ok, so she was getting 3/4-1 unit, so I should give 1/2- 3/4? It's so crazy - prior to DKA she was getting 3 units twice a day! Ok, so the bounce might be temporary? I'm still trying to determine if this drastic up and down is serious or even what to make of it! It seems odd to me, but obviously I have a lot to learn still. :)
 
What did you shoot today? Drop 0.25 off of that. Aim to be as consistent in possible in the dosing.
Bounces are temporary and clear within about 3 days.
 
Ok, I'll go for 3/4 this evening. And when should I watch for her to drop again? Do I need to get up throughout the night to check her glucose you think? It's 7:45pm now.
 
With Lantus, snagging a +2 may give you a clue whether or not she is going to dive down again. If it greatly lower than the pre-shot, you'll need to monitor some overnight, or abort the cycle by feeding high carb food so you can sleep.
 
She looks so happy in that pic. :) That's so lovely to see! :) I remember how great it was to see Rosa get back to normal after obviously feeling so ill for a while - it's just the greatest feeling in the world! :D

I definitely agree on getting the +2 reading when you can - we can often get a good idea of where she's likely to go over the cycle from that so it gives you a heads up if you maybe need to leave her with some medium or high carb food if you have to go out for a while. :) If you can post her pre-shot and +2 numbers tonight, I'll look in and help you work out whether she needs testing again later or if she's likely to be safe to be left overnight.
 
Ok, her last pre-shot test was at 7:15, which was 203, then I had someone drop by the house, so I didn't get her insulin of 3/4 given until 8pm. I just tested her now and she's at 297, 2 hours post shot.

And thanks again Manxcat!
 
That's fine - usually if the +2 is higher than the preshot, that means it should be a fairly quiet cycle (she might even bounce from the low numbers earlier today). A test just before bed never hurts just so you can sleep through knowing she's not dropping too fast at that point, but I don't expect her to do anything too alarming tonight based on that +2 number. :)
 
Whew, ok! I am happy to hear that. I probably will head to bed by midnight which will be +4, so that should tell me too. So, I guess the big question is what do I do in the morning? If she's super low, or super high, what would you guys recommend? She will be due for her insulin (if we go back to the every 12 hours) at 8am EST which is 9 hours from now.
 
If you get a +4 and she's still good, then you're definitely good to get some sleep. :) It's always nice when they have a night where they run a bit higher so you don't have to set alarms and get up a couple of times!

I'm not going to be around for your AM shot time as that's only 5am here. However, given that she might be bouncing, I wouldn't be too surprised if you see a higher number in the morning than you've been seeing recently. If that happens, you should go ahead with the reduced dose...you don't want to give her the same dose that dropped her low today and she definitely earned herself a reduction!

If she's really low, then I hope someone will be online to help you decide what to do based on how low she is at the time. You do, of course, have the option of skipping or reducing the dose further than the 0.25 reduction she earned as a one-off reduction to keep her safe if you get a number you're not comfortable giving the full dose at. Some cats can clear bounces in just a few hours as they get more used to being in normal numbers so it's possible you might get a fairly normal number from her in the morning (which would make it much easier for you to decide what to do as that way she can have her dose based on the reduction she earned today).
 
Thanks for the info again Manxcat. Do you think it's possible (totally reaching for the stars of hope right now), that she could be getting used to the wet food and not needing as much insulin? I'm not sure why she'd have these extreme high 300's and then lows in the 30's and 50's, but again, I have a lot to learn. I'm hoping that someday she can be OTJ as you put it (I totally love that btw!) and be free of this burden. I think I'll get some of that Friskies Salmon Pate too so I can make my $44 of 24 cans last longer. lol

And bouncing is when she goes extremely high from being low, correct? (Just making 100% sure I have my terminology correct). What numbers are ok to give insulin? 200 and above? Or 150+? Or? I'm not even sure what a normal cat glucose level is. I've read so many different numbers on websites, but I know that whenever they did her blood work nearly 2 years ago, it was elevated enough for them to know she was diabetic. :(

Thanks again!!! You're so helpful! :)
 
Yes, bouncing is going extremely high after going much lower than normal for that cat, from dropping very quickly, or both.

See my signature link Glucometer Notes for feline-specific reference ranges using a variety of glucometer types.
 
It might be that she's dropping even into the low 100s or upper double digit numbers and bouncing from that - cats that have been running high can bounce even from numbers in the 200s, though Chloe is better regulated than that at this point for sure. Then, if the bounce breaks, she could drop quickly again. It is, of course, also possible that the combination of diet and regular insulin is reducing her insulin needs. That's a perfectly reasonable hope to have at this point. :) And yes, at that price for 24 cans of food, I'd add in some of the Friskies as well - I pay about $15 for 32 cans of Friskies pate at Walmart!!

You have bouncing right. :) We usually give 200 as the no-shot number for a newly diagnosed diabetic, but that does reduce with Lantus as you get more experienced and have more data on what she tends to do with the insulin. Eventually, most people giving Lantus to their cats will shoot anything above 50, but that takes time and data. And the first time you shoot a low, or low-ish number we would always want there to be someone experienced who can stick around to help you if Chloe drops low. You might want to think about 150 as a no-shot number (or at least the number you ask for help) with Chloe as you've already handled some low numbers so you do have a good idea of what to do with them.

Normal cat glucose levels, generally, are between 40 and 120 on a human glucometer. BJM's document has a lot more information on that, but if you're just looking for quick numbers to refer to those are around what we'd consider normal. We don't like our kitties on insulin to go below 50 for any length of time as there really needs to be some sort of safety net to catch them before they go way too low - it can be difficult for them to bring their own numbers back up when they have added insulin in their system pushing them right back down again.
 
that was a great pic. she looks content.

some of us have made foodcicles for longer periods.... some kitties will lick it when frozen... but it keeps the food fresher longer if you are in a
warm climate.
the other trick is to add water, make the food soupy, that will also keep the food from getting dried out and undesirable.
 
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