New Member Snowball has been testing low all weekend

jwbsings Snowball

jwbsings Snowball

Member
Hi, jwbsings and Snowball here.
I have been testing Snowball throughout the day and after giving him 1.5 units of ProZinc, his BS levels began sinking. I just tested him and it is now 32 on the Pet calibrated Meter. I've given him Dextrose and more to eat (he's only nibbling) and will test him again in an hour and will try to get him to eat more. He seems normal. I didn't shoot any insulin tonight. Is there anything else I should do? I'm very worried.
 
Are you with me? As long as you are testing and feeding then you are in control. We can bring him up! It’s important to keep testing at short intervals because he can drop back down.
 
I will set a timer and I will be here in 30 minutes. He is in a safe number but we don’t want him to drop back down. If he’s only having dextrose it can happen. Actually it can happen with HC food as well - as the carbs “wear off.”
 
Suzanne & Darcy said:
I will set a timer and I will be here in 30 minutes. He is in a safe number but we don’t want him to drop back down. If he’s only having dextrose it can happen. Actually it can happen with HC food as well - as the carbs “wear off.”
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I have some low carb food that I give my other cat. Should I try that?
 
See how he rose up to the blue today and then you took a break from testing and then he dropped back down. We don’t want that to happen again. I don’t think it will, but we must be sure. So since he’s in the 200s we can wait an hour between tests now.
 
Can you do that? I know it’s getting late there since it’s 5:35 here it’s 11:35 there.

Please go ahead and put all his tests into the spreadsheet.
 
Suzanne & Darcy said:
See how he rose up to the blue today and then you took a break from testing and then he dropped back down. We don’t want that to happen again. I don’t think it will, but we must be sure. So since he’s in the 200s we can wait an hour between tests now.
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Yes, I see that on the spreadsheet. I thought he was okay when he got to 135. I was shocked when I tested him before his scheduled feeding and shot and saw it at 50!
 
jwbsings Snowball said:
Yes, I see that on the spreadsheet. I thought he was okay when he got to 135. I was shocked when I tested him before his scheduled feeding and shot and saw it at 50!
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. That happens to a lot of people. They don’t realize how the numbers can drop back down. That’s why we always say to keep testing for a full two hours after the last HC is given. (honey/karo/dextrose or food).
 
Anyway, I am a bit surprised at these protracted low numbers as well. Clearly 1.5 units is too much for him. We don’t know what would have happened on the 1 unit dose. I think at this point, if Snowball were my cat, I would hold off on giving him insulin for a few cycles and just test his BG at what would be his usual shot time - and get a few other tests spaced out to see what happens with no insulin. Then after we see where he is, would you be okay starting with a really small dose and working our way up from there? As I was saying before on your other thread, I would much prefer to work our way up than to have him go into lime green again.
 
Suzanne & Darcy said:
Anyway, I am a bit surprised at these protracted low numbers as well. Clearly 1.5 units is too much for him. We don’t know what would have happened on the 1 unit dose. I think at this point, if Snowball were my cat, I would hold off on giving him insulin for a few cycles and just test his BG at what would be his usual shot time - and get a few other tests spaced out to see what happens with no insulin. Then after we see where he is, would you be okay starting with a really small dose and working our way up from there? As I was saying before on your other thread, I would much prefer to work our way up than to have him go into lime green again.
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I just started a conversation with you. You should have it in your messages. I agree with you 100%. I also spoke with my Vet and his advice is what I wrote in the conversation. I'd love to hear what you think.
 
I am very happy to be here to help you and Snowball! What was the number? The family wanted to eat the last of the Christmas stollen, and I had to go out and feed my feral cats
 
Suzanne & Darcy said:
I am very happy to be here to help you and Snowball! What was the number? The family wanted to eat the last of the Christmas stollen, and I had to go out and feed my feral cats
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He got away from me and hid where I couldn't get to him. So I gave up and went to bed. This morning I tested him at the usual time and his BG was 147. Hope you enjoyed your Stollen. My favorite is the Dresden stollen with almonds, raisins and marzipan! My step-daughter makes a delicious version as well.
 
That sounds delicious! I’ve never actually tried the marzipan stollen yet. That’s next. We always eat Dresden Stollen at Christmas.

Poor Snowball had had enough yesterday! I would test him once mid-cycle today and then at his p.m. shot time. Do be sure to give him a small treat with every single BG test.
 
Oh, if you test 3-4 hours after the morning meal and his BG is lower than the AMPS/PMPS numbers, that is a good indication that his pancreas is working.
 
