10/25 Jace AMPS 226 +3.15 155 +5 121 + 9.30 85 + 10 85 PMBG 85 +.50 103

HurstJace

HurstJace

Member Since 2022
Hi all,

Hopefully I did this correctly. I've been scouring the forums for an hour learning how all this works as I'm a new member; however, I've been treating my diabetic cat for 6 years and somehow made it this far before we had a crisis.

Jace had a low PMBG this evening of 85 using our human meter. He did not have much of an appetite after eating this morning and the last couple of days I've noticed he is eating only about half of what he used to. He used to be ravenous and always finished 3/4 of a can of Friskies pates morning and night. Today he rejected his freeze dried chicken and was not even tempted by regular chicken. He vomited a tiny bit earlier today but has not since.

I did not give him insulin tonight because we were advised by an ER vet not to shoot if he is under 250... I've slightly modified that to 200. He was hospitalized last weekend for a severe hypo episode that occurred when he was on 3.5 units of Lantus 2x daily. He was released the next day and given 1 unit in the AM per vet orders but still had severe hypo symptoms and was returned to the ER. Two days later we him to a specialist/ER where he was hospitalized two more days because he had totally stopped eating, was drinking excessively, and was close to going in to DKA after not having insulin for that short period of time (2 days). They also said he had a mild case of pancreatitis per his ultrasound results but not much was said about it. They gave me Cerenia and Mirataz. Since being discharged, he's been on 2 units 2x daily.

He had DKA 6 years ago when he was first diagnosed. I'm scared of not giving his shot and triggering DKA again, but also scared of giving his shot as I'm not experienced with manipulating his dose yet and don't want to trigger hypo as that episode was absolutely terrifying. As now it's been a few hours from his normal shot time, should I test again in the AM and hope his number is higher so that there's no question on shooting or not? He was fed dinner and ate 1/2 his food again but then wanted a ton of freeze-dried chicken pieces.

Please send guidance for this stressed momma.

Thank you.

edit: No ketones in his urine as of yet.

Link in case I didnt set up signature correctly:

https://docs.google.com/spreadsheet...fqS3f3jWwXiMOr0g6p9eanTzAwmcKCf_JQKOB/pubhtml
 
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Hello and welcome. Since he's had DKA in the past and the recent vet visit said "close to DKA", you are right to worry about skipping a shot. Next time you see a low number and need immediate help, use the subject prefix "?", and add text something like "recent DKA need help", as well as the numbers. That'll hopefully get more eyes on you sooner.

How long have you been testing Jace? Though you are a new member to FDMB, it sounds like you've been dealing with feline diabetes a while now.

For now, I would also ignore the instructions about not shooting if under 250. On our Feline Health forum - where you should have posted first as we ask people to do, we suggest that brand new members do not shoot below 200. But we also change the guidelines with recent DKA in the picture. It'll really best to get some insulin in him if possible.

People here will pick one of the two dosing methods described here: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
That Sticky Note and the dosing method selected give guidelines on how low you can shoot. With experience, the "no shoot" number gets a lot lower on this forum. And there are also several options when confronted with a lower than expected number. One of which is delaying the shot, another is reducing the amount given. If you post here and ask for help with a question like "need help with lower preshot", someone may be able to help you decide which action is best for the situation.

For tonight, I'm glad you were able to test ketones. I'd put something like "ketones neg" in the Remarks column, so we can track those results.

For tomorrow, I might reduce his dose to 1.75 units, in the hopes that it will prevent lower numbers and having to skip shots again. If you were to follow the SLGS dosing method, Jace would have earned a reduction in dose by going under 90 anyway.

Do you have a hypo kit ready? With testing blood sugars and food, we can keep our fur babies safe.
 
Thank you for the information above. Feeling a little overwhelmed and wasn’t sure what dosing method we’d be following as he’s been on insulin for years at the same dose.. I know that’s not normal now. Also wasn’t sure what method we’d be considered as we started higher, then went lower.

We just started home testing as of the first date on spreadsheet (10/17 I think?) and that was with a libre. We started ear pricks on the 23rd because I didn’t feel comfortable only going off of the libre readings.

Thank you for tips on how to get replies sooner. It felt urgent last night but also not 911 worthy.

Early this AM I woke up to Jace vomiting again. His BG was 261. He’s not interested in eating at the moment, but I gave his shot at a reduced dose of 1.75. I’ll try getting him to eat periodically today and keep an eye on him as well as test for ketones when I can catch him in the box. I’m worried that his pancreatitis is still lingering and was not fully treated as the ER vet didn’t say much about it while he was admitted. Their only concern was getting his glucose down to normal levels. May be calling his primary vet when they open. :(
 
I hope Jace feels better soon. You are in the right place, the support and information available on this forum is incredible.
 
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