Need help with Beau’s dosing!!

Sharon555

Sharon555

Member Since 2023
I need help!

I also posted in the group, hoping someone, somewhere will get back to me. I am feeling lost.

Beau has always been a good eater. When first diagnosed, he was eating 1 1/2 - 2 cans for his morning and evening meal, as well as a mid morning and late night snack. Several months ago, he slowed down, but would still eat a whole can, sometimes a little less, as well as at least the two extra meals, sometimes three. The last week or so, he has shown less interest in his food and is eating much less. I’ve tried different varieties of FF (he usually eats the savory centers), but nothing makes him happy. As you can see, his numbers have been very low because he has been eating very little. Even when I fed him higher carb food, 8 - 10%, or put gravy on his food, even Karo, he still eats little and his numbers don’t go up much. It’s been my understanding that, as BG is lower, they won’t eat as much. But they also still need to eat. I keep waiting for a spike because that’s what he has always done when he drops low. But it hasn’t happened. I thought we were headed in the right direction last night, but here we are again. I don’t even remember what I fed him last night to get him at a higher number. Probably something the other cats eat, out of desperation. As you can see I’ve also reduced his dose to keep him from dropping. His PMPS 30 minutes ago was 54. All he would eat was a few licks of the gravy from the cheddar pate and a bite of his food. We were at 2.75u when this first started. I’ve reduced him twice to 2.25. This morning I went back to 2.50 based on his numbers last night. Given what has been happening I am concerned about giving him his shot. Should I skip it or drop it to 2, or even lower? We’ve not been in this situation before and I am worried. Please help!
 
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Hi Sharon. I haven’t heard from you for a while. I’m sorry I didn’t see this message last night.

I see the 2 units were still too much. You might want to consider lowering his regular dose to 2 units and holding it there for a week to see how he settles at that dose. If he’s still eating poorly and dropping too low, you know to reduce further. And of course if he has a similarly low preshot to last night and isn’t eating then you have already proven that 2 units is too much for that situation.

I am a little concerned about his lack of appetite. Is he still taking in enough calories or is he losing weight? Do you know? When was the last time he had some bloodwork done at the vet? It might be a good idea to get him checked out. Any other behavioral changes? Drinking more water? Urinating more? Acting strangely when he is eating? Activity level changes? Anything?
 
That’s OK. It’s good to hear from you.

We made it through last night. I freaked out a little when he dropped lower than 50 again at +4. I fed him some high carb food from one of my other cats, as well as Karo and high carb dry treats. After. 45 min he jumped to 85 and had an AMPS BG of 180 this morning. He ate a little better, I shot 2u and he dropped to 129 +2 and 65 +4. He ante about 1/3 can at that time and is still only at 68 at +6.

I’ll keep him at 2u for now unless he drops into lime again.

The not eating as much and not having a huge interest in food has been my concern because he’s always been a good eater. He’s holding his weight at 13 lbs in spite of it. When we went to the vet we saw the one who diagnosed him in May of last year, when he had his last bloodwork, a senior panel. She said he looked good and I had nothing unusual to report, so when I asked about a new senior panel she didn’t think it was necessary. I am disappointed in myself that I didn’t insist because he is a diabetic cat and needs to be monitored. I am taking him to see my favorite vet at the practice on Friday. He will have new blood work done because I need peace of mind.

I haven’t really seen any behavioral changes other than he’s not quite as active, but it’s been hot and he’s 11. He doesn’t seem to be in any pain, drinking and using the litter box. The only unusual behavior when he eats is that he just sniffs and takes a few licks and a couple of small bites.
 
@Suzanne & Darcy Good evening! So, today we held that 65/68 BG all day. I tested him last 2 hours ago at +9. His PMPS will be in about 30 minutes. It looks to me like he most likely won’t be over 70. Do you think I should keep him at 2u to see how he does with tonight’s cycle or reduce?
 
