3/17 Sid - need advice please

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Lydia & Sid & Jake(GA)

Lydia & Sid & Jake(GA)

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Sid is not starting out his St. Paddy's day with any green :(

I updated his SS and he is starting to come down now at +6. I fed him Friskies chicken & tuna instead of his usual 9 lives because it has lower carbs, but I guess I find it strange that the Friskies has rice as an ingredient while the 9 lives doesn't. The lower carb food doesn't seem to be helping him today anyway. Maybe it is just a bounce from yesterday, but he did stay in the 200s all night long, which was very good for him!!!

He is acting hungry and keeps following me into the kitchen but he has already eaten all of his meals for the morning so I've only given him his freeze dried chicken treats - he has lately decided he will eat these again after months of refusing them. He is also still eating carpet from his anemia. The vets have so far offered no treatment and they don't agree with giving him the Jarrow B-right that some people have suggested. I'm going to talk to them on Monday and revisit this issue. Another discussion on Monday is to see if we can reduce his dose of pred to 1/2 table (2.5g) per day instead of 1 tablet.
 
Re: 3/17 Sid

Yes! He is eating carpet and then wretches. It is very frustrating. I have learned it is very common for anemic cats to eat strange things such as carpet, litter, paper, whatever. Sid is at 22% HCT while normal cats are around 45%. He isn't critically low yet but he is low. Just now he was eating a cardboard box so I had to give him a small meal of FF whitefish and tuna (0 carbs). He usually doesn't like the flaked food but he did eat this. Poor guy. I really wish there was some treatment I could give him to help with the anemia.
 
Re: 3/17 Sid

Are there any diabetic friendly foods with higher iron? Poor baby. Maybe salmon? Liver?

I have no idea, just guessing.
 
OK, if I'm reading this right, his PMPS was 304, you shot 1.5 prozinc. He did the normal climb a little right after eating, then climbed all the way up to black, and then he's dropped 300 points in two hours? When you saw that drop, you gave him some higher carb FF with gravy. And he got 50ml of fluids.

Wow.
AT first I thought it had something to do with the other meds he got at PMPS time, mainly the pred because yesterday he was in the black after pred. But other days, the pred has not done that, so that doesn't make sense. And he didn't drop that fast that cycle either.

I think you've done the right things...feeding the drop with higher carbs. But I don't understand why it happened tonight. The dose is actually .1 lower than it was yesterday, but then the PMPS was a lot lower tonight than last night. 208 is still safe, but maybe the dose needs to be more based on his preshot number? My worry is that you'll see a bounce from the yellow number. Not that it is too low, but that it is so much lower than the black number from two hours earlier. Is there any chance that the 529 was just a bad number/test strip? If you take that number out of the picture, the curve doesn't look bad at all. 304 to a food boosted 375. and then a drop to 208. That's not a bad curve. Can you check again at +5?

Carl
 
Laurie,
Help me understand....which bounce?

Carl
 
The bounce from the R Friday morning. He has stayed relatively high since then. When the bounce clears, they often come down quickly...I'm guessing this drop is from the bounce clearing.

He may bounce again from the fast drop. I hope not, but that was a fast drop...
 
I just checked him at 10:30 which is +5.5 and he is at 161. I was so worried - he's never quite had drops like this. Maybe it is the bounce clearing with the infection improving. I always give him fluids when he gets up over 400-500 and that usually doesn't make him drop.
 
Looking at Sid's numbers... they look great to me. I am still not sure why you're giving HC food. I know every cat is different, but I didn't think there was a point drop system to go by? At least, I never did that with Prudence. I always felt HC was used only if kitty was dropping below 40ish. Maybe I missed something after Prudence went OTJ and I wasn't on the board as much? I just feel that adding HC food will definitely mess with BG numbers. I will check back in the morning!
 
Michelle & Prudence said:
Looking at Sid's numbers... they look great to me. I am still not sure why you're giving HC food. I know every cat is different, but I didn't think there was a point drop system to go by? At least, I never did that with Prudence. I always felt HC was used only if kitty was dropping below 40ish. Maybe I missed something after Prudence went OTJ and I wasn't on the board as much? I just feel that adding HC food will definitely mess with BG numbers. I will check back in the morning!
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I would agree, if you take the black out, the numbers are very good. I've had meter issues that I've questioned, rechecked, and rechecked again. Perhaps when you get a high red or black, you would want to consider doing a recheck, if you aren't already.

