12/30 - Hershey PMPS +19/+17(220) +2.17(227)+5.5(257)

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Doug N Libby

Doug N Libby

Member Since 2012
12/29 Hershey

We've been moving Hershey's shot time so we could shoot before leaving for Greensboro on 1/9. I gave him his PM shot at 10:30 and was getting ready for bed when the +2 feeding time came. Doug decided to do it, but thought it was shot time and gave Hershey another shot! It had been about :15 before I knew it and he had already eaten his full meal. I went ahead and gave him 2 tsp 19% (I have no idea about the phos in that!) hoping to head off disaster.

Is there anything else I need to do? I know I need to test more often, maybe every hour unless he's dropping lower? He was (140) when Doug gave the shot.

12/30/13:
PMPS (120) + 11.25 - Shot .5u at 10:30pm + 1/8th tsp Miralax
+2 (140) - Shot .5u +1/8th tsp Miralax (I presume) - fed meal + 2 tsp 19%
+3/+1 (144)
+4/+2 (120)
+5/+3 (113)
+6/+4 (77)
+7/+5 (59)
+8/+6 (41) - fed tsp 19% - promptly gave that back, so fed another tsp 19%, spread it out in his bowl thinking maybe he ate too fast?
+8.5/+6.5 (50) - fed tsp baby food
+9/+7 (44) - tsp baby food + 2 drops Karo
+9.75/+7.75 (59)
10.75/8.75 (32)- tsp 19% + 2 drops Karo
+11.5/+9.5 (120)
+12.5/+10.5 (45) - tsp 7% + regular meal
+13.5/+11.5 (60)
+14.5/+12.5 (70)
+15.33/+13.33 (85)
+16.5/+14.5 (117)
+17.75/+15.75 (108)

12/21/13:
PMPS (220) +19/+17 - Shot .5u at 5:30pm + 1/8th tsp Miralax
+1.5 (222) - Hershey was acting funny. Not moving out of my chair when asked. Not stirring at all. When I put him down, he was wobbly. Thought maybe it was his BG, but I guess not.
+2.17 (227) - fed - Hadn't finished PMPS meal and not much interested in eating now. Added tsp baby food, which he dug out and ate.
+5.5 (257)

THANKS!!!!

Libby (& Hershey, too!)
 
Re: 12/30 - Hershey given TWO SHOTS

Oh no!!!!! I hope that Hershey ignores one of the shots and just surfs the blues like a good boy! Hope someone has eyes on your post in case you need a little moral support. I'm headed off to bed with my sleepy kitty. Hugs to you Libby!
 
Re: 12/30 - Hershey given TWO SHOTS

You are going to need to be super diligent with regular testing for at least 12 hours if not longer. If at any point you don't think you can keep him up it will mean vet time and a glucose drip. I would test every hour and keep steering with high carb wet and syrup if he starts to drop fast or low.

Also you might want to change the icon to 911 to get more eyes.

Wendy
 
Re: 12/30 - Hershey given TWO SHOTS

- Thanks, Deborah - Sleep some for me!

- Thanks, Wendy - I'll change the icon. I'm going to test in about :10 and if he looks okay, I'll set my loud kitchen timer to get up in an hour.

This has always been one of my greatest kitty fears... nailbite_smile
 
Re: 12/30 - Hershey given TWO SHOTS

longer than 12 hrs. this happened to someone just recently, although i'm drawing a blank on who.

Make sure you know where an ER is if you need to go.

You're watching for low numbers, but because of the L insulins' long duration, you must monitoring for multiple cycles. i'll try to find the info from the last person that did this.
 
Re: 12/30 - Hershey given TWO SHOTS

- Thanks, Julie. I'm planning to just skip the AM shot altogether and shoot tomorrow evening at 5:30pm, since I was trying to get him to 5:30 shot time by the 9th. I think I'll just log it like two cycles on the SS. Hope it's not too confusing for anyone that looks at it. :YMSIGH:
 
Re: 12/30 - Hershey given TWO SHOTS

Positive thoughts & vines are with you, Libby & Doug. I hope Hershey stays in high enough & safe till that extra shot wears off.
 
Re: 12/30 - Hershey given TWO SHOTS

- Thanks, Suzanne - Praying Hershey listens and doesn't drop too low.


