Nutella - Under control

Ralba

Ralba

Member
Recently diagnosed cat, amps 327mg/dl, we have been giving 1.0IU for the three weeks, with mixed results, we made a curve and found her nadir to be around 5 hours after shot and we have been testing every day.

today after the morning shot we give plenty food, she was hungry, we then waited and now +5hrs tested BG, first result was 49mg/dl retested, for 48mg/dl, immediately gave more food and a drop of honey in my finger, now I’m waiting for 15 minutes to test again, any advice? Previous low record BG at nadir was 88mg/dl
 
Tested now and result was 75mg/dl, she seems ok, tested for ketone in the blood, negative/low, so everything seems right, just not sure why BG spiked so low
 
You need to reduce her dose. Do you have a record you can share with the AMPS and PMPS blood glucose test numbers and with the nadirs/other tests you have gotten? We need to get you a spreadsheet set up, it would be so helpful.

What is her BG now? After giving any high carb/honey/karo stuff, you need to keep testing every two hours to make sure BG will not drop back down (it happens.)
 
Nutella’s BG spreadsheet

please find it above, last BG test was 135mg/dl, well test later and then in the pmps, so far we have stocked to the 1U initial ProZinc dose but I’m not sure if she is adapting or how to handle it, because pre-shot usually is on the 300s range but nadir often is getting lower and lower, but always bounce back to 300s
 
Thank you for sharing that. Well, a lime green number (49 in your case) is an automatic reduction by .25 units, to a new dose of .75. Hopefully you have syringes with the half unit markings because it makes it a little easier to dose between the half unit mark and the full unit mark.

What is your feeding schedule like for Nutella? Are you giving snacks in the early part of the cycle? That would be snacks of about a teaspoon or so of low carb wet food. Feeding multiple small snacks throughout the day is the best way to smooth out the cycle. Feeding after nadir is not recommended, of course. I assume all of your preshot tests are fasting preshots? So no food for two hours prior to the preshot tests?

It also would be a good idea to at least get a +2 test if possible so you can see if she is trending down in a quick way or going a little more slowly.
 
Ok! Thanks for the advice! We made a 0.75u dose an hour ago, we feed her maximum 2 hours before the test, then she has to wait for the pre-shot test, last one came 328mg/dl, feed and apply the insulin, in general we have a small bow and leave free eating for around +6 hours after the injection, she has no teeth due to she having a teeth disease, the vets recommended to remove all of them, so she eats more slowly, she usually eat 1/3 of a small bowl, go to sleep or do something, then come later to eat some more, we give her the same food since we found about her condition, mjamjam wet food made of chicken with low phosphates, no grain and high protein. We will try to test in around 50 minutes and tomorrow we update the table.
 
Last edited:
And is it possible to get a night time test? Many cats tend to drop lower at night. I’m wishing you and Nutella all the best.
 
Suzanne & Darcy said:
But you had a green nadir. I would not go back up to 1 unit yet. I would hold the dose longer.
Click to expand...
We’re keeping the 0.75U as is getting good results, after a few days we tried 1U but it got close to 50mg/dl so 0.75U it is.

I’ll check next Friday night or Saturday for her overnight BG, I know that she is eating well during the night as before sleeping we leave a bow for her and early morning she calls us hungry for more

her weight is not increasing still, same 2.4kg as before we measure occasionally
 
Ralba said:
We’re keeping the 0.75U as is getting good results, after a few days we tried 1U but it got close to 50mg/dl so 0.75U it is.

I’ll check next Friday night or Saturday for her overnight BG, I know that she is eating well during the night as before sleeping we leave a bow for her and early morning she calls us hungry for more

her weight is not increasing still, same 2.4kg as before we measure occasionally
Click to expand...
Can you add dates to your spreadsheet? And update it? That would be helpful. If you need help in a pinch, it will save you a lot of time if your spreadsheet is up to date. We need to see trends in the numbers. I’m really happy to hear that she seems to be doing well! :cat:
 
We
Suzanne & Darcy said:
Can you add dates to your spreadsheet? And update it? That would be helpful. If you need help in a pinch, it will save you a lot of time if your spreadsheet is up to date. We need to see trends in the numbers. I’m really happy to hear that she seems to be doing well! :cat:
Click to expand...
We will be adding, we write it on a notebook and later go to the computer

any tips on handling too much hair in a skinny cat, lately I’m missing too many shots as FS or being afraid of get insulting somewhere it shouldn’t go, I pick her skin but there is not much fat below it, I can feel her rib cage easily
 
Ralba said:
We

We will be adding, we write it on a notebook and later go to the computer

any tips on handling too much hair in a skinny cat, lately I’m missing too many shots as FS or being afraid of get insulting somewhere it shouldn’t go, I pick her skin but there is not much fat below it, I can feel her rib cage easily
Click to expand...
Some people will have a very small spot shaved on their cat -- at the scruff -- to make it easier to inject insulin.
 
