4/3 Minnie home w/tube, PMPS 105, +1 148, +3 342, +5 370

Christie & Maverick said:
How is she compared to when you picked her up from the vet's? Did they leave you with any instructions as to what to watch for when she is home?
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She is definitely not as well as when she got home, but she's been quiet from the time we got home. There is nothing in the discharge instructions on what to look for but they did say she was going to be tired. However they also said her eating was 'excellent' and she was taking potassium in pill pockets but ZERO food interest since coming home.

If I ask them about levemir dose tonight they will definitely say give the 5u because that's what 'our' internist has written in the notes, but I think the same thing likely to happen overnight based on last few days when not bouncing off the dextrose IV.

@10 67
@10.25 81
@10.5 82
@10.75 77

should I feed her a bit more? I have a bunch of tubes all ready to go. Shot time is in 75minutes. Unfortunately don't know how much of the rise was from syrup vs food though I'm sure you have insight with all your experience!
 
Liz & Minnie said:
I just think they made her bounce a lot by giving IV dextrose for the low numbers then extra 0.5u R when she bounced over 300. I put it into the s/s
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Not so much made her bounce, but too much R at the wrong time. It was only 4 hours apart. If she was clearing a bounce, plus you add that second R at the same time, you've got too much momentum.

I'd definitely reduce to 4.75 units. At what + time did you last give food?
 
Liz & Minnie said:
She is definitely not as well as when she got home, but she's been quiet from the time we got home. There is nothing in the discharge instructions on what to look for but they did say she was going to be tired. However they also said her eating was 'excellent' and she was taking potassium in pill pockets but ZERO food interest since coming home.

If I ask them about levemir dose tonight they will definitely say give the 5u because that's what 'our' internist has written in the notes, but I think the same thing likely to happen overnight based on last few days when not bouncing off the dextrose IV.

@10 67
@10.25 81
@10.5 82
@10.75 77

should I feed her a bit more? I have a bunch of tubes all ready to go. Shot time is in 75minutes. Unfortunately don't know how much of the rise was from syrup vs food though I'm sure you have insight with all your experience!
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She doesn’t really seem to be rising much and it’s close to shot time
 
She sure isn't making much of a move upward with 25% carbs. Anytime I see numbers in the 30s it's an automatic reduction, and that was from your usual meter. I'd drop back down to 4.75u. Let me see if I can get some other opinions.
 
She was 70@+11. I just gave her another 5ml of the slurry, then re-tested @+11 20min, 59 on the libre. 56 with ear prick. More syrup?

She is a bit more alert than before, changed position and was trying to get away while I was flushing the tube after feeding.
 
Wendy&Neko said:
Not so much made her bounce, but too much R at the wrong time. It was only 4 hours apart. If she was clearing a bounce, plus you add that second R at the same time, you've got too much momentum.

I'd definitely reduce to 4.75 units. At what + time did you last give food?
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Christie & Maverick said:
She sure isn't making much of a move upward with 25% carbs. Anytime I see numbers in the 30s it's an automatic reduction, and that was from your usual meter. I'd drop back down to 4.75u. Let me see if I can get some other opinions.
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2 votes for 4.75, I agree.

Food timeline:
@+7 3ml wd slurry
@+7.5 3ml
@+8.5 6ml
@+9.5 12ml
@+11 5ml
 
Wendy&Neko said:
Not so much made her bounce, but too much R at the wrong time. It was only 4 hours apart. If she was clearing a bounce, plus you add that second R at the same time, you've got too much momentum.

I'd definitely reduce to 4.75 units. At what + time did you last give food?
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By my count, last 12ml food would have been at +9.5, although Liz has noted since then in her SS another 5ml food, unsure of reference to preshot. @Liz & Minnie
 
Thanks Liz, we cross posted. So her pottassium levels were still lower than normal when she was sent home? Did you happen to catch what her values were? That can make them super lethargic.
 
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How late can you delay shot time and still be OK to shoot 12 hours later tomorrow? I'm worried that she's dancing in the 50's, with influence of high carb food, and so close to shot time.
 