I just have a feeling that maybe he needs a reduction. Unless he really has a big appetite tonight and/or a little higher BG than last night’s PMPS, I think I would reduce to 1.75 tonight and going forward. If it’s a mistake, then just go back up.
 
I think last night’s lime was a combination of eating very little throughout the day and at dinner and the 2U PM shot. Today he ate less than 1/3 can of 9% C FF at breakfast and another 1/3 at +4 AMPS. Just tested him and he’s at 80. I gave him the rest of that 9%C FF can and he ate most of it. So I’m thinking that I’ll stick with the 2u and see what happens.

Overall, I feel like he ate better today. But it’s still just one can for the whole day.

In the past 9%C would send his numbers up. Until this last week, his usual meals were FF Savory Centers which are lower than 2%. So the 8 and 9% are new for him. They don’t seem to be affecting him as they did before. But it makes me nervous. I keep waiting for a spike that never comes from either the higher carb food or the very low numbers.
 
Oh, and he also ate several little pieces of chicken I cooked up between +8 and +9. That probably pushed him up just a little to 80.
 
I am glad you are taking him to the vet. Let me know how it goes. It does seem like maybe his pancreas is trying to help the BG.

I know you don’t want to lose ground with all the wonderful progress that he’s made. His numbers today were beautiful, but we also need him to eat.
 
I agree! My greatest concern has been that he hasn’t been eating as much. I will feel better after he’s seen the vet and has that senior panel done.

Our messages crossed in the ether world. Last night’s BG was 54, then 62 after stalling 45 min.
Tonight it was 80, so I shot 2u. If he has any drops at all tonight, I’ll reduce him to 1.75 in the morning.

He did eat a little better, overall, today.
 
Sharon555 said:
I agree! My greatest concern has been that he hasn’t been eating as much. I will feel better after he’s seen the vet and has that senior panel done.

Our messages crossed in the ether world. Last night’s BG was 54, then 62 after stalling 45 min.
Tonight it was 80, so I shot 2u. If he has any drops at all tonight, I’ll reduce him to 1.75 in the morning.

He did eat a little better, overall, today.
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Aaaw. I love that Beau. Give him a kiss or love pets for me tonight.
 
Well darn it! So, I didn’t get your message with the advice to reduce to 1.75 until after I already shot 2u. His PMPS was 80 instead of 62 as it was last night. And he had happily eaten 1/3 can of 9% and I was feeling confident. Now, here we are at +2 and he has already dropped to 60! Off to try and get him to eat some more. This is going to be a long night … again. Ugh!
 
Hi. I see that you narrowly avoided a lime green last night. Good job. I am sorry you didn’t see my message suggesting a decrease to 1.75. I thought you had, but I thought maybe since he was a tiny bit higher at PMPS you had decided to keep with 2 units and see how things went.
 
Good morning!

Yup! We were pretty close the line at 51. Of course, I kicked myself for sticking with the 2u. I fell asleep when he hit 66, then woke up a couple hours later and was happy he was at 93. Long night.

Good start to the day with a 114. He ate some, about 1/4 can of 9% with some chicken on top. Shot 1.75. I was feeling a little confident, took a nap, but didn’t set the alarm. So I didn’t test him until +2.5. I was surprised to see him already at 51. He ate a bit more. Keeping a close eye on him.

I can’t believe he’s only getting 1.75! Until a week ago we were at 2.75, having reduced from 3. We bounced between those two doses most of the year!
 
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Well, adding Karo to Beau’s snack at +5 AMPS when he hit 47 was an unnecessary panic move. 90 minutes later he’s at 110.
 
Down to 1.5 units he goes! I wouldn’t have waited that long to test him again when he was at 51 so early in the cycle. He’s really up to some shenanigans!
 
Yup! I was surprised how far he had dropped in 2 1/2 hours.

1.5 it is! And I think I’ve learned my lesson about the Karo. Right now he doesn’t need that big boost, but just enough to keep him level.

This is somewhat exciting, but a little scary also. I’ll feel much better after the vet appt and labs on Friday. I’m asking for a senior panel. Is there anything I need to be sure to have included?
 
