? Help! PMPS of 87 for Minnie PM dose skipped again!

Status
Not open for further replies.
Ale & Bobo & Minnie (GA)

Ale & Bobo & Minnie (GA)

Member Since 2019
Minnie had a bad day Friday with nausea and vomiting in the morning, but her numbers were fine so she got her regular insulin dose. I managed to get her to eat baby food (2jars), about a can of fancy feast and a can of tuna. She was fine yesterday but had a high amps and it seems like she was bouncing the rest of the day. This morning more nausea and vomiting and her pre shot was a low 95. I got her to eat a few temptation crunch treats, an Inaba Churu packet and a little baby food but not even half a jar. She won’t touch the fancy feast now and I’ve already tried 2 different grilled flavors. I retested 30 minutes later and she was going down not up at 84. I skipped the insulin dose obviously. I’ll keep trying the baby food every few minutes.

The other question I have is when I give her the ondansetron and Pepcid and she throws up 10-15 minutes later, I’m assuming she’s throwing up the meds and I give it to her again. Am I wrong in doing that?

Any suggestions?

Thanks!
 
I tried the flavors she likes shrimp & salmon and ocean whitefish & tuna. Honestly, Minnie hasn’t met a flavor she doesn’t like when she’s feeling well.

I guess I was wondering if it’s like us. If I take an anti nausea med and throw up in less than 30 minutes, I know that med didn’t have time to be absorbed into my system and it’s basically worthless... I also feel if the ondansetron had worked she wouldn’t have vomited...?

how often do I check her BG levels now?
 
majandra said:
Did she vomit or regurgitate?
When giving Rhubarb a pill in a pill pocket, she sometimes regurgitates after, but the pill is not in there. I would never re dose.
Unless you see an intact pill, you need to assume she metabolized at least some of it.
Click to expand...
she vomited. Minnie never really regurgitates. Bibi does sometimes. The catch 22 for me is, no I never see the intact pills but if the ondansetron is what helps keep her not nauseated and not throwing up and I assume it was absorbed but wasn’t, then she’ll have an even harder time eating for the rest of the day until the evening when she gets it again :banghead:
 
Last edited:
Nan & Amber (GA) said:
So, AMBG 95, +0.5 84, correct?

I'd test an hour after that 84, just to make sure she's not still dropping. That's a pretty sizeable depot with a 3.25U dose, so you can't assume that a skip means she won't go low.
Click to expand...
Okay I’m going to retest her now but I’ve e been watching her and she’s behaving normally. I got her to finish eating one jar of baby food and one of those kroeger tender meat sticks. Also a tiny bit of fancy feast turkey pate. I’m going to try a bit more now
 
Nan & Amber (GA) said:
So, AMBG 95, +0.5 84, correct?

I'd test an hour after that 84, just to make sure she's not still dropping. That's a pretty sizeable depot with a 3.25U dose, so you can't assume that a skip means she won't go low.
Click to expand...
And now she’s at 245! Is that crazy?!

Any thoughts because that feels like a pretty big increase even without the shot given she hasn’t eaten much at all. Is the baby food that carby?

And follow up question, if I had tested her an hour after the second am test and gotten a number over 200, it would have been too late to give her a shot at that point right? Since that would have been 1.5 late...
 
Last edited:
I don't think it's the carbs, I think she's just bouncing to yellows like she has every other time she spotted green :rolleyes:. She'll get over that reaction (eventually).

If you had shot 1.5hrs late, you would have to be able to tolerate that schedule shift for a few days-- when that happens and we have to re-adjust, we like to do it slowly, 15mins per cycle. Other than that, yes, you could have shot then, if you were confident that the 200 was not overly food-influenced and she was "truly" at a number you were comfortable shooting.

As it is, you can take this as a little more data for next time. You did the right thing in stalling and getting a re-test, but she was going down so you were wise not to shoot based on that info. One option might be to stall one more time and see if you can catch her starting her bounce so you know it's safe to shoot. The thing about that, though, is that when stalling you don't want food influence, so she'd be without her meal for a long time. Given that she's having nausea problems anyway, not sure I'd want to mess with her feeding schedule any more than necessary.

It's all a balancing act, for sure!
 
