1/3, Dusty, AMPS 146, 169, +3 212, +11 147, PMPS 160

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Michelle & Dusty

Michelle & Dusty

Member Since 2012
Dusty is low but not terribly low, but I'm not at all sure what to do with her this morning.

Here's her yesterday:
AMPS: 332
+3: 308
PMPS: 181
+2 126
+3 89 (gave 1T HC)
+4 65 (gave 1t HC)
+4.5 96
+5 78
+6 68 (gave 1T HC with a small bit (~.5 t?) of karo)
I couldn't collect anything after that because Dusty would run away from me. So instead I just got up and watched for signs of hypo. (It's because she was being quite resistant that I have her the HC and Karo at +6. I didn't want her to crash while running away from me.)

This morning she's at 146.

I'm quite surprised that the HC (FF gravy lovers) hasn't had more of an effect on her. I also have to be away from home for several hours, from about her +3 - +7, so I'm hesitant to shoot normal lest last night repeat but without the HC intervention.

What do you think I should do? Give her a token dose? Or a half dose? Skip? I'm loath to skip because I feel I've been skipping far, far too many as it is. But I'm also worried about her dipping too much while I'm gone. I've reread the sticky on shooting low, but I'm still not entirely sure what to do in this case.

(Here's her condo from 1/1: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=86097 I'm sorry I didn't get do one from yesterday. I had a big obligation that took much of the morning and kept me away from the internets. )
 
Re: 1/3, Dusty, AMBG 146 (DOSING ADVICE?)

Hi guys 146 is an ok number to shoot, you will be home to get up to a +3? Does Dusty eat when you are not home? You have to do what you feel comfortable with and I know you will be gone so it is up to you.
 
Re: 1/3, Dusty, AMBG 146 (DOSING ADVICE?)

Thanks, Michelle! I'll have to leave before her +3, but can grab a +2. And, if she moves, she's usually moving by that +2. I could always leave HC out, but I have a civvie who, if given a chance, would gobble it up. And if I'm gone, he'll definitely have his chance. Perhaps halving her dose, to .75, would work?

(Edited to add: Dusty does usually eat when I'm gone. I've been struggling with her not eating as much as she normally did. This could be, I guess, from getting better numbers via insulin...but she went several days without wanting to eat much of anything at all. So I don't know if I trust her to be willing to eat when I'm gone.)
 
Re: 1/3, Dusty, AMBG 146 (DOSING ADVICE?)

a +2 is definetly good at least you can see where Dusty is headed. Do you have an auto feeder? I would still leave food out at least Dusty would get some of it. Darn civvies lol. If you would feel more comfortable shooting a reduced dose I would shoot 1u. It is up to you, then you will be home for +7?
 
Re: 1/3, Dusty, AMBG 146 (DOSING ADVICE?)

I'll definitely be home for the +7. I'll go ahead and shoot the 1 unit and then just leave all any number of tasty things. Hopefully Gus won't gobble them *all* up. ohmygod_smile :lol:

Thanks for your advice, Michelle! I really appreciate it!
 
Re: 1/3, Dusty, AMBG 146 (DOSING ADVICE?)

Your welcome, way to go shooting the 1unit. After you get a +2 try to feed while you are there to make sure Dusty gets some food, then I would leave some out just in case. Glad you will be home by +7 to see how Dusty is. Have a good day!
 
Re: 1/3, Dusty, AMPS 146, 169

OK. She'd also risen to 169 since I first tested, so I'm feeling more comfortable giving her the 1 unit. I'll plan to get her +2 (so long as she doesn't lead me on a merry chase around the house, like she did last night) and will leave out tasty goodies for her while I'm gone.

Thanks again, Michelle, for your advice!
 
Re: 1/3, Dusty, AMPS 146, 169

That is good that she has risen you should feel comfortable shooting for sure! Hope she let's you get a test before you head out without going on a wild goose chase lol! Have a great day!!! Again way to go on shooting!
 
Re: 1/3, Dusty, AMPS 146, 169

Got back home just about half an hour ago. I had one of my early meetings rescheduled from the morning to the early evening which meant that I could take a +3 (which was a 212). Because I reduced the dose, and because of how much I tested last night, I'm just going to hold off on testing her again until her PMPS. She's behaving wonderfully, though. Eating and purring and vocalizing and exploring more than she has in the last couple of weeks. Hurrah!

