Lowest preshot and lowest reading of all time time today! Go Gizmo! The reading at +3 was higher than AMPS. Could this be based on how much food was consumed? She ate a lot more than she normally does this morning - a can and a half over the course of an hour or more. This sometimes happens when she poops and makes some room. Do you think that’s just a post big meal #? How does that work?
I'm inclined to think that was a food bump somehow, and/or just meter variance (as in AMPS was probably lower pink, the +3 was probably lower pink so roughly flat). Again don't lose your mind over it, I know it's hard not to. But when you get an unexpected number, always good to test again. Sometimes the meters do weird things when it's not actually enough blood but it gives a result anyway, mine does that every now and then and the number is always weird. The other option is she was starting a bounce from overnight, but then the insulin kicked in and started to bring her down. Or a combination of all the above
I’m gonna start doing that. The amount of blood has varied wildly. Since we started this I have never had a problem getting her to bleed, it’s actually usually too much. So I switched to much smaller gauge lancets because the 28s were causing much more bleeding than I wanted. Now with the smaller ones, it’s a much smaller sample. I wonder if the sample gets contaminated with the Vaseline since it’s so tiny. Might be good to get the 2nd drop that comes out and retest with that.
We had a little incident tonight with the shot. She got tested, She ate, then She didn’t want to get out of her bed to come back for the shot a few minutes later. So I took the whole operation into her “room” and gave her the shot in her bed with the normal treat. She was so pissed. Growling and bucking. Got it in but not all of it. I hope this doesn’t set her on the wrong path and traumatize her with it. Thus far she’s not even paid attention to the shot because it usually happens on the kitchen counter with a snack. Boy, was she pissed. Do you guys have any thoughts on when you start to see regression with their tolerance of things? thinking today might be an outlier because I clipped her nails and she’s had enough of me touching her today. But just want to be prepared by thinking of any ideas to butter her up going forward.
It might have just been that's "her space" and she didn't want any of that...so you kind of violated her space. Shes a cat - she'll give your grief for it, then she'll get over it The only time I've had trouble is at high doses when it stings, or when he's just feeling really really poorly. But all of our stuff was always same spot. I tested, shot right after that, gave treats, then put out food
I don't want to be! I've just had all sorts of animals for years and years. Some are chill and don't care, others are... particular. If I try to test Mr Kitty anywhere near his or my bed, or his food area he gets irritated. Anywhere else, pleasant as can be
You’re probably exactly right. It was the bed. She was giving very big “at the vet and being held down” rage vibes. Lesson learned.
I’m really not loving these big swings. This morning was super high and went down to 138. I’m gonna try to stay up all night to see how the heck we get to high 4s in the morning. Ugh.
So the answer actually lies in the lead up to the low number, not after. She really isn't dropping that quickly, it's fairly nice and gradual to these low numbers. About the only thing you can do is strategically feed the front part of the curve to slow it down. It means her nadir will be higher overall, BUT it will help improve the swings and bounces (and therefore also giving you room for increases when needed). What's current feeding schedule?
Very interesting. The feeding schedule is pretty whack. I’ll try to simplify it as best I can. This is not the result of any choice I made, just what’s always been happening before the diabetes as well. 5am test and feed 1 can FF pate Eats this can all the way until 6 at shot time, grazing Shot Continues to eat after shot, often gets another half can No eating again until 2-3pm (usually). Some days it’s a little earlier at 1. I let her eat until 3 and then pick it up until 5pm test, feed, shoot at 6. Then continues to pick at that food all night until 10pm, sometimes squeezes another half can out of me around 8pm. Pick it up and leave an auto feeder snack for 2am. Sometimes get eaten, sometimes not - never all.
In other words, the front part of the curve is typically the most loaded with food, but there is that in between 1-3pm area where there’s some consumption after the *typical* nadir. Am I making sense?
Ah! This somewhat explains things! I should have double checked after food transition was done. Is there a reason for the gap between testing and shooting? Normally we do all in quick succession with ProZinc. Think of it this way - by the time preshot rolls around, the insulin is basically gone. Zero help with regard to BG, and certainly not able to offset any food. So you're essentially giving possibly 1/2 her daily food/carbs with no help from insulin, and then some again as it's starting to wane after nadir. Whereas if you fed at the same time as the shot, the insulin kicks in sooner to help lower those numbers. How difficult do you think she'll be about changing up the routine? I mostly ask because this may drastically change some numbers.