Nan & Amber (GA) said:
I don't think it's the carbs, I think she's just bouncing to yellows like she has every other time she spotted green :rolleyes:. She'll get over that reaction (eventually).

If you had shot 1.5hrs late, you would have to be able to tolerate that schedule shift for a few days-- when that happens and we have to re-adjust, we like to do it slowly, 15mins per cycle. Other than that, yes, you could have shot then, if you were confident that the 200 was not overly food-influenced and she was "truly" at a number you were comfortable shooting.

As it is, you can take this as a little more data for next time. You did the right thing in stalling and getting a re-test, but she was going down so you were wise not to shoot based on that info. One option might be to stall one more time and see if you can catch her starting her bounce so you know it's safe to shoot. The thing about that, though, is that when stalling you don't want food influence, so she'd be without her meal for a long time. Given that she's having nausea problems anyway, not sure I'd want to mess with her feeding schedule any more than necessary.

It's all a balancing act, for sure!
Click to expand...

oey vey and yes it is. Thank you for the info it makes total sense. I’m happy my instincts were right and I’m relieved she’s not hypo and bounced back up. Thanks so much Nan!

one last question, do you suggest I test her again at +6 or +7 or just wait for the pmps now. I feel like she’ll probably stay in the 200’s until then and it’s not like I can shot her in between now and then so the pmps may be all I need... do you agree?
 
The thought did cross my mind ha!

I’d like to keep her at 3.25 for a few cycles before trying to lower her again since I just lowered her from 3.75 to 3.5 and 3.25

At least she didn’t hold a grudge, got on my bed and rolled over so I could give her belly rubs with lots of purrs :kiss:
 
Aleluia Grugru & Minnie said:
The thought did cross my mind ha!

I’d like to keep her at 3.25 for a few cycles before trying to lower her again since I just lowered her from 3.75 to 3.5 and 3.25

At least she didn’t hold a grudge, got on my bed and rolled over so I could give her belly rubs with lots of purrs :kiss:
Click to expand...

Okay so she was over 250 last night and I gave her 3us just to be safe. 368 this am so back to 3.25. Her BG at +7 was 88, which I realize is pretty much the acceptable 90 and she hadn’t had any food in 5 hours when I tested her, but does that significant drop from 368 to 88 in 7 hours mean something I should be aware of or is it normal? I had her at 3.25 longer than I thought when I checked the ss, so now I’m inclined to keeping her at 3u. Do you guys agree?

I’ve been lowering her dose steadily since I started testing her AMPS and PMPS consistently. We started from 9u a day last October to 8 and we’re now at pretty much 6. I guess that’s a good thing huh?

anyway, I’d love some second thoughts please @Deb & Wink @Nan & Amber (GA) @Diane Tyler's Mom :cat:
 
That 88 at +7 was an automatic dose reduction of 0.25U, to take effect immediately. Yeah Minnie, for "earning" that reduction.

So please, drop the dose to 3U for the next week, unless Minnie gives you another indication that she needs a dose reduction. With SLGS and lantus, any time your cat drops below 90 mg/dL, it's time for a decrease.

Any time, pre-shots or in the middle of the cycle. Doesn't matter, the dose needs to be reduced.

Yes, it's a good thing that she keeps getting lower and lower doses. It means what you are doing for Minnie is helping her. :)
Go Minnie!
 
Deb & Wink said:
That 88 at +7 was an automatic dose reduction of 0.25U, to take effect immediately. Yeah Minnie, for "earning" that reduction.

So please, drop the dose to 3U for the next week, unless Minnie gives you another indication that she needs a dose reduction. With SLGS and lantus, any time your cat drops below 90 mg/dL, it's time for a decrease.

Any time, pre-shots or in the middle of the cycle. Doesn't matter, the dose needs to be reduced.

Yes, it's a good thing that she keeps getting lower and lower doses. It means what you are doing for Minnie is helping her. :)
Go Minnie!
Click to expand...

yay for Minnie and yay for my instincts that are learning as well. Yay to all!!! :bighug:

and just to be clear, 368 down to 88 is okay? It just reinforces the reduction I suppose...?
 
