5/11 Pixie PMPS=180, +2=79, +3.5=59,+4=63,+4.5=65,+6=88

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caringcdn

caringcdn

Member Since 2014
Happy Mother's Day!

I'm trying to get all the background information necessary to be able to understand Pixie's spreadsheet but I think what he experiences each day and what the BG results are will be the best teaching.

I want to first address some of your concerns about Pixie's food. Pixie is on a combination of Royal Canin Hypoallergenic and Sensitivity-VR. My understanding from the vet was that, though this is not the ideal food for Pixie, it will be ok as Pixie eats this food and not other diabetic-specific diets. The vet indicates that the Hypoallergenic is 5% and the Sensitivity-VR is 5.5% which are acceptable carbohydrate levels. When I do the math with the ingredients, I can also confirm that these are the correct carb values. Now I'm hoping this is correct and that the company is not understating the numbers. On the off chance that the food may be Pixie's problem, I have started investigating other brands. When studying the list, I'm looking for a label that has both low carbohydrates and phosphorus levels. Pixie is in the early stages of CKF but who knows at this point in time. With all his very high BG numbers over the last three months, he may be worse. I have noticed that in the last 2 weeks Pixie's been drinking less water but he's still urinating quite a bit - not overflowing the tray but large puddles. He does get 100mls of subq fluids BID. Last night I tried a tsp of BFF Tuna and Chicken in aspic and he absolutely loved it however, I've since read some concerns about fish products and how they are addictive and potentially high in mercury. Today I decided to mix about 1-2 tsp into his regular food and this has been helpful in getting him to eat more. I will continue to experiment slowly with new foods.

I'm curious as to what some of you think about the numbers. I don't have a great sense of what a bounce or rebounding is just yet but I'm wondering if that is what is happening to Pixie. He seems to go from pretty high to much lower and then high again. Any thoughts? Grateful for any input, Anne and Pixie.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Hi Anne!

Here's the link to your last post: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=118507&p=1240979#p1240979 (We try to link to our last post each time so that others can easily click back through to catch up on any posts they may have previously missed. To do that, just click the URL tab in the top center of the box and paste the web address of your last post in between the little url boxes that appear.)

There are several members on here who are currently dealing with kitties who have diabetes along with pancreatitis and/or CKD. Amy & Trixie, Elise & Max, and Mariko & Lucy are some of the members who immediately come to mind. Some of them are also giving sub-q fluids. You might want to visit their "condos" (posts) and look at their profiles to get some food ideas. I also know there is a tip out there about the sub-q fluids in combination with the Lantus - something about moving the injection sites around on days when you do the fluids. Hopefully someone with more experience can chime in on that.

It's certainly possible that Pixie is bouncing from those lower numbers. He hasn't seen those numbers in a while, and his body no longer recognizes them as normal. When he gets into those lower numbers, his liver panics and releases extra sugar that drives the numbers back up. It looks to me like that's what happened yesterday afternoon. He hit lower numbers Friday night and then "bounced" Saturday afternoon.

I know you're using the AlphaTrak, and it's great that you noted that in your signature. You might want to increase the font and/or bold it so that it stands out a bit more. You might also want to type somewhere (noticeable) on your spreadsheet that you're using the AlphaTrak. Most of us here use human meters, and our brains automatically "read" the numbers according to the human meters. Since we have to "read" AlphaTrak numbers a little differently, we want to make sure that people remember that's what you're using when it comes times to make dosing recommendations.

I'm hoping some of the more experienced users will be along soon to help you with dosing suggestions. One thing I noticed is that there were several dose changes this past week. That can sometimes cause wonky numbers. Since Lantus is a depot insulin, it takes time for the depot to fill and begin to work. If you change the dose rapidly, the depot "gets confused" and doesn't know how much to release. For that reason, we try to hold the dose constant for several cycles so that we can begin to see how a given dose will really work. Of course, one huge exception to that is if the kitty falls under 50 (on a human meter) or 68 on the AlphaTrak. (NOTE: I think this is most current cut-off number for the AlphaTrak, but let's verify that.) In that case, we reduce the dose.

