2/5 Sandy AMPS 163, 120@+2, 47@+4

Christie & Maverick said:
If I recall correctly, the previous time you had also used syrup by now? Syrups are good at being up the numbers, but do tend to wear off quickly. The FF is technically MC food, of course depending on how carb sensitive your cat is.
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I added syrup to the food he just ate so probably same will happen. I’m hoping he doesn’t drop again.
 
Christie & Maverick said:
I see +5 =85, so let's try if you can give just a tsp of LC now, and check in 1 hour.
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Just tried to wake him up to feed but he’s not interested. Doesn’t even want freeze dried treats. It’s 11:30pm here right now and he’s back to sleep.
Should I wait to see if his number keeps going up on his own if I can’t get him to eat?
 
Bron and Sheba (GA) said:
Hi Liza,
When did you last get a ketones test?.
How long until the next test?
Did you manage to get some ondansetron from the vet today?
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Last ketone test was 12 hours ago. I usually will do it in the morning so next one in 7-8 hours.
I did call the vet and left message, usually vet calls me same day or next at latest. I’ll probably hear back form him today. Sandy’s appetite was actually better today thankfully. He’s had 4.5 ounces of food and some freeze dried treats in the past 6 1/2 hours.
3 ounces was 8% carbs
1.5 ounces was 13% carbs
Still his numbers dropped again.
The syringe literally just has a slither showing for the .10 and I’m still baffled that this may be too much for him because it still is causing him to drop.
 
tiffmaxee said:
Has he always had an appetite issue? Was he tested for pancreatitis? Usually when the bg is low they are starving.
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No he never has. He was in ER for 5 days and I know they ran a whole bunch of tests. The only one that they said was an issue was the ketones and acute injury to his kidneys. Jan8th kidneys were normal numbers.
Jan 13 at Er level was 4.5, went up to 6.9, last checkup 1 1/2 weeks ago was 3.5 showing healing. I also had an ultrasound done to check for anything else like tumors. It was clear.
His BG numbers have been above 200 at times and have dropped after insulin shot even though it was a small amount .25 units. Sand happened at beginning with higher BG numbers and higher unit amount. Reason why he’s now to .10.
And still at .10 unit now 2 cycles has had drops after shot.
I’m completely at a loss.
 
Pancreatitis exhibits as just not acting right sometimes. It’s common to become inappetent. There’s a blood test for it, the SpecfPL. If not that I wonder if the food changes don’t agree with him. However it doesn’t sound like he will eat much of any food, even the dry.
 
Liza Morales said:
No he never has. He was in ER for 5 days and I know they ran a whole bunch of tests. The only one that they said was an issue was the ketones and acute injury to his kidneys. Jan8th kidneys were normal numbers.
Jan 13 at Er level was 4.5, went up to 6.9, last checkup 1 1/2 weeks ago was 3.5 showing healing. I also had an ultrasound done to check for anything else like tumors. It was clear.
His BG numbers have been above 200 at times and have dropped after insulin shot even though it was a small amount .25 units. Sand happened at beginning with higher BG numbers and higher unit amount. Reason why he’s now to .10.
And still at .10 unit now 2 cycles has had drops after shot.
I’m completely at a loss.
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ok. We are discussing what to do.
 
tiffmaxee said:
Pancreatitis exhibits as just not acting right sometimes. It’s common to become inappetent. There’s a blood test for it, the SpecfPL. If not that I wonder if the food changes don’t agree with him. However it doesn’t sound like he will eat much of any food, even the dry.
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The dry he will eat no problem. I was mixing some in his wet food on few cycles where it shows the blue amd yellow flow. I was giving him the dry because again he was dropping even if he was above 200. I was told to stop the dry so I did. Just gave him some last night to get his number up from the drop to 47. He ate a lot better today than he has in weeks and still had drop. I was really crossing fingers because of his appetite today this wouldn’t happen. His BG was good at shot time and the .10 caused him to drop once again.
I’m new to all this but I’m completely baffled at this point
 
Bron and Sheba (GA) said:
I see 116 @ +6.
Don’t feed any more and see how he goes.
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Ok he just got up and ate some and the. I just saw this. I took a video but I don’t know how to upload it from my phone. Just wanted to show you how he is eating because today he’s really had a better appetite than other days. He’s eating the ff grilled chicken in gravy like it’s his job.
 
I wish you could get the meter to work because the libre I have heard is not so accurate at low numbers. It might be reading lower than he really is.
 
