12/30 AMPS 234, +2 148, +3.5 92

[Matty&Fam]

Hello, we've found ourselves at another scary moment with Matty dropping significantly from a .75u shot.

Our main post: Newly Diagnosed Kitty - Seeking Early Advice

We've been struggling to find a dose that won't make him go hypoglycaemic, we've been on .75u of Lantus as of yesterday morning,
and today we're seeing a rapid drop in BG (92 mg/dL) at +3.5 from a starting point of 234 mg/dL.

Our worry is that his nadir is usually around +7-8, so we have 4+ hours to go of him continuing to drop.

At the moment we're feeding him wet food, it's not low carb, it's a gastro specific food, because we've had issues with soft stools for the past few weeks which we are trying to remedy.
The food he's been eating and is eating now is Kattovit Gastro (Turkey and Rice), it's 23g carbs as a dry matter basis.

Our vet's phone is off so we can't get a hold of him to ask any questions.

Our plan from here is to measure every hour to see how things progress.

On the food side, we are not sure what to do. Let him eat as much as he wants? Feed every hour? What should we feed?

Could the gastro food with rice be endangering him even more? Because rice could potentially spike and then drop his BG?

Would boiled chicken breast be more gentle on the BG while still buffering the insulin as to keep him from dropping too low?

Any and all help is appreciated, thank you!

 

[Lara & Luciole (Lu)]

Hello! Good news: your Matty is in good, safe numbers. No need to panic or feed high carb food.

You just aren't used to seeing these numbers, so that's understandable that you'd feel scared.

Just give him small meals, like 2 tablespoons, at +4 which you're at, then test him at +5 and give a small meal again. We'll see how Matty's doing.

But no need to panic.

 

[Lara & Luciole (Lu)]

When you have a chance, please change the 911 prefix on your post to the blue question mark prefix. You'll still get lots of help. Thank you!

 

[Karolina & Nestle]

That's a big drop but he's in safe numbers. As long as he's in the green zone and not in the lime he's not experiencing hypo. Like Lara said he's safe and keep monitoring and testing and if he's continuing to drop you can feed small meals to bump him up a little bit.
The more you test the better too cause that gives you data to see how he's doing and how carb sensitive he is, and his patterns etc. All this will help you make better and informed decisions later on.
You're doing great and I think you can remove the 911 prefix for now.

 

[Matty&Fam]

Thank you for your quick responses.

We just tested again at +4.5 and he is at 74 mg/dL.

We will feed another small meal again, but we're really worried what the next few hours will bring.

 

[Karolina & Nestle]

Thank you for your quick responses.

We just tested again at +4.5 and he is at 74 mg/dL.

We will feed another small meal again, but we're really worried what the next few hours will bring.

Are you home and able to monitor? Do you have your hypo kit ready just in case? Did you read all the sticky notes that are important to know?
As long as you're prepared you'll be fine. And if you have any questions you can always jump on here. Someone is always around.

I think you're doing great

 

[Monster's Mom]

Sounds like you're doing a great job. If you've fed him it's likely you'll be able to maintain those good green numbers and keep him out of the limes. That all depends on how carb sensitive he is.
Remember, not to feed too much at one time because you want him to be able to eat again later if needed.
Again, you're doing great!

 

[Lara & Luciole (Lu)]

He's still in good numbers. He will likely be reaching his nadir soon and going back up, so take a deep breath, and we are cheering you on.

 

[Matty&Fam]

Thank you all so much, your words of encouragement really does mean a lot.

We just tested again at +5.5 and he is at 77 mg/dL.

Seems like we're balancing out, will continue to test over the next 2 hours to make sure he doesn't suddenly dip anymore.

Apologies for the panic

We're wondering what this may mean for our next dose, in our experience with Matty if we go with the same .75 unit tonight, he will likely dip further and go lime in the night.

We could try shave off some of the dose, or if his readings are in the low 100s we may skip all together.

I guess we'll get the PMPS measurement and go from there.

Again, thank you all, this forum has been truly amazing.

 

[Lara & Luciole (Lu)]

You can test every hour for the next couple of hours, and then ease off and do every 2nd. Just to see what kind of curve he does, as this tells you a lot about how he uses his insulin. And, unless he is hungry, don't feed him until his dinner time, because his numbers will be naturally rising on their own, most likely, and we want to keep him coasting in those nice, healing numbers for as long as possible. If he's asking for food, just give him small amounts.

What protocol are you following? TR or SLGS?

For your PM dose, he has not earned a reduction. Let's see what he does for the rest of the cycle, which you're only halfway through. But Matty still gets his .75U current dose. Remember: we dose based on the nadir, which is how low he goes, not on his preshot numbers, with some caveats for actually low numbers, which Matty is not at.

You are both doing wonderfully!