Will do! Just getting ready to start the dinner process for 5 residents and 9 fosters, 4 of them kittens. Beau is always last. I’ll be testing him in about 30 minutes.

The 158 at +10 made me a little sad. I never thought I’d say something like that! I’m assuming I should still reduce to 1.5 because of the lime this morning.
 
Preshot test is 202 Have we reached the end of this ride? I’m a little depressed. Do I need to worry?

Still shoot 1.5 or stay at 1.75?
 
Can you hang with the program and still stick with the reduction to 1.5 units? If it’s not going to work for him and you need to go back up, we will know in a few cycles. Besides, you may get some rest tonight? I am trying to think positive. But I think we need to trust the process— or at least give the process a chance and see how it goes for Beau!
 
Hey Sharon! I thought we had agreed that he had earned a reduction to 1.5 units! Your spreadsheet says you shot 1.75. Is that correct? He has dived early again so please feed him and don’t wait too many hours to test again.
 
Good morning Suzanne! I shot the 1.75 yesterday morning because our messages crossed and I missed yours saying to do 1.5. I sure wish I would have.

Last night I did shoot 1.5, as well as this morning. His preshot number this morning was 131. Ate 1/3 can 10%. He has no interest in the lower carbs he was eating before. At least not the ones I have on hand. It’s just the 8 - 10% ones.

Yesterday was a roller coaster. For some reason that 47 freaked me out. I gave him 10% plus some Karo. Looks like that was a mistake. He ended up at 158, then 202, preshot. But he settled into the blues overnight.

I’m so happy I’m getting him to the vet tomorrow. Can you think of anything I should ask or bring up other than the eating issue and, of course the reductions and low numbers of late? I’m going to have them do a senior panel. Anything I should make sure they test for?
 
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Okay I was mixed up about my dates this morning and was looking at the previous days entries. I am sorry.

But today, I see he’s gone lime again early today on the reduced dose. Cut him back again to 1.25 starting tonight and going forward. I wonder if we should reduce even more? He just won’t stop! I know you will take care of him, but what about tomorrow’s vet appointment? What time during the cycle will you be going to the vet? We don’t want him trying to go lime on you when it would be difficult to test and feed him. Maybe shoot a reduced dose tomorrow? I’m just thinking ahead. Beau is certainly making things very exciting!
 
That’s what I thought probably happened.

He’s eating, just not a whole lot at any one time. At most between 1/4 and 1/3 can.

Yup! We are lime again. I just tested him and we are still lime at +5!! Can’t seem to get him up. I fed him 9 and 10% carbs at +3 and +4, even added gravy at +4. At this point he doesn’t want anything to eat. They’ve been small, but he’s had 3 meals already today. He’s doing OK and I don’t see any problems at this point. Should I get some Karo into him? I’m not really worried. I just don’t want him to go lower. If he stays where he is until insulin starts to wear off, that would be good. I will definitely drop to 1.25u tonight.

I need to leave at 8:30 (about +1.5) for his appointment tomorrow. If there aren’t any emergencies while we’re there, we should be home by 11, which is +4. I was wondering how I should handle his morning shot. And who knows where his preshot BG will be. ‍
As I finally finish this message and get it sent, we are now at +5.5. I just tested him and he’s at 54, out of the lime finally.
 
Sharon555 said:
That’s what I thought probably happened.

He’s eating, just not a whole lot at any one time. At most between 1/4 and 1/3 can.

Yup! We are lime again. I just tested him and we are still lime at +5!! Can’t seem to get him up. I fed him 9 and 10% carbs at +3 and +4, even added gravy at +4. At this point he doesn’t want anything to eat. They’ve been small, but he’s had 3 meals already today. He’s doing OK and I don’t see any problems at this point. Should I get some Karo into him? I’m not really worried. I just don’t want him to go lower. If he stays where he is until insulin starts to wear off, that would be good. I will definitely drop to 1.25u tonight.

