10/6 Biscuit 57, 64, 71, 80, +1 84, +2 83, +3 84, +4 82, +6 90, +8 107, +9.5 139, +12PMPS 241

ShannonandBiscuit

ShannonandBiscuit

Member Since 2019
Last Post

2 days ago, Biscuit was running very high for him. He was trending up even with insulin, so we increased the dose yesterday morning by .25. After we decided to follow TR. Then, all day yesterday he went steadily down. AMPS 339, +4 257, PMPS 207, +2 177, +6 83, +8 68.

And now with his AMPS at 57, I’m not sure what to do. I’ve fed him but am waiting on insulin. Advice?
 
Shannon, I am not a shot advisor but have tagged some help....since you just started TR I’d be tempted to stall bit longer...but I am very conservative and cautious...
 
Hmmm.... Now that you've fed, you're going to get a bit of a food bump in any additional tests. Usually, in this situation, what we try to do is "stall": don't feed, test in 30 mins. If the cat is going up at that point, it may be safe to shoot.

With the history of DKA in the recent past, we try to do everything we can to avoid skipping. Test again in 30mins, and we'll try to figure things out-- maybe a reduced shot?
 
Not making it easy, there, Biscuit! That's up a little, but realistically, pretty flat.

I'm thinking that he's going to start rising soon and will be safe to shoot, but we'd really like to see it. If it's OK for you to get a little off-schedule, you could wait another 30mins and test again to see where he is. If he's only up by a little then, I'd suggest a half-dose, but if he's started to zoom, maybe we could even do the full dose. I'm just unwilling to suggest that for you right now, given that he is so much lower than any number you've shot before.

Can you monitor all day today? Do you have plenty of supplies?
 
I work from home, so I’ll be home all day today and next week so getting off schedule a bit for now is fine.

We have HC gravy food in the 15-20 range and Karo and honey and plenty of test strips.
Definitely have no idea how he’ll react at this point it’s just so new for him and he’s like a roller coaster right now it seems.
 
Usually you get to gradually shoot lower and lower pre-shots but Biscuit is not giving you that opportunity. Since you've fed him and have no experience shooting low numbers, I'd suggest you either give him a BCS ) big chicken shot of perhaps 0.75u and monitor closely or skip. I can't stay to monitor today...just on my way out now but maybe others will be.
If there is any history of ketones, then opting for the reduced dose is the better option.
 
OK, slowly rising (but with food on board).

With the DKA, I really would recommend at least some insulin if at all possible. How do you feel about 0.75U?
 
So at +1.25 he has moved like a turtle to 71. Not really a vote of confidence.

Also, yes. He is coming out of a DKA episode last week, and I don’t want another of those. Although vet er is not good for hypo either. This is only his first full week on Lantus.
 
One thing about Lantus is that you aren't really shooting the pre-shot number, you're shooting the +2 or +3 when the insulin really starts working. Biscuit has been spending a lot of time in high numbers, so chances are he's going to bounce. Edited to add: we just don't know when!

ShannonandBiscuit said:
If I go with the .75u. How often should I test him to make sure we stay out of the danger zone?
Click to expand...

I would test at +1 and +2 to start, and go from there. If he's stubbornly sticking to greens then, we may consider just giving him some HC food at the get-go. With DKA recovery, it's not about keeping them out of the high BG numbers so much, you sometimes have to give extra carbs and calories to be able to give the insulin that does the real work.
 
Looking at that +1 of 84.... I mean, the good news is, these are great numbers for Biscuit to be in! Would like to see him rise a bit more than that, though.

On 9/28, he hit 38 (!) at PMPS, today he was at 57 at AMPS. Small amount of evidence and that first one is an unusual situation (just out of the hospital for DKA, big jump in dose), but based on that, he may be a cat that likes to nadir on the later side. If so, these low pre-shots may become a more regular sight for you.

Another possibility could be that he is breaking a bounce from another recent low that you didn't happen to see. Sometimes, they can build up a real head of steam when bounce-breaking, and just power through the end of a cycle when the insulin is tapering off.

Let's see what he does with the partial dose today. Time to come up a bit, Biscuit! You don't have to go into a full bounce, you can stay in nice numbers, but maybe blue instead of green for a little extra safety margin?
 
ShannonandBiscuit said:
So far so good... apparently he likes the 80’s. Should I keep testing hourly or every 2 hours?
Click to expand...
Also, his feeding schedule is LC at 8 and 8 usually, and then half a small can of 0 carb tiki cat around now. So far I haven’t given him anything else in case I had to feed HC. Should I stick to that?
 
