08/06: Squallie Hypo Watch - AMPS 419, +3.5 86 - BG Rising OK

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Critter Mom said:
Also when you fed what you fed, please, so that we can have a record here and see what works best to raise / keep Squallie in safe numbers.
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He gets a half can every morning before his shot, then he'll nibble on dry kibble around the +2 and +4 hour marks. Then he gets another half can, his shot, and then will usually nibble again around the +1 / +2 mark. He is a kibble junkie.
 
I understand kibble junkie but imho it would be best to stop feeding kibble as it is too high carb. Squallie may be carb sensitive
 
Critter Mom said:
@Elizabeth and Bertie - The vet's decision today was very poor. I am concerned about her level of expertise in treating FD.
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I do find it worrying that the vet hasn't suggested lowering the dose. :(
And I do feel for Lucy... We know how hard it is when the vet says one thing and 'those (potential) crazies on the internet' say something different...

My thoughts are that the dose should be lowered and the numbers allowed to settle out a bit. Chances are that the numbers will level a bit anyway once the steep drops and (possible) bounces are reduced.
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Critter Mom said:
Ah, confusion!

Per my above post, can you itemise all that you have fed thus far since this morning's AMPS. Also when you feed / give syrup from now on can you post:

* How long after shot time.
* What you fed (carb value of food / syrup / honey)
* How much you fed.

Example:

+5 - fed 6 drops honey
+6 - fed 1 tsp high carb gravy
+7 - fed 20g low carb food

.
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Yes, I'll try. Give me a couple of minutes to clear my head from all the upset.
 
Thanks for that info, Lucy. However, I still need you to post what you're feeding as you go along in this cycle. We need to know which foods / syrup were given at what point in the cycle and the effect they're having on Squallies blood glucose in real time. Without this information, any suggestions we make if you get stuck might not be as good as they could be. (We don't want to suggest something that might make Squallie too full, or to make him vomit if he gets too much in one go.)

Hope I've explained what we need a bit better this time.
 
Squalliesmom said:
Yes, my beloved Bengal boy. Killing me.
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If he doesn't come back in next 24 hours I would get 2 or 3 of these traps from Wal-mart maybe. The local shelter SHOULD let you borrow 2-3 of them for free if you leave a credit card with them, I'm sure you can find some to use for free. My mom has 4-5 on loan from a place called Rescue Nation here and she paid $0 for borrowing them (she does fix & release). Maybe make some calls if you don't have the money to buy a few. One is better then zero also. Our roommate let Mushu out on accident last year and he was gone for 3 weeks and I set 3 traps up right outside the house with tuna inside and we caught him after 22 days.

http://www.amazon.com/Havahart-1079-Professional-Style-One-Door-Groundhog/dp/B00004RAMT/ref=sr_1_1?ie=UTF8&qid=1438893079&sr=8-1&keywords=cat trap

Maybe you can delegate this task over to your son if he has free time since you're so concerned with Squallie. Just needs to find the traps and set them up once/twice a day. Trapping is best way to get your cat back.
 
Squalliesmom said:
I have Squallie and crew at one end of the house and have the other end opened up hoping my missing kitty will come home.
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Does your missing kitty usually go outside, Lucy?
If not then he may be showing 'displaced' behaviour. He may not have wandered far at all, but may actually be hunkered down and hiding somewhere close by. He may not respond to your voice at the moment, but may well be able to hear it.
Do you have food and water out? Litter tray and/or bedding that smells of him? Clothing that smells of you? Is there anyone you can borrow a trap from...?

Edited to add: Just saw that Pevsfreedom gave a lot of info about traps above.
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we have a nice Vetsulin User Guide on our Vetsulin forum: Caninsulin/Vetsulin User Guide. I suggest that you take a look at that, as well as the original "Start Low Go Slow" approach that was created with insulins like Vetsulin and Humulin N in mind.

These links should give you a good start toward understanding your insulin and should help you come up with the questions you need to ask. Shooting three times a day is certainly a possibility and can be used very successfully with Vetsulin. It's pretty hard on the caregivers, though, so most people use it as a last resort.

For what it's worth, lack of duration is one thing that can make numbers shoot up at the end of the cycle. That problem can be helped by shooting more often. However, another thing that can make the numbers shoot up so high is if he is going too low or dropping too fast. Then the body feels compelled to dump extra sugar and hormones into the system to protect itself from hypo. I'm oversimplifying, but you get the idea. If that is the problem, then the solution would be to make him not drop so low or so fast by reducing the dose. It might be helpful to reduce the dose AND shoot more often, as your vet suggested, but a more conservative approach might be to try one of those things, see how it works, and decide if you need or want to add the other thing. Especially if you are extra stressed right now. Just a thought.
 
