oregano 8/29 numbers dropping regardless of dose adjustment +9 115, +10 94

wade

wade

Member
weird goings on and hoping someone can give me some clarity on this.
i moved oregano up to 3 units 2x daily because she was staying consistently high on the 2.75 2x. (300's)

on 8/25 pm we started on 3, then held that dose through both doses on 8/26 and half way through 8/27. she earned a reduction down to 2.75 by pm dose on 8/27, then on 8/28 she was between 150 and 200 when it was pm shot time so i gave her 1/2 her 2.75 dose, which was 1.375.

then for am shot on 8.29 (today) she was under 150, so no insulin at all. and today she has been going low all day--dropped below 90 twice thus far, and drops fast. we continue to give her a little food to help keep it from crashing, and it will bump her up to the mid to high 100's, then she comes barreling down again.

i am at a bit of a loss. no dose this morning, and half a dose last night and still she's keeps coming down. have y'all seen this before?

thanks,

oregano and wade
 
Hey Wade, glad you made it over.

Those are nice numbers today! Have you read about the Insulin Depot? Maybe you're seeing the effects of the 2.75 and 3 unit doses from the last couple days?
 
Tim & Pookey said:
Hey Wade, glad you made it over.

Those are nice numbers today! Have you read about the Insulin Depot? Maybe you're seeing the effects of the 2.75 and 3 unit doses from the last couple days?
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i am familiar with it and have read the stickies on it. maybe you're right. not sure, but its some seriously fast dropping and i don't know how active i should be in countering it. or maybe i just let it ride until she gets closer to 50, then intervene? this is new territory for us.
 
wade said:
i am familiar with it and have read the stickies on it. maybe you're right. not sure, but its some seriously fast dropping and i don't know how active i should be in countering it. or maybe i just let it ride until she gets closer to 50, then intervene? this is new territory for us.
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That sounds like a good plan. If it were me, I wouldn't be intervening any more during this cycle (unless she gets a bit lower, 50s). You're pretty late in the cycle and with the skip this morning you don't want her to go sky high tonight either. Hopefully she comes up a smidge so you can shoot tonight.
 
Tim & Pookey said:
That sounds like a good plan. If it were me, I wouldn't be intervening any more during this cycle (unless she gets a bit lower, 50s). You're pretty late in the cycle and with the skip this morning you don't want her to go sky high tonight either. Hopefully she comes up a smidge so you can shoot tonight.
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ok. we will take it that way then and hope she does not drop too quickly.
 
wade said:
i am familiar with it and have read the stickies on it. maybe you're right. not sure, but its some seriously fast dropping and i don't know how active i should be in countering it. or maybe i just let it ride until she gets closer to 50, then intervene? this is new territory for us.
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Hi Wade. So glad to see you and Oregano!
If you’re following SLGS, you don’t want her dropping under 90 (the 50 threshold is for TR)
Are you still giving sub q fluids?
Do you notice any issues with the Libre and doing fluids?
I’ve read you should do fluids on the opposite side of the body as the Libre sits since fluids can cause issues with the readings.

How old is the Libre? (New or end of cycle?)
Just asking a lot of questions to try to help troubleshoot here ❤️‍🩹
 
Staci & Ivy said:
Hi Wade. So glad to see you and Oregano!
If you’re following SLGS, you don’t want her dropping under 90 (the 50 threshold is for TR)
Are you still giving sub q fluids?
Do you notice any issues with the Libre and doing fluids?
I’ve read you should do fluids on the opposite side of the body as the Libre sits since fluids can cause issues with the readings.

How old is the Libre? (New or end of cycle?)
Just asking a lot of questions to try to help troubleshoot here ❤️‍🩹
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this libre sensor is on day 11 of 14, so 3 more days left before it will have to be changed.
we do the sub-q fluids every other day. so they were done yesterday. haven't had an issue but they do seem to flush the glucose out of her system a little additional and i do think that plus the increase to 3 units is alot of what caused the lower readings yesterday. i am surprised that we are struggling with lower numbers now though, after half a dose last night and zero dose this morning.


we are following SLGS and her monitor's alarm just went off to signal under 90. she was at 78. so i gave her a little HC soft food and gravy to see if i could nudge her back up.

it looks like we may have to skip tonight's dose too.
 
gave a little food and she went up to 165. 15 minutes later her alarm went off and she was at 88. she's never dropped this fast or this consistently.

just scanned her again and the libre is not giving a reading, of course. it loves that move when we really need a reading. so will check again in 14 minutes and likely take her to the vet. something unusual is happening with her. no insulin this am, half dose last night--she really shouldn't be dropping like this.
 
