12/6/22 Jackson AMPS 420 +1 450 +2 435 +3 339 +4 309 +6 317 PMPS 406 +2 316 +4 240 +5.5 200 +7 386

[Skye & Jackson]

https://felinediabetes.com/FDMB/thr...-322-6-324-8-396-pmps-381-3-425-5-357.271511/

I’m really starting to worry now. It been long enough since Jack’s last blues that he can’t be bouncing anymore, can he? I keep thinking every day I see reds that he’s about to break, but he’s just staying in pinks and now a lot of reds. I haven’t seen so many reds in a long time. He’s going higher every day.

He also worried me this morning by waking up and not diving straight for the kibble dish, which is what he usually does even though I give him wet food (and he eats that too) a few minutes later. Although he did go for the wet food when I put that dish down. And he drank well afterward.

He’s worrying me so much I stuck both his ears to get both blood BG and ketone readings (he wouldn’t let do the same ear twice). It showed the Libre was a little off at high numbers… it read 450 where the BG meter said 420… but definitely still similar. The ketones were only 0.7 mmol/L, thank God, present but well below DKA range. Although it does show he is producing some… although from some quick reading it looks like that could also be because of his higher protein/fat diet. I don’t know how worried to be about that reading.

But what is going wrong?? I’m getting actually rather anxious now, especially without any drop at +1 and no appreciable drop at +2. He was doing so well, even reducing, and now this.

Help? Advice? Should I be panicking (I’m starting to) or what? He’s in near constant 400s. He isn’t coming down after his dose. He always comes down. What’s happening? I’m honestly trying not to cry.

@Bron and Sheba (GA) @Bandit's Mom @Suzanne & Darcy @Wendy&Neko

 

[Skye & Jackson]

He finally came down to 339 by +3. Is it possible he stayed high for awhile out of stress? He did fight me about the second ear stick (for the ketones).

So I’m not feeling as panicked right now. Still doesn’t solve the problem of why he’s staying so high though. He’s on cycle 9 since his last run of blues now (and cycle 7 since a dose increase) and instead of coming down he’s having more reds every day.

And I can feel that he’s lost a little weight too. He was still too thin already; now I can just feel his spine. Not too boney yet, but enough to know he’s lost some of the ground he had gained.

 

[Bandit's Mom]

It's been enough time since the last string of blues for any bounce to clear. Considering his history with ketones/DKA and he has been largely over 270 for the last 7-8 cycles, I think you can increase. Maybe even by 0.5U (dose increases are by 0.5U when nadirs are over 300).

Let's see what @Wendy&Neko advises.

 

[Suzanne & Darcy]

I agree with Bhooma. If you were following TR, we would have increased after 6 cycles anyway (with these high numbers.) You do so much testing, you could follow TR if you wanted to. Is it because he eats dry food that you follow a modified SLGS? Or maybe you are only giving the YA Zero Mature for treats?

Can you think of anything else going on with him that would be causing higher BG? You've past the "new dose wonkiness" phase, I think. I would wait until after tonight's cycle and consider increasing in the morning. This will give Wendy time to weigh in on this matter as well. Then you could do the increase in the morning (I like increasing in the morning anyway.)

 

[Wendy&Neko]

He definitely needs an increase. You have enough test data to show you aren't missing any lows.

@Suzanne & Darcy Kibble is part of his regular diet, see the reference to the kibble bowl in the first post. Hence the SLGS.

 

[Suzanne & Darcy]

He definitely needs an increase. You have enough test data to show you aren't missing any lows.

@Suzanne & Darcy Kibble is part of his regular diet, see the reference to the kibble bowl in the first post. Hence the SLGS.

Thanks! Right. I did read that and then got to staring at that spreadsheet so hard that I forgot it's part of the regular diet. Got me!

 

[Skye & Jackson]

The eating dry food and SLGS are both because of my sometimes varying and sometimes long-hours work schedule (medical profession). I can’t hover over him every day enough to safely do TR. So since I can’t do small measured meals, he gets to graze YA to keep the risk of ketones down. The only reason I have so many “tests” is because Jack wears a Libre sensor, and I have family members that will scan it for me when I’m not home (when they have time, they work in and out of home different schedules).

I do wonder why he decreased as he did and is now requiring increases again. I had expected maybe the one re-increase back to 1.5 when 1.25 failed, but now he’s not even doing as well on 1.5 as he did on 1.25 last week. I worry if there’s something underlying wrong but I don’t know what. He’s not showing any symptoms of pancreatic pain - I even massaged his belly a little and he just purred. I wonder if he has something silent dental going on. He hasn’t had an actual dental check (beyond whatever the vet does with yearly checkups) in… I really don’t know when. Ever? I’ve never been told he has dental disease but I don’t think he’s had a cleaning either. So… possibility?

It’s just disheartening how his numbers were doing so much better than this just a couple weeks ago. And I’m also concerned about the slight-but-I-can-tell weight loss. Was concerned enough to actually fight him for a blood ketone test. Which was only just barely within non-ketotic diabetic range (though still not showing up on urine strips), so that plus the weight loss do I think tell me he’s been too high too long. I do fear ketones. I have no money or credit left for him to need another ER stay. I’ll be paying on the last one for a while.

I will give him an increase to 1.75 units tomorrow morning. I also prefer morning increases, because if he’s going to come down it will usually then be on an evening cycle. And I’m home later in the evening to watch him if need be.

 

[Skye & Jackson]

Well at least he’s safely lower tonight - still yellows but not so high. I just hope it lasts a few hours at least and gives him some recovery time. His appetite also seems better tonight. I will be increasing tomorrow morning.

 

[Skye & Jackson]

Well, yellows lasted about three hours on a nice gentle downward slope (per Libre graph) until almost exactly midnight when Jackson touched about 200 (maybe slightly less but not sure) and then immediately started skyrocketing back up. Like a hard bounce. From only 200. I fear/strongly suspect he will be over 400 again very shortly. (But what can I actually do about it? Believe me, I wish there was a safe quick solution to highs, I would use it. But I’m not comfortable and haven’t been trained in anything like shooting R. I’m not even sure that that would be recommended. And I can’t just give more Lantus. Also I need sleep.)

Definitely getting a dose increase tomorrow. At least he’s acting more normal tonight than he was early this morning. Though tomorrow will have to be seen. He seems to start feeling crummy when he spends too much time in reds. Which is to be expected, I suppose. I just hope that the dose increase helps bring those levels back down sooner than later.