4/9/2024 | Lord Fuzzy Bottom | +6 50

Min and Lord Fuzzy Bottom

Min and Lord Fuzzy Bottom

Member Since 2024
Previous thread: https://www.felinediabetes.com/FDMB/threads/4-8-lorda-fuzzy-bottom-6-600.288545/#post-3168393

Doing well this morning. He was a bit fickle about getting his insulin and bg tests- but we've learned he doesn't want to tolerate my 5am nonsense. I gave him a can of Fancy Feast Classics Pate first thing when I got up and he nommed down on it eating about 1/5 and not just licking juice which is wonderful. We did skip last night's bg reading because my husband told me I needed sleep that I was starting to crash and burn. How do others do the every 6 hours readings? If it was a matter of wake up and go right back to bed afterward, that would be great. But once I am up, I can't go back to sleep for a couple of hours. I don't want to burn out taking care of him.

Anyhow, Fuzzy is doing well this morning. Will check ketones when I catch him tinkle. I gotta say, that is the easiest test to do as soon as I catch him going. No messes and he doesn't care I stick a condiment cup in his pee stream.
 
His numbers are.looking so much better. I understand the waking up in middle of night issue. I have same problem.
Glad to hear he's feeling better!
 
When did he last eat? It's late enough in the cycle that some of his usual food will be enough to keep him surfing.
You don't need to bring him to the vet. Just feed him and test again in 20-30 mins.
 
I agree with Bhooma. A 50 on a human meter is a safe number and we wouldn’t give honey at that number at +6. What honey at that time can do if the BG is 50 or above is stop his duration.

I took the 911 down as this is not an emergency. But please update us as soon as possible.
 
The vet should know better - they used to all use human meters before the pet ones came out. 50 is a safe number, but we don't want him going any lower. Did you get a second test?

Min said:
How do others do the every 6 hours readings?
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I didn't do that all the time. If you get a test around +2-+3, you can see if the cycle will be an active one that needs more monitoring. If it doesn't, no need to set an alarm for later. If I was expecting a lower night's numbers, I'd get an afternoon nap before hand.
 
Ok, just got home from vet. They are keeping him for a few hours to monitor. 30 minutes after a little honey on the gums his bg was 77. I had them test my monitor against their Alpha 3 and they both showed the same number. I am sorry for panicing, I didn't know what to do exactly. Like, I know to give honey/karo but I didn't know if his numbers were low enough and while I've read the whole thing on hypo... for the life of me my brain shut down and I couldn't think. Like after they said they wanted to keep him for a few hours, I broke down sobbing in the vet's office. So after I hit enter on this post, I am going to print out the hypo page.
Also, I am sorry for marking it as 911. Again, my brain shut down for the most part and I didn't fully know what to do. Please forgive me.
 
No need to apologize! Lower numbers (even within the normal range) can be scary till you get used to them. :bighug::bighug::bighug:
How long will they be keeping him? He will probably head up and it's safe to bring him home.
 
Min said:
Again, my brain shut down for the most part and I didn't fully know what to do.
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We have all been there. It's scary in the beginning. I agree with Bhooma that you can probably go get him soon as his numbers will probably be going up (especially being at the vets office). At least now you know their meter reads the same as yours. ;)
 
They said a couple/few hours, but I live in Texas.... so that could be two or 5. Also, if his numbers stay low, like, I'm scared about the whole insulin thing. Because wouldn't that cause his numbers to crash again?
 
He will probably bounce from the lows he saw today. So you might see him get really high instead. Also, later in the cycle, insulin action is on the wane. Plus the carbs from the honey would have applied the brakes on it. You want to call and check his BG and bring him back if he is headed up.

As long as you are testing and feeding, you have the means to keep him safe at home itself.
 
Glad to hear he's on the rise. You did a great job catching that 50 today, we don't want them lower than that while on insulin. Side note, I've tested non diabetics in the 40's on a human meter. Below 50 just doesn't give much margin for error so we want them above. Which you managed to do - so good for you! :) Almost everyone puts a 911 up for their first lower numbers, we just ask that they remove the 911 once they have someone's attention, especially if not a medical emergency.