Potassium normal this morning
4/3 8:30am 3.5

they took her off IV potassium last night, oral only. while in hospital they were giving IV potassium + oral and for them she was eating pill pockets
 
Wendy&Neko said:
How late can you delay shot time and still be OK to shoot 12 hours later tomorrow? I'm worried that she's dancing in the 50's, with influence of high carb food, and so close to shot time.
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I can delay as long as needed. I do not want to be doing this at 3am.
 
Liz & Minnie said:
Potassium normal this morning
4/3 8:30am 3.5

they took her off IV potassium last night, oral only. while in hospital they were giving IV potassium + oral and for them she was eating pill pockets
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Ok, low end of normal, usually you want them up around 4.4, but solidly above 4. Let's park that for now, and we can focus on the insulin dose issue for tonight.
 
back down to 58. Called vet, they insist she needs the 100ml of food (less the 30ml already given) and to continue w/that every 6-8hrs
 
Christie & Maverick said:
You can certainly oblige them, just feed in smaller intervals :). Ask them if they'd like to drink water from a fire hose :rolleyes:. Sorry, perhaps a little uncalled for, I'm just worried for you and Minnie.
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Thank you! I just gave her another 15ml after a reading of 49 @ +12 10min. Again they only put me through to the tech. She said no need to take her back, she needs food to get her BG up so she needs the 100ml every 6-8hrs and likely the only reason she is not eating at home is because of disruption to her routine. Only reason to bring her in would be if I gave her the 100ml of food and BG didn't go up. If she vomited, so be it. She sounded confident but didn't really make me feel better (esp when she told me they'd been giving Minnie 100ml through the tube while she was there until I pointed out the tube only went in last night)

What do you suggest food/shot wise? I'm probably making it all worse taking 2 sets of directions.
 
Liz & Minnie said:
Thank you! I just gave her another 15ml after a reading of 49 @ +12 10min. Again they only put me through to the tech. She said no need to take her back, she needs food to get her BG up so she needs the 100ml every 6-8hrs and likely the only reason she is not eating at home is because of disruption to her routine. Only reason to bring her in would be if I gave her the 100ml of food and BG didn't go up. If she vomited, so be it. She sounded confident but didn't really make me feel better (esp when she told me they'd been giving Minnie 100ml through the tube while she was there until I pointed out the tube only went in last night)

What do you suggest food/shot wise? I'm probably making it all worse taking 2 sets of directions.
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Nope you are doing everything right :bighug:. Personally, I'd like to see the last Lev dose wear off a little, you may need to hold off on the next dose a little longer. If you hadn't been feeding 25% carb I wouldn't be so worried, since usually the Lev onset is many hours away, but I don't like that she's not budging even with such high carbs.
 
56 @12.75 after another 5ml food

70 5ml food
@19:20 59 libre 56 ear bit of karo
@19:40 67 libre
@ 19:55 58
+12 (20:10) 49 15ml food
@12.5 45 5ml food
@12.75 56 5ml food
@13 92

ETA +12.75 food/ +13 BG
 
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Liz, all last tests from Libre? I'd love to catch her on a solid rise, maybe hold the insulin another 20 Minutes longer, depending on that next test, and perhaps other opinions :)
 
Christie & Maverick said:
Liz, all last tests from Libre? I'd love to catch her on a solid rise, maybe hold the insulin another 20 Minutes longer, depending on that next test, and perhaps other opinions :)
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Yes all on the Libre, can do an ear prick when you ask. Not sure if I should continue with food? Gave her another 5ml after the 56 @12.75.
 
oh is that a 92 I see?! Finally :woot:. Maybe I'm being a bit overly cautious, but if you can delay just another 20 Minutes, i would feel better seeing one more number that is still either flat or on the rise without food.
 
If we get a test at +13.75 that would be 1 hour since HC food, but it would put you 1 3/4 hours past original shot time, are you okay with that? I'm trying to guage the timing of giving insulin vs, the HC food effects.
 
