11/5 Simon AMPS 353

Alexandra & Simon

Alexandra & Simon

Member Since 2026
After a 3 night hospitalization last weekend (caught high ketones very early) Simon is now under the care of a small animal internal medicine doctor (whom I really like and has great experience in cat diabetes.) She was more worried about an underlying GI issue so she did some additional testing. His GI panel ruled out pancreatitis but he is going to start b12 since those numbers were low. They did an ultrasound while he was in the hospital that showed some enlargement of his intestinal lymph nodes and spleen 😭 . She is hopeful it is just inflammation but we've got a repeat ultrasound next week to re-check and hopefully that has subsided and isn't something "more insidious."

We managed to get a Libre on him this week to monitor his curve and I talked to the Internist this morning and we are going to increase his dose from 1 unit twice a day to 2 units twice a day since he has been consistently still in the mid 300s. I was still doing a manual check of his BG before each injection which is what I have listed on his spreadsheet.

We're going to start the 2 units tomorrow morning so keeping my fingers crossed and will be monitoring him closely!
 
Thank you for the well wishing! Just really hoping we can get his BG down with the increase!

The vet didn’t specifically mention IBD but from the discharge report there is a small possibility that the enlarged lymph nodes and symptoms might be a sign of lymphoma 😭 so that would likely be one of our next steps to rule out if the next ultrasound hasn’t improved. Trying very hard not to think about that as an outcome though.
 
I’m so sorry. I really hope it’s just inflammation and he needs a bit of B12 supplementation. Like Ivy and Binx and a couple others on this forum, Moonie has seen really great results since starting B12. So I’m keeping my fingers crossed for Simon!

Sending you lots and lots of prayers and healing vines. Please keep us posted!
 
Sending more healing vines and well wishes for Simon 🍃🍃🍃🍃🍃🍃🍃🍃🍃🍃🍃
It's great that you have a specialist you like and trust to help you.

Ivy is now on weekly B12 shots (since August as her levels were low and she was having a bad IBD flare and I couldn't get loose stools under control for almost a month).
As Briana and Connie have said, the B12 shots are like magic and seem to really help. I hope Simon will feel much better soon🙏😻

This guide has lots of good information about using a Libre in case you need it as a reference
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

Since you are using the Libre for now, it would be good to fill in some values on your spreadsheet each day so we can see how low the dose is taking him.
Especially since you are planning on a 1 unit increase, you will want to watch him very closely.

You may want to change your title to see if you can get some dose advice (use the question mark drop down) and put DOSE ADVICE in your title just to see if that seems to be a safe increase.
Just a suggestion.
 
Staci & Ivy said:
Sending more healing vines and well wishes for Simon 🍃🍃🍃🍃🍃🍃🍃🍃🍃🍃🍃
It's great that you have a specialist you like and trust to help you.

Ivy is now on weekly B12 shots (since August as her levels were low and she was having a bad IBD flare and I couldn't get loose stools under control for almost a month).
As Briana and Connie have said, the B12 shots are like magic and seem to really help. I hope Simon will feel much better soon🙏😻

This guide has lots of good information about using a Libre in case you need it as a reference
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

Since you are using the Libre for now, it would be good to fill in some values on your spreadsheet each day so we can see how low the dose is taking him.
Especially since you are planning on a 1 unit increase, you will want to watch him very closely.

You may want to change your title to see if you can get some dose advice (use the question mark drop down) and put DOSE ADVICE in your title just to see if that seems to be a safe increase.
Just a suggestion.
Click to expand...
I haven’t added the Libre numbers because I still manually test before each injection and feel those are more accurate. I know the Libre can be off and is really more helpful to see where he dips throughout the day but it will normally say HI (over 400) and then when I test he’s in the 340-350s.

It also just said “glucose sensor lost” for about 24 hrs even thought it was still secure and I tried all the steps to get it to reconnect. Then as soon as I got home from work today it reconnected.

It does look like he got as low as 280 around 12pm today. I had to work away from home today so he didn’t get his usual midmorning and midafternoon meal so I think he went lower than what I typically see.

With the difference though on what I get on his manual check I’m wondering if he was truly even lower than 280.

Thank you for the suggestion! I’ll post tomorrow on dose advice and add a few of his markers from the Libre to the spreadsheet. I have to be away from home tomorrow morning for a doctors appt so I’m going to hold on increasing his dose until I can be fully at home and monitoring!
 
