10/20 Comet AMPS 137

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Jenny and Comet (GA)

Jenny and Comet (GA)

Member Since 2020
Critter Mom said:
Hi Jenny!

Glad you got some sleep. I know the blues are scaring the bejeezus out of you, but they're very good for Comet! :)

I'd suggest grabbing an early reading at +11.5 this morning and post it in a new thread for today. That'll give a little bit of time to look at possible options and hopefully keep you on schedule. Then please take the AMPS reading at the normal time and post that too.

In the meantime, can you answer a few standard pre-flight checks:

- Is Comet over his tum upset and eating well again?

- Are you are at home and available to monitor him today?

- Do you have an adequate supply of higher carb food options, honey/karo, etc., in your toolkit?


Mogs
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Starting a new thread as directed. (Hoping I did the thread title correctly.)

I tried sleeping again so only just saw this. 131! Only a few minutes before AMPS.

He is eating pretty well.
I am home but unfortunately not for the full day. I have 2 Zoom work meetings that I can't get out of.
I have honey and medium carb foods (FF chicken and liver with gravy, some other FF with gravy). I think I may have a can or two of higher carb stuff, but oddly it would be stuff that he didn't love very much when he did eat it. I have a couple of things that I am guessing are higher carb but aren't on the food chart, so I don't know (Wellness Tiny Tasters).
 
Hi again, Jenny.

Thread title is absolutely fine. :)

PM+8.50 176.
PM+11.75 138.

Considerations:

* Lowest PS to date. No history of giving insulin with PS BG < 200.
* BG numbers fell from PMPS through to AMPS.
* Very strong response to 1/4 unit dose, even after a skipped dose and without a full depot.
* History of dropping to greens on 3 consecutive 1/4 unit doses (depot not full).
* Intensive monitoring not possible for all of the cycle.
* Comet eating OK.
* No history of positive ketone tests or DKA.

Based on the above considerations, my suggestion is that you skip this AM's dose (safest option).

What do you think, Jenny?


Mogs
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Critter Mom said:
Hi again, Jenny.

Thread title is absolutely fine. :)

PM+8.50 176.
PM+11.75 138.

Considerations:

* Lowest PS to date. No history of giving insulin with PS BG < 200.
* BG numbers fell from PMPS through to AMPS.
* Very strong response to 1/4 unit dose, even after a skipped dose and without a full depot.
* History of dropping to greens on 3 consecutive 1/4 unit doses (depot not full).
* Intensive monitoring not possible for all of the cycle.
* Comet eating OK.
* No history of positive ketone tests or DKA.

Based on the above considerations, my suggestion is that you skip this AM's dose (safest option).

What do you think, Jenny?


Mogs
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I am relieved, frankly. It does feel safest. I am guessing based on the last couple of days that he will be in the 200s in a couple of hours and probably high enough to shoot at PMPS. Thank you, Mogs. Will check in again then and keep tabs on him while I am here. (Easy to do right now, he is sitting on me.) Breakfast time!
 
Enjoy your brekkie, Comet! :cat:

As with yesterday, it would be great if you could grab a few readings here and there to see how the numbers trend. In particular, if you're able to grab a +1 this morning it would give you helpful info on whether he's starting to rise.

Have a grand day, the pair of you. :)


Mogs
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`
Critter Mom said:
Enjoy your brekkie, Comet! :cat:

As with yesterday, it would be great if you could grab a few readings here and there to see how the numbers trend. In particular, if you're able to grab a +1 this morning it would give you helpful info on whether he's starting to rise.

Have a grand day, the pair of you. :)


Mogs
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Will do! And thank you. He had a few bites and waked away. I forgot that I left the second can from last night down until I woke up at four a.m. (honestly didn't think I would sleep for that long), and it was nearly gone. I am guessing he had several snacks during the night.
 
Critter Mom said:
Lower, and that's after food. Looks like skipping was very much the smart move, Jenny.


Mogs
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99 at +2.5. He never went back for more breakfast after the few bites he had earlier, was too busy snoozing with his brother as they do most mornings after they eat. Just put a new can of FF down and he has had some bites. He has walked away but will hopefully go back a few times, which is how he usually eats. His non-diabetic brother is happily chowing down, of course -- he tends to eat a good amount at one time and then is done. I wish Comet ate more like that, but he he never has in their whole lives, so why would he start now? Argh. I know 99 is a great number, I am just nervous. And very glad I didn't shoot this morning!
 
jt and trouble (GA) said:
if theres no insulin on board theres nothing to worry about. When was his last shot?
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Last night at 7:35, 1/4 unit. I think he is still reacting to it. Is that possible?

