? 4/16 MILLIE Post DKA, AMPS 161 (AT) URGENT: What to do?!!!!!

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Sylvia & Millie said:
We are out of town and the care taker just sent a text saying Millie's AMPS BG is 161!! I told her to give her food with gravy and retest in 15 minutes but her shot is due in 20 minutes. Should e reduce the 1.5 u for now? She is post DKA twice.


http://www.felinediabetes.com/FDMB/...ka-amps-490-at-5-332-9-400-new-bounce.176119/
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If you were at home to monitor you could probably stick with the 1.5 u. Not sure what to say in this situation other than do what's safest and that would be to reduce. When are you going back home?
 
We are getting back later this evening. I was thinking of reducing to 1.0 but don't know if that's too much of a reduction?
 
Sylvia & Millie said:
We are getting back later this evening. I was thinking of reducing to 1.0 but don't know if that's too much of a reduction?
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Could the sitter give 1.5 u and leave HC food for Millie? Or come back mid day to test and/or feed HC? Do you use a timed feeder? It would be best not to reduce insulin too much after two DKAs.
 
Kris & Teasel said:
If you were at home to monitor you could probably stick with the 1.5 u. Not sure what to say in this situation other than do what's safest and that would be to reduce. When are you going back home?
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Kris & Teasel said:
Could the sitter give 1.5 u and leave HC food for Millie? Or come back mid day to test and/or feed HC? Do you use a timed feeder? It would be best not to reduce insulin too much after two DKAs.
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Kris, thanks so much for always reposting to my posts. It's nice to feel supported!

Yes, the care taker (who we are using for the first time) gave her HC food and will test her again in a few hours. Then we'll take it from there.
 
Sylvia & Millie said:
Kris, thanks so much for always reposting to my posts. It's nice to feel supported!

Yes, the care taker (who we are using for the first time) gave her HC food and will test her again in a few hours. Then we'll take it from there.
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Good plan. So she's giving the 1.5 u dose?
 
Sylvia & Millie said:
I told her to give her food with gravy and retest in 15 minutes but her shot is due in 20 minutes. Should e reduce the 1.5 u for now? She is post DKA twice.
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When your sitter rechecks the number is going to be food influenced by the gravy.
At 161 she is safe and gravy wasn't needed, a better strategy would have been to withhold food and see if she is rising in 20 min, that way you can tell if she was still dropping or if in fact that 161 was her on her way up.

Even if your sitter shoots a reduced dose, the first part of the cycle can still play out as if you gave the full dose.
Can your sitter leave higher carb food out for Millie in an autofeeder.
If Millie is currently not having any other issures, ie she is eating, acting normally, no infections you could get the sitter to shoot 1u, and leave higher carb food out for her to snack on for the early part of the cycle. +1 through to +5. Then take the dose up to 1.5u tonight. The problem with that choice and DKA in the mix, is that it might not be enough insulin and we don't want to court another DKA episode, and she will likely still have a similar cycle.

Can your sitter possibly get a +1 and or +2?


If it weren't for the history of DKA as you are out of town skipping would be an option, but I don't like that choice in Millie's case.
 
Gill & George said:
When your sitter rechecks the number is going to be food influenced by the gravy.
At 161 she is safe and gravy wasn't needed, a better strategy would have been to withhold food and see if she is rising in 20 min, that way you can tell if she was still dropping or if in fact that 161 was her on her way up.

Even if your sitter shoots a reduced dose, the first part of the cycle can still play out as if you gave the full dose.
Can your sitter leave higher carb food out for Millie in an autofeeder.
If Millie is currently not having any other issures, ie she is eating, acting normally, no infections you could get the sitter to shoot 1u, and leave higher carb food out for her to snack on for the early part of the cycle. +1 through to +5. Then take the dose up to 1.5u tonight. The problem with that choice and DKA in the mix, is that it might not be enough insulin and we don't want to court another DKA episode, and she will likely still have a similar cycle.

Can your sitter possibly get a +1 and or +2?


If it weren't for the history of DKA as you are out of town skipping would be an option, but I don't like that choice in Millie's case.
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She already gave her the 1.5. We didn't know what to do and I didn't want to wait too long to have the shot given because it would influence the next round. She will leave food and come back at +3 or +4, she will not be available otherwise. I should be home by +7. So there will be some monitoring.
 
Sylvia & Millie said:
I can ask her to do +2 OR +4. I guess it should be +2?
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I'd go for a +2, that way you can intervene early should the cycle be particularly active.