The gap explanation is purely this. When this all started (I know you probably know but it’s awhile ago and you help everyone, not just me) she was totally not eating. She started eating basically the first shot day. I refused to give her insulin until she started eating. So because of the inappetence and diarrhea and random vomiting, I was very hesitant to give the insulin simultaneously and risk vomiting or not eating at all. I was like “let me get this food in her and let it settle”. I think we are out of the woods of risking that. She hasn’t vomited or been sick or not eaten for two weeks now at least. The second half of that is the absolute hunger meltdown begins at 5. I would really, really prefer to do the shot at 5 and 5 for various reasons. Namely, that’s when she begs for big meals. I try and try to push her closer to 6, feeding small treats and playing, but the furthest I ever get every night and morning is 5:30. I think she will balk about the routine if I force her to wait - that will be a big problem. But if we do 5 and 5, she doesn’t have to wait and I can do it simultaneous. it would lessen the load significantly on me as well. I don’t have to gear up for two sep. events and it could all be done in one. Just haven’t explored changing the timing.
She also makes me nervous - when I put the plate out, she eats for a total of 5 seconds and then goes and farts around somewhere. Every time I fear she will just stop eating and I’ve already done what I can’t undo. Is it a problem if she eats that first meal throughout +1 and +2? That’s just how she is. Frantic to eat, but once it’s down she goes and does something else and works on it for an hour or two. Maybe I have had it in my mind wrong but I was thinking she should have a good full belly before I mess with it.
Ok that's what I thought! As I typed it I thought she was the picky eater/hangry cat, but there's another cat that weighs like 3.8 lbs with IBD and I thought maybe I had my wires crossed. The next day (or even better, a span of 2-3 days)you can be home to monitor (plus have strips, hypo kit stocked) - try the 5 and 5, and reduce dose by 0.25U just to have an extra buffer. Moving carbs around can be a bit like a diet change. Try the 5 and 5 first, keep everything else the same (grazing, snacks). Once we see how the 5/5 does, we can explore tweaking the other stuff. I just hope she doesn't then want a 4 and 4 schedule...
Not at all. It may take some playing with dose, but whenever possible we want to adjust insulin around how they go about a normal day. We try to make tweaks to that to manipulate the curve, but we don't want something that isn't reliable (example, sometimes we recommend a feeding at +3...if a cat wouldn't reliably eat that, we'd try to brainstorm something else) Edit: ideally you want her to eat at least a little something. You can always spread the **** back a little bit, say maybe 10-15 mins. As long as she's eaten maybe a tablespoon or so you're good. But if she's overall not wanting to touch it, or nibbling, I'd consider a one-time reduced dose
okay, just repeating so I understand. I’m always around, never leave the house. So I can start any day and have 90 something test strips and hypo kit. So theoretically tomorrow I can test, feed, and shoot 1.25u at 5? Do I need to do this progressively at all, like, test and feed at 5, shoot at 5:30 and work our way to 5? If it becomes 4 and 4, there will be a small spritz bottle of water nearby and possibly me checking into a rest home and calling it a good life. But I’m fairly confident it won’t. My husband is up at that time often and says she’s always dead asleep, upside down.
I would much prefer to work it into her schedule, too. That’s been the most exhausting part - trying to keep this same time and work around when she’s screaming at me for food. She definitely eats at least a tablespoon in the first 5 mins. I’d say by the 30 minute mark she’s eaten half the can. Then the rest goes over the next hour. I can speed it up if it’s going too slow with tiki stix toppers, too. She would eat dog **** quickly with that on it.
You could do it gradually, but honestly I'd just go cold turkey. Yes, theoretically you could do 1.25U tomorrow at 5am if you want to start then. I would probably do hourly testing til nadir if she'll let you. If you need to be strategic, I'd start with a +2 and decide the next one from there (might end up being hourly anyway LOL). Remember, all the way down to 50 is technically safe, just don't want her below that. I don't expect that much of a difference but you just never know. It may take a few days to see how the change pans out, for the new trends to settle in. Please be sure to tag me whenever you do decide to start, I'll try my best to check in. Rest home hahaha I feel that. Need a cat nanny for a few days. Good about the toppers! Mr Kitty is that way about PureBites, and these random kindfull toppers my husband picked up at Target
Okay, will tag you. Maybe tomorrow or Sunday when I get those half unit marking syringes. That’ll make that easier. And then there’s like random days where she wakes me up at 5:45 to eat. So it all ends up happening in 15 mins. She’s diabolical. My extended family calls her TDO - The Dark Overlord. Always looming around corners waiting to strike me down in a new, creative way. Mr Kitty is a black cat, too, I’m sure you get it. Thanks and I’ll let you know how it goes.