Elizabeth and Bertie said:
I do find it worrying that the vet hasn't suggested lowering the dose ...
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As I posted at the end of Lucy's condo from yesterday, it was a HOWLING error. She should not have instructed Lucy to give a dose that was known to have produced a severe hypo. (I'm wondering if the vet is using a sliding scale for Vetsulin based on preshot and completely ignoring nadir? One of Saoirse's (ex) vets told me that was how she did it. (You know the type: their way or the highway, kitty cornflakes, and nooooooooooo home testing. ;) ) Frankly, given Vetsulin's action profile, I feel uneasy on that high a dose to see nadirs - some of them rather late - well into the greens. There's also evidence in Lucy's data that Squallie's getting significant carryover from that 7IU dose.

My thoughts are that the dose should be lowered and the numbers allowed to settle out a bit. Chances are that the numbers will level a bit anyway once the steep drops and (possible) bounces are reduced.
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I concur.
.
 
pevsfreedom said:
If he doesn't come back in next 24 hours I would get 2 or 3 of these traps from Wal-mart maybe. The local shelter SHOULD let you borrow 2-3 of them for free if you leave a credit card with them, I'm sure you can find some to use for free. My mom has 4-5 on loan from a place called Rescue Nation here and she paid $0 for borrowing them (she does fix & release). Maybe make some calls if you don't have the money to buy a few. One is better then zero also. Our roommate let Mushu out on accident last year and he was gone for 3 weeks and I set 3 traps up right outside the house with tuna inside and we caught him after 22 days.

http://www.amazon.com/Havahart-1079-Professional-Style-One-Door-Groundhog/dp/B00004RAMT/ref=sr_1_1?ie=UTF8&qid=1438893079&sr=8-1&keywords=cat trap

Maybe you can delegate this task over to your son if he has free time since you're so concerned with Squallie. Just needs to find the traps and set them up once/twice a day. Trapping is best way to get your cat back.
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I have a trap set up, but I think something has happened to him. I don't think he's coming back. Breaking my heart, he's my baby.
 
Elizabeth and Bertie said:
Does your missing kitty usually go outside, Lucy?
If not then he may be showing 'displaced' behaviour. He may not have wandered far at all, but may actually be hunkered down and hiding somewhere close by. He may not respond to your voice at the moment, but may well be able to hear it.
Do you have food and water out? Litter tray and/or bedding that smells of him? Clothing that smells of you? Is there anyone you can borrow a trap from...?

Edited to add: Just saw that Pevsfreedom gave a lot of info about traps above.
.
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He only goes out when he sneaks out, he's not supposed to go outside at all.
 
Put some food out and alert your neighbors to do the same. Good advice from others above. "Missing Cat" signs help too.

Though the vet BG # was good, it was likely higher than what your home reading will be so it will be helpful to re-check Squallie's BG #'s again and keep updating here so expert members can advise.
 
Squalliesmom said:
Yes, I'll try. Give me a couple of minutes to clear my head from all the upset.
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Critter Mom said:
Ah, confusion!

Per my above post, can you itemise all that you have fed thus far since this morning's AMPS. Also when you feed / give syrup from now on can you post:

* How long after shot time.
* What you fed (carb value of food / syrup / honey)
* How much you fed.

Example:

+5 - fed 6 drops honey
+6 - fed 1 tsp high carb gravy
+7 - fed 20g low carb food

.
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Okay: half a small can of wet food pre-shot AM/ 0 carbs
+2 Evo kibble about a quarter cup 8 carbs
Honestly, I just left the dry food dish with him and let him eat as he chose because I was looking for Khoji at that time, as well
Tested at +2 and he had dropped a lot, from 417 to 104
Tested again at +3, was down to 86
Tested at +4, was 53
Fed a dropper of Karo syrup (prob about 1/2 tsp) and loaded him up for the vet's, Karo, gravy food and test kit in hand
 
Cat Ma said:
Put some food out and alert your neighbors to do the same. Good advice from others above. "Missing Cat" signs help too.

