? Ravan not doing well?

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I’ve just come to know a few people who can help, when u want to do a private message just click their name and a box will pop up and hit start conversation, you can click anyone’s name and it will pop up, click on me and see if a box pops up
 
Hey there. I am trying to get caught up. So today how much did Ravan eat? It looks like you increased the dose 3 cycles ago, no doubt when he was eating fine. You mentioned lip smacking. That sounds like nausea. Is he meatloafing? Has he ever had pancreatitis before?

The 98 is later in the cycle when the lantus will start to lose it's strength so that is a good thing. Just keep offering small amounts of food to see if he will eat. Have you tried all the tricks to get them to eat? Tuna juice, flortiflora, baby food?
 
Hi Bobbie What do I do if the bg is still under 100 at shot time. Do you think it will continue to drop now? Have you looked at his sheet? he's been real high since I increased to 1.25 now a 327 drop?
 
Ravan only ate about 2 tbls. of food this morning he's been Sleeping all day. I came home at 4:30 & was shocked when I saw such a Huge drop. I checked 2 times to be sure.
No, he not eating now he looks nauseous. I just gave him slippery elm that usually helps. if he still won't eat I'll give him a syringe of chicken. And 100cc of Ringers sub Q.
 
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JoyBee said:
Ravan only ate about 2 tbls. of food this morning he's been Sleeping all day. I came home at 4:30 & was shocked when I saw such a Huge drop. I checked 2 times to be sure.
No, he not eating now he looks nauseous. I just gave him slippery elm that usually helps. if he still won't eat I'll give him a syringe of chicken.
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Here is a list complied by Jill and Alex to help get a kitty to eat.

CATS NOT EATING
AS Per Jill
Here's some info Jill often posts when a kitty won't eat:Here are some things you can do do entice your cat to eat:
-sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core. * I have added Young Again Zero Carb
-making a buffet to give him choices
sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- heating food
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.
other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

Cats that are not eating much for a few days are at risk for hepatic lipidosis
Last resort to eat give Medium or the high carb, wet food
 
No DKA or Ketones I have tried everyone of the things listed. (Except dry food) Over 15 yrs he ate a raw food diet. When he's nauseous he won't eat! What do Ido at 9:30 tonight shot time if bg is below 100 or even down to 68 (it went that low before.?

When he's not nauseous he'll eat Sardines in water or Soulistic chicken in gravy. He stopped eating his Raw food 8 months ago? Thats when i took him to the vet back in June his bg was 117 they thought maybe bowel inflamatiom!Monocyte & Lipase was slightly elevated.
 
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JoyBee said:
Did you see the Huge Drop? 425 to 98

No Ketones Doesn't want to eat, I'll syringe feed in a while.

I'm concerned about this Huge bg drop?
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Actually that's a great number. It's most likely from the dose increase and partly also from him not eating much. It's not a number to be afraid of. I suggest you test again at +10 and then again at +12 for the usual pre shot test. That BGs over that time interval should show you if he's staying level, falling or rising. That will determine the dosing advice we give.
 
In january bg was 511 That;s when he was diagnosed with diabetes. Alp & Lipase was also elevated. Vet said it was from stress & diabetes

Isn't that a HUGE drop? wouldn't that make him feel sick? is a drop that BIG normal?
 
JoyBee said:
In january bg was 511 That;s when he was diagnosed with diabetes. Alp & Lipase was also elevated. Vet said it was from stress & diabetes

Isn't that a HUGE drop? wouldn't that make him feel sick? is a drop that BIG normal?
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Ravan hasn't been very responsive to the Lantus for the last 10 days or so, although I'm basing that on limited data. That can cause glucose toxicity, meaning the cells lose their sensitivity to insulin because of the toxic effects of being constantly bathed in too much glucose. This is reversible. Often all it takes is a bump up to a higher dose and suddenly you see a response again. That might be what's going on today.

Yes, constant high numbers can make them feel ill and so can a big drop. That's why you want to test appropriately and keep up the dose increases in a safe way. Lingering in high numbers too long can cause glucose toxicity. You have to act based on what you see at this point in time. Anything that happened as little as a week ago is ancient history.
 
Kris,
I thought I was doing good? tested 8 times on 18th, 7 times on the 24th ,7 times on the 25th.
I thought it was OK to give Ravan & myself a break?

After I test at 7:30 do i contact you or just post it here?
 
JoyBee said:
Kris,
I thought I was doing good? tested 8 times on 18th, 7 times on the 24th ,7 times on the 25th.
I thought it was OK to give Ravan & myself a break?

After I test at 7:30 do i contact you or just post it here?
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Post it here. We keep all dosing advice and other insulin/health related discussion out here on the public forum for peer review. :) When I referred to data that's limited I meant the mid cycle numbers from about Mar 15 to Mar 23. Lantus is dosed based on nadir numbers, not pre shot numbers.
 
7:30 pm 85 (Still dropping ) ( he ate an hr ago tabls. Fancy feast in gravy) I expected bg to come up not down?

What If it goes Lower before shot at 9:30?

People say, OK now I get the Karo Syrup . Do they give the Karo & Rush to the Emergency Vet? There is no way I can stay Calm if he might get Hypoglycemic!
 
JoyBee said:
What If it goes Lower before shot at 9:30?
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You can track it more closely by testing again at +11 and then for pre shot at +12. Here's the section from the Lantus SLGS (Start Low Go Slow) dosing guide that pertains to this situation. I've highlighted the relevant parts in blue.

How to handle a lower than normal preshot number:

In the beginning we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus and Levemir users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near usual preshot numbers:
  • Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, your goal is to achieve flat numbers that are greater than 90, so there is no need to push a cat into numbers lower than that.
 