@FrostD i got the food way closer to the shot this morning. I kind of met her in the middle. Tested at 5:20. She ate at 5:30 and I shot at 5:40. We will see how that does and going to attempt to work it back to 5 tomorrow. I may need to make this a separate thread, but one consideration I wanted to just bring up in all of this. In 8 days I’m going on a mandatory work trip from the 6th to the 9th. It’ll be my husband giving 7 shots in that time period with the help of a sitter. Neither him or the sitter will be able to test. There’s no way, she won’t let them, that’s a total mom only thing. What’s the protocol for this kind of situation or do we see where we are at closer to next weekend?
Good! Let's talk next Friday (remind me lol). We do a what's called a vacation dose - a temporarily reduced dose that keeps them in a higher range. But I won't know what that is until this food schedule is done, and how she does this week. Will they be able to check urine ketones? If it'll give you a lot of stress you could also look into a Libre (I think I mentioned before I just forgot what you said about it). Downside to those is cost, and sometimes cats just end up ripping them off/messing with them enough they disconnect.
Also - she gets a bit of an unusual food bump. I'll keep an eye on it this week, but I'm wondering if she's one of a few very carb sensitive cats (as in a 1-3% difference carbs makes a big difference in BG). It's a little muddied with the schedule and meter variance at higher numbers so I'm not sure yet. Are you feeding a variety of the pate flavors?
no, won’t be able to check that either. He’s going to come home from work a few times a day to check on her and feed snacks per my schedule but will be virtually impossible for him to spend as much time as I do with her and catch that very moment she goes in the box. wish I could do the libre - talked to every vet around here and it’s a no. I live in a pretty rural town with a lot of old school horse vets.
So I just got home from Target trying to figure that out. She has been eating a mix at every meal. 3/4 3% flavor and 1/4 1% flavor. Only been doing it that way to get more mileage out of the one she likes so far. Everything is out of stock. I find a flavor she likes and I can’t find it anywhere. I go to three stores a week and it’s out - online too. I want to stick with one flavor but it’s getting tough. just got home with 10 cans of the 3% and another flavor as a backup. But I did notice when she has a bit more of that 1%, the numbers are marginally lower.
Ok. You can also use the autofeeder for snacks! Just make sure he knows signs of DKA. Another option, not sure if she'd cooperate - when I need urine sample for vet I leave empty box with a sprinkle of litter in one corner. That's enough for Mr Kitty to go in a clean box. Now the downside is if it sits too long, that changes concentration or anything in urine. No ketones is no ketones, but there's a difference between say trace and anything larger than that. You might be able to do Libre yourself... @Katherine&Ruby thoughts on her placing Libre by herself? I personally am a bit queasy about Libres (ironic isn't it, after all the things I've had to do). Just not sure how easy it is/isn't. Does she need a script for it?
Ok. The shortage is a giant pain, I'm lucky Mr Kitty is a garbage disposal. I would start adding to Remarks column just to help find any potential patterns. There's no harm in feeding different flavors, but really depends on her. Like I'd go nuts eating the same thing every meal, but some cats are just like that
I do Amazon subscribe and save, I know lots of people do chewy too...but guessing you checked those. I'm also fortunate to have many pet stores in the area though.
Awesome! Well not entirely because that's a big drop and she'll bounce, but it's still good number! It sounds like she feeds her own curve in a sense, eats when she feels it changing. Mr kitty is like that, makes it easier many times. She may just need more carbs earlier, we'll see how this shakes out. Check again 30 mins from last test if you can
I’m thinking just like you said, I moved the shot closer to the food and maybe it “caught” it just as onset started. I feel like that’s exactly what she’s doing. The bowl has a bunch of food and every 30 mins she jumps down from her bed and goes to eat some. getting another in a few
Sorry got caught up with kids. Shes good. Flat with food is good. Remember down to 50 is still safe, 40s are ok but want them out of there quickly.