While a reduction is earned if under 90, you don’t need hc unless in the 50’s. Have you tried mc instead, 10-15% carbs? Hc will raise the bg but when it wears off it can drop again. Remember normal bg is 50-120 so you aren’t seeing unsafe numbers. The depot can effect 4-6 cycles.
 
ok.
tiffmaxee said:
While a reduction is earned if under 90, you don’t need hc unless in the 50’s. Have you tried mc instead, 10-15% carbs? Hc will raise the bg but when it wears off it can drop again. Remember normal bg is 50-120 so you aren’t seeing unsafe numbers. The depot can effect 4-6 cycles.
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it is helpful to keep hearing that. we are not using to seeing anything near 50-100 with her. it just dropped so fast. i reviewed the spreadsheet in light of the 2-3 day depot (4-6 cycles) info and that makes sense. probably going to have to skip tonight (930 is shot time, so one more hour) and then get back into the swing of things tomorrow. not sure how i'm going to go to sleep though if she's in the 70's. i've never done that.
 
Hi Wade and Oregano--you're getting some great advice here, but I wanted to say HELLO! Looks like she's experiencing some good numbers and having a good response to the increase. I know those lower numbers can be nerve wracking, but they are good for Oregano. This situation is one I don't always understand, so...question for @tiffmaxee or anyone else: Oregano hasn't had insulin today and only a 1/2 dose last night. There is no risk of hypo at this point is there? I recognize that the depot is still in play, but do cats have to wait out the depot effect to avoid hypos?
 
The depot + the fluids may indeed be the answer for what you are seeing today. With no insulin this morning, you don't need to be aggressive about the carbs. Also factor in that the Libre tends to read lower in low numbers than a hand held meter. Those high greens may be even higher and in safe territory. The depot can influence 4-6 cycles after a reduction. So do keep an eye on her.

You might consider marking on the spreadsheet remarks column what time you gave fluids, just to see if you can see any pattern in fluids and the numbers afterwards.
 
Mary & Jude said:
Hi Wade and Oregano--you're getting some great advice here, but I wanted to say HELLO! Looks like she's experiencing some good numbers and having a good response to the increase. I know those lower numbers can be nerve wracking, but they are good for Oregano. This situation is one I don't always understand, so...question for @tiffmaxee or anyone else: Oregano hasn't had insulin today and only a 1/2 dose last night. There is no risk of hypo at this point is there? I recognize that the depot is still in play, but do cats have to wait out the depot effect to avoid hypos?
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that is a key question that is keeping me on edge now; are we at risk of hypo? she dropped to 77 a few moments ago and is eating her dinner now, and it seems odd to me that with half a dose last night, and no dose this am or pm, she'd be at risk, but these numbers do keep dropping. are we thinking that she'll just stabilize in the 60's-70's and i don't need to respond with carbs?
 
Wendy&Neko said:
The depot + the fluids may indeed be the answer for what you are seeing today. With no insulin this morning, you don't need to be aggressive about the carbs. Also factor in that the Libre tends to read lower in low numbers than a hand held meter. Those high greens may be even higher and in safe territory. The depot can influence 4-6 cycles after a reduction. So do keep an eye on her.

You might consider marking on the spreadsheet remarks column what time you gave fluids, just to see if you can see any pattern in fluids and the numbers afterwards.
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yep, good idea re the spreadsheet. she gets the fluids every mon, thursday, and saturday now but i think seeing it on the spreadsheet would help. i'm staying up with her tonight. i just don't know what to do when she hits 75 or so. wait it out? give her a little HC food? what's the number where i have to intervene? we live 30 min from the e-vet so i don't want to wait too late if i am going to need to take her in.
 
wade said:
that is a key question that is keeping me on edge now; are we at risk of hypo? she dropped to 77 a few moments ago and is eating her dinner now, and it seems odd to me that with half a dose last night, and no dose this am or pm, she'd be at risk, but these numbers do keep dropping. are we thinking that she'll just stabilize in the 60's-70's and i don't need to respond with carbs?
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77 is still safe—a great bg number for Oregano. No need to carb manipulate that number.
 