+3/+1 (144)
 
Re: 12/30 - Hershey given TWO SHOTS

Are you trying to change the shot time only for the January 9th event? if so, i would either skip the shot or get someone else to give it. We had a vet tech from our clinic who would come test and shoot punkin for $15-20. I wouldn't rearrange things for days in order to accommodate one event if it was avoidable.

Do you know where a clinic is that's available all night if you need to go?

And could you post the numbers in the subject line so it can be seen from the main page as you test?

we're hoping for an uneventful response, but i'm glad to know you're monitoring closely.
 
Re: 12/30 - Hershey given TWO SHOTS +3/+1 (144)

Julie - No, the shot time change wasn't just for the 9th. We've been in and out so much lately that his shot time is WAYYY off and we'd like to get it back closer to 7/7. I was moving it to 5:30 to give us a little breathing room. I'm expecting his PM shot to be late on the 9th 9or maybe we'll have to skip it) since I don't know what the day will bring.

I don't have anyone else who can give his shot right now. And, yes, we know an all-night vet hospital - unfortunately, we had to use them ~6 weeks ago(?). Hoping we don't need their services tonight!

Going to close my eyes for ~:45. What a terrible night to be sleepy!
 
Re: 12/30 - Hershey given TWO SHOTS +3/+1 (144)

i'm headed for bed. glad to know you're around Sandy.

sending all the best thoughts your way, libby!
 
Re: 12/30 - Hershey given TWO SHOTS +4/+2 (120)

- Goodnight, Julie. Thanks, again, for coming over!

- Hey, Sandy. Yes, Hershey has always had a good appetite. Lately, he's been less predictable. Now, I'm wondering if that's a kidney issue. Still hoping his repeat labs will show there's nothing wrong there, but I'm afraid that's not going to be the case.


+4/+2 (120)
 
Re: 12/30 - Hershey given TWO SHOTS +4/+2 (120)

So here he is so far, correct?

+ 11.25 = 120 - 0.5u - PMPS (10:30pm)
>>>>+2 = 140 - 0.5u - 2nd dose - fed meal + 2 tsp 19%
>>+3/+1= 144
>>+4/+2= 120

Continue to monitor closely & go easy on the food - don't want him getting his belly full right now.
Below for your convenience is an excerpt from the "how to handle low numbers" sticky- (always be prepared) :cool:
The symptoms to be concerned about include but are not limited to:

staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
disorientation (yowling, walking in circles, etc.)
twitching
stupor
convulsions or seizures
coma

If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.

DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.
Click to expand...
 
Re: 12/30 - Hershey given TWO SHOTS +4/+2 (120)

I'm starting to wind down, too, but wanted to check in on Hershey - glad he's doing well so far - keeping you in our thoughts & sending out positive vines!
 
Re: 12/30 - Hershey given TWO SHOTS +7/+5 (59)

Good luck tonight/this morning Libby. :YMHUG: Jill and Libby had some thoughts about overdosing when Melissa accidentally did that to Ebby a while ago: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=108046&hilit=overdose You can work back a couple of days to the actual event. Rich did the same to Rex a couple nights ago to and skipped like you are planning to.

Sending tons of "non event" vines to you.
 
Re: 12/30 - Hershey given TWO SHOTS +7/+5 (59)

Any updates, Libby?
I would probably test every half hour or so, now that he's around when the two nadirs are coinciding, and because he's in the 50s. I would try to feed him some MC or even some HC depending upon your next test.
I'm here for about an hour. I hope you are doing okay.
 
Re: 12/30 - Hershey given TWO SHOTS +7/+5 (59)

I see he's at 41 now. We need to get him up. I would test again in 15 minutes, and probably feed some HC gravy and test again in another 15 minutes.
 
Re: 12/30 - Hershey given TWO SHOTS +8/+6 (41)

I was so far beyond stupid tired that Doug got up to test the last couple of hours. Sorry I missed your notes and support, but we SOOO appreciate them!

- Wendy - Thanks for the link; I'll go check it out.

- Dyana - I completely slept through the (59) test and had left instructions to test hourly, so that's when Doug set the alarm. Wishing I HAD tested :30 (smacking forehead repeatedly!)


+8/+6 (41) - fed tsp 19% - promptly gave that back, so fed another tsp 19%, spread it out in his bowl thinking maybe he ate too fast?

Here I was thinking at +8/+6 we could start to relax...guess I 'thought' too soon. :sad:
 
Re: 12/30 - Hershey given TWO SHOTS +8/+6 (41)

Are you saying he threw it up?

