? AMPS do I dose this morning??? Update: still needing guidance this evening

[Lauren and Loki]

I am so sorry for my late reply everyone! I have been trying to get some sleep in with all of this. I am needing further guidance still. Thank you for hanging in there with me! I will answer your questions, followed by an update below.

Actually, I feel like we’ve been told not a lot of members are on that prozync forum and that it’s best to post here? When did you feed the gravy after you got the 97? And is the 97/77 from two back to back tests? He seems to be in a good range right now so I’d just keep monitoring. Blues are good

I didn't feed the gravy till I got the 77 reading. 97 reading was @ +3, 77 was @ +3.5, so thirty min later. Not sure how soon between testing is considered back to back?

I would have held off on higher carb food just a little longer, but no harm done, especially when trying to manage these things in your own and him being a little complicated at the moment. Either way, a reduction down to 0.75U now! If he was not so recently DKA I'd say 0.5U since he'd have gone lower without that food, so it's really up to you to weigh the options.

How much longer, or how low, do you think you would have waited? On a Libre, how low should I wait? Because I know it reads a little lower than it probably is, but it changes fast. I fed him about a tablespoons worth, just so I could get some kind of sleep. I have been here doing this on my own, like you said, and have been exhausted. I have been unable to do anything else, and have had to take this week off from work in order to handle this.

I’m glad you were around to help with the dose Melissa. Loki is in a hurry to get to the bottom of the dosing scale it seems.
I also think 0.75U considering the event DKA.
How often are you testing for ketones Lauren? would you mind putting the results of the ketones test in the remarks column but in bold so we can see easily please?

Bron, yes he is in a definite hurry to get to the bottom apparently! Just see my update below!

I'll give my update here: I reduced the dose tonight to 0.75U. Just now @ +5, he hit 67, and I'm kind of holding off just a bit on feeding just to see where this is going. I suppose that will call for another 0.25 reduction in dose, but in doing that, how worried should I be with the recent DKA?? If his body is getting too much insulin and taking him too low, how does this effect the DKA issue? How do you keep ketones at bay if they don't need as much insulin? I don't know how to word what I'm asking, but I think you get the idea of what I'm trying to say. As far as ketones, I have not been able to catch him peeing in order to test since yesterday! I understand how important it is, and I have been waiting for him to go to the bathroom. He is just not peeing nearly as much as he was, which is great, however, I have to catch it now, and it's hard to stay awake with the lack of sleep I've been dealing with. Believe me, I'm trying. I was really upset with myself earlier because I was concentrating on updating his SS, and then I heard him finishing up in the cat box I will update ketones in BOLD on the SS when I am able to pee test!

2nd Update: In the time it took to type this, Loki jumped back up to 119. He did NOT have any HC food. He did have a few licks of LC food that was left in the bowl, but not sure if that would really cause that much of a jump in 30 min.

Any thoughts? Thanks y'all!

 

[Bron and Sheba (GA)]

Hi Lauren,
It is hard making decisions when you are feeling exhausted with lack of sleep.

Can you tell me are you still feeding FF pates?
And are you giving any snacks in the first 3 hours of the cycles.?
I’m wondering if you feed him a bit more early on the cycle, if that would stop the early drops…although he doesn’t always drop early.
I’m just wondering if we could increase his carbs a bit so we could keep the dose at 0.75 a bit longer.
Do you have any cans of food that are around 7 or 8% carbs?
My thinking is if we could feed him the higher low carbs for a few days, we could hopefully keep him on the 0.75 U a bit longer.
If we did that how would you be placed to monitor the cycles?
I’m going to tag @FrostD to see what she thinks about the dose as I am not a prozinc user. She’ll be asleep atm.
Getting the ketone test will let us know how he is going.

 

[Lauren and Loki]

Hi Lauren,
It is hard making decisions when you are feeling exhausted with lack of sleep.

Can you tell me are you still feeding FF pates?
And are you giving any snacks in the first 3 hours of the cycles.?
I’m wondering if you feed him a bit more early on the cycle, if that would stop the early drops…although he doesn’t always drop early.
I’m just wondering if we could increase his carbs a bit so we could keep the dose at 0.75 a bit longer.
Do you have any cans of food that are around 7 or 8% carbs?
My thinking is if we could feed him the higher low carbs for a few days, we could hopefully keep him on the 0.75 U a bit longer.
If we did that how would you be placed to monitor the cycles?
I’m going to tag @FrostD to see what she thinks about the dose as I am not a prozinc user. She’ll be asleep atm.
Getting the ketone test will let us know how he is going.

Yes, it is..I suppose we all here have experienced the lack of sleep lol

Loki dropped back down to 67, then to 57 fifteen minutes later..so I just gave a little FF Gravy.