Mary & Jude said:
77 is still safe—a great bg number for Oregano. No need to carb manipulate that number.
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Ok. Just scanned her post-supper and she was at 94. Really surprising given no insulin since last night and only a half dose then. We skipped today’s am and pm dose. I’m going to continue to check her every half hour through the night and I guess if she gets below 60 I’ll intervene. She’s full now and likely won’t eat for me so it’ll be caro on the gums and I may need to take her in at that point.


Thank you everyone for your wisdom and time. We appreciate it.
 
She’s not in danger of a hypo since she has not had insulin. It doesn’t last much more than 12 hours. She’s in normal bg which is good for her pancreas. Sometimes when cats hit a breakthrough dose they race down the dosing scale. I’m not saying that’s what is happening but it could happen. You don’t need to stay up and test.
 
tiffmaxee said:
She’s not in danger of a hypo since she has not had insulin. It doesn’t last much more than 12 hours. She’s in normal bg which is good for her pancreas. Sometimes when cats hit a breakthrough dose they race down the dosing scale. I’m not saying that’s what is happening but it could happen. You don’t need to stay up and test.
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ok. well that is relieving then. you mean the insulin doesn't last more than 12 hours in her system then, correct? if so, then she should have none in her since her last dose (1/2 dose) was yesterday's pm dose, so 29 hours ago. meaning you are probably right then--the 3 units 2x was a breakthrough dose and she raced down the dosing scale, and now is just hanging out in the 70-130 range. if she is not in danger of going hypo then i'll relax a bit. will test her in the am and see if she's in a spot where she can get her am dose. thank you for responding. we appreciate it a great deal. have a good evening. :)
 
Sometimes there carry over to the next cycle and sometimes they get longer duration but if in safe n bg after 12 hours you won’t see a hypo. If very low I’d continue testing hourly until in safe bg.
 
afternoon everyone, oregano stayed in the low numbers all night despite no insulin at all yesterday. at AM shot time this am she was in the 70's so skipped that dose too. currently she's in the 80's and is bouncing from low 70's to low 150's throughout the day. very strange from my experience given her lack of insulin over the past 3 dose-times but we are enjoying these lower numbers. i hope everyone has a great day.

--oregano and wade
 
tiffmaxee said:
Sometimes there carry over to the next cycle and sometimes they get longer duration but if in safe n bg after 12 hours you won’t see a hypo. If very low I’d continue testing hourly until in safe bg.
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sounds good. no hypo's last night, you were right. plenty of drops below 90 (so the sensor went off throughout the night and got me up to check) but no hypos. she went from the low 70's to low 100's and back to the 80's throughout the night with no real rhyme or reason that i could see. but she slept well; snored even. :)

thanks for the assist and info.

oregano and wade.
 
tiffmaxee said:
That’s a really good question. I want to discuss that with a few others as she’s surfing green with all the skipped doses.
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ah. i misunderstood. i was thinking you were asking what she is on now. which would be the zero. we are headed into the e-vets to get her looked at. something is way off with these numbers this low (53 now) and no insulin since 8/28 pm dose, which was a 50% dose (so 1.375%)
 
Wendy&Neko said:
Keep us posted. I hope the vet has some answers. Is she otherwise doing fine? See if they will do a hand held test too, just in case it's the Libre.
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Seems like it was the libre. She seems fine. No symptoms or anything. They are running other tests but seems like this was a sensor that stopped working correctly. Makes sense I guess as I have been getting alot of error messages/“test again in ten minutes” over these past two days.

They are giving her a bump of short acting insulin and replacing her sensor, and advised that I need to give her her normal dose starting tonight.
 
