? 4/6/17, Sprocket, AMPS 320.3.5u. +4/45, 77, +5/120, +6/105,+7/139,+8.5/312, PMPS 458,advise

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Darnell & Sprocket (GA)

Darnell & Sprocket (GA)

Member Since 2015
http://www.felinediabetes.com/FDMB/...l-learning-please-follow.175881/#post-1933835

Yesterdays posting above.


He was up early seeking plastic. He is hungry. Ketone urine strip negative.
Gave wet food before I went to bed 5 hrs ago but he ate early leaving no food for later. He did a morning smelly poop. He just ate & he is next to me & i hear his belly making gurgling sounds. He took pill pockets like they were nothing. I think the dose is finally working. Lowest at shoot time again. 320. Last night was 360.
He still wants plastic though. He chews on it but doesn't eat it.
I will try autofeeder tonight.

Is this a good sign?

He is still seeking plastic after eating. He ate about 1.5oz of 3 oz can. He ok?
 
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I have a cat that likes to lick plastic-- something about it tasting salty, I think, maybe? Someone else might have an idea of what that is about and what it might mean, but I wouldn't worry about it-- I'm just happy he's eating (real food) well!

320 isn't that low, definitely shoot. Weren't we talking before about an increase to 3.75U? I think after the DKA you don't want to go too cautious on the insulin-- he's been in pinks and yellows on the 3.5 (the blues on the first day were probably the depot from the earlier 4.0U dose), so he can handle a bit more to try to get him in better numbers.
 
Eleanor loves to lick plastic. Her insulin syringes come packaged as 10 in a plastic bag, when I get a syringe out I have to remember to put the plastic bag away, otherwise there she is slurping away on it.
 
I have always heard that it's the coating on the plastic shopping/grocery bags (rendered from animal fat, used to keep the bags from sticking to each other) that causes cats to be attracted to them. But that doesn't take into account the other plastics, like package wrapping, etc, that cats will lick. I have a civvie with pica, and she will eat them - she eats all sorts of weird stuff. I get up in the morning and see remnants of things she has chewed or shredded and then eaten.
 
Omg!!! Freaking out!!! 45, gave gravy food, syrup. 48. Gave more. Plus evo dry. 77 now. Gave more wet low carb then zero dry. Thank god for Holly!!!
Idk what happened.
He was seeking plastic this am. Up at 530am est. Poop was formed but smelly.
He ate 2oz low carb. Wanted more. Gave 1.5 more.
10am. Wokebto damn jets overhead. He hid under bed. Got up. Vomited & soup for poop. Got him out from under bed. Then tested. As said above.
 
Ack, poor little guy! I guess the (unusual for him?) plastic-licking was a sign he was feeling a bit off.

It's great that his numbers are back up. Hold off on feeding anything more for 30 minutes, then re-test.

For anyone watching: I'm at work and can only stay here online for another half hour before I have to go to a meeting. Are others around who can help?
 
Just tested 120. Holly going to work now too. She said to test in one hour now n give low carb wet food if wants it.
Person to help with fluids is coming in hour or so. Good to do sub q fluids or hold off a few hours?
 
I can keep an eye on the thread.

Good catch on the 48, it is low, but not dangerously low yet. We do not want it going much lower so keep testing, and feeding as neccesary. The first few times of low numbers are really hard on the nerves, but we have all been there and understand. They syrup will give a quick boost to the numbers, but wears off fast. The dry food typically takes longer to start working, but lasts much longer. We usually use high carb wet food and syrup if needed since they work faster.

77 is a better number, like Nan said, wait 30 min to test again and see if he is holding steady or starting to drop again.
 
Thanks for stepping in @saltycat

Darnell & Sprocket said:
Just tested 120. Holly going to work now too. She said to test in one hour now n give low carb wet food if wants it.
Person to help with fluids is coming in hour or so. Good to do sub q fluids or hold off a few hours?
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Sounds good.

Fluids might make him feel better (he'll be a bit dehydrated after vomiting/diarrhea), but I imagine you wouldn't want to do it if it looked like he was at immediate risk for another vomiting episode. If he's kept down the food he got at the 48 a half hour ago, he's probably good.

I think you can take down the 911 for now-- you can always put it back up to get some quick attention!
 
Darnell & Sprocket said:
Why did this happen so fast?
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Short answer.... He's a cat:)

Slightly longer answer, there are a number of reasons cats can drop quickly. I see Sprocket pulled a similar move on the 31st, going from 280's down to greens. Sometimes the pancreas starts healing and the cat starts producing more insulin on its own. A cat that isn't feeling well or even constipated can have elevated numbers and when they start feeling better the numbers drop. Pain is known to cause higher bg numbers. Some medications can affect BG numbers(prednisone, a steroid, is well known for causing higher numbers in cats), and food can also play a big role. Changing their diet can also have a big impact, lots of cats that transition from dry to wet food end up needing less or sometimes no insulin. Just reducing the carbs can have a big impact on the numbers. I saw yesterday that Sprocket was getting less dry food, this could be part of the reason as well.