All of the cells for the last 19 days of testing do not have a date in the date column. So it's not possible to tell when these tests were taken. That's what I was talking about. I'm sorry if I did not express it clearly.
 
Suzanne & Darcy said:
All of the cells for the last 19 days of testing do not have a date in the date column. So it's not possible to tell when these tests were taken. That's what I was talking about. I'm sorry if I did not express it clearly.
Click to expand...
Oh, just saw it, fixing.

sadly we are in a very bad situation, she became really uncooperative since we shaved her hair, when we try to inject the insulin she gets very agitated, meows violently and make the syringe move, we were unable to give her last two shots, I’m completely stressed and exhausted from this situation, she is very skinny at 2.4kgs (5.2lbs), usually I injected on the side of the belly, close to the armpit, but her skin lately seem thicker than usually and it got hard to get though, and sim afraid to hit her rib cage since I can feel it while making the tend, her BG is on the 380-400 range pre-shot, tomorrow I’ll try again..
 
Why do you not lift the skin on her scruff and make a little “tent” and inject into that??
I’m sorry this is happening!
 
What is the length of the needle that you are using. They don’t need to be very long. I used 8 mm length needles. I believed there are even shorter ones.
 
Suzanne & Darcy said:
Why do you not lift the skin on her scruff and make a little “tent” and inject into that??
I’m sorry this is happening!
Click to expand...
I’ve been seeing many videos, the best seems to be one where you keep the tent with the finger, my problem is that I get too nervous/worried to do something wrong, then the cat feel it and see I’m struggling then she gets nervous, on the videos people pick, poke, press, bye, I keep looking where to apply etc

no need to be sorry that’s my own fault, definitely won’t be nurse, medical staff or veterinary any time soon, not fit for the profession :)

I think I got 1/2 shot today, she felt it but I think I took to fast the needle and a drop formed outside, I’ll test later to check if it was a fur shot or not, I’ll add photos of our baby so you can see how skinny she is, I mean she got zoomies a few days back and is still quite strong, jumps high etc but I wish she was chonkier to facilitate the injection hehe
 
I use 8mm U-100 syringes from UltiCare, 31G (.25 mm) and I inject on the back of her neck to the left or right of her spine between her shoulder blades. My husband rubs her ears and chin while i make a little tent with my thumb and 2nd and 3rd fingers, and I inject into the tented area. She doesn't seem to feel it at all, and she gets a low carb treat of dehydrated chicken breast after, so she associates the injection with something she likes. I've only been doing this for about 6 weeks now since she was diagnosed, and I found to go slow and calmly, slow down the actual act of injecting, don't try to "stab and run", just go slowly and calmly. I am needle phobic, so this has been quite something for me to be able to do this.
 
TinaMom said:
I use 8mm U-100 syringes from UltiCare, 31G (.25 mm) and I inject on the back of her neck to the left or right of her spine between her shoulder blades. My husband rubs her ears and chin while i make a little tent with my thumb and 2nd and 3rd fingers, and I inject into the tented area. She doesn't seem to feel it at all, and she gets a low carb treat of dehydrated chicken breast after, so she associates the injection with something she likes. I've only been doing this for about 6 weeks now since she was diagnosed, and I found to go slow and calmly, slow down the actual act of injecting, don't try to "stab and run", just go slowly and calmly. I am needle phobic, so this has been quite something for me to be able to do this.
Click to expand...
Your Tina is very cute! You use U100 insulin syringes because your kitty gets glargine insulin. Nutella is on ProZinc insulin and therefore must use a different kind of syringe, U40 syringes. We had a cat go into hypoglycemia here because a veterinarian made the mistake of injecting ProZinc insulin into a cat using a U100 syringe. This means the cat received many times the dose of insulin that he was supposed to. I am sure that you already are aware of the differences, but I am writing this because a lot of people may read this post who do not realize that ProZinc requires U40 insulin syringes. I will never forget staying up all day and night to help the kitty’s owner get him through this hypo. Having said that, your suggestions about doing the shots are excellent. Thank you for stopping by and lending support!:)
 
Ralba said:
Oh, just saw it, fixing.

sadly we are in a very bad situation, she became really uncooperative since we shaved her hair, when we try to inject the insulin she gets very agitated, meows violently and make the syringe move, we were unable to give her last two shots, I’m completely stressed and exhausted from this situation, she is very skinny at 2.4kgs (5.2lbs), usually I injected on the side of the belly, close to the armpit, but her skin lately seem thicker than usually and it got hard to get though, and sim afraid to hit her rib cage since I can feel it while making the tend, her BG is on the 380-400 range pre-shot, tomorrow I’ll try again..
Click to expand...
We reward shot time with a treat. One treat before and 1 treat after and ours has come to expect and sits still for us knowing she is getting a treat after. Remember to, to give the shots in various locations so you dont built up scar tissue which will prevent the insulin from be absorbed
 