Kris, He dropped such a huge amount at the higher dose 327 p0ints, if his bg was 300 & i give him 1.25 Couldn't it drop a huge amount again?

Right now he's crying for food! I looked at his dish & he ate the other 1/2 can & still wants more. Do I let him eat as much as he wants? He's only has a few spoons all day?

He's only done this when the bg drops. It was 85 an hour ago I think it's still going down!

Why has it continued to drop when he's eating?
 
Because his bg dropped all day There isn't any number I'd be comfortable at shooting.

I'm scared it will keep going lower all night!
 
JoyBee said:
Kris, He dropped such a huge amount at the higher dose 327 p0ints, if his bg was 300 & i give him 1.25 Couldn't it drop a huge amount again?

Right now he's crying for food! I looked at his dish & he ate the other 1/2 can & still wants more. Do I let him eat as much as he wants? He's only has a few spoons all day?

He's only done this when the bg drops. It was 85 an hour ago I think it's still going down!

Why has it continued to drop when he's eating?
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Let him eat. He needs the calories. Did you read the section from the SLGS guide I posted above? The blue highlighted sections fit this situation.
 
Kris., I don't understand? He dropped 329 points after i increased the dose even if his bg came up to 300 couldn't it do a huge drop again after the shot?
 
Sharon,Your cats bg went to 40's ,You gave him honey. Did you take him to the emergency clinic? I thought the Honey was only temporary till you get them to a DR.? I would definitely be in a panic I don't think I could drive. The nearest clinic is over 30 mins away!
 
JoyBee said:
Kris., I don't understand? He dropped 329 points after i increased the dose even if his bg came up to 300 couldn't it do a huge drop again after the shot?
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It might but that’s speculation. Post the next number when you have it. If your +12 pre shot is below 90 you’ll be skipping the shot tonight.

Something to think about: it’s wise to have a healthy respect for hypo numbers but you don’t need to live in terror of them. There are things you can do to be prepared such as:
  • having a “hypo kit” ready - gravy style wet food, extra test strips, sugary syrup of some sort
  • reading up on how to handle a hypo here on FDMB
  • getting middle of cycle tests daily to catch low numbers and be able to intervene.
Being afraid to dose properly because of an inordinate fear of a hypo creates other health risks ranging from wear and tear on organs from excessively high BG to development of ketones.
 
JoyBee said:
Sharon,Your cats bg went to 40's ,You gave him honey. Did you take him to the emergency clinic? I thought the Honey was only temporary till you get them to a DR.? I would definitely be in a panic I don't think I could drive. The nearest clinic is over 30 mins away!
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Most of us deal with hypo range numbers from time to time and can successfully steer BG into higher numbers using small snacks of carbs while we track progress with more testing at short intervals of 15 to 30 minutes.

It’s rare that a kitty has to be taken quickly to a vet hospital. The most likely scenario for that is when a kitty is accidentally overdosed by a lot or the owner hasn’t been testing BG and suddenly is confronted with a symptomatic hypo - yowling, stumbling, seizures, etc.
 
Just tested bg 148 I'm so Happy it didn't go lower! It must be from the Fancy feast!

I'm still concerned that if I give insulin he might do a huge drop again?

Do I give any insulin tonight? I'm not sure I'm able to get up all night to test . I'm so worn out!
 
I did not take him to the ER. Colin was on a very high dose and had a full Depot when he dropped into the 40’s. I had to syringe honey and gravy and feed him temptations treats as well as test every 20-30 min. Doing that I was able to keep him from going any lower. His dose(8u) is now half of what it was then, so I feel confident I can keep him safe. As long as he’s above 50, he gets insulin, though not always a full 8unit’s.
 
Sharon I still don't know enough about Diabetes but 8 units sounds like a HUGE amount Like for a Human? Didn't it go down to 38 last august on a dose of 1.5 of insulin?

You guys all talk about giving treats My cats don't know what that is. They always ate raw meat . Once years ago my mother tried to give them treats & they smelled it and walked away. I guess they didn't think it was food because it wasn't Raw!

Colin's spreadsheet ends in 2017 ?
 
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Kris , Do you really think I should give him 1.25 tonight with a bg of 148?

I was posting on the lantus forum & someone told me to come back to the Main forum This is all so confusing!
 
JoyBee said:
Kris , Do you really think I should give him 1.25 tonight with a bg of 148?

I was posting on the lantus forum & someone told me to come back to the Main forum This is all so confusing!
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According to the SLGS method you decrease the dose by 0.25 u immediately if you have a BG under 90 in a cycle. That 85 is the deciding number today so reduce the dose to 1 u. Please study the SLGS info sticky. It’s all laid out for you there.

If you were on the Lantus forum asking for advice on dosing Lantus I don’t understand why they’d send you back here. That forum is where you want to be.
 
Thanks Kris I just posted a question on Lantus I'm still Waiting for an answer I've never given Ravan's insulin past 10 I'm very regular with 9:30 am -9;30 pm What do I do it''s after 10 now?
 
It's OK to give the shot even though he's been eating & it's near an Hour after shot time? He's also been eating again. Will I need to test every 1 or 2 hrs all night?

Still haven't got a reply on Lantus?
 
wow...yur amazing...keep up the good work...I am following you and Raven...in the shadows as i do not have any advice. .just words of encouragement and i hope this gets easier real soon for you!!
 
Retested at pmps and we will see what it is, what time is it there
Sharon14 said:
How is Ravan this AM? Looks like he bounced last night, that’s normal. Remember if you shot an hour late last night, you’ll need to either shoot an hour later this AM, or adjust by no more than half an hour.
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@Sharon14 , she posted on lantus forum
 
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