3/20 Checkers +12 134 +12.5 117 dosing help

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Checkabunny

Checkabunny

Member Since 2011
Checkers' history is that he has a late nadir and according to one of the stickies I need to get used to shooting him low -- only do I do the full amount or a skinny amount? I'm already 30 minutes late. I have begun, as of last night, to introduce vitamin fortified whole ground cooked foods. Can some please advise? He's also coming off a bounce.
 
what does your day look like? are you able to get spot checks at +1 and +2 & stick around if needed? do you have supplies... karo, test strips, HC food, if needed?
 
Yes, I've got all day to be with him and all the supplies.

Something else seems to be going on. He didn't seem to be able to use his box at all yesterday, and now is finally "clearing himself out both urine and poop, that's good. But his stool was a little slimey and I just saw a little blood. Not sure what to do.
 
I'm thinking shooting low --- 1.0? Should I test again and do it? His history has been to turn back up after about 14 hours on his most super late nadirs.
 
not sure if DM is known for constipation... though it is possible. you should look into a probiotic (Fortiflora is a popular one) to help ease any tummy issues as you switch foods.

as for shooting.... lemme look at your ss. brb
 
Thanks,---- don't think it was constipation.....may have been....except he wasn't voiding either. His neuropathy has been getting worse by the day where he just wasn't able to walk by last night. Tried to jump on the couch and made it about an inch off the ground and fell back down. I was thinking that was why he wasn't going at all.
 
Hi, the change in diet may be effecting his elimination. Don't know what to say about the blood in his stool. Perhaps you should have your vet check him out this coming week, or perhaps it was just something that scratched. Keep an eye on it. The neuropathy issue is troubling. Definitely get that checked out.

I can't advise you on your dose. I don't know enough and you have only been at this for a short time and need someone more knowledgeable to look at your spreadsheet. I do observe, however, that you have been jumping around in dose. I think you should stick with a dose for the required number of cycles. Lantus needs consistency and all the inconsistency in your dosing is having an effect on Checkers' shed.

Good luck today, Checkers is in safe numbers, having cleared his bounce, and I suspect that he will remain in safe numbers, but get frequent checks today just to make sure.

Ella & Rusty

p.s. If you want to feed half canned food, why don't you pick something other than Purina DM. See Janet & Binky's lists of canned food (in the "New to the Group" sticky). DM is, as Sienne says, "junk".
 
Oh good, Christie you use the custom raw food from Dr. Lisa. Is what's happening with the stool from my introducing the Whole food? I did speak with the people at Woody's yesterday and looked on their labels and they are vitamin fortified. I had read that the slimey stool could be a sign of detoxification. What do you think?
 
Looking at your spreadsheet, it is hard to tell what Checkers is doing because you've just started doing the same dose am/pm very recently. Checkers shed is likely still processing all of that. Personally, because you are available to monitor Checkers all day, I would go ahead and shoot the full 1.5u. At this point, you're shooting late, which acts as a decrease anyway. And 117 on a human meter is a safe number to shoot. At this point, if you skip or shoot a reduced dose, I think it will just continue to make things wonky with Checker's shed. We want to get him to consistency ASAP.

Take a look at Willie's spreadsheet. There is a day a little over a week ago when I shot 2 hours late, then had to make up for DST. Even though he'd been super regulated to that point, it set off a chain of events that got his shed all wonky, and we're just now getting back to normal. Consistency is key.

Just remember that if you do shoot, your PM shot will be 12 hours from the time you shoot!
 
I agree re DM being junk. I was going to pick up some of the Merrick's (from that list) but really want to go to the whole foods and figured I'd slowly switch Checkers off the DM and on to the whole food cooked, then raw if he'd go for it.

So you think shoot the full 1.5?
 
How about retesting at +13? Checkers doesn't always have a late nadir or what may seem to be a late nadir may be an artifact of shooting uneven doses at AM and PM times. This could be the lowest number you've shot and I'm reticent to say go ahead and shoot a dropping number. I'd like to see this flatten out a bit more before you shoot.
 
