1/29 - Sami - PMPS 524; +2 497

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Tina & Sammy

Member Since 2010
Hi Everyone,

Yesterday and last night were really hard. I didn't sleep much because each time I got up to test and was discouraged by the number I wished I had gone ahead and increased the dose. But then I would think I would be stressing more if I was off at work and worried that she might go to low. It really is a difficult decision.

She did rise up after her shot last night but that is to be expected because she did eat. At +6 PMPS last night she was at 407. I was highly hopeful that she would drop into the 300's so when I was still up at +7.5 I tested again and was disappointed. I have been leaving food out until about +9 so she could have eaten any time during that time.

I have a new plan for today. So far I have been feeding her 7% and 5% food. Today I am going to try 4% and 5% for the morning and 0% for between +6 and +9, pulling all food at +9. I am hoping this will help to keep her stable after +6. I have no idea if this will play a part. I am going to stick to the .5 unit for now, but I am going to see if I can take tomorrow afternoon off work so that I can be home to monitor in the afternoon if I decide to increase the dose tonight. I am still in limbo as to whether I should increase to 1 or .75. I know that based on her trend she has earned the 1 unit, and I would probably be okay with that when I am going to be home all weekend and can test and provide MC or HC food. If need be I can always drop down to .75 on Monday if she is trending low this weekend.

Again, I want to thank everyone so much for their support. I know I have been through this before and I should be like riding a bike. Well, testing and giving shots really is like riding a bike, but the roller coaster of emotions not so much.

Hopefully we will see some better numbers to day to bring up my spirits.

Yesterday's Condo
 
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Hi Tina!

I saw your comment on Doobie's condo

Yes...it's possible that just giving Sami kibble for her "testing treat" can be causing some of her wonky numbers, but I think it also looks like she just might need more juice. Yes, it's true that a few kibbles can cause BG to be much higher, so it'll be better for Sami if you can find something else to use for her treats, like freeze dried chicken (or just a little piece of boiled chicken) and get rid of the kibble completely.

Some kitties do better if they don't get any food after nadir (since the insulin is already starting to wear off) but whether Sami is one of those kitties, there's no way to know until you just try some different feeding patterns and see if it seems to make a difference.

I'd get all the kibble out of the house. We've seen it before where people have said "but he/she NEVER gets into it"....but they're sneaky little guys and if it's in the house, they can find it!

I think I'd only go up to .75 (if you decide to increase) especially if you're removing those few kibbles you've been using for treats. We do want to keep her on the same dose for at least 6 cycles before making any changes, so you've done well by holding the .5 for that long

It may be better for you to remove the kibble and stay at the .5 for a few more cycles and see if getting rid of the high carb treats helps

Hang in there! We all understand the frustration you're feeling!
 
@Chris & China

I stopped giving the kibble this morning. I have some freeze dried chicken and fish, but she doesn't seem to like it, or at least she wasn't interested in having it when I try to give it to her with her +6 test today. I know she wouldn't be able to get to the kibble because it is sealed in a tupperware container, but I might be tempted to give it to her if it is in the house, so it will be gone tonight when I get home.

I just started letting her graze until +9 since the evening on the 26th. Prior to that I was pulling the food within the hour of shot time.

She did have a better +6 than yesterday, today's 475 vs. yesterday's 502, but I also noticed that she didn't eat much this morning and there wasn't much eaten out of the feeder when I went home for the +6 reading. This morning before I left for work I left the feeder open to see if she was going to like the 0% food, and she choose to eat that over the 4%-5% food that was in the other slot on the feeder. I don't think she liked the Wellness that I tried to slip in there this morning. I really wanted to get her off the Friskies, but maybe she isn't quite ready for that. For the last few meals I have been giving her a Special Diet (low Phosphorous) Friskies, and another HIGH Phosphorous Friskies variety that I know she likes. I have splitting the dish half and half. Both Sami and Crystal, my other cat, have been gobbling those two up, but this morning neither of them liked the change to Wellness. I will keep trying because I know the Wellness food is so much better for both of them. I have also purchased some other Low Phosphorous food that I want to try. I know I will find the right combination of low carb, low phos, that will work.