 

[Matty&Fam]

You can test every hour for the next couple of hours, and then ease off and do every 2nd. Just to see what kind of curve he does, as this tells you a lot about how he uses his insulin. And, unless he is hungry, don't feed him until his dinner time, because his numbers will be naturally rising on their own, most likely, and we want to keep him coasting in those nice, healing numbers for as long as possible. If he's asking for food, just give him small amounts.

What protocol are you following? TR or SLGS?

For your PM dose, he has not earned a reduction. Let's see what he does for the rest of the cycle, which you're only halfway through. But Matty still gets his .75U current dose. Remember: we dose based on the nadir, which is how low he goes, not on his preshot numbers, with some caveats for actually low numbers, which Matty is not at.

You are both doing wonderfully!

Thank you for all your support, truly means the world. We might have overfed out of panic, as we’ve risen to 122mg/dl now. Or it might be all the residual carbs showing up in this reading. Hopefully his gut will improve asap so we can switch to lower carb for tighter regulation. We haven’t gotten officially on a protocol yet, we were following instructions from our vet thus far (with tweaks of course when invaluable advice would roll in from this forum). But we’ve read and re-read the TR protocol and we think it sounds the most promising. At the same time terrified at the possibility of another hypo experience. We haven’t been getting much sleep keeping an eye on Matty, and having a hard time coping with pressure.

Thank you again for guiding us through this

 

[Christie & Maverick]

Looks like you had a bit of excitement earlier, glad you got some help. With TR you want to be feeding either a high quality low carb canned or raw food diet. Since you need to feed the high carb gastro albeit it is canned food, I would point you to following SLGS for now, which means taking a reduction down to 0.5u, since he went under 90.

 

[Matty&Fam]

T

Are you home and able to monitor? Do you have your hypo kit ready just in case? Did you read all the sticky notes that are important to know?
As long as you're prepared you'll be fine. And if you have any questions you can always jump on here. Someone is always around.

I think you're doing great

Thank you for your kindness and support Our hypo kit is ready indeed. Glucose syrup on standby, emergency clinic number, high carb dry food which we know his belly can handle. We’re only missing a high carb wet food which we can’t risk giving now due to his gastro issues, which hopefully resolve asap. Would like to be better prepared in case it’s ever necessary

 

[Matty&Fam]

Looks like you had a bit of excitement earlier, glad you got some help. With TR you want to be feeding either a high quality low carb canned or raw food diet. Since you need to feed the high carb gastro albeit it is canned food, I would point you to following SLGS for now, which means taking a reduction down to 0.5u, since he went under 90.

Thank you for that, we were definitely considering that at least for tonight, or like you’re suggesting until the gastro issues are resolved that does makes a lot of sense. AI bot earlier revealed that the higher carb food might be too ‘crashy’, with rice not offering a slow and sustained BG release, increasing hypo potential. Running on 3-4 hours of sleep average each night these days, I think we too need a recharge, to be better able to cope with the lower numbers and hourly testing if the need arises.

 

[Lara & Luciole (Lu)]

Hopefully he will be bouncing for a bit, so you will get some rest
And TR is always waiting for you, when you get Matty's gastro problems solved. I haven't read his entire back story yet, so I haven't had a chance to suggest Slippery Elm, which is great for gut issues.

 

[Christie & Maverick]

Well, let me just say, I find AI can be blatantly wrong. It depends on a lot of things, how carb sensitive your cat is, when the carbs are given in the cycle, how the insulin is generally working, among other things. I fear that AI may be extrapolating what could be human-like aspects in managing diabetes, which is inherently problematic, because cats are not furry humans, and at the very least we know from experience here that cats metabolize insulin differently than people do.

Also, try not to expect that each cycle will look the same. Insulin is hormone not a medicine, so things can vary. Especially when a cat bounces, which I believe Matty is doing. Bouncing can happen when the cat drops too quickly, or hits numbers their body isn’t used to.

From the basics sticky:

Bouncing - is simply a reaction to what the cat's system perceives as a BG value that is "too low". "too low" is relative. If a cat is used to BG in the 200s, 300s or higher for a long time, then even a BG of 150 can trigger a "bounce". Bouncing can also be triggered if the BG drops too low and/or too fast. The pancreas, then the liver release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream. *Usually* bounces clear within 3 days (6 cycles).

