21 Nov | Girlie AMPS 85; +6=160; PMPS 362: Still not eating

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Marje and Gracie said:
That would be logical but the 101 was at +6 which, while possible for her to nadir that early, would be atypical. But heck....nothing about FD is typical, is it? I believe I was incorrect about 187 being her nadir; I didn’t see the 113 and so it’s more likely that was her nadir and then she was on her way up.
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Oh dear, @Marje and Gracie - now I am officially confused about nadirs when on Levemir... :confused: Here are my nadir questions for all Levemir folks:

  • Is the nadir on Lev the lowest they hit in the cycle - no matter where it is - or the lowest they hit before they start to rise? So the 101 @PM+6 the other night wasn't the lowest as she still stayed in blue - so the 113 @+9 would be the nadir as it was later in the cycle?
  • I assume they can have different AM and PM nadirs...?

I think I can vaguely see a pattern developing with Girlie, but this is only week 2 of Levemir, and a lot of her cycles have been food influenced as I've been trying to either keep her from diving too quickly or too low. I hope, hope, hope that she'll start to level out at some point and stop this horrific bouncing act of hers so we can get to using lower carb food and some stability. I can dream, eh? :p

Marje and Gracie said:
Once they stop dropping fast, the goal is to teach their liver to surf with only LC food, if they need to eat. You did a good job last night getting her to stay right around upper green with no food. With Lantus and Levemir, feeding around and after the nadir (if it’s not necessary to keep them safe) slows the action of the insulin and can also put the brakes on duration. With Girlie, it might be that stopping her food at +7 works just fine as long as she doesn’t continue to drop to +12. That’s the tough part. I often had to feed Gracie at +10 because she got great duration and would nadir at +12 or after.

I hope you got some rest and she kept surfing. I’d give her a chance to clear any bounce and if she doesn’t come back down to green, I’d take that dose right back up. She needs to learn green = good!
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Great, great tips and info, Marje - thank you so much!
 
Great amps, congratulations, I think that's the lowest green you've shot:D

Hope she comes down at onset, it's bedtime here, hope I see some more nice numbers from Girlie when I look in in the morning.
 
Girlie's mom said:
Oh dear, @Marje and Gracie - now I am officially confused about nadirs when on Levemir... :confused: Here are my nadir questions for all Levemir folks:

  • Is the nadir on Lev the lowest they hit in the cycle - no matter where it is - or the lowest they hit before they start to rise? So the 101 @PM+6 the other night wasn't the lowest as she still stayed in blue - so the 113 @+9 would be the nadir as it was later in the cycle?
  • I assume they can have different AM and PM nadirs...?

I think I can vaguely see a pattern developing with Girlie, but this is only week 2 of Levemir, and a lot of her cycles have been food influenced as I've been trying to either keep her from diving too quickly or too low. I hope, hope, hope that she'll start to level out at some point and stop this horrific bouncing act of hers so we can get to using lower carb food and some stability. I can dream, eh? :p


Great, great tips and info, Marje - thank you so much!
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I’m sorry...I didn’t mean to confuse you. I can see how I did.

You are correct that the nadir is the lowest point in the cycle and so it is logical to assume that 101 would be her nadir. Also remember that there isn’t really any difference between 101 and 113 as they are easily within 20% meter variance. It just looks to me like she was clearing a bounce and so coming down fast. You gave her 14% which slowed her down but didn’t stop her before she got to 101. Then she leveled out. It’s hard to pick out the nadir when we are feeding other than LC food. Yes, they “can” have different AM and PM cycles and nadirs but usually once they settle into an insulin, you more see the nadirs change with dose requirement and that can sometimes, in some cats, be a clue as to whether they are getting ready to earn a reduction. What I observe is that often the difference between AM and PM cycles isn’t so much where the nadir is as that cats, typically, prefer to go low at night. But then they might switch it up and have the lower cycle during the day.

Pls let me know if that info is even more confusing.
 