So you are suggesting that even though she hasn't been reaching even the yellow the last few days I should still only increase by .25 unit. She hasn't even hit pink in the last 20 hours. I was really hoping to do the 1 unit starting tonight because I will be able to heavily monitor her tonight and all weekend. The only time I won't be able to monitor heavily is for about 4 hours tomorrow morning. I will be able to get a +1.5 tomorrow morning before I leave for work and if she seems like she might plummet then I could always leave out some MC or HC before I leave. I should be home by +6 tomorrow.

Do you really think that a few pieces of kibble could be causing her to stay in the 400-600 range?

If I don't go for the full unit tonight it won't be until Sunday night when I will be able to increase again and then I will only be able to monitor through Monday, I will be back to work on Tuesday morning. I really want to give Sami the best chance possible to go OTJ again, and everyone keeps saying how you need to be a bit more aggressive.
 
I can't advise but know what you mean about liking to increase over the weekend where you can monitor some more. Hopefully you will get a consensus of opinion
 
The protocol says if you are getting nadirs above 300, to go with a .5U increase. The protocol is based on research and is a safe way to get her out of these ugly numbers quickly. Unless you are giving her more than a few kibbles a day, I would still give her a .5u increase up to 1.0 unit tonight. Do it sooner rather than later.

My Neko also started out in very ugly numbers, but she has two high dose condition, acromegaly and IAA. She was still getting blacks with over 5 units of insulin, so I have a pretty good idea of how you are feeling. I do sympathize. :bighug: One thing that really helped me was to learn when I needed to test, and when I didn't. As long as Sami is still in higher numbers at preshot, and if her +2 is higher than her preshot, you can take a break the rest of the cycle. Get a mid cycle test if you are around, but it's not necessary. Getting enough sleep and taking care of yourself so you can take care of Sami is very important. Make sure you do some things for Tina. Whether it's yoga, exercise, house work, going out for a walk, or whatever.

For test trests other options are just some loving, combing, catnip or whatever she really likes. Make it Sami's special time. There are also freeze dried meat options other than chicken. Some people use dried bonito flakes. Orijen make a line of pure meat treats. My kitties like the Tundra (mostly venison), but the lamb and wild boar were also popular. A bit of regular chicken breast boiled and cut into small cubes also works.
 
@Wendy&Neko

Thanks for the encouragement. Yes, at the very most Sami is getting 3-4 pieces of kibble a day. I haven't given her one at every test or shot time, because sometimes I test her wherever she is sleeping. I only give her a piece when she comes to the kitchen for testing, which is usually only around meal time, and I never give her kibble after +9.

I will probably increase to 1 unit tonight. I know I will be able to test tonight because I know I will have the time to monitor more closely. I am very hopeful that she will be reduced back down, or very stable by Monday night.

So I just want to be clear on testing. If she is HIGHER then PS at +2 I can take a break and don't necessarily have to test until the next PS? Such as on both mornings of 1/24 and 1/25?

Where as on 1/24 PM and 1/26 AM shot she was lower at +3 and +2 respectively, I should continue to test as I did that night and morning.

Should we always get a +2 if possible?

And if they are lower at +2 what is the best interval to test if they are not in the green. I figure if they are in the green and it is early in the cycle you should test as often as necessary to make sure that they don't go too low.

I do need to remember to take care of myself also. That is something that I do need to think about more often, because even my husband tells me that I obsess a bit too much, and Sami is his favorite kitty and he wouldn't want anything to happen to her. I hope that I can find some balance really soon, because running on limited sleep is going to catch up with me.