I checked his numbers one more time before shooting and they had begun to rise +13 was 138.

The blood I'm seeing is when he tries to pee. He's obviously in discomfort and I just saw very red little urine drops. Do I need to get him to the ER? Is it his kidneys? A bad UTI?
 
I would get that checked out ASAP. It could be a UTI or it could be crystals, especially if Checkers is straining. Boy cats have badly planned plumbing and it's best to have a vet see him. If it's a UTI, it's best to get Checkers on an antibiotic before his numbers go haywire. Also, make sure they do a cytocentesis (use a needle to collect a sterile sample) and have a culture & sensitivity (C & S) done so you know that Checkers is on the appropriate antibiotic. It will take a couple of days to get the results from the C & S.

(Re. the stools: When I switched the kitties to raw, Gabby had loose stools for a bit until her system adjusted.)
 
Poor Checkers has already been through the wringer plumbing-wise. He had the crystals so badly 6 or 7 years ago that he had the surgery to "correct" his plumbing. That's when they put him on that awful c/d stuff that when his diabetes was just diagnosed, they said was very fattening! Can't win! Thanks for help and advice --- going to try to find house call vet a friend told me about. If can't, I guess it's to the ER. That would make sense that's what I'm seeing.
 
Not much --- oh no! There isn't any more than can do for him if it's crystals --- they've already done all there is that can be done by surgically altering him so he was larger and couldn't get obstructed -- supposedly.
 
Tess had a similar problem just before christmas . The ER treated her w/ antibiotics, but according to DR. Lisa it is often not an infection so get the C&S done if they can. Tess didn't have enough urine though. And since they started her on ABs right away our regular vet said it wouldn't do any good to do it the next day.

It is often painful so ask for pain meds. They also recommended Cosequin, it helps bladder inflammation as well as joint problems.
 
Just got back from LONG time at ER vet clinic. Very good news for us -- there was blood in the urine but it's only a uti -- no crystals! There were so many emergencies going on that they had to call in an extra vet who was fantastic -- explained a lot re utis and diabetes. We just started him on Clavamox and will now recheck bg, but he's very alert and active -- not outwardly looking like an bg problems. (Was emotionally difficult time watching all the other beans and why we had to wait so long was due to so many animals dying and being put down.)

Since I dosed Checkers an hour late this morning, is there a way, and when to start, to wean us back to our normal time without causing his levels to go wacko?
 
ok good to see the update (please remove the 911 when u can k?)

as for shot, you can move in 15 to 30 minute increments to get back on schedule, to be on the BG safe side, you could try 15min increments, will that mess up your monday morning schedule? (work/school?)

As Sienne mentioned earlier, did they do this?
Also, make sure they do a cytocentesis (use a needle to collect a sterile sample) and have a culture & sensitivity (C & S) done so you know that Checkers is on the appropriate antibiotic. It will take a couple of days to get the results from the C & S.
 
Checkers is at 90, +6. I asked for the cytocentesis and they're doing a culture, so will call. They said to start him out with a broad spectrum antibiotic for now (clavamox) to get inflamation down. Said Clavanox shouldn't interfere with the blood sugars or insulin -- is that right?

Tess, interesting about the chondroitin -- I figured Checkers is so reactive to carbs in any hard type food, snacks included, and that I'm probably shooting myself in the foot giving him a treat every blood draw that just raises his sugars and doing many blood draws. So found an interesting treat that he seems to like -- and started using that last night -- it's small strips of dried chicken breast with glucosamine and chondroitin. He loves it and I figured it's better for him than the dry hard treat. So that should help with this too?

I'm fried, gave Chex some more food and am going to get out for a little bit. Not too worried about his numbers even though they're where I'd love to see them stay. Won't be gone long.
 
Thanks -- didn't realize I could remove the 911, went in and did that.