 

[Tyleete]

Howdy! Popping in to talk about the gastric problem. Has Matty been diagnosed with ibd or anything else?
I do rescue work and am always left with the ones I can't adopt out due to medical problems. I always have ibd kitties, as well as some with small cell lymphoma gi.
I have 2 currently on cooked food. Neither would do raw. 1 with severe food related ibd, the other is my diabetic in remission. Cooked is wonderful for a couple reasons. For me I like being able to control what exactly they're eating. My ibd boy cannot eat any type of poultry, fish, or gums, so he gets pork tenderloin and ground beef. I cook the beef on the oven and drain it, while the pork is baked inside it with water to keep the nutrients cooked out into a broth. You add a meal completer like EZ Complete, and that's it. It's so easy AND as long as it's not something they're allergic to, it is very easy on their system. There are just so many things in manufactured pet food that's not needed and not good, in my opinion anyhow.
Have you found if any type of food effects the stomach? My Nico (diabetic) isn't allergic to anything and he eats the pork tenderloin or chicken.
This is my freezer, most all of it is for my 2 that eat fresh meat.

 

[Matty&Fam]

Howdy! Popping in to talk about the gastric problem. Has Matty been diagnosed with ibd or anything else?
I do rescue work and am always left with the ones I can't adopt out due to medical problems. I always have ibd kitties, as well as some with small cell lymphoma gi.
I have 2 currently on cooked food. Neither would do raw. 1 with severe food related ibd, the other is my diabetic in remission. Cooked is wonderful for a couple reasons. For me I like being able to control what exactly they're eating. My ibd boy cannot eat any type of poultry, fish, or gums, so he gets pork tenderloin and ground beef. I cook the beef on the oven and drain it, while the pork is baked inside it with water to keep the nutrients cooked out into a broth. You add a meal completer like EZ Complete, and that's it. It's so easy AND as long as it's not something they're allergic to, it is very easy on their system. There are just so many things in manufactured pet food that's not needed and not good, in my opinion anyhow.
Have you found if any type of food effects the stomach? My Nico (diabetic) isn't allergic to anything and he eats the pork tenderloin or chicken.
This is my freezer, most all of it is for my 2 that eat fresh meat.

The carnivore’s freezer stack haha love it! Thank you warmly for taking the time to write! We haven’t been diagnosed with IBD (at least yet), up until a few weeks ago we hadn’t faced such an issue with Matty before. We too rapidly switched from full on dry & varieties of snacks to full on wet food since our diagnosis, (sadly against all warnings about the rapidity) as we never perceived our boi’s belly to be sensitive in any way. Not only we did a rapid switch, we also were providing a huge variety cause he’d get bored of each wet food very fast and stop eating it.

He first got gaseous for a few days, then diarrhea showed up, next day he refused food for half a day and appeared nauseous vet suggested we give a 1/4 Peptan pill, which luckily relieved his belly and he started eating. This was on the 13th. We then went on Gastro wet food and boiled chicken breast. Alternating the two or giving it together. Thennn, his started firming up so we went to introduce a diabetic variant of the wet food we’re currently giving to make a transition, which backfired and back to soft poop we went. AI bot said we did it too rapidly - I had mixed a little in his gastro food, and that mixed with chicken. So we fully went back to gastro food. To make matters worse, on the 26th of the month we had a hypoglycaemic event which led to a combo of feeding wet food/dry kibble/glucose syrup and a few churus. Next day, we had full on diarrhea again. In the past few days we saw firmer poops yet today after his shot he had quite a loose one - which makes us believe that’s what caused such a rapid drop in his numbers today. Big sigh.

To be honest we have been thinking about a switch to cooked food, just couldn’t find the right amount of data and got a little frightened we wouldn’t provide adequate amounts of nutrients for his needs. It’s something we would really like to consider, and have tried providing some chicken hearts and liver to test that out (during our wet food switch), but he refused. His taste buds do seem to be changing and adapting to all the new foods though (even if his belly isn’t). Must look into this EZ Complete, and will do, thank you for the tip!

Don’t really know how to handle this gastro thing right now as an immediate course of action, would switching to cooked food help or worsen? Tried calling the vet but his phone has been off today. We’re scared about how erratic the insulin acts with the gastro issues and also scared of doing the wrong thing (yet again).

 

[Matty&Fam]

Hopefully he will be bouncing for a bit, so you will get some rest
And TR is always waiting for you, when you get Matty's gastro problems solved. I haven't read his entire back story yet, so I haven't had a chance to suggest Slippery Elm, which is great for gut issues.

Thank you again for the kindness and suggestions looking into Slippery Elm right now. As we had a bounce back to 346, we decided to go with a shaved .75U for tonight. A tiny bit over .5 basically. Last time we tried .5 for two cycles on the 27th he remained quite high throughout. He didn’t dip into lime greens for a full reduction, but he did dip rapidly, so we thought that might be the most logical approach. We remain on high alert for tonight and will test +2 to catch any early signs of a big drop.

 

[Matty&Fam]

Thank you for that.

Well, let me just say, I find AI can be blatantly wrong. It depends on a lot of things, how carb sensitive your cat is, when the carbs are given in the cycle, how the insulin is generally working, among other things. I fear that AI may be extrapolating what could be human-like aspects in managing diabetes, which is inherently problematic, because cats are not furry humans, and at the very least we know from experience here that cats metabolize insulin differently than people do.

