6/21 *curve day* Sampson+11 408. Will he go low today?

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Jenn

Jenn

Member Since 2015
The past couple days have been up and down as far as eating, not eating, and vomiting. It is all explained in the comments section of his spreadsheet as I'm not always able to post a thread each day. Even so, here is my last thread from 6/13 (last weekend) http://www.felinediabetes.com/FDMB/threads/6-13-sampson-amps-336-4-233-no-vomiting.139402/

Everything was going well until 6/19 PM (PMPS 455) when Sampson was a little more quiet than normal but not enough for me to be significantly concerned. Since he was doing so well back on the chicken chunks I offered him some organ and some bone. He has eaten bone before but this would be his first time eating straight organ. In the midst of it another cat got in his bowl and stole his bone. That night he had diarrhea.

The next day AMBG 408 he was not hungry at all and was very quiet. This is when I discovered the diarrhea. He didn't eat anything, would only drink the water I mix in. An hour and a half later the fiance gave him a piece of a rabbit nugget from Primal and he ate about half of it. (About half a normal meal). Had to be out for most of the day and I didn't give him any insulin. At around +11 I gave him some Vaseline in case it was hairballs and 5mg famotidine (he is 10 pounds) in case his stomach was upset. Also found more diarrhea in the litter box. (He was alone in the room.)
PMPS 355, gave 1u. Was hungry but wouldn't eat the rabbit he had the meal before but he did eat a chicken wing and beef heart. I wasn't measuring it out so I was just letting him eat until he was full. I have never fed him until he was full before. +3 215 and he vomited all of his food. Wanted to let his stomach settle from that. +6 139 and he had about half a meals worth of beef heart.

This morning AMPS 140. Gave 1u. Sampson was his old self again. Chirping for food, super hungry. He was so hungry he wouldn't sit still for his test. He ate all of his food, he was eating so fast I put it in his slow feeder bowl. He had pork, chicken, and beef heart chunks. No bone or organ. He has not vomited yet today.
+2 102 +4 48 +5 42

Why is his bg so low?? What do I do?
 
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Both, he has never, ever been this low before, never been below 150 until this weekend and norma numbers are 3-400s. How do I know when it is time to act. He is not doing anything abnormal at the moment.
 
Cats to not always go hypo just because they are in the 40s. For some cats these are normal numbers. He could be finally settling into this dose and getting over the vomiting and that made his numbers come down.

Did you see the procedure above for low numbers I posted? Do you have HC food and plenty of test strips? You'll need to keep testing every 20 to 30 minutes until he comes back up. Don't feed too much or he may not eat when you need him to.

Ask if you have questions.
 
He has also earned a reduction. Congrats on that. First breathe. He will be fine as you will guide his numbers with food. Post your results 20-30 minutes after he eats the he food. If you don't have he food give Karo or honey.
 
Right now let's get him up off that 42 - he needs some kind of carb, either gravy food or a bit of karo....oh, I see you just posted that you gave him gravy food...good!

Couple of reasons he may have gone this low:
* Sputtering pancreas releasing some natural insulin
* When he was feeling bad, his ph balance may have been off enough to not precipitate the last dose of Lantus well

As Tiff said, guide with food right now...BREATHE! Panic won't help anything, just upset you more. I remember our first low numbers tho', it's not easy to not panic is it? Another breath!
 
Ok feeding now. I'm worried about tomorrow when I leave the house for 12 hours. Or should I take him with me?
 
It's a good idea to update your subject line with each new number so people can quickly see where he is and help if needed.
 
Also texted the vet about it and told her you guys suggested lowering him. Problem is that she thinks he's still on 2u but really he's only on 1. We are at 66.
 
Jenn said:
Also texted the vet about it and told her you guys suggested lowering him. Problem is that she thinks he's still on 2u but really he's only on 1. We are at 66.
Click to expand...

Your vet will likely say reduce. He should. Now that you are up to the 60's I would not feed and check in 45- an hour. I've leaving now as well.
 
She said yes, we will need to lower him. She may be coming over today to bring me some furniture and so I can help her change a dog's bandage so I guess we will talk more about it then. (She's also my boss and since Sampson is technically owned by the shelter where I work I'm supposed to defer to her.)
 
Just checking to see how Sampson is doing. Have you tested yet? I have to leave soon and will be gone the rest of the afternoon.
 
+7.5 is 88. Glad you caught that in my sig! He was diagnosed 5/27, started insulin 6/9. We started suspecting it around 5/16, sent out bloodwork the following Monday 6/18, and it took a little over a week for it to come back for some reason, normally it takes just 48 hours or less.
 
Can't wait to hear what the vet says if you tell her what he is actually getting. Trying to figure out how to tell my vet as well. Shiloh was on 2.75 units two weeks ago, and is now on .75. My vet really wanted her around 150-160 (regulated), and not below 100. As you can see from Shiloh's SS, I'm not quite listening.
 
Yes! A diabetic dog we had was at like 72 and she said that was way too low! I'm not sure what she's expecting Sam to be at regulated. :$ I'm not telling her yet what I'm doing, I hope that one day we will be on the same page. If not, I'll just pass his spreadsheet and a link to this message board on to the adopters and hope they don't ask to speak to her.
 
Think I need to stay up with him or test him at +6 this evening? Or should we wait and see what the rest of the day holds?
 
I think you need a PMPS and see where he is. Some cats, like mine, will bounce after going lower than they are used to and will be high by then. Sometimes the bounce hits on the next cycle and other times the next day. If real high you can either shoot the current dose tonight, shoot through the bounce, or reduce tonight. The choice would be yours. If still under 200 at PMPS the depot may be in effect and you would need to reduce and get a +1 and +2 to see what is likely to happen later tonight.