I only have maybe 15 or 20 more minutes on the board before I have to log off for work.

I hope he ate the spread out HC. Maybe just gravy would be easier.

If he's on Lantus, with the doubled dose and the one nadir around +6, and the other nadir just waning now (if that's what they are doing), you should be on your toes, for a couple hours here, please.
 
Re: 12/30 - Hershey given TWO SHOTS +8/+6 (41)

Any update, Libby?

I would start the ~O)

Did he keep the last food down?
 
Re: 12/30 - Hershey given TWO SHOTS +8.5/+6.5 (50)

Yes, ma'am, he vomited it back. I don't know if he ate it too fast or if it's the loss of teeth trying to eat HC shreds. Either way, he kept down the second tsp, so YAY!

He's on Levemir and I sure hope the first one is waning, but I've seen him drop until the next shot time, so who knows??

+8.5/+6.5 (50) - fed tsp baby food - Ordinarily, I'd wait and retest with a (50), but I'm thinking tonight isn't the norm. I would've fed 7%, but don't have any portioned out and my eye is acting up, again, so struggling...Will retest :30
 
Re: 12/30 - Hershey given TWO SHOTS +8.5/+6.5 (50)

I have to log off, in a sec.

If he normally nadirs around +7ish, then you have basically two nadirs going now. Please be dilligent sp? and if he throws up again and you can't get him to keep food down, you may have to take him to the ER. You could try two drops of Karo in that baby food and see if he would tolerate that.

I wish you luck.
 
Re: 12/30 - Hershey given TWO SHOTS +8.5/+6.5 (50)

I hope Hershey keeps his food down and comes up nice and easy, real soon.

I'll be thinking about you.
 
Re: 12/30 - Hershey given TWO SHOTS +9/+7 (44)

+9/+7 (44) - tsp baby food + 2 drops Karo

Thanks, Dyana, for the Karo reminder.
 
Re: 12/30 - Hershey given TWO SHOTS +9.5/+7.5 (59)

Maybe mash up the shreds with a fork so they're more pate-like.

Hang in there!

Test, feed, wait, repeat until you've gotten past the 2nd nadir or 2nd +9ish (since Lev nadirs late for many) and when you start seeing consecutive rising numbers heading into the safe zone.

I'll keep this page open on my phone and check back in a bit.
 
Re: 12/30 - Hershey given TWO SHOTS +9.5/+7.5 (59)

Libby --

I'm just seeing your thread. Good job last night.

You don't need to give Hershey a lot of the solids. The carbs are in the gravy. The solids help to even things out but in this case, I'd be concentrating on the gravy. The baby food is fine as is using Karo.
 
Re: 12/30 - Hershey given TWO SHOTS +9.5/+7.5 (59)

Morning Libby - wow on it all, and good job! When Mannie went on these adventures I always fed the gravy only, with karo if needed. For him, the gravy always/usually brought him up, helped set up the surf. Hang in there...
 
Re: 12/30 - Hershey given TWO SHOTS +9.5/+7.5 (59)

Holy cow, Nice job last night Libby, and so scary for you and Hershey. You are in excellent hands. I hope Hershey is going to be fine and that you get some much needed sleep. :smile:
 
Re: 12/30 - Hershey given TWO SHOTS +10.25/+8.25 (32)

update???

Remember, Lev overdoses can take the form of extended duration as well as low numbers. That means that even if numbers start to rise after his normal nadir, they might drop again or might just stay low for a hours and hours. Don't get complacent, and don't hesitate to take him to the vet if you can't bring him up. At least it is now regular business hours, so taking him in should be more reasonable in cost.

((((((Libby and Doug)))))
 
Re: 12/30 - Hershey given TWO SHOTS +10.25/+8.25 (32)

Just checking in as well and I was going to say the same as Libby....you might want to consider a trip to the vet if 32 is your last test. That might not even be his nadir from the second shot...it could just be the first nadir.

Remember how long the duration of levemir can be normally.

Sending hugs and crossed paws he heads up soon.
 
Re: 12/30 - Hershey given TWO SHOTS +11/+10 (120)

Hey guys, thanks for keeping up with us through the night! After the 44 he posted, I took over checking and feeding. I thought it was the least I could do for causing this mess. As you can see, it looks like the carbs kicked in at the last test. He is up and vocal and is now having a romper room session with oreo. You guys were really great and Libby relies on your comments and advice more than you know. :-D ~O) anyone?
 
