? Keno 1/5 AMPS 365 - Question about low nadir of 66 - please respond

[jacereske]

Keno has been fully transitioned to low carb food since 12/1/16. She has been eating only Wellness Core Lamb, Venison & Beef which is 5% carbs. She is not crazy about the Wellness, so to get her to eat better I started adding Fancy Feast classics to her diet last weekend. Now she gets 1/8 can of Wellness and 1/4 can of FF five times a day. I also started giving her a phosphorous binder because her phos level has gone up. I know that FF is high in phos, but I need her to eat.

My husband tests her at +6 (her nadir) everyday when I'm not home and then texts me. On Tuesday, he texted me that her BG at +6 was 66. As you can imagine, I was alarmed.

Unfortuately I did not get the text until 2 hours later (thanks Verizon) and of course I called him immediately. He said that Keno was acting fine. He wouldn't do another BG test (he is squeamish about it and it's a big win for him to do even one a day), so he did feed her some low carb food which she ate happily.

I told my husband that if she ever tests below 75 to immediately re-test using our Alpha Trak meter that we use for our other diabetic cat (who is insured) and to call me.

I immediately took a 1/4 reduction from 4 u to 3.75 u that evening, but I really wonder about that 66 BG. Could it have been a meter malfunction? She has never tested that low. I would appreciate your thoughts.

thanks,
Jeanette

 

[Madrona and Leda (GA)]

On a human meter 66 is a healthy number. The only question I would have is how confident you are that she consistently nadirs at +6. It's always helpful to restest on an unexpected number, but I can't say I've ever actually caught a bad reading that way--just a lot of surprises from the cat. Congratulations on the reduction.

 

[jacereske]

On a human meter 66 is a healthy number. The only question I would have is how confident you are that she consistently nadirs at +6. It's always helpful to restest on an unexpected number, but I can't say I've ever actually caught a bad reading that way--just a lot of surprises from the cat. Congratulations on the reduction.

I'm pretty confident about her nadir being at +6 based on the curves I've done.

The 66 was very unexpected.

I'm not sure that she needed the reduction - she seemed to do better on 4 u. We keep dancing back and forth between 4 u and 3.75.

Thank you for responding.

 

[Madrona and Leda (GA)]

I'm not sure that she needed the reduction - she seemed to do better on 4 u. We keep dancing back and forth between 4 u and 3.75.

I don't know the ins and outs of SLGS very well, but you might be able to hold for multiple drops below 90 since she's a long term diabetic. The steep drop down to 66 might mean that a reduction could help her even out though.

 

[Gill & George]

I'm pretty confident about her nadir being at +6 based on the curves I've done.

Hmmm, though a kitties nadir might often occur at around a certain point in the cycle, they can and do nadir at any point in the cycle.
George typically nadired at +6, but he also through me nadirs as late as +12 and as early as +1 take a look at his ss.

and just to complicate things they can and do change their patterns. It's worthwhile getting spot tests in at different times as and when you are able to.

I think as he dropped below 90 and you are on slgs, you should stick with the reduction for now, although you haven't 'caught' any greens on the 4u until that 66, I do wonder whether he might have dropped to green in the pm cycle 12/30, she dropped 160pts at +2, and by amps 12/31 was 191 (looks like she was possibly rising by then), that begs the question, How low did she go??? (I wouldn't be surprised if she had seen some green then)

For future reference, when you get a steep drop like that by +2, it's worth following it up with at least one other test, to see if you need to monitor more, or if indeed you need to intervene with food in order to keep her safe.
Not sure if your +2 is your before bed test or not, I used to TFS at 7am/7pm and bed was midnight for me, so I would always get a +5/ before bed ( as well as a +2), I found that by TFS ing early it was easier to monitor him later into his pm cycles. Initially I was doing it 9am and 9pm, and that schedule was a nightmare.

 

[Wendy&Neko]

I'm pretty confident about her nadir being at +6 based on the curves I've done.

Looking back, I saw some nadirs at +4 and +5. We find it better to sprinkle the tests around the cycle to get better data. You might want to suggest to your husband that he try testing between +4 and +6, if he is home during the day.

Since you are following SLGS, I agree with Gill that it's best to hold the dose for a week, and then re-evaluate. It's not uncommon for a kitty to have to dance up and down around a dose for a while.

If you are worried about Keno's phosphorus levels, have you taken a look at this list of low carb, low phosphorus foods. Fancy Feast is a good one to avoid, unless it's the only thing she'll eat.

 

[tiffmaxee]

Do you have a copy of her labs that you can input on her labs section on her spreadsheet? Some of us are pretty good at interpreting them. Depending on the numbers ff classics might not be a good food choice.

 

[jacereske]

Do you have a copy of her labs that you can input on her labs section on her spreadsheet? Some of us are pretty good at interpreting them. Depending on the numbers ff classics might not be a good food choice.

Thanks - I have labs but I am heading to work and don't have time to post them right now. I am in a Feline CKD group and have had them reviewed there. Her creatinine is fine - BUN and Phos are high - that's why she is on the Phos Binder.

I'm aware that FF is high in phos but it's what she will eat. The Wellness is a bit lower in phos - 88% and she gets a mixture of the two.

Her food choices are very limited. She cannot eat Weruva - they use potato starch and she has a sensitivity to that - it raises her BG even though it is low carb. And I don't like to feed fish. So not many options. The positive on the FF is that it does not have carageenan.

thanks,
Jeanette