? To Shoot or Not to Shoot.

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Phil (my boyfriend) works just across the road and will be testing again at +6.
Wow! Well-trained boyfriend! (Must be love..... ;) )

Nikki, it's clear that another dose reduction is in order here (it's definitely an improving picture for your boy!). But the next pre-shot number you see might be inflated by any higher carb food that you've given (especially if you've given dry food...?) so don't be thrown by that.
If it were my kitty I'd be thinking of dropping back to one unit or even halving the dose (ie, between .75 to 1 unit) to see how that works out. But I'm going to tag BJ @BJM to see what her suggestions are regarding dosage.
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Thanks for the update. 7.2 is good for now.

It's fantastic news that Phil works so close to home and that he's helping you with the testing. (Not all members here are that lucky! :) )

I'd suggest that if he drops back again at +6 to maybe feed some medium carb and check again in 30-60 minutes depending on how low Melty's numbers are. I think that if he is still rising at +6 maybe give him some of his regular lower carb food - enough to keep him going but not to completely fill him up - and check his BG again an hour later.

IMPORTANT: I strongly recommend you reduce the dose tonight even if he's a bit higher on the PMPS test because he has had some high carb food. Once that wears off you could find Melty in low numbers again later on. Cats can really race down the dosing scale with the changeover to lower carb wet food and Melty is showing every sign of doing so.
 
Linda and Eliz,

Are you OK to keep an eye on Nikki and Phil from here on in? I'm really struggling at this end with the sleep deprivation.
 
@Critter Mom

I can't thank you enough for all of the advice. I will definitely pass the instructions along to Phil as well to make sure we are doing what is best for Melty.
Please don't deprive yourself of sleep any longer! I think he is on the rise, and we will be careful to monitor to make sure.

Thank you again. :)
 
Great news about Melty's BG! Not so good with the boss! My only concern would be whether some of that number is still from the corn syrup. Let us know what the next reading is @+6! Fingers crossed Melty'll be over the hump soon!

@Critter Mom I will keep monitoring until they are over the hump. Thanks so much for your help and the education I am getting from your experience!
 
@MeltyCat - Nikki, only too glad to do something to help. You did a great job today. :)

@MrWorfMen's Mom - Linda, thanks for taking over. If you get stuck and there's no-one else around, post a request for help on the Lantus board with a link to Nikki's thread.


Blessings to beans and scritches to kittehs.




Moggers
 
Just heard back from Phil. He has apparently spiked to 14.7 (say he tested twice to be sure). Not ideal...but better than another low dip.

I can't thank everyone enough for the support through this. It really is a HUGE comfort.
 
Thanks for letting me know. It's likely the high carb food clicking in at this point. Not to worry. It happens.

You did a great job today! :DI'll check in later this evening to see how Melty is doing.
 
Hi Nikki,

Just checking in. Glad to see that Melty's numbers went to safer levels. I'm assuming that all is OK now. Yourself and Phil did a great job helping Melty get through the low. :)

@MrWorfMen's Mom - Thanks for helping Nikki. :)
 
@Brashworks , @Critter Mom, @MrWorfMen's Mom , @Elizabeth and Bertie, and @BJM

Thank you all so much for the support this morning :)

Melty is back up to 22.5, but I'm not surprised at all. I have him all kinds of treats and food to try to keep his level up, and left him dry food to munch on all day (since no one was consistently available).

I'm hoping to draw upon your knowledge once more today.

I spoke with my vet and he said it would be fine to skip Melty's insulin completely tonight if I needed to.
What do you wonderful people think?
 
Hey Nikki - wish I could have been more there for you but you were in far more experienced hands.

When I had that situation with Genghis she cranked up to a 26 I think. She had been on 2.0u prescribed from the vet and I gave her a reduced dose and continued with that 1.0u until now. Sort of the same situation but Melty's numbers might be that much more pronounced because of his more drastic food change.

That said, Genghis never fell so hard and fast as Melty did today - well managed and must have given you quite a fright but you and Phil did great!!

I'm not sure if you can monitor him tonight as much as you did today - maybe a token dose but I am really really not comfortable making any definitive suggestions.

I hope someone with more experience can guide you!!
 
@Brashworks I appreciate any help I can get, and your support has been really lovely :)

I thought 1.5u this morning was a safe dose, just a little slice of humble pie to let me know that my dosing instincts aren't quite there....yet!
Phil is heaven sent on most days! I'd better put a ring on it soon hahaha

I can monitor FOR SURE until +4 tonight, and of course am always willing to stay of late if the numbers bid me to do so, hah.