Alexandra & Simon said:
I haven’t added the Libre numbers because I still manually test before each injection and feel those are more accurate. I know the Libre can be off and is really more helpful to see where he dips throughout the day but it will normally say HI (over 400) and then when I test he’s in the 340-350s.

It also just said “glucose sensor lost” for about 24 hrs even thought it was still secure and I tried all the steps to get it to reconnect. Then as soon as I got home from work today it reconnected.

It does look like he got as low as 280 around 12pm today. I had to work away from home today so he didn’t get his usual midmorning and midafternoon meal so I think he went lower than what I typically see.

With the difference though on what I get on his manual check I’m wondering if he was truly even lower than 280.

Thank you for the suggestion! I’ll post tomorrow on dose advice and add a few of his markers from the Libre to the spreadsheet. I have to be away from home tomorrow morning for a doctors appt so I’m going to hold on increasing his dose until I can be fully at home and monitoring!
Click to expand...
Are you using your personal phone to read the sensor, or do you have a phone you leave at home with him (or a Libre reader?).
If you leave the house with your phone and it’s the one used to scan the sensor, then it won’t read the Libre if you’re out of the house.
Make sense?
 
It actually disconnected in the middle of the night when I was home with him. I know there is a distance requirement but it is very sensitive and disconnects if he goes into a different room from where my phone is. Then when he was right beside me it wouldn’t reconnect for whatever reason.

Then randomly tonight after I’d been gone all day it decided to finally connect again: it backfilled the data from the daytime so I can see he dipped at 12pm and then again around 3pm into the high 200s.
 
Hi Alexandra, As you probably know, on the forum, we take increases/decreases gradually, in .25u steps, so a 1u increase is a lot. As Staci mentioned, keep a close eye on Simon with testing to ensure he's managing the insulin well. Good luck!! I hope that this new dose will take him into normal bg numbers.
 
Mary & Jude said:
Hi Alexandra, As you probably know, on the forum, we take increases/decreases gradually, in .25u steps, so a 1u increase is a lot. As Staci mentioned, keep a close eye on Simon with testing to ensure he's managing the insulin well. Good luck!! I hope that this new dose will take him into normal bg numbers.
Click to expand...
What syringes do you use? My main concern is the syringes I have now are 100ml and each line represents one unit. So I’m not even sure with my current syringes if I could confidently draw up just an extra .25u. I may need to get new syringes first if I try and do a smaller adjustment than the 2 units his internist recommended. I was also nervous about the big dose change based on what I’d read here about taking it in smaller steps.
 
Alexandra & Simon said:
What syringes do you use? My main concern is the syringes I have now are 100ml and each line represents one unit. So I’m not even sure with my current syringes if I could confidently draw up just an extra .25u. I may need to get new syringes first if I try and do a smaller adjustment than the 2 units his internist recommended. I was also nervous about the big dose change based on what I’d read here about taking it in smaller steps.
Click to expand...
There are syringes with half unit markings like these - https://www.amazon.com/dp/B009LTE0DO?tag=felinediabetesfdmb-20

I also use calipers for dosing, which also helps a lot - Info - Dosing with calipers updated w/videos
 
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Alexandra & Simon said:
It actually disconnected in the middle of the night when I was home with him. I know there is a distance requirement but it is very sensitive and disconnects if he goes into a different room from where my phone is. Then when he was right beside me it wouldn’t reconnect for whatever reason.

Then randomly tonight after I’d been gone all day it decided to finally connect again: it backfilled the data from the daytime so I can see he dipped at 12pm and then again around 3pm into the high 200s.
Click to expand...
Yes the phone needs to be within 33 feet of the Libre to read it (if using a Libre 3 Plus).
If there are walls in the way it won’t read. But it will fill in when he comes back into range.
 
Alexandra & Simon said:
It does look like he got as low as 280 around 12pm today.
Click to expand...
It would be really helpful to us if you can put the lowest values that you see during each cycle into the spreadsheet. An increase by 1.0 units is a lot larger increase than we would suggest especially if seeing under 300s. You could try a 0.5 unit increase, but best if you get the U-100 3/10cc syringes with half unit markings so you can also do the 0.25 unit changes.

Here is the link to yesterday's post 10/24 Simon AMPS 351 which we like to see for continuity.

Regarding the GI issues, the next step suggested after an ultrasound may be a biopsy, which is the only way to determine if it is IBD (inflammatory) or small cell lymphoma (SCL). Don't let that phrase freak you out, the majority of cats with SCL can go into remission. I had a kitty with both IBD and SCL, and the SCL was definitely treatable, leaving still the IBD which was harder to treat.
 
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