Aleluia Grugru & Minnie said:
and just to be clear, 368 down to 88 is okay? It just reinforces the reduction I suppose...?
Click to expand...
Yes, it reinforces the reduction, but also tells us that Minnie can have VERY big drops, steep dives. More like a cat on a shorter acting insulin like Prozinc, than a cat on lantus.

Are you sure she hasn't been consulting with Jacque's Tiger? (Just kidding.)
 
Deb & Wink said:
Yes, it reinforces the reduction, but also tells us that Minnie can have VERY big drops, steep dives. More like a cat on a shorter acting insulin like Prozinc, than a cat on lantus.

Are you sure she hasn't been consulting with Jacque's Tiger? (Just kidding.)
Click to expand...
Well it may have something to do with the dose I had to skip Sunday am I was thinking. That could explain the high on the next cycle if the depot was almost empty?

I don’t think but let me check her journal and get back to you on that one :p:cool:
 
Deb & Wink said:
Yes, it reinforces the reduction, but also tells us that Minnie can have VERY big drops, steep dives. More like a cat on a shorter acting insulin like Prozinc, than a cat on lantus.

Are you sure she hasn't been consulting with Jacque's Tiger? (Just kidding.)
Click to expand...
PS she also drank way more water today than she has in a really long time. It doesn’t add up given the BG levels
 
Aleluia Grugru & Minnie said:
Well it may have something to do with the dose I had to skip Sunday am I was thinking. That could explain the high on the next cycle if the depot was almost empty?

I don’t think but let me check her journal and get back to you on that one :p:cool:
Click to expand...
Retest was 67 so I fed her and I guess I’m skipping the shot. But here’s the problem, if Lantus needs consistency, aren’t all these skipping shots bad? I’m at a loss especially with all the drinking
 
Aleluia Grugru & Minnie said:
Retest was 67 so I fed her and I guess I’m skipping the shot. But here’s the problem, if Lantus needs consistency, aren’t all these skipping shots bad? I’m at a loss especially with all the drinking
Click to expand...
She was at 193 at +2 and 332 at AMPS
I don’t understand the drops and having to skip doses so often
I posted this last night. Can I get some input today please? @Deb & Wink @Nan & Amber (GA) @Bron and Sheba (GA) @Sienne and Gabby (GA)

thanks!
 
Last edited:
My guess? She's a fairly bouncy kitty, prone to dramatic swings, so that makes it hard to shoot consistently unless you are willing to shoot lower numbers. You may need to start doing that, but she's not making it easy.

What is your current "no shoot" number? Eventually, on SLGS, you can shoot anything over 90. She hasn't given you much between 100-200 lately to allow you to work yourself down to that slowly, but once you get there, it will help the situation. The bounciness is still probably going to be with you for a while, though, the only thing to do with that is to wait her out!
 
Nan & Amber (GA) said:
My guess? She's a fairly bouncy kitty, prone to dramatic swings, so that makes it hard to shoot consistently unless you are willing to shoot lower numbers. You may need to start doing that, but she's not making it easy.

What is your current "no shoot" number? Eventually, on SLGS, you can shoot anything over 90. She hasn't given you much between 100-200 lately to allow you to work yourself down to that slowly, but once you get there, it will help the situation. The bounciness is still probably going to be with you for a while, though, the only thing to do with that is to wait her out!
Click to expand...

Ive been following the guidelines on the Lantus sticky note for SLGL. only shoot regular dose when the PS is over 200, token dose between 150-200 and if I get a BG under 90 reduce dose. Last night she was under 90 and then 67 30 minutes later. But once she ate almost a can and a half of fancy feast and some treats she was already up to 193 at +2. I think I agree with you that I should shoot lower numbers maybe at least a token dose but she went down so much I didn’t want to risk. I guess what’s stressing me out is her drinking way more water yesterday and this morning too. she sat in front of the bowl drinking for a few minutes

the only difference was she didn’t eat her 1/2 can of fancy feast at about 2.5 before shot time like she usually does. I also wonder if not having that meal could explain the low PMPS
 
Last edited:
Not sure about the drinking. It might just be that she's been in high numbers recently, so she's doing the typical diabetic thing. It could be something else, though-- when was the last time she had lab work done? The most obvious thing to worry about would be kidney function, so if this keeps up I would take her in so they can check that out. But again, it could just be a temporary thing.
 
