12/7 Webster AMPS=403+2=344+3=272

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Sandy and Black Kitty said:
Good Morning ~O) :cool:

AM+4 = 197 ... now that's more like it
Bounce over :-D
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I'm afraid that his fast drop off is going to trigger yet another bounce. I started to feed him 1tbs of 15% food and gravy @3.5 once I saw that he was not slowing down. I fed him another 1 hour later.

Sometimes I'm just not sure if I should immediately start feeding rapidly falling numbers. I mean, for the first 4 hours after his shot he has various portions of food being served on the hour. I often wonder if hes going to slow down on his own by simply eating his LC food. I hate to give him higher carb food because it counteracts the insulin. Do you know what I mean?

At what point do you start feeding quickly dropping numbers? When they are coming down at a rate greater than 50 per hour? 75 per hour?
 
Sandy and Black Kitty said:
Does he eat on the overnight cycles?

Also, I'm wondering why you increased on 12/05/AM. . .
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He was having issues dropping very fast at the beginning of his cycle so I started to divide his food into 4 portions each cycle with a heavy emphasis on the first 2 hours. In other words, he get 4oz per cycle, and I give 2oz@ps, 1oz@+1, .50oz@+2, .50oz@+3. He has no other food until his next dose which is 9 hours later. To answer your question, he receives his insulin @8pm and eats at 8pm,9pm,10pm,&11pm. His next feeding is at 8am pre shot.

As for the dose increase, While his nadir was less than 200 on 12/4, for several cycles prior to the reduction he seemed to have high nadir's and I was seeing a lot of numbers in the black at pre shot. Now that you mentioned it and looking back, I'm not sure if I should have increased it. :?: After having DKA I'm trying to be precaution by ensuring that he has enough insulin. What are you thoughts?
 
I am intimately familiar with DKA . Early on My Black Kitty went 2 rounds in as many months. Prior to the second instance his urine went from negative ketones to large in 24 hours - he was literally at deaths door.

My $0.02-
It's possible that that last increase has put his dose higher than his needs. Even with the skip on 11/30/PM followed by a bounce and reduction on 12/01/AM, he saw green on 12/04/PM. I know it's hard to sit on your hands in the face of a bounce, particularly with the threat of potential DKA looming. Frequent testing for ketones can bring peace of mind that he is safe while you wait. There are BG meters that check the blood for ketones as well. The strips are pricey however making just one test per day on a meter like that and using your regular meter for all the other testing would be well worth it. Much easier on the pocketbook than a trip to the ER and hospitalization. A stitch in time saves nine.

At this point being that he has a recent history of DKA I would not recommend reducing without a clear signal (BG <50 for newly diagnosed kitty). Your challenge now is to monitor closely to catch any lows you may be missing on the overnights.

From the 'hindsight is 20/20' dept.-
The 12/03/PM cycle is a good example. PMPS-489, PM+2-377, PM+3-285, PM+4-234. AMPS of 137 followed by a steady climb. It does not look like the PM+3 HC put the brakes on. Where did he go from there? That night would have been a night to continue monitoring and guiding with food. If that was not an option then leaving out some food (assuming he would feed himself) may have helped.

Regarding feeding ECID (and BK was very D) however FWIW I fed BK a full meal at PS times and mini meals (generally half of a full meal) at +4 and +8. The amount varied over the course of our journey since after the 2nd DKA he was down to 7 lbs and change and needed to regain the lost weight. When his weight stabilized a full meal was 1/2 can FF and the mini meals were 1/4 can. The schedule was the same for both AM and PM cycles. When he started (the very long trip) down the dosing ladder and guiding with food decisions where made it was always around the regular feeding/food schedule. I used a timed feeder, which was a lifesaver.

Hang in there - and hang in here. You are doing great. It's a steep learning curve under the best of circumstances. The added complication of DKA makes it a bit trickier.
I certainly was nowhere near the progress you have made after just one month following DX , however persistence prevailed. :cool:
 
Sandy and Black Kitty said:
I am intimately familiar with DKA . Early on My Black Kitty went 2 rounds in as many months. Prior to the second instance his urine went from negative ketones to large in 24 hours - he was literally at deaths door.

My $0.02-
It's possible that that last increase has put his dose higher than his needs. Even with the skip on 11/30/PM followed by a bounce and reduction on 12/01/AM, he saw green on 12/04/PM. I know it's hard to sit on your hands in the face of a bounce, particularly with the threat of potential DKA looming. Frequent testing for ketones can bring peace of mind that he is safe while you wait. There are BG meters that check the blood for ketones as well. The strips are pricey however making just one test per day on a meter like that and using your regular meter for all the other testing would be well worth it. Much easier on the pocketbook than a trip to the ER and hospitalization. A stitch in time saves nine.

At this point being that he has a recent history of DKA I would not recommend reducing without a clear signal (BG <50 for newly diagnosed kitty). Your challenge now is to monitor closely to catch any lows you may be missing on the overnights.

From the 'hindsight is 20/20' dept.-
The 12/03/PM cycle is a good example. PMPS-489, PM+2-377, PM+3-285, PM+4-234. AMPS of 137 followed by a steady climb. It does not look like the PM+3 HC put the brakes on. Where did he go from there? That night would have been a night to continue monitoring and guiding with food. If that was not an option then leaving out some food (assuming he would feed himself) may have helped.

Regarding feeding ECID (and BK was very D) however FWIW I fed BK a full meal at PS times and mini meals (generally half of a full meal) at +4 and +8. The amount varied over the course of our journey since after the 2nd DKA he was down to 7 lbs and change and needed to regain the lost weight. When his weight stabilized a full meal was 1/2 can FF and the mini meals were 1/4 can. The schedule was the same for both AM and PM cycles. When he started (the very long trip) down the dosing ladder and guiding with food decisions where made it was always around the regular feeding/food schedule. I used a timed feeder, which was a lifesaver.

Hang in there - and hang in here. You are doing great. It's a steep learning curve under the best of circumstances. The added complication of DKA makes it a bit trickier.
I certainly was nowhere near the progress you have made after just one month following DX , however persistence prevailed. :cool:
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Thank you so much for taking a close look at Webster's numbers and replying. Your response was thoughtful and very helpful.

After experiencing DKA, I don't want to go through that again and agree that a meter is going to be much cheaper than an er visit (and less stressful). Iv'e been using urine test strips but have only been able to catch him in his box every couple days or so. What meter do you recommend? I'll have to pick one up.

I see what you are saying about PM on 12/3. I should have stayed up and worked his drop. Instead, I believe that I left out some HC and LC and went to bed. It was a long day outside of taking care of Webster and had to get some rest.

I'll keep the .50u dose, and watch him closer if and when his numbers drop. As you can relate to, those high numbers are very convincing when it comes to raising his dose back up. It was likely a bit premature but I would rather raise it up and watch him closer than to experience DKA again.

Like your black kitty, Webster was near death when when took him in to the ER. Don't want that again of course.
 
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