Re: 12/30 - Hershey given TWO SHOTS +11/+10 (120)

Thanks, Doug, for updating us. I would still stay really vigilant because that may or may not be his nadir from either shot, it's likely carb influenced, and you have that extra insulin on board that might really extend the duration and cause him to drop again.

I know you all must be exhausted.
 
Re: 12/30 - Hershey given TWO SHOTS +11/+10 (120)

Keep up the good work! But watch for that HC wearing off and him coming back down again.

Wendy
 
Re: 12/30 - Hershey given TWO SHOTS +11/+10 (120)

Good morning :cool:

Great job you guys! Hang in there!

I'm adding my voice to the "be vigilant" chorus. Hershey may not be out of the woods yet. . .

Oh, and since you offered ~O) , make mine a double please . . .
 
Re: 12/30 - Hershey given TWO SHOTS +12/+11(45)

Thanks Sandy, he just tried throw us another curve ball.......we keep at it. :smile:

- Doug
 
Re: 12/30 - Hershey given TWO SHOTS +12/+11(45)

Wow! What a night! Glad y'all made it through. Hope Hershey continues the day in safe numbers. Whew!
 
Re: 12/30 - Hershey given TWO SHOTS +12/+11(45)

Wow, what a night you guys had! And what a great job handling it. Please come up some now, Hershey, and how about a safe surf for your beans? You all must be exhausted. Beans and Hershey~

Sending safe surfin' vines :-D
 
Re: 12/30 - Hershey given TWO SHOTS +12/+11(45)

Wow, what a night you have had! And isn't it nice to have some angels standing by?
 
Re: 12/30 - Hershey given TWO SHOTS +12.5/+10.5(45)

Thanks y'all, for checking in on us and offering support. When the double-dosing happened, I was like - great, nobody will be around at this hour. So, I just started doing what y'all taught me. (I tried just getting the gravy, but the shreds doesn't really lend itself to much extra gravy, so fed the saturated solids. I do need to find a way to mash them up a little better, but they're much like trying to mash an oven pot roast.)

Thankfully, I was wrong and people were around, even people I'd never met before. Y'all are AWESOME!

Through all of this, Hershey has been himself. He has been alert, affectionate, talking to me and even purring loudly enough for me to hear it! (That doesn't happen all the time.) I've seen a few P's (pooping, preening, purring) and Doug noted the (playing). So, only one I haven't witnessed.

When he gave us that (120) at +11.5/+9.5 - I thought ALL the carbs had kicked in, it was the beginning of a bounce and breathed a sigh of relief. Then came (45) at +12.5/+10.5 and I wondered if the (120) was a wonky test or if the carbs were wearing off. I also realized meal times were out of whack, so we added his full meal to the tsp 7%. (I'm SURE Oreo appreciated getting fed. He never asks for food but is always happy to see it!)

Glad this happened last night/today instead of tonight/tomorrow because my aunt always said, "Whatever you're doing New Year's Day, you'll be doing all year." No, thank you!
 
Re: 12/30 - Hershey given TWO SHOTS +13.5/+11.5(60)

I'd stay on top of the feeding HC gravy/karo and testing every 30 mins. I would try to get him up and keep him up even if you overcarb him.
 
Re: 12/30 - Hershey given TWO SHOTS +13.5/+11.5(60)

Definitely don't slack off on testing yet. It will be a little tough to tell when it is ok to back off, since Hershey isn't much of a bouncer anymore, but since you're still having to stuff him with food to keep him up, the insulin isn't wearing off yet. We have seen Lantus overdoses last 16+ hours, and I'm sure Lev can last longer than that. Usually they start a bounce at some point, but Hershey might not. Vet is still an option that I would consider.
 
Re: 12/30 - Hershey given TWO SHOTS +13.5/+11.5(60)

I hope you can get Hershey up and surfing higher numbers. You're doing a good job. Hang in there. Sending prayers your way.

You might want to keep in mind the vet may close early today due to the holiday and the regular vet won't be open tomorrow in case you need to get him to the vet.
 
Re: 12/30 - Hershey given TWO SHOTS +13.5/+11.5(60)

Oh boy! I hope you are off today! Karo can wear off suddenly, we usually get a 2 hour duration for Tess and then its GONE.