Nan & Amber (GA) said:
Right. Those guidelines are for new diabetics, where you don't have a lot of data or understanding of the cat's patterns. When you get more data, you can adjust those recommendations to suit you and your cat.

Although, as I said, Minnie is not exactly making it easy for you to make those adjustments!
Click to expand...

I don’t know that I feel experience enough to know how low I can shoot and would it be the regular dose or a lower dose? I’m the kind of person who needs guidelines too so “playing by ear” is going to be a challenge :banghead:
 
Totally get it!

How about if you decided to amend the guidelines now, before the next decision point? Like, you could change

Aleluia Grugru & Minnie said:
only shoot regular dose when the PS is over 200, token dose between 150-200
Click to expand...

to "only shoot regular dose when the PS is over 175, token dose between 125-175", no-shoot below 125, and decide what the current token dose will be (keep the "reduction under 90" guideline). That way, it's still a solid rule to follow and you won't be having to make decisions on-the-fly :).
 
She’s due I was trying to ride out the covid19 wave and do it after but will make an appointment with her previous vet since it’s just blood work. They’re still letting patients come in with the cats. Her current vet is out pregnant and I don’t know when she’ll be back because of covid. Okay, so here are my concerns for y’all:
1. How do I know how low a number I can still shoot the regular dose? I was hoping to have gotten some replies last night but I think I’m 3 hours behind y’all in PST
2. She had very severe neuropathy and she’s still only 90% better so I’d rather shoot than not and risk neuropathy again
3. I’ve asked about food but didn’t get a consensus. She’s on a 300 calorie diet per nutritionist because she had lost so much weight. I feel like it should be less now but I’m told diabetic cats lose weight by peeing and need more calories than non-diabetic cats. She eats a lot less during the pm cycle and I feel that’s causing the lower numbers at night. Again, here’s the feeding schedule:
A. A can of fancy feast around am shot time. 1/2 can with shot and another 1/2 30 minutes later
B. Another 1/2 can about 2 hours later
C. 1/2 can at the +6/+7 mark after test
D. 1/2 can about 2 to 2.5 hours before pm shot - this is the one she skipped yesterday
E. A can of fancy feast split in 1/2 with shot and then an hour later
F. She’s suppose to get another 1/2 can before bedtime but it’s been hit or miss. Some nights she eats it abs some she doesn’t. She gets treats here too and those she always does eat
 
Nan & Amber (GA) said:
Totally get it!

How about if you decided to amend the guidelines now, before the next decision point? Like, you could change



to "only shoot regular dose when the PS is over 175, token dose between 125-175", no-shoot below 125, and decide what the current token dose will be (keep the "reduction under 90" guideline). That way, it's still a solid rule to follow and you won't be having to make decisions on-the-fly :).
Click to expand...
Our posts crossed. I like that plan!
Especially because you guys are probably asleep when I’m giving her the pm shot ;)

See my question about the food
 
Hmmm, eating less at night could definitely bring down the numbers some (and then rebound, both from eating and the bounce from hitting the low!). The unevenness in her diet could be a factor.

For an extra feeding in the middle of the night, there are a couple options that don't involve you having to set an alarm to serve a meal :rolleyes: : you can get an automatic feeder that you can program to open for a few feedings at night, or you can freeze food portions ("catsicles") and leave them for her to eat when they thaw.
 
Nan & Amber (GA) said:
Hmmm, eating less at night could definitely bring down the numbers some (and then rebound, both from eating and the bounce from hitting the low!). The unevenness in her diet could be a factor.

For an extra feeding in the middle of the night, there are a couple options that don't involve you having to set an alarm to serve a meal :rolleyes: : you can get an automatic feeder that you can program to open for a few feedings at night, or you can freeze food portions ("catsicles") and leave them for her to eat when they thaw.
Click to expand...
Even when I leave a bowl by her bed, she doesn’t eat it. I like the catsicle idea though. I’m partially to blame because of all the coaxing to get her to eat, now sometimes she only eats if I’m holding the bowl to her face or I have to get her started with hand feeding then she’ll eat. I know I created a little kitty monster :nailbiting:
 
Nan & Amber (GA) said:
Hmmm, eating less at night could definitely bring down the numbers some (and then rebound, both from eating and the bounce from hitting the low!). The unevenness in her diet could be a factor.