With a 45, he might need a reduction. I would want to get some advice from other members though since I am not comfortable with dose advising in a post DKA kitty. Since Sprocket has had DKA and recently had ketones, we want to make sure to address that since DKA episodes are something we do not want to have you go through again.
 
I been posting for days without a lot of imput on that. Chris was saying go up on dosage but he never had low numbers like this at shoot time. Please if u know good person on this situation please tell them. He has been in hospital 3 times now. Ketones n liver stuff. I am trying to help him but i am still learning.
So scared.
 
Darnell & Sprocket said:
I been posting for days without a lot of imput on that. Chris was saying go up on dosage but he never had low numbers like this at shoot time. Please if u know good person on this situation please tell them. He has been in hospital 3 times now. Ketones n liver stuff. I am trying to help him but i am still learning.
So scared.
Click to expand...
The pinks and yellows recently are probably bouncing from the blues and then suddenly this AM the bouncing stopped and he dropped like a stone. Some cats will do that extreme thing more than others. I have one of them. The important thing for you is to know that Sprocket can do this and make a plan for how to proceed when it happens.

The episodes of ketosis are worrying of course. He needs a high enough insulin dose to reduce the chance of them developing. Sometimes that means feeding the cat higher carb food on a regular basis so they can handle the higher insulin doses.

I can tell from your posts that you're trying really hard to get on top of things and are very worried about him. If you can spend a little time thinking about a plan for dealing with low numbers and then get some ideas for feeding a ketosis prone kitty from experts here (@Meya14 ) you'll feel more confident that you can cope with what comes along.

So - two tasks for you:
  1. write out a step by step plan for what to do if he drops too low and put the plan in your hypo kit (do you have one?) http://www.felinediabetes.com/FDMB/threads/hypo-links-be-prepared-just-in-case.48385/
  2. make a list of all the types of food you give Sprocket and their approximate carb count (if known) as well as when you feed him so that the knowledgeable people can assess it and offer advice.
 
Keep up the good work and keep asking questions. We were all a little overwhelmed at first, there is a lot of information to absorb.

Darnell & Sprocket said:
Chris was saying go up on dosage but he never had low numbers like this at shoot time
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I would not hesitate to give insulin when shot time tests are pink or yellow. Those are still considered higher numbers. The blues and greens are where we start to make judgement calls based on the cat and their tendencies. The first few times you see a blue pre-shot test, stall without feeding and ask for advice on the boards here. As you get to know how Sprocket responds to foods and his normal patterns, it makes it easier to decide on whether to give insulin and how much. Since Sprocket is prone to DKA skipping shots is something we try to avoid, even a little insulin is usually better then none in DKA prone kitties.

Kris's tasks are good ones. I keep track of what food I fed and how much when my cat goes into lower numbers. It makes for a nice reference when it happens in the future. Being prepared by having some data and the hypo kit makes low numbers much less stressful since you have the tools and knowledge to safely bring his numbers back up.

One other minor note, the test strips are not perfect, sometimes there is a bad strip. Re-testing if you get a really strange number can be a good idea to make sure it was accurate.


Darnell & Sprocket said:
Back to 105 now!
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This is letting you know the carbs from the food earlier are wearing off and the insulin is working. Since he only dropped 15 pts in an hour. I would test again in 1 hour. If Sprocket's appetite is still so-so I would hold off on low carb food, we don't want to fill him up in case he needs some more higher carb foods.
 
The low point for Lantus is around +6 so he should be getting close to his low point for the day. He might just surf along in similar numbers for the day, but testing is still highly recommended to make sure he can keep his numbers up on his own. All these mid-cycle tests help fill in the picture of how Sprocket responds to the Lantus, all cats are a little different.
 
He doesn't want wet anymore. He had alot sn hour ago. He ate 1tblsp of evo though. Plus a finger of karo in mouth. .
I have been writing down everything he eats for awhile now. I keep track of pills, bgs, ketones strips, pill pockets, fluids, & keep eye on poop n urine.
 
Just checking in again, in between meetings ;).

saltycat said:
Short answer.... He's a cat:)
Click to expand...

No kidding! Sprocket really is full of surprises, isn't he? I was all set for something like this to happen the other day when he first got back from the hospital and... nothing, just a nice blue surf in the afternoon. Now he pulls this today!