- Yes, still on the FF pate's.
- I'm trying to get him to eat more, and I do put out snacks and show them to him. His appetite is not as ravenous as before, but he is still a good eater overall. I can't say about the timing of the snacks, that's partially why I took off work so I can figure out a time schedule and watch how he does. I can give more snacks while I'm here this week and time them. So a snack at about +3, then like +6?
- I can go get some higher low carb food tomorrow. I don't have any at home. I had a ton of Tiki Cat food, but I moved recently and they are in a box somewhere. I don't think that food is very HC anyway. I can find which ones on the food list, correct?
- I have off until at least next Tuesday, so plenty of time to monitor (just no sleep lol )
- Will ketone test ASAP

 

[Bron and Sheba (GA)]

With that drop down to 57 I don’t think you have an option but to reduce the dose again to 0.5 U
We have to keep him safe as well as free from ketones.
Are you giving him an antinausea medication at all?
It is possible he has some nausea if he is not eating as well as before he got sick. I think it would be worth while giving him some ondansetron if you have any, or ask the vet for a script to pick up some. It’s not uncommon for post DKA kitties to have lingering nausea.
And if we are having to reduce his insulin, we really do want him to be eating really well.

I think the Tiki Cat food is very low carb. You should find some higher low carb on the food list easily.
Do you have an automatic timed feeder for when you go back to work? If not I would think about getting one and getting him used to having snacks out of it before you go back to work.

I would try snacks at +3 +5 and +7 if he will cooperate.

 

[Lauren and Loki]

With that drop down to 57 I don’t think you have an option but to reduce the dose again to 0.5 U

Is it possible that he is not actually this low because it's from a Libre? Or do we just take it at face value until I can actually manually test? Manually testing is also something I plan to practice with this week off. I just need to read some advice here and watch some videos, and make sure I have everything I need.

Are you giving him an antinausea medication at all?
It is possible he has some nausea if he is not eating as well as before he got sick. I think it would be worth while giving him some ondansetron if you have any, or ask the vet for a script to pick up some. It’s not uncommon for post DKA kitties to have lingering nausea.
And if we are having to reduce his insulin, we really do want him to be eating really well.

He is taking both Ondansetron and Cerenia, but at half dose (4mg & 8mg, respectively). He just ate the FF Gravy really well. And he ate his snack earlier well too (LC pate). Not sure if I need to go back up to a full dose of these meds? Maybe I need to request an appetite stimulator? Or maybe he just really needs the higher low carb food for now. I find that to be a great idea. How often would I feed the higher low carb food? Just at main meals? Just snacks? Or all throughout the day?

Also is the food list the 2012 one by Dr. Lisa Pierson? I remember seeing somewhere a long time ago there was an updated food list but no idea where I saw that.

Do you have an automatic timed feeder for when you go back to work? If not I would think about getting one and getting him used to having snacks out of it before you go back to work.

I need to look at the timed feeder suggestions for canned food that were made on my new member post and get one.

I'll keep track of the snacks. Thank you for these suggestions.

 

[Bron and Sheba (GA)]

need to look at the timed feeder suggestions for canned food that were made on my new member post and get one.

You can use any of the timed feeders for a wet food. I used one which was advertised for dry food. Most of them are, but they are fine for wet food. You just need to wash it out each time. I fed Sheba all her meals in the feeder for a few days until she got used to it so I was sure she would use it when I wasn’t there. She loved it and would come racing from wherever she was in the house as soon as she heard the click of it turning over to the next feed. She would even lie beside it with her arm over it!

Is it possible that he is not actually this low because it's from a Libre? Or do we just take it at face value until I can actually manually test? Manually testing is also something I plan to practice with this week off. I just need to read some advice here and watch some videos, and make sure I have everything I need.

The libre can be a bit unreliable in the lower numbers but if it is showing say 60, it definitely would be below 90.
If you can get a manual meter you can check it when it is lower. I would get a human meter as they are just as good and are much cheaper and our dosing methods are based on them. If you live in the US, the ReliOn premier meter from Walmart is a good choice. You will also need some lancets…get size 26 or 28 gauge and some cotton balls to hold behind the ear when you test.

He is taking both Ondansetron and Cerenia, but at half dose (4mg & 8mg, respectively). He just ate the FF Gravy really well. And he ate his snack earlier well too (LC pate). Not sure if I need to go back up to a full dose of these meds? Maybe I need to request an appetite stimulator? Or maybe he just really needs the higher low carb food for now. I find that to be a great idea. How often would I feed the higher low carb food? Just at main meals? Just snacks? Or all throughout the day?

I would ask about an appetite stimulant but give it after the anti nausea meds. And see how that goes.
I would feed the higher low carb food all the time for a few days to see if it helps keep the BGs high enough to stop any more reductions.
We use this strategy sometimes for DKA kitties that need the insulin but are dropping in numbers like Loki.

 

[Lauren and Loki]

She would even lie beside it with her arm over it!