Well that +13.5 makes me feel a whole lot better, looks like she is on the rise now, I'd be ok shooting this number, 4.75u.

ETA: you probably could have shot the 85, but with such HC in the mix, it was throwing me off :rolleyes:
 
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105 by ear prick @13.75 (can't get to the libre, it's under the kittycollar and she is lying on the velcro)
 
OK, I will shoot 4.75 now. then finish the feed by tube? Ugh, another 60ml just to get the right number of calories down her to ward off the ketones.

I don't feel like I'm doing a great job, I feel ill! Definitely couldn't do this without you all. :bighug: I'm dreading the rest of the night. Too wound up and hungry to catch any sleep now, and too scared not to stay up all night watching numbers.
 
Now that she's come up on the BG where you can give her insulin, I'd just keep getting food in a little at a time. How is she doing now? Maybe a bit more settled?
 
Hopefully things will go smoothly tonight, I'm going to be online again in about 6 hours when I get up, so I'll watch for an update. I would think with the HC food she shouldn't be coming down too quickly, but as Elise said, if you have any need for help, just put back the 911. I may end up waking up in the middle of the night just to take a peek and make sure you are ok. As others have said, you are doing a great job, don't forget to take a minute or two to unwind a little, you've had a rough day too :bighug:
 
Just caught up on the last few posts and updated the title. 148 @+1 with the libre after 50ml food.

Less than 5min after the shot, she opened her eyes and stood up - not quite as extreme as that scene from Pulp Fiction, but along those lines - so I put some food in front of her and she gave a couple of licks at one of them (Weruva pate, LC - no interest in peking ducken today tho she was eating it in hospital). I held my breath and stood back, was so excited, but she turned her back on it. I gave her 50ml via the tube and just finished. She definitely perked up at the end of the 35ml tube.

Now waiting 5min for BG reading then I will hit post. I may have hit my quota of messages today - makes up for yesterday's silence!

For tomorrow, target exactly +12h for AMPS or can I check at +11.5 and shoot then to start bringing forward 30min? I realize all dependent on BG of course.

THANK YOU SO MUCH.

She is sleeping now. I'll get some food.

@Bandit's Mom You will be back just in time to hold my hand again! I am hopeful it will be quiet for the next little while.
 
If the numbers are not low you can definitely shoot 30 minutes early in the morning. No quota for messages. :bighug:
I am glad she’s come up.
 
Bron and Sheba (GA) said:
I’ll be around if needed. I got home a short time ago.
What a day you have all had!
Liz, you are doing a magnificent job with Minnie with some wonderful help from the troops.:bighug:
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Thank you!! I don't know how you all do this all the time, for all of us. I am wrung out like a dirty dishrag. Literally. I am splattered in slurry.
 
Now we're back in familiar territory. 348 @+3.

Per internist's instructions, that means give 0.5u R but that terrifies me. Plus if I try and use the thinking part of my brain and what I've learned here, this is a bounce from the low numbers earlier.

I'm a bit confused about getting all the calories into her. They want her to have 320kcal/day which is 4x100ml feedings (or less depending how much she eats). I gave her 100ml total, plus they fed her 100ml breakfast so that's 160cal plus around 28cal that she ate tonight, =190kcal so short by 130kcal. However the slurry is high carb so I would expect BG to go up if I give her more of that. Suggestions welcome!

In the meantime I will try and make some slurry out of the LC weruva pate, probably have to sieve it.

ETA. Or I can put on the patience pants, she just decided to eat more of the LC peking ducken after a nice negative ketone pee.
 
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I have no experience with R so can’t help you there but I don’t think I would be giving any at the moment after the day you have just had.
Most likely a bounce from all those low greens this morning. And she could still be feeling the effects from all the high carb food she got earlier.
Great the negative ketones! and eating some on her own! Yay!

I think I would try and give her some lower carb food if you think you can make it into a slurry. The a/d is around 12 to 13% so that is a bit higher than low carb but if that is what you need to give that should be fine.
How does she seem in herself.? And how are you?
 
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