? 07/12 Mačka not hungry all day :( Shot 1.5 - PMPS 508 +2 447 +4 268

Hey take a look at Tigger's cycle last night on his SS. I woke up every hour on the hour. I am exhausted. Each time I had to seriously fight the urge to panic and give high carb food. I didn't even really push his LC. We recently started letting Tigger sleep in our bed and it has actually caused a big problem! Before he would eat lots of tiny meals thru the night - I would watch when I got up to test etc. Now ALL he wants to do is get back in bed with us. I'll carry him to his food dish, get busy for a second, turn around and he is gone! Right back into bed, snuggled nicely next to his other mommy. Don't get me wrong, it's not like we are used to these numbers over here, but after a year trusting the advice and info on this board I have been much better about panicking. Learning your kitty's specifics is key. This am he only climbed to 114 at preshot. I stalled, didn't feed, retested, saw he was climbing without food . . . and Tigger is true to his name and very bouncy. I summoned the courage and shot . . . it could be the one cycle he is different of course but experience tells me he is going up! Don't be so hard on yourself either, you're doing great, we all are. Good luck today, you got this!
 
For us visual learners, Nikki gave me an idea...and gives me a chance to use more emojis!


:blackeye: Black = so bad there is no emoji, here’s a black eye, this will do
:mad: Red = bad
:oops: Pink = not the best, but getting better
:) Yellow = respectable, decent, but still can do better (like the really sweet boyfriend that needs to lose 30 pounds)
:cool: Blue = very cool!
:D (Dark) green = great!
 
Julie and Honey said:
For us visual learners, Nikki gave me an idea...and gives me a chance to use more emojis!


:blackeye: Black = so bad there is no emoji, here’s a black eye, this will do
:mad: Red = bad
:oops: Pink = not the best, but getting better
:) Yellow = respectable, decent, but still can do better (like the really sweet boyfriend that needs to lose 30 pounds)
:cool: Blue = very cool!
:D (Dark) green = great!
Click to expand...
Lol love
Need this added for black!
ETA I added a devil emoji from my phone, and learned phone emojis don't come through lol
 
You are hilarious!

Moms2Tigger&Blu said:
Hey take a look at Tigger's cycle last night on his SS. I woke up every hour on the hour. I am exhausted. Each time I had to seriously fight the urge to panic and give high carb food.
Click to expand...

@Moms2Tigger&Blu I am so sorry, I can see you stayed up all night just like me :( I can also see on Tigger's SS that you test less during the day, did you decide to test almost only at +5/nadir? He has a lot of blues in his curves, and a low dose, that's great!
 
nslade001 said:
Penelope, you did well last night! I have to say, I've been watching many spreadsheets here since I joined in November after Willow's diagnosis....And honestly, Macka is one of the most beautifully responsive I've seen as a newcomer! He's been starting largely black (which are horrible, unhealthy numbers he needs to get out of) and *smoothly* dropping into gorgeous yellows and blues! Wow!
Click to expand...
Thank you so much for your encouragements. An external and experienced pair of eyes is needed here to see the beauty lol, I don't see it that way quite yet.
But obviously he's getting there. If only he would have more appetite these days! I would worry less I guess (or not).
nslade001 said:
Here is my current recommended guideline for Macka, will change as you gain confidence in your control...

Black.... Horrible/must get out of!
Red....Very bad
Pink....Much nicer!
Yellow...Oh, this is getting good!
Blue.....Yay! Celebrate! Let's stay in blues a while!
Dark green..Scary only because I'm not used to them...These are healing numbers!!! But because of that, I know there are many eyes on us ready and experienced, and able to help!
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This is amazing. I promise I'll try. It's just that the night is not my best companion, the vibe is weird at home, in the dark, with the lack of sleep, and the vet clinic being closed.

When you say healing numbers (green), what exactly do you mean? That it put the pancreas on pause for a few hours?
 
Penelope and Mačka said:
You are hilarious!



@Moms2Tigger&Blu I am so sorry, I can see you stayed up all night just like me :( I can also see on Tigger's SS that you test less during the day, did you decide to test almost only at +5/nadir? He has a lot of blues in his curves, and a low dose, that's great!
Click to expand...
No we work during the day usually, and even on vacation he never seems to go low in day cycle
 
Penelope and Mačka said:
When you say healing numbers (green), what exactly do you mean? That it put the pancreas on pause for a few hours?
Click to expand...

