? 2/24 Kokkinoulis AM +5 45 & BG rise & fall again please advise & PM insulin dose?

Kokkinoulis

Kokkinoulis

Member Since 2023
Previous post: https://www.felinediabetes.com/FDMB...e-10-45-89-dose-advising.286981/#post-3155293

Dear all,
@Wendy&Neko, @Bandit's Mom , @Marje and Gracie , @tiffmaxee , @Chris & China (GA), @Ale & Bobo & Minnie (GA), @Sienne and Gabby (GA)


Kokkinoulis had α hypoglycemia of 45 mg/dl at +5.20 (13:20). After that I gradually fed him up to +9: 3 tbsp from his low carb can, as the BG didn't go up much after that I fed him half of Royal Canin Vet Diet Cat Diabetic wet, after the other half, it went up a bit and dropped again so I fed him half a HC can with , and then the other half with some dry friskies and at +9.24 (17.24) is still 68mg/gl. I tried to avoid syrup.
His BGs have not increased as expected after all this food. They rise a little and then fall again.
Please advise?

Also what should I do with his PM insulin dose? After 45 he earned a decrease to 7.0 but as he is still not seems to be tottaly recovered from hypo what should I do??
 
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I’m going to let Bhooma continue with this as I am on the way out but please remove the 911. That is only for true emergencies like a symptomatic hypo, not just lower numbers. A 50 is a very safe number.

thank you.
 
Kokkinoulis said:
It was with libre and 50 with accu-check
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Normally I would say don't reduce since he hasn't earned a reduction based on the meter (since Libre lows can be unreliable), but considering how he is doing after a skip and the fact that you are worried that you cannot monitor him as closely because of your work schedules, you might want to take a reduction to 7U going forward.

As for whether you can give the full dose tonight, how are you placed when it comes to monitoring? He might bounce a little and stay in higher greens/blues. Shall we take a call based on his PMPS?
 
The numbers in ss are with libre but the differences with accu-check are not very big now as in high numbers. It was for example 83 with libre and 93 with accu-check. The issue is that yesterday ate in the evening 3 tbs LC wet food and the BG increased with 40 mg/dl and now the increases are minimal and then it falls again.
 
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Bandit's Mom said:
Normally I would say don't reduce since he hasn't earned a reduction based on the meter (since Libre lows can be unreliable), but considering how he is doing after a skip and the fact that you are worried that you cannot monitor him as closely because of your work schedules, you might want to take a reduction to 7U going forward.

As for whether you can give the full dose tonight, how are you placed when it comes to monitoring? He might bounce a little and stay in higher greens/blues. Shall we take a call based on his PMPS?
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If i wait a little more it would drop also below 50 with accu-check..it is only 1 mg/dl. Yes, it will be wonderfull if I could call you before his PM shot.
 
Kokkinoulis said:
The issue is that yesterday ate in the evening 3 tbs LC wet food and the BG increased with 40 mg/dl and now the increases are minimal and then it falls again.
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Yes, it's not unusual for a cat to respond to food differently in different cycles on the same dose. One of the reasons could be that he is headed for a reduction (although there can be other reasons as well).

Kokkinoulis said:
If i wait a little more it would drop also below 50 with accu-check..it is only 1 mg/dl.
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I would take the reduction. It could be a case where he has hit a breakthrough dose and wants to go down in dosing.

Kokkinoulis said:
Yes, it will be wonderfull if I could call you before his PM shot.
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Sure. How long till the PMPS? 2.5 hours?
 
Bandit's Mom said:
Yes, it's not unusual for a cat to respond to food differently in different cycles on the same dose. One of the reasons could be that he is headed for a reduction (although there can be other reasons as well).


I would take the reduction. It could be a case where he has hit a breakthrough dose and wants to go down in dosing.


Sure. How long till the PMPS? 2.5 hours?
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It is 18:09 local time here. In 2 hours, at 20:00. I am in panic. I am so sorry!! How can I call you?

Have you seen again this pattern the BGs to not rise a lot and fall again after HC food?
 
Kokkinoulis said:
It is 18:09 local time here. In 2 hours, at 20:00. I am in panic. I am so sorry!! How can I call you?
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Oh sorry, when I said "take a call at PMPS', I meant "let's decide at PMPS". :oops: Don't panic, I will be watching out for you.

Kokkinoulis said:
Have you seen again this pattern the BGs to not rise a lot and fall again after HC food?
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Yes, I am seeing that.