I worry because this is what today looks like (see first image). And this is what the last 24 hours look like (last shot 7:35 p.m.). it does not look like he is stopping or leveling out. And it doesn't seem like he is slowing down.

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Critter Mom said:
Hi again, Jenny.

Thread title is absolutely fine. :)

PM+8.50 176.
PM+11.75 138.

Considerations:

* Lowest PS to date. No history of giving insulin with PS BG < 200.
* BG numbers fell from PMPS through to AMPS.
* Very strong response to 1/4 unit dose, even after a skipped dose and without a full depot.
* History of dropping to greens on 3 consecutive 1/4 unit doses (depot not full).
* Intensive monitoring not possible for all of the cycle.
* Comet eating OK.
* No history of positive ketone tests or DKA.

Based on the above considerations, my suggestion is that you skip this AM's dose (safest option).

What do you think, Jenny?


Mogs
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Agreed!
 
Urgent questions, Jenny:

1. How long are you able to check on Comet right now? An hour or two? Or less? (I know you've got meetings scheduled.)

2. Do you think Comet would eat a couple of teaspoons of food now, 2 more in 30 minutes, and another 2 more again 30 minutes after that?

.
 
Aleluia Grugru & Minnie said:
Now I’m thinking he needs a dose decrease so you’re not skipping doses so often. Critter Mom, do you agree?
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There's no stable depot for the 1/4 unit dose. Comet's BG dropped after eating earlier. I am wondering whether his pancreas is sputtering [ETA] or whether he's getting carryover from last night's dose. Not enough data yet to get a clearer picture.

I think if the depot filled even partway on the 1/4 unit dose it would be too much. The 0.1 needs to be considered.


Mogs
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Aleluia Grugru & Minnie said:
Yes please try the medium carb food now
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Critter Mom said:
Can you let us know what's happening please, Jenny? Worried about you.


Mogs
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Sorry, I was focusing on him. Got him to eat a few bites of a medium carb food (FF liver and chicken in gravy). He settled down next to me a few minutes ago and has seemed okay. Just got a 122. It really only was a few bites, so not too much behind it. Will encourage him to eat a few more in a few minutes.
 
Phew! Glad you're both OK. :)

That's a fair food bump. Maybe try switching to low carb once you feel happier with his BG levels. If you're free, I suggest checking the Libre in the period from 60-90 minutes after he finished eating to see whether he might be bringing down numbers any bit by himself.

Questions for you when you have a spare minute to answer:

- Is Comet still underweight?
- What carb % is his regular low carb food?


Mogs
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Critter Mom said:
There's no stable depot for the 1/4 unit dose. Comet's BG dropped after eating earlier. I am wondering whether his pancreas is sputtering [ETA] or whether he's getting carryover from last night's dose. Not enough data yet to get a clearer picture.

I think if the depot filled even partway on the 1/4 unit dose it would be too much. The 0.1 needs to be considered.


Mogs
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I think I noted this on the spreadsheet. He didn't get any insulin at all after 9/26 PM until 10/17 PM. His vet had set targets of 300 (still at 1/4 unit) and he was never reaching them. Occasionally he would come close, but never around shot times. He would go up and down by himself, ranging in the 100s and 200s. She and another vet from the same practice that he saw thought he was heading towards remission. I wasn't convinced because I was still seeing signs, but they were encouraged by the direction he was moving in and thought he was getting there. The vet recently reset the threshold at 250 and because I saw that I started shooting again.

What I wonder is if he tended to be in that 100s-200s ranges on his own anyway, so was just reverting back to that after a brief period of insulin. It is hard to know what to think about everything.
 
Jenny, any news on the vet and an anti nausea prescription? I’d call them back today and say this is not urgent since he vomited again today. They can call in a prescription for you if ondansetron at any human pharmacy. Do you typically get all the pet meds form them or do you order them from a pet pharmacy? Cerenia would have to come from a pet pharmacy I’m afraid @Jenny Ellen
 
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Jenny Ellen said:
Is it something like you see a line of daylight between the zero line and the plunger?

