12/28 Quintus: adventures in lime green and honey and what to do next

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Steph & Quintus & L & O

Steph & Quintus & L & O

Member Since 2017
condo: http://www.felinediabetes.com/FDMB/...9-15-97-skipped-am-dose-decrease-1-75.188614/

Hi folks! Woke up to a lime green kitty AGAIN, despite skipping the dose last AM and decreased dose (1.75u instead of 2) last night. He's hungry of course and left to his own devices would love to eat and get higher, but as we're less than two hours before shot time, I've removed food. As I can see he has not eaten that much tonight (compared to last night).

What do I do? I can stall and not feed, of course, but I'm a bit at a loss. He's clearly happy in his lime greens, but I don't really know what to do with my shots and doses.

Thanks!
 
I'd stall again, just in case it makes a difference

You might want to start trying to get a +9 or +10.....instead of waiting until the end of the cycle....that way we know if he's still dropping at PS and (if you test earlier and he's low) you can give him a snack to hopefully make him "shootable" on time

I think you may just have to go back down to 1.5 and see if we can find a dose you can reliably give every 12 hours.
 
What on earth, Quintus! Are you still transitioning to low carb? Has that changed much in the past few days? What’s his food situation at night? Is he eating at different times than the day or different amounts?
 
Stacy & Asia said:
What on earth, Quintus! Are you still transitioning to low carb? Has that changed much in the past few days? What’s his food situation at night? Is he eating at different times than the day or different amounts?
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Well, tonight he didn't eat much. I think he's an irregular eater. The night before he ate a lot. He still has his HC/LC mix and I'm kinda stuck on it. The good thing with that is that if he gets hungry because he's falling, the "end of the meal" has more HC than the beginning of the meal.
 
Snack time!

https://photos.app.goo.gl/hBECpN3OpoINI0mo1

Here was poor Quintus 10 minutes ago just hoping something would happen:

bdaQ-oXf5DVw2kZbDUGeaidv3U51ZBIWsCucKF5kwMuQjK5yGy3B3ZjwQ_WoLq-cnmKa5iLuv6xaLxrmQQ1ABv_m72-wk9qSjvNFTpMq7TdsWqilf1XoogRDJYI_Rio83kZ2BpZzKdjiPaD76_qmj_GhvLGBRIPhccSLDTCuavwa7RTdPPrmZTCe2ABwRVoy1tgphuN-wEJTAmkhcR0imGUTsHJAAVY9XBHKGvaEPgHUWmwujrZRpGVkP-2k3XSU-TCgRVMafdVATUzCfwL0Bt_dOpLR9IFQ25CR0GGFH30Hll59bQHvUOumz6z8ZI3Z5POH60FVf4-0hkmT-Fz1gFOk5xf0xYutydaHYl7_RU9WBe1N0CzIfL_ZGa4YFKbFev_VCi86TAQP6P3tHe6VoMlidfr2jLBJGcLNSpR1AURAKar9m9Ka7XwGOuWA3hs-eFf-WzBr1iXODgS0kQ6aQdnVEJYGjahY8fvql1tJvYn0ZI3suDD2ipzITL4lJDJJbKqj-PJI2HDa3BusjNbrThiEjbgvTJz3gjBOfzLFo_f_cr7zK4Uf48FZ4au22CXeTDh4ubHYcrd092pODr2ghVFQIuh8eeIHPvL03KPLRBEGUDima4KBktANQZZImM5ZKeKpYnXDij1NCKEVj_R_LUr5Q0ZwB4j9vg=w595-h793-no
 
He’s so cute! It’s crazy drastic to go from blacks/pinks/reds to neon green in under 12 hours. I don’t know if that could happen from not eating much, but I think things will be a lot smoother if you can find a dose to consistently shoot am and pm. ECID is so true, I’m shocked they could develop a protocol that would work for more than 2% of them, honestly! :rolleyes:
 
So, here's what might be going on with the food. He sleeps when I sleep, and unless he's really hungry, well, he doesn't get up to eat. He would normally eat when I get up and the movement in the flat wakes him up (unless he's sleeping with me).

