Still bouncing, then hypo, what do,I do

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I would hold off for a little while before giving insulin. Continue to encourage him to eat.

He doesn't have any history of ketones or DKA, correct?
 
OK, then there's a little more leeway (and an in-and-out insulin like Novalin has time flexibility in any case). So, let's try to get him eating a little bit more-- at least half a regular meal would be good. He is probably feeling a little yucky from having his BG bounce up and down like a yo-yo, and he's definitely at a high point for him right now. He may start to feel better after eating a little, and just needs a little more time. Maybe there's something he really likes you can tempt him with? Even a few treats might get him interested in eating.
 
I was told Novolin N had some carry over & not an in & out?!? I’m sorry if I was wrong but when Baby was on this, the vet said that... nope? She keep going lower the longer amt of time... ok
 
I'm not directly familiar with Novalin N, so it may have some carryover (like the crystalline fraction of Vetsulin?), but I do know that it does not act like a "depot" insulin like Lantus or Levemir. With those, you have to try to keep to a 12-hr schedule, and always have to be conscious of the effects of the depot. With something like Novalin, I think you have more flexibility on shooting late, which it seems is what is going to happen tonight. Again, it's not an insulin I've used myself, so I may have the details wrong!

In any case: I'm glad he's eating a bit more. Would you say it's approximately a meal's worth of food he's gotten in the past hour or two (I guess he'd eaten a bit before)?

Another option might be to shoot an even smaller dose, like 1.0U. Here's the caution on that: we've been decreasing insulin rapidly over the past couple days, he's in high numbers right now, and he's not eating well. What we don't want to do is to trigger a ketones episode (potentially dangerous, and expensive to treat). So if we can get him eating enough that you are comfortable shooting the 2.0U, I'd feel better about it.
 
Becky & Baby Girl Kitty said:
I was told Novolin N had some carry over & not an in & out?!? I’m sorry if I was wrong but when Baby was on this, the vet said that... nope? She keep going lower the longer amt of time... ok
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What food do you feed, he seems like he’s tired of fancy feast, I opened 3 different flavors
 
Nan & Amber said:
I'm not directly familiar with Novalin N, so it may have some carryover (like the crystalline fraction of Vetsulin?), but I do know that it does not act like a "depot" insulin like Lantus or Levemir. With those, you have to try to keep to a 12-hr schedule, and always have to be conscious of the effects of the depot. With something like Novalin, I think you have more flexibility on shooting late, which it seems is what is going to happen tonight. Again, it's not an insulin I've used myself, so I may have the details wrong!

In any case: I'm glad he's eating a bit more. Would you say it's approximately a meal's worth of food he's gotten in the past hour or two (I guess he'd eaten a bit before)?

Another option might be to shoot an even smaller dose, like 1.0U. Here's the caution on that: we've been decreasing insulin rapidly over the past couple days, he's in high numbers right now, and he's not eating well. What we don't want to do is to trigger a ketones episode (potentially dangerous, and expensive to treat). So if we can get him eating enough that you are comfortable shooting the 2.0U, I'd feel better about it.
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Yes he are normal over a cpl hrs
 
OK, if you think he's gotten a reasonable amount of food in him in the recent past, I think you can shoot.

I'd get a reading around +2, the way you've been doing. to see where he's at.

Bellasmom said:
I think he may not feel real good or he’s just tired of this, he’s tired of being stuck, de doesn’t understand
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Poor little guy :(. Hopefully we can get him feeling better soon.
 
Nan & Amber said:
OK, if you think he's gotten a reasonable amount of food in him in the recent past, I think you can shoot.

I'd get a reading around +2, the way you've been doing. to see where he's at.



Poor little guy :(. Hopefully we can get him feeling better soon.
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I worry about how much to give him in the am before I go to work, I won’t be here to check it
 
Hopefully @Kris & Teasel will be back online later tonight or tomorrow morning before you shoot, she's very good at this kind of thing, and by then, we should have a good idea of what he's likely to do with the 2.0U.