She didn't have a bad day as far as numbers go, really, but she didn't eat: she had 1 tsp max of food today and doesn't want to eat again tonight. This is day 2 of not really being interested in food and iffy on the days before.
  • Cerenia: She's had 8 mg of Cerenia today.
  • Ondansetron: I have to wait another hour before I can try the Ondanestron as I already gave her the Phenobarbitone and the Cisapride after her shot.
  • Mirtazapine: I'm reluctant to give her the Mirtz as she clearly isn't feeling so well.
I'm kicking myself for giving her the injection tonight. I desperately need a full night's sleep, and I was planning on perhaps not giving her a shot tonight or a reduced dose just so I could sleep without worrying, but then I went on automatic pilot and gave her the injection, and now she won't eat! Sigh...:banghead:

I'm going to have to take some selfish days coming up the rest of this week and over the weekend; not sure how this will work for her. But I have to revise my CV and get my job applications in over the weekend, as well as prepare for an interview on Monday, and I can't do all of that if I can't think - and I can't think if I can't sleep. I feel horribly guilty about this, but I have to try to keep my job, as well. I have a feeling this reduction probably won't hold, so I'll either have to leave it not holding or do a BCS. Any other thoughts on this? Oh, poor Girlie...
 
Girlie's mom said:
But I have to revise my CV and get my job applications in over the weekend, as well as prepare for an interview on Monday, and I can't do all of that if I can't think - and I can't think if I can't sleep. I feel horribly guilty about this, but I have to try to keep my job, as well. I have a feeling this reduction probably won't hold, so I'll either have to leave it not holding or do a BCS. Any other thoughts on this? Oh, poor Girlie...
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You have to do what you have to do. Just remember you are doing the best you can and much, much more than NOTHING! :):bighug: Our kitties are more resilient than we give them credit for. As long as she isn't vomiting I would give the Mirtz after you give the Ondansetron (and Cerenia if you have it) but I would wait an hour or so to give the Mirtz after the others. Maybe stagger them by 30-60 min apart with the Mirtz being the last given.

Be sure to sneak in a ketone test or two.

I guess I missed what is going on with your job (if you posted it) - but good luck. :bighug:

Girlie, you need to help mama right now, she needs a bit of a break from your drama. :cat:
 
Girlie's mom said:
She didn't have a bad day as far as numbers go, really, but she didn't eat: she had 1 tsp max of food today and doesn't want to eat again tonight. This is day 2 of not really being interested in food and iffy on the days before.
  • Cerenia: She's had 8 mg of Cerenia today.
  • Ondansetron: I have to wait another hour before I can try the Ondanestron as I already gave her the Phenobarbitone and the Cisapride after her shot.
  • Mirtazapine: I'm reluctant to give her the Mirtz as she clearly isn't feeling so well.
I'm kicking myself for giving her the injection tonight. I desperately need a full night's sleep, and I was planning on perhaps not giving her a shot tonight or a reduced dose just so I could sleep without worrying, but then I went on automatic pilot and gave her the injection, and now she won't eat! Sigh...:banghead:

I'm going to have to take some selfish days coming up the rest of this week and over the weekend; not sure how this will work for her. But I have to revise my CV and get my job applications in over the weekend, as well as prepare for an interview on Monday, and I can't do all of that if I can't think - and I can't think if I can't sleep. I feel horribly guilty about this, but I have to try to keep my job, as well. I have a feeling this reduction probably won't hold, so I'll either have to leave it not holding or do a BCS. Any other thoughts on this? Oh, poor Girlie...
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We can’t take care of our babies if we don’t take care of ourselves so it’s not being selfish by trying to get some rest and prepare for a job interview. Just think of it as doing something else that will benefit Girlie.

Are you able to syringe feed her if you feel the nausea is addressed? When Gracie started showing signs of her IBD/lymphoma and had occasional times of inappetance, she easily let me syringe feed her so I could get all her calories in her and I didn’t have to worry about whether I could give her insulin or not. I also found that the more I could keep something in her tummy, the better she felt. I also used the SEB and George’s aloe vera slurry as well as cerenia and ondansetron and it all worked well. By being able to syringe feed her, I never had to give her any appetite stimulants.

Vines for you both. Don’t worry about the dose right now....focus on resting and doing what you need to do.
 
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