Whenever you have questions, you can click on the "?" icon in the subject line of your very first post. That way, it's easy to see, at a glance that you have a question. It will get more eyes to your condo more quickly. When you have received an answer that you're satisfied with, you can go back and remove the "?" icon. That's just a tip for "working the board." ;-)

Have a great day!
Shelly
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Hi Anne - did the vet say whether the %carb values on the Royal Canin foods were the "Guaranteed Analysis" or "As-Fed". Most will quote the guaranteed analysis which is not what we use and with looking at the ingredients in those foods, it would be surprising for them to be as low as-fed carb as the numbers you have listed. Keep in mind that vets do like to sell you the veterinary food, as it is a source of income for them. As Shelly said, there are other people here dealing with both CKD and diabetes. Tess's Ann has a list of acceptable commercial foods for CKD diabetics on a tab on Tess's spreadsheet.

As for the numbers, yes Pixie is bouncing, but that's very common for cats. Neko's been at this for 2.5 years and she still bounces. :roll: Just not as high as she used to. Over time as Pixie's body gets used to lower numbers, he will bounce less. You have had a number of dose changes in the last few days. I'd stick with the 3.0U dose for a couple more cycles yet so we can see what this dose is doing. Keep in mind that if you supplement the diet with lower carb commercial foods, Pixie's numbers may come down some more. But those blues you are seeing are lovely. :-D
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Hi Wendy and Shelly,

I just read your posts after injection time and I'm really disappointed I didn't check first. Pixie's PMPS was 180 which is almost as low as 171 on May 8th. That morning I didn't give Pixie a shot because these numbers scare me. He can drop so much that it makes me extremely nervous, however this evening, I did what I read was recommended and I shot low to stay low. Because I didn't read the posts first, I ended up giving him 2.75 instead of 3, another dose change. You can tell I'm new at these low numbers and they make me extremely nervous. The other reason I gave Pixie a little less is because he isn't eating near as much as he was earlier in the week. I'm not noticing too much weight loss so I'm thinking he's leveling out and his body is starting to use the food he eats to supply his nutritional needs.

I'm not sure about the as fed or guaranteed analysis, so I'm going to check on this tomorrow with the vet or the Royal Canin company. If it's the food, I'll be real sore that they're selling me a product that is complicating Pixie's progress.

Please note that I will be keeping Pixie's numbers posted throughout the evening and if I run into trouble, I'll send out the s.o.s. I am familiar with what to do for low numbers and I have my tool kit ready. Fingers crossed, Anne.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Don't worry about it, Anne. This is a ton of information you're trying to take in all at once. If you have looked at my spreadsheet, you'll see that I skipped shots when I shouldn't have, didn't test when I should have, etc. Just take it one day at a time!

Great job shooting. It's nerve-wracking shooting lower numbers for the first time. (It was nerve-wracking for me every time!) It really will help Pixie level out, though. You might want to get a +1 or +2 test just to see where Pixie is headed this evening. Those early tests can reveal a lot about where a kitty might decide to head for the night.

Someone will be around if you need help, I'm sure. It sounds like you've been doing a lot of reading and are prepared to handle low numbers. "Paws" are crossed that Pixie will just "surf" in these great numbers. (Don't worry - you'll get used to all the jargon we use here, too! ;-) )

EDIT: By the way, you can remove your AM numbers from the subject line of your first post today and start putting in your PM numbers if you want. We usually can't fit in all of our AM and PM numbers in the subject line - we end up running out of room. :-D
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Yahoo! Looks like Pixie got over that bounce pretty quickly! That's great news. :-D Good job shooting that number. :cool: The one thing I always found it hard to wrap my head around the first time shooting low is that if they start out low, their cycles are much flatter. Neko used to be able to go from the 400's to green and back to pink in one cycle. The first time I saw blue I was pretty worried too. This will be a great opportunity to gather data to see how Pixie reacts and starting with those early tests Shelly suggested is a good idea. I'm on the west coast so up for another 6 hours or so.

As for the food, you wouldn't be the first. We have heard of some vets insist on dry food in the 35% carb range as the solution for diabetics. :roll: Any wet food will be much better than that.
 
5/11 Pixie PMPS=180,+2=79.2

Hi again,

I'm panicking a little, it's only +2 and Pixie is already at 79.2. This freaks me out as he's not eating much of his regular food, even if it's mixed with the BFF Tuna and Chicken. So I tried straight BFF and he did eat some after getting his injection but it doesn't seem to be doing much. The carb content is only 1 or 2%. I have some cooked chicken which he usually likes, I wonder if I should try this? I hesitant about changing things too quickly as he may end up with diarrhea. Please advise.