I'm not sure about dose at this point. Before this morning, he really did look like a cat who needed an increase rather than a decrease, especially considering that he is a DKA-prone kitty. Let's wait until some of the experts can check in and consider the case.
 
When i last tested his ears were like clammy & were slow bleed. Used 3 test strips. 2 not enough blood.
Waiting on sub q fluids for now. He is napping. Lookig at me like a i got 3 heads n i am fruitloop. Suppose thats good cause he is not feeling bad.
I inboxed @Meya14 as someone said she is expert.
Thank you all for helping us. I am major frantic n shaking but trying to stay calm
 
This is a good example of why home testing is so important. This green came out of nowhere and I would agree that it looked liked he needed an increase after the last few days... until today's surprise.
2oz of HC wet food, karo and 3tbsp of dry is a lot of carbs, I would have expected a bigger rise in the numbers. You did the right thing by getting carbs in him and he is in a much safe range now.

Some members have noticed similar things with their cats ears when they are low. I'm not sure why, but it is somewhat common.

@Marje and Gracie
@Wendy&Neko
Any thoughts on dosing for Sprocket, he has had a few DKA episodes. Until today it looked like he needed a little more insulin, but he went under 50 today and according to the SS, took a good bit of carbs to come up.

Hang in there, and take a few minutes to let the nerves calm down. You are doing a great job staying on top of the situation and making sure Sprocket is safe. Looks like he is due for a test in a few minutes. We can see if he is holding steady or needs a little food after the test.
 
Darnell & Sprocket said:
I am major frantic n shaking but trying to stay calm
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Take a deep breath. Center your mind. Sprocket is at safe numbers and I think the fluids will be good since he threw up.

When he threw up - had he just eaten? Or was it a while afterward? It is good that he is willing to eat now (well, not now that he isn't hungry, but after the vomit).

In the future - try and only give gravy so that it doesn't fill him up. The higher carbs are in the gravy so a couple of tablespoons of the HC gravy and then test again in 20-30 min.

Should almost be time for another test?
 
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First thing, have you been testing daily for ketones? If so, please put the results of the ketones tests on the spreadsheet as we would like to see the results. If you aren't testing daily, you should be. How he's doing on the ketones tests may impact what we suggest for dosing. We would be more aggressive if there is any hint of ketones present. It may be interesting to note when you do fluids too. For some cats but not all cats, fluids can lower the blood sugar. I tried to give fluids a couple of hours before the shot, on the different side and location on the body. One time Neko got fluids at the vet not far from where she got her shot, and her numbers did go down.

Second question, on your spreadsheet today, you said the shot was at 6:55 AM. How long after last night's PMPS was that? Two nights ago you noted that the shot was at 7:30 PM. An early shot can act like a bit of a dose increase.
 
LizzieInTexas said:
Take a deep breath. Center your mind. Sprocket is at safe numbers and I think the fluids will be good since he threw up.

When he threw up - had he just eaten? Or was it a while afterward? It is good that he is willing to eat now (well, not now that he isn't hungry, but after the vomit).

In the future - try and only give gravy so that it doesn't fill him up. The higher carbs are in the gravy so a couple of tablespoons of the HC gravy and then test again in 20-30 min.

Should almost be time for another test?
Click to expand...

139 at 1:55pm.
Is there only gravy food? I had gravy lovers beef. He loves it. Hard to get out gravy from pieces. Hands were shaking.
 
LizzieInTexas said:
Take a deep breath. Center your mind. Sprocket is at safe numbers and I think the fluids will be good since he threw up.

When he threw up - had he just eaten? Or was it a while afterward? It is good that he is willing to eat now (well, not now that he isn't hungry, but after the vomit).

In the future - try and only give gravy so that it doesn't fill him up. The higher carbs are in the gravy so a couple of tablespoons of the HC gravy and then test again in 20-30 min.

Should almost be time for another test?
Click to expand...


139 at 1:55pm.
Not sure when he vomited. Before
10am. I went to sleep about 720am after giving more wet@1.5oz after he wanted more after eating 2oz at 615am.
 
Wendy&Neko said:
First thing, have you been testing daily for ketones? If so, please put the results of the ketones tests on the spreadsheet as we would like to see the results. If you aren't testing daily, you should be. How he's doing on the ketones tests may impact what we suggest for dosing. We would be more aggressive if there is any hint of ketones present. It may be interesting to note when you do fluids too. For some cats but not all cats, fluids can lower the blood sugar. I tried to give fluids a couple of hours before the shot, on the different side and location on the body. One time Neko got fluids at the vet not far from where she got her shot, and her numbers did go down.

Second question, on your spreadsheet today, you said the shot was at 6:55 AM. How long after last night's PMPS was that? Two nights ago you noted that the shot was at 7:30 PM. An early shot can act like a bit of a dose increase.
Click to expand...

