? 9/20 Dora PMPS 52 (!) 116 after food +1 346 +2 451 +3 422 +6 411 +11 412

Dora the Explorer

Dora the Explorer

Member Since 2020
Link to last: https://www.felinediabetes.com/FDMB/threads/doras-curve-so-discouraged.235472/#post-2637504

first, apologies that the data is thin. After we did the curve and she was high and remained high at all spot checks, she seemed like she was headed in the right direction. Came home and she was due to be tested at 6:30 but she was acting really starved so tested her early. I just fed her Soulistic chicken dinner and gave her a handful of Dr. Elsey’s on top and will test again but what do I do? Is that hypo on AlphaTrack? This is just driving me crazy! If I skip she’ll be high. Last reading at +5 was in the 200s.

Should I skip? I’ll test her again in 20 minutes to be sure she’s coming up and I have some gravy lovers. She’s acting fine aside from being hungry. This roller coaster is so frustrating! Is she ok? She looks it? Past experience tells me if I leave her alone she will spike within a day or two. Help?

thanks!

jane and d
 
You are following SLGS so you need to reduce as she is under 90. If she comes up to a safe number her new dose starting tonight is now 1.50 . Otherwise it's 1.50 in the morning and for the next week unless she earns another reduction by falling under 90. Congrats on the earned reduction.
 
Thanks. Is it considered safe is she comes up to it because of food? I promised myself the next time I wouldn’t freak out and over-carb her when she comes up low but 52 is just a little too extreme! I was giving my dogs some treats and Dora came around hollering for food. She spent yesterday doing her high bg lying around routine.
 
Dora the Explorer said:
Thanks. Is it considered safe is she comes up to it because of food? I promised myself the next time I wouldn’t freak out and over-carb her when she comes up low but 52 is just a little too extreme! I was giving my dogs some treats and Dora came around hollering for food. She spent yesterday doing her high bg lying around routine.
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Disclaimer: still learning the dosing methods!
I wouldn't give insulin with her that low on an AlphaTrak, but I would feed some low or moderate carb food to prevent her from going any lower.
 
Looks like she's coming up now...

Please set an alarm to get up and check her BG tonight. No night time tests is a recipe for disaster.
 
The second test was about 15-20 minutes later. I did call the vet since I was reading all about SLGS and was getting nervous because of the numbers being based on a human meter. The nurse said to give her a half dose and call in the morning, as long as she comes up more after eating. Overnight she just sleeps. Last night I had to drag her out of her bed to get her to have her “second dinner” at 1am. I didn’t test her because my husband was asleep. I really didn’t expect her to drop that low although I’m seeing a pattern of this happening here at out beach house. We go back home tomorrow. She did come up on regular pate and some Elsey’s. She’s not in the kitchen now. I’ll find her and retest soon.
 
Dora the Explorer said:
I will keep an eye on her! Whenever we have tested her in the evening it’s usually followed the same pattern as her curve, not lower.
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That won't always be the case. As you increase the dosage sooner or later she's going to take a swim in the lagoon...when you least expect it. Might as well wait a couple of hours to start testing...Lantus onset is usually around 2+ or later.
 
I might not even bother to shoot her tonight although I know she’ll go up high; that scares me less than these lows. I think I’m going to try the Libre after all. She is 111 now. I gave her more food but it’s not gravy lovers. She’s +12 now.
 
Dora the Explorer said:
I might not even bother to shoot her tonight although I know she’ll go up high; that scares me less than these lows. I think I’m going to try the Libre after all. She is 111 now. I gave her more food but it’s not gravy lovers. She’s +12 now.
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I thought her numbers were going up? Why skip?

btw, you can stack all the pre-shot numbers into the same cell. Just use the paint bucket tool at the top to add the colored background - in this case the lime green since she was under 68 on the AlphaTrack.

Any chance of getting a human meter? 52 would not have been a lime green...but on SLGS you still earned a reduction.
 
Sue and Luci said:
I thought her numbers were going up? Why skip?

btw, you can stack all the pre-shot numbers into the same cell. Just use the paint bucket tool at the top to add the colored background - in this case the lime green since she was under 68 on the AlphaTrack.

Any chance of getting a human meter? 52 would not have been a lime green...but on SLGS you still earned a reduction.
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Thanks, I changed it. I’m on a phone so the cells are tiny.

I did get a human meter but it’s at home and I’m doing this dance trying to keep the vet happy with me and she wants us to use AlphaTrack. Plus it’s so easy to use. I may have to switch.
 
