Dexter's Hypo - Continuation

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Jo_

Jo_

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Hii everyone!

I come to you for advice again :)
This is my previous post.

We reduced his dose to 2.75u. He's been energetic and a happy cat. Playful, good apetite and drinking water normally (one day he was drinking less, but I mixed a bit with his food and he ate it happily).

He's getting a bit grumpy with all the pricking so we put a FreeStyle Libre 2 on him. We know it is not reliable on values below 100 (got that scare last time he had one :blackeye:).

But we've been getting such high levels that we're worried. We are wondering if we should increase back to 3u. But, as usual, not yet confident to make this decision.

Also, after seeing a 24.9 on the FS (441) decided to double check. We got a 334 on the AccuChek and 347 on the AT3. Which is a big difference.

Any advice on how to proceed? Anything we're doing wrong or should adjust?
Any advice is highly appreciated.

Thank you :bighug:
 
Jo_ said:
Hii everyone!

I come to you for advice again :)
This is my previous post.

We reduced his dose to 2.75u. He's been energetic and a happy cat. Playful, good apetite and drinking water normally (one day he was drinking less, but I mixed a bit with his food and he ate it happily).

He's getting a bit grumpy with all the pricking so we put a FreeStyle Libre 2 on him. We know it is not reliable on values below 100 (got that scare last time he had one :blackeye:).

But we've been getting such high levels that we're worried. We are wondering if we should increase back to 3u. But, as usual, not yet confident to make this decision.

Also, after seeing a 24.9 on the FS (441) decided to double check. We got a 334 on the AccuChek and 347 on the AT3. Which is a big difference.

Any advice on how to proceed? Anything we're doing wrong or should adjust?
Any advice is highly appreciated.

Thank you :bighug:
Click to expand...
Hi, I will tag a couple of members that have been assisting in previous post for dosing advice:bighug::cat::cat:
@Diane Tyler's Mom GA
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
 
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Since you are following TR, I'd increase back up. With TR, you hold a dose with green nadirs for 10 cycles. It's been longer. Just watch him carefully as he has gone really low on 3.0 units, though that was a while ago now.
 
view


We've increased to 3u.

For context, Dexter has been doing well. Playfull, alert, good apetite, drinking water normally.
And we know we haven't been giving him 3u for that long (5 cycles so far).

But his numbers are kind of wild :banghead:
We don't know if he's bouncing whenever his body gets to lower values closer to 100 and freaks out or what can be happening :(

His ss looks like a pink and red blob these days, despite our efforts.

Any advice on what to do or what we should look into is always kindly appreciated.
 
Jo_ said:
view


We've increased to 3u.

For context, Dexter has been doing well. Playfull, alert, good apetite, drinking water normally.
And we know we haven't been giving him 3u for that long (5 cycles so far).

But his numbers are kind of wild :banghead:
We don't know if he's bouncing whenever his body gets to lower values closer to 100 and freaks out or what can be happening :(

His ss looks like a pink and red blob these days, despite our efforts.

Any advice on what to do or what we should look into is always kindly appreciated.
Click to expand...

@Bron and Sheba (GA)
@Sienne and Gabby (GA)
@Diane Tyler's Mom GA
 
Jo_ said:
view


We've increased to 3u.

For context, Dexter has been doing well. Playfull, alert, good apetite, drinking water normally.
And we know we haven't been giving him 3u for that long (5 cycles so far).

But his numbers are kind of wild :banghead:
We don't know if he's bouncing whenever his body gets to lower values closer to 100 and freaks out or what can be happening :(

His ss looks like a pink and red blob these days, despite our efforts.

Any advice on what to do or what we should look into is always kindly appreciated.
Click to expand...
@Wendy&Neko
 
The post you shared is great! Thank you so much! :bighug::bighug:
We should have kept a closer eye on his failed reduction, but now I understand what may be causing the current values.

He already spent the night (mostly) below 300.

Between his panicky liver and panicky mom, we still have a lot to learn!
 
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Update: spoke WAY too soon... He started the day in the yellow... and he's already in the red :banghead: :banghead: :banghead:

He spiked more than 100 in the afternoon and I have no clue why. He didn't eat anything different, had a super chill day...

Measured ketones with the blood meter: 0.5

He spiked +/- 4 hours ago and shows no sign of coming down from it...
I'm so scared of these numbers. The vet always said that high is ok, better than low, but it's SO high...