P.S. When you say to change the numbers in the topic line, it doesn't mean that it changes at the top of the thread or is there a way to change it there, i.e., if I have a 911, it might be buried down in the thread. Do I start a new thread? Thanks, Anne.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

You have to go to your first post of the day, and change that subject line. That's the one that everyone can see when they browse the forum.

I would give some food with carbs in it now. Boiled chicken is zero carbs. Would he eat any of the Sensitivity of Hypoallergenic food? The number we use for a dose reduction when using an AlphTrak is 68, so you are getting close to that quite early in the cycle.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Great job with shooting. :-D Remember to breathe. Do you have karo syrup or honey, just in case? You don't need it right now but you want to be prepared.
Liz
 
5/11 Pixie PMPS=180, +2=79,+3=59

We're going down fast and Pixie won't touch his Hypo or Sensitivity, even mixed with the Tuna and Chicken. He has been eating throughout this last hour but it's the Tuna and Chicken - he's eaten about 2 oz. How long would it take to show up in his BG levels? I think I'll open a can of the fancy feast grilled chicken with gravy and see if he'll eat. If he doesn't eat it, do I rub his gums with a bit of corn syrup or do I wait until he shows physical signs of hypo?
 
5/11 Pixie PMPS=180, +2=79,+3=59

We're going down fast and Pixie won't touch his Hypo or Sensitivity, even mixed with the Tuna and Chicken. He has been eating throughout this last hour but it's the Tuna and Chicken - he's eaten about 2 oz. How long would it take to show up in his BG levels? I think I'll open a can of the fancy feast grilled chicken with gravy and see if he'll eat. If he doesn't eat it, do I rub his gums with a bit of corn syrup or do I wait until he shows physical signs of hypo?
 
5/11 Pixie PMPS=180, +2=79,+3=59

We're going down fast and Pixie won't touch his Hypo or Sensitivity, even mixed with the Tuna and Chicken. He has been eating throughout this last hour but it's the Tuna and Chicken - he's eaten about 2 oz. How long would it take to show up in his BG levels? I think I'll open a can of the fancy feast grilled chicken with gravy and see if he'll eat. If he doesn't eat it, do I rub his gums with a bit of corn syrup or do I wait until he shows physical signs of hypo?
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

It's okay. You can steer with food. Yes - open the can of gravy lovers. Try feeding just some of the gravy off of it - that's where the carbs are. Test in 30 minutes. By then, the high-carb food will kick in. You do NOT want to wait until you see actual symptoms of hypo.

If you can't get him to eat, you can rub Karo/syrup on his gums.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

The board is being really wonky right now. If you can't get back online for some reason, just keep steering the numbers with food. You want him to stay above 68 on the AlphaTrak. Test every 20-30 minutes and give Karo/high-carb gravy until you get the numbers above 68. The carbs will wear off fast, so you'll want to keep testing until you get at least two numbers in a row above 68 without giving Karo/high-carb.

You're doing great. Hang in there!
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

If you haven't printed out a copy of the Handling Low Numbers Sticky, it's a good thing to have in case the board has issues. Here is part of it for you:
If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.

DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
Click to expand...
If Pixie will eat low carb but not gravy food, an alternative is to add a drop or two of corn syrup to a couple tsp of low carb food.

Test again 20 minutes after he finishes eating. It takes a while for the food to go from the stomach to the blood stream.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

I'm just now getting caught up on all the previous posts:

P.S. When you say to change the numbers in the topic line, it doesn't mean that it changes at the top of the thread or is there a way to change it there, i.e., if I have a 911, it might be buried down in the thread. Do I start a new thread? Thanks, Anne.
Click to expand...

When you need to add info to your subject line, you have to change the subject line in the very first post that you made for the day. Likewise, if you need the 911 icon, click it for the very first post that you made. Otherwise, people can't see the information/icon until they actually "enter" your condo.