Though the vet BG # was good, it was likely higher than what your home reading will be so it will be helpful to re-check Squallie's BG #'s again and keep updating here so expert members can advise.
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I just checked him a little bit ago, he was at 95
 
Julia Rae said:
So what is the decision Lucy in regards to the insulin??
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I'm going to check him pre-shot tonight and if warranted, give him 4 units. I will monitor him and then see where his BG numbers are AMPS (8 hrs ffrom PMPS). If they're high, and provided he had a good night with no huge drops, I will give him another 4 units. Then repeat the process 8 hrs hence. If I think he will go too low I will not shoot. And then I'm sure I'll come here asking for more advice!
 
Squalliesmom said:
I'm going to check him pre-shot tonight and if warranted, give him 4 units. I will monitor him and then see where his BG numbers are AMPS (8 hrs ffrom PMPS). If they're high, and provided he had a good night with no huge drops, I will give him another 4 units. Then repeat the process 8 hrs hence. If I think he will go too low I will not shoot. And then I'm sure I'll come here asking for more advice!
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My suggestion is to wait and have some experts here advise about shooting/dose.
 
Elizabeth and Bertie said:
I do find it worrying that the vet hasn't suggested lowering the dose. :(
And I do feel for Lucy... We know how hard it is when the vet says one thing and 'those (potential) crazies on the internet' say something different...

My thoughts are that the dose should be lowered and the numbers allowed to settle out a bit. Chances are that the numbers will level a bit anyway once the steep drops and (possible) bounces are reduced.
.
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You guys aren't the crazies, it's the vet!
 
Then why are you following her directions and not listening to your guts and hart. I know it is sooo very scary to go against vet instructions trust me been there and bought the shirt. My best advise is to listen to your fur baby, your own hart and the advise here and make your OWN decision as to what to do. As for advise if you need something clarified or explained but when it is the time.. it is you your cat and the insulin and no matter what anyone says YOU have to make the choices.
 
Really sorry to hear that, Julia. I've only had one migraine headache in my life (triggered by SSRI withdrawal). Agony! I had no idea how much migraine sufferers go through. I hope you can head off the worst of it, Julia. :bighug:
 
Hi im here just been reading whats been happening, you ok critter mom? Ive got some experience with caninsulin with Molly, I will do my best to help if needed
 
Hi Lorraine,

Thank you very much for your reply. :bighug:

I can't stay the whole way through the cycle. My PTSD symptoms got a lot worse over the last few days so my GP has put me on beta blockers. I'm feeling really groggy. Would you be able to take over keeping an eye on Lucy?
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Oh sorry to hear your having a tough time, you need some rest, I can certainly keep an eye out for a while, unfortunately got to get up for early breakfasts, but hopefully others will join again. Look after yourself x
 
Hi Rhonda, my molly was on caninsulin so I have some experience but thankfully she was only on it for 5 weeks , but I know how I found the best way to work with it. so I will help if needed to
 
you know what I would do tonight? I would skip the shot, or at most give a teeny tiny shot so you can look for your other kitty without worrying about hypo. That is assuming Squallie isn't ketone prone, but you haven't mentioned that yet so I'm hoping that means he's not. He'll probably go high tonight, but he'll recover just as quickly.

One of our members recently used a pet detective to help find her missing cat. They did it all by email and phone. I'll see if I can find the info. He was within sight of her condo the whole time but was hiding and too scared to come out.
 
Squalliesmom said:
Hi, all, thank you to everybody for sticking with me! Just got back from the vet (yes, we went early, I figured if he was going to have more problems, better that it happens there), she wants to put him on 4 units every 8 hours, three times a day. Does this sound reasonable? She says she wants to try this to eliminate the steep highs and lows he's been experiencing. Btw, his BG was 97 at the vet, up a little from the prior reading (I gave him Karo and have cans of gravy food standing by if we need them!) I will test him again in a few minutes to make sure its not starting to drop again.
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It sounds reasonable. But maybe even more reasonable to switch to an insulin without such a steep drop and low nadir. Lantus, levemir or compounded bovine PZI are my top 3 choices. All of these are closer to feline insulin than vetsulin so you need to decrease the total daily dose starting out if you switch.
 
Hi Lucy,

Saying prayers that Khoji will be home soon ...

When you get a chance, please let us know how you're getting on and what Squallie's BG is doing.
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Giving 4 units shouldn't drop him nearly as much, but I'd want to monitor around +3 to +4 for the likely nadir.
Dosing TID with the 12 units spread out actually might work as Vetsulin/Caninsulin lasts roughly 8-10 hours, so there'd be a bit of overlap to help keep the glucose from skyrocketing.
 
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