? Ginny's "normal" numbers at preshoot time

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Kimmy & Ginny

Kimmy & Ginny

Member Since 2022
Hi guys,

This is my first post here. I normally lurk for awhile, but Ginny has forced my hand tonight (8:10pm, here in Australia). Her result of 6.8mmol/L (122) followed by 8.8 (158) 10 minutes later, means I won't be giving her an insulin shoot, as per the vet advice not to shoot anything below 10. However, I understand there are circumstances where a smaller dose or so is recommended. I can't do that tonight, as I'm not expecting a quick answer here, but I would like to be better prepared. In addition, I understand this may throw her curve out. I was planning on doing one tomorrow, so I can monitor what happens in real time, but I would like to know if there's any information I need to hopefully mitigate any negative effects.

Thank you.
 
Kimmy & Ginny said:
Hi guys,

This is my first post here. I normally lurk for awhile, but Ginny has forced my hand tonight (8:10pm, here in Australia). Her result of 6.8mmol/L (122) followed by 8.8 (158) 10 minutes later, means I won't be giving her an insulin shoot, as per the vet advice not to shoot anything below 10. However, I understand there are circumstances where a smaller dose or so is recommended. I can't do that tonight, as I'm not expecting a quick answer here, but I would like to be better prepared. In addition, I understand this may throw her curve out. I was planning on doing one tomorrow, so I can monitor what happens in real time, but I would like to know if there's any information I need to hopefully mitigate any negative effects.

Thank you.
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Hi and welcome. I am too new to give advice but
I'm going to tag @Bron and Sheba (GA). She's fantastic and with the recent DKA would be best to advise you.
 
Hi Kimmy and Ginny and welcome to the forum. I live in Australia….Sydney.
I can see from your signature and Angela’s post that you have DKA in the recent past.
Have you been testing for ketones in the urine?
It is not advisable to skip doses of insulin with DKA in the recent past.
Looking at your Spreadsheet I can see you are not testing during the pm cycles at all. do you think you would be able to test during this pm cycle tonight? Because I would like you to give some insulin
Have you fed Ginny since you took the last BG?
I will wait for your answer
 
Bron and Sheba (GA) said:
Hi Kimmy and Ginny and welcome to the forum. I live in Australia….Sydney.
I can see from your signature and Angela’s post that you have DKA in the recent past.
Have you been testing for ketones in the urine?
It is not advisable to skip doses of insulin with DKA in the recent past.
Looking at your Spreadsheet I can see you are not testing during the pm cycles at all. do you think you would be able to test during this pm cycle tonight? Because I would like you to give some insulin
Have you fed Ginny since you took the last BG?
I will wait for your answer
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I just fed her 10 mins ago (2 cans FF classic Pate), she is only just finished eating now, so I'll go and get her insulin and give her a shot now. I will do PM shoots, yep, especially if I'm going to give insulin. The only time I've ever done a PM shoot is when she had a preshot number of 10, and because it was low, I was a bit worried, and wanted to make sure she didn't dip further within the insulin onset time frame. Thank you for such a quick response and your availability <3
 
Bron and Sheba (GA) said:
Can you test again before you give the insulin please?
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She was 8.8 again at 8:25pm. 8.5 post feed at 8:45pm. I've now given her insulin. Will test BG every hour for a few hours, then probably every two hours until morning. It will be good to get a PM curve on the spreadsheet.
I haven't been testing for ketones at home, but two vet follow ups have included samples of urine drawn from the bladder being tested and found clear - no ketones. I'm not yet sure what I need to perform the tests for Ketones at home, but if it involves me getting samples of urine from Ginny, it's a no go. She never pees where I intend. Maliciously. It's actually far easier for the vet to just draw it direct from her bladder. She's a very good-natured cat and so doesn't need to go under for tests, scans, and sample collection, thank goodness.
 
@Kimmy & Ginny i can see on the SS you have given 1 unit.
Because this is the lowest pre shot you have shot, can you get a +1 and a+2 to start with so we can see how the cycle is going . You will also need to continue testing until after nadir.

