Lola New Thread

Okay. She’s at 181 for her AMPS. I’m going to stall 20 minutes and check again.

My thoughts process is: if she’s closer to 200, I’ll give her .5u and 1 can FF and at +2 or 3 give her a 6% food (Weruva pate) after a bg check

35 min stall: 187
Another 30 min stall: 241
 
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Wow. It’s good to see she came down some. The problem is that we can’t see what happened mid-cycle yesterday so we don’t know if she went a little lower than her body is comfortable with— and then the red PMPS. Any mid-cycle tests today?
 
Suzanne & Darcy said:
Wow. It’s good to see she came down some. The problem is that we can’t see what happened mid-cycle yesterday so we don’t know if she went a little lower than her body is comfortable with— and then the red PMPS. Any mid-cycle tests today?
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I didn’t have a chance. I have a work deadline looming and we’re pet sitting while a friend is out of town, so my days have been so busy 😰.
But she did give me a yellow PMPS today! 🎉

I’ll be sure to do a spot check before I give her her last meal at +3 tonight.
 
Yes. I feel like she needs an increase to .75 units soon. I checked her SS earlier this morning but you hadn’t done the AMPS yet. I am sorry to see the red.

I hope your vet visit will go well. What is the plan for the visit tomorrow?
 
Suzanne & Darcy said:
Yes. I feel like she needs an increase to .75 units soon. I checked her SS earlier this morning but you hadn’t done the AMPS yet. I am sorry to see the red.

I hope your vet visit will go well. What is the plan for the visit tomorrow?
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We’re checking her platelets. She’s been off of steroids since 1/10, so we want to see where she’s at.
 
Just did a +6: 242.

I don't know if it's the weather (we're sub tropical so these dips into the 30s suck), stress over a temporary visitor (our friend's dog) or what, but I don't like today's numbers. I'm worried she'll be back in the red by PMPS. How did we go from a potential decrease to a potential increase?

Please know I'm emotional right now and just venting, but in this moment, I'm so frustrated. I thought I had a better handle on things, and now I'm even more worried.

The silver lining is that earlier I tested her blood ketones and she was at 0.3 mmol/l, which is supposed to be in a really good range?
 
She started throwing up right after PMPS. The little bit of her food that she did eat, she threw right up. The on-call vet recommended cerenia and to try offering a small amount of food in a few minutes. If she keeps it down, she recommended a .25u dose.
 
I don’t know what could have caused her to rise prematurely by +6 today. It could be stress for sure— or a feeding difference?
 
Elohelay said:
know I'm emotional right now and just venting, but in this moment, I'm so frustrated. I thought I had a better handle on things, and now I'm even more worried.
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She isn’t doing badly on this dose. She just seems to be jumping around a bit right now, but she’s only been on insulin for about a month now! You have to be patient. You are doing really well so don’t beat yourself up! Didn’t you say she’s feeling better and acting more like before the diabetes? She’s definitely gained weight. Those are all very positive things!
 
Elohelay said:
She started throwing up right after PMPS. The little bit of her food that she did eat, she threw right up. The on-call vet recommended cerenia and to try offering a small amount of food in a few minutes. If she keeps it down, she recommended a .25u dose.
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Are you checking ketones? If she were my cat, yes, I would have given Cerenia and waited an hour after that to offer a small amount of food. I hope she will eat for you. Ketones are low so I am at least not worried about that.
 
Suzanne & Darcy said:
What happened today with Lola?
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We had our vet visit today. She weighed in at 7.9 lbs! Still a ways to go, but everyone agrees she's looking better.
Her platelet count was down from previous (389 vs 225), but it's higher than we were expecting.
Her RBC, HCT and HGB were all back to normal levels. Some values on her chemistry panel were just a smidge off, but the vet said she wasn't worried as she seems to be improving.

She was also tested for pancreatitis. She was just a smidge over the acceptable range. If vomiting continues, or she stops eating, we'll discuss home IV fluids and go from there.

She was ravenous today and I think she's eaten 4.5 cans of food total. She wandered the house and was being her curious, nosey self all afternoon. It was fabulous!
 
First BG of the day was an 88. Totally unexpected. Checking again in 30 mins.

Edit: I waited 45 mins and she was at 135. Still stalling.
+1.5 and still only at 139 😰

I stalled for 2 hours. I gave a 6.4% carb food and gave .25u. I'll watch her closely and test every 2 hours.
 