You haven't mentioned whether you are following one of our dosing methods, or are going by what the vet wants you to do. Putting either dosing per vet, SLGS, or TR in the signature will help us help you better. A reading of 50 may or may not mean you lower the dose, depending on what dosing method you are using.
 
Ok, Fuzzy is home from the vet. The vet is still focusing on getting his numbers level and told me that if his numbers are below 200 pre shot, do not give him insulin. So, we are going to do that for the next couple of days and he have his curve test on the 11th and we will see how things go.
 
Min said:
Ok, Fuzzy is home from the vet. The vet is still focusing on getting his numbers level and told me that if his numbers are below 200 pre shot, do not give him insulin. So, we are going to do that for the next couple of days and he have his curve test on the 11th and we will see how things go.
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I am sorry he feels that way. Today was a good cycle and not shooting if under 200 will not level him out. He will likely be high from bouncing so at the most you might miss a shot if you follow your vet’s advice. He might bounce the whole time as well. If that happens the experiment will not tell you anything.
 
Min said:
Ok, Fuzzy is home from the vet. The vet is still focusing on getting his numbers level and told me that if his numbers are below 200 pre shot, do not give him insulin. So, we are going to do that for the next couple of days and he have his curve test on the 11th and we will see how things go.
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I agree with Elise. Most members here learn to shoot all BGs 50 and above. If he’s eating all wet food, you can easily shoot to 150 without anyone to help you but we usually suggest if you get a 150 or below at preshot, don’t feed and post here for someone to walk you through it and stay with you online.

It is especially concerning that a vet suggested skipping shots with a cat who has DKA. That’s not good advice.
 
@Min Are you still feeding some dry food? If so then by default you go with the dosing method called SLGS (“Start Low Go Slow”).

A dosing method/protocol is important because it provides guidelines and “guardrails” to dosing decisions so you can be methodical and consistent in dosing and dosing decisions, rather than willy-nilly or emotional. Following a method/protocol is really very helpful in managing your cat’s diabetes as well as offering you a sense of understanding and peace of mind that you’re following a plan (perhaps even providing some semblance of “control”).

If following SLGS, the guidelines say a dose reduction is warranted any time the BG goes under 90, which would be applicable given today’s 50.

If using the more aggressive “Tight Regulation” (TR) protocol, then reductions typically don’t occur unless you see a number under 50, so you would hold the dose. But the rule of thumb for using TR is no dry food, so that’s why I asked about it above.

I’ll let others advise whether they recommend a dose reduction. @Wendy&Neko @Bron and Sheba (GA) @Marje and Gracie @tiffmaxee

With DKA in the picture, you want to try to make sure insulin is given consistently. Loosely speaking, insulin is like a “medicine” to combat DKA. Lantus has a cumulative (“depot”) effect, so there’s some carryover from shot to shot. What you shoot, or don’t shoot, affects this cycle as well as the next. Some vets are more well versed in using “in-and-out” insulins that tend to be out of the cat’s system by the next shot time. Lantus is not typically like that, so you can often shoot lower numbers than one might choose to shoot with a different insulin.

In defense of your vet…I can completely understand why you were told not to shoot under 200. Their oath is to “first do no harm” and insulin is a powerful hormone, so I’m sure they’d rather you err on the side of caution than potentially get in trouble with low BG. However, although we here on the board can understand the logic behind the advice, we can at the same time respectfully disagree with it and that’s what you’re seeing. The DKA strongly influences the advice here. No one wants to see LFB backtrack. But I want to emphasize that even if we say your vet’s advice is questionable under the circumstances, no one is saying your vet is bad.

This can all—testing, food, curves, dosing, spreadsheets, shoot or don’t shoot, DKA—be overwhelming at the start, especially when what you’re hearing on the board here differs with what your vet is advising. Please don’t let that scare you away. The folks here have cumulative years of experience “in the trenches” dealing with day-to-day feline diabetes and everyone has your and Lord Fuzzy Bottom’s best interest in mind.

One final suggestion: when you have days where you see the BG dropping, it would be great if you could get in tests at other than +6 to fill in the blanks. No pressure, but diabetes is a puzzle and the more data points we have, the better able to see the big picture.