In these moments I feel like I forget all I read here and I just don't know what to do :( I just want to figure out what I'm doing wrong.... I really want the best for my baby!
 
Jo_ said:
Update: spoke WAY too soon... He started the day in the yellow... and he's already in the red :banghead: :banghead: :banghead:

He spiked more than 100 in the afternoon and I have no clue why. He didn't eat anything different, had a super chill day...

Measured ketones with the blood meter: 0.5

He spiked +/- 4 hours ago and shows no sign of coming down from it...
I'm so scared of these numbers. The vet always said that high is ok, better than low, but it's SO high...

In these moments I feel like I forget all I read here and I just don't know what to do :( I just want to figure out what I'm doing wrong.... I really want the best for my baby!
Click to expand...
His last shot, could you might have given a fur shot?? It’s happened to me, that’s why I shoot down not sideways, it’s happened a few times, no high is NOT ok! They are high but tomorrow is another day unfortunately there’s nothing we can do for high numbers, tomorrow make sure you pick up the scruff and shoot down, I can’t think of another reason, also when cats are used to such high numbers, it takes a while to get them used to lower don’t beat yourself up it’s ok:bighug::bighug::cat::cat:
 
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I can't exclude that I missed the shot.
But we keep a patch of fur shaved (we alternate sides) to try our best to keep it from happening.

I always check to see if it's wet...
That's why that hadn't crossed my mind. But won't exclude it :(
 
I've been even more careful to avoid any fur shots but still, I don't see his values decreasing...

I am getting more and more concerned about his unmanaged state.
At this point, multiple things run through my mind.

The vet pointed out that he has gingivitis and he has a teeth cleaning scheduled for 13.02, so in a few days.
I know that this may be causing/aggravating the insulin resistance we've seen.

Another scenario could be acromegaly.
I've been reading up on the symptoms and besides the insulin resistance, we don't notice any obvious signs. Maybe his appetite. Some days, not often, he wants to eat a bit more frequently than normal during the day.
He has not gained weight and has no visible signs of any enlarged extremities.

He had an ultrasound on 30.12.24:
  • Homogenous spleen. Borderline large.
  • Kidneys of normal size on both sides.
  • Stomach ok.
  • Small intestine ok.
  • Pancreas slightly heterogenous, of normal size and shape. Signs of pancreatitis (he was in the ICU at the time with DKA)
  • No changes in lymph nodes.
Also, based on his lab work from a month ago, other indicators of acromegaly are not present.
  • Phosphate: 1.45 mmol/L (within normal range) → No indication of hyperphosphatemia.
  • ALKP (Alkaline Phosphatase): 62 U/L (normal) → No significant liver enzyme elevations.
  • Cholesterol: 3.01 mmol/L (normal) → No hypercholesterolemia.
  • Urine Protein: Traces → Minimal kidney involvement.

He'll be sedated for the teeth cleaning, so that is the ideal time for any tests to be done (he's not too fond of vets ;)).
-» But I am wondering if it is something I should ask for now or wait for the recovery from teeth cleaning to see if that was impacting the insulin resistance.
 
Jo_ said:
I've been even more careful to avoid any fur shots but still, I don't see his values decreasing...

I am getting more and more concerned about his unmanaged state.
At this point, multiple things run through my mind.

The vet pointed out that he has gingivitis and he has a teeth cleaning scheduled for 13.02, so in a few days.
I know that this may be causing/aggravating the insulin resistance we've seen.

Another scenario could be acromegaly.
I've been reading up on the symptoms and besides the insulin resistance, we don't notice any obvious signs. Maybe his appetite. Some days, not often, he wants to eat a bit more frequently than normal during the day.
He has not gained weight and has no visible signs of any enlarged extremities.

He had an ultrasound on 30.12.24:
  • Homogenous spleen. Borderline large.
  • Kidneys of normal size on both sides.
  • Stomach ok.
  • Small intestine ok.
  • Pancreas slightly heterogenous, of normal size and shape. Signs of pancreatitis (he was in the ICU at the time with DKA)
  • No changes in lymph nodes.
Also, based on his lab work from a month ago, other indicators of acromegaly are not present.
  • Phosphate: 1.45 mmol/L (within normal range) → No indication of hyperphosphatemia.
  • ALKP (Alkaline Phosphatase): 62 U/L (normal) → No significant liver enzyme elevations.
  • Cholesterol: 3.01 mmol/L (normal) → No hypercholesterolemia.
  • Urine Protein: Traces → Minimal kidney involvement.