I have limited experience w/ high or higher carb food, as Grayson so rarely goes low, but I saw Hershey climb with 1 tablespoon of Friskies Prime Filets w/ Salmon & Beef in sauce about 20 points in about 45 minutes - I gave my numbers to Libby, not sure if she entered all of them into his ss, but worth taking a peak. It would've been this past Wednesday night. Likewise, with Grayson, I gave him FF w/ gravy after he tested w/ MODERATE ketones on 3/6 between 2:52 and 4:01 am. BG went from 243 to 356! YIKES!!! The following day he went from 310 to 337 in 4 hours time. Not sure how high it actually went, but he was still coming down 5 hours later when I shot him (307).

The specific type of FF hi carb you used may make a difference as well. Grayson almost always gets the FF Classic Chicken or Turkey & Giblets. Yesterday we started tracking the type of food, to see the amt of food spike. I gave him a treat and gave him Ocean Whitefish... 0 Carbs. No food spike at all!!! If I could, I'd give it to him forever, but that's discouraged! I was blown away by how quickly HC impacted him - and how long it tended to stay in his system. (I was also questioned why I gave Grayson HC to begin with - it was because of the ketones and getting food into him).

FWIW, since his numbers aren't but so low, I think I'd eliminate the HC food... maybe use regular food when he drops, so you know what kind of spike to anticipate, cuz you want it to go up, but not skyrocket!
 
I know what you all are saying about the high carb food. I was concerned about the fact that he was dropping so much so fast so I gave him just a tsp of gravy to even him out a bit, thinking the HC would work a bit faster than regular food. I wouldn't do this for a "typical" diabetic but sid is a dive bomber and loves to just shoot on down. I was very concerned about the rate of the drop. 300 points in 2 hours? He has also spiked up over 100 points in less than an hour due to food but he did not do that this time- I'm guessing that means he had enough insulin in his system to prevent that much of a food spike.

As Laurie said, the bounce was clearing and his infection seems to be clearing and I just wanted to make sure we didn't get into a crisis if 1.5 U was too much insulin for him.... Thankfully he rose back up but not too high! I am on my way to update his SS.
 
Hi there. From one Sid to another we send you our best. We are new to the ProZinc experience ourselves so we are definitely looking at everyone's progress. I'm glad your Sid made it through ok. Looks like you got a nice steady climb after the food. Good! My Sid chomps on carpet too. Not because he is anemic though ( just had him checked), he's just a butthead. LOL But just wanted to say our thoughts are with you! I hope his numbers continue to improve. :)
 
Good morning! Sid's numbers look good. Here's the question I would be thinking to myself now, but I know this can be tricky for you since you have to leave the house to go to work and I was able to be home since I work from home. Most likely Sid will start climbing by +6, so you could either go to TID to keep him out of the really high numbers, but that also means giving 1.5 again and watching him closely around +3 (which I think is around 3pm your time?) If he stay's somewhat in the 200's and climbs towards the 300's I would definitely give insulin again. I would continue with 1.5 for at least another day to get more data.

Hope you are having a good Sunday! My other cat just started chomping on carpet as well confused_cat He's always tried to chew on plastic... you know those Walmart plastic bags. Not sure what that's all about.

Thinking of you guys! I'll check back in a bit :smile:
 
I am thinking the higher carb food was fine to give. He dropped 300 points in 2 hours. I think Lydia is trying to avoid the bounces. There's no point in going from black to green if it's going to result in three days of bounces where she has black and red numbers, and doesn't know if it's a bounce or not, and has to keep guessing on what dose to give.
Sid is better off dropping less and riding a kiddie roller coaster instead of an insane one. It's easier on him (and Lydia) if he's pink and yellow rather than red and green. She's combining the "feed the curve" from lantus with the deeper curves you get from PZI in an attempt to keep his numbers more consistent. As long as Sid remains ketone free, he's better off with milder curves.

If you look at his curves lately, he's closer to a BID than a TID routine. Maybe every ten hours makes sense? 8 hours is too few, and 12 is probably too long, but he has had some "normal" 12 hour cycles lately, at least with the nadir appears to be taking place around +6 like it's supposed to.