That is adorable! Okay thank you for the tip!!

If you can get a manual meter you can check it when it is lower. I would get a human meter as they are just as good and are much cheaper and our dosing methods are based on them. If you live in the US, the ReliOn premier meter from Walmart is a good choice. You will also need some lancets…get size 26 or 28 gauge and some cotton balls to hold behind the ear when you test.

I have the ReliOn Premier Classic from Walmart, as well as 26 gauge lancets, a lancing device, and some packs of cotton rounds. I also bought some cheap rice to put into a sock for warming the ear.

We use this strategy sometimes for DKA kitties that need the insulin but are dropping in numbers like Loki.

Thank you for this amazing guidance! <3<3

 

[Bron and Sheba (GA)]

have the ReliOn Premier Classic from Walmart, as well as 26 gauge lancets, a lancing device, and some packs of cotton rounds. I also bought some cheap rice to put into a sock for warming the ear.

Fantastic!
Let me know how you get on!

 

[Lauren and Loki]

Fantastic!
Let me know how you get on!

@Bron and Sheba (GA) And lastly, since I do not have the higher low carb food yet, do I give the 0.75U dose in the AM, or do I reduce to 0.5U? Maybe @FrostD will know, but she might not see this by dosing time.

 

[Bron and Sheba (GA)]

@Bron and Sheba (GA) And lastly, since I do not have the higher low carb food yet, do I give the 0.75U dose in the AM, or do I reduce to 0.5U? Maybe @FrostD will know, but she might not see this by dosing time.

I think you will need to reduce the dose to 0.5 units.
He is still quite low at +8. Have you fed him again?
If he is still lower at AMPS…stall, don’t feed, and test again in 20 minutes. And post and ask for help.
I will be asleep at AMPS, but I have asked @Bandit's Mom and @tiffmaxee to look in on you in case @FrostD hasnt come online yet.
They are not prozinc users either but they may be able to help you.

 

[Lauren and Loki]

I think you will need to reduce the dose to 0.5 units.
He is still quite low at +8. Have you fed him again?
If he is still lower at AMPS…stall, don’t feed, and test again in 20 minutes. And post and ask for help.
I will be asleep at AMPS, but I have asked @Bandit's Mom and @tiffmaxee to look in on you in case @FrostD hasnt come online yet.
They are not prozinc users either but they may be able to help you.

Yes, i just gave him another small snack of the FF Gravy Lovers. He has eaten it all.
I am hoping he is higher by then. Thank you for tagging them! And for being here. I don't know how you do it <3

 

[Bron and Sheba (GA)]

Yes, i just gave him another small snack of the FF Gravy Lovers. He has eaten it all.
I am hoping he is higher by then. Thank you for tagging them! And for being here. I don't know how you do it <3

Remember not to feed for the two hours preshot.
I’ll be glad to see the next ketone test result.

 

[Lauren and Loki]

Remember not to feed for the two hours preshot.
I’ll be glad to see the next ketone test result.

Thank you for the reminder! And just to be clear: Reduce to 0.5U for AM, get the higher low carb food and feed that throughout the day, and then most likely go back to 0.75U at PM dose?

 

[Bron and Sheba (GA)]

Thank you for the reminder! And just to be clear: Reduce to 0.5U for AM, get the higher low carb food and feed that throughout the day, and then most likely go back to 0.75U at PM dose?

Yes, give the 0.5 units in the morning if the BGis high enough. And start feeding the higher low carb food.
Then we need to see the next test of ketones result and see what Melissa thinks of the dose.
If there are no ketones and Loki is eating well, we can hopefully stay with the 0.5 units but feed the higher low carb to keep the dose of 0.5 units going for longer.
If there are ketones, then we will have to probably increase the dose and the food.

 

[Lauren and Loki]

Yes, give the 0.5 units in the morning if the BGis high enough. And start feeding the higher low carb food.
Then we need to see the next test of ketones result and see what Melissa thinks of the dose.
If there are no ketones and Loki is eating well, we can hopefully stay with the 0.5 units but feed the higher low carb to keep the dose of 0.5 units going for longer.
If there are ketones, then we will have to probably increase the dose and the food.

Understood! Thank you so much!

 

[FrostD]

Agree with 0.5U dose. I also agree with increasing carbs a bit to hopefully keep him more afloat...but until we can verify just how low he's going, better safe than sorry.

I'm glad to see it though!

 

[Bron and Sheba (GA)]

Lauren would you like to start a new thread please as this one is getting too long. Thanks.
Don’t forget to link this thread with the new one for continuity.

 

[Lauren and Loki]

Lauren would you like to start a new thread please as this one is getting too long. Thanks.
Don’t forget to link this thread with the new one for continuity.

New thread started!

https://www.felinediabetes.com/FDMB/threads/new-thread-for-dialing-in-on-lokis-dosing.272701/