I need to leave at 8:30 (about +1.5) for his appointment tomorrow. If there aren’t any emergencies while we’re there, we should be home by 11, which is +4. I was wondering how I should handle his morning shot. And who knows where his preshot BG will be. ‍
As I finally finish this message and get it sent, we are now at +5.5. I just tested him and he’s at 54, out of the lime finally.
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I might even reduce by .5 units down to 1 unit. His limes have gotten too protracted even with food that’s on the higher end of LC and it’s not bringing his BG up. He may go up a little high because of the limes today, but he hasn’t been staying high for very long.
 
I was very surprised that I couldn’t bring his lime numbers up this morning. But I didn’t panic and throw Karo at him. In the past, just some 4 or 5% food was enough to stop the drop and bring him up within an hour.

I will take your advice and drop him to 1u tonight rather than 1.25, especially since I have that vet appointment early in the day tomorrow.

It will be interesting to see what happens. I just wish I could get him to eat just a little more.

It will also be an interesting conversation with the vet tomorrow explaining to him what has been going on the last 10 days.

I know you’ll keep an eye on us.
 
Don’t let the vet talk you into stopping his insulin prematurely. If he has decided to go into remission then we want to do things the right way to ensure a lasting remission.

Other than the senior blood panel, I am not sure what else I would recommend except maybe a urinalysis (since that’s often overlooked in a cat health check up.) Hopefully, they will give him a really thorough examination.
 
Suzanne & Darcy said:
Don’t let the vet talk you into stopping his insulin prematurely. If he has decided to go into remission then we want to do things the right way to ensure a lasting remission.

Other than the senior blood panel, I am not sure what else I would recommend except maybe a urinalysis (since that’s often overlooked in a cat health check up.) Hopefully, they will give him a really thorough examination.
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Thanks for mentioning it, but there is no way I would stop the insulin completely. Slow and easy works for me.

I’m almost positive the senior panel includes a urinalysis. I’ll make sure to have them check for ketones.

The vet in the practice who I saw when Beau was diagnosed is the same one we saw when he had his annual. She didn’t do much more than give him the once over and tell me he didn’t need the senior panel.
The vet I’m seeing tomorrow is fabulous and thorough. It’s his practice and we use him for our fosters in the Rescue also. We love our Dr G. I’m happy he’s seeing Beau.

Fingers crossed everything looks good and it’s his pancreas starting to do its job.

Thank you for helping me through this new journey.
 
Here we are, high again. PMPS 256 after 182 at +9. If his pancreas is trying to work again, would he still be bouncing after the limes from this morning, lasting 3 1/2 hours?

We had decided to drop to 1U instead of 1.25. And, hopefully to keep him from dipping low early again in the morning while at the vet. I know doses are based on nadirs and not preshot numbers. I just need some to know that you feel 1 u is still a good idea tonight.

He ate very little for dinner. Less than a spoonful. I will try to get him to eat more a little later.

Still, he is a conundrum.
 
Well! Here we are! Yellow last night and 269 preshot. Does that mean we’ve lost the pancreas again? I’m a little disappointed this morning. Or is it maybe a bounce from being in line for 2 1/2 hours. Do they still bounce when the pancreas starts sputtering back to life?

I shot only 1u last night. Should I hold that for this morning or increase back to 1.25?

I haven’t fed him yet.
 
I would shoot 1 unit today because of the vet visit. And I would test and see how he does today after the visit and I would decide if I wanted to go back to 1.25 based on the afternoon and PMPS numbers.
 
I retested before feeding and he’s now at 227.

He ate with a little more enthusiasm, if you could call it that, this morning. About 1/3 can of 8%.

Thanks for mentioning that being in those yellows is still good for being on such a low dose. I didn’t think of that.

I’ll let you know how things go at the vet.
 
Yup! Back home. Just sat down with a cup of coffee to decompress and take it all in.