Lydia has just recently decided to hold off on the R unless she sees ketones. And she's been trying to do the 12 hour shot timing. And trying to stick to a dose. IMO, it makes sense to "hold" something, dose and timing, routine for a few days. There has to be some sort of constant to the equation. An equation with only variables isn't solvable.

Carl
 
@Michelle- I agree with your thinking - about giving a dose early to avoid the high numbers. He actually climbed into the 300s by 11:00 today (which was +6) so now he is HI. I'm going to give him his dose an hour early at 4 pm. I'm still doing a trial of BID because the insulin has been having a longer duration with a little bit higher dose. I don't want to get too far off track from our schedule because my work schedule isn't flexible. I just hope his bounce clears very soon. :-D
 
@Carl, I think we were typing at the same time. :-D I just read your response.
Yes, your thoughts are where I am at also. I'm trying to keep Sid to a 11-12 hour insulin schedule if possible. For me personally, I have no problem doing a TI, but when I held off on it, I realized that he was getting a pretty good duration that lengthened with a little increase in insulin. I agree that sometimes he only lasts 10 hours, but it's hard to shoot to this because eventually his dose times would be off schedule so that is why I sometimes have to hold out for his usual times. (what I wrote sounds confusing so I hope you all get what I mean)

The problem I'm still having is what I see as a delay in onset sometimes. I won't use R to counteract this as I said before unless I see ketones. It's really a challenge with Sid to keep him steady and I still don't feel I have the best feeding schedule. Sometimes it works to feed the curve early on (+1, +2, +3) and other times he needs food later in the cycle to avoid a dive. That 34 the other night I did not see coming and I kick myself for not checking him in between 9:30 and 12:30...

In my previous post I said he was HI. I should have checked because he isn't. Infact he has only risen 30 points in 2 hours - not bad... He's in the red but it's better than black. He is ready right now for his food and PMPS but I have to wait until 4 (in one hour) to avoid throwing us off too much. I updated his SS...
 
Hi Lydia, I know it's hard to go TID when you can't be home, but I really feel that Sid is a special baby :-D I think you will be fine shooting as early as +7ish or +8 to keep him from going too high. I really don't think his body is made for 12/12. If things go well and you can stay away from the R. I think the next few days at 1.5 he'll be fine. I just feel as long as you can keep him out of the red & blk.... you wouldn't have to worry as much for ketones.

On days that you may feel he will go low and you have to be at work... I would just make sure you leave out some wet food and water it down , so it doesn't dry out. I am curious where he's at right now. I had check the board while I was at Walmart, but I couldn't get to his SS. I'll check back in awhile.
 
Hi Amanda & Sid Vicious - My Sid is named after Sid Vicious also! because of the irony that is so not vicious and really the sweetest boy ever :-D Welcome to PZI I hope you and your boy do well and you will find lots of help here.


Hi Michelle, I am heading over to update his SS. PMPS was 521 and +1.5 457. For the first time ever, his ketone reading on the meter was LO!!!! :RAHCAT
 
Ya! Low readings on meter :-D I have to run out for a bit, but will check back soon!!! You're doing great, Lydia.

I feel bad that I didn't say Hello to Amanda & her Sid. Welcome to FDMB cat_pet_icon
 
...AND keep an eye on those ketones!!!

I was told by someone (maybe Nancy and Paine?) that they had 2 negative tests, and the next day HIGH - so it can creep up on you without a hint!

I noticed Grayson's eyes looked a little glassy. He never lost his appetite, although it waned slightly. The increased insulin and the fluids have kept his ketones at bay since then...

TEST, TEST, TEST!!! Best little insurance policy in a $6 bottle!
 
I was looking through some other SS and noticed that there's seems to be a 100 to 200 drop from blk to red to even yellows. I dunno, maybe it's not unless kitty is in the blue/greens that the drops even out more? Pru did some skydiving come to think of it, but I was more concern on tight TID and focused more on getting her in the blues & greens. I know Sid's situation is different. Poor baby is dealing with a lot more than I had to with Pru. I hope Sid can ride in the blue this evening. SS update please :-D

Will check back in a few hours!
 
I agree with what others have suggested on dose, I would hold the 1.5u dose for now. You may find that the 1.5u doesn't give you the duration you need to shoot BID, but I would give it a chance. If he needs TID, then you can shoot TID.