Liza Morales said:
He’s got the lifestyle libre on him. I have a human meter but it gives me Error every time I try on it.
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I’ve been told the lifestyle libre is pretty accurate so I’ve trusted it. And when he has dropped to 45 and under he looks little disoriented and sleepy so it’s why I worry with these drops
 
It’s good to have a backup meter to check when you get a really high or low reading. That being said from how he was acting I do think he was low.
 
tiffmaxee said:
It’s good to have a backup meter to check when you get a really high or low reading. That being said from how he was acting I do think he was low.
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Yeah I don’t know I just pricked him 3 times and still gave me error code, but the second time I tried it on myself it worked. I’m definitely going to grab another meter.
Yesterday when he dropped he definitely had me worry because of how he looked m. Tonight wants that bad but he still looked disoriented/dazed so Keynes it’s not quiet as low but still low
 
Last 2 BG #’s 116 + 114. Do you guys think he’s flattening out? Maybe I can sleep a little bit I can still set alarm for every couple of hours if necessary.
mom going to pick up another meter tomorrow because the one I have I just used about 6 strips and only worked 1 time on me
 
I
Liza Morales said:
Last 2 BG #’s 116 + 114. Do you guys think he’s flattening out? Maybe I can sleep a little bit I can still set alarm for every couple of hours if necessary.
mom going to pick up another meter tomorrow because the one I have I just used about 6 strips and only worked 1 time on me
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It is hard to tell with Sandy.....if you feed him now and he eats well you could set the alarm for two hours I think, but no longer
 
Bron and Sheba (GA) said:
I

It is hard to tell with Sandy.....if you feed him now and he eats well you could set the alarm for two hours I think, but no longer
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Ok will do that. Do you think I should do the same dose come morning? I can also run out and get another meter in the am when Walmart opens. Not sure why the one I got is giving me such a hard time.
 
Liza Morales said:
Ok will do that. Do you think I should do the same dose come morning? I can also run out and get another meter in the am when Walmart opens. Not sure why the one I got is giving me such a hard time.
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We are discussing the dose now and will let you know.
Check in here when you wake up, and take a BG for us and post will you please?
I have to go out in an hour, but I should be back before preshot.
 
I'm so happy he ate for you and aside from that drop to 47 he did have a decent cycle, he came up nicely, you were not having to fight as hard as on 2/4, so that is positive.
Liza Morales said:
The dry he will eat no problem. I was mixing some in his wet food on few cycles where it shows the blue amd yellow flow. I was giving him the dry because again he was dropping even if he was above 200. I was told to stop the dry so I did.
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I know you have given some when he was low on 2/4 am cycle.
But when exactly did you stop regularly mixing the dry in with his food? (could you mark it and highlight it on the SS please when you get a mo)
If you have had to give dry or the temptations either to encourage him to eat or to keep his numbers up, please note that on the SS as well as what time he had them, it helps us to assess the SS to be able to see if you've had to take 'extreme measures', we can look at those numbers and see how they relate to the food he has had, ideally it would be good to see what you fed and when on the SS at a glance, to see what is working for him at what isn't.
(I'm sorry to ask you to do a little more admin, you have been working tirelessly for Sandy, I wouldn't ask but I think it will help us help you better)

To give you an example of what I mean.
For instance I know you fed a teaspoon of +1 from reading through the posts, but I don't know what carb's it was.... maybe a higher carb than whatever you fed, might have slowed him down a bit more....???
What did you feed with the 47? I have to look through the thread, posts 142 through to 154 to figure out you gave 12% with a drop of syrup. Then look at the SS trying to remember that info, and relate that to the numbers we are seeing, which is fine I can do that, but what happens in a day or two, if I, or someone else, want to see what worked for Sandy? or didn't work for sandy?
It becomes very difficult and it will delay the advice.:)

I'm really impressed with all your tireless work you are a very dedicated sugar mom, and all without a word of complaint:bighug:
 
Hi Liza,
I don't know if you have shot or not.
Have been thinking and debating what to do with the dose for Sandy.
Too options
1) Hold the 0.1
2) Reduce the dose to a drop

Neither of these decisions, because of the recent DKA, are without risk. You are there with Sandy, you know what you are having to do to keep him from dropping, how he is dropping, behaving etc. So I will try to present you with our thought process to try to help you to come to a decision.

Holding the Dose.
The problem with holding the dose is that he may indeed drop again.
I'm not sure if when you shot the 0.1u in his previous cycle if the drop you saw was the insulin or a combination of that and the dry/temptation snacks working out of his system/or the depot from the 0.25u still having an effect (upto 6 cycles, diminishing with each successive cycle)
Now that you have removed the dry as a regular food, his insulin needs may have diminished, I am wondering if that is why you may have been struggling to keep him from dropping.
If you held, and he dropped again tonight, would he eat, the big question? You mentioned that he is always, up to now happy to eat dry, so maybe if he drops into the 40's again, you could give him a tablespoon of dry food, it's very high in carbs, and you have other tools such as syrup to give you a more immediate bump should you need it, while the dry gets absorbed.
I would avoid the dry/temptations unless he has dropped below 50 again and you need him to come up and stay up.
Feed him the MC as his pmps, and HC for his snacks at ?+1+2 +3 if he doesn't give you a food bump at +1
I can't guarantee he will not drop and that you will have to work hard to keep him safe, so you need to assess whether you are able to do that for him tonight. I wish I was there so I could physically support you with this:bighug:

Reducing the Dose.
The recent DKA puts him more at risk, if he isn't getting enough insulin and he is not getting enough calories, we only have to add in an infection/inflammation/stressor and it could be a recipe for a relapse.
It really puts you in a tough position.
It's good that he's been eating in the previous 18hrs or so, and that he is still negative for ketones, and has been since he came home. Those are positive signs.
If he has been acting lethargic or seems like he is not well, then that would make me more nervous about taking the dose down.
You will need to stay on top of those ketones, perhaps checking that a couple of times a day at the very least, they can develop very quickly.
You still need to make sure he is eating well, perhaps even more so with taking the dose down. Since lack of calories and lack of insulin are both precursors to DKA.
I would suggest taking him down to a drop dose if you want to go for this option.
 
