9/20 Olive's PMPS BG 154. Decided to shoot, but scared silly

OlivesMom

Member Since 2020
https://www.felinediabetes.com/FDMB...-to-olive-bolting-as-the-shot-went-in.235594/

Olive definitely got the AM shot and is doing really really well. She's more herself today than I've seen in months. She's following us around everywhere, getting on her back and doing the exposed belly roll she used to do before. It's been so nice to see. She's been vocalizing too. Going down into the basement to get into mischief. She likes to pull the strings around the edge of the carpet down there for which I'm forever trimming so she doesn't eat them and cause problems. All great signs today.
 
Miss Olive's BG is a beautiful 122 but this means I can't give her the injection right now at +12. She's very hungry. Knowing I will have to stall another hour or 2, should I go ahead and feed her and then inject 2 hours from now? I last tested at +10 at which time she got 3 1/2 tsp food and during the last 2 hours she's only up to 122. I'm not sure how long it will take her BG to rise enough to reach 200 which is an acceptable shot number. Any suggestions as I stall?
 
Miss Olive's BG is a beautiful 122 but this means I can't give her the injection right now at +12. She's very hungry. Knowing I will have to stall another hour or 2, should I go ahead and feed her and then inject 2 hours from now? I last tested at +10 at which time she got 3 1/2 tsp food and during the last 2 hours she's only up to 122. I'm not sure how long it will take her BG to rise enough to reach 200 which is an acceptable shot number. Any suggestions as I stall?
Was the 122 with human or pet meter i see ur switching??? In ur signature or not
 
Miss Olive's BG is a beautiful 122 but this means I can't give her the injection right now at +12.

Why are you not able to give her an injection at her regular time?

And why are you giving such small amounts of insulin?

Sorry for all the questions, but I'd like to get a better understanding of what's going on. Her numbers are so high other than just today...I would not hesitate to give her insulin - just wondering why such a tiny amount? And multiple skips...??

Are you feeding DM wet or DM dry food?
 
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Was the 122 with human or pet meter i see ur switching??? In ur signature or not
I'm using a human meter.
Why are you not able to give her an injection at her regular time?
Unless Olive's BG is at around 200 she goes too low. It's been a mess trying to figure this all out but over time we've come to learn she'll be just about perfect if she gets the insulin at 200 and not much less than that. So there's no way we were going to shoot at 122 so we are stalling to allow her BG to at least reach 200. So that's why the skips in the past...or she's gotten fur shots or ran away just as we started to inject and didn't get he insulin.
And why are you giving such small amounts of insulin?
We've also come to learn she bottoms out at anything higher than 0.01 IU. The vet is aware. We have been trying to get her transitioned over to DM (against what I'd hoped for as we are holistic) to get her weight up and allow for more insulin. History has repeated itself way too many times that if we give higher than 0.01 she hits the ditch, but she needs insulin and so far is handling the 0.01 better than anything so far. I don't mind the questions...it's how we learn.
 
Do you have high carb wet food for when she 'hits the ditch?

You need to feed those dropping numbers to keep her away from the ditch...and then when she rises back up you'll need to start giving her a tad more insulin...

Also on the food, DM wet or dry?
 
You don't know that, you've never shot that low before. Lower preshots mean much flatter cycles.
You're right about that. I don't know what would happen and the folks I talk to regularly on here have also been nervous at shooting too much under 200 at this point in time. Maybe later when she becomes more predictable. I'm willing to try at about 180. I just tested her again and she's 137. She's only gone up 15 points in 30 minutes. The vet said I can stall up to 4 hours. Not that I'm going to wait that long, but it's only been 45 minutes since I began stalling. I use Friskies gravy to boost her with. She's on a food ratio of 25% raw to 75% DM right now. That's her LC food. The gravy is all I've ever had to boost with aside from honey when she's gone Hypo.
 
If you stall her too long, her numbers will start dropping without food.

There are a lot of people on Feline Health who are nervous shooting anything under 200, and that's because a lot of the people posting there are very new, might not even be comfy testing yet. Plus you'll get people there on other insulins. The L insulins are different.
 
I'm trying to learn how the Lantus works. I appreciate the feedback on it. My fear is that giving the shot at what would be half her usual shot BG would cause her to bottom out and I'm too terrified of that happening again to risk it. The vet was on the fence at shooting at 200 and said only I knew Olive best. I guess it's because of Olive's history of plummeting even when given the injection at much higher numbers like 300+ that makes me worry what would happen if given the insulin at half those numbers.
 
One more observation, every time you've shot low 200's (your lowest so far), she's had lovely cycles. The only times she dropped really low were when she started the cycles in red or black or once pink. That is very typical with Lantus. Those flatter cycles are why I loved shooting lower. Lantus is great at keeping lower numbers flat and lower.
 
