Help with Elmo Hypo

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Beth 73 said:
PMPS at +11...156...... feeding in 15 minutes....insulin 30 minutes after that
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Two choices: 1. more brave: give 0.25 u; 2. less brave: no shot. :)
He'll probably be more insulin sensitive after today's hypo so 0.25 u might have a bigger effect than it normally would.
 
Kris & Teasel said:
Two choices: 1. more brave: give 0.25 u; 2. less brave: no shot. :)
He'll probably be more insulin sensitive after today's hypo so 0.25 u might have a bigger effect than it normally would.
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I agree with Kris's take on the number. A lot of that is going to depend if you are able to monitor the next 4 or 5 hours after the shot. If you can you could give the 1/4 unit reduced dose Elmo earned today. If you don't feel you are up for a potential pajama party, then a skip would be in order. Elmo certainly surfed those blues nicely today.
 
Kris & Teasel said:
Two choices: 1. more brave: give 0.25 u; 2. less brave: no shot. :)
He'll probably be more insulin sensitive after today's hypo so 0.25 u might have a bigger effect than it normally would.
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Hmmmmm....pros and cons on both....gotta think on this ...:bookworm:
 
Tuxedo Mom said:
I agree with Kris's take on the number. A lot of that is going to depend if you are able to monitor the next 4 or 5 hours after the shot. If you can you could give the 1/4 unit reduced dose Elmo earned today. If you don't feel you are up for a potential pajama party, then a skip would be in order. Elmo certainly surfed those blues nicely today.
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I definitely will be up and can monitor...just what would be safest is my initial thot...
 
Maybe also feed a bit higher carb food ?? Core beef is 5 carb while Core chicken/Turk/ liver is 8....
 
Beth 73 said:
I definitely will be up and can monitor...just what would be safest is my initial thot...
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If you are feeling brave you could give a skinny, skinny 0.25 unit and watch him. The one nice thing is Elmo seems to be carb sensitive and did well with the higher carb foods you gave him today.
 
Usually right now the Wellness Core Beef venison lamb and Wellness chicken and beef....that's what he currently likes....
 
If he lags eating those I throw in some FF chunky turkey or chicken.....he REALLY likes those...they r my bribe foods currently
 
I don't often suggest anything dose-wise except to articulate things that are fairly obvious but nevertheless important not to assume, so:

1. The 0.5 dose is definitely too high. Given the data you've recorded I think it would be dangerous to give this dose to Elmo at this point. A somewhat higher nadir in the normal range would be safer for a Vetsulin kitty.

2. Make sure to check Elmo for ketones daily because of his history - especially when a dose reduction is made.

3. If you do give insulin tonight I would advocate a very conservative approach plus I would strongly recommend starting to test at +2 (or even earlier if Elmo starts looking for grub - appetite uptick usually signals dose onset) and keep testing until confident that nadir is passed safely (you've got very little recent PM cycle data to help so testing's the safest thing to do).


Mogs
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Beth 73 said:
Maybe also feed a bit higher carb food ?? Core beef is 5 carb while Core chicken/Turk/ liver is 8....
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Word of caution:

It doesn't always follow that higher carbs produce higher BG levels; sometimes a slightly higher carb food may result in better BGs (depends on the cat and how functional their pancreas may be).

At these BG numbers plus Elmo's BG patterns of late plus using Vetsulin it's safer to test than take a chance that a carbier food will keep him in safe numbers (IMHO).


Mogs
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Critter Mom said:
I don't often suggest anything dose-wise except to articulate things that are fairly obvious but nevertheless important not to assume, so:

1. The 0.5 dose is definitely too high. Given the data you've recorded I think it would be dangerous to give this dose to Elmo at this point. A somewhat higher nadir in the normal range would be safer for a Vetsulin kitty.

2. Make sure to check Elmo for ketones daily because of his history - especially when a dose reduction is made.

3. If you do give insulin tonight I would advocate a very conservative approach plus I would strongly recommend starting to test at +2 (or even earlier if Elmo starts looking for grub - appetite uptick usually signals dose onset) and keep testing until confident that nadir is passed safely (you've got very little recent PM cycle data to help so testing's the safest thing to do).

Mogs
.
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Critter Mom said:
I don't often suggest anything dose-wise except to articulate things that are fairly obvious but nevertheless important not to assume, so:

1. The 0.5 dose is definitely too high. Given the data you've recorded I think it would be dangerous to give this dose to Elmo at this point. A somewhat higher nadir in the normal range would be safer for a Vetsulin kitty.