:)
 
Huh....BG went down to 20 all by itself, about 30 minutes after having a meal of wet food. I think I'm going to skip dosing tonight.

Please feel free (anyone) to chime in if you think that's a bad idea!
 
Hi Nikki,

First off kudos to you and Phil for your efforts today! :D It's tough work! I'm a little tired from the anxiety of "looking in from the outside" and can only imagine what you feel like. Glad to be of any help although I'm grateful Aine and Elizabeth were there to help due to my lack of experience. It was a learning experience for me too!

I don't think I'd make a decision based only on that 20 now. That is within meter variance (+-20%) allowance so it's virtually the same as the 22.5 from before. If he drops more, then reconsider. It's not always the best answer to skip the dose rather than reducing.

If Melty were my guy, given my conservative nature and what I perceive as either a wonderful response to the diet change or Melty's body trying to go OTJ or both, I'd give no more than the 0.75u tonight as suggested by Elizabeth and Bertie. Even 0.5u if you are more comfortable with that. Or you can skip, it but he will probably be high tomorrow.

Melty was going lower at night anyway and is going lower every day now. Today has been tough on all of you so I'd suggest taking a middle of the road approach. You'll still need to monitor for that first few hours after the shot to see where Melty is headed and how fast but hopefully the reduced dose will get him surfing in some nice numbers instead of diving and you can get some much needed shut eye. :bighug:
 
Hi Nikki,

Glad to hear that Melty's well and truly out of the danger zone. No surprise about the number tonight after all the contraband earlier. ;) That said, he hasn't gone crazy high. Nice going, Melty!

One thing I do know is that Melty needs a dose reduction going forward. That 1.5 is way too much now that he's eating more low carb wet food.

I'm naturally extremely cautious so I would be inclined to skip and get some rest. Other members may recommend a conservative Big Chicken Shot. (I wouldn't even attempt that unless I knew I could monitor all night should the need arise.) I'd suggest waiting for opinions from other members.

Based on my experience of transitioning Saoirse to wet food, I'd be inclined to post for advice at each preshot over the next few days as the dose requirement may need reduction on every cycle. Even if Melty's preshot is high in the morning I'd still urge caution: it may take a little while for the carbs from today's dry food to work out of his system. Once they're gone, he could go low unexpectedly if you're just basing dosing decisions on preshot readings. Will Phil be able to get mid-cycle tests over the next few daytime cycles? With such a strong response on such a low dose, to keep Melty safe you really need to know what his nadirs are because Caninsulin can still produce fairly sharp drops even at tiny doses. (Maybe have a look at the early part of Saoirse's spreadsheet from last year to see a real-world example - the food transition started on 10.07.14.)
 
Nikki,
Aine makes some good points and has experience with Caninsulin so on reconsideration, this seem like one of those times when skipping the shot may be the right move. With the Lantus I use, you don't generally get those sharp drops so token doses are less of a potential problem.
 
Indeed, Linda. Another difference between the two is that skipping a dose on Lantus or Lev can muck up the depot. Skipping a dose of an in-out insulin doesn't lose the same ground. Possibly the most important thing to consider when choosing whether or not to skip is whether a kitty is ketone-prone. If yes, then skipping carries a greater risk.
 
@Critter Mom and @MrWorfMen's Mom,

All suggestions greatly appreciated :)

I did end up skipping, simply because both Melty and I need a break from all the testing.
I just checked him again at +1 (from no shot at all) and he is at 17.1 now.

The drop isn't really surprising at all, but will make sure to check him before bed to make sure his body isn't somehow phantom dosing itself. He's also eating more and more of the wet food meals, and just free feeding on the dry a little bit throughout the day/overnight.

I definitely agree that a dose reduction is in order, as did the vet when I spoke to him this morning.

I will post his pre-shot numbers for better advice before shooting. Linda would have saved me this morning, had I waited until she posted and not just gone full steam ahead.

I asked Phil today if he'd be willing to do +3 and +5 readings for me the next few days. He has no problem doing it (I'll even leave him a chart with food options incase the numbers are lower than expected). Would love some suggestions for working that out. Like...>6, give x amount of wet food and so forth.

On the subject of Ketones, I did order some strips so I can spot-test, but they haven't arrived yet. So I'm unsure if that is a factor or not at this point.

I just want to say thanks again for all of the kind words. Despite being scary and stressful, today has been a huge learning experience, and given me more confidence about dealing with his low swings.
 
@Critter Mom ......Wonderful info I shall add to my "depot". Thank you Aine for sharing and for staying with Nikki today. I'm at that point where I don't want to leave anyone "stranded" but having never dealt with Caninsulin or low numbers yet for that matter (DARN!) I am so grateful you saw the post and came to the rescue. It's been a great learning experience for me! :bighug:
 
OH! I also swapped out the pumpkin in his wet food for FortiFlora tonight.
Just incase that has any effect on anything.
 