I would shoot a dose of .25 and then monitor if it were me. She clearly needs more insulin to get her to stop bouncing up to those black numbers.

When she starts to drop - at any time she drops more than 100 points from one test to the next, bring out the medium carb, feed and then test again...slow the drop.

I would not continue to stall - her numbers are already climbing. Time to shoot...
 
One more observation, every time you've shot low 200's (your lowest so far), she's had lovely cycles. The only times she dropped really low were when she started the cycles in red or black or once pink. That is very typical with Lantus. Those flatter cycles are why I loved shooting lower. Lantus is great at keeping lower numbers flat and lower.
Okay...
I would shoot a dose of .25 and then monitor if it were me.
I'm definitely not ready for that. We and the vet want to see her stabilize a bit on the new food before we tinker with IU.
When she starts to drop - at any time she drops more than 100 points from one test to the next, bring out the medium carb, feed and then test again
I don't have medium carb food. What would that be considered? The vet only said to feed the DM , use gravy as the HC. What kind of food is MC?
I would not continue to stall - her numbers are already climbing. Time to shoot
I think I'll try it. But I'm scared to death of her dropping too low by +6.
Lantus is great at keeping lower numbers flat and lower.
Since I'm not familiar with how Lantus works, I'll have to trust you on this.
 
I agree with Wendy.

Unlike the other insulins that the people on Health may be using, Lantus can be counterintuitive. On the surface, it makes sense that if you shoot a lower number, the cycle will put your kitty in dangerous numbers. Once you get comfortable with shooting progressively lower numbers, if you opt to follow TR, you can shoot any number above 50. (I know. That sounds inconceivable to you.) The reason is that Lantus doesn't typically yank numbers down. The ideal Lantus cycle is flat. Take a look at the subject lines on the board. You'll see that many people shoot low numbers.

We do not suggest you jump in and start shooting low from day 1. It's a matter of collecting both data (i.e., becoming "data ready") and gaining confidence in your ability to manage low numbers. You'll get to know how your cat responds.

Low carb is below 10% carb. Medium is from 10 - 15%. High carb is over 15%. If you look on Dr. Lisa's food chart, you can find a carb level to meet every need! I'm curious why your vet wants you to switch to DM from raw. Have you looked at the ingredients in DM?
 
Since I'm not familiar with how Lantus works, I'll have to trust you on this.
It's a great leap of faith. :bighug: My first few times shooting low were terrifying. I'm on the west coast, I'll be up another 8 hours and keep an eye on you.

When you shoot your lowest yet to date, get a +1 and a +2 to see if you need to intervene early. Since she's on her way up (test again before shooting) and onset isn't for a couple hours, and you'll be feeding, she will be higher before the insulin takes effect.
 
We and the vet want to see her
The vet only said to

I think I see the problem here...you keep mentioning 'the vet'.... I'm sorry to have to say this but it's becoming more apparent to me by the minute that your vet doesn't know anything about FD.

If you're read any other posts on here about bad advice people have gotten from vets, it's repeated, constantly...and even moreso on FaceBook...vets simply do not have time to read and understand everything there is to know about treating cats with diabetes.

The sooner you take that into consideration the sooner you'll start to see better numbers! You've gotten some wonderful advice from several experienced people AND the moderators - Please, please do yourself a favor and take a break from your vet for a couple of weeks, minimally and trust what these folks are saying to you.

If you don't believe it, look at other condos and Spreadsheets! Look at the number of cats that have gone into remission...the proof - as they say, is in the pudding...

How many cats has your vet gotten into remission? Or at the very least, treated long term to the point where they are regulated and doing well on a regular diet of low carb wet food and regular shots of insulin?
 
t's a great leap of faith. :bighug: My first few times shooting low were terrifying. I'm on the west coast, I'll be up another 8 hours and keep an eye on you.
Thanks! I just gave her the insulin at a BG of 154. OMG. I am terrified and will be watching her like a hawk tonight.
As to all the other comments and questions I will get to them but it won't be for a while as hubby needs his dinner and some down time with his wife. I greatly appreciate everything you've all said. I am totally understanding how little vets actually know. You guys have helped me more than they have thus far. And yes I KNOW the ingredients in DM which is why I didn't want to ever put her on it. I wanted raw and healthy, but everyone kept saying she needed more carbs than the 0.04% she was getting which wasn't putting the weight on her that she needs, but I'll touch base on this later. We are holistic people, so it killed us to put her on DM. Later guys....I'll keep this updated on how her BG goes.
 
@Wendy&Neko said she's going to be up for the next 8 hours so she'll be around to help you.

