1/20, Bell, AMPS 104 +2 112 +4 116 +6 82 +8 65 +9 71 PMPS 91 +2 85 +4 87 +5 85

bluesunshine

bluesunshine

Very Active Member
Yesterday

Looks like this increase did the job. After dropping really quickly last night, Bell surfed her normal greens and got to eat every hour :rolleyes::rolleyes::rolleyes:

With her being low like this and decreases in dosing sometimes taking longer to reflect for cats with IAA, should I take a half dose tonight along with the standard recommendation for the AM half shot? I know @Wendy&Neko mentioned this was an ECID scenario, but I don't have any data on Bell's reactions to half shots. This is also the first time she will be under anesthesia as a diabetic taking insulin.

I take her in at AMPS +1ish and I'm guessing the procedure will be around AMPS +1.5-3ish. This is assuming I move her shot time a half hour early tomorrow morning to get a bit of food in her, as previously suggested. Thanks so much!
 
Dental?!?!?!
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Do you know how much monitoring the vet will do? A second option is dose as regular tonight and skip tomorrow AM based on what you think that cycle will do. Not saying it's better option, just another one.
 
I am honestly not sure, but they assured me they would check her. With her dropping this low I’m half inclined to do a half dose tonight and in the morning. I hate to do it with such a great cycle, but I’m concerned with her being without food for a period and being in the low 60s at that time.
 
Not only those eyes, but the daggers! Claws out!

My recommendation is …. Whatever wise one said. Aka Wendy. :)

Minner also has some late nadirs or possibly two nadirs. It actually seems to change. Why can’t they all be like Pookey and Gumung ??? :joyful: I think if it were me I’d probably not go half dose PM and AM. I think I would do 75% tonight and then depending on how the overnight went then do 50% or 75% in AM. But that’s just my personal opinion for Minner and gut. Wendy keeps me honest and sometimes it’s like she can see the future, so “what she said”.
 
Thanks Laura! I don’t want to put Wendy in a position to be forecasting where she isn’t comfortable, but I fully trust in her sorcery :p

I think the AM half dose is a hard and fast rule here for cats under anesthesia, but I’m really torn with the PM one. I’m usually aggressive when I have full control of her food supply and sugars but it being out of my hands makes me a bit nervous. I’ll see where she ends up tonight and think on it some more :bookworm::bookworm:
 
bluesunshine said:
Oh and @Staci & Ivy, I finally got the pharmacy to honor the 5 pens for $35 coupon. I had my vet write the prescription as 8 to 25 units twice a day and that seemed to do the trick. I owe you and DH a nice dinner :bighug::bighug::bighug:. Can’t believe I was charged $100+ for a single ml of this stuff at the beginning.
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Yay!!! That’s payment enough for me. I’m just so happy I was able to help you get it for the right price. I can’t tell you how thrilled that makes me.:bighug::bighug::bighug::bighug::bighug:
 
One thing I learned to listen to with Neko was my gut. If you want to do 1/2 dose tonight, that's OK. Remember that the depot will still pretty much control what happens the first part of the cycle when you do a reduction. It typically takes 1/2 dose to interrupt the depot influence, but the first part of the cycle can play out like you shot full dose. With her playing with the 60's, being cautious is OK. Note for any lurkers, this is me talking to Seth about Bell who has IAA, not for general information.

Definitely half dose or less for the AM. I once gave Neko just a token dose before a dental cause she was toying with a reduction, and the test by the dentist came in at low 70's on the AT. :eek:

Regardless of what you do, she will get back on track when you start shooting full doses again. You can think of this as a learning opportunity and time to gather data. Time will come when you'll be doing BCS (reduced doses) when her dose needs start to shrink.

Dentals and anaesthesia are stressful enough, even without worrying about blood sugars. :bighug:
 
Thank you so so much for looking out, Wendy. Still thinking it through. I may dial it slightly back to 7.5 or 7 tonight and then have the option of doing a half dose or a token or no dose at all in the morning.

Sorry for yet another question, but I’m assuming I go right back to the 8 unit dosage in the evening after the dental. And then be on high alert this week if indeed dental issues were a factor in the IAA?
 
A minor reduction like 0.5 or 1 unit will hardly be noticed. Go to at least 2/3 a dose tonight if you want an impact from it.

Yes, go back to 8 units after. If there are extractions, there may be inflammation (and resulting higher numbers) for a week to 10 days after. After one of Neko's dentals I had to temporarily increase the dose. With one caveat for tomorrow night. Test her when you get her home, then test at PMPS. Also give her a little food to see how she handles it. One of the older anaesthesia induction drugs actually reduces blood sugars. If there is a drop into PMPS and eating is difficult for her, a full dose could be too much for tomorrow night.

Best of luck with the dental. :bighug:
 
I went with ~2/3 dose (5.25 units). I think it was the right call. Too many unknown factors (still some unknowns for the 8 unit dose, first time with insulin and anesthesia, first time relying on the vet to monitor her, etc). I’m sorry, Bell, :(. You were doing so so good, we’ll get you back to this good place soon.

Just want to thank all of you for the advice and support, I don’t know where I’d be without it :bighug:
 
Hi Seth and Bell!

Good luck with the dental tomorrow we'll be thinking about you. Nestle has his dental coming up in March and I've been stressing about it since it booked it.
I don't know what I'm gonna do the day of :nailbiting::oops:

We hope you have a peaceful and good night
:bighug::cat::bighug::cat:
 
Thank you, Karolina!! It’s so stressful even without the diabetes to contend with! I will be thinking about Nestle in March :bighug:
 
I think I may be able to actually go to work without the constant worry of what is going on back home... I will still be worried but I would be just as worried at home :p
 
bluesunshine said:
@MinnerPip: Laura, maybe an interesting datapoint for us - depot still holding strong at +5 even with a ~2/3 capacity shot in the PM.
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Thank you Seth. I’m staying vigilant on this for sure. So the depot controlling what happens in first part of cycle and it would appear that pent up insulin jumps in and controls as if you gave full dose. Equally potent. Will see soon how 2nd half of cycle compares. As side note, Minner just had that 2nd nadir late in cycle that I was talking about earlier … 74 at +9. So here I am feeding her at +9. Loco. If this is IAA releasing bound insulin later in cycle then in theory a dose reduction like you are doing right now would not result in as much of a BG reduction in 2nd half cycle as would happen in kitty w/o IAA. Something to noodle on. Very curious to see where Bell lands at anps. I also hope your vet shares the times of each bg test they do so you can transfer to sheet. I would want some kind of written timetable record kept for the whole procedure and given to me. Years ago my vet was willing to use a camera of mine to record the entire procedure for me but I didn’t think I would be ok watching.

Fingers crossed for this dental and its improvement to Bell’s health.
 
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