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So you see that her BG was rising at the end of the previous cycle and so you should have been good to give the full .5 units. Having said that, it’s really new that she should be in these numbers at shot time so I understand completely. I am actually proud of you for giving a half dose. Please try to get some tests today? Will you be around to do that? Whenever you are shooting a lower number that you haven’t shot before, it’s a good idea to get a +2. Remember also when shooting a lower number that the mew shot isn’t going to onset until about +2 so her BG has time to rise before that. Also, she will have food to support her BG.
 
If you had gotten a before bed test last night, we might have had an idea of what was coming. Not sure…. but at least getting a +2 or +3 before turning in for the night is always a good idea.
 
May I ask what happened on the evening of the 27th. Your spreadsheet says you only gave .25 and her PMPS was pink. I saw this yesterday when I was checking in on her numbers and I didn’t know why you didn’t give the full dose.
 
Elohelay said:
First BG of the day was an 88. Totally unexpected. Checking again in 30 mins.

Edit: I waited 45 mins and she was at 135. Still stalling.
+1.5 and still only at 139 😰
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About your spreadsheet. Can you please stack these numbers into the AMPS cell. First put the 88 then underneath that put 135@+.75 and then underneath that put 139@+1.5 (to show that the 135 was 3/4 of an hour later and then that the 139 was 1.5 hours late.) It’s helpful to write something in the comments too — about stalling.

I would have gone ahead and shot with the first rise from 88 to 135.

Now let me ask one more question— you did not feed her during the time you were stalling the shot, right?
 
Suzanne & Darcy said:
May I ask what happened on the evening of the 27th. Your spreadsheet says you only gave .25 and her PMPS was pink. I saw this yesterday when I was checking in on her numbers and I didn’t know why you didn’t give the full dose.
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That was the night where she was having a tough time keeping food down. She eventually ate, but had vomited several times and I wasn't sure that she was going to keep her meal down.
Suzanne & Darcy said:
About your spreadsheet. Can you please stack these numbers into the AMPS cell. First put the 88 then underneath that put 135@+.75 and then underneath that put 139@+1.5 (to show that the 135 was 3/4 of an hour later and then that the 139 was 1.5 hours late.) It’s helpful to write something in the comments too — about stalling.

I would have gone ahead and shot with the first rise from 88 to 135.

Now let me ask one more question— you did not feed her during the time you were stalling the shot, right?
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I will work on stacking the numbers!

I gave her two freeze dried minnows just to calm her down a little bit. She was very spicy because she wasn't getting her post shot meal, and I needed her to stay calm so I could still get future readings. I ended up waiting two hours and then dosing. Her +1 was 133, and I will test her +2 in about 10 minutes.

This is all from a brand new pack of test strips. I control tested twice and it gave me the same number both times. But I'm going to go ahead and try a new container just in case. She's so low, even after eating a 6.4% carb food, so I'm kind of worried, but I have the time to monitor her today.

This makes me really want to switch to a libre censor even more. I have them available. I personally have used them, so I know they aren't painful, but she doesn't have a lot of extra padding right now, so I kind of want to wait until she hits about 9 lbs. She's still very slim.
 
Elohelay said:
That was the night where she was having a tough time keeping food down. She eventually ate, but had vomited several times and I wasn't sure that she was going to keep her meal down.
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Okay. I understand. Did you write that in the comments? I must have missed it if you did.
 
Elohelay said:
She's so low, even after eating a 6.4% carb food, so I'm kind of worried, but I have the time to monitor her today.
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Low? Remember normal cat BG is between 50-120 on your ReliOn meter? But do let me know what your +2 is. Then we will have a heads up for the remainder of the cycle.
 
Elohelay said:
A full serving? Or 1/2? Or a few teaspoons?
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Yes. A few teaspoons. Don’t fill her up in case we need her to eat again soon. We can steer her numbers with food if we need to.

Tell me what other foods you have and what their carb percentages are? We may want something closer to 9 percent or we may want a 10/11/12 etc. Some cats are more sensitive to carbs than others.
 
Suzanne & Darcy said:
Yes. A few teaspoons. Don’t fill her up in case we need her to eat again soon. We can steer her numbers with food if we need to.