Last time I weighed Beau, 5 days ago, he was still just over 13 lbs. At the vet, he was at about 12 1/2, so a small weight loss. He was 13 1/2 at the vet at the end of May. But his food consumption has been way down. He’s mildly dehydrated, so I’m going to give him fluids. Also said to give him some mirataz and see if that helps with his eating. Other than that, said he looks good.

Went over everything that I’ve been doing with him and showed him my spreadsheet. He agreed with the reducing we’ve been doing.

When he brought him back after drawing blood and urine, he said that, while doing the ultrasound when pulling urine he saw a small amount of free fluid in the abdominal cavity. Depending on results of bloodwork, he may want to do an ultrasound. He also did a blood drop BG test and got 60 on an alpha track pet cat meter. When I checked him with my human meter in the cat 20 minutes later he was at 165. He wants me to skip tonight’s insulin and see if he stays in 200s or lower. I told him I wasn’t comfortable with that because we have been reducing slowly. Then he said he wants to see what the labs show before any other insulin changes. You see his spreadsheet. Do you think I should stick with the 1 unit tonight or skip to see what happens?

I also mentioned that, at his diagnosis last year, Dr T had me start him on insulin. I was uneducated at the point and did it. He said that, given he was not over 300, he would have started with trying to control with food, rather than going straight to insulin. Well, damn!

Anyway, that’s where we are now. Waiting to see what the labs show.

Again, what do you think about skipping tonight’s 1U dose to see what happens? Maybe I’ll just “forget” he said to skip tonight.
 
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Don’t know how I didn’t see this yesterday…I think it was that I had to take a cat to the vet who isn’t doing well and drop him off. Then I took my car for an oil change and tire rotation and ended up also needing a brake job. Then ran to the grocery store and back up to pick up William before the vet closed down.

I am glad you shot 1 unit last night. It’s looking like 1.25 would be better, but my opinion could be totally different come AMPS this morning. You are three hours behind me, I believe, so I am not sure what time that will be. :)
 
Suzanne & Darcy said:
Don’t know how I didn’t see this yesterday…I think it was that I had to take a cat to the vet who isn’t doing well and drop him off. Then I took my car for an oil change and tire rotation and ended up also needing a brake job. Then ran to the grocery store and back up to pick up William before the vet closed down.

I am glad you shot 1 unit last night. It’s looking like 1.25 would be better, but my opinion could be totally different come AMPS this morning. You are three hours behind me, I believe, so I am not sure what time that will be. :)
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Good morning!
Sounds like you had a wild day yesterday. Days like that are just exhausting.

Yes, Dr G wanted me to skip last night to see how Beau would do. Just couldn’t do it. Stayed with the 1 unit. Also gave him transdermal mirataz last night, as well as 100 ml fluid.

We’re getting a little bit of a late start this morning. Worried about lab results and why there is some fluid in his intestinal cavity so didn’t sleep well.

I just tested him and AMPS is at 211. He’ll eat and get his shot in about 15 minutes. Need to take care of the rest of the minions first.

I think we are probably 3 hours difference. It’s 7:15 and I’m in California.
 
I shot 1.25. It will be interesting to see if it drops him back into green.

Vet wanted me to skip last night to see if he would stay in the 200s. Couldn't do it.
I guess when I talk to him later today I’ll just have to tell him I’m not comfortable with skipping insulin. I don’t know if that’s what he wants me to do going forward or just last night.
 
I would not want to keep him in the 200s. Too high. He would be spending time probably over the kidney threshold which is harder on his kidneys. Even blues would be better.

I totally understand your worry about the labs and fluid. It’s my understanding that all cats have a small amount of free fluid in the abdomen so hopefully it’s just a small amount and the vet is just being cautious.
 
I agree! I don’t like when he’s been in the 200s. I can always see that he isn’t feeling his best. I would be thrilled if I could keep him in the normal range without dropping into those low 50s. He seems to feel his best when he’s closer to 100, both green and blue.

Regarding the free fluid, I’m sure he is being cautious. It’s the kind of vet he is. Hopefully, the labs come back good and the fluid will be a non-issue.
 
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