? Should I skip a shot to get back on schedule?

SmallestSparrow

Very Active Member
Here’s where I got off schedule: https://felinediabetes.com/FDMB/thr...r-after-1-161-2-155-3-75-176-5-25-163.294298/

a few days ago I overslept then also had to stall Methos’ am shot, putting me about 2.25 hours off schedule. This has wrecked havoc on his test results and everyone’s appetite in the house including the other cat with pancreatitis, in part bc they both require small frequent meals, and Methos takes other meds that shouldn’t shift around and require a meal.

He was reduced from 3.5 to 2.5U. Following the link provided by @tiffmaxee (thank you and I hope I understood it) I tried thr shift backwards 30 min every two cycles except if he was already a low (for me) PS I just held the previous day’s time. So over seven cycles I’d made it back an hour toward the appropriate time. This was close enough to his other meds for me to advance them an hour and finally get meds/meals/insulin in sync even if still happening 60 min later than I’d like …a short lived celebration this am.

I’d planned to start sliding everything back 15 min a day if his numbers were steady and high enough. But:

it’s looking like I may have a pmps too low (for me) to give a full dose. I just can’t do hourly ear sticks on him again, it’s already in tatters. He may fool me and pull up…he did it a few days ago when I was praying for a NoShot cycle so I could auto reset to the right time and we’d both get a break. Instead he was over 300 pmps (little stinker)

I’d appreciate opinions on what I should do if pmps is too low (for me)—I can think of three things:
1. No Shot, ears rest, and we skip back an hour in the am to the correct time
My concern here is i hate jerking his BG around but the rest of it has massive appeal.

2. Partial shot (like 1/2 unit), and if BG in am high enough go head and skip back the hour (not sure if that’s acceptable to do but it feels like a compromise between my other two options and again means less sticks tonight (I’d still do at least nadir

3. Partial shot as high as I can stand it and coninue inching time backwards—I sort of feel this is the worst combination—lots of ear sticks and still an hour off but if it’s best for him I’d do it
Thanks
 
Am I correct that he’s never had ketones? Are you testing his urine for ketones? If too low for you to give insulin and if I’m correct I see nothing wrong with skipping tonight so you can get back on schedule. I know Cushings makes it hard on him to test a lot. A reduced dose might still lead to an active first half of the cycle. How off are you now time wise?
 
Am I correct that he’s never had ketones? Are you testing his urine for ketones? If too low for you to give insulin and if I’m correct I see nothing wrong with skipping tonight so you can get back on schedule. I know Cushings makes it hard on him to test a lot. A reduced dose might still lead to an active first half of the cycle. How off are you now time wise?
Because he was on Bexacat for a few months I tested him 3x/wk and he was always 0.1-0.2 (i test blood with Precision Xtra). Bc he’s been so poorly regulated since starting insulin 2 Aug I test him once a day. He’s been 0.1-0.4, usually 0.2 and noted in SS remarks. The last four days starting oldest have been 0.2, 0.1, 0.1, 0.2.

he approached my hard floor of 100 with 108 at +9.5 and got 50 cal of LC food that is more than his usual 4 meals and 4 snacks. At +7.5 he came asking for his snack early which is why I tested him then and gave him 25 cal LC mousse (but it has more carbs than his usual snack of 20 cal chicken breast.

so I don’t even know if a pmps would be reliable esp since I’m going to feed him at +11 if he’s still around 100

edit: in fairness to my vet she’d rather I stop testing his ketones so much. She liked the 2-3/wk when on bexa but she knows anxiety is driving the daily test now. My goal is test only 300 and above but the drop is just sitting there and I can’t not test

edit: ketones above 0.2 are highlighted yellow in remarks
 
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I didn’t explain the food correctly. But he’s 70 cal ahead of where he should be at this point (he can use the extra calories) and some of them while LC were more than the almost zero carb he would normally eat. Hard to explain. But since the extra came later in the cycle than he normally eats I expect it will boost his pm number but idk that I’d trust it
 
Sorry I’m an hour off. The time finally wasn’t a deal breaker (it’s been hell getting to here but from here on the shifting would be manageable. But I wouldn’t mind being able to make the hour leap all at once with a skipped shot. If I gave 0.5 U instead of his 2.5 could I still skip back an hour?
 
Shooting an hour early MIGHT act like a slight increase but with a token dose I think you probably could give the shot an hour early. The way the bg has been low at shot time it might be better to do a half hour and see what that does and decide tomorrow night if you want to wait until the next morning and do another 30. That’s if you give a token .50. Does this make sense?
 