Here are some pictures, sadly she has been diagnosed missing a brain cell, she is on the looking since we got her, we were able to apply this evening but she is really sensitive :( she was really mad but even mad she didn’t got violent/pat us and came to eat after

9-C8-DB0-CB-A9-D1-4-D05-87-D7-9-A79-C3-E5-CC9-D.jpg



https://i.ibb.co/RjB3pNx/0-DD7-E880-E3-DF-4013-B01-E-11-F658-C87-A35.jpg
0-DD7-E880-E3-DF-4013-B01-E-11-F658-C87-A35.jpg
 
I can't imagine trying to inject in the belly/armpit area, the shoulder/back of neck to the right or left of the spine should be easier. She should have loose skin there. At this point, I think she needs to eat. As soon as you can get insulin in her, her body will be able to start using the glucose to actually put weight on.
One other option if she is uncooperative, is to put an elizabethan collar on her when you do the injection so that she can't see what's going on, put some yummy food/treats in front of her and let her stand in a comfortable position so you can inject in her shoulder area. Start by petting/scratching her in that area to desensitize the area, then do the injection.
 
Ralba said:
Here are some pictures, sadly she has been diagnosed missing a brain cell, she is on the looking since we got her, we were able to apply this evening but she is really sensitive :( she was really mad but even mad she didn’t got violent/pat us and came to eat after

9-C8-DB0-CB-A9-D1-4-D05-87-D7-9-A79-C3-E5-CC9-D.jpg



0-DD7-E880-E3-DF-4013-B01-E-11-F658-C87-A35.jpg
Click to expand...
Oh she is so pretty! She has a lovely face. She is very underweight though, as you said. How long have you had her? How old is she? I do hope we can get her into better blood glucose numbers so that she can make use of her food and put some weight on.
 
Last edited:
When you can, could you please update your spreadsheet. I wanted to look at it and see how it is going. I realize that you have been having great difficulty in getting the shots completed. I am glad that tonight she was angry but did not hold a grudge against you but came back to eat!
 
Suzanne & Darcy said:
Oh she is so pretty! She has a lovely face. She is very underweight though, as you said. How long have you had her? How old is she? I do hope we can get her into better blood glucose numbers so that she can make use of her food and put some weight on.
Click to expand...

she is sweet, a bit don’t touch me where I don’t like, but she loves chin rubs and to scratch her paperboard, that’s a good question, we have her for 7 years already but we got her as adult from an shelter and she came to us with severe gengivites, we took her to the vet and he said that at the stage the best option was to remove all her teeth, that was done, so to have this kind of dental issues I think she was at least 5-7 years old, the shelter didn’t know since they got her from the streets, so the guess is from 12 to 14 years, due to the gengivite she never ate well, then afterwards without teeth was hard to eat a lot and was always skinny but fluff, lots of hair. We let her eat whenever she wants but she eats not a lot, today was hard, she was on the defensive and I believe we got a partial fur shot, I’ll measure BG now and see if there was anything in.

The vet gave us a Gabapentin to help with the preparation of the other cat (Pancake) to make a blood exam, we are thinking of giving Nutella it and see if she gets calmer, lately to hold her for 10 seconds is already too long and she wants to let it go, any experiences with Gabapentin?
 
Another day another complication

After being really irritated and we missing almost two days in a row of the insulin, she was today lethargic and not eating properly. She also was drinking a lot of water, we had purchased some time ago a ketone blood test, we did it and she have 0.9mmol/l, we administer the insulin after measuring the blood and will monitor closely
 
Update, ketones are down to 0.1m mol/l, BG is currently at 328mg/dl, she is still lethargic and not eating, when she reaches 1xx range I will offer some food if not +5 hours I test to see if it didn’t went too low and if needed give some sugar

nadir update BG 166mg/dl, she is much more awake, still weak from eating nothing all day, went to grocery and brought some chicken breast that the devoured, never seen she so eager to eat, tomorrow more updates, we called a vet to check on her
 
Last edited:
Vet came, we tested blood glucose, 447mg/dl, he told us to increase the insulin and monitor closely, he also tried to give liquids, which was impossible she hated and got really triggered, we let it be, even for he gave the insulin he saw she was on the defensive, just to make the tend make she agitated and want to run, he mentioned that she might have developed it from the past due to a stressful even this behavior and it’s gonna be tricky, he preferred not to give her gabapentin due to her current condition
 
You must log in or register to reply here.
Back
Top