Do you think last night's insulin (we are a bit over +16 from that shot) is still having an effect?
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That’s what I’m thinking and it shouldn’t last this long so that’s why I’m considering he needs a dose decrease. You’d have to eye ball 1/2 of a 1/4 but it’s doable. This could also mean he’s working towards remission and not needing insulin
 
Critter Mom said:
Phew! Glad you're both OK. :)

That's a fair food bump. Maybe try switching to low carb once you feel happier with his BG levels. If you're free, I suggest checking the Libre in the period from 60-90 minutes after he finished eating to see whether he might be bringing down numbers any bit by himself.

Questions for you when you have a spare minute to answer:

- Is Comet still underweight?
- What carb % is his regular low carb food?


Mogs
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He really didn't have very much, less than 1/4 of a can. I just looked at him now and it's 108. I think he ate about 45 minutes ago.

He usually eats Fancy Feast Classic pates, most of them under 3 or 4% I think. He occasionally has some Wellness Complete Health that are 4-6%, and some Weruva that are lower. (Prediabetes, his wet food varied from 0-20% [where I can find values for them]. He of course had dry food, which was much higher.)

I think he is. He's 9.4 and spent most of his adult life around 10.5-10/8 and wasn't overweight. One vet said some of the weight loss could be aging (he's sixteen); his brother is still healthy and also weighs less than he used to.
 
Jenny Ellen said:
He really didn't have very much, less than 1/4 of a can. I just looked at him now and it's 108. I think he ate about 45 minutes ago.
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That's exactly what I was hoping you might catch. 17 hours out from the previous dose it is highly unlikely that the Lantus had anything to do with that drop - from a medium carb food as well.

When the Libre works, it works really well! :cool:

I suggest taking a reading at AM+11.5 and posting on the Lantus board for dosing advice before tonight's cycle. Copy/paste the URL for this thread into the first post on the Lantus thread.

I think Comet looks to still need some insulin support because he has been hovering in diabetic numbers without it but right now the 1/4 unit dose looks too high.

Things to consider going forwards:

* It can sometimes be trickier when treating kitties who need to regain some weight because they may exhibit quite strong responses to even tiny doses of insulin.

* If insulin is still needed and even a microdose of Lantus proves tricky to give safely, bumping the carb load of the food closer to the 10% mark may help to support more consistent dosing.

Be sure to let the people advising you know what your schedule is like and what your availability is to closely monitor Comet should he have a low run. Safety is paramount. Also, be sure to tell them that Comet has been intermittently vomiting and can be slow to eat sometimes.


Mogs
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Jenny Ellen said:
Got him to eat a few bites of a medium carb food (FF liver and chicken in gravy). He settled down next to me a few minutes ago and has seemed okay. Just got a 122. It really only was a few bites, so not too much behind it.
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[Emphasis mine]

Jenny, please can you also add the reading above into Comet's spreadsheet in the appropriate cell. It's really important that members advising you tonight see that the MC food raised his numbers but that BG level dropped back shortly after even though no insulin was given this morning. Also, it would be helpful to both yourself and members assisting you if you make a note of how much you fed and the carb level (e.g. "+?.?? - fed 2 tsps 20% carbs"). It's invaluable to have a record of what works to refer back to. :)


Mogs
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Aleluia Grugru & Minnie said:
Did you see my post about the anti nausea med? You haven’t answered it and I think it’s important :)
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Sorry, I missed it! :( I have a call into the vet and am waiting to hear back. She still hasn't gotten back to me from my message and email the other day. Will ask her about the anti-nausea stuff. I know they had him on mirtzapine (?, am sure I am spelling that wrong) when he was there for a hypo, but he seemed really upset when he was on it and acted very erratically. (He has seen four vets at this practice, the one who put him on it for that only saw him the second day he was there). I am a little scared of him going on something like that again, is the one you suggested better? If the practice doesn't have it, if I can get it a regular pharmacy I can do it, otherwise I would have to order.

He doesn't seem nauseous. He has eaten a few times now in his regular grazer-y way and it's stayed down. He looks unbothered.

My other cat, however, just had a hairball.
 