Gill & George said:
Hi Liza,
I don't know if you have shot or not.
Have been thinking and debating what to do with the dose for Sandy.
Too options
1) Hold the 0.1
2) Reduce the dose to a drop

Neither of these decisions, because of the recent DKA, are without risk. You are there with Sandy, you know what you are having to do to keep him from dropping, how he is dropping, behaving etc. So I will try to present you with our thought process to try to help you to come to a decision.

Holding the Dose.
The problem with holding the dose is that he may indeed drop again.
I'm not sure if when you shot the 0.1u in his previous cycle if the drop you saw was the insulin or a combination of that and the dry/temptation snacks working out of his system/or the depot from the 0.25u still having an effect (upto 6 cycles, diminishing with each successive cycle)
Now that you have removed the dry as a regular food, his insulin needs may have diminished, I am wondering if that is why you may have been struggling to keep him from dropping.
If you held, and he dropped again tonight, would he eat, the big question? You mentioned that he is always, up to now happy to eat dry, so maybe if he drops into the 40's again, you could give him a tablespoon of dry food, it's very high in carbs, and you have other tools such as syrup to give you a more immediate bump should you need it, while the dry gets absorbed.
I would avoid the dry/temptations unless he has dropped below 50 again and you need him to come up and stay up.
Feed him the MC as his pmps, and HC for his snacks at ?+1+2 +3 if he doesn't give you a food bump at +1
I can't guarantee he will not drop and that you will have to work hard to keep him safe, so you need to assess whether you are able to do that for him tonight. I wish I was there so I could physically support you with this:bighug:

Reducing the Dose.
The recent DKA puts him more at risk, if he isn't getting enough insulin and he is not getting enough calories, we only have to add in an infection/inflammation/stressor and it could be a recipe for a relapse.
It really puts you in a tough position.
It's good that he's been eating in the previous 18hrs or so, and that he is still negative for ketones, and has been since he came home. Those are positive signs.
If he has been acting lethargic or seems like he is not well, then that would make me more nervous about taking the dose down.
You will need to stay on top of those ketones, perhaps checking that a couple of times a day at the very least, they can develop very quickly.
You still need to make sure he is eating well, perhaps even more so with taking the dose down. Since lack of calories and lack of insulin are both precursors to DKA.
I would suggest taking him down to a drop dose if you want to go for this option.
Click to expand...
I gave him ff beef in gravy and he ate almost a whole can (13% carbs). He seems to have a great appetite and ate it pretty fast. I know he had more than 2 ounces. I decided to give him the drop. Which I guessed at it just touching the zero line since the .10 was a slither right before it.
I’m sure he’s going to drop again since this is what’s been happening.
The thing I was afraid of happened, as I slept right through my alarm (Again) and didn’t get any more bg’s between +2 and PMPS. He was at 112, ate a good meal, and I gave the drop of insulin.
So now I’ll wait and watch for the drop.
And go from there.
Thanks for the advice and the options I chose the drop because he seems to be needed less insulin and that’s a good thing. And I’m afraid to take it away completely because of the DKA he had.
But since he’s eating better, if he drops again with this cycle do you think I should just give a drop per day?
 
Hi Liza,
I am really pleased he is eating well, that is a good sign.
Now that you have chosen the drop dose you will need to test the ketones twice a day so we can make sure he is able to keep those ketones negative. This is really important.

Any sign of lethargy, or seeming unwell please let us know.

Continue to make sure he is eating well during the cycles, except for the two hours before the preshot when we don’t want you to feed as we want to see the preshot number unaffected by the food.

Test at +1 and if he doesn’t have a food bump ( a higher BG higher the preshot number,) then feed a HC food for his snacks at +1 and +2 and +3.

With the drop dose the easiest way to get the drop is to push the plunger of the syringe in hard and then put the needle into the insulin then release the plunger. Take the needle out of the insulin cartridge. That should give you a drop. I would practise it a several times with an old syringe and some water to perfect the dose. See if you get a drop when you push in the plunger, then release it.

I am heading to bed now.Gill will be back soon and will guide you through the next several hours.
You are a wonderful caring mom to Sandy and he is so lucky to have you.

Liza Morales said:
But since he’s eating better, if he drops again with this cycle do you think I should just give a drop per day?
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Let’s wait and see how he goes on this dose. He’s making great progress but we want him to stay on some insulin as long as we can because of the DKA and also you want a strong remission. You don’t want to rush things.
Try and feed him to prevent him dropping low if you can
 
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Here is another way to get the drop dose. I like the other option where you push in the plunger and let go but you can try this one and see how much insulin comes out. I would trial it first if you chose this way
 

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