So post the PMPS and ask what to do if not sure.
 
Been an exciting day for you and Sampson!! Your first drop under 50 is always stressful but you had good people helping you! The next time (and there will be a "next time") it'll be easier with a little less panic each time....that's why we're so crazy about home testing here...it keeps YOU in control of Sampson's BG instead of just "hoping" he'll be OK! Thank goodness you did a curve today!

If there's ANY way to start getting a midcycle on the AM cycle, it'll make it much easier to know what's going on as well as keeping him safer. I have to wonder if he might have gone low during the AM cycle on 6/17 too and when you got that 153 at PMPS, he was actually on the way up from an unseen low during the day....then he bounced (for 3 days which is normal) and last night broke the bounce and today you had the 42

If he'll eat the Primal, I'd just keep him on that. It's a good food and you won't have to worry about if he's getting enough organ/bone, etc. since it's a complete food.

Just a little tip for the future.....that +2 can be a lot like a crystal ball, so it's a great test to try to get! We have some loose "rules" here about the +2 test

If the +2 is lower than the Pre-shot (like it was today) that's your "early warning system" that kitty may be planning to make a move, so when you see that lower +2, those are definitely days you want to make sure to get more tests in later in the cycle. It's amazing how well this "rule" works

If the +2 is about the same as the Pre-shot, that usually means it's going to be a more "normal" cycle....with the BG gradually going down to nadir, then gradually going back up to the next Pre-shot

If the +2 is higher than the PS, that can indicate the beginning of a bounce....those are the cycles where you can usually take a break from poking (and when they happen at night, get some sleep!!)

Great job today with Sampson and hopefully he won't bounce too high tonight!
 
Sam is still doing well! Thank you all so very, very much! Updating his SS right now and will post with updated numbers. I did .75u (or at least what I thought might be .75u, will have some questions about that later.) and he ate all of his chunks very well. Unfortunately I can't keep him on the Primal as it is too expensive. I'm hoping to convince him to go back to eating the Blue ridge Beef grind as that was so much easier! My own cats are young and will eat anything and digest anything just fine so the mix works for them, but Sam is 6 years older than them and has been on crap food his entire life, I'm sure so I imagine this is why it is harder for him. Anyone have any thoughts on Slippery elm Bark? Someone on the raw feeding group suggested it, she used it for her sugar cat. I read one article that mentioned it should be used with caution in diabetics because of the complex sugars.
 
+8 207 +9 139 +10 269 +11 had to run to Wamart! :p
PMPS 296 and gave what I thought was .75u, picture of syringe. Tell me what you think. I can try to get my brother to do a +2 and +6 during the day as needed. He isn't home every day and I was hoping he would move out soon (lol) but that is a perk if he stays. Hopefully once we get a second car I will be able to shoot at 6 then leave the house at 8 in order to get to work. Then I could just bring him to work with me on the days he is low. Right now, I am out for 12 hours because of my fiance's work schedule and I have to sit at a friends house from 6:30 till I go to work at 8:30. She has 4 dogs and Sam HATES being in the carrier in a back room. So I can bring him in cases of emergencies but I would rather not put him through that if it absolutely isn't necessary.

As for the syringe. I found this thread (http://www.felinediabetes.com/FDMB/threads/to-measure-a-dose-consistently.34424/) explaining that consistency is more important than the actual dose (within reason). I am using different syringes than I was before, every other time it has been some off brand that we can order cheaply at the shelter, for this dose I used a ReliOn syringe because we had a whole box donated. (yay!) Hope this won't throw him too far off, I didn't realize there could be a difference in consistencies between each syringe. These syringes have shorter needles, that threw me off and I poked myself twice. lol. I've asked before but no one answered. Is it okay for me to pull back on the plunger once it is in his skin to make sure that it is actually in there? We do it for vaccines all the time, if the plunger goes back to place due to a vacuum effect you know you're sub q and not sub fur. That thread said I should get 10 drops from 1u but I only got 5, think maybe my drops were too big? I don't have a straight pin for comparison haha.
Syringe pics: https://drive.google.com/open?id=0B42FsUS4-dKVNkZscEp4VDhxb00&authuser=0
https://drive.google.com/open?id=0B42FsUS4-dKVX3hDUUFveUVrX0E&authuser=0
 
I didn't see that question about pulling the plunger back, and I haven't done it. But I can tell you that the instructions my vet gave me says to do that. Will try to attach.
 

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One thing you can do is shave a small spot until you get used to the "feel" of it. With such tiny needles, it doesn't feel like the vaccines do, but you'll get to the point where you can feel that tiny "pop" when it goes through the skin....but we all do furshots occasionally and they're not the end of the world. You just never shoot again when you give a furshot because there's no way to know how much actually got in!

The links above (to your syringe pics) are just taking me to "My Drive"....no pictures, but here's a picture of .75 for you
.75 unit dose.jpg
 
That's okay! It wasn't on this condo, was on another one I posted but I don't think anyone saw it. I'm dying to know because it helps me prevent fur shots.
 
It's best if you can keep using the same syringes. The number of drops in a dose can differ with each syringe. I know it's hard to measure 0.75 units. It's as best you can get in between 1 and 0.5. Your picture looks pretty good to me. I use calipers to keep Furball's dose consistent. I've never heard of pulling the plunger back, but I don't see how it could hurt. There are people here who use Slippery Elm Bark for their kitties. You should put SEB? in the subject line to get their attention.
 
I will stick with these syringes from now on since I can get them OTC at Walmart anyway, right? I hadn't heard of pulling back on the plunger suggested so I was afraid there was some secret reason not to haha.
 
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