9/18 Kitty Cat PM+10 83, AMPS 92, +1 124, +2 81, +3 95, first time in range

Christina & Kitty Cat

Christina & Kitty Cat

Member Since 2020
Yesterday's thread

Shooting in 2 hours and he's in green at PM+10 83. Last time he was in green, he went hypo.
Reading the low numbers sticky but still panicking...
Will do a test every 30 but he just had a snack with ondansetron. I don't think I can skip since he previously had ketones.
His usual dose is 1u but per @Wendy&Neko 's direction, he's had 0.5u for 2 cycles, and then 0.75u for 2 cycles following hypo on 9/15.
Do I need to feed him something carbier before shooting? I'm scared!
History: ketones, vomiting
 
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Hi! I can't offer dosing advice but you may want to edit your title and throw up the ? from the drop-down to draw eyes. Sometimes the board is quiet in the morning for Eastern Timezone. From my little knowledge on ketones (I don't have experience), I don't think you want to skip the dose entirely.

My cat drops at PMPS consistently so I give a snack at +10 pretty much every day these days. If you give any food after +10, you should adjust your shot time accordingly (your BG test for shot should be 2 hours without food) - so if you give a snack at +10.5 then you need to delay your shot routine by 30 minutes.

Are you following a particular dosing method (TR or SLGS)?

@Butters & Lyla - you know of anyone w experience to help? @Sue and Luci are you around?
 
Bandit's Mom said:
When did he last eat?
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I gave the tinest snack at PM+10, ~1tsp FF classic chicken just to get the ondansetron down but I'm holding food until his AMPS. Before that, at PM+2 he had .5 can FF classic turkey with ondansetron.
JaxBenji said:
Are you following a particular dosing method (TR or SLGS)?
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I haven't gotten so far as to choose that yet
Bandit's Mom said:
Don't panic. You have time. You have caught this 2 hours in advance.
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I almost didn't test until AMPS. so glad I did. Thank you for the reassurance. Will do a +11. Want to avoid "unnecessary extra testing" since he gets really aggravated by it still and I'm not great at it either when it's more than 3-5x a day.
 
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Normally I would ask you to follow the sticky for low numbers. Stall w/o feeding etc. But considering his history, its better someone senior weighs in.
Someone should be along soon. Hang in there :)

ETA:
(a) How is he doing as far as food is concerned? Has a good appetite and keeping food in?
(b) He has earned a reduction per SLGS with that 83, but you test enough to follow TR.
 
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JaxBenji said:
If you can, I'd get a +11.5.

Do you have high-carb, medium carb, syrup/karo? Just trying to think of things people ask me in similar situations :bighug:
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I will get a +11.5. This last test was hard, he's been getting increasingly more aggressive, maybe because the last few days have been a lot of tests. he just banged his head into my teeth. feel like i've tried all the tips for testing but he just hates it.

I have a high carb FF gravy (15-20%) and honey in case of hypo.
Also have purina cat chow dry (27%) and the hills w/d wet (25%) and some greenies treats which I know arent low carb but not sure exactly how to read the carb %? found this:
"Does FELINE GREENIES™ Dental Treats contain any sugar?
FELINE GREENIES™ Dental Treats do not contain any added sucrose, corn syrup, glucose or fructose. However, the total complex carbohydrate content of FELINE GREENIES™ Treats are about 30% which is predominately starch."
 
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Christina & Kitty Cat said:
I have a high carb FF gravy (15-20%) and honey in case of hypo.
Also have purina cat chow dry (27%) and the hills w/d wet (25%) and some greenies treats which I know arent low carb but not sure exactly how to read the carb %? found this:
"Does FELINE GREENIES™ Dental Treats contain any sugar?
FELINE GREENIES™ Dental Treats do not contain any added sucrose, corn syrup, glucose or fructose. However, the total complex carbohydrate content of FELINE GREENIES™ Treats are about 30% which is predominately starch."
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Yay glad you are prepared. I don't know about the greenies but someone else might. And just for FYI, I believe medium carb is 11-15% and high carb is >16%. The idea is to use food to help bring your kitty up if her numbers drop as it lasts longer than syrup/honey. I use medium carb often to help keep my kitty in the greens (and not go into the light greens).

How many minutes until your AMPS? Others may hopefully be coming on soon.
 