There is a video on how to apply the Libre on your own: https://www.felinediabetes.com/FDMB...stration-explanations-tips-discussion.221630/ Basically, you need to get a prescription from the vet--if you can, get the prescription for the Libre standalone reader as well. It takes a few days for a pharmacist to order the reader. Take it to the pharmacy, tell them it's for a human over 18. Here is a coupon for a free sensor: https://www.freestyle.abbott/us-en/myfreestyle.html Then the challenge is getting a shaver that will give you patch of clean skin without much hair. This is what will allow the Libre to stay on. When I applied it myself last time, I did it right after Ruby was at the vet for something else and the vets shaved a patch for me. I chose to shave a patch on the side of her neck--that way, the cat can't lick it off. I also got Vet Bond and applied it to the sensor before putting it on Ruby. I covered the sensor with a Kitty Kollar. Then once the sensor konks out, you will need to rub off the adhesive of the sensor very slowly and patiently with some baby oil or medical grade adhesive remover. It's a lot of supplies to get but once you have your set up, you can do it yourself often and easily (as long as the cat is compliant ). @Tomlin coached me through the whole process as that is how she monitors her kitty all the time.
thank you for all the info! I may call my vet and see if they’d be willing to prescribe it, but I’m guessing not. Last time I asked about it I was told “that’s not really a thing”, but then again, they also told me I couldn’t test at home, so it really depends how many times I ask
This is such a common scenario unfortunately. Vets just aren't up on the latest in treating diabetes in animals. Not surprising since they are supposed to be generalists, and endocrinology is one subject of a hundred that they have to study. A quick search on the internet for "feline diabetes CGM" brought this up: https://todaysveterinarypractice.com/continuous-glucose-monitoring-in-veterinary-patients/. Maybe you can send this to your vet along with that video I linked. One of Ruby's many vets had never done it before until I asked him to, and he was so psyched when he figured out how to do it because after that he could do it for other cats and dogs who might need it. It was a good learning experience for him so he was glad to have the challenge.
@FrostD well I’m glad you had me reduce the dose…damn. 94 Edit: on the way down the hill this time, she wasn’t feeding it like she was yesterday. She was sleeping. I woke her up and encouraged her to eat at the normal time she has mid morning snacks. She’s happily eating and voracious now, but was weird how I had to wake her up this time.
Ah nice! Love green. It is a bit odd because it's basically the same sort of drop as yesterday lol she just likes her sleep! Id try feeding slightly higher carb LC at +2 (maybe 7% ish), possibly +3. I know she's fickle, but if you don't have something around 7% you could try mixing her regular LC with some MC food. Example: If regular LC is 3%, MC is 13% - that's a 10% difference. Doing half and half would give you 8%, close enough. Alternatively, if she needs more of the LC to actually want to eat it, mix in some HC. So if LC is 3%, HC is 19% that's a 16% difference. Only need 4% extra carbs so 1/4 HC + 3/4 MC. Not sure how you are with math but I can run the numbers with whatever foods you have if you can just give me %s
I have a bunch of 12-13% ones she likes. The FF grilled in gravy. I don’t want to get too wild with them just because the stool quality has been better with the LC, but she would be happy to eat them. so current is 2% per the chart, and the grilled would be either 12% or 13% based on the flavor she ends up eating.
Ah you know what, go ahead and try that. I would pull her usual food after breakfast, and leave the DM til +3.5 (or use autofeeder, that'll help sanity). Then back to LC after that.
hopefully she doesn’t stick up her nose at it - knowing her she will now that I’ll want her to like it. Is there any benefit to giving a handful of DM kibbles in the alternative after breakfast? Don’t they take longer to digest? Was just thinking maybe that’ll be like a slow release, but maybe too high. I can tell she doesn’t feel great today. Ever since that last test, she’s been kinda sitting like a meatloaf and not a great mood.
That's the way cats go The trouble with kibble is yes it takes longer to kick in ,but also hangs around much longer. So it starts to obscure numbers/trends when it's given randomly (and even when it's given consistently as the only food, patterns can still be odd). Poor girl. Is she otherwise eating ok? Drinking? Meatloaf worries me a bit, namely pancreatitis.
she perked up a little while ago and came and ate, peed and did some random bunny kicking on the stairs and darted around a corner, so I think she’s okay, but I can just tell that when she’s going through that transition from high to low to high it’s zapping her energy maybe. Do you think I should do the DM or mix in MC protocol for the evening cycle or just mornings? why did I think before a month ago that insulin was some kind of stabilizing thing….apparently not.