Also, try not to expect that each cycle will look the same. Insulin is hormone not a medicine, so things can vary. Especially when a cat bounces, which I believe Matty is doing. Bouncing can happen when the cat drops too quickly, or hits numbers their body isn’t used to.

From the basics sticky:

Bouncing - is simply a reaction to what the cat's system perceives as a BG value that is "too low". "too low" is relative. If a cat is used to BG in the 200s, 300s or higher for a long time, then even a BG of 150 can trigger a "bounce". Bouncing can also be triggered if the BG drops too low and/or too fast. The pancreas, then the liver release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream. *Usually* bounces clear within 3 days (6 cycles).

Thank you for that. We don’t usually blatantly rely on bots for information (and do tend to ask them for the sources and verify, if of course the source appears reliable), however the lack of sleep has definitely impaired our judgement. What you’re saying makes absolute sense. Will need to do some tests (perhaps +1 after feeding) to see how the carby gastro food affects our boi to get a better idea.

We certainly do appear to have bounced at the moment, and I do hope we made the right dosing decision for tonight (shaved .75U, just a tad over .5U). I was vaguely aware of the bouncing phenomenon after lows, but hadn’t realised it can last multiple cycles.

This thing is not easy, wholeheartedly grateful for all you guys here educating and supporting us

 

[Lara & Luciole (Lu)]

My pleasure, Matty and his caring family!

In this article there's a recipe for making a Slippery Elm syrup, which is something that has worked wonders for my cats, far beyond what a small drugstore of pet and human meds did. Slippery Elm is good for people too, so I always (annoyingly) mention that everybody should have it in their homes. You can read about its soothing and anti-inflammatory benefits in the linked article.

I hope you go easy on yourselves and don't feel like you're doing the wrong thing in any way. It can be difficult to decipher what's going on with our beloved pets sometimes. The good things about being here is that there's about 30 years of knowledge in these posts, and many wise and caring longtime members, some of whom have already said hi. We're all here to help.

 

[Tyleete]

The carnivore’s freezer stack haha love it! Thank you warmly for taking the time to write! We haven’t been diagnosed with IBD (at least yet), up until a few weeks ago we hadn’t faced such an issue with Matty before. We too rapidly switched from full on dry & varieties of snacks to full on wet food since our diagnosis, (sadly against all warnings about the rapidity) as we never perceived our boi’s belly to be sensitive in any way. Not only we did a rapid switch, we also were providing a huge variety cause he’d get bored of each wet food very fast and stop eating it.

He first got gaseous for a few days, then diarrhea showed up, next day he refused food for half a day and appeared nauseous vet suggested we give a 1/4 Peptan pill, which luckily relieved his belly and he started eating. This was on the 13th. We then went on Gastro wet food and boiled chicken breast. Alternating the two or giving it together. Thennn, his started firming up so we went to introduce a diabetic variant of the wet food we’re currently giving to make a transition, which backfired and back to soft poop we went. AI bot said we did it too rapidly - I had mixed a little in his gastro food, and that mixed with chicken. So we fully went back to gastro food. To make matters worse, on the 26th of the month we had a hypoglycaemic event which led to a combo of feeding wet food/dry kibble/glucose syrup and a few churus. Next day, we had full on diarrhea again. In the past few days we saw firmer poops yet today after his shot he had quite a loose one - which makes us believe that’s what caused such a rapid drop in his numbers today. Big sigh.

To be honest we have been thinking about a switch to cooked food, just couldn’t find the right amount of data and got a little frightened we wouldn’t provide adequate amounts of nutrients for his needs. It’s something we would really like to consider, and have tried providing some chicken hearts and liver to test that out (during our wet food switch), but he refused. His taste buds do seem to be changing and adapting to all the new foods though (even if his belly isn’t). Must look into this EZ Complete, and will do, thank you for the tip!

Don’t really know how to handle this gastro thing right now as an immediate course of action, would switching to cooked food help or worsen? Tried calling the vet but his phone has been off today. We’re scared about how erratic the insulin acts with the gastro issues and also scared of doing the wrong thing (yet again).

From my experience with cats and food changes, is the type of protein as well as the amount. Many if my cats eat a do kibble called Young Again Zero. Zero, because it has less than 1% carbs. That food is so protein dense packed, that am average 10lb cat only eats 1/4 cup of food all day/night long.
Now, I tried to switch them to that quickly. But then they would have immediate diarrhea. It was such a different food, it caused that. I just backed up and went slower. They did great.
Now, for the guy I had that needed raw rabbit, we pulled a quick switch. Because he was in rough shape and needed something to work quick. Oh! And that website, Food Fur Life? Read through it, when you have time. There is SO much info in all their pages