As she has already given HC, you would expect that +2 to be significantly high from a HC food bump, if the +2 is lower or about the same as PS then that would indicate a pretty active cycle and I would err on the side of caution feeding some HC (because no one can monitor till +7 when you are home), the good thing with HC wet is that it get's out of the system quickly, but that also means that some HC snacks should also be left for +3 +4 +5 should that +2 be lower or the same as PS.
If the +2 is quite a lot higher than PS, ie in the high yellows and it looks like Millie is headed for a bounce then you could get her to leave some LC snacks out instead.

BTW what was the PS in the end? Did she shoot that 161? or did she get another test 20min after she fed and shoot that?
 
Gill & George said:
I'd go for a +2, that way you can intervene early should the cycle be particularly active.

As she has already given HC, you would expect that +2 to be significantly high from a HC food bump, if the +2 is lower or about the same as PS then that would indicate a pretty active cycle and I would err on the side of caution feeding some HC (because no one can monitor till +7 when you are home), the good thing with HC wet is that it get's out of the system quickly, but that also means that some HC snacks should also be left for +3 +4 +5 should that +2 be lower or the same as PS.
If the +2 is quite a lot higher than PS, ie in the high yellows and it looks like Millie is headed for a bounce then you could get her to leave some LC snacks out instead.

BTW what was the PS in the end? Did she shoot that 161? or did she get another test 20min after she fed and shoot that?
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So sorry, this didn't come up in my email feed & I haven't been on the site, recovering from traveling. She feed HC food, retested (went to 331), then shot. I paid the caretaker extra and she was able to change her schedule, she did additional testing & Millie was OK. Sh swings from high/low quit easily.

Thanks for the help.
 
Sylvia & Millie said:
So sorry, this didn't come up in my email feed & I haven't been on the site, recovering from traveling. She feed HC food, retested (went to 331), then shot. I paid the caretaker extra and she was able to change her schedule, she did additional testing & Millie was OK. Sh swings from high/low quit easily.

Thanks for the help.
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If you could update your SS when you have a minute that would be helpful. I'm glad Millie is OK. Yes, some kitties are quite volatile in their insulin responses. My guy is one of those too.
 
Kris & Teasel said:
If you could update your SS when you have a minute that would be helpful. I'm glad Millie is OK. Yes, some kitties are quite volatile in their insulin responses. My guy is one of those too.
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I just did that. She was actually 142 at +7 and 106 at +10. I gave her a little HC food and I will test her again before her shot. She is up and down a lot. I tested last night because I thought an increase might be due, not so I guess. I was also rereading some of the stickies, they make a little more sense now.
 
Sylvia & Millie said:
I just did that. She was actually 142 at +7 and 106 at +10. I gave her a little HC food and I will test her again before her shot. She is up and down a lot. I tested last night because I thought an increase might be due, not so I guess. I was also rereading some of the stickies, they make a little more sense now.
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Nice blues! Yes, those stickies make a lot more sense as your level of experience goes up. Always good to review periodically though. How is Millie feeling?
 
Kris & Teasel said:
Nice blues! Yes, those stickies make a lot more sense as your level of experience goes up. Always good to review periodically though. How is Millie feeling?
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She seems fine. She was up a lot last night (chewing on my hair and doing 'nails'). She didn't eat much last night which I think caused the low numbers. She just finished eating some regular food with a little HC gravy. I'll be testing again shortly.
 
I always get confused about just waiting it out or feeding her HC when her numbers are low. Since her numbers jump to extremes, my tendency is to feed her. I am around today and I can monitor her.
 
Sylvia & Millie said:
She was 114 at +12. Don't know if I should give her some high calorie treats then shoot?
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DO NOT FEED YET. Wait about 20 minutes without feeding and do a retest to see if the numbers are rising, staying the same or dropping and post back with the next test number.
 
Also you might get more attention if you start a new thread (post) Sometimes the older threads do not get noticed when there is a change in the question since people think it is from an earlier date and has been answered.
 
Tuxedo Mom said:
DO NOT FEED YET. Wait about 20 minutes without feeding and do a retest to see if the numbers are rising, staying the same or dropping and post back with the next test number.
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Oh no, I started earlier and she ate. She hadn't eaten last night and was starving this morning.
 
Sylvia & Millie said:
Oh no, I started earlier and she ate. She hadn't eaten last night and was starving this morning.
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The usual approach with a lower than usual preshot is to wait without feeding and do a recheck.

Are you home and able to monitor today? With the history of DKA you do need to give insulin. I am just not sure exactly what dose since this is a lower than usual preshot.

I will copy my response to the new thread (good job) and see what others have to say.
 
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