What is a BCS? I can wait. She got her shot at 6:40 this morning. We can give her a reduced shot if she holds her number but it just basically stayed flat for the second test (116 to 111 after another 20 minutes). She’s not really hungry anymore so I guess that’s a good sign? She’s just walking around. I gave her a little more food with Dr. Elsey’s mixed in. Should I break out the gravy lovers if it doesn’t start rising soon? The pattern I’ve seen is it rises in the next couple of days. It’s so frustrating. We aren’t even near her vet if she had an emergency.
 
Dora the Explorer said:
trying to keep the vet happy with me
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I was just asking Olive's mom this question - how many cats has your vet gotten into remission? How many cats does she treat currently successfully long term who are healthy and on a regular dose of insulin?

I'm not sure why vets prefer the AT2 meters unless they're getting paid for recommending them to everyone. What you're looking for are trends - high numbers are high on any meter, pet specific and human; same for lows - when you start to see numbers in the 200's or less; if you look at your SS, the colors are blues and greens; highs are reds and blacks...so it wouldn't matter about the meter as much as it does on the dosing method.

So often I hear horror stories of vets making recommendations to their clients on feline diabetes and they know so little about it I can tell from what they're saying that they haven't read the latest information nor do they have much experience treating FD cats. Some dogs, yes, cats, not so much.

Please do yourself a favor and take a break from your vet. Spend your time reading condos and looking at the Spreadsheets here in this forum - you'll learn more than your vet has time to learn in the next two weeks.

Dora the Explorer said:
What is a BCS?
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Big Chicken Shot
Dora the Explorer said:
Should I break out the gravy lovers if it doesn’t start rising soon?
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I would not feed any gravy style foods when she's in the 100's - that's a safe number to give some insulin as long as you can be up to monitor - and have gravy food just in case; plenty of strips to monitor.

If I had to guess, I'd say her numbers are going to soar tonight - she's going to bounce from that low green she saw today...
 
LOL. Ok I am a big chicken. That’s what I will do but I’ll wait an hour to be sure she is holding her own and will test her a few times tonight. Ugh! I’ve been sleeping so badly and was soo hoping for sleep tonight

thank you.
 
Dora the Explorer said:
LOL. Ok I am a big chicken. That’s what I will do but I’ll wait an hour to be sure she is holding her own and will test her a few times tonight. Ugh! I’ve been sleeping so badly and was soo hoping for sleep tonight

thank you.
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I hear ya...I remember the early days with Luci...

Sleep? What's that?

I know all of this is frightening...we've all been there...but sometimes you just gotta push through. Take a deep breath - you know what to do. And you've got a plan - monitor, feed accordingly, monitor and monitor some more...that's the way to keep her safe and pull her back from the brink should she decide to go there...

But her numbers lately won't win any beauty contests...LOL...she needs the juice I'm afraid...and that bounce won't add anything to the look of her SS...

Hang in there...it'll get better...just takes time...and read up on the dosing methods and what to do 'if'...

Look at other condos and study those other SS's - I found that once I started doing that I learned so much from other peoples experiences with lower numbers, what they did when...that sort of thing. It was like watching You Tube videos or play by play of how they handled all sorts of issues with their kitties.

Now it's your turn :) Have a great evening!
 
Thanks! I’ve been spying other ss’s. I always imagined it would be a nice level response. Find the right dose, it will be higher at shot time with a predictable midpoint and that’s that. It’s been NOTHING like that with D as you see. And I think how we have been thrown off has been with skipping when numbers were low. She had a 72 for her very first reading after a week on one unit. Vet said skip tonight and go to one unit once a day which I now know was a bad move. It took going up to two units to get her down again. You’re probably right about another high.

how much should I feed her at once? Just a little? She’s the only cat here with us now so I can monitor what she eats. At home she shares with her frenemies.
 
Sue and Luci said:
I was just asking Olive's mom this question - how many cats has your vet gotten into remission? How many cats does she treat currently successfully long term who are healthy and on a regular dose of insulin?

I'm not sure why vets prefer the AT2 meters unless they're getting paid for recommending them to everyone. What you're looking for are trends - high numbers are high on any meter, pet specific and human; same for lows - when you start to see numbers in the 200's or less; if you look at your SS, the colors are blues and greens; highs are reds and blacks...so it wouldn't matter about the meter as much as it does on the dosing method...
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Oddly, my vet had a diabetic cat herself! And my first meter was a human meter and she was truly confounded when I told her, she even checked with the internal medicine specialist about it! But yet she wants us to do the Libre.