He'll be sedated for the teeth cleaning, so that is the ideal time for any tests to be done (he's not too fond of vets ;)).
-» But I am wondering if it is something I should ask for now or wait for the recovery from teeth cleaning to see if that was impacting the insulin resistance.
Click to expand...
I see that Dexter’s numbers are high but not red, so that’s good, I’m sure that after the teeth cleaning things can change he will probably rise in BG due tomorrow stress, and maybe then can he start a new road, but do not despair or obsess over reading illnesses that may not be there you are stressing out too much and Dexter feels that cats are very sensitive to our emotions, I am sure after the tooth cleaning he’ll be better:bighug::bighug::bighug::cat::cat:​
 
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CORKY said:
I see that Dexter’s numbers are high but not red, so that’s good, I’m sure that after the teeth cleaning things can change he will probably rise in BG due tomorrow stress, and maybe then can he start a new road, but do not despair or obsess over reading illnesses that may not be there you are stressing out too much and Dexter feels that cats are very sensitive to our emotions, I am sure after the tooth cleaning he’ll be better:bighug::bighug::bighug::cat::cat:​
Click to expand...

It's true! and a great advice!
I just want to be try to be ahead of something for once to help Dexter as much as I can. I know that the vet will not proactively suggest exams...
 
Jo_ said:
It's true! and a great advice!
I just want to be try to be ahead of something for once to help Dexter as much as I can. I know that the vet will not proactively suggest exams...
Click to expand...
Xams Xams Exams, Vets loves them, and if you ask for them ,hell' do exams even if he knows there's nothing wrong, especially if they see the desperation on our faces, Save your money, wait till you get Dexter home, relaxed a couple of days will go by for him to heel from the pain the cleaning has caused his gums, and you relax and breath in and breath out a couple of times and a new start begins:bighug::bighug::bighug:;):cat::cat:
 
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They don't really like to do exams on Dexter, he keeps them on their toes :D
He is THE sweetest, cuddliest boy at home. In the vet he transforms into a cat 10 times his size with 20 times the strength and 50 times the attitude.

The first time they suggested doing a curve they only wanted to do it in the office, I waited in the parking lot because I was betting that he wouldn't stay the whole day... 10 minutes later got a call to pick him up, they couldn't take him from his carrier :facepalm:
Started doing the curve at home :D:D
 
Dexter waited for me to write the previous post about his high values to show some blues... And then some greens... and then too low.
At least now, I was calmer and knew how to proceed (it helps that he doesn't have symptoms, I know)

But after 2 days in a row with hypo values, we tried to reduce his dose to 0.25 from 3 to 2.75...
I'm still in shock how much a difference such a small change in dose makes, especially when we were increasing and reducing by a full unit before we got the help from the amazing people in this forum.

Seeing that his numbers are high today after 2 cycles with the reduced dose, I just wanted to be sure if I can already call it a failed reduction and go back up in his evening dose to 3 or should give at least another cycle?
 
Jo_ said:
Dexter waited for me to write the previous post about his high values to show some blues... And then some greens... and then too low.
At least now, I was calmer and knew how to proceed (it helps that he doesn't have symptoms, I know)

But after 2 days in a row with hypo values, we tried to reduce his dose to 0.25 from 3 to 2.75...
I'm still in shock how much a difference such a small change in dose makes, especially when we were increasing and reducing by a full unit before we got the help from the amazing people in this forum.

Seeing that his numbers are high today after 2 cycles with the reduced dose, I just wanted to be sure if I can already call it a failed reduction and go back up in his evening dose to 3 or should give at least another cycle?
Click to expand...
I’m not experienced enough to say, but it does take a few cycles for the depot to adjust. Hopefully a more experienced member comes along.
 
Tim & Pookey said:
I’m not experienced enough to say, but it does take a few cycles for the depot to adjust. Hopefully a more experienced member comes along.
Click to expand...
I see great numbers, hypo is 50 and under, it takes several cycles for the insulin reduction or increase to see results, it is amazing how we can regulate our furr babies (Dexter) with the help of this forum, I am happy to see this, also when in the mid 50’s you can give 1-2 tsps of medium carbs or 1 tsp of high carb every 1/2 hour test and repeat as necessary!:bighug::bighug::bighug::cat::cat:
 
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