Yes, that will set me back late at work, but I've got a pretty mellow boss who knows what it's like to love a pet and want to do the best for him. I'll explain. At least I don't have an early morning meetings to worry about.

Yes, asked for the cytocentesis and a long culture to know if we're on the correct antibiotic.

This vet said that the meaning of diabetes mellitus is "sweet urine" and that when a cat is over about 250 for very long, it starts kicking off the sugars into the urine which then makes a ripe environment for the uti. He checked Checkers' ketones for me and explained that as well. This vet was really a blessing as my regular vet doesn't know much about diabetes at all (which she even told us).
 
Checkabunny said:
Checkers is at 90, +6. I asked for the cytocentesis and they're doing a culture, so will call. They said to start him out with a broad spectrum antibiotic for now (clavamox) to get inflamation down. Said Clavanox shouldn't interfere with the blood sugars or insulin -- is that right?

Tess, interesting about the chondroitin -- I figured Checkers is so reactive to carbs in any hard type food, snacks included, and that I'm probably shooting myself in the foot giving him a treat every blood draw that just raises his sugars and doing many blood draws. So found an interesting treat that he seems to like -- and started using that last night -- it's small strips of dried chicken breast with glucosamine and chondroitin. He loves it and I figured it's better for him than the dry hard treat. So that should help with this too?

I'm fried, gave Chex some more food and am going to get out for a little bit. Not too worried about his numbers even though they're where I'd love to see them stay. Won't be gone long.
Click to expand...


hmm, that sounds like sugar...have you seen the freeze dried treats out there? Halo and PureBites are a couple of brands, just pure meat (chicken, beef, salmon, and cheese too) with no added ingredients, here is a link on low carb treats: Low Carb Kitty Treats

whats the name brand of treats you have?
 
i couldn't find appropriate treats here locally that weren't dried (which he won't eat), so per someone's idea, i boiled a chicken breast, cut it into 1/4"x1/2" bits, froze most of it and give one treat at a time. too small to do any damage and he loves it.
 
Ronnie, no, hadn't seen those. Will follow up on that.

I kept the packaging and it says "no added sugar" besides a long list of other "no addeds". It also says the ingredients are chicken breat, vitamin E supplement, flaxseed, glucosamine hydrochloride, chondroitin sulfate. Bad stuff? I didn't even think to look out for sugars. It's kind of like kitty chicken jerky -- and I'd thought about it, beef jerky is full of bad stuff for people.
 
glucosamine hydrochloride - I googled it, it looks like salt??? I'm no scientist, but I thought glucosamine was sugar... :lol:
maybe, anyway, thats too many "other" ingredients for me, lol.
next time you're at the pet store, look for the brands on the link I gave you.
stick with chicken if you can, sometimes beef treats can upset tummies.
cooked chicken breast works too (with no seasonings!)
 
I guess I was still thinking the "easy" route and finding a packaged thing. It makes sense to cook my own chicken, cut into bites, and freeze. I had started with real chicken --- makes sense to go back to it as treat. Oh well!
 
These treats are on that link -- Catswell, and you click on it, it shows the Happy Hips. But salt isn't good either! :lol: I should have guessed something was wrong if both Checkers (food -- my favorite) and his brother Fluffy (who is finicky) aggressively like them.

The specialty food store had freeze dried mouse bites for treats. That was more than I could stomach though --- I thought -- I'd have to touch that. I can cook a chicken breast and cut it up and freeze it so it lasts as treats. I guess that's probably best. :YMSIGH:
 
I'm glad you went to the ER, even if it was an ordeal. The Clavamox should be fine unless they find that they need a more specific antibiotic once the results of the C & S are back. I think it's probably better to start something and not have to deal with the effect of the infection on BG levels.

Happy Hips are fine. The glucosamine/chondroiten combo is a supplement that is used for joints (e.g., arthritis). I've given Gabby Happy Hips. If Checkers likes the jerky style treats, Wellness makes a jerky treat, as well. They're a favorite here, as well. I doubt that you're "over salting" your cat!!
 