Tell me what other foods you have and what their carb percentages are? We may want something closer to 9 percent or we may want a 10/11/12 etc. Some cats are more sensitive to carbs than others.
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I've got
  • Weruva Cats in the Kitchen Mack, Jack & Sam that I have down as 18%
  • FF Gravy Lovers Salmon Feast in Gravy that I have as 15%
  • Weruva Cats in the Kitchen Meowiss Bueller that I have as 6.9%

I can run to the pet store about 5 mins away if those won't work.
I know they stock Weruva Truluxe Pecking Ducken that's at 9.1% and Mediterranean Harvest that's at 13.4%.
I *think* that Dr. Elsey's kibble raises her bg as well.
 
Good. I was actually hoping that she would surf in the “healing greens” (where pancreatitic healing can occur.) But with the reduced dose today it’s to be expected that she will rise.
 
Suzanne & Darcy said:
Good. I was actually hoping that she would surf in the “healing greens” (where pancreatitic healing can occur.) But with the reduced dose today it’s to be expected that she will rise.
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Do you think I did wrong by giving her the reduced dose? I really wanted to skip, but I'm here all day and decided to be brave and monitor.

What's my plan now? Can we both relax a little until it's time for a +4?
And just in case you're not available at +4, if its a higher green number do I just let her hang out there, or do I give her a little more of the 6.4%?
 
Elohelay said:
Do you think I did wrong by giving her the reduced dose? I really wanted to skip, but I'm here all day and decided to be brave and monitor.
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Not at all. We don’t have data for her at this low AMPS so it was a good opportunity to watch her and see. If she ends up going really high we will know maybe next time to give a little more. But it’s quite early in her cycle so we can’t say yet. She seems full of surprises lately!
 
Elohelay said:
And just in case you're not available at +4, if its a higher green number do I just let her hang out there, or do I give her a little more of the 6.4%?
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And I would still give her the planned +4 snack of a few teaspoons of wet food — even if she is on the way up. It’s always good to adhere to the feeding schedule no matter what (although you can vary the foods a bit depending upon her BG.) She needs the calories too.
 
Suzanne & Darcy said:
I think you can wait until +4. How long is that now?
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About an hour from now.
Suzanne & Darcy said:
And I would still give her the planned +4 snack of a few teaspoons of wet food — even if she is on the way up. It’s always good to adhere to the feeding schedule no matter what (although you can vary the foods a bit depending upon her BG.) She needs the calories too.
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But this should be the normal FF low carb if it's on the way up, correct?
 
Elohelay said:
  • Weruva Cats in the Kitchen Mack, Jack & Sam that I have down as 18%
  • FF Gravy Lovers Salmon Feast in Gravy that I have as 15%
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Back to the foods. The two above are HC foods and should be saved for if the drops below 50.


Elohelay said:
I know they stock Weruva Truluxe Pecking Ducken that's at 9.1% and Mediterranean Harvest that's at 13.4%.
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And these two would be good to keep on hand for it you just want a few more carbs (the 9.1) or need a medium carb food (the 13.4) if she’s not responding to LC snacks.
 
You’ve done great today, by the way. It’s VERY nerve racking when encountering lower numbers for the first time (or even until you get used to them.)
 
Suzanne & Darcy said:
Back to the foods. The two above are HC foods and should be saved for if the drops below 50.



And these two would be good to keep on hand for it you just want a few more carbs (the 9.1) or need a medium carb food (the 13.4) if she’s not responding to LC snacks.
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yes! I thought we were focusing on the medium/high carb foods.

I also have a ton of FF pates, some Weruva Truluxe Glam 'n Punk .6% and some Rawz 96% turkey and turkey liver 0% carb for her normal feeding.
Suzanne & Darcy said:
You’ve done great today, by the way. It’s VERY nerve racking when encountering lower numbers for the first time (or even until you get used to them.)
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Thank you for that, and thank you for being here! I really appreciate your support and guidance!
 
So back to the Libre sensors, they are a handy tool to have and some of them can be viewed remotely if you leave a phone at home with her. The Libre 3, I believe. The only issue that we have with the Libre sensors is that they generally read too low when the cat is in the lower numbers say below 100 —or in the anywhere from 50 to 70 or 80 range. Oftentimes the Libre will give you a much lower number than what your handheld meter will give you. So you need to have that ReliOn meter to use as a check so that you can see what the actual BG is and not become alarmed when the Libre is telling you that she’s at 40 and the rely on meter is saying she’s at 65 or 75. Fortunately, you’ve got that part covered already :-)

We have members here who place the Libres on their cats themselves and they don’t use any glue because that can really be hard on their skin and tear the skin —they just put a little shirt over it —and she’s used to wearing clothes, so she’ll be fine with it I think.
 
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