For an extra feeding in the middle of the night, there are a couple options that don't involve you having to set an alarm to serve a meal :rolleyes: : you can get an automatic feeder that you can program to open for a few feedings at night, or you can freeze food portions ("catsicles") and leave them for her to eat when they thaw.
Click to expand...

can I ask you if you’re familiar with Hound and Gatos? I was hoping to transition Minnie from fancy feast to that, less carbs more fat which could help with the GI tract issues, but then read yesterday that agar agar is something used on grain free foods that can actually be bad for the GI tract. The company send me samples and she loved it, but I don’t want to transition her only to make things worse. Her nutritionist doesn’t see a problem with it but she also doesn’t have a problem with fancy feast and is opposed to consumer raw food because of cases she knows of salmonela in both animals and humans. Anyway, also concerned how a new diet will affect her BG levels that are already all over the place :woot:
 
Aleluia Grugru & Minnie said:
can I ask you if you’re familiar with Hound and Gatos? I was hoping to transition Minnie from fancy feast to that, less carbs more fat which could help with the GI tract issues, but then read yesterday that agar agar is something used on grain free foods that can actually be bad for the GI tract. The company send me samples and she loved it, but I don’t want to transition her only to make things worse. Her nutritionist doesn’t see a problem with it but she also doesn’t have a problem with fancy feast and is opposed to consumer raw food because of cases she knows of salmonela in both animals and humans. Anyway, also concerned how a new diet will affect her BG levels that are already all over the place :woot:
Click to expand...

I don't have any experience with Hounds and Gatos myself, it's good that Minnie approves!

In terms of GI issues, it's tough guessing which ingredient is the one causing problems. One approach is to go with novel proteins and a hypoallergenic diet, that can get pricey and doesn't always meet with the approval of the customer :cat:. Another is just to experiment with different foods, giving them some time, and seeing which ones cause problems and which ones don't. If she's having trouble with the FF, it makes sense to move her off it, for sure, and if she already likes the Hounds and Gatos, why not give it a try? I wouldn't worry too much about the BG effects, as long as they are low carb varieties, there are so many variables that go into BG swings, many of which are totally beyond your control!
 
Nan & Amber (GA) said:
I don't have any experience with Hounds and Gatos myself, it's good that Minnie approves!

In terms of GI issues, it's tough guessing which ingredient is the one causing problems. One approach is to go with novel proteins and a hypoallergenic diet, that can get pricey and doesn't always meet with the approval of the customer :cat:. Another is just to experiment with different foods, giving them some time, and seeing which ones cause problems and which ones don't. If she's having trouble with the FF, it makes sense to move her off it, for sure, and if she already likes the Hounds and Gatos, why not give it a try? I wouldn't worry too much about the BG effects, as long as they are low carb varieties, there are so many variables that go into BG swings, many of which are totally beyond your control!
Click to expand...

so I went on this link what Wendy posted about GI tract and it says a few things are bad like peas and agar agar and hounds and gatos has the latter. The Ziwi everyone loves has DL-Methionine is basically fake meat and really bad “A carb “red flag:” Meat is high in methionine, an amino acid used by many companies as a urine acidifier. If the synthetic version, “DL-methionine” is supplemented, especially if you find it towards the top of the supplement list in commercial food ingredients, alarm bells should go off; this is an indication the food does not contain protein primarily from meat or that the food is otherwise high in carbohydrates. Those carbs make the entire GI system, not just the stomach, too alkaline, and this can lead to various issues”
Anyway, now I found this:

https://rawznaturalpetfood.com/cat/rendered-free-cat-food/turkey-turkey-liver-pate/#our-recipe

I’m going to see if i can buy a few or get sample to try it on her. Also low carbs and high fat. Btw, did you see how well our girl is doing today? Keeping fingers and toes crossed over here :nailbiting:
 
Last edited:
Status
Not open for further replies.
Back
Top