Nikki,

The trick to using food to steer the numbers if they start dropping is to feed small amounts at a time to avoid ending up with Melty so full he won't eat at all. I've seen suggestions of giving a teaspoon or 2 and then retesting after 20-30 minutes. Repeat as needed. I don't know of any reference docs that can tell you how much at what number. I think it becomes a judgment call based on ongoing testing if numbers are dropping and what your testing availability is.

If Melty is dropping sharply then higher carb food would be appropriate. If there is a slow drop, low carb might do the trick. If he dives corn syrup or honey is a quick sugar boost but won't last long so it needs to be accompanied by some food. Canned food will get into his system faster than dry so while dry can be left for him to nibble on, it also will fill him up faster so it's not ideal and especially not when his numbers are dropping as he may become reluctant to eat faster acting canned food.

Not exactly what you were looking for I'm sure but I don't think anyone can give you a "formula". Hope that helps a bit.:)
 
I did end up skipping, simply because both Melty and I need a break from all the testing.
I just checked him again at +1 (from no shot at all) and he is at 17.1 now.
Looks like skipping that shot was the right call, Nikki. Well done.
Melty was already starting to drop by the end of the cycle (and it's generally not a good idea to shoot on a falling number.)

Very encouraging that he has dropped without insulin. (Those carbs should be wearing off now, but hopefully his little pancreas is weighing in also).
It'll be interesting to see how Melty's numbers are by the time of the next shot....

Ironically, it can be challenging when a kitty's numbers start to improve! You can find yourself back-peddling on the dose fast; sometimes cycle by cycle. Fortunately, one of Caninsulin's good points is that its shorter duration makes it easier to change doses as needed. :cat:

You've worked very hard, Nikki. I do hope you managed to get some good rest afterwards. You deserve it!
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The trick to using food to steer the numbers if they start dropping is to feed small amounts at a time to avoid ending up with Melty so full he won't eat at all. I've seen suggestions of giving a teaspoon or 2 and then retesting after 20-30 minutes. Repeat as needed. I don't know of any reference docs that can tell you how much at what number. I think it becomes a judgment call based on ongoing testing if numbers are dropping and what your testing availability is.

If Melty is dropping sharply then higher carb food would be appropriate. If there is a slow drop, low carb might do the trick. If he dives corn syrup or honey is a quick sugar boost but won't last long so it needs to be accompanied by some food.
Sounds like a good summary, Linda. :)

It really does depend on the situation. Sometimes low carb food is all that's needed to 'steer the drop'. Sometimes higher carb food is needed.
The gravy from higher carb food is particularly useful as it adds carbs without bulk. Syrup/karo acts really fast, but doesn't last as long as food. So, you may often see the advice to give a little syrup and a little food.

And as Linda says, it also depends on your testing availability: If a caregiver isn't going to be around to test much then just getting carbs on board to raise the numbers (and 'abort the cycle') may sometimes be the safest option. Some folks would use dry food if they need a longer acting carb source (but there was one memorable instance here where a member used potatoes because that was all she had available! (It worked well as I recall...))

We often tell caregivers to try not to let the cat drop below 50/2.8 (on a human meter) in order to give some buffer of safety. But for some cats (and in some situations) it may be better to try to keep them at a higher level than that, especially if they're using a shorter acting insulin and the cat is prone to dropping fast. (There have been caregivers who've tried to keep their kitties BG above 90/5 for example.) When numbers are dropping fast things can change very quickly.
A brief story of Bertie's first hypo:
I'd given a shot at a BG of 200/11. Two hours later he was 47/2.6. It was obvious I needed to take some action to stop the numbers dropping further, although Bertie looked completely normal. In the time it took me to run downstairs and get syrup everything had changed though. His eyes were like black saucers. He was staggering and falling over, and kept swatting at the air in front of him as if he could see something that wasn't there. And he was aggressive; so it was really hard to get the syrup into him. I couldn't believe that the situation could change so fast...
And I recall a member here (a couple of years ago) whose cat was just sitting with her watching TV. He then jumped down from the couch, keeled over on the floor and had a full hypoglycemic seizure.

Some cats show hypo symptoms early on (increased/ravenous hunger for instance). Some cats show symptoms when the hypo is moderately advanced (like Bertie does). And some cats do not show symptoms until the hypo is severe (as in the seizure example above). 'Absence of symptoms does not mean absence of hypo'.

