Opie and the Flat Pancake

Hi Julie

You’ve had some great help and Opie has been up to a few tricks I see. Great job getting those +2 tests but, as Suzanne reminded in the previous thread, it’s good to occasionally grab a +1, especially if he’s due to break a bounce, so you can see if he gets a food bump then but also when he’s flat to see if he gets any bump from food. Also like she said, not every cycle but look at the pattern and choose some here and there. I always think the +1 is important for every cycle that it appears he’s going to break a bounce. The earlier you can stop the dive and flatten it, the better.

A couple comments on what I see but please understand, everyone, that these are just observations and not criticisms. Everyone does their very best but every day, we all can learn, including the Moderators!

  • going back to 7/17, Opie obviously earned a reduction; remember reductions of 0.25u are always taken the next cycle when a cat drops below 40
  • 7/18: dose reduced night before but he dropped to 48 and another reduction was taken the night of the 18th. Opie is a long-term diabetic and PZ doesn’t have the kind of depot the L insulins have so I wouldn’t have reduced again; even with the reduction, he still got back down to green on 7/20
  • on 7/18, boy did he lose duration going from green to pink in a couple hours and then on to red. That is definitely loss of duration for whatever reason (as has been said, less absorption, maybe some extra carbs to keep his BG from dropping more, etc). It’s really, really helpful to have food information in the Remarks. It can tell us so much about his duration.
  • after the greens on 7/20, let the bouncing begin and I think you lost some time by reducing his dose to 1.75u when it didn’t need to be at that specific time.
  • I would have suggested taking the dose back up again on 7/24 (so with not reducing on 7/18 and an increase on 7/24, he would have been on 2.25u already). He’d already made a couple of swipes at clearing the bounces and wasn’t getting back to green so there was no need to keep holding a dose that wasn’t working.
I wish I had an answer for you on why a cat will earn a reduction on a specific dose and then just fizzle on the reduction and need to go back up. It’s common.

In this case, because he didn’t go really low on 2u, I would have taken him back up to it pretty quickly instead of holding 1.75u for so long. I know this is different than other advice you got and that’s fine. That’s why this is a peer review board. I also tend to advise a bit more aggressively when a cat is a long-term diabetic and the CG tests as much as you do.

Just remember, if you increase and you aren’t seeing some strings of blue and a little green within six cycles, I’d definitely increase. If you decrease and you give him time to clear the bounce and you aren’t seeing blues and greens, increase.

And as an important note, when I give the above advice for Julie and Opie, it’s because she is testing and knows she can increase as she tests enough to see how low the dose current dose is taking him. Please do not increase a dose if you don’t know how low the current dose is taking the kitty; grab those nadir tests!

I’ve thrown alot at you and again, no criticisms intended. Just thoughts from a different perspective.
 
Last edited:
Opie has had several nights in a row in green and today all green! I know he will always have his ups and downs but right now he is doing so much better. Thank you all for your help to make this possible. Much love to you all.
 
Suzanne & Darcy said:
Yesterday looks so good - both a.m. and p.m. :D:D:cool::cool:
Click to expand...
He is looking good today as well. It seems sometimes that his bounce is blue, a flat blue which I can't complain about. I didn't get the last test in the PM cycle last night, fell asleep so soundly that I never heard the alarm. Doing good certainly takes a lot of work.
 
Opie just went Hypo, at +3 he is 38 which means an automatic reduction to 2 units tomorrow. Sad about it because he was doing so good. I had a difficult time today because he was being fussy and would only eat 1% carb food. It was not easy to keep him away from going hypo. I guess Opie will be Opie. . .
 
Good job catching that 38. Opie is safe, that's the main thing. And I do agree that it could be different this time. He's made some progress. All paws here at our house are crossed for Opie on his new dose!
 
I would have given him a touch of syrup at 63 -- normally, I would not say to ever give karo when a cat is at 63 which is a great number... but, as you said, Opie was only willing to eat 1% carb food at that time -- and that's not enough carbs to steady him if he's going down at +3 -- so I would have either mixed a drop of karo into the 1% carb food -- or I would have just put a touch in his mouth -- and the reason would be that he was already at 63 at +3 -- so hours away from nadir -- and to top it all off, this was occurring at night. Optimally, some 8-9 or even 10 percent carb would be given in such an instance, but you said he wouldn't touch anything except his favorite 1%! As you said, Opie will be Opie. He is stubborn about his food! Good job!
 