I just ordered some of the Orijen Treats, and I can try the chicken until the treats arrive. She always goes for cat nip too, so that will also be an option.

Thanks again for the support.
 
The +2 is a common test here, cause it does give a good hint how the cycle is going to go. For Neko, the +2.5 or +3 was a better indicator (when she was on Lantus). If that +2 test is lower than the preshot, then it's a really good indicator that it's an active cycle where you'll need more testing. When to do the next test depends a bit on where they are at, and how much they dropped. It also depends on the cat. With Neko, I learned that if she started in low blue, she could go low (below 50) by +3.5.

The AM cycle of 1/25 is good example where the cycles didn't do much when she had a higher +2/+3. You had increased the dose on the AM of 1/24, so that would warrant a little more attention.
 
Still nervous here, I gave her one unit tonight, and at 525 I can't believe she would go too low tonight. I will test again at +2 and see where she is.

@Wendy&Neko are you saying that even if she is higher at +2 on a new higher dose it is a good idea to monitor more closely? How often should I test tonight?

I went back to the 7% and the 5% food tonight. I want to make sure Sami eats and I know she didn't care much for the food I gave her this morning. So I decided to give her something I know she likes. I have the MC and HC food ready. I don't have Karo, but she would never eat it before anyway, so I will stick with the HC and force feed if it is absolutely necessary. Did I read somewhere that you can also use honey?
 
Either is fine. (just don't get the PRIME)

AND if you get a relion, the maker of those strips sells them under a different name online even cheaper. So you will be able to get them in future even more cheaply. BUT you also will always have access at the store if you need them quickly.

You will be fine I would not skip another shot.

@bettyandhank I saw this in another condo, and would love to know where to get the Relion Micro/Confirm strips cheaper online. Thanks.
 
Did I read somewhere that you can also use honey?

Yes, honey, maple syrup, Karo or even just plain sugar mixed in water...the important part is just having something that contains "simple sugars" in case they really drop low and you need to get them up NOW

You have to remember though that these "simple sugars" wear off quickly, so if you use them, it's still very important to keep testing
 
Just tested for +2 - 497

I am assuming she is pretty safe for me to go to bed and check again at +6.

@Chris & China Thanks for the info about the sugars. So technically if she does go low I could sprinkle a little table sugar on her food and that would work, or should I dissolve it in water? Sami has had water added to her food since she was original diagnosed with diabetes and she has come to like it better that way. She almost won't eat the food unless we add about a quarter can of water too the food. The other cats seem to like it better that way too.
 
I wouldn't try sprinkling it on food just because there'd be no way to know how much they got.

We also try to be careful if they go low that we don't "fill them up" with food too fast so that IF they drop down again, they aren't hungry anymore and won't eat

I doubt if you're going to need it tonight, but you might want to plan on getting some Karo, maple syrup or honey over the next day or two to have IF you need it. If they won't eat, you can rub it on their gums to get the sugar into them
 
@Chris & China I had not thought about rubbing it on her gums. I have honey and maple syrup so I think I should be good, and I am prepared to see some lower numbers this weekend, just don't know that they will come down enough tonight to worry about it.

I am off to bed for a few hours. Hopefully tonight will not be a replay of last night when I would get up to test and then couldn't get back to sleep. I might be sleep deprived enough right now for that not to happen to night. But worse come to it, I can sleep tomorrow afternoon.
 
You should be good with getting up in a few hours to see where she is. We've occasionally had kitties that go from black to green, but thankfully not too common. If you have some HC food with gravy, you can press the lid against the can and squeeze out just the gravy. That's where the carbs are, you just need a tsp or two. Most cats go wild for it. My non diabetic cat dances around wanting his share as soon as I open a can - he gets the solid bits.
 
@Wendy&Neko

I am not sure if I have HC with gravy, I think I bought mostly Science Diet HC 24-25% is that high enough carb? I will have to look a the list and see about picking some up on my way home from work today.
 
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