For more advice on handling low numbers do see the FDMB hypo document linked to below for general information/guidelines. It is an extremely helpful document; well worth reading and then printing out and keeping with your hypo kit (especially for times when there is nobody online to help you with advice tailored to your particular situation) :
How to treat HYPOS - THEY CAN KILL! Print this Out!!

(Sorry, I hadn't meant to go off into my usual 'hypo spiel'. But I've not said it for a while so it probably doesn't hurt to give it a little airing. :rolleyes: )
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Every bit of information is useful and you ladies have been so wonderful. Melty and are are indebted to you. :)

I woke up a bit late this morning. So I've just tested him (while he was eating his yet food) and he is at 19.0.

He tends to eat his leftover dry food really early in the morning. So the number may be a bit inflated.

My gut says only to shoot .5u, but I'm hoping someone can assist :)
 
Hey Nikki,

I'm late to the party but for what it's worth, 0.5u sounds reasonable to me as long as Phil is able to test/feed if Melty starts dropping too much. He's not THAT high considering what he took in yesterday.

I know Phil was going to check him at +3 and +6 and you probably took another reading before leaving for work. If so what was that reading?

Looking forward, can you measure .25u on your syringes? I wouldn't be surprised if you are going to need to drop the dose back even more over the next few days.
 
Good Morning Linda,

Thanks for the response!
I did test him at almost +2 (am I that predictable? hah) and he was at 14.7, which is consistent with his more even days.

I am absolutely thrilled that his dose is dropping, but he is still peeing an awful lot. I've e-mailed the vet to ask if I should be testing for Ketones at this point. What do you think?
There's no weight loss, in fact, I think he's actually gained a little bit of weight, but it's something that I still want to be wary of.

Phil will be testing him at +3, and then again as needed. I might have to buy him a new video game or book as thanks. He has been really wonderful about helping.

I've instructed to give Melty a little bit of wet food (a moderate carb food), if he is below 7 at +3. Is that too cautious? Not cautious enough?
I'm not sure about .25? Sometimes I'm not even confident with my .50 readings...
 
Update: +3 reading popped up on my phone at 9:59 and is 12.3. Looks like we are having a nice even drop today. Phil will test again at +5.
 
I think if he is below 7 @ +3 I would go with the high carb food but just a few teaspoons. If he did get to 7, will Phil be able to stay and monitor to see if Melty is holding steady or continuing to drop? That is the main factor you need to consider.... your testing availabilty.

Melty has been throwing you some punches (albeit good but tough ones) so if he gets down to 7, I'd be intervening a little more aggressively to slow the drop and hopefully avoid another situation like yesterday.

Are you using U40 or U100 syringes? I know your insulin is U40 but some people use the U100 syringes so they can adjust doses easier. There is a conversion chart for doing this. :)
 
Cross post!

Beautiful! Whoo Hoo! Looks like your 0.5u was a great decision for today but that doesn't mean that Melty is going to continue needing that dose. I think you are now in a position of having to make the call as you go based on his numbers and your availability. I can only imagine how tough this is on you and Phil but you are a great team.:bighug: And yes I think a treat for Phil is in order. Sounds like a keeper to me! :D
I'll check back in to see how things are going @+5 (around noon).
 
Just checking in quickly to see how things are going. Looks like a much smoother ride today. :)

Nikki, bearing in mind that you skipped a dose last night Melty might have a stronger response on this evening's PM cycle. If he were mine I would not go above 0.5 IU. Indeed, if his PMPS is low I might think about lowering the dose further. As always, be sure to ask for support when PMPS comes around.

Going forward, should the need arise to microdose the Caninsulin using the conversion chart and U100 syringes, you need to get the 0.3ml U100 demi syringes. These have narrow barrels and half-unit markings, both of which make it a little easier to measure tiny amounts of insulin.
 
Can't edit post above (I have problems drafting posts using this forum's software for some reason :rolleyes:).

Just wanted to add that this evening's cycle has the potential to be affected by some 'carry over' from this morning's dose. Also, when some cats have their levels go down to the hypo threshold it can make them more sensitive to insulin. Just some things to be aware of. :)
 
I think we are up to the challenge of the dose reductions. Phil's boss has a diabetic cat, so if Phil needed to check in every 15 minutes (or stay for an hour), he'd have free reign. We are in an incredibly lucky situation for Melty. :)

I do use U40 syringes for his dosing, so doing .5 is even a bit sketchy. I suppose it's time to pick up some U100 syringes.
Does anyone have the conversion chart that they could link me to?

Good to see you Aine, thank you for the wonderful advise, as always. <3
I will definitely be posting his PMPS around 6:15-6:30 to give a little time for responses.
 