He doesn't have a history of ketones, right?
Can you get a test at 19:00 with an Accuchek?
When did he last eat and what?
 
Bandit's Mom said:
Oh sorry, when I said "take a call at PMPS', I meant "let's decide at PMPS". :oops: Don't panic, I will be watching out for you.


Yes, I am seeing that.

He doesn't have a history of ketones, right?
Can you get a test at 19:00 with an Accuchek?
When did he last eat and what?
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No he has not have history of ketones. I am waiting the results for IGF-1 test. He lately ate half can of PURINA Gourmet Gold Double Pleasure With Beef And Chicken 85 Gr. (high carb) and after some hour the other half can mixed with some kibbles Purina Friskies 5 Promises Dry Food Rabbit Chicken & Vegetables. It was about before 2 hours...I dont remember exactly. His BG is now 71 with libre ..I will check it at 19:00 after 15 min with accu-check
 
Hi Bhooma, Now he has 104 with accu-check and 73 with libre but i should check iagain libre after 10 min ...because it is 10 min after the current BG
 
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Kokkinoulis said:
So, 104 with accu-check and 80 with libre ...
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That's good. He is headed up. Let's see where he is at PMPS.

Do you feel comfortable shooting the full 7U if he is at the same levels? Can you monitor? Or would you prefer to shoot a token dose of 3.5U? Even if you give a reduced dose, the first part of the cycle will continue to be affected by the 7.5U depot.
 
With these numbers other times I shot 7.5 unit. My concern is that the numbers did not increased as
Bandit's Mom said:
That's good. He is headed up. Let's see where he is at PMPS.

Do you feel comfortable shooting the full 7U if he is at the same levels? Can you monitor? Or would you prefer to shoot a token dose of 3.5U? Even if you give a reduced dose, the first part of the cycle will continue to be affected by the 7.5U depot.
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In other times I would shot 7.5 with these numbers but as I told you 1. the BGs did not increases as usual with so many high carb food and 2. I could not closely monitor the next week in case of hypo..and with this dose of 7.5 is tight regulated very close to hypo without food when it needed.
So, as safety is first lets see how he will react in 7.0 unit. What do you thing? I will monitor him all night and all day tomorrow.
 
Kokkinoulis said:
With these numbers other times I shot 7.5 unit. My concern is that the numbers did not increased as

In other times I would shot 7.5 with these numbers but as I told you 1. the BGs did not increases as usual with so many high carb food and 2. I could not closely monitor the next week in case of hypo..and with this dose of 7.5 is tight regulated very close to hypo without food when it needed.
So, as safety is first lets see how he will react in 7.0 unit. What do you thing? I will monitor him all night and all day tomorrow.
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I understand. I'm suggesting that you take a reduction and go down to 7U. However, for tonight, I was asking if you are okay to shoot the full dose? He might stay in higher numbers or he might give you an active cycle requiring constant feeding and monitoring.
 
Bandit's Mom said:
I understand. I'm suggesting that you take a reduction and go down to 7U. However, for tonight, I was asking if you are okay to shoot the full dose? He might stay in higher numbers or he might give you an active cycle requiring constant feeding and monitoring.
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The full dose you mean 7.5 or 7.0? I prefer to shot full 7.0 and monitoring and feeding.
 
My dear Bhooma, ♥️ As his BG increased to 118 with libre I decided to give him a change to earn his reduction.. I shot 7.5 unit. For more severe hypo I have honey, sugar and Marple syrup. How much honey do you usually dissolve in water? How much sugar or Marple syrup?
 
You just add a little honey to the food to increase the carb %. No need to dissolve in water. If needed, you can also apply honey to his gums to bring his numbers up quickly.
 
Bandit's Mom said:
You just add a little honey to the food to increase the carb %. No need to dissolve in water. If needed, you can also apply honey to his gums to bring his numbers up quickly.
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Bandit's Mom said:
You just add a little honey to the food to increase the carb %. No need to dissolve in water. If needed, you can also apply honey to his gums to bring his numbers up quickly.
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I want one more time to express my heartfelt thanks for your unwavering support, guidance and advices.:cat::bighug::bighug:

धन्यवाद
 
Hi Gabriella:)
Kokkinoulis really kept you on your toes today. Well done on handling this so well. He's blessed to have you as his mum.
I hope you get some good rest tonight :bighug:
 
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