Hang in there. This really does get easier over time. :bighug:
 
JL asks a really important question. Are you feeding any dry food? It would help us help you if you add whether she is eating all wet or some dry food as explained above.
 
As per the spreadsheet, he's eating some type of Science Diet kibble the vet gave to take home. No doubt, it'll be high carb dry food. And it means his dose should be reduced because of how low he went today.
 
JL and Chip said:
@Min Are you still feeding some dry food? If so then by default you go with the dosing method called SLGS (“Start Low Go Slow”).

A dosing method/protocol is important because it provides guidelines and “guardrails” to dosing decisions so you can be methodical and consistent in dosing and dosing decisions, rather than willy-nilly or emotional. Following a method/protocol is really very helpful in managing your cat’s diabetes as well as offering you a sense of understanding and peace of mind that you’re following a plan (perhaps even providing some semblance of “control”).

If following SLGS, the guidelines say a dose reduction is warranted any time the BG goes under 90, which would be applicable given today’s 50.

If using the more aggressive “Tight Regulation” (TR) protocol, then reductions typically don’t occur unless you see a number under 50, so you would hold the dose. But the rule of thumb for using TR is no dry food, so that’s why I asked about it above.

I’ll let others advise whether they recommend a dose reduction. @Wendy&Neko @Bron and Sheba (GA) @Marje and Gracie @tiffmaxee

With DKA in the picture, you want to try to make sure insulin is given consistently. Loosely speaking, insulin is like a “medicine” to combat DKA. Lantus has a cumulative (“depot”) effect, so there’s some carryover from shot to shot. What you shoot, or don’t shoot, affects this cycle as well as the next. Some vets are more well versed in using “in-and-out” insulins that tend to be out of the cat’s system by the next shot time. Lantus is not typically like that, so you can often shoot lower numbers than one might choose to shoot with a different insulin.

In defense of your vet…I can completely understand why you were told not to shoot under 200. Their oath is to “first do no harm” and insulin is a powerful hormone, so I’m sure they’d rather you err on the side of caution than potentially get in trouble with low BG. However, although we here on the board can understand the logic behind the advice, we can at the same time respectfully disagree with it and that’s what you’re seeing. The DKA strongly influences the advice here. No one wants to see LFB backtrack. But I want to emphasize that even if we say your vet’s advice is questionable under the circumstances, no one is saying your vet is bad.

This can all—testing, food, curves, dosing, spreadsheets, shoot or don’t shoot, DKA—be overwhelming at the start, especially when what you’re hearing on the board here differs with what your vet is advising. Please don’t let that scare you away. The folks here have cumulative years of experience “in the trenches” dealing with day-to-day feline diabetes and everyone has your and Lord Fuzzy Bottom’s best interest in mind.

One final suggestion: when you have days where you see the BG dropping, it would be great if you could get in tests at other than +6 to fill in the blanks. No pressure, but diabetes is a puzzle and the more data points we have, the better able to see the big picture.

Hang in there. This really does get easier over time.
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Ok, lets see if I can answer these questions.
1. Yes, still feeding dry food. He is very picky and barely touches wet food. The vet told me to feed him anything he would eat. I had tried to go with as low a carb dry food as I could find (TikiCat Carnivores High Protean) and he won't touch it. I've tried various different wet foods and tried the chicken sprinkle stuff. He doesn't really like it. He likes shredded chicken, but it doesn't have all of the nutrients he needs, so that is more of a treat than plain meal.

2. The dosing- when he first was diagnosed and I was setting up the spreadsheet I became confused over it. I really don't know what the vet's protocol is. I am following what he is telling me- although I personally found it really weird that you would skip doses of a depot insulin. He does have a curve set up for tomorrow - so I will type up notes for the vet about it and ask. I may be more ready to even just drop his dose down to perhaps 1u that way he is still getting SOME insulin and it doesn't totally deplete the depot. For right now, following the vet's words and watching closely.

3. Days when Fuzzy is dropping - I have already been considering doing my own 'curve' that way I will have that data for myself and can make educated decisions.
 
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