Also, he has been a kibble grazer most of his life. He wolfs down wet food. So instead of having lots of tiny meals, he now tends to have larger meals, and possibly overeats (christmas feast every day, anybody?) and after having stuffed himself takes half a day off.

I'm struggling with figuring out his portions, when and how much to give. I think I've been trying to give him too much, which increases the "pig in and then fast" dynamic. I've never really had to portion out cat food. Sure I can do the maths, that's not an issue, but I'm not too sure of my numbers for overall calories (one calculator gives me 200/day, another 300!)
 
He definitely should be at 1.75u for now.
12/23...reduction earned to 2u
Today...reduction earned to 1.75u

He did drop below 90 in between those dates but we want to be careful of reductions too close together.

Getting into a routine of skipping shots and shooting at +18 is not the best approach.

He’s giving you plenty of clues that he’s clearing bounces and is going to give you a low PS. Chris is correct that it’s a good idea with a kitty with patterns like this to test at +10 and if he’s dropping, give him a snack.

Even better, why not test at +2, see if he’s the same or less than the PS, and then flatten out the curve with food earlier in the cycle so he doesn’t drop to where you can’t shoot?
 
Stephanie & Quintus said:
Sure I can do the maths, that's not an issue, but I'm not too sure of my numbers for overall calories (one calculator gives me 200/day, another 300!)
Click to expand...

That's why it's a good idea to have a baby scale around...you can weigh once a week and adjust the calories by what you're trying to do....gain, lose or maintain weight.

It's not as accurate, but even a bathroom scale will help. Weigh yourself, pick up the cat and do the math.

What's his weight? The general starting "calories per day" that we usually go by is [weight in lbs x 13.5] + 70
 
Marje and Gracie said:
He definitely should be at 1.75u for now.
12/23...reduction earned to 2u
Today...reduction earned to 1.75u

He did drop below 90 in between those dates but we want to be careful of reductions too close together.
Click to expand...

Why not 1.5? I did an 18h cycle after coming down to 2, after a no shot, and after two normal cycles at 2 he was already unshootable (yesterday morning). My first 1.75 after a NS, and he's already unshootable. I actually wanted to drop to 1.5 directly. His food intake has dropped quite dramatically with his numbers.

Marje and Gracie said:
Chris is correct that it’s a good idea with a kitty with patterns like this to test at +10 and if he’s dropping, give him a snack.

Even better, why not test at +2, see if he’s the same or less than the PS, and then flatten out the curve with food earlier in the cycle so he doesn’t drop to where you can’t shoot?
Click to expand...

To put this into perspective, getting a +10 means waking up at 5am for me when I very badly need to sleep and get better. I've been ill non-stop since December 7. Flattening the curve earlier in the cycle, if you're talking about the PM cycle, also means getting up at midnight or 1am. Last night I shot at 7, got a +3 at 10 just before going to bed...
 
Chris & China said:
That's why it's a good idea to have a baby scale around...you can weigh once a week and adjust the calories by what you're trying to do....gain, lose or maintain weight.

It's not as accurate, but even a bathroom scale will help. Weigh yourself, pick up the cat and do the math.

What's his weight? The general starting "calories per day" that we usually go by is [weight in lbs x 13.5] + 70
Click to expand...

Going to ask my neighbours with babies if they have a scale lying around... But really not sure this is the kind of thing people own.

He weighs 5kg, so by that formula he should be getting around 200kcal, equivalent to 1can of DM. But as I can't give him pure DM (runny poop) he gets some kibble mixed in. So far I've been giving him quarter can meals with kibble mixed in, but now trying to move to 1/6 of a can at a time. I'll get out the calculator in a bit but I should probably aim for giving him two thirds of a can, probably.