Go with your gut, no harm. She doesn't seem to be bouncing, if she was going to it probably would have happened already Responding to other part shortly...
I would do the food both cycles, since at least right now it seems to affect her the same way each cycle for the most part Each cat reacts to insulin differently. Some do nicely on ProZinc, others take awhile to settle in, some never do. The depot insulins (Lantus/semglee/glargine/basaglar, Levemir/detemir) are usually the most stable, but even some cats swing on those. I usually let people try to optimize on ProZinc for a month or two, then start thinking about a switch
1U, assuming you can keep an eye. 0.75U if you really want to be comfortable, I think 0.5U too low. Remember it's not linear, so just because she's dropped 200-300 pts at 1.25U does not mean the same will happen at these lower numbers.
You're in the weird in-between land, where her body wants to come down but is still fighting itself. It's a haul to get regulated, but once she is it's usually fairly smooth sailing
thank you for all your help today, I know it’s been a constant whirlwind. Idk how I would get through any of this without someone to bounce this stuff off of.
Side note, I just opened the can of DM for later and gave her like a pea sized amount to see if she actually likes it and she went nuts and is now refusing the other stuff. FML.
Hahaha hopefully it's just the newness of it, many of them get sick of it quickly. Now when you actually need her to eat it she'll turn her nose up I'm sure. And you're welcome for the help, it's why we're here
when we are admonishing her, we can add to that “Gizmo Lynne”. Cause you know, she has a middle name and all. Of course we only took two bites of the DM and it has to be administered straight from the can. Fabulous. Might have to do the 13% ones.
Without it she probably would have gone below 90. If you don't think she'll reliably eat it, might be better to reduce to 1U. Your call
I’m starting to get kinda good at predicting it a little and encouraging her to eat it, then like you said, I can get it to stay flat. I’m giving her a little break here to nap but gonna test again in 45 minutes or so. I’m just concerned that if I’m not home or next week for my trip, there won’t be anyone here to say c’mon, eat this, stir it around with a fork, bring it to her. She requires that kind of coddling. I’m inclined to reduce it to see what actually happens. As we saw last night, she didn’t go high from that .75. I’m just thinking if I can’t do so much management all the time, it might be better to restart at 1 once we get this food routine more stable and then increase from there. We’ve made so many changes these past few weeks it would be interesting to see what 1 does.
We don’t know, maybe 1 could be the right dose for now and we went past it with all the changes. Not all of this routine and food was set in at that juncture I went up to 1.5.
Going to try to make the most out of the next few days while I’m still here testing. Feeling hopeful for the first time! Will start a new thread tomorrow if no developments tonight. Thanks for checking in!
PS - just sent the vet a screenshot of the spreadsheet. “You go girl, you don’t even need me!” Glad I paid $2000 a few weeks ago to not even need you. -_- I better get whatever prescriptions I need going forward with a text message alone lol.
It's funny these are the numbers you want, but it's scary the first few times. Not a bad drop between PMPS, so just check in 45 mins or so (can always do sooner if you want, just trying to spare her ears a bit). Don't want to wait an hour just in case she's got another big drop
I know, for how long was I crying that nothing was happening and now I’m constantly white knuckling a can of high carb food.
45 mins later I did two tests cause the first one was crap blood. 101/111. She’s eating a full bowl now
Yeah, almost 2 weeks!! She’s so happy, she fell asleep on my stomach today. Haven’t seen that in years.
Today was a crap day for testing, too, but - I haven’t seen friends or gone out to eat since I had COVID in Jan and then this happened, so I took the day off work to see friends and do stuff for myself. Was really nice.
Been thinking of ways to do a little party for her - maybe an upside pate on real china with a candle LOL. I may grab her a balloon so we can watch her get frightened of it and it be a waste of money. I’ll post the party for y’all!
Ha! Oh you know what, I forgot @Katsallday volunteered to do the ProZinc and Vetsulin OTJ videos. Life got busy for her so not sure if she's still around. You're making me feel guilty I never gave Mr Kitty a party! Better late than never I guess....
Oh yeah, we gotta do it up big for this one. Her most life threatening feat yet! I think she’s past her ninth life - black cat magic.