Her diabetic cat had acromegaly I think - so he was a challenge. Ok off to check on D again to see if she’s ready for her BCS.
 
Dora the Explorer said:
Her diabetic cat had acromegaly I think - so he was a challenge.
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That's a horse of a different color for sure!

Dora the Explorer said:
And my first meter was a human meter and she was truly confounded when I told her, she even checked with the internal medicine specialist about it! But yet she wants us to do the Libre.
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I'd go back to my human meter - not a debatable point for my vet to tell me otherwise - I don't discuss Luci's diabetes with my vets - yes plural, one in Michigan, one in Florida...I do tell them she's a diabetic, and that I'm treating her...I show them her SS if they ask...their eyes grow wide when they see and then they say things like well, how about feeding her some Dietitic Maintenance food and increasing her dose, or why did you decrease here or there - they don't know what those low numbers mean...so it's obvious to me in about 5 minutes of their speaking that they don't know as much as I do about FD..so I smile pleasantly and say thank you and pay my bill and that's that...no I don't call them back about dose changes; no I don't buy their food...no we just don't go there at all...

As far as a Libre goes, I wouldn't bother...they're expensive, and often fall off early...only if you aren't able to test for whatever reason would I even bother...and then you're going to get a lot of data...and then what? You need to know how to respond to those numbers...I don't see the advantage...
 
tiffmaxee said:
You need to keep her hungry so feed just a couple teaspoons and see what the +2 is. Feed every hour to two hours small amounts unless she bounces high.
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ok she is up to 211 and I gave her 1.0 along with a Sheba perfect portion. She ate it all. I suspect she could have taken more and I’ll wish I’d shot 1.5. But BCS it is!
 
Pe
Chris & China (GA) said:
I'm going to bet $1 on Dora bouncing from the 52 today and you being able to not only take a break in testing, but getting some sleep tonight!

We should know if I win my bet or not by +3
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I hope you win. Advice on FB has scared me that I shot too high with the 1 unit. Dora is running around playing and feeling great. I hope she doesn’t drop too low. I have honey and FF and will keep testing.
 
@Dora the Explorer ...getting Pre-shots that are too low to shoot is a good indication that the dose is too high so the one thing to take from all this advice is to reduce the dose down to 1.5U tomorrow.

Then if at all possible (I don't know what your regular schedule is), try to get a +2 on every cycle. It can sometimes act like a crystal ball in predicting what's going to happen later in the cycle. In some cats the +3 is a better predicter but let's start with getting +2's.

It's also important to get at least 1 test on the PM cycle....every cycle. Without testing on the PM cycle, we're all handicapped and have no idea what little Miss Dora is doing!

If you're not into staying up late, you might want to see about changing her dose to earlier in the evening (which also means shooting earlier in the morning unfortunately!)

Dora the Explorer said:
Advice on FB has scared me that I shot too high with the 1 unit.
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I think you did the right thing by shooting the 1U but we'll all know soon enough! Remember, as long as you are able to test, YOU are in control of her blood glucose!
 
Re, your vet's recommendation: Why on earth would you go to 1 unit once a day when you could do 0.5 units twice a day?? Plus her numbers don't seem to support dropping that much yet.

We did 1 unit once a day at the rescue when a cat was approaching remission because the vet didn't trust our med team to be able to dose 0.5 units consistently (med team was a mix of staff and volunteers). There was 1 cat in my 4 years there who metabolized Lantus very slowly and the best way for him to get Lantus consistently was once a day, but that was one cat out of 20--and he would have been diet-controlled if his bg hadn't gotten increased from other medical issues.
 
THH said:
Re, your vet's recommendation: Why on earth would you go to 1 unit once a day when you could do 0.5 units twice a day?? Plus her numbers don't seem to support dropping that much yet.

We did 1 unit once a day at the rescue when a cat was approaching remission because the vet didn't trust our med team to be able to dose 0.5 units consistently (med team was a mix of staff and volunteers). There was 1 cat in my 4 years there who metabolized Lantus very slowly and the best way for him to get Lantus consistently was once a day, but that was one cat out of 20--and he would have been diet-controlled if his bg hadn't gotten increased from other medical issues.
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I don’t know. This was one week into treatment and I didn’t know any better. I was just thrilled not to have to poke her twice a day. That didn’t last long. We did go to 0.5 twice a day but by then she was messed up and needed more. Dora was my son’s cat who moved in with us. She is every bit her captor’s cat! If there’s any strange thing she can have, she will have it!
 