Make sure you refresh your page often so you don't miss any posts, too!
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Pixie won't eat the gravy food, so I took the gravy it rubbed it on his mouth and then on his gums. Is this enough or do I have to go the corn syrup? I'm sorry if things got posted several times but I'm having network errors all the time so as I'm working with Pixie, my daughter tries to post the message. Please forgive me if I can't change the subject line in the original post but I seem to be missing what it is I should be doing. Perhaps when I have more time I can try figuring out. In the meantime, I'm going to do another BG test and let you know what it is. Anne
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Don't worry about updating the subject line right now - I won't leave you until Pixie is safe. If we get disconnected, just follow the guidelines for steering low numbers.

Yes...since he won't eat the gravy, try rubbing a bit of corn syrup/Karo on his gums.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

I saw the 63 on the spreadsheet. We're moving in the right direction. Let's try a little bit more corn syrup and retest in 20 minutes.

You're doing fantastic, Anne. I know this is really stressful.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Thank-you. I'm glad you're looking at the spreadsheet as I am able to change these numbers without any problems but I am not always successful at submitting a response. If you don't hear from me it is because of network errors but I will continually update the spreadsheet. I am continuing to rub the gravy and will check his BG in 15 to 30 minutes. As I understand it, I need to have two consistent numbers about 68 without any high carb or syrup. Is that correct? If this is so, then this means it will be a while before we get to that condition. Thanks again for all your posts, I am able to get them but not necessarily able to post.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

I know, Anne. This board is extremely frustrating tonight. You're doing a great job. Yes - we want to get Pixie above 68. Once we do that, we want to hold off on giving any more Karo/high-carb food and see if we can get two readings in a row that are still above 68/rising.

I know you're there - and I can see your spreadsheet. It's okay if you can't post immediately. Just know that we're watching for you!
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

One more note that I want to get out there just in case we lose touch - since this dose took Pixie below 68 (AlphaTrak), he has earned an automatic decrease. Once we get past these low numbers, we'll get someone in here to help you with determining what tomorrow morning's dose should be.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Great job so far Anne!

I find that high carb food lasts about two hours so I like to test for a couple hours after giving gravy or syrup. However, once Pixie's numbers get above 68 you can go to testing every half hour and if they go over 100 (all AlphaTrak numbers), you can go to hourly testing.

For future reference, if Pixie won't eat the gravy, you might want to try getting a dropper or plain (non needle) syringe so you can syringe feed the gravy. Or rub the syrup on the gums or add to a couple drops syrup to food she will eat.

These numbers are worthy of a reduction for Pixie. Since there is a food change in the mix, I think it would be safer to go to 2.5U tomorrow morning if all she wants to eat is the 1-2% carb food.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

We're making slow progress - up to 65. Looks like it's time for some more Karo syrup.

Like Wendy said, if you can mix some Karo in with some regular food, that can work, too. I'm guessing Pixie still doesn't want to eat anything on his own?

How are you doing?
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Pixie's readings - +3.75= 63 and +4.5=65. It doesn't seem like much considering I've been rubbing his gums with gravy but I guess he's not getting as much as if he were licking it up himself. Would I be better off rubbing with corn syrup or would that spike him too much and it's better in the long run to do it with gravy? Just a few questions I'm wondering about as I'm going through this process. Thank goodness he's so gentle and tolerant of whatever I do. He doesn't seem too bad right now because he's grooming himself, trying to clean all the gravy mess on his face.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Yes - rub the Karo syrup on his gums, not the gravy from the Fancy Feast. (I think you may have missed a few of my posts from earlier.) The Karo will bring him up much faster.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Karo in the US is what we call corn syrup. It's OK to bring the numbers up quite a bit at this point, you don't want Pixie hanging around the 60's for too long. They are safe numbers, but don't give us any room for dropping more. Karo won't spike him too much but should give a good bump to the numbers.

One thing you should do when you have time later tonight or tomorrow is to re-read this post. There has been lots of information suggested to you. For later, when you want to change the subject, go to the first post where you said "Happy Mother's Day". There is an Edit button to the right, click on it, then you can change that first subject line to give tonight's latest numbers.
 
Re: 5/11 Pixie AMPS=425,+3.5=322,+6=175

Ok I got you now, Karo time. I seem to be a bit behind but I am up to date now. I'll post in another 15 to 30 minutes either on my spreadsheet or here. I noted that I could probably put a few notes on the spreadsheet if I can't get a message out. So please note that if you start seeing longer notes on the spreadsheet, it's because I can't get through but I can still read your posts. Thanks for the support and kind words of encouragement. I guess it's not such a bad thing to go through. At least you understand that you have some control with the numbers if you have the right supplies.
 