Suzanne & Darcy said:
Good job catching that 38. Opie is safe, that's the main thing. And I do agree that it could be different this time. He's made some progress. All paws here at our house are crossed for Opie on his new dose!
Click to expand...
Thanks Suzanne. He started today in pink but is already down to yellow. I think that is a good sign. Also, in regards to your previous comment about the 1% food. When he went below 50 I fed karo and HC. It is the rest of the day when he was going down that I need to get a little more carbs and worried about what he would and wouldn't eat.
 
LovingOpie said:
Thanks Suzanne. He started today in pink but is already down to yellow. I think that is a good sign. Also, in regards to your previous comment about the 1% food. When he went below 50 I fed karo and HC. It is the rest of the day when he was going down that I need to get a little more carbs and worried about what he would and wouldn't eat.
Click to expand...
Yes. I was just thinking that it would have been good to give MC when he was in green (63) at +3. But, as you said, he wasn’t cooperating by eating anything other than 1%. It is good that he’s gone to yellow now - no flat pink cycle after the lime green is definitely a good thing. Have a good day!
 
Not sure about the lower dose. Today he lost duration and was going up already at +8 to end the cycle in pink. We are now on the 4th cycle at 2 units and I know it is too early to tell but I am having my doubts.
 
having had no response to my latest posts, I increased back up to 2.25 this morning after a long night in pink. If this is too much I will tweak the dose somewhere between 2 and 2.25. It was 4 cycles and MPM does say between 3-6 cycles before increasing. I know he went down to blue at one point but since then it is just higher and I hate seeing the pink again. It is after all only a guessing game in the end isn't it?
 
well today the insulin kicked in after all the bouncing and he hit 32 at +3. . needless to say, it has been a real ordeal because it is such a long time until nadir. I thought I would be able to handle the higher dose but normally he moves slow and today it has been fast. I will have to tweak the dose and make it somewhere between the 2 and 2 1/4. I considered just upping the amount of carbs I feed him to balance it off but I don't think that is such a good idea. Anyway. . . that is where we are at today.
 
You may also want to consider shooting only 2 units if he's below 150, as he was today. What did he eat between AMPS and +3? Was he eating okay? Was it all the 1% carb?
 
I especially wonder, did he eat at +2? If so, he needed more carbs to support him -- if not, then he needed to eat something. I do agree that the +2 number wasn't anything alarming -- but a 6 or 8 percent carb at that point might have been a good choice. But I know you are not enthusiastic about giving him higher carbs -- and I know that a lot of the time he seems to be fond of the 1% carb food and refuses to eat anything else.

Did he eat his normal breakfast?
 
Suzanne & Darcy said:
What’s wrong with Opie? He’s not sick is he?
Click to expand...
Opie has been not feeling well due to a ruptured Anal gland. I wasn't sure what to do with the insulin at such a time since his numbers have been flat for most of the time. Seemed to me that I shouldn't change dose or do anything until he is off the antibiotic.
 
LovingOpie said:
Opie has been not feeling well due to a ruptured Anal gland. I wasn't sure what to do with the insulin at such a time since his numbers have been flat for most of the time. Seemed to me that I shouldn't change dose or do anything until he is off the antibiotic.
Click to expand...
I am sorry for poor Opie. That sounds really painful. I was thinking it had been a long time since you posted anything and I went to check your thread this morning. I definitely would not change anything (unless he needed a reduction, obviously) until he is finished with meds. That’s a good move. Is he eating better now (hopefully indicating that his fever is gone?
 