I would like to give you some information about looking after a kitty that has had recent DKA
  • It is really important that you feed 1 and a 1/2 times as many calories as Ginny normally eats. I would suggest giving snacks every few hours during the day and night.Do you have a timed automatic feeder you could use?
  • Don’t skip any doses of insulin. If the present is too low, stall, don’t feed and test again in 20 minutes to see if the BG is rising. You can post and ask for help. Even a partial dose is better than skipping.
  • I can see you have said you can’t test for ketones. That is a shame. You can however get a blood ketones meter that works just like a glucose meter and measures the ketones in the blood. It’s important to monitor ketones as they are your early warning system.
  • If Ginny will let you, add an extra teaspoon of warm water to each snack so he is getting extra fluids.
It sounds as if he she is eating well and doesn’t have any nausea..is that right?

Can you list each hour and tell me the BG please? Thanks
Bron
 
I would also recommend you test at least once every cycle to see how low the dose is taking Ginny as Lantus dosing is based on the nadir, or low pest point in the cycle, not the preshot. The pm cycle is just as important as the am cycle and many cats drop lower at night.
Getting a before bed test in is a good habit to get into to keep Ginny safe. If that test is much lower than the pre shot test I would get up and test again a couple of hours later to see she is still in safe numbers.
Do you have a hypo kit set up?
HYPO KIT
You might like to look at our two dosing methods and choose one
DOSING METHODS
 
@Bron and Sheba


Ginny is actually very good; good appetite, playful, grooming etc. Post feed, she's relaxed in a loaf position.
No automatic feeder yet, and I have a multi-cat household, odd work hours, so feeding snacks is a bit difficult. I've been adding warm water to her meals, so she's getting plenty of water (with the bonus of a warm meal on these cold days).

Thanks for letting me know about blood ketone meters, I hadn't heard of them. I will track one down.

I have several cans of FF salmon in gravy available, yes, plus honey if it's needed. I've been told this is essentially a hypo kit.

Thank you, Kim
 
Kimmy & Ginny said:
+2 = 8.4
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That is good he has responded to some higher carb food.
I would give him the same amount of food again as at +1 as it is early int he cycle and the onset of the insulin is just starting and we don’t want him to be too low for that as we don’t have much data on how he goes in the lower numbers yet.
Well done getting the tests in . I would get a +3 please.
Can you put in the remarks column of the Ss what you fed and when please..eg fed xxcarb at +1 and +2
 
Bron and Sheba (GA) said:
That is good he has responded to some higher carb food.
I would give him the same amount of food again as at +1 as it is early int he cycle and the onset of the insulin is just starting and we don’t want him to be too low for that as we don’t have much data on how he goes in the lower numbers yet.
Well done getting the tests in . I would get a +3 please.
Can you put in the remarks column of the Ss what you fed and when please..eg fed xxcarb at +1 and +2
Click to expand...

+3 = 7.3 plus another nibble of some high carb
 
Bron and Sheba (GA) said:
I would give the same amount of the higher carb food again and test in an hour. What is the % of the carb food, do you know?
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Not sure how to calculate that, sorry. I will keep testing her until she returns to >10 I'm watching her every second, so you rest assured, thank you for the help. I will keep updating the SS, and continue offering snacks as needed.

Have a good night xx Kim.
 
Kimmy & Ginny said:
Not sure how to calculate that, sorry. I will keep testing her until she returns to >10 I'm watching her every second, so you rest assured, thank you for the help. I will keep updating the SS, and continue offering snacks as needed.

Have a good night xx Kim.
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I’m going to ask @Bandit's Mom to watch out for you as she is in India and it’s mid afternoon for her.
As you are feeding high carb you will need to have not fed high carb for 2 hours before you can be sure she won’t drop again. Bhooma, (bandits mom) can help you with that.
See you tomorrow :) you are managing really well with it all.
 
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Bandit's Mom said:
I see she is lower at +4. Did she get more of the gravy?