JaxBenji said:
Yay glad you are prepared. I don't know about the greenies but someone else might. And just for FYI, I believe medium carb is 11-15% and high carb is >16%. The idea is to use food to help bring your kitty up if her numbers drop as it lasts longer than syrup/honey. I use medium carb often to help keep my kitty in the greens (and not go into the light greens).

How many minutes until your AMPS? Others may hopefully be coming on soon.
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30min until AMPS. I have FF gravy lovers chicken 15% and beef 20%. Would prefer to stick to chicken due to not-yet-figured-out stomach sensitivity
 
Bandit's Mom said:
Think you can pick between SLGS and TR? The next dose would be determined by that - as well as the AMPS!
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I've been trying to think about it but with past ketones, I'm not really sure what to do since I think skipping doses isn't really an option? I tried thinking about it the other day but I haven't been able to focus with all these surprises happening this week.
 
Skipping is definitely not an option. Not unless he is below 50 on the human meter. Even then, with DKA I am not sure...maybe someone with experience with DKA would advise that you feed and shoot after some time. I really don't know.

Will you be around today to test?
 
Recap for anyone hopefully coming in soon:
PM+10 83, tiny snack FF classic chicken with ondansetron
PM+11 83, purebites treat
PM+11.5 88, more purebites treat
AMPS due in 15 min
CAN'T SKIP DOSE DUE TO KETONES, ALMOST DKA

started on 1u
9/13 ketones small, vet said "not DKA yet" (negative ever since)
9/15 hypo
9/16 reduced to 0.5u for 2 cycles
9/17 0.75u for 2 cycles

sensitive stomach, vomiting 9/11-9/13, 9/17 (this day might've just been bc unfamiliar food flavor)
on ondansetron & famotidine

regular food: ff classic chicken 3%
in case of hypo: ff gravy chicken 15%, purina cat chow dry 27%, hills w/d wet 25%, honey, greenies treats

I will be home to test at anytime, HUMAN METER
 
Do you have any flexibility in your shot time? Once you get to AMPS, you could test, not feed, and stall another 20 to see if someone with DKA experience can weigh in. Just throwing it out there - it means you'd shoot your PMPS 12 hours from whenever your AMPS ends up being.
 
JaxBenji said:
Do you have any flexibility in your shot time? Once you get to AMPS, you could test, not feed, and stall another 20 to see if someone with DKA experience can weigh in. Just throwing it out there - it means you'd shoot your PMPS 12 hours from whenever your AMPS ends up being.
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I guess I can stall? I had to stall 1.25 hours on 9/16 to confirm the reduction following hypo so everything shifted that day.
 
80s are good, safe healing numbers. Let's wait and see where the AMPS is?

@tiffmaxee Why are we considering stalling? To see if the numbers trend higher? The last proper meal was at PMPS +2. Without food wouldn't the numbers only go lower?
 
If she doesn’t eat her bg might very well drop. One possibility would be to feed and test in 2 hours. With SLGS she’s earned a reduction to .50. With TR no reduction is earned.
 
Bandit's Mom said:
80s are good, safe healing numbers. Let's wait and see where the AMPS is?

@tiffmaxee Why are we considering stalling? To see if the numbers trend higher? The last proper meal was at PMPS +2. Without food wouldn't the numbers only go lower?
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We cross posted. I think she might be extra sensitive to insulin. When she shot the green she dropped under 68 on the AT.
 
The other option is to shoot .50 on time and feed some mc but you will need to monitor and feed often. Is her appetite ok?
 
tiffmaxee said:
The other option is to shoot .50 on time and feed some mc but you will need to monitor and feed often. Is her appetite ok?
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I was thinking the same thing. Since we don't have enough data on how he reacts in low numbers and skipping is not an option with the DKA, a 0.5 unit dose might make sense.
 
AMPS is 93
gave some more treats to stay still, definitely hungry, wasted 5 test strips and had the lancet in his mouth when I was collecting blood, I want to cry. He's getting super hangry
what do I dooooo
 
tiffmaxee said:
The other option is to shoot .50 on time and feed some mc but you will need to monitor and feed often. Is her appetite ok?
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okay I can do that! aligns with what the second vet wanted yesterday as well. okay I will feed FF gravy chicken 15% since it's mc. will monitor and feed in small portions
 
Hi Christina,

Just got the alert (been busy with stuff for my own civvie).

Let me have a quick look at the SS. Back in a minute or two...