The other problem with wet food (and also why I've fed my cats dry food all my life) is that he likes it when it's fresh, but not so much when it's been lying around for a few hours (he will eat it if he's hungry, though). It makes it difficult to know if he's eating because he's hungry or because it tastes so nice.
 
Damn, he's still not coming up. I don't want to skip another shot :(:nailbiting:

Not sure what to do, still. Kind of regretting I didn't do the 18h cycle shot yesterday :-( (yeah yeah always more intelligent after the fact)
 
If your gut tells you to do 18 hours, go ahead......or you can go ahead and skip this shot again and see where he's at tonight.

Might just see where he's at at +18 and go from there.

18 hour cycles aren't ideal, but it's important to keep him safe too
 
Chris & China said:
If your gut tells you to do 18 hours, go ahead......or you can go ahead and skip this shot again and see where he's at tonight.

Might just see where he's at at +18 and go from there.

18 hour cycles aren't ideal, but it's important to keep him safe too
Click to expand...

My gut is telling me drop to 1.5 and do two 18h cycles again, and then see if he behaves better on 1.5 after that. And if he's still in the lime greens with 1.5, go ahead with two 18h cycles again and drop to 1.25.

I have the feeling his pancreas is kicking in again and that is explaining some of what we are seeing. Recall his diabetes is "very recent" (I've got all his labs back and checked) and definitely due to his pancreatitis.

I think we are not in a stable situation, but as my vet said: "doesn't really matter how you do it as long as his BG stays pretty. if 18h cycles work, go ahead"
 
47 @13, I think he's telling us quite clearly he wants an 18h cycle and a meal now. I'm off to the doctor's (for myself). No shot and left him plenty of food -- he's eating his "breakfast" now.
 
I’m just curious as to why you don’t just skip this shot and shoot at +24? Then you can get back on a 12 hour schedule much faster.

His numbers will rise but they will come back down.

The 18 hour schedule is great for some circumstances but I wouldn’t use it just because of a skipped shot.
 
From my phone, so a bit brief:
- he gets to have better numbers until this evening
- it’s more relaxing for me
- looking at the accumulation on AMPS like greens, clearly this cat likes to sleep the night and wake up nice and low. Less chance of that happening yet again tomorrow morning with a midday shot than shot tonight (I already skipped yesterday morning, so this morning’s line green is the first shot of a reduced dose after a skipped shot and with two 18h cycles in the depot...)
 
+17 he's at 88.

So I'm wondering: how sudden can remission be, with a cat who has fresh diabetes secondary to pancreatitis? Not that I'm getting my hopes up but I need information to help me understand what I'm seeing, and not miss it if that is what is going on.

He ate this morning, about 1/6th of his 24-hour allowance. I'm giving him food again now, shot or not, because he's hungry. I'll see how that impacts his number in one hour.

He's surfing low each time longer and flatter after a shot, it seems.

If a cat is at 90 preshot (pet meter), how risky is it to shoot? Is this the kind of thing one might consider if one can hover over the cat and test over the next hours? Or not even under those circumstances?
 
You're asking how sudden remissions can happen. Rex is a prime example, but I always say he's the exception. I think his free fall is related to the cats switching to wet food from dry food. They were getting wet food as snacks in addition to dry food before I found out Rex had diabetes. I kept dry food available as snacks until I noticed Rex's numbers go up every time he ate some so I stopped it 100%. 1-2 weeks later, his insulin needs changed.
 