With any luck, he's just feeling a little "off" because of the high numbers, and once the insulin pulls him down a bit he'll feel better. although, as I said earlier, just the ups and downs themselves can be unsettling (at least according to human diabetics who experience it).
 
I suggested on your other thread you drop him to 2 u tonight. Ignore the black bounce number. Try for a +2 or at least just before you go to bed. That plus your AM test should give a hint of what to do tomorrow. Post here in the AM. I'm in EST and am usually checking FDMB by 8 AM my time.
 
OK, seeing a 365 at +2. That's 200pts since pre-shot (which was maybe an hour before the shot, with the delay?).

How is his appetite doing? Any better? If you could convince him to eat a bit at this stage, it might slow him down a bit, so that he doesn't dive down and bounce up quite so high afterwards.

Hope he's feeling a little better now!
 
Adding: he's still high enough that I don't think he'll drop down too low tonight, this is partially just general advice to try to help tamp down the bounces, now or in the future. :)
 
I see that red this AM and the 2 u dose. He’s bouncing but the dose might not be high enough too. Don’t worry about that right now. Let’s see what he does today. If you don’t have half units on your syringes think about getting some that do. You’ll probably need them to give fractional doses. :)
 
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Kris & Teasel said:
I see that red this AM and the 2 u dose. He’s bouncing but the dose might not be high enough too. Don’t worry about that right now. Let’s see what he does today. If you don’t have half units on you syringes think about getting some that do. You’ll probably need them to give fractional doses. :)
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I have to leave for work at 7am I was just worried if I gave him more then it would go real low while I was at work
 
Bellasmom said:
I have to leave for work at 7am I was just worried if I gave him more then it would go real low while I was at work
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You did what I suggested and that's fine. The goal is to keep him safe for sure. The whole unit dose drops I recommended were based on those lime greens and on the fact that Novolin is fairly aggressive in its BG lowering action. There needs to be an extra margin of caution when you get active cycles like you've had.

It's wise to do urine ketone checks with all diabetic kitties but certainly if he's in higher numbers. I might have mentioned it in earlier posts but you can buy human urine ketone test strips at any human pharmacy and here are some ways to get a sample:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

I also don't recall if you said your syringes have half unit marks or not. You'll need those because his good dose range will likely involve fractions of units.
 
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Yes! I would not give more than 2 units if you’re going to worry! I know this is so hard for you... :bighug: you don’t want the highs but as they say- better high than a hypo event! Again! Sometimes trusting your own instinct is best!!!!
Have a great work day! Let it go....
 
Kris & Teasel said:
You did what I suggested and that's fine. The goal is to keep him safe for sure. The whole unit dose drops I recommended were based on those lime greens and on the fact that Novolin is fairly aggressive in its BG lowering action. There needs to be an extra margin of caution when you get active cycles like you've had.

It's wise to do urine ketone checks with all diabetic kitties but certainly if he's in higher numbers. I might have mentioned it in earlier posts but you can buy human urine ketone test strips at any human pharmacy and here are some ways to get a sample:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

I also don't recall if you said your syringes have half unit marks or not. You'll need those because his good dose range will likely involve fractions of units.
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I will have to pick up both, thanks
 
Becky & Baby Girl Kitty said:
Yes! I would not give more than 2 units if you’re going to worry! I know this is so hard for you... :bighug: you don’t want the highs but as they say- better high than a hypo event! Again! Sometimes trusting your own instinct is best!!!!
Have a great work day! Let it go....
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Very hard and it’s hard on him, yeah there is no one home and I was worried, heck I wonder how many time I’ve given him 4u like he’s suppose to have and wonder how many times it got close to low omg
 
I felt the same with Baby at first! Go low & he will be ok! Just for today at least! Glad you did a 2!
My original vet started Baby on 5 units- it’s a wonder she’s alive! Stupid vet! Also didn’t find Lizzie’s breast cancer soon enough (thought it was a fatty tumor) otherwise I probably could have kept her a few more years! Glad I found a good vet that knows more!
 
