02/03 - Sami PMPS 416; +2 421; +3.5 317 - Dropping FAST - HELP!

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Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's condo

I set up the feeder last night for a few small meals throughout the night. I also got up and did a couple of tests, her lowest point was at +4 263. All day yesterday I tried to only give Sami two types of food that only contained turkey. Last night, it might have been at +4 I gave her some beef. I am starting to wonder if that is what took her on the rise last night. I might just need to stick with the turkey. I will do that for a few days and see how it goes. I have pretty much already eliminated chicken from her diet. I would like to add back in some lamb, duck or venison, but we will have to see how it goes, maybe she just needs to have a simpler diet and not so much variety.

I am off to work today. I will probably try to get home for a test sometime mid day, but then I won't be able to test again until PMPS. I have set the timed feeder to provide 3 small 2-3 tsp meals today.
 
Most cats enjoy variety....in the "wild", one meal is going to be mouse, the next bird..and the next something they found in the garbage, so unless you know they have problems with a particular protein or suffer from IBS, there's really no reason you need to worry too much about the diet....other than to keep it low carb of course!!

It's great that you have the auto-feeder....they're a real God-send for people who have to report to TBP 5 days a week!

If you can get a mid-cycle test, that's great! Hopefully Sami will have a nice slide down today!
 
I am not thrilled with her +7 today, but I had almost 2 tablespoons of food in the feeder for +6 time and it was all gone. She gets one more small snack at +8 and then food is pulled at +9. I won't be able to get a +10 or +11 today, I won't be home until almost PMPS, but hopefully I can persuade my husband to get a +11 over the next few days.

@Chris & China The doctor suspects that Sami's pancreas is acting up because of an allergy to something. I am still not convinced of this, but I have noticed when I feed her something other than Turkey her numbers rise a bit more. This could just be my imagination, and maybe it is a bounce from lower numbers. It is hard to say. I am hopping that if I stick to the Turkey for awhile I will be able to tell if it is from the food or a bounce or something else.

I also talked to the vet this morning, and she suggested that I stick with the 1.5 unit dose for 2 weeks. I told her that I really didn't want to do that and I would prefer to stick to the tight protocol of 6 cycles. She explained that they don't think that 6 cycles is long enough to see how she is going to adjust on the dose, but she also stated that they don't typically have pet owners home test and monitor as much as I do. So in the end she was okay with this route.

Right now I am not sure if I should "fast track" Sami and increase to 1.75 units tonight or hold off for another two cycles. I am presuming that her higher numbers are a bounce and from what I know we are suppose to shoot through the bounce so maybe we need to stay at 1.5 units for another 2 cycles to see how she does.
 
I think you could probably go up tonight...she's staying too high....The one question would be "how much to increase tonight"?

Either 1.75 or 2 units ...let's see what others have to say

From the German Diabetes-Katzen Forum:
However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose).
Click to expand...

I think it's possible that she's got a bounce going off the yellow, but those are still pretty high yellows....but on 1/30 she got down to 291 and looks like she bounced all the way to 513 before heading down again, and she's been heading pretty much straight up from that 262 last night too

When we talk about "shooting through the bounce", what we're talking about is when the cat has already earned a reduction by going below 50, but at the NEXT Pre-shot time, they've bounced high because of the low (example...dropped to 48 but by PMPS, had bounced to 300 due to the release of stored sugars and hormones)....for that ONE cycle, you could go ahead and shoot the previous dose (the same one that just dropped them to 48) to give them a little "head start" against the bounce, but you'd still do the reduction they earned on the next cycle
 
I don't think she is bouncing at all. I think the yellow numbers are just about in meter variance and she is high and flat.

Since she is coming back from remission, if you can test, I think I'd increase to 2u tonight and see if you get a little more yellow where we can slow it down a bit. That is assuming that she stays high the rest of today. If she drops into yellow and stays there before PMPS, I'd probably give her a couple more cycles at this dose.
 
@Marje and Gracie I can test heavily over night if necessary, but not during the day. Sami's AM shot is at 5:30 and I can get a +2 before I leave for the office. I would be lucky if I could get back for a +5 and then maybe again for a + 8, and I could possibly get my husband to get a +11 before PMPS. But that is about the best I can do while I am working during the week. I do want to give Sami the best chance she can have to go into remission.
 