I'm an early to bed, early to rise girl...

Good luck tonight...I'm sure you can help get her to some better numbers...

Try to get to the store and get some Fancy Feast gravy style foods. If you need more info on which foods have more carbs take a look at the food chart here https://catinfo.org/chart/index.php

I found this enormously helpful and would copy down portions of it and print it off to take to the store with me. Often there were only a few kinds of gravy style in one store or another so I had to check the list multiple times to find the right ones and then I'd take them home and write the carb count on the bottom of the cans with a Sharpie so I could grab the right carb amount when I needed it and not have to look it up again - especially when I was panicky about a low number and didn't feel like I had time to fret over what was what.

Being prepared will help you remain calm and you can deal easily with lower numbers without being 'terrified'.
 
everyone kept saying she needed more carbs than the 0.04% she was getting which wasn't putting the weight on her that she needs,

Just to clarify...

For any animal that needs to gain (or lose) weight, carbs are not the issue. Calories are the issue. It's possible that a low carb diet may be lower in calories. However, if you were feeding your cat raw chicken and switched to raw lamb, there would be a large jump in calories. In addition, cats are obligate carnivores. Their bodies do not metabolize the plant matter in their food. They do best on high grade protein like in muscle meat vs animal by-products.
 
er the chewy.com website listing for Purina DM canned, 1.78% carbs as fed, 7.27% carbs on a dry matter basis. (No full 'as fed' nutritional analysis available on the site with which to calculate the % calories from carbs.)
I actually spoke to a vet in charge of the Purina foods company (I wanted answers and took my quest right to the top of the food chain) about the DM as well as the Fancy Feast foods about carb content and what it actually means and just exactly was the carb count in their foods. You all probably know all of what I'm about to say. He said you have to go by the dry matter, not the as fed. I personally don't get that even after he explained it many times as it only seems more logical that "as fed" means exactly what's in the can you feed your cat. Nope, logic doesn't come into play here. Evidently it's the dry matter that we are supposed to account for when looking for foods and the analysis isn't listed in full on many of these cat foods making it impossible to calculate carbs. Purina had the data for me, but it's a shame you have to actually call to get this info. FF turkey, which we had tried her on right before the DM contains 3.9% carbs to 53% protein and the DM 7.14% carbs to 56.9% protein. He did all the research into it because of my need to know exactly what the carb content was as I told him how confusing these labels are and how we simply have to be guaranteed of the content. He was most helpful and actually spent 20 minutes on the phone with me explaining how carbs/dry matter/as fed works. It's dry matter that we go by and often times all the data isn't listed making it impossible to calculate. If anyone needs more info, call the Purina vet line. They've also updated the food analysis data so I got the latest, most accurate numbers direct from the horses mouth.

I think I see the problem here...you keep mentioning 'the vet'.... I'm sorry to have to say this but it's becoming more apparent to me by the minute that your vet doesn't know anything about FD.
It's mind boggling to me how all the vets I've spoken to admit they know just enough to scrape by when it comes to FD. Well, all but that one vet I NEVER want to see again and dismissed in Olive's care. She thought she knew it all and berated us for not wanting to go on the DM and wanting to keep Olive on the raw diet she'd been on. I've learned more from you guys then I have them. Being new to FD the fear factor has been overwhelming. On one hand you are supposed to be able to trust your vet, but when they don't appear to know much it's quite unsettling. This is why my vet handed Olive's case over to the vet I dismissed, because she thought the other vet would know more. Afterwards, I went back to my original vet for whatever help they could offer. I do have an appointment set up with our old holistic vet on the 25th. We used to take our KD kitty to her and Sophie thrived under her care. So we thought she could help us with Olive. Although, I've come to learn she has only a few FD kitties under her care so now I'm not sure what to do. Hubby thinks we should cancel that appointment. I like the fact she's holistic, as we've always been, so hoping she can suggest a diet that will give Olive the fat and calories she needs so we can get her off the DM. I do know the garbage that's in DM and admittedly in FF as well. No offense, anyone. But if it's not holistic, I'm not a fan. I believe animals should eat what nature intended. That's another reason we're glad Olive is still at the 75% DM/25% Raw ratio. at least a quarter of her diet is still raw food and the food we wished she could remain on. It has virtually no carbs. That's our goal for her in the future, to return to raw food, but right now the raw isn't putting the weight back on her and that's what she needs most right now.

Try to get to the store and get some Fancy Feast gravy style foods. If you need more info on which foods have more carbs take a look at the food chart here https://catinfo.org/chart/index.php
Thank you! For the time being we are doing whatever we have to do whether we like the ingredients or not.