2. Make sure to check Elmo for ketones daily because of his history - especially when a dose reduction is made.

3. If you do give insulin tonight I would advocate a very conservative approach plus I would strongly recommend starting to test at +2 (or even earlier if Elmo starts looking for grub - appetite uptick usually signals dose onset) and keep testing until confident that nadir is passed safely (you've got very little recent PM cycle data to help so testing's the safest thing to do).


Mogs
.
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I routinely check ketones and did so twice today...he balances on edge of litter box to go so makes it easy to catch....and yes , being extra hungry has been one of his signals..I will test at +2 and monitor til at least + 5
 
I'm on board with everyone else. Back on the 1st of Dec, when Elmo got the 0.25u after a 73 earlier in the day cycle, he nicely surfed in the 160 range through the night ...possibly a bit of a bounce and wasn't much higher the next morning. He went much lower today and then surfed nicely. Doesn't look like he bounced so I'd be inclined to go with the skinny 0.25u and monitoring up to at least +5 if that's doable. Aren't PJ parties fun! ?
 
One last question before it is bedtime for many of you on east coast time.......thots on tomorrow morning dose? Stay with reduced 0.25 depending on tonight and AMPS ???
 
Also will only be posting my BGs on SS tonight unless there is a problem....which there will be none:)
 
I agree with sticking to the 0.25u for now. I'm with Mogs re: aiming to keep Elmo's nadirs in very low 100's range and absolutely no lower than 90 on the pet meter so you always leave yourself a little extra room for drops. It may take a few cycles to see exactly how the 0.25u is working for him so even if you see slightly higher readings over the next few days, I'd hold the lower dose unless of course Elmo is too low to get his shot.
 
With PM reads of 133 +3 and just 134 +5 (was acting hungry at +5 so fed him) , believe I will pj party til +7 to see what we get...would rather stay up than get alarm woke up :coffee:
 
Encouraging morning Elmo update to the Kitty Cavalry:)...Elmo AMPS 165...gave 0.25 unit vetsulin. BG at +2 126........will be testing at +2, +4 and +7 today and then +2 and +4 this evening.....again a HUGE thank u to all the Cavalry who pulled Elmo and I thru yesterday...words don't adequately express:bighug::bighug::bighug:
 
Elmo wasn't too high this morning and he's had a good drop at +2 so you might want to test at +3 just to make sure he is not going to quickly so you can steer him if need be. Elmo is definitely progressing well and in the right direction but he's also a little less predictable than they are at higher ranges.
 
MrWorfMen's Mom said:
Elmo wasn't too high this morning and he's had a good drop at +2 so you might want to test at +3 just to make sure he is not going to quickly so you can steer him if need be. Elmo is definitely progressing well and in the right direction but he's also a little less predictable than they are at higher ranges.
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I agree. Looking good but predictability might suffer right now.
 
MrWorfMen's Mom said:
Elmo wasn't too high this morning and he's had a good drop at +2 so you might want to test at +3 just to make sure he is not going to quickly so you can steer him if need be. Elmo is definitely progressing well and in the right direction but he's also a little less predictable than they are at higher ranges.
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Thank u , Linda...+3.5 just taken was 144...monitoring extra thru out next few days..taking ketone check several times a day..his balancing act on edge of litter box aids that ...eating and acting normal
 
Well isn't Elmo full of surprises! I thought he'd be down not up at +3.5. Oh well, we all know, our kitties are all doing slightly different steps and they change them up just to keep us on our toes.
As for the ketones, I think checking once a day is more than sufficient unless there are any ketones showing up. He's not running high BG, is healthy otherwise and eating well so chances of ketones right now are low. You are a wonderful kitty Mom Beth, but take a break when you can so you are in good shape when Elmo really does need extra attention.:bighug:
 
MrWorfMen's Mom said:
Well isn't Elmo full of surprises! I thought he'd be down not up at +3.5. Oh well, we all know, our kitties are all doing slightly different steps and they change them up just to keep us on our toes.
As for the ketones, I think checking once a day is more than sufficient unless there are any ketones showing up. He's not running high BG, is healthy otherwise and eating well so chances of ketones right now are low. You are a wonderful kitty Mom Beth, but take a break when you can so you are in good shape when Elmo really does need extra attention.:bighug:
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:bighug::bighug::bighug:
 
MrWorfMen's Mom said:
Well isn't Elmo full of surprises! I thought he'd be down not up at +3.5.
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He seems to be like Saoirse; metabolising the dose really quickly at the beginning of the cycle. FWIW Saoirse's nadirs started getting earlier and earlier when she started heading for remission.