I'm so glad to see the 0.2 on the BK meter yesterday, and LO today....yippee! :RAHCAT

Regarding the PS, +1, +2, +3 feeding schedule, that was a starting point, please change it if you think it isn't working. He may do better if you shift feedings a little later. You can also make the feedings different amounts if you think that might work better, or add (or subtract) another feeding. There are no mistakes, you just need adjust things to try to make it work better. :smile: This is all experimentation.....as Carl said, it's a combination approach with PZ and feeding the curve as is commonly done in LL. PZ is harsher, a bit less predictable and quirky at times, so it may be trickier to figure out a schedule, and it may not work as well as it does with Lantus. I think you are doing a fabulous job! :-D

I see he is on the express elevator down again. Sid, please slow down....maybe you can spend more time in the blues and greens if you take your time getting there!
 
I updated his SS. Sorry about the delay on that. I had to work at home last night and I guess I was on the computer so much that I though I had updated it when I hadn't. :oops:

He is busy dropping again. I checked him right before I left for work and he was 10 points higher than the +3. I don't recall exactly but I believe it was 220. I decided to try not giving hc but regular food and see if we can avoid a spike. I will go home at 11 to check him. In 3 hours. Any suggestions to avoid these drops are welcome.
 
Hi Lydia,

I typed up a long post, and lost it...let me try again! I like how you are putting the exact food on the SS, that is very useful information.

It looks to me like the Friskies supreme supper (7%) and the chicken & tuna (6%) are good candidates for foods to slow the drop. When you see the big drop from PS to +2 like last night and this morning, I would try feeding one of those at +2. The supreme supper seems to hold him up pretty level, the chicken & tuna allows a small drop. I see you fed the supreme supper today, and it appears to have held him in the yellows. You could try experimenting with foods in that carb range (5-7% maybe) if he will eat them.

Some cats do better with a slightly higher carb low carb food, Sid may be one of them. There are many examples in LL....Gracie and Zener come to mind if you want to look at other SSs. I know they are lantus kitties, but the principle is the same. Actually, Alexia's Blue was a PZI kitty who benefited from the same sort of strategy. I'll get some links for you and edit this post.....
 
Thanks Laurie. I went home on lunch and checked. He was 243 +7 which means he stayed in yellow all morning. He really wanted some food but I only gave freeze dries chicken an just 2 pieces. Hes Benn liken the freeze dried treats again.
 
I looked up some of the foods...the 9Lives chicken is 4% and doesn't seem to spike his numbers. The FF chicken is supposed to be 4%, but they reformulated it since then, so it may be higher....the data is less clear on that food, but it also looks like he doesn't like it. What you could try is feed the 6-7% early when he is dropping fast, then go back to 4% or lower after that. The idea is to slow the steep drop, but still allow Sid to get down into normal numbers..just get there a little slower. I would use this week as an opportunity to see if the 1.5u dose can work....assuming that the ketones stay away. If the ketones start to rise, all bets are off...please post immediately if you start to see them rise again.

There are some links for Alexia & Blue are below, if you search the PZI forum you will likely find more threads if you (or anyone else) wants to explore Blue's journey further.

Blue's SS

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=21026&p=209960&hilit=alexia's+blue#p209960 Thread outlining the strategy that Hillary & Maui helped Alexia develop to slow the steep early drops.

Lydia & Sid & Jake(GA) said:
Thanks Laurie. I went home on lunch and checked. He was 243 +7 which means he stayed in yellow all morning. He really wanted some food but I only gave freeze dries chicken an just 2 pieces. Hes Benn liken the freeze dried treats again.
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I'm glad he likes the freeze dried chicken again! Do you think he is getting enough to eat? Remember that the calorie count on different foods can be very different. I don't know the calorie count on the authority food, I would compare that to what you are feeding now and increase his total food intake if need be...he's still underweight.
 
Hi Michelle, Thanks for posting the links!

Laurie, his ketones have risen to 0.9 so tomorrow I am going to up his insulin to 1.6 U. I know what you mean about the food intake. I believe he is still getting enough to eat. Tomorrow I am taking him to the vet to be weighed. I am also requesting to decrease his dose of pred.
I knew if I posted about his ketones being lo he would rise. Isn't that the way it goes???
 
I see the ketones have risen again....as Sandy says, evil ketones! :evil: I think the increase is a good idea. I had doubts that the 1.5u was enough insulin anyway. Now that you can see the effect of the 6-7% food, you can use that to your advantage if you are concerned that he may go low while you are at work. :smile:

I see you fed Supreme Supper at PS, +1 and +2...I think I would try either +1 and +2 or just +2 next time. He doesn't need the boost before then, I don't think. Just my thoughts....