Shooting an hour early MIGHT act like a slight increase but with a token dose I think you probably could give the shot an hour early. The way the bg has been low at shot time it might be better to do a half hour and see what that does and decide tomorrow night if you want to wait until the next morning and do another 30. That’s if you give a token .50. Does this make sense?
If I understand correctly, if I gave like a half unit tonight (I assume that’s a token) the rather than skip an hour do a half hour early if BG high enough in am and then decide after that how to make up rest of hour
 
150. That’s lower than I’ve done before. I hate that he may be 400 tomorrow if I don’t do anything but I’d rather not get his adrenals involved. And I had trouble finding a spot for the pmps.
I’ll regret it I’m sure but I don’t think I can do this. I think I’ll just take the time bonus reset and hope his ketones stay down
Thanks so much for your help
 
So for anyone looking at his SS, as soon as I decided NS I became anxious I’d wake up to a BG of 500 and ketone 4.0. So I gave 0.5u. Immediately i regretted it. And poor baby I’ve now probably got to stick his ear two more times tonight. But with +2 being 235 I’m worried in both directions. So much for a quiet night. Now to debate whether i should try to give the other one his narcotics.
Old ladies and old cats are not the ideal combination.
 
So how late did you shoot? If immediately means on time you might not be in for an active cycle with the +2 increasing.
 
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So how late did you shoot? If immediately means on time you might not be in fir an active cycje with the +2 increasing.
About 12 min. I’m hopeful. Resisting testing bc he’s awake and I want to minimize pokes but will probably give in bc both of them want final meal and I can’t stand the suspense. Hopefully I’m not killing him

edit: I gave the shot after about 12 min of agonizing over the decision. Immediately refers to regretting the shot once given. Poor boy deserves better.
 
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Oh Colleen, I am sorry this is so stressful. You are doing such a great job taking care of your boys. I keep my fingers crossed everything is gonne be alright! :bighug::bighug::bighug:
Thanks so much Heike. Well the half unit didn’t let us all sleep, didn’t give his ear a break, and didn’t seem to help his BG although perhaps it would have been worse. Live and learn. At least I should be able to start moving the time 15 min each cycle and I’m NEVER stalling 2 hours again!
How’s Binie doing? I bet she’s glad you’re home
 
Thanks so much Heike. Well the half unit didn’t let us all sleep, didn’t give his ear a break, and didn’t seem to help his BG although perhaps it would have been worse. Live and learn. At least I should be able to start moving the time 15 min each cycle and I’m NEVER stalling 2 hours again!
How’s Binie doing? I bet she’s glad you’re home

Been there, done that. I also stalled for two hours and even more in the past. Seems to be part of the learning experience.

I'm not sure why Binies bg is like that. Could be the infection. Me being away is usually not a stress factor for her. She was doing well on the "old" not so effective antibiotic but I am worried how she will be on the Chloramphenicol. I just started today so we'll see. So far everything is good. Hope you have a relaxed sunday! :bighug::bighug::bighug:
 
And to round out my fun Tammuz had diarrhea last night—which he’s never had. From his pancreatitis? From the pain meds? From all the fish flavors used to entice him to eat? The mirataz? The Zofran? The cernia?
Or because he wants to torture mom who’s now washing sheets and blankets (and hoping she got all of it off of him when she bathed him earlier today)?
I’m hoping it was the pumpkin/psyllium chews I gave him for constipation. Because a) I know something powerful for future needs and b)because I need to keep using everything else.
Looks like another day of cereal for dinner
 
Been there, done that. I also stalled for two hours and even more in the past. Seems to be part of the learning experience.

I'm not sure why Binies bg is like that. Could be the infection. Me being away is usually not a stress factor for her. She was doing well on the "old" not so effective antibiotic but I am worried how she will be on the Chloramphenicol. I just started today so we'll see. So far everything is good. Hope you have a relaxed sunday! :bighug::bighug::bighug:
Stalling turned out to be a bigger issue than I anticipated. They already eat 4 meals and 4 snacks so I thought “no big deal I can line it up with food some where” —I was wrong. It was hard to test him more than 2 hours after food, the food he got after was often near zero carb rather than low carb, or he was still full from the meals he has to take with meds that can’t be moved much. I was calculating carbs and rearranging times all day. Soooo glad that’s over
 
And to round out my fun Tammuz had diarrhea last night—which he’s never had. From his pancreatitis? From the pain meds? From all the fish flavors used to entice him to eat? The mirataz? The Zofran? The cernia?
Or because he wants to torture mom who’s now washing sheets and blankets (and hoping she got all of it off of him when she bathed him earlier today)?
I’m hoping it was the pumpkin/psyllium chews I gave him for constipation. Because a) I know something powerful for future needs and b)because I need to keep using everything else.
Looks like another day of cereal for dinner

Ohhhhh.... Colleen, I am sorry. It's really not easy at the moment. I hope Tammuz recovers soon and you find some time to take care of yourself! Binie also suffers sometimes from constipation and it happened to me too, that I was overdoing things.... All the best for you and the boys! :bighug::bighug::bighug:
 
Ohhhhh.... Colleen, I am sorry. It's really not easy at the moment. I hope Tammuz recovers soon and you find some time to take care of yourself! Binie also suffers sometimes from constipation and it happened to me too, that I was overdoing things.... All the best for you and the boys! :bighug::bighug::bighug:
:bighug::bighug::bighug: Back to you. On more reflection it may have been his anesthesia. Both boys have had diarrhea within 24hr of any anesthesia. Anyway thanks and my fingers are crossed no more. On the positive, his appetite is better now.