Jenny Ellen said:
Sorry, I missed it! :( I have a call into the vet and am waiting to hear back. She still hasn't gotten back to me from my message and email the other day. Will ask her about the anti-nausea stuff. I know they had him on mirtzapine (?, am sure I am spelling that wrong) when he was there for a hypo, but he seemed really upset when he was on it and acted very erratically. (He has seen four vets at this practice, the one who put him on it for that only saw him the second day he was there). I am a little scared of him going on something like that again, is the one you suggested better? If the practice doesn't have it, if I can get it a regular pharmacy I can do it, otherwise I would have to order.

He doesn't seem nauseous. He has eaten a few times now in his regular grazer-y way and it's stayed down. He looks unbothered.

My other cat, however, just had a hairball.
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Mirtazapine is an apetite stimulant and yes, it does make Minnie act weird and ravenous too. It doesn’t work if the cat is nauseated so that’s not what you need. You want an anti nausea. Again, Cerenia or ondansetron. Ondansetron works well for Minnie. Cerenia did nothing but it does work for others. You can give both simultaneously as they work differently so depending on how easy going your vet is you could ask for a prescription for both to see that works. Anti nausea meds are something you must have in your diabetic cat tool box. It’s a must because they need to eat

and yes, vets tend to not get back to you in a timely matter. Definitely, not fast enough when you’re having bg issues. This is why we rely on the people in this forum who are here 24/7
 
Critter Mom said:
[Emphasis mine]

Jenny, please can you also add the reading above into Comet's spreadsheet in the appropriate cell. It's really important that members advising you tonight see that the MC food raised his numbers but that BG level dropped back shortly after even though no insulin was given this morning. Also, it would be helpful to both yourself and members assisting you if you make a note of how much you fed and the carb level (e.g. "+?.?? - fed 2 tsps 20% carbs"). It's invaluable to have a record of what works to refer back to. :)


Mogs
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Mogs, have added that reading, will add more. I didn't feed him by tsps, I just eyeballed, so am not sure how helpful that will be/is.
 
Aleluia Grugru & Minnie said:
Mirtazapine is an apetite stimulant and yes, it does make Minnie act weird and ravenous too. It doesn’t work if the cat is nauseated so that’s not what you need. You want an anti nausea. Again, Cerenia or ondansetron. Ondansetron works well for Minnie. Cerenia did nothing but it does work for others. You can give both simultaneously as they work differently so depending on how easy going your vet is you could ask for a prescription for both to see that works. Anti nausea meds are something you must have in your diabetic cat tool box. It’s a must because they need to eat

and yes, vets tend to not get back to you in a timely matter. Definitely, not fast enough when you’re having bg issues. This is why we rely on the people in this forum who are here 24/7
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You are godsends. Seriously. So appreciated!
 
Jenny Ellen said:
I feel terrible. I sent him too far in the other direction. Now over 300 at +8, which is higher than he was for his PMPS last night. I completely failed him.
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I feel like that about every decision I make with Minnie all the time. Just today in fact because I let a low amps scare me into feeding her more and now she’s higher than I wanted her to be because of it. You did the safe thing and going higher is safer than going too low. I think tonight start with a lower dose and let’s see what happens. Hopefully his amps will be high enough so you don’t have to skip the dose
 
Jenny Ellen said:
I feel terrible. I sent him too far in the other direction. Now over 300 at +8, which is higher than he was for his PMPS last night. I completely failed him.
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Please don't feel bad, Jenny. We've seen cats here go into the Oort Cloud! :woot:

Comet's BG levels will come down again. You're keeping him safe. That's everything. The rest will come with learning, time, and a lot of trial and error (goes with the territory). Cats lead this dance - and they keep the steps very close to their chests. :rolleyes:

:bighug:


Mogs
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Aleluia Grugru & Minnie said:
I feel like that about every decision I make with Minnie all the time. Just today in fact because I let a low amps scare me into feeding her more and now she’s higher than I wanted her to be because of it. You did the safe thing and going higher is safer than going too low. I think tonight start with a lower dose and let’s see what happens. Hopefully his amps will be high enough so you don’t have to skip the dose
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I have to keep reminding myself that I did the safe thing. Better to be too high than too low. Thank you, Ale. I am sorry that your little girl went higher than you'd wanted; you take such good care of her and she knows it.
 
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