Beth, a bit of an advanced heads-up for you to think about: if you find that you can't nudge Elmo into regular nadirs in the low 100s on 0.25 IU Vetsulin but also find that the 0.5 IU dose continues to be unsafe (and I really do think it is taking Elmo too low for comfort on this particular insulin, even on days when he hasn't dipped below the hypo threshold) it might be worth sounding your vet out now about possibly using Lantus or Levemir to continue Elmo's treatment.

The L insulins typically don't produce wide variations in BG levels over the course of a cycle (provided a good dose is established!) and because of this they can provide a means to keep a kitty in healing numbers for more of the day while allowing treatment to continue safely for a longer period of time. This allows the pancreas to rest for longer and hopefully recover more beta cell function.

I was able to get Saoirse switched from Caninsulin to Lantus because it became unsafe to give her even a tiny dose of Caninsulin but she was not in remission. I was able to help her into much better BG levels and because I was able to safely extend the period of her insulin treatment she did achieve remission. It's certainly worth running the idea past your vet if you run into a Vetsulin dosing 'brick wall'.

:bighug:


Mogs
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Critter Mom said:
He seems to be like Saoirse; metabolising the dose really quickly at the beginning of the cycle. FWIW Saoirse's nadirs started getting earlier and earlier when she started heading for remission.

Beth, a bit of an advanced heads-up for you to think about: if you find that you can't nudge Elmo into regular nadirs in the low 100s on 0.25 IU Vetsulin but also find that the 0.5 IU dose continues to be unsafe (and I really do think it is taking Elmo too low for comfort on this particular insulin, even on days when he hasn't dipped below the hypo threshold) it might be worth sounding your vet out now about possibly using Lantus or Levemir to continue Elmo's treatment.

The L insulins typically don't produce wide variations in BG levels over the course of a cycle (provided a good dose is established!) and because of this they can provide a means to keep a kitty in healing numbers for more of the day while allowing treatment to continue safely for a longer period of time. This allows the pancreas to rest for longer and hopefully recover more beta cell function.

I was able to get Saoirse switched from Caninsulin to Lantus because it became unsafe to give her even a tiny dose of Caninsulin but she was not in remission. I was able to help her into much better BG levels and because I was able to safely extend the period of her insulin treatment she did achieve remission. It's certainly worth running the idea past your vet if you run into a Vetsulin dosing 'brick wall'.
Once again, thank u to the moon and back,Mogs, for ur wisdom and guidance...i will be picking ur brain in the near future as this all plays out..what a comfort u and others have walked this road before Elmo and I:bighug::)
:bighug:


Mogs
.
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Mogs,,,sorry i am often techy deficient and today sleep deprived...posted a reply on ur previous post...how i manage to do it correctly one day and not the next is beyond me:nailbiting:
 
Don't worry, Beth; I found it. And boy, oh boy! can I relate on the sleep deprivation side of things.

:bighug:


Mogs
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:DThose sleepless nights do take their toll! We've all been there. Hopefully Elmo will let you get a good night's sleep tonight Beth!:bighug:
 
Critter Mom said:
Linda?!! (Teasing. :p)

Wow! You really are punchy tonight, Beth. Sending you an extra big batch of :bighug::bighug::bighug::bighug::bighug::bighug:. I hope you'll get a good sleep tonight.


Mogs
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Ahhhhhhhhhhh:nailbiting::nailbiting::nailbiting:......shoots holes in my "I'm doing ok on 3 hours sleep" mantra;).........seriously tho, when/if Elmo and i do hit the vetsulin wall, please feel totally free to give me a nudge in the changing insulin direction...i tend to overthink things and will be depending on u and others to urge me on...hopefully on a day where ive had more than 2.5 hours sleep :p:eek::joyful::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::woot:
 
"Both of ur precious black kitty pics thru my bleary mind for a loop!! At least that's my story and i'm sticking to it:nailbiting::nailbiting::nailbiting::coffee::coffee::coffee:;););):bighug:"

I believe ya! The pics are quite similar AND beautiful! :p
 
Beth 73 said:
Ahhhhhhhhhhh:nailbiting::nailbiting::nailbiting:......shoots holes in my "I'm doing ok on 3 hours sleep" mantra;).........seriously tho, when/if Elmo and i do hit the vetsulin wall, please feel totally free to give me a nudge in the changing insulin direction...i tend to overthink things and will be depending on u and others to urge me on...hopefully on a day where ive had more than 2.5 hours sleep :p:eek::joyful::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::woot:
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Whatever would we do without those emoticons to convey what's going on mentally??!!
 
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