I hope you have a wonderful restful night and miss Binie is even blues tomorrow
 
And to round out my fun Tammuz had diarrhea last night—which he’s never had.
I’m hoping it was the pumpkin/psyllium chews I gave him for constipation.
Could be any of the new things you listed, especially if you were generous with the psyllium/pumpkin, but was he severely constipated or just slightly? Because another cause of “diarrhea” in a severely constipated cat is liquid poo that is working its way around a solid impacted stool. Just something to keep in mind. Not that you need anything else to worry about. :nailbiting:

If you put your hands on both sides of the abdomen and palpate gently, sometimes you can feel whether there’s a hard chunk of stool.
 
Could be any of the new things you listed, especially if you were generous with the psyllium/pumpkin, but was he severely constipated or just slightly? Because another cause of “diarrhea” in a severely constipated cat is liquid poo that is working its way around a solid impacted stool. Just something to keep in mind. Not that you need anything else to worry about. :nailbiting:

If you put your hands on both sides of the abdomen and palpate gently, sometimes you can feel whether there’s a hard chunk of stool.
Well thanks for the new addition to my closet of anxieties :)
I may try that tomorrow but in retrospect I think it may have been the sedation they used to get his X-rays done (he did fine for his ultrasound on gabapentin but since he was breathing funny they got him au natural on Friday). I think he had a loose poop in 2020 when they did a CXR before his I 131, and used sedation, and Methos also had diarrhea after they sedated him for an ultrasound. ‘Muz is very regular in his poop but they have always been big marbles. Otoh he buries it so perhaps they didn’t start out that way. I was giving the pumpkin/psyillium was to see if it brought his cholesterol down and bonus if it bulked up his poop
 
Could be any of the new things you listed, especially if you were generous with the psyllium/pumpkin, but was he severely constipated or just slightly? Because another cause of “diarrhea” in a severely constipated cat is liquid poo that is working its way around a solid impacted stool. Just something to keep in mind. Not that you need anything else to worry about. :nailbiting:

If you put your hands on both sides of the abdomen and palpate gently, sometimes you can feel whether there’s a hard chunk of stool.
Admitting I haven’t done this yet. Going to wait until I’ve pissed him off giving him his narcotics. But do you think if he had impacted stool they’d have seen it on his ultrasound he had last week? My vet is back in the office tomorrow and I’ll ask her about that and if the did belly films when they did the cxr Friday?
 
Admitting I haven’t done this yet. Going to wait until I’ve pissed him off giving him his narcotics. But do you think if he had impacted stool they’d have seen it on his ultrasound he had last week? My vet is back in the office tomorrow and I’ll ask her about that and if the did belly films when they did the cxr Friday?
Sorry I mentioned it—it’s probably not likely in your scenario and perhaps just caused you more stress to put that in your head. :(. It’ll be clear on X-ray and there would likely be other symptoms as well, such as projectile vomiting, straining in the litter box, etc.
 
Sorry I mentioned it—it’s probably not likely in your scenario and perhaps just caused you more stress to put that in your head. :(. It’ll be clear on X-ray and there would likely be other symptoms as well, such as projectile vomiting, straining in the litter box, etc.
Thanks and don’t be sorry. I’d probably have found it on Google anyway. He hasn’t done any of the other things except he did vomit and stop eating almost two weeks ago. Saw vet, BUN and bili up, fPL in the gray zone (I think 8 or 10, dealing another cat emergency or I’d look). His wbc was depressed but it has been for over two year—bothers me more than his vet. They gave him fluids and cerenia injection. I enticed him with fish flavored food and firtiflora. His US was nml. Then Fri am I thought he was having abdominal breathing. They said it’s just rapid shallow breaths. His cxr was nml, bun and bili nml, wbc still depressed. He was given buorenorphine to go with the cerenia and mirstaz (no mirataz x2 day now). He ate really well yesterday and this am. Now he’s not eating again.

methos had pmps 138. My vet told me to give 1U but I’m too afraid I might have to leave to take Muz to ER so I gave him a little more than 0.5U. Killing both my cats
 
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