Suzanne & Darcy said:
I am sorry for poor Opie. That sounds really painful. I was thinking it had been a long time since you posted anything and I went to check your thread this morning. I definitely would not change anything (unless he needed a reduction, obviously) until he is finished with meds. That’s a good move. Is he eating better now (hopefully indicating that his fever is gone?
Click to expand...
Thanks for checking in, Opie is doing better and his appetite is improved without the fever. Opie will be Opie with food as you well know. FYI I don't feed him 0% carbs because it was my choice, it is one of the FF classic pates and all of those are LC. He switches on which one is the food of the week and it just happens to be 0% or 1%. I also feed him 0% in the time after nadir when he is starving and wants to eat but I am not supposed to feed him. It works well for him.
 
LovingOpie said:
Opie has been not feeling well due to a ruptured Anal gland. I wasn't sure what to do with the insulin at such a time since his numbers have been flat for most of the time. Seemed to me that I shouldn't change dose or do anything until he is off the antibiotic.
Click to expand...
I am so sorry to hear this. It happened to my little Livia and so I know how tough it might be for Opie. I hope they gave him something for pain.

I agree with Suzanne that I’d hold the dose. He is seeing some green on this dose. He could be doing better but because his BG might improve a bit more as the antibiotic takes full effect, you might see a bit more green. It’s hard to say but I’d would be testing his ketones every single day since he has this infection.
 
Marje and Gracie said:
I am so sorry to hear this. It happened to my little Livia and so I know how tough it might be for Opie. I hope they gave him something for pain.

I agree with Suzanne that I’d hold the dose. He is seeing some green on this dose. He could be doing better but because his BG might improve a bit more as the antibiotic takes full effect, you might see a bit more green. It’s hard to say but I’d would be testing his ketones every single day since he has this infection.
Click to expand...
Thank you so much. Actually, he went down into green this afternoon and it was nice and slow and good. I will be sure to keep checking his anal glands from this point on and appreciate your advice.
 
Opie went down to green at 46 this afternoon and has gone up so very gradually that it is almost time to shoot and we are at 78. Looks like I may be shooting my lowest yet. Kind of scary at these numbers. . . I shot 90 before so I am guessing that around 80 will be ok?
 
Having had no one respond to my last post when I needed the advice on shooting low, I decided to shoot at 82. My lowest ever! I fed him a little higher carb than usual and in one hour the food bump gave him 111. So far so good.
 
LovingOpie said:
Having had no one respond to my last post when I needed the advice on shooting low, I decided to shoot at 82. My lowest ever! I fed him a little higher carb than usual and in one hour the food bump gave him 111. So far so good.
Click to expand...
Sorry no one responded in time. I think you made the right decision. I know you will be monitoring & testing him throughout the cycle. Your doing great & Opie is very lucky to have you:)
 
WOW! Opie went down to 23! I caught it and all is well but what a scare. I think that he has had infection problems with the anal glands for quite some time and that may have been affecting his BG and why he never really settled in. He seems very different now and I think he may have earned a reduction today. Wow, I have to keep on my toes with him.
 
yep, he went down AGAIN! 36 this time. . . the challenge seems to be knowing just exactly how much HC to feed without giving him a huge spike.
 
So PMPS was 86 and I decreased his dose to 1 3/4 units. I can only hope that I did right. Again, I have had no response.
 
Opie went down to 29!!! I can't believe it Twice in one day. I don't know what is protocol on back to back reduction but it looks like I will be reducing the dose again in the AM. It is going to be a long, long night. . .

I don't know if I will continue to post or not. The lack of any response when I really needed it is disheartening.
 
LovingOpie said:
Opie went down to 29!!! I can't believe it Twice in one day. I don't know what is protocol on back to back reduction but it looks like I will be reducing the dose again in the AM. It is going to be a long, long night. . .

I don't know if I will continue to post or not. The lack of any response when I really needed it is disheartening.
Click to expand...
Im sorry no one responded. The PZ board just doesn’t get the traffic that the Lantus and Main Health boards get.

I’m glad you’ve been staying on top of this. It’s a good idea to reduce again in the morning. You can always go back up if you need to.

I hope you rechecked 30 mins after you fed that 29. Remember high carb food wears off after two hours so if he comes up, you’ll have to keep texting to be sure the BG stays up.

I’ll check back in shortly.
 
You must log in or register to reply here.
Back
Top