I know you are groggy now but for later consideration (I had written a long post yesterday and then it seemed to disappear!) :

Tess is also early CKD and it's harder to find foods for both, but they are out there. We have a list of the foods that are lower carb and low phos on a tab on Tess's SS. A really good option is Nature's Variety raw. The chicken/turkey, beef, lamb, venison and organic chicken are all less than 1% carbs and about 150mg/100kcal phos. or less. You can also make your own w/ a premix supplement, Feline instincts has one for CKD cat and TCFeline says they will have one available soon (Tess isn't crazy about the Feline Instincts.) You won't find them on Tanya's list as she doesn't like raw.

Other foods we use are Precise Mixed Grill ( 7% carbs/ 206mg/ 100kcal phos), Pinnacle Chicken & Ocean fish ( 5% carbs/ 175mg/ 100kcal phos), Avoderm Chicken ( 9% carbs/ 196mg/ 100kcal phos), EVO 95% Chicken & Turkey ( 2% carbs/ 155mg/ 100kcal phos) and Friskies SPECIAL DIET Turkey and Giblets ( 5% carbs/ 189mg/ 100kcal phos) or Sliced Chicken in Gravy ( 15% carbs/ 166mg/ 100kcal phos) for HC. Wellness Turkey is good too but she's snubbing it as well as a few others. Oh and NV Instincts canned Duck, but I have a hard time finding it.

Tess's phos has gone down very nicely w/ just the change in diet and her other numbers are holding steady. Remember too that a high protein diet will have a higher BUN. It is no longer given as much weight in dx. When both BUN and Creatinine are up the warning flags go up. Old school thinking was to restrict protein to decrease BUN values, but unless it is an advanced stage CKD that thinking no longer applies. So far we have not had to use a phos binder, but are giving her Renafood supplement and are considering Azodyl.

We also have a tab for her labs and the SS is a great way to track changes. If you want you can down load or copy it and save yourself the hassle of retyping all the test names.
 
Re: 12/30 - Hershey given TWO SHOTS +14.5/+12.5(70)

- Marje - i was delayed (getting the guys off to work and getting a shower!) so it was an hour before I tested, again.

- Libby - Yikes! 16+ hours?! Guess I need to double-check my supply of testing strips. I try to keep 3 boxes on hand, but this kind of event goes through them quickly.

- Carla - Good call. I hadn't thought about the vet maybe closing early or not opening tomorrow. New Years has really snuck up on me this year and today I'm not thinking as clearly as I'd like. @-)

- Ann - Thanks for all the information. I'll definitely be heading over to your SS - thanks!! Hershey has been on Wellness since his diagnosis, mostly Turkey, but I recently stocked up with a case of Turkey & Salmon (higher calories and phos), case of Chicken and 2 cases of Turkey. Now, I'm afraid to feed him the T&S or the Chicken. I certainly don't want to add to his troubles. I priced some of the ones the vet mentioned and GOOD GRIEF! I'd have to get a job to afford them.

+14.5/+12.5 (70) - I hope he's decided he likes the mid-range double digits, but I'll keep testing. It's days like this I'm thankful not to have a (paying) job
 
Re: 12/30 - Hershey given TWO SHOTS +14.5/+12.5(70)

It always happens once we get stocked up. Oreo will be happy though! I think an occasional treat of the T & S wouldn't hurt much. Hmmm, I didn't mention the beef fuds, there are several, but Tess is allergic to beef.

The raw if you can find it locally isn't as bad in price as it seems. It has a lot more calories ounce per ounce (less water) (65kcal/oz for NV, Wellness is the next best at only 40 and some foods are down in the 20s) so you feed less. Shipping is the killer if you can't find it locally. The premix powders make a pretty reasonable cost food too and you have control of the quality. We figure out how much Tess gets by calories not by portion size since the calories per ounce can vary so much.
 
Re: 12/30 - Hershey given TWO SHOTS +14.5/+12.5(70)

Hi Libby, Doug & Hershey,

Glad to see you are all weathering the storm, albeit your gonna lose that test strip stockpile. I often need to test Tigger every 30 min., so we keep at least 600 on hand - American Diabetes & Ebay come in handy for that! :cool:

Keep up the good work, hopefully you'll be able to get some good sleep tonight once Hershey's definitely back to normal.
 
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