Thanks so much for checking in, though! I hope you're feeling a bit better!
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, PMPS 147

I should be happy with these numbers. Thrilled! Especially because Dusty seems to be more active and engaged than she has in at least a couple of weeks. But I'm also so tired and the thought of shooting her a full dose tonight, with the knowledge that I will probably have to get up almost every hour throughout the night to check her levels, makes me...just...I don't know. More tired? Apprehensive?
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, PMPS 147

So you haven't shot yet? Let me look at her SS and I will be right back.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, PMPS 147

Michelle

You need to find a dose you can safely shoot twice a day and still maintain your sanity ;-)

It's hard to know where she went today and so it's always good to get a +10 or +11 so you know if she's dropping into PMPS or she was lower during the day and is just on a second dip. Just from the look of it, she could be slightly dropping but there's no way to know other than for you to stall and see if she comes up a bit.

However, you will have to shoot 12 hours from when you shoot tonight so you might not have much ability to stall if you have to work tomorrow. The other thing about stalling is she could keep dropping. If you shoot, you can feed her and she might get a bit of a food spike. But she could also then come back down.

And your other options are to shoot another reduced dose or skip. It's your call.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, PMPS 147

Thanks, Gracie! I gave her a reduced shot this morning at 10:30 (I was stalling a bit to see where she was going and because I didn't know how much to shoot) so I think I may just wait until then and check her and shoot her then. At least at that point I'll know if she's still dropping or is raising. She only ate a bit of dinner. And then, just to freak me out, she has been going in to the litter box quite frequently and peeing very little each time.

Actually, she just did again and it looks like there's a touch of blood in her urine. I just called our emergency vet line to talk to a vet and see whether this is something that warrants her being seen tonight. I'm waiting to hear back. (You call a pager/message and they call you back.)

Ugh. And she seemed to be in such good spirits today.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, PMPS 147

OK. Probably a UTI according to the vet on call. So she gets to go in tomorrow to be checked out.

Oof. Which complicates things. Give her some tonight? A reduced dose? Just skip things until this other health issue resolves itself? Bang my head against the wall and admit defeat? ohmygod_smile nailbite_smile
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Oh no sorry on the uti hope the vetty visit goes well tomorrow! I will let Marje advise you on the dose. Don't give up it gets easier trust me. You just have to put some patient pants on you are doing great!
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, PMPS 147

Gracie is the kitty ;-) :-D :-D

Usually when we stall, we don't shoot a reduced dose because stalling is like reducing the dose just as shooting early is like increasing the dose. If you shot at 10:30 this morning, then shooting at 10:30 tonight would be correct. So you should change the "PMPS 147" to "+11 147" since it had only been 11 hours since you shot this morning.

It sounds like she has cystitis. I am very, very familiar with this as Gracie had it chronically for almost three years and the steroids she was given for it are what got us here. Cystitis can either be idiopathic and sterile meaning its caused by stress, inflammation, etc. but not infection. Or it could be a bacterial infection; some FDs are more prone to urinary tract infections because of the sugar sitting in their bladder when they are unregulated. You should know that the only way to accurately dx whether she has a a bacterial infection is for the vet to do cystocentesis and then running a culture and sensitivity. If the vet just gets a free catch urine sample by expressing the bladder, the test is less likely to show what is really going on. More likely than not, the vet will just want to put her on antibiotics.

In most cases, cystitis in cats is idiopathic but it's wise to do the cysto and c&s to be sure.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Thanks, Michelle! I really hope so. These last two weeks have been pretty hellacious. Last Friday Dusty had to go into the vet for constipation and had to be anesthetized and be manually evacuated. It took her until about two days ago to get over that (and, in fact, she's still not eating as much as she normally would). And now this. I just want her to be healthy for at least a week or two! Hopefully she'll get some good antibiotics that will clear this up nicely. Fingers crossed!
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Did you see my message above?

Just in case it actually is a UTI, which it might be, you don't want to skip a shot. Infection, not enough insulin, not enough food and water is a recipe for diabetic ketoacidosis. So you should be checking her every day for ketones and making sure she gets insulin, plenty of food and water.

Typically infection causes the BG to go up and once antibiotics kick in, the BG comes down.

Can you please test her now and post and we will see where she is, ok? Then we can decide.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Eep! Sorry, Marje! :smile:

I'm really hoping this is stress induced. Dusty had a very, very stressful week and a half, beginning with a road trip to my sister's for Christmas, where she hid in the bedroom the entire visit, and capped with a horrible vet visit that included being housed next to a very loud yappy dog and treatment for constipation.