Is the FF Salmon in Gravy that you have listed here?
https://catinfo.org/chart/index.php
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Thank you for coming! So nice of you <3 Yes, so 6.1 at +4

(Edited because the screenshot didn't show, have entered the food info manually)
FANCY FEAST - Gravy Lovers Salmon Feast in Gravy Carbs: 15
FANCY FEAST - Grilled in Gravy Grilled Salmon in Gravy Carbs: 13

It's one of these two. It says salmon feast in gravy - grilled. (I think the second one, because it's not 'gravy lovers', so carbs would be 13). Yeah, I gave her some (a teaspoon-ish), this time with a bit more of the gravy than the last two times.

Thanks, Kim xx
 

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Welcome
Here are some suggestions , try not to feed that many fish flavors because of mercury in them
Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-
 
Diane Tyler's Mom said:
Welcome
Here are some suggestions , try not to feed that many fish flavors because of mercury in them
Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-
Click to expand...

Thank you so much, I didn't know about the mercury. Fortunately, Ginny's low carb pates don't have fish. I grabbed the fish because one of my other cats, Max, he loves wet food, and has a need for fish in his diet to maintain healthy skin and fur. So I decided to toss one stone [can], hit [feed] two birds [cats].
 
Maybe a novel protein like duck, pork, venison, or rabbit will work fur Max? My Mocha has skin issues. She was eating venison for over two years but recently I had to switch her food again to rabbit.
 
Bron and Sheba (GA) said:
Hi Kimmy, how are things today with Ginny?
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AMPS = 14.8; +2 = 17.8
Very different to last night, her numbers are higher again. I don't know if I've taken enough BG tests to make this conclusion yet but it seems the day after having MC food, her numbers go into the high teens (low pinks). It's early yet, she's had her meal and shot, and behaving normally, so I expect her numbers will go back down into the yellow around lunchtime. I'm going to try for some more PM pokes tonight, get an idea whether the blue numbers are normal for Ginny at night, maybe she's at the point where her LC diet and Insulin are just working well enough without making her dip too low. I know it's about the nadir, but it's hard to ignore the overall patterns. Anyway, Ginny's good, thank you for asking.
 
Ginny is bouncing from the lower than normal pre shot last night and that string of blues.once she starts to come off the bounce, she could come back down quite quickly so be on the lookout for that. Bounces can last up to 6 cycles. From the yellow sticky ..the basics:

  • Bouncing - 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).

 
Bron and Sheba (GA) said:
Ginny is bouncing from the lower than normal pre shot last night and that string of blues.once she starts to come off the bounce, she could come back down quite quickly so be on the lookout for that. Bounces can last up to 6 cycles. From the yellow sticky ..the basics:




    • Bouncing - 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).
Click to expand...

Ah! The picture is getting clearer; this seems to have been the second time this happened then (that I can see on the SS). Thank you, every day I understand a little bit more <3 So how can I help Ginny's body see the blues as normal rather than a "perceived low". It seems to be a self-perpetuating cycle, is there a way to break it, or should I just be patient and wait for the body to slowly adapt with the LC diet and insulin?
 
Kimmy & Ginny said:
Ah! The picture is getting clearer; this seems to have been the second time this happened then (that I can see on the SS). Thank you, every day I understand a little bit more <3 So how can I help Ginny's body see the blues as normal rather than a "perceived low". It seems to be a self-perpetuating cycle, is there a way to break it, or should I just be patient and wait for the body to slowly adapt with the LC diet and insulin?
Click to expand...
Ginny ‘s body has to get used to the lower normal numbers again and this will take time and patience!
 
It’s not much use doing a curve today because she is bouncing from the lower numbers last night. These numbers today look as if she needs more insulin when in fact she doesn’t need an increase at all. I would wait until the BGs settle back down again before doing a curve.
 
Bron and Sheba (GA) said:
It’s not much use doing a curve today because she is bouncing from the lower numbers last night. These numbers today look as if she needs more insulin when in fact she doesn’t need an increase at all. I would wait until the BGs settle back down again before doing a curve.
Click to expand...
Yes, I realised this when I saw the numbers following the same pattern as the last bounce, so I let myself nap lol. I'll do a curve on Tuesday instead. I have Tuesdays off. Thanks again for all your help <3
 
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