Good for you for shooting. :bighug: I see a 214 at +1. That's a good bump up. Make sure you don't overfeed her, just in case she needs to eat a little bit more later.
Thank you! Boy, oh boy was that ever scary. So far so good. We're at +4 and she's 269. You said not to feed her too much just incase. How much is too much? I wish we could go longer periods of time between her feeding. Because we are trying to get weight on her and because we can't get her to eat more than 3 tsp (4 if we are lucky) in her at any given time, topped by the fact she's always been a grazer, we have to feed her every few hours just to attempt to get enough calories in her in 24 hours. We aren't there yet, although she's beginning to show some promise. I can't reduce her food amounts or frequency at this time, unfortunately. Wish we could. Her tummy wouldn't take but a tsp or 2 at the beginning as larger amounts made her sick and we had to feed on the hour so she would be able to hold it all down, and she was still losing weight because we couldn't get enough in her daily. Now she's eating every two hours and a good 3 tsp each time. Even though it's not an ideal plan, it is effective, and a step in the right direction, and I'd rather see her try and get some weight back on and worry about amounts and frequency later. She's definitely made progress though. Baby steps. I'm currently trying to get her to eat 4 tsp in one sitting but it's more miss than hit at this point. Only she knows what her tummy can handle and she's been steadily improving. Olive hasn't exactly been the most cooperative kitty since this began, but she sure is a trooper when it comes to BG testing. Often times she just lays there without even lifting her head. Good girl!

I think I'll call it a night, unless Olive drops by her AMPS, but right now I'm rather surprised quite frankly by her levels staying so level when I thought for sure she was going to dip low and maybe even hypo tonight. I don't want to jinx anything, but at this moment I'm glad I at least tried shooting when she was below 200...and she was 154 PMPS! To you guys her numbers are still too high, but after we've been dealing with BG not only in the black but off the meter's ability to read it any longer, these numbers and the fact they are staying so steady is like a miracle to me. I will continue to monitor closely tonight just for my own peace of mind because I did shoot at 154. If anything goes wrong I'll be back on here. If not, you can find Olive's BG updated in her SS up until I go to bed. I will get some sleep between tests. If you don't see any updates in her SS you'll know all is well until morning when I can get it all entered in. Night everyone!
 
+2 215 Good girl Olive, keep steady and flat.

How you doing @OlivesMom ?
Our messages crossed. I'm doing very well, thanks. I'm quite shocked that her numbers are staying as they are when I'm so used to big swings in all different directions. Is this how Lantus is supposed to work when you shoot at lower numbers?
Just to clarify...

For any animal that needs to gain (or lose) weight, carbs are not the issue. Calories are the issue.
So does this mean we could have kept her on the full raw diet then, just increase the amount she eats? I thought it was carbs that mattered. All we know is she needs to gain a lot of weight back and we absolutely hated having to put her on the DM.
 
Our saying here is "shoot low to stay low". Looks like the delay and blues today caused a little bit of a bounce. Feed her what you need to now, and go to sleep. I had suggested not feeding too much early on, but once she onsets (+2-+3) and still flat or up, then dropping isn't a worry.

For what it's worth, my raw fed girl got Weruva Grandma's Chicken Soup (21%) for high carb if she needed a real boost, and some of the Cats in the Kitchen pouches around 16-17% when she needed a lighter touch. Neko reacted poorly to gravy in Fancy Feast - the wheat didn't agree with her. Sienne is right, calories puts on weight. Lamb and duck are two fattier and higher calorie meats. If doing chicken, chicken thighs are higher calorie than chicken breast. The nice thing about a raw diet is that lower volume is needed to get the same calories, so they don't need to eat as much.
 
A lot of really good feedback tonight. I'm learning. Thank you! I can't wait to share this info with hubby. We both want her back on a raw diet.
The nice thing about a raw diet is that lower volume is needed to get the same calories, so they don't need to eat as much.
That's exactly what Olive needs since she never eats a lot at one time. I'm kind of chuckling here as we just bought TEN 3# bags of Primal frozen turkey nuggets as there was a shortage for a while and our girls like the turkey. I wonder if they'd eat Duck. Well, I think it's best to eat through those ten bags first...lol If there's anything I've learned tonight it's that Olive can indeed get the injection at a lower number than I ever imagined. I'm glad I took that leap of faith or else I never would have known nor would have ever attempted to shoot so low. I'm going to get some sleep now. Until next time.
 
But 200 or even 100 something isn’t too low to shoot? Isn’t it shoot low to stay low? I’m confused what the fear is.. also the stalling 4 hours thing- how does that work when it’s every 12 hours and even giving the dose as little as 30 minutes before could be looked at as an increase.
 
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