The vet did mention that they'd get a urine sample from her tomorrow and run it, so hopefully they'll do that and run a culture and figure it out. Better to get it right the first time then to just guess and hope.

As it stands, I think I'm going to skip her evening dose. She's relatively low at the moment and I am about as anxious as can be, and I don't know if I could really deal with worrying about low numbers on top of this. I'll test her tomorrow morning before taking her to the vet to make sure her numbers aren't too high.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Hi Marje,

Thanks for that last post! I'll definitely check her now and see how she stands. I've been checking her for ketones pretty regularly (last time was yesterday) and it's been negative. But I know how quickly that can change.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

OK...she's at 160 at the moment. And I just went into the bathroom where Dusty peed a bit on the puppy pad that I've put in front of the litter box. there's definitely blood in the urine. Poor dear.

Can I do a reduced dose, since Dusty's not really eating much tonight? Another 1u, perhaps?
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Marje - when Gracie had it, how did she pee? I can't tell whether Dusty has a full bladder and needs to pee and can't (thus the many trips) or whether whatever infection she's got makes her feel like she needs to pee and she's squirting out whatever it is that she can in an otherwise fairly empty bladder. Or, to put it another way, the problem here isn't likely a blockage, since at least some small bit of urine is coming out, right? If Dusty actually had a full bladder she would be able to pee it out?
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

I wouldn't shoot any less than that. If she won't eat, can you syringe her? If that is a possibility, I'd tend to shoot her full dose because she might be on the way back up because she depot is draining a bit from the reduced dose this morning.

however, you also know whether you can be up with her tonight or not to be sure she eats. If you can't, then shoot the 1u dose. Either way, please be sure you get at least a +1 and a +2.

What do you think?
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

OK, I think I'll do a fat 1U/1.25. Last night scared me a bit (especially once Dusty decided she had enough of my testing and started running away from me) and I want to avoid that if possible. That said, I'm going to bring her into the vet at 7:30 tomorrow morning, so may have to skip tomorrow's AM dose.

I can syringe feed her (I'm, in fact, already doing that with another of my cats who is also going to the vet tomorrow...because when it rains it pours). I'll try first, though, to entice her with some new cat food with some freeze dried turkey sprinkled on top.

I'll also definitely plan to get a +1 and +2. I'm terrified of hypos and will, if nothing else, just do what I did yesterday and set my alarm for every hour.

OK...off to dose her.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

She just got a fat 1.25 and is currently eating some Wellness turkey and duck with a bit of freeze dried turkey sprinkled on top. I'll grab a test at 11:45 and then again at 12:45 to see her trend (and then at least 1:45 as well).
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

I know those first numbers like that are scary but I wouldn't have fed HC. In fact, I don't give HC unless Gracie is in the low 30s but ECID. I know she will come up with 10%. But Dusty was in very safe numbers last night.

I wouldn't skip her shot in the morning unless she is a very fractious cat at the vet that they have to anesthetize to treat at all. She's starting to do well.

There is a link to Handling Low Numbers in my signature block. Basically, if she comes down into green, feed her a couple tsp of LC food to see if she will flatten out or surf in green. If she gets below 50, then you can feed her a tsp of HC gravy to get her up. Remember to not over feed because you don't want her to get full. If she does go below 50, she earns a dose reduction.

I've been sick and running a temp so I can't stay up but just remember you are in control ok because you can test and then you can feed.
 
Re: 1/3, Dusty, AMPS 146, 169, +3 212, +11 147

Yeah, that was me worrying because of the drop so early. I need to start trusting the process, but it's hard (especially in the middle of the night!).

Thanks so much for your advice! I'll be sure to test and keep an eye on her throughout the night. And will bring the insulin with me to the vet in case she has to be there through her test time.

I hope you feel better! And, again, thanks so much for your help!
 
You're welcome. Hope she comes up a bit so you can rest. Please let us know tomorrow what the vet says.

Really great job shooting tonight! You will gradually feel more confidant in your ability to manage numbers. It's just a learning curve and we are here to help you.

Ni Ni!
 
Just an addendum before I turn off the lights :-D

You should see a food spike at +1. If her +2 is much higher than her PMPS, it's likely to be a quiet night and you can sleep. I'd her +2 is close to her PMPS, she's likely to come back down for a normal, active lantus cycle. If her +2 is much less than her PMPS, she might come down early and have a very active cycle.
 
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