:lol: its been a while since I actually looked at the treat link, ohmygod_smile time to update my link notes :lol:
glad you got more input thou, hope your night is going well!
 
Thank you --- yes, now that the blood crisis had mostly passed!

Should I start a new post to ask my now question? Checkers is doing a nice slow rise -- heading into about an hour away from his pm shot (which is the late time to match the late shot this morning). His number at +10 is only 124. Shoot the 1.5u again?

When can I start tapering him back if his numbers warrant it? And what kind of numbers warrant that? (or should all that be a new post?)
 
yup you are in the right spot, one thread/condo per day per kitty, AMPS & PMPS stay in the same thread, you just update your first subject line as you go.

giving you a bump for feedback on the dose
 
Nope - you ask your question in Checkers' condo from today (one condo per cat per day).

Now I get to be teacher -- remember to read the sticky notes. The guidelines for when to increase and decrease dose are in the tight regulation sticky.
"General" Guidelines:
* Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

* Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

* Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Reducing the dose...
* If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

* If an attempted reduction fails, go right back up to the last good dose.

* Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...

So, you don't get to reduce the dose until Checkers' BG drops below 50.
 
Thanks teach! :smile: I knew I'd read something, but forgot where. Ok, but some questions on the reducing. When the time is right to go down, is it both AM and PM at same time? And what about worrying about hypoglycemia?

So, with my newest "worry" (I do worry alot lately :sad: ) with a 124 at +10 (it is on a gentle rise), I shouldn't need to worry abuot hypoglycemia? Just shoot the normal 1.5?

And should I be changing my subject line?
 
The dose is the dose. That said, if Checkers earns the reduction in the PM cycle, typically you reduce the cycle after the reduction is earned and the new dose is carried forward. There is an exception to that rule when a cat bounces high but we'll cross that bridge when we get there. The new (reduced, or increased dose for that matter) is what you shoot both for the AM and PM cycle.

The best defense against hypoglycemia is your meter, a supply of strips, and a stockpile of HC food. There is a difference between low numbers and symptomatic hypoglycemia. Because we encourage you to test and to know your cat, very few people have had a cat experience a symptomatic hypo. All of us have cats who drop into low numbers, though, and they are just fine. If you take a look at Gabby's SS, she earned a dose reduction on the evening of 3/17 by dropping into the 30s.
 
But why did you drop from a 1.5F to a 1.?. Isn't a dose reduction 0.25 or is that what the F was meaning? I see what you mean about the numbers -- I'd be excited to see that much green for Chekcers. So even though Gabby had nice low numbers, it wasn't until dropping below 40 that earned her the dose reduction?

And since Checkers looks perky and happy (still neuropathy legs though) in lower numbers, that's where I keep him -- and the perkiness is where you mean don't necessarily go by the numbers alone re hypoglycemic. If he's acting fine and no symptoms, be glad but vigilant? How do you live a normal life and go to work?

Well, getting close to going to bed and getting a new condo tomorrow if need be. Hoping for a restful night and a better tomorrow!
 
Gabby is a longer term diabetic so she has to drop below 40 to earn a reduction like you noted. Because she doesn't hold reductions well, I shave her dose rather than take the full 0.25u, even when she drops below 40. Here's the big however.... I am very confident in my ability to manage her numbers with food and I'm a testaholic. I would never suggest to someone new or who is not good about getting tests or who has limited experience with using food to manipulate the curve to take less than a full reduction. Safety is the first and foremost issue.

Glad but vigilant is a good way to look at it. You'll start to notice little things when Checkers' numbers are running low. Gabby will follow me to the kitchen. Her coat feels different when she's below 150. As far as my schedule, I've organized my schedule at work around shot times. I get up early to shoot and I'm able to stick around home for a few hours to monitor (since Gabby typically drops early -- or gives me signs that she's going to drop). I also won't work late. I can do a certain portion of my work from home, as well.
 
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