Hi, I'm going to give my rather jumbled understanding...

Basically, yes. The beta cells, which are responsible for producing insulin, are given a chance to rest and repair once a cat is in the "normal" range of 50-120. The longer we can keep a cat in these numbers, the more repair occurs, and the pancreas can heal. ..eventually, hopefully, to the point that the pancreas can by itself provide enough insulin to manage it's body's needs, and we no longer need to give it.

On the other side of the coin, the longer a cat spends in high numbers (hyperglycemia) the more damage is being done to those beta cells.

I see you gave another different dose today. I'm going to try to explain why this (frequently adjusting the dose) isn't good for Macka; please bear with me.

From my understanding, Lantus works best when it is given at a *consistent* dose twice daily. Every time we give an injection of insulin, some is used and some is stored. The stored is a "depot" which is released back slowly into the bloodstream.

When we miss a shot or give a partial shot, more insulin is pulled from the depot to help "cover" the loss, so a change isn't usually seen in that cycle. What we *do* see is less insulin being available for the body to use the next few days/cycles as the depot "refills", causing more stress on the pancreas and higher blood glucose levels. When we actually "reduce" a dose...It means there's a need for *less* stored insulin, so the depot releases more into the bloodstream over the next few cycles/days as the depot drains. Increase the dose? Another adjustment in what's available for the cat to use, as the depot now needs to store more insulin, so there's less available for use.

"Adjusting" the Lantus doses does not result in expected changes in that cycle, but *does* affect the following days/cycles as the depot tries to stabilize. We can't do short term thinking or adjusting with depot insulin; it just doesn't work, and causes more harm than good overall. It's why we "hold a dose"... So the depot can stabilize and we can see what the cat is doing with *that* dose; then we adjust as necessary. Otherwise, it's just a guessing game.

I hope this makes sense; if I've made an error, someone please correct me! And I hope it helps to clarify why we are constantly asking you not to change Macka's dose....

With love, Nikki
 
nslade001 said:
I see you gave another different dose today. I'm going to try to explain why this (frequently adjusting the dose) isn't good for Macka; please bear with me
Click to expand...

Thank you for this long explanation. I'm starting to get it. The only reason why I reduced (very little), was because I am worried that with less food intake (he ate 1/2 his regular intake yesterday and today), the insulin was going to be too much. But looks like I'm wrong with my assumptions. Can he receive the same dose even if he barely eats? I read in the sticky note that cats with loss of appetite should have a reduced dose, did I get that wrong? :'(
 
Hi, please don't take the fact that my post was long personally...I have a very hard time being concise:rolleyes:.

Appetite issues can absolutely be very difficult to deal with, but we really try to deal with getting food in rather than reducing dose, especially with ketone-prone kitties.

You have probably seen this article on stimulating appetite, it has some really good tips. Next are antinausea drugs; I know you've got Cerenia on board, but double check the dose, because some vets start too low. Also, I think it was @Wendy&Neko who suggested Ondansetron, which can be used along with cerenia or separately, whichever works best (targets different nausea receptors than cerenia).There are also appetite stimulants such as mirtazapine (which comes in tablets, liquid or transdermal) and cyproheptadine which you can try after the antinausea meds are given, if they're not doing the trick by themselves.

There's a lot of info here on appetite, because (unfortunately) inappetence is not at all uncommon in diabetic cats; I'm not sure if it's the diabetes, or concurrent medical issues, but there it is.

There is quite possibly mention of reducing dose if cats are anorexic in a sticky, but again...last resort in ketone-prone kitties.

With love, Nikki

(ETA for Wendy: I'm not sure if I should have tagged you, Wendy, but it felt wrong to mention you without the tag lol)
 
nslade001 said:
Hi, I'm going to give my rather jumbled understanding...
Click to expand...
HI Nikki,
Your explanation is very clear to understand. Thank you for taking the time to write all that down. I read it already 4 times :)
All I wish is to stick to a dose. The adjustments at the beginning were beginner's mistakes. I was listening to my vet (but if I had really listened to her, I would have gone from 1 to 2 units in one cycle!!).
The recent adjustment was because of the hypo (I admit I went too far but I was so scared), and yesterday was because Macka barely ate and I thought I'd seen it written somewhere here that I had to reduce the dose in that situation. Now, let's stay at 1.5 for 6 cycles and see how it goes. He is still not eating much.
Thank you again for your time and thoughtful posts.
 
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