What to do? Sami is 416 at PMPS. I am feeding her now I will need to shot in the next 10-20 minutes. Should I increase to 1.75 unit, or should I hold at 1.5 unit for another two cycles. I am not sure I am comfortable increasing to 2.0 unit when I can't heavily monitor during the day tomorrow.
 
If you can get that +2, that'll give you a good idea of where Sami might be going during the day and you can leave down some LC, MC or HC (depending on the situation)

I really think you need to increase tonight and let's see if we can get her into some better numbers. The longer she stays in those high numbers, the more damage is being done to her kidneys and other internal organs

I agree on the 2 unit dose too
 
Tina
I increased Milo by .25 last night since we were both suggested the fast tracking. He is on 2U now of Levemir. I noticed a difference in numbers today. At +10 he was 257. Didn't hit blue but much better than I've seen.
Have you tried the natures variety instinct from the food list. Milo loves the duck and rabbit. It's expensive but lower carb. We alternate that and FF.
I'm hoping to see more improvement in his numbers. Hoping Sami sees good numbers. Know long way for both of us but we know they can do it.
Meredith
 
Okay, I am sort of nervous about the 2.0 units, but I know you all have been doing this a lot longer than me, so I am going to rely on your expertise. I am also going to give Sami Fluids in the next hour too, so hopefully we will see some progress in her numbers tonight.
 
If your concern is about being able to monitor, you hold the syringe. If you are willing to go up to1.75 units, it is still an increase.
Pros are you'll feel more comfortable and probably sleep more easily.
Cons include keeping him in higer numbers longer and that can cause damage to the body. Plus, with those numbers, you need to be testing for urine ketones.
 
Milo was at 1.75u. Then I just did .25u increase last night. I was not comfortable with a larger increase.
 
@milosmommy I will have to see about ordering some of that food, I know it is more expensive, but if I can combine it with other less expensive foods it might work out.
 
@milosmommy I bit the bullet and went for the 2.0 unit. (doc is not going to be happy about this) I figure if she starts dropping fast I can always reduce back to 1.75 unit with the next dose. I have plenty, and I do mean plenty of food, all carb levels to help out. Sami has been eating very well so far. I gave her a little less than normal amount of food at PMPS tonight just in case she needs more later, but it seems that all the food was eaten from the timed feeder today, but that could have been either cat.
 
Tina
Milo eats about every 3 hours. When he was OTJ we just did that. Trying to cut back now but he's set in his ways. He knows when it's going off.
Good luck tonight
 
Sometimes they need a good kickstart. If you get a number in the a.m. That you are nervous about shooting, back it down.
 
Just a little higher at +2, hopefully this means that she won't go much higher and will start coming down. We are going to try to get some sleep for a few hours and will check again at +4, +6 and maybe +8 depending on how she is looking.

Do you think we can skip +8 if she is still well over 200 at +6, or should I test at +8 because we don't know what she is going to do on this higher dose?

I will try to keep the spreadsheet updated throughout the night and I know I will check in if I have questions or concerns.
 
Let's see how the first part of the cycle goes...Unfortunately, our crystal ball broke at one of the Full Moon parties and we haven't found a new one yet

More than likely, you'll be fine to get some sleep tonight, but we've been surprised before. Usually the first dosecrease cycle isn't real exciting
 
I just checked Milo at +4 last night and he was fine. I made sure his magic feeder went off at 230.

Hope things go well
 
Okay, a bit nervous here! Sami just dropped 100 points in an hour and and a half. I just let her eat a little more than a tablespoon of her regular low carb food. I know she is no where near the danger zone right now, but I am still nervous that she might go too low.

I will set the alarm to test again at +5, that will be 90 minutes from now. What should I do if she has dropped another 100 points? That would only take her into the low 200's, but should I try to stop the plummeting with MC food, or test again more frequently?
 
I'm glad you went ahead with the increase. Looks like she is seeing some response, that's a good thing. We usually don't feed anything other than low carb until they get into lower greens. "See" you in 90. We can decide what to do next based on that number.

If she's going to bounce from the drop, not much you can do, she's dropped already.
 
Don't forget to breathe!!

When they start out that high, they have further to fall.....dropping from 416 to 317 in 3 1/2 hours isn't that unusual

We WANT to see her coming down...that's the whole idea of the dosecrease!
 
I know this is a little nerve wracking but also remember the meter variance. She likely didn't drop as much as it might appear. And even if she did, she has room.
 
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