6/2 Betty AMPS 365, +3 256, PMPS 403, +5.5 56, +6.5 67, +8.5 270

Betty'sMom

Betty'sMom

Member Since 2021
Good morning... This is my first post, so I'm also trying to figure out the lay of the land, and am reading all the intros.

Thank you to Margaret for showing me the way here! Hopefully I get this figured out and it becomes easier.

I created an intro post on the other thread and my spreadsheet is just getting started so not a lot of data

Betty is 15yo, very thin, and kind of cranky. She's newly diagnosed, so mom is still learning how to swim in these waters. Lol
 
Yay! So, will Betty eat at all? I know you were talking about this in your original post on the other forum. Fancy Feast is very tempting to most cats. And some Gerber baby food meat. And please make sure you do feed her when hungry, except for what Wendy told you about NOT to feed before shot. (Vets normally say only feed 2x/day, but you will see on this forum most of us have figured out that is not the best recipe for keeping our cats BG steady). ALSO, so you know: diabetic cats do NOT utilize energy or calories well, so they do need to eat more than a healthy cat, because they are not using the nutrients effectively. When Betty gets regulated, you will see her eating get more normal in terms of amount.

I give Pearl lots of mini meals during the day - a lot of us do it that way. Helps to control the BG numbers and keep a handle on what is going on. I do think you should be testing at random times, yes. Outside the 4-6 hour window, yes. You don't yet know when Betty will go low, you have to figure that out with testing. If you look at Pearl's spreadsheet, you will see that she NADIRs super early on in her cycle. But I wouldn't know that without my testing at random times, to build the data over time. You don't have to test obsessively like I did early on, but keep in mind you are trying to create a picture of what the patterns look like with your testing. For Betty, she has already had some GREEN numbers. When you start seeing green, you do want to keep up on your testing b/c you really need to know how low she is going and when.

ALSO! You mentioned vomit. Can you list in your signature what other conditions she has and medications? When you get time ;) FD goes along with other issues a lot, and those issues may complicate getting her BG under control. It helps everyone to know what is going on. Look at my signature - you know all about Pearl's issues after reading. That is what you want to do if you have conditions to list.

Here is the link to your previous post, for continuity. When you write your post tomorrow, use your link for today's post. That way, all of your posts stay together forever.
https://felinediabetes.com/FDMB/threads/new-member-sandy-mom-and-betty.248017/#post-2798642

 
She is usually starving by morning, so she will eat at least half a can to 3/4s if I let her.

By noon she is often asking for more, but will only take a few bites (maybe a tablespoon). Even if I don't feed her til supper, she acts like she is dying and yet barely eats half a can. She'll go back and graze.

I just learned that I was contaminating my insulin, by pushing the extra back into the vial. So I'll discard the rest of that insulin vial and start with a new one.

When the tech showed me how to draw the insulin, she left the needle in the vial and tapped the needle to get air bubbles out and then pushed them back into the vial. That would bend the needle tip. So I'd pull it out, tap the needle and then put it back in to get rid of the air and extra insulin. I just watched the video and realized how much I did wrong already.

Another thing that makes me question my vet.
 
Betty'sMom said:
She is usually starving by morning, so she will eat at least half a can to 3/4s if I let her.
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Can you try giving her 1/4 or 1/3 of a can after PS reading, then another 1/4 to 1/3 a couple hours later, and so on? That way, you can guide her eating? You will find in time that will be very helpful as her BG numbers start coming down. She is going to need to eat between breakfast and lunch and between lunch/dinner to hold steady at some point.

Betty'sMom said:
Even if I don't feed her til supper, she acts like she is dying and yet barely eats half a can. She'll go back and graze.
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Grazing is ok. I put down for Pearl 1/4 can every 2ish hours. She grazes till gone. You can divide the amount of food Betty should be eating into 8 equal feedings, 4 feedings or more AM cycle and 4 or more PM cycle. You only need to withhold food for the time period
@Wendy&Neko mentioned in your other post, and make sure she is hungry when you are giving her shot, b/c she will need to eat at that time or else you will have to assist feed.

Betty'sMom said:
I just learned that I was contaminating my insulin, by pushing the extra back into the vial. So I'll discard the rest of that insulin vial and start with a new one. I just watched the video and realized how much I did wrong already.
Click to expand...

Good you watched the video. I am not sure about Levemir. With Lantus unless you see floaty things, the insulin should be ok, but I don't know what to look for with Levemir. I might discard the pen and start a new one too, but might be worth asking for advice. If you only did it a few times, you might be ok.
 
Margaret (and Pearl) said:
Good you watched the video. I am not sure about Levemir. With Lantus unless you see floaty things, the insulin should be ok, but I don't know what to look for with Levemir. I might discard the pen and start a new one too, but might be worth asking for advice. If you only did it a few times, you might be ok.
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I have the vials and use the u/100 needles for the draw. They come in a 5pack of vials for $135 and with only giving a unit a day, I'm not even close to half done with the first vial. I worry there will be a lot of expensice waste if it expires. The box (however) says its good til 2022!
 