Mogs
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tiffmaxee said:
I would shoot .50 since you can monitor. Others might shoot 1.0 but she is so new to insulin I just feel .50 makes sense.
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Elise, he was on 0.75U. After he earned that reduction from 1 unit - after going below 68 two days back- Christina had taken a reduction to 0.50 but Wendy thought that 0.75 made sense with the DKA in play so he went back up to 0.75 yesterday.
 
Bandit's Mom said:
Elise, he was on 0.75U. After he earned that reduction from 1 unit - after going below 68 two days back- Christina had taken a reduction to 0.50 but Wendy thought that 0.75 made sense with the DKA in play so he went back up to 0.75 yesterday.
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I know. IF he were higher I would have said .75. You can do .75 as well.
 
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I see you're able to monitor throughout the cycle, but I have a couple of questions for you first:

1. How is Kitty Cat's appetite?

2. Has he thrown up at any time since he vomited in the middle of yesterday's AM cycle?

3. Have you got a good supply of medium carb and high carb wet foods? (Fancy Feast Gravy Lovers? Which varieties?)

4. Is Kitty Cat still getting ondansetron? If yes, when was his last dose, and when is his next dose due?

Sorry if you've already posted some of the above. I'm conscious of your schedule and don't have time to read through recent history.

Please don't give any insulin until you've heard back after answering the above.


Mogs
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Critter Mom said:
I see you're able to monitor throughout the cycle, but I have a couple of questions for you first:

1. How is Kitty Cat's appetite?

2. Has he thrown up at any time since he vomited in the middle of yesterday's AM cycle?

3. Have you got a good supply of medium carb and high carb wet foods? (Fancy Feast Gravy Lovers? Which varieties?)

4. Is Kitty Cat still getting ondansetron? If yes, when was his last dose, and when is his next dose due?

Sorry if you've already posted some of the above. I'm conscious of your schedule and don't have time to read through recent history.

Please don't give any insulin until you've heard back after answering the above.


Mogs
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Good appetite. Has supplies.
 
Critter Mom said:
I see you're able to monitor throughout the cycle, but I have a couple of questions for you first:

1. How is Kitty Cat's appetite?

2. Has he thrown up at any time since he vomited in the middle of yesterday's AM cycle?

3. Have you got a good supply of medium carb and high carb wet foods? (Fancy Feast Gravy Lovers? Which varieties?)

4. Is Kitty Cat still getting ondansetron? If yes, when was his last dose, and when is his next dose due?

Sorry if you've already posted some of the above. I'm conscious of your schedule and don't have time to read through recent history.

Please don't give any insulin until you've heard back after answering the above.


Mogs
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OH NO I DID IT ALREADY!!! I gave 0.5u. Is he gonna be okay???
1. good appetite, just ate half can ff gravy chicken 15% with lots of water
2. no vomit since yesterday's AM+7
3. all the ff gravys are 15% except the beef which is 20% but I'm hoping to stick to chicken to rule out food allergy
4. ondansetron 2 hours pre shot, AM+6
 
tiffmaxee said:
I know. F he were higher I would have said .75. You can do .75 as well.
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I disagree with the 0.75IU dose, both yesterday and today. The reason I suggested the 0.5IU dose is because Kitty Cat is underweight and swung from high to hypo to high over the last couple of days. His glycogen stores are likely to get depleted quickly and, because the body is protecting muscle mass, it can take a bit of time for the liver to play catch-up with synthesis of new glucose. I thought there was less likelihood of him going too low on the lower dose [ETA: and possibly ending up with PS BGs that are too low to safely dose in a cat with very little data and notable complications. Also hoped that more even cycles would reduce chance of triggering larger magnitude bounces, possibly amplified by consumption of HC food, as was the case a couple of nights ago. With Christina diligently monitoring ketone status I considered the risk of additional hypos to be greater.]

It looks very much like the problem Robyn has with Olive (and other cats I've seen here in the past).


Mogs
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he usually eats 1.5can ff chicken 3% for breakfast. is this half can high carb enough to eat with his 0.5u dose? he's definitely still very hungry. Shot was ~15 mins late. I'm going to get a +1. will then have the question of which food to feed (lc or hc) for the rest of his breakfast
 
Christina & Kitty Cat said:
good appetite, just ate half can ff gravy chicken 15% with lots of water
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Better that he's eating the higher carb food. I was going to suggest a slower switchover to a medium carb diet for the time being to help make insulin administration safer and more consistent (and also to hopefully help Kitty Cat gain weight a bit faster).