Re: 5/11 Pixie PMPS=180, +2=79, +3.5=59,+4=63,+4.5=65

We did it :-D !! I know it might be only temporary but he's at 88. I have stopped the Karo and will check his numbers again in 30 min. Pixie's nadir is always usually +6 so hopefully we're almost out of the woods with the decrease. I have been trying to keep up with the posts and will definitely reread several times in order to process all the great information.

You know I learned a lot about this episode. I know that I need a better method for bringing Pixie's numbers up and I agree that a syringe would have been very useful for getting syrup or gravy in his mouth. I feel more confident about shooting low numbers now that I know I can do this without putting Pixie in too much danger. I have to admit, although his numbers were low, he didn't ever look too bad. I also figured out that his shaking is due to hypoglycemia because this evening he was exhibiting a lot more shaking as the numbers were going lower. So although other times Pixie wasn't officially hypoglycemic, his body thought it was and was causing him to shake and tremble. You know the first time I saw him shake, my gut feeling was that he was hypoglycemic but his BG test wasn't, so I was searching for other possibilities to explain it. I'm glad I know now that it's his own natural mechanism and probably resulted in many bounces and rebounds over the last three months.

I'm going back to Pixie now and will call back in later. Anne
 
Re: 5/11 Pixie PMPS=180, +2=79, +3.5=59,+4=63,+4.5=65

Well done, both on the numbers and that subject line! :thumbup If you could update the subject line with the 88 then people scanning the board will know Pixie is in safer numbers again.

The first time is always the hardest but you are right, you do have control with food. Two things you might want to do. Keep track of what you fed, how much and when. You want to get an idea what works or didn't so you know what to do next time. Over time, I've gotten an idea how much high carb to feed. It can also be different at different times of the cycle. Earlier in the cycle you might need more carbs than for low numbers late in the cycle.

Next up will also be an experiment on food. Although we suggest gravy the first times, some people have really carb sensitive cats and can get by with medium carb food. Regardless, you do want to find a higher carb food that Pixie really likes and will eat when you need to. You also have to be careful not to feed too much food earlier in the cycle, in case you need to feed more later. One strategy might be to feed part of the meal after you've taken the +2 test. If he's diving then, you can hold back part of it and substitute with higher carb food.

Interesting that Pixie was shaking. Often cats show no signs of being low. Neko just let's me know she's really hungry, but then she always is. :lol: But seriously, sometimes she'll go to the testing spot letting me know it's time for a test. Pixie probably feels uncomfortable in those numbers as it's been a while. I hope as he gets more used to them he'll not shake.
 
I saw the last number 12.2(220). Looks like Pixie has started to bounce and you can call it a night. Great work tonight!
 
Thank-you Shelly and Wendy and all of you out there going through this with me. I've updated my title line to let everyone know Pixie's last number spiked so I guess I might have overdid it with the Karo. It obviously is very effective and you really don't need much but I kept rubbing more and more and probably used about two tsp. Rubbing the gums doesn't give you a good sense of how much is getting in so I guess, the tendency is to do more. Definitely, the karo is much more effective than the gravy if you need something fast.

Tomorrow I'll start looking for something Pixie will eat - low carb for everyday and high and/or medium carb for emergencies. Too bad I started with Tuna and Chicken because he just loves it but I'm not crazy about feeding it to him. I'm glad we're lowering his insulin dose to 2.5 starting tomorrow morning, it makes me feel better that we're going down and not up.

I'll continue to test Pixie's BG over the next little while and will be sure to post his results on the spreadsheet. If I encounter any problems I'll post a message. Anne
 
Usually just a drop or two of karo are good enough. But you wouldn't be the first person to overdo it the first time their cat went low. :oops: Have a great night.
 
Anne,

You're right - you have definitely learned a lot tonight about shooting low and steering numbers tonight. That's a heck of a way to get familiar with it all, though! ;-)

I sent you a private message (PM). When things settle back down, look towards the top, left-hand side of the page. Next to "User Control Panel," you'll see (# new message). If you click on that new message link, it will open up your messages. (Sorry - I don't know if you've used the PM system yet, which is why I'm giving you directions.)

Pat yourself on the back for a job well done tonight!
Shelly
 
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