I will bookmark this and print out a copy for our fridge. Thanks again, Aine. :)

Combine (her sugar kitty) has been regulated for about 6-7 years now. Darilyn is a pro, and is even willing to catsit herself when we are away.
Melty and I couldn't be more lucky with our current support system, FDMB included.
 
@Brashworks Hi Melanie!! :)
Genghis' numbers look good, kudos to both of you.
Looks like your dosing instincts are pretty spot on for her.
I will bookmark those needles for later, but probably stop at the vet for convenience and time's sake.

I'm finding this place to be a WEALTH of knowledge, and a huge comfort.
It's quite heartwarming to have access to such a big group of great, like-minded people who are devoted to their sugar kitties.
 
Looks like your dosing instincts are pretty spot on for her.

Well, I had a lot of help from the folks here, just like you!

It's quite heartwarming to have access to such a big group of great, like-minded people who are devoted to their sugar kitties.

I could not agree more!

Lastly, if you want, we can work something out to combine our order and get free shipping from that site. I can order them and ship them to you for a lot less -- if you want to PM me an address you feel comfortable with we can work that out, just let me know! I plan on placing an order later this week - they do free shipping for orders over $150 or $9.00 flat rate under that and I know I can tag off my work Purolator account to ship for less than half that. $9.00 to me equals nearly 9 test strips or 15 cans of FF!!

PS Did anyone else here notice the "black cat" trend? I'm outnumbered and my black cat Jet isn't diabetic but his photo would certainly fit in better!
 
Nikki,

I somehow doubt the vet will have the syringes you need so I would at least call before making the trip there. If you can get to a Walmart, they have them at close to the same price. Those syringes come in several needle lengths so make sure to get the 8mm rather than the 6mm. I made that mistake once because they didn't have the 8's and it was harder to make sure I got/kept the needle in far enough so I now have almost a whole box of useless syringes. :banghead:
 
Hello Ladies!

@Brashworks - I will definitely PM you when I get home, and we can work out a way to possibly order together.
Any opportunity to save money without cutting corners for the kitty is a good one. :)

I also noticed the black cat trend! I have such a soft spot for black kitties, so love seeing everyone's pictures on here.

@Elizabeth and Bertie

Welllllll...his name is actually Junior.
However, when I started dating my boyfriend, his then three year old son called him "The melty cat" because he was rather fat and it looked like he was melting when he laid down.
I started using Melty as a nickname and it just stuck. He comes running when I call so I don't think he minds. ;)

Edited to Update: +5 reading was 11.2, so he is having a slow and steady day today!
 
Much smoother. And probably easier on his glucose regulation system. Really wondering what PMPS will be like.

I also noticed the black cat trend! I have such a soft spot for black kitties, so love seeing everyone's pictures on here

Me, too. It makes me so sad to think that people are so reluctant to adopt black rescue cats. They were always my first choice.

@Brashworks -

I propose that we grant Genghis honorary Black Cat Status. :)
 
IMG_8746.JPG Jet says, "Genghis has been endorsed by the Black Cat Authority"

This is my boy about 2 weeks after I got him from the rescue folks. He was part of a feral colony, full of ear mites but otherwise healthy. Still a bit skittish but getting there!

@Critter Mom LOL your endorsement rings far truer - we were doing this at the same time! I'm like you - they are my first choice and I don't understand why people have such a reluctance to adopt. :(
 
I was reading through the posts and I totally missed the discussion on "mix of insulins" yesterday - sorry - I wasn't ignoring the questions. Yes, Elizabeth was correct, I meant because it was made of two types, short and longer acting. Thank you both for your wisdom and knowledge. I am thankful for this thread as I have learned so much.

Curious as well to see Melty's PMPS #. Go Melty!!
 
@Critter Mom and @Brashworks

I am also very curious to see what his PMPS will be. I'll try to make sure I post it by 6:15 or 6:30 so I can get some advice before shooting.
BJM suggested giving dry food before the shot and then wet food after (which is the opposite of what I've been doing). Do you think that would make a difference?

I'm very thankful for this thread as well, it has been very informative and full of support from all of you wonderful people. If Melty could reach you I'm sure he'd give you all a boop of the nose ;)

My sister has black cats as well and insists they are good luck (contrary to popular belief).
 
The dry food would possibly cushion the drop and prepare Melty for onset of the amorphous part of the Caninsulin (first to kick in). The usual drill with Caninsulin/Vetsulin is to 'front load' the cycle with carbs and give less as the cycle progresses and the dose starts to lose strength. The crystalline part doesn't have as much welly.

I'm all for nose boops! :)

Saoirse has been lucky for me. She saved my life.
 
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