I'm so glad you have the BK meter as an early warning system, it allows you to jump on it right away, rather than waiting for the ketones to show up in the urine! I want to post this link for anyone else who might want/need a BK meter, you can get a free Nova Max Plus if you fill out the application here.
 
Lydia & Sid & Jake(GA) said:
Hi Michelle, Thanks for posting the links!

Laurie, his ketones have risen to 0.9 so tomorrow I am going to up his insulin to 1.6 U. I know what you mean about the food intake. I believe he is still getting enough to eat. Tomorrow I am taking him to the vet to be weighed. I am also requesting to decrease his dose of pred.
I knew if I posted about his ketones being lo he would rise. Isn't that the way it goes???
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Hi Lydia, I am sorry that ketones have risen again :YMSIGH: Hopefully, you will be able to stay away from the R and like you suggested going to 1.6 tomorrow. Just be prepared by late Wednesday could be Thursday that Sid could go low. I am only bringing this up because of 3/15 SS. I know he was bouncing from 3/12 & 3/13 from 1.8 to R, so anything can happen. But he did have a full day an half of 1.6 before he hit the BG34.

Thinking of you guys!
 
Thank you MIchelle for noticing that on his SS. I have a hard time seeing patterns in the SS though the bounces are pretty clear. I will keep a close eye on him. I'm kind of prepared for a low number, I just hope it doesn't happen while I'm at work.
 
Lydia,

You may need to feed the higher carb food in order to get more insulin into Sid. When ketones are in the picture, the dose needs to go up, even if you have to feed HC food all cycle long to keep him from bottoming out. Ketones mean he isn't getting enough insulin...with Sid's history of multiple DKAs, you don't really have any choice but to increase the dose and feed HC if necessary.

Make sure he keeps eating, Lydia. If he gets picky, give him whatever he will eat.

When he went low (47 & 34) he was eating 2% food, wasn't he? Isn't that what you said the Authority chicken was, 2%?
 
Laurie and Mr Tinkles said:
...I'm so glad you have the BK meter as an early warning system, it allows you to jump on it right away, rather than waiting for the ketones to show up in the urine! I want to post this link for anyone else who might want/need a BK meter, you can get a free Nova Max Plus if you fill out the application here.
Click to expand...


Thanks for posting this. With Grayson's ketone issues since Feb 23rd, I don't feel like I can test enough! Hopefully the meter will help me catch them even earlier!
 
@Laurie, Thank you for posting that link for everyone!! I wasnt completely sure about the Nova Max because every control test i've run has been out of range - I've run 4 on 4 different lots and wasted a lot of strips. I called the company and they had me send back the control solution and sent me a new bottle but it made no difference. However, I tested the meter on one of the civvies tonight and got a LO so I believe the meter is relatively accurate and that Sid's LO was right last night and for some reason he is at 0.9 today.

I think that value I provided for the authority was wrong. I got it from Scheyder carb calculator. When I compared some of the values it provided to Binky's list, it didn't always match up. I feel there is some other calculation to do that wasn't provided in the instructions. I did find Binky's Excellent Carb Calculation Sheet which is an excel file, and looked up the authority chicken and it says 6%. Not sure if this is the flaked or the pate style - Sid ate the pate. This chart confirmed the 9Lives was only 4%. I attached the file...
 

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Boy, Sid loves keeping you on your toes, Lydia! I guess the question now is what kind of number will he give you at shot time confused_cat Gosh, I wish I had a magic potion to give you and fix him all up ;-) I guess depending on where he's at will determine 1.5 or 1.6 in the AM. Since you have to leave for work, if you do shoot 1.6AM just make sure you leave food out and I believe it was Laurie that mentioned to maybe leave HC food out? I know with prudence.... although when she was at only .2 I would get crazy numbers from yellow to blue to green back and forth, so all I can offer to you is that, whatever you decide... I'll be here for you guys! I know you need to stay clear of those H readings of ketones, so I see why the 1.6 is in order. Thinking of you ((((((HUGS)))))))

I do have a question when you get a chance, ok? I was just wondering why you fed HC with gravy on 3/18? I know with Pru I had to stay away from any type of gravy b/c it shot her BG up way too much.
 
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