Betty'sMom said:
I have the vials and use the u/100 needles for the draw. They come in a 5pack of vials for $135 and with only giving a unit a day, I'm not even close to half done with the first vial. I worry there will be a lot of expensice waste if it expires. The box (however) says its good til 2022!
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Keep it in the fridge. Don't worry, the vials will last!
 
PS - you may find yourself re-thinking "meals". There isn't really a "lunch". There is breakfast (AMPS timing) and dinner (PMPS timing). Feedings in between go according to this breakfast and dinner schedule (so if you don't think about "lunch" that might be best). Just think about mini feedings between these two anchor points (rather than 3 anchor points). Does this make sense?
 
Betty'sMom said:
I have the vials and use the u/100 needles for the draw. They come in a 5pack of vials for $135
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So it's probably the Lev cartridges you are using. Been a while since I needed to give insulin, but the price seems similar to what I was paying back then. If you watch the video, you want the instructions for using a syringe to take insulin out of a pen. The cartridges are just pen refills, not available in the US. I used to withdraw about 1/2 unit more than I needed, then when the syringe was out of the cartridge, I'd do the tap thing to get rid of bubbles, twisting the plunger to slowly move it down to the level I needed.

And just because your vet tech got it wrong, doesn't mean the vet is wrong. I had a vet tell me his soon to be former vet tech showed a client how to withdraw 2 units of insulin, but actually showed them how to do 20 units. :eek: For some reason luck was sort of the clients side, the cat had acromegaly and needed a higher dose. It wasn't until they told the vet they were out of the vial way earlier than he thought they should be that he found out the problem.

As for testing times, on Levemir the typical nadir or low point is around 8 hours after the shot. Of course there is some variability between cats and cycles. My girl's low point was spotted anywhere from 5 to 15 hours after the shot, though most commonly 9-12 hours after.

By the way, the high numbers you saw yesterday were likely not due to the food, but to her bodies reactions to the green numbers she saw the day before. There is a phenomenon we call bouncing. From the New to the Group Sticky Note:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
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So I only got the one morning reading, and then just did her PMPS shot and her numbers are in the red.

In the beginning I was giving her insulin after she had finished eating (which could be an hour from the first bite) , now I'm giving it while she is eating and it makes me wonder if a half unit is the right dosage.

They're so all over the place that I really don't see any trends yet. Maybe I just need to be patient.
 
Yep, patience is key. There are files you can read about how long to hold a dose, and you need more numbers (I know you're working on that). Since Levemir is a depot insulin, it takes time to build inside to reach full effectiveness at any dose. You can always put a question mark in your title and ask for dosing advice - it's normal to be unsure about when to increase a dose and what that looks like. The admins here will help you.
 
As annoying as bouncing is, it is extremely common with newly diabetic cats. The most common phrase I see from new members is "my cat is all over the place". With time, as she gets used to normal blood sugar numbers again, the bouncing will diminish. If you look around at the spreadsheets of other new people, you will find it's a common phenomenon.

Most of us test, feed, and shoot while they are eating. Neko ate in about 40 seconds, so it was after food for me. But I also gave her about 1/3 of her cycles food at preshot time, and spread the rest out to smaller meals throughout the cycle. Once you find out when she onsets, giving a small meal just before hand can help slow any drops that happen as the insulin takes effect. Fast drops also cause bounces.
 
So at +5.5 after her dinner shot, her BG dropped to 56. I gave her a quarter can of snack, so that'll likely raise it again.
 
Betty'sMom said:
So at +5.5 after her dinner shot, her BG dropped to 56. I gave her a quarter can of snack, so that'll likely raise it again.
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That’s a big drop. I would test again in a half hour. Do you have some medium carb food, something in the 10-15% range if she’s still in the 50’s? You can also mix a few drops of honey into the DM.
 
PerfumedCatMom said:
That’s a big drop. I would test again in a half hour. Do you have some medium carb food, something in the 10-15% range if she’s still in the 50’s? You can also mix a few drops of honey into the DM.
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She is at 67 now... Tested half hour later... So maybe that was close to her bottom?
 
Bandit's Mom said:
Looks like it! Did you feed her LC when she dropped to 56 or higher carb?
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I have some corn syrup here (per vet recommendation), but when I gave her that last time, she spiked quite high for the next reading. I just gave her the 1/4 can of DM (and two temptations treats for the test) at the time of the +5.5 test and then retested half an hour later.
 
Betty'sMom said:
(and two temptations treats for the test)
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The Temptations treats are high carb. Enough to spike BG. You may to look at some low carb treats to give after tests.

Since she is on Levemir, the nadir is later in the cycle. I would get another test to see if she is staying up once the food bump wears off.
 
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