I just tested him at 4 hours and his BG is 157. The AMPS was 147. His last PMPS was 239. So the newest number is lower than his PMPS but a bit higher than his AMPS. Should I be testing him after his meal? This morning I tested him before his meal.
 
jwbsings Snowball said:
I just tested him at 4 hours and his BG is 157. The AMPS was 147. His last PMPS was 239. So the newest number is lower than his PMPS but a bit higher than his AMPS. Should I be testing him after his meal? This morning I tested him before his meal.
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Keep testing before his meal, that’s the correct way to do it. If you do it afterwards, the number will be inflated due to carbs. That’s the reason for our “no food for two hours prior to the morning and evening BG preshot test —so you can get an accurate reading that’s not inflated by food — and you can then know if it’s safe to give the insulin.

His numbers are not too bad today considering you are using a pet meter (it is a pet meter and not a human glucometer, right?
 
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Did you get a pmps (well really we call it a pmbg if no insulin is being given) on Snowball tonight? I keep checking because I am just sooo hoping he won’t go very high! Paws crossed.
 
Suzanne & Darcy said:
Keep testing before his meal, that’s the correct way to do it. If you do it afterwards, the number will be inflated due to carbs. That’s the reason for our “no food for two hours prior to the morning and evening BG preshot test —so you can get an accurate reading that’s not inflated by food — and you can then know if it’s safe to give the insulin.

His numbers are not too bad today considering you are using a pet meter (it is a pet meter and not a human glucometer, right?
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Yes that's right.
 
jwbsings Snowball said:
Yes, I tested his PMPS before his evening meal. It was 147. Not bad, right?
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Very good for no insulin! I have been thinking about Snowball a lot today. Tell me about when he was first diagnosed. Was he ill? Any urinary tract infection? Upper respiratory infection? Bad tooth/teeth? Anything inflammatory going on?
 
Suzanne & Darcy said:
Very good for no insulin! I have been thinking about Snowball a lot today. Tell me about when he was first diagnosed. Was he ill? Any urinary tract infection? Upper respiratory infection? Bad tooth/teeth? Anything inflammatory going on?
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Snowball had been diagnosed with early signs of chronic kidney disease in 2017, when he was two-years old. He was put on a prescription renal diet and semintra for his blood pressure. He has been a robust and healthy cat aside from that - very active and playful - lots of personality. The only other issues have been gastric irritation. About a year and a half ago, while we were in the USA, he began losing weight and drinking lots of water and was very lethargic. His appetite was healthy, so it made no sense. I took him to a vet in Michigan, who did blood work and told me he had stage 4 kidney disease and that it looked bleak. His calcium numbers were up, so we did another test to rule out cancer. We came back to Germany and his regular vet. It was determined that the elevated calcium was related to his kidney issues and that his kidneys were not much worse off than they had been previously. The prognosis was not at all dire - especially because Snowball was still eating, peeing, etc. with no problems. I began the SUC therapy and his entire demeanor changed. He grew more muscle mass, gained weight, returned to his old self. This was from January to May. In May, I noticed he was drinking and peeing excessively. The vet did another blood test and the only concern was his kidneys - no talk of diabetes. I think his diabetes began then. In July, I brought him in again for his check up to travel to the States. Everything seemed fine. The only issue was his teeth and we spoke about having them cleaned when I returned a couple of months later. In the States this year, the same things began to happen. Weight loss, excessive drinking and peeing, but still eating like normal and still active. I brought him back in November and went to the Vet immediately for another round of blood tests and that is when I got the diagnosis of diabetes. As far as I know, there were no inflammatory issues, no UTI (he was tested for that and no bacteria grew in the cultures), no upper respiratory infection. We will see his vet on Thursday. Snowball will be 10 years old on January 10th!
 
Snowball is quite the traveler! Just like you! I am glad you take him with you. Do you bring him on the plane with you? Does he get stressed? Do you give Gabapentin?

Did he ever end up having his teeth cleaned? Tooth problems are a major source of inflammation and can definitely raise BG. I have seen quite a few cats knocked out of remission, or needing increased amounts of insulin, due to tooth problems- even gingivitis when no extractions are necessary. The problem is, to my mind, he has kidney disease and therefore I would hesitate to put him under general anesthesia because of potential negative impacts to his kidneys. I have had a few cats with kidney disease and we were not able to have their teeth cleaned (or extractions done). What we did instead was pulsed dosing of Antirobe (Clindamycin) to keep the infection/inflammation under control. We would do a week on and a week (or two weeks) off the antibiotic. There are different ways of doing it. I am not saying that Snowball needs to do that because I don’t know the state of his teeth- but you mentioned that the vet talked about cleaning his teeth.
 