Contingency Planning:

Do you also have any low carb FF chicken paté in the house (belt and braces, just in case the Gravy Lovers were to upset his tum and you needed to switch back.)


Christina & Kitty Cat said:
OH NO I DID IT ALREADY!!! I gave 0.5u. Is he gonna be okay???
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Oh, well. Can't get it back out. ;)

You're there to monitor and steer numbers if and when needed, Christina. You will keep Kitty Cat safe. :)


Mogs
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Christina & Kitty Cat said:
he usually eats 1.5can ff chicken 3% for breakfast. is this half can high carb enough to eat with his 0.5u dose? he's definitely still very hungry. Shot was ~15 mins late. I'm going to get a +1. will then have the question of which food to feed (lc or hc) for the rest of his breakfast
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You don't want to fill him up too early, Christina. There is a possibility that you may need to feed him several snacks through this cycle if he heads for the lower part of the reference range again.

Reminder:

With the human meter, you don't want to let numbers go below 50.

If it were me and it was still early in the cycle I would actually intervene at a higher BG level to steady numbers (60s or 70s - a little of the higher carb foods at a time, and adequate testing to make sure he doesn't drop too low).


Mogs
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Second Recap:
PM+10 83, tiny snack FF classic chicken with ondansetron
PM+11 83, purebites treat
PM+11.5 88, more purebites treat
AMPS 92 1/2 can FF gravy chicken 15% (FIRST TIME HAVING MC)
Will get AM+1 soon

started on 1u
9/13 ketones small, vet said "not DKA yet" (negative ever since)
9/15 hypo
9/16 reduced to 0.5u for 2 cycles
9/17 0.75u for 2 cycles
9/18 (today) AM 0.5u

sensitive stomach, vomiting 9/11-9/13, 9/17 (this day might've just been bc unfamiliar food flavor)
on ondansetron (PM+10, AM+6, PM+2) & famotidine (PMPS)

regular food: ff classic chicken 3%
food in house: ff gravy chicken 15%, purina cat chow dry 27%, hills w/d wet 25%, honey, greenies treats

I will be home to test at anytime, HUMAN METER
 
Critter Mom said:
You don't want to fill him up too early, Christina. There is a possibility that you may need to feed him several snacks through this cycle if he heads for the lower part of the reference range again.
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okay he's calmed down a bit now. holding food. just to clarify, when you say "higher carb", the 15% is okay? Just learning today about the inbetween "MC"
JaxBenji said:
I believe medium carb is 11-15% and high carb is >16%. The idea is to use food to help bring your kitty up if her numbers drop as it lasts longer than syrup/honey.
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I have the gravy beef 20% but prefer to stick to chicken to rule out food allergies.
 
Christina & Kitty Cat said:
1. good appetite, just ate half can ff gravy chicken 15% with lots of water
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A thought:

I suggest that you only add a small amount of water to what you feed Kitty Cat for this cycle (say, a teaspoon or two max to a small meal), again because you don't want to fill him up. If you need to give food to steer numbers I'd suggest offering it 'neat' during the middle of the cycle. You can always give him more water after the cycle is complete.


Mogs
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Critter Mom said:
A thought:

I suggest that you only add a small amount of water to what you feed Kitty Cat for this cycle (say, a teaspoon or two max to a small meal), again because you don't want to fill him up. If you need to give food to steer numbers I'd suggest offering it 'neat' during the middle of the cycle. You can always give him more water after the cycle is complete.


Mogs
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understood! He doesn't drink much from fountain anymore and with all the tummy troubles, I've been making his food more soupy but will not put water in food for rest of this cycle to avoid him getting too full.
 
Christina & Kitty Cat said:
just to clarify, when you say "higher carb", the 15% is okay? Just learning today about the inbetween "MC"
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In general FDMB terms, anything that isn't low carb is technically regarded as 'higher carb'. :D

To clarify, foods from 10% to the mid-higher teens would be medium carb, and it's normally the first thing to reach for when steering a cat who's normally fed a low carb diet. Anything 20% or over definitely counts as high carb.



Christina & Kitty Cat said:
thanks for coming on when you did <3 always appreciate your presence. Hope your kitty is okay!!
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Lúnasa has IRIS stage 3 CKD complicated with HCM, hypertension and anaemia. She's due at the vets on Monday for a cystocentesis and another round of bloodwork. I'm trying to get her records up to date for the vet.


Mogs
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