3/17 advise please Baileyuk AMPS 162 (9) +6 61 (3.4)

[BaileyUK]

Thanks everyone for your advise on the amount of bg testing I am able to do on Bailey,I fully understand where you are all coming from on the issue of not being available to test through the night,and the possible dangers,and appreciate your concerns.Baileys numbers have continued to drop again today, AMPS 162 + 6 61 I have rearranged and now will be able to bg test him at +4 after the PM shot,what you call a before bed test.(this will be on a regular basis) Taking into account his present low readings would this give me enough information at ( at +4) to be able to see what his numbers would be doing through the night? I know these numbers are good,and it would be a shame to lower his dose,as he has been doing so well for the last month (no pinks!!) but these previous two days numbers have made me slightly nervous,if you don't think testing 4 times daily is sufficient to keep him safe,do you think I should drop his dose slightly?
To you all that helped out on Saturday and kept an eye on us many many thanks.
Thank you Julie for checking back on us yesterday.

Diane

 

[Chris & China (GA)]

Hi Diane!!

Let's see where he is at +4, but if it were my cat, I'd set an alarm if I had to and get at least one more test in. Since the nadir is usually about +6, and he's so close to 50 (2.8) we don't want him going too low

If he does go below 50, he'd "earn" a reduction of .25, but right now, he's in good, pancreas healing numbers. The concern (again) is that he could continue to drop since most cats go lower during their nighttime cycle.

You might want to go ahead and give him a teaspoon of his regular, low carb food. See if we can get him to level out some

 

[julie & punkin (ga)]

yes, i think that would probably work out fine.

one tool that could really be helpful in your case is a timed feeder. I used the PetSafe 5 comparment feeder - when i get back from work i can find a link for you. You could get in the habit if leaving food for Bailey during the night, and even during the day when he isn't being tended.

i don't think you'll be sorry going this route - i mean trying to manage the lower numbers. for whatever reason, cats seem to only flatten out when they are in the lower ranges. trying to keep them below Renal threshold without having high numbers is very hard to do - their range is too broad and full of highs and lows. getting the overall range down allows you to flatten the numbers out somewhat and Bailey's going to feel great with that.

gotta run to work. have a good day!

 

[BaileyUK]

Thanks Chris for your support and advise.
Julie when you say " you think that would work out fine"are you referring to testing PM shot at +4 being sufficient.
,or lowering his insulin dose?

 

[Anne & Zener GA]

Welcome to LL, the best place you never want to be. ;-)

We make some little frozen "meat-cicles" in a small ice cube tray, and we put these out at night (or during the work day) in an auto feeder or in bowls near by our sleeping FD kitty. If your kitty is a good "self-feeder" this may work and keeps the food fresh and tasty. Well, that's what the cats tell me..about the tasty part.



A nice thing about freezing the food, we don't waste as much food anymore. We can freeze leftovers! :razz:

 

[BaileyUK]

Anne thanks for the tip,I have some freezing now!
I don't seem to be able to post Baileys numbers onto his ss , so here they are. PMPS 158 (8.8)
+ 4. 167(9.3)
Bailey has been on good form today,he must be feeling better being in such low numbers throughout the day,the nadir reading made me worry about how low he would go tonight,so I lowered his PM shot to 4.25 hope I did the right thing,I looked at the stickies and it said at those numbers to decrease the dose by 0.25 to 0.5 ,so this is what I did.

 

[julie & punkin (ga)]

sorry - nothing like trying to post and run to make the post be unclear!

i meant the testing at +4. If you can figure out a way to always leave food out for Bailey if you test at +4 and he's lower, that would be good.

I think i would suggest a combination of tactics.

-being able to see his daytime low point becomes even more important so we know about how low a dose is getting him

-even though we don't normally adjust doses based upon the preshot, you may need to reduce your evening shot if you see a lower number in order to keep him safe. it's not ideal, but i think it could be a workable solution.

-having food be available for him during the nights.

will he eat it all up the moment it's put down, or do you think you could count on him making it last for a while? if he's a "eat it all up" kind of guy, a timed feeder might be a good option. that releases the food at preset times. The frozen catsicles are another great option. Some people will do some small ones like Anne is suggesting along with a combination of larger ones in a muffin tin. Then they will thaw at different rates. A really hungry cat might eat them frozen though, and that defeats the idea of feeding them over a period of time.