I'm glad it was nothing more serious than a faulty Libre. And good instincts on going and getting it checked out. The short acting insulin should help. I suspect it is R, also called Regular insulin? Curious also what dose they give.
 
Oh wow that is super frustrating, Wade, I'm sorry you had to go through the worry and hassle because of a faulty sensor. Hopefully she comes down gently for you soon with a working sensor.

I'm not sure if this helps, as it cat-specific, but I have certain cues for Bell that can act as a sanity check for my meter. Biggest for Bell is that when she starts drinking from her fountain, she's really high. Lots of peeing as well. She gest pretty hungry in the high numbers too, and often loses her appetite in the blues. On the other side of things, she gets ravenously hungry (licks her plate clean, which she never does otherwise) when she's in the low greens.
 
Staci & Ivy said:
I’m wondering if giving the fluids killed the sensor? You may ask about that.
And give fluids on opposite side of her body from the sensor in the future.
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yep, good call there. I did ask and they advised to begin doing fluids at least 4 hours apart from dosing, and on opposite side of body from sensor. so we will be doing her every-other day sub-q fluids between 3 and 5 pm moving forward. and on opposite side.
 
Wendy&Neko said:
I'm glad it was nothing more serious than a faulty Libre. And good instincts on going and getting it checked out. The short acting insulin should help. I suspect it is R, also called Regular insulin? Curious also what dose they give.
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it is R, actually. she dropped to 79 on it (was at 201 20 minutes earlier, so more weirdness there) so i called the vet 90 min ago and the tech said it should pop up with her dinner, which it did. fed her normal dinner and she went up to 209, now 198 an hour later. i did not ask what size dose but she said it would wear off in about 4 hours and that it was "R." regular insulin.
 
Seth&Bell said:
Oh wow that is super frustrating, Wade, I'm sorry you had to go through the worry and hassle because of a faulty sensor. Hopefully she comes down gently for you soon with a working sensor.

I'm not sure if this helps, as it cat-specific, but I have certain cues for Bell that can act as a sanity check for my meter. Biggest for Bell is that when she starts drinking from her fountain, she's really high. Lots of peeing as well. She gest pretty hungry in the high numbers too, and often loses her appetite in the blues. On the other side of things, she gets ravenously hungry (licks her plate clean, which she never does otherwise) when she's in the low greens.
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yeah that makes sense now. i stayed up with her last night and she just pounded the water all night. like double the normal amt. and she'd hit 68 or something and i'd give her more HC food, which only made the problem worse since she wasn't low at all. and she ate more than she usually would, so that tracks with your and Bell's experience. I will know next time. Also i ordered the alpha-trak 3 blood test kit for a back up to check the sensor's numbers in case i get wonky data like this again. we have been on these sensors since sept of last year and change them out every two weeks and have never had this issue in the past. i know now though.
 
4-5 hours is an average length of time for R to last in most cats Neko wasn't "most cats". :rolleyes: It lasted a little longer in her.
wade said:
it is R, actually. she dropped to 79 on it (was at 201 20 minutes earlier, so more weirdness there
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I would think that means too high a dose of R. When we dose R, we don't want them to drop more than 100 points overall, or you'll get a bounce from the fast drop.

Can you shoot late? Looks like she's starting to zoom up.
 
wade said:
yep, good call there. I did ask and they advised to begin doing fluids at least 4 hours apart from dosing, and on opposite side of body from sensor. so we will be doing her every-other day sub-q fluids between 3 and 5 pm moving forward. and on opposite side.
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Ok I’m glad they confirmed that information. At least you know now.
And I’m glad you’ve decided to get a meter to double check weird readings. It’s the safest way to go.
(Just be aware you can’t get alpha track strips locally, so you have to order them well in advance and have plenty on hand).
Or, you could get a human meter with much less expensive test strips and you can get the strips locally if you need them. (Many people use Relion from Walmart since they’re everywhere).

Wishing you and sweet Oregano a much better night and a good day tomorrow 🥰❤️‍🩹🥰❤️‍🩹
 
I’m glad you are getting some answers, Wade. Are you not able to check her at home with a handheld human meter?

Can you please start a new condo every day and link the previous day? Thank you.
 
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