Yes, stick to his usual feeding schedule.

Pretty impressive run so far!

I think I would get a +4, then move to a less frequent testing schedule. He sure looks like he's going to behave himself today!

How is he feeling/behaving? And do you have any recent ketone tests? It's good to note those (including the negatives) on the spreadsheet. When there's a recent DKA in the picture, you'll always get that question when people are trying to assess the situation and offer advice, so it's good to have it all available.
 
Nan & Amber said:
How is he feeling/behaving? And do you have any recent ketone tests? It's good to note those (including the negatives) on the spreadsheet. When there's a recent DKA in the picture, you'll always get that question when people are trying to assess the situation and offer advice, so it's good to have it all available.
Click to expand...

Noted the negatives on the SS. I’m following him as much as possible today trying to do a test today. (Only doing by strips right now. Work is slow and the ER vet bill hit hard) Eventually we’ll try to get a blood ketone meter.

He seems fine. Behaving normally. He’s an older cat so not very energetic anyway but he comes when called, isn’t hiding etc. He still has some sort of URI going on (think he got it at the er vet) but it seems to be getting better. (Slight sneezing and small bit of eye drainage but it’s better than a few days ago)
Overall crossing my fingers...
 
@Nan & Amber Since I dosed him 2 hours later than normal this morning, I’m assuming we’ll stay off schedule for today and dose at 10 pm instead of 8 pm. Also, he usually eats at 8 but I don’t want to influence his numbers before we know what dose for the night so what is the protocol in this situation?

Thanks a lot for all the help this morning and the kind words throughout the day.
 
ShannonandBiscuit said:
@Nan & Amber Since I dosed him 2 hours later than normal this morning, I’m assuming we’ll stay off schedule for today and dose at 10 pm instead of 8 pm. Also, he usually eats at 8 but I don’t want to influence his numbers before we know what dose for the night so what is the protocol in this situation?

Thanks a lot for all the help this morning and the kind words throughout the day.
Click to expand...
Meaning not till +12 vs +10 because of overlap issues right?
 
Right-- you'll have to go 2hrs late tonight. If that means you are shooting at 10pm, you can go ahead and feed him at his usual time of 8pm, just not right before (the new) shot time. You just need a 2hr window to be sure that the pre-shot number doesn't have a food influence.

Moving forward, you can adust your shot time back bit by bit. Usually, we move a max of 30mins per day-- either two 15min adjustments, or one 30min.

He's having quite the run of greens today, isn't he???? Way to go, Biscuit!
 
You can shoot 30 minutes early tonight to start getting back onto your regular schedule i.e 9:30pm. as .long as Biscuit's BG has come up high enough to shoot which it appears it will but that mean no food after roughly 7:30pm.
 
Nan & Amber said:
Right-- you'll have to go 2hrs late tonight. If that means you are shooting at 10pm, you can go ahead and feed him at his usual time of 8pm, just not right before (the new) shot time. You just need a 2hr window to be sure that the pre-shot number doesn't have a food influence.

He's having quite the run of greens today, isn't he???? Way to go, Biscuit!
Click to expand...

So I tested him at +9.5 and then went ahead and fed him. I’ll test again at +12 as the PMPS. Thoughts about what the dosage should be? Back to the normal of 1.25u or? I’ll post the number later and ask for advice but not sure who’ll be up.

He really surprised me today with all those wonderful greens. Giving that 0.75u dose was a real nail biter for me, given I’m mostly used to only shooting pinks and yellows.
 
It appears Biscuit will be high enough to shoot your current dose of 1.25u tonight. While Biscuits' number were terrific he didn't earn a reduction by dropping to below 50.
 
Yes, I agree. 1.25U tonight.

He's still not super-high, which makes me wonder even more about what could be going on with him. It may be that the bump-up to 1.25U was just what he needed to break through all those yellows and pinks? Or possibly, he's finally feeling better after the thing that sent him into DKA, and you're seeing the results in the numbers. Hmmm. Glad you are able to monitor him so much to keep him safe through these changes!
 
Ok. PMPS was 241 2.5 hrs after food, so I gave him the full dose. 1.25u

Do I need to wake up anytime tonight and test him again? I usually go to bed by 11 and am up by 6, central time.
 
A before-bed test would be at +1 for you, correct? It probably won't give you a lot of information, but in the very unlikely event that he goes down from pre-shot, at least you'll know to set an alarm. Other than that, I think I'd just try to get the +8 or thereabouts when you wake up.

Give Biscuit an extra scritch for being such a rockstar today, and sleep well!
 
You must log in or register to reply here.
Back
Top