For example, if you check him at 10pm (let's just say that's +4) and he's at 100, I would set the timed feeder to rotate and open up a food compartment at 10:30, 11:00, 11:30 and midnight.

I'm going to get some more ideas on your situation and will ask a couple of others to come and comment. many brains can make better ideas, sometimes!

 

[julie & punkin (ga)]

by the way, diane, i meant to respond earlier to your comment about him being on insulin for 14 months and that you don't expect him to go off of insulin.

we have had cats go off even 2 years after diagnosis. it's most common in the first months post-diagnosis if the cat can immediately get tightly regulated, but it definitely does happen later. What we see is a person increases the dose until the dose can finally "click" and the cat's blood sugar begins to even out, the bouncing stops, and then the cat begins going down the dosing scale.

It may be that whatever the underlying reason that caused the cat to become diabetic has resolved - they're now on low carb food, perhaps their pancreatitis has resolved, they've lost weight or become more active, or perhaps they had an infection that's now been treated and healed.

what i see on Bailey's ss is that his bouncing is greatly reduced. his body has gotten accustomed to blue and green numbers. he's not having the high highs anymore. so . . . SOMETHING is getting better. it may be that he's gotten to a good dose. that can take a while, but he's definitely doing better.

i think your efforts are for a good cause and you are seeing good results.

 

[BaileyUK]

Julie thanks for your comments,yes he will scoff his food as soon as it has been put down,but today he didn't always finish what was in his dish,this is the first time in over a year he has not polished the lot off in one go,am sure it must be because we have had a day of such good numbers,and I'm sure he feels more his old self.I will sort out a timed feeder,that is the easy! Now for the more complicated question of when I see a low numbers like today ,(you say about reducing his evening shot) do you mean two different doses AM different to PM? Looking at his numbers of today knowing my circumstances what would you have done? Sorry if I am asking too many questions,you must be tired after working,and helping us needy out on the forum! Just want to give B the best chance I can to make him feel better while keeping him safe.
Many thanks Julie. D

 

[julie & punkin (ga)]

i don't mind you asking questions, diane. all of us here are volunteers, and we've all been in your shoes trying to figure out how to take care of our kitties. how else can one learn?

i quickly became "hooked" on wanting to know what punkin's blood sugar was doing and i soon began to test quite a bit. i tested a minimum of 5 times every day. i always did preshots, then i pretty much always did a +3. I learned that with punkin, the +3 at both am and pm was like an arrow indicator pointing which direction the cycle was going to go. During the day i also got a +5ish, because his nadir was around +5.5 most of the time.

At night, i checked the +3 and unless it pointed low, i didn't test again.

each cat has its own pattern of cycles, but that was what worked for me with punkin. If he was pointed low, i tested and took care of him until he was past his nadir, both am and pm.

punkin also had acromegaly, which sometimes influenced what i did and how i managed his blood sugar. he also had a number of other medical issues and treatments that sometimes changed what was going on and how i managed him. he had 7 anesthesias over all of his stuff.

so . . . asking what i would do is not necessarily going to help you.

knowing how Lantus works, it's not ideal to have a dose change regularly. the numbers tend to be the most stable when the dose is consistent.

i'm not suggesting you drop the dose at every pm shot. i'm just saying if you can only test at +4, it would be better to have his numbers go up than it is for him to get too low and be unattended. i think it's a reasonable choice for you to reduce a dose when you are faced with a low preshot number and aren't going to be able to monitor him.

as far as his appetite, when his numbers are lower that means that the nutrients/energy from what he is eating is getting into his cells to nourish him. whenever you see high numbers, that means the glucose (energy) is floating about in his bloodstream rather than being able to get into his cells. his appetite should be better (more normal) when his numbers are lower.

does any of that help?

 

[BaileyUK]

If I had a PMPM say in single figures,and decided to lower dose,by how much should I lower it by? If the next AMPS his numbers are back in double figures what should I do? Keep at the reduced dose or take it back up? Also if I adjust a dose, am I right in thinking it has to be adjusted to the same amount at both ends of the day? I find it a little confusing as the reduction won't become effective for a few cycles,so it won't be helping the immediate problem,and as we know B could be back in higher numbers the next day.
Many thanks Julie, Diane