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Bellasmom said:
Very hard and it’s hard on him, yeah there is no one home and I was worried, heck I wonder how many time I’ve given him 4u like he’s suppose to have and wonder how many times it got close to low omg
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You were following your vet's advice like all of us did - in the beginning. Now you're on a path to doing things differently and better for Bella. :)
 
Becky & Baby Girl Kitty said:
I felt the same with Baby at first! Go low & he will be ok! Just for today at least! Glad you did a 2!
My original vet started Baby on 5 units- it’s a wonder she’s alive! Stupid vet! Also didn’t find Lizzie’s breast cance soon enough (thought it was a fatty tumor) otherwise I probably could have kept her a few more years! Glad I found a good vet that knows more!
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I, so glad you found another, I was thinking about the same thing, it’s so expensive those vets
 
Kris & Teasel said:
You did what I suggested and that's fine. The goal is to keep him safe for sure. The whole unit dose drops I recommended were based on those lime greens and on the fact that Novolin is fairly aggressive in its BG lowering action. There needs to be an extra margin of caution when you get active cycles like you've had.

It's wise to do urine ketone checks with all diabetic kitties but certainly if he's in higher numbers. I might have mentioned it in earlier posts but you can buy human urine ketone test strips at any human pharmacy and here are some ways to get a sample:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

I also don't recall if you said your syringes have half unit marks or not. You'll need those because his good dose range will likely involve fractions of units.
Click to expand...
 
Let's see where he is as you get closer to shot time. As Kris says, he's probably bouncing. Plus, on at least one day (2/17) he's done a big bounce in the middle of the day that faded by the next shot time, so you wouldn't want to shoot a larger dose if he's already heading downwards on his own.
 
Kris & Teasel said:
No, don’t increase just yet. He’s bouncing from the recent lows. Keep 2 u tonight and collect a before bed test. If a dose increase happens it’ll be only 0.25 u. I have a feeling that the dose you need right now is somewhere between 2 and 3 units.
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BG 436
 
Bellasmom said:
Sorry missed your message, I was in bed, I will try and stay up later at night, will do tonight at +4, sorry
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No problem! Sleeping is allowed. ;)

I see you gave 2 u this AM. Do that again tonight. Try for a mid day or coming home from work test if you can as well as an evening test tonight. That data will fill in the picture better. I'll likely recommend you increase to 2.25 u tomorrow AM. If you don't yet have syringes with half unit marks you'll need them ASAP. In the interim you can make up a reference syringe using coloured water drawn up to your best eyeballed estimate of 2.25 u. Use it as a comparison guide for the 2.25 u doses.

Think about urine ketone testing too (post #22 above).
 
Kris & Teasel said:
No problem! Sleeping is allowed. ;)

I see you gave 2 u this AM. Do that again tonight. Try for a mid day or coming home from work test if you can as well as an evening test tonight. That data will fill in the picture better. I'll likely recommend you increase to 2.25 u tomorrow AM. If you don't yet have syringes with half unit marks you'll need them ASAP. In the interim you can make up a reference syringe using coloured water drawn up to your best eyeballed estimate of 2.25 u. Use it as a comparison guide for the 2.25 u doses.

Think about urine ketone testing too (post #22 above).
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I’m not able to check until it’s his dinner time, have to work over
 
Well, that’s a surprise! Give him a small snack of high carb food, wait about 15-20 minutes and retest. Repeat the small snack, wait 15-20 min, retest until he’s above 68. Then, try leaving him without food for 30 min and retest. If he can hold himself above 68 without snacks test after 1 hour.

Tomorrow reduce his AM dose to 1 u.
 
Kris & Teasel said:
Well, that’s a surprise! Give him a small snack of high carb food, wait about 15-20 minutes and retest. Repeat the small snack, wait 15-20 min, retest until he’s above 68. Then, try leaving him without food for 30 min and retest. If he can hold himself above 68 without snacks test after 1 hour.

Tomorrow reduce his AM dose to 1 u.
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Did not see your post till this am after his insulin shot, gave 2u, Im sorry, I’m trying real hard to follow what you say, husband is home today he can watch his BG today, got his BG to 108 last night, hubby woke,me up in panic as he was checking is BG at +4 last night. Will check here from now on before insulin given
 
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