Stephanie & Quintus said:
If a cat is at 90 preshot (pet meter), how risky is it to shoot? Is this the kind of thing one might consider if one can hover over the cat and test over the next hours? Or not even under those circumstances?
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Per TR you would shoot anything 68 or over on a pet meter, that being said, this is where know thy cat comes in to play, when you have enough data to guess how that will play out, the risk is more relative to that. Many cats stay flat when shooting low numbers and it's great, Asia likes to go lower when I have a low preshot, so I have different considerations. Looking at the 130 and 196, I think the lowest numbers you've shot, you can get an idea. For the the 130, he came down 36 points by +2, so as long as you test early and often on a low number, you should have time to intervene with food when necessary.
 
he's down in the lime greens at +3. Ate now, ate an hour ago, ate two hours ago, ate three hours ago. I'm going to check in 10 minutes (30 after last test) and I have honey handy if needed.

Seems even 1.5ui is too much for him now.
 
OK, that's good to know-- if he dropped from 67->43 half an hour after gravy, I'd say it might be time to go to the vet to keep him safe. But let's see what he'll do with the gravy/honey now. [edit: and, he's coming up!]

Behavior all OK?
 
OK, now is there I would need guidance. He's gone up, that's good.

- when do I test again: 15 or 30?
- do I feed him more NF gravy (not sure of the carb content but he loves it) and honey, or do I hold off?
- do I try and feed him DM+NF (his usual LC+HC mix)?
 
Stephanie & Quintus said:
OK, now is there I would need guidance. He's gone up, that's good.

- when do I test again: 15 or 30?
- do I feed him more NF gravy (not sure of the carb content but he loves it) and honey, or do I hold off?
- do I try and feed him DM+NF (his usual LC+HC mix)?
Click to expand...

Bit of a grey area in my opinion. Strictly speaking, he's up over the "take action line", so now is when you would stop feeding and see if he can hold his numbers. If it were me, though (I tend to be more conservative on these things than the letter of the procedures), I'd probably give him at least a bit of MC (hold off on honey for now) to give him a bit more of a boost up with some staying power. It's still quite early in the cycle for this.

Others may weigh in with an opinion, but I think you could do either (feed or don't) now, but definitely test again in 15 either way to see what he's got in mind. If he keeps going up, you can withhold food and go to an every-30 for a couple tests to make sure he's safe.
 
I would test again in 15-30, I would hold off until that test just so you can get an idea on how long the HC sustains him. It would be good to contact the manufacturer of that food to find out the carb percentage if you can, but at least keep a note of how much you gave him and what kind of rise he got from it for future reference
 
ECID but I find the gravy by itself wears off in under an hour, honey too, and would only raise Asia 20 points or so at a time. The karo with the gravy can raise her a LOT and she seems to stay higher for a couple of hours. Very valuable info to find out how it works for Quintus.
 
I'm also going to have to figure out what to do with him tomorrow morning (a time when the board is generally quite quiet given my timezone).

In between now and then I'll have more numbers, but I'm tempted to:

- shoot 1ui (or might even that be too high/risky? guess it depends how the next hours unroll)
- try not shooting anything to see what he does?
- shoot 0.5ui (this seems definitely safe to me, probably too low)

The one thing I have my eyes on is how rapidly the changes are happening in how he reacts to insulin. Over the last five days I have only been able to shoot one AM because he was too low on all the others.

The "curves" sheet in his SS also gives a good idea what is going on, easier for me to read because I have the shot amounts in my head and can compare. e.g. the last "midday shot" like this one was on 25th, and it was 2ui. And see what's happening today with 1.5ui, two days later.
 
Stacy & Asia said:
I would test again in 15-30, I would hold off until that test just so you can get an idea on how long the HC sustains him. It would be good to contact the manufacturer of that food to find out the carb percentage if you can, but at least keep a note of how much you gave him and what kind of rise he got from it for future reference
Click to expand...

That's a good point about using this for data-gathering. Always a silver lining, even during these stressful periods!
 
I need to find a 30-minute window to go to the pharmacy and pick up my metronidazole. For me, not for the cat. Guess who got giardia? Yep, that kind of explains why I've been so ill the last weeks and couldn't get over my tummy upsets. They think I brought it back from India in... April (and I'm wondering: if April, why not 2015? or before?) o_O:confused:
 
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