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Looks like his BG is creeping up. I did not want to see a yellow on that spreadsheet. Try to get another test mid-cycle and then the PMBG test. At least you can show your vet. If he stays in yellow, I would restart the insulin at a Very small dose, because he is very sensitive to it, it seems. I’m talking low dose - like .25 units (I hope you have the syringes with the half unit markings.). Alternatively, when doing fine dosing of ProZinc, we can use U-100 syringes (still need half unit markings) and a conversion chart that tells you where to draw the insulin on the U-100 syringe to draw a certain amount of ProZinc.

I know you have an appointment for Snowball tomorrow. I will be interested to see what your vet has to say. Most vets aren’t familiar with fine dosing for cats. They tend to increase in whole units, but cats are small creatures and need smaller adjustments. I have had a lot of ProZinc cats on just a .25 unit dose or even a 0.1 dose ….they needed only a tiny bit of insulin support. Believe it or not, there’s actually a “drop dose.”
 
Oh, and I would love to know more about how you got Snowball. You said his birthday is January 10, you know when he was born, and maybe who his mother was? I bet there’s a story behind you and Snowball coming together :cat:
 
He was high yesterday. And then had a 198, which is almost a yellow.

HAPPY NEW YEAR, Janet and Snowball!!! I wish all the best to you and yours!
 
Suzanne & Darcy said:
Snowball is quite the traveler! Just like you! I am glad you take him with you. Do you bring him on the plane with you? Does he get stressed? Do you give Gabapentin?

Did he ever end up having his teeth cleaned? Tooth problems are a major source of inflammation and can definitely raise BG. I have seen quite a few cats knocked out of remission, or needing increased amounts of insulin, due to tooth problems- even gingivitis when no extractions are necessary. The problem is, to my mind, he has kidney disease and therefore I would hesitate to put him under general anesthesia because of potential negative impacts to his kidneys. I have had a few cats with kidney disease and we were not able to have their teeth cleaned (or extractions done). What we did instead was pulsed dosing of Antirobe (Clindamycin) to keep the infection/inflammation under control. We would do a week on and a week (or two weeks) off the antibiotic. There are different ways of doing it. I am not saying that Snowball needs to do that because I don’t know the state of his teeth- but you mentioned that the vet talked about cleaning his teeth.
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The vet is worried about how the anesthesia will affect his kidneys, but I will see him tomorrow and ask about the Antirobe. I used to brush his teeth when he was younger, but he stopped letting me near his teeth after a couple of years. Snowball and his catmate Sissy travel well. I don't sedate them and bring them in the cabin with me. He is agitated going through the security screening, but then settles down and sleeps most of the time.
Suzanne & Darcy said:
Looks like his BG is creeping up. I did not want to see a yellow on that spreadsheet. Try to get another test mid-cycle and then the PMBG test. At least you can show your vet. If he stays in yellow, I would restart the insulin at a Very small dose, because he is very sensitive to it, it seems. I’m talking low dose - like .25 units (I hope you have the syringes with the half unit markings.). Alternatively, when doing fine dosing of ProZinc, we can use U-100 syringes (still need half unit markings) and a conversion chart that tells you where to draw the insulin on the U-100 syringe to draw a certain amount of ProZinc.

I know you have an appointment for Snowball tomorrow. I will be interested to see what your vet has to say. Most vets aren’t familiar with fine dosing for cats. They tend to increase in whole units, but cats are small creatures and need smaller adjustments. I have had a lot of ProZinc cats on just a .25 unit dose or even a 0.1 dose ….they needed only a tiny bit of insulin support. Believe it or not, there’s actually a “drop dose.”
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I will discuss all of this with the vet tomorrow and let you know what he says. Snowball is still fluctuating - today he stayed in the blue range. I will test him again before I go to bed and will not feed him before his vet visit so that he gets an accurate reading. I'll bring the syringe I have
Suzanne & Darcy said:
He was high yesterday. And then had a 198, which is almost a yellow.

HAPPY NEW YEAR, Janet and Snowball!!! I wish all the best to you and yours!
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Happy New Year to you, too, Suzanne! Thank you so much for your support of me and Snowball. It means the world to us!
Yes, I am concerned that his BG was rising, but then I just tested Snowball again at +4 hours from his PMBG and evening feeding today and his BG was 143. I'll let you know what the Vet says tomorrow.
 
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