Ketones i test every time I see him pee, been putting in remarks section. He has been negative.
I have written down times for fluids. I will add to ss.
He was late on tuesday because we had appt with specialist at 430-530pm. 45 min drive home n he pooped& peed in cage on way home.
 
Darnell & Sprocket said:
Is there only gravy food? I had gravy lovers beef. He loves it. Hard to get out gravy from pieces. Hands were shaking.
Click to expand...

When you get a number under 50 and need to feed high carb, what you should do is pop the top off the Gravy Lovers and then put it back down......push down and "squeeze" the gravy into another bowl so you can feed just the gravy part......you should start with a teaspoon or two of just the gravy

The gravy part has most of the carbs.....we want to bring them up gently without sending them to the moon.

At some point Sprocket is probably going to bounce (plus all the high carb food) so don't be surprised if he's high again by PMPS
 
Darnell & Sprocket said:
Ketones i test every time I see him pee, been putting in remarks section. He has been negative.
Click to expand...
So the last time you tested for ketones was April 4th?
Darnell & Sprocket said:
He was late on tuesday because we had appt with specialist at 430-530pm. 45 min drive home
Click to expand...
Did you move the shot times up yesterday to make up for the 45 minutes delay? Still wondering when shot time was last night.
 
Sorry still updating.
Ketone negative yesterday and this morning.
Shot times:
Sunday, 7:15am, 7pm.
Monday 715am, 630pm
Tuesday, 7am, 730pm due to appt
Wed, 7am, 6:45pm.
Thurs 6:55am

Is the +1, etc off the bg time or shot time?
 
+1 is from the shot time. When we need to make up shot times, typically we do it by 1/2 hour once a day or 15 minutes per cycle. Yesterday you did both the 1/2 hour change and 15 minutes, but it shouldn't have impacted today's cycle.
 
Kris & Teasel said:
The pinks and yellows recently are probably bouncing from the blues and then suddenly this AM the bouncing stopped and he dropped like a stone. Some cats will do that extreme thing more than others. I have one of them. The important thing for you is to know that Sprocket can do this and make a plan for how to proceed when it happens.

The episodes of ketosis are worrying of course. He needs a high enough insulin dose to reduce the chance of them developing. Sometimes that means feeding the cat higher carb food on a regular basis so they can handle the higher insulin doses.

I can tell from your posts that you're trying really hard to get on top of things and are very worried about him. If you can spend a little time thinking about a plan for dealing with low numbers and then get some ideas for feeding a ketosis prone kitty from experts here (@Meya14 ) you'll feel more confident that you can cope with what comes along.

So - two tasks for you:
  1. write out a step by step plan for what to do if he drops too low and put the plan in your hypo kit (do you have one?) http://www.felinediabetes.com/FDMB/threads/hypo-links-be-prepared-just-in-case.48385/
  2. make a list of all the types of food you give Sprocket and their approximate carb count (if known) as well as when you feed him so that the knowledgeable people can assess it and offer advice.
Click to expand...

I did inbox Meya14.

I have a hypo list printed but forgot it.
I have all food written down
 
Wendy&Neko said:
First thing, have you been testing daily for ketones? If so, please put the results of the ketones tests on the spreadsheet as we would like to see the results. If you aren't testing daily, you should be. How he's doing on the ketones tests may impact what we suggest for dosing. We would be more aggressive if there is any hint of ketones present. It may be interesting to note when you do fluids too. For some cats but not all cats, fluids can lower the blood sugar. I tried to give fluids a couple of hours before the shot, on the different side and location on the body. One time Neko got fluids at the vet not far from where she got her shot, and her numbers did go down.

Second question, on your spreadsheet today, you said the shot was at 6:55 AM. How long after last night's PMPS was that? Two nights ago you noted that the shot was at 7:30 PM. An early shot can act like a bit of a dose increase.
Click to expand...


I updated the ss. Going to do pmps bg soon. Will need help in dose amount??
 
He is bouncing. It will be safe tonight to stick with the same dose. Even if you were to decrease the dose, we have a method we call "shooting through the bounce" where we shoot the old higher dose one more time to help with the bounce, then decrease the next cycle. Hopefully we'll have an answer soon on what to do tomorrow morning.
 
I think sticking with the 3.5 tonight is a good plan-- his body is going to be trying to push him up into those high numbers for a while after that low, with the history of DKA I think it's a good idea to make sure he has a decent amount of insulin counteracting it, at least for tonight.

No more vomiting/diarrhea today? And did he get his fluids as planned?
 
With him bouncing, I'd definitely give the 3.5 again tonight but it's still a little early......you don't want to change the shot times more than 15 minutes per cycle or 30 minutes ONCE in a 24 hour period
 
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