Chris & China (GA) said:
@Dora the Explorer ...getting Pre-shots that are too low to shoot is a good indication that the dose is too high so the one thing to take from all this advice is to reduce the dose down to 1.5U tomorrow.

Then if at all possible (I don't know what your regular schedule is), try to get a +2 on every cycle. It can sometimes act like a crystal ball in predicting what's going to happen later in the cycle. In some cats the +3 is a better predicter but let's start with getting +2's.

It's also important to get at least 1 test on the PM cycle....every cycle. Without testing on the PM cycle, we're all handicapped and have no idea what little Miss Dora is doing!

If you're not into staying up late, you might want to see about changing her dose to earlier in the evening (which also means shooting earlier in the morning unfortunately!)



I think you did the right thing by shooting the 1U but we'll all know soon enough! Remember, as long as you are able to test, YOU are in control of her blood glucose!
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Thanks Chris- we usually shoot at 6:30-7 so we can test at +3 regularly. Usually when we do, she’s been fairly high so we don’t always do it. When/how often should we test her tonight?
 
Chris & China (GA) said:
I'd test at +1 and +2 to start with. The fact that the 212 was "food influenced" is a bit of a concern, but again, as long as you're prepared, you will be able to deal with whatever comes.
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How quickly does food begin to influence, and when does it wear off? I assume the insulin starts to hit around +3? I’m concerned I misunderstood that it was safe to shoot so when would I give the gravy lovers or not at all unless she goes low?
 
Food should begin to raise the glucose in 20-30 minutes....that's why we tell people to feed their cat when they drop below 50 (68 on AT) and test again in 20-30 minutes.

Don't beat yourself up over the decision you made. You're still learning and it's easy to get confused when you have 10 people telling you one thing and 10 other people telling you something else.

This will be a learning experience for you no matter what
 
Update +1 346. I think she will be ok. I won’t feed her and will test in an hour. When will the effect of the food wear off vs when the new insulin kicks in?
 
Dora the Explorer said:
+2 451 now two hours since she last ate and still climbing.
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I think you can pretty safely say that she's well into her bounce and take advantage of it and get some sleep!

You'll have plenty of chances to stay up all night other nights so when you can safely go to bed, do it!

If you happen to get up in the middle of the night, it'd be great to grab a test because the more data the better, but it's not something I'd set an alarm for.
 
I have clothes in the dryer and will test her at +3. I can tell she’s not feeling well, she’s lying in what I call her “sick pose” with her head sticking out forward of her body. It must not feel so nice to go from 300+ to 52 and back to 451 in a day . She’s purring through the tests instead of being mad, though...thanks for the encouragement!
 
+3 411. So coming back down but still quite high. She’s having something else to eat now and I’ll leave some food out for her. Will set an alarm for three hours from now and see how she is doing. Thanks again all!
 
+6 431

I think we are good to get some sleep now. 1.5 units in the am? And we will work our way back to our old shot time (an hour earlier.)

I’m still leaving food out for her just in case she suddenly drops but that seems unlikely to me at this point. Thanks again all -

Jane and D
 
Update: still very high this morning. We tested her at +11 and she was 421. She was hungry so I let her eat. I had left food out but she didn’t seem to have eaten it.

I’ll start her with the 1.5 in an hour (didn’t want to make her wait to eat so I’ll feed her again) but I feel like this is the same thing that has happened in the past but with a lower number. I didn’t drop her dosage when her PMPS was in the 100s and it still took days to come back to normal so I wonder what will happen now.

Also, I won’t call the vet just yet but I realized she said to drop from 2 to 1.5 so she will be thrown off by that, she’ll probably recommend a drop to 1 unit!

Finally, what to make of the fact that I did give her insulin despite the hypo level number yet she is still soaring in the 400s? What does that mean? Just that she bounced? When would that end? Hopefully having at least the 1 unit on board will help her recover to better numbers. I wonder where she’d be if I’d skipped? Possibly about the same, I wouldn’t have fed her quite as much.

We are heading back home this afternoon. I do find it really interesting that her pancreas often kicks in when we are down here (because really, who isn’t relaxed at the shore?!) Thanks to all who weighed in. I’m tired, but we got through the night!

jane and D
 
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