? 5/13 Fred +2 543, +7 518 PM dosing advice after hypo

Purrberry

Purrberry

Member Since 2020
Last night's adventures:
https://www.felinediabetes.com/FDMB/threads/fred-6-5-57-on-alpha-trak.247300/#post-2789365

First, an amazing thank you to @Bron and Sheba (GA) for staying with me and pulling us through last night!

And thank you to @Summer and Susie and @Suzanne & Darcy for checking in and your kind words! As you've been through it yourself....what a nightmare.

Fred is at 227 at +11.25. I can almost be sure he'll rise like a kite today, but nothing is for certain! Other than the definite decrease to 7u, should I do anything different this morning? Drain the depot a bit? I'm still so frazzled and freaked and I'm terrified for this to happen again!

Fred is still kind of off. He's strangely docile, I guess you'd call it. I'm not sure he's particularly hungry, after being stuffed with carbs all night, so I don't know how he'll do with breakfast. And oh, his poor ears! The sun was backlighting them just now, and they are a mess. :-(( I had trouble getting a decent drop just now..I think they are swollen. Ugh! Poor boy!

Thanks again, everyone!
 
Hi Kathleen, you must be really tired after staying up most of the night.
You did really well managing Fred through those low numbers.
Let’s see where he is at AMPS, but I’m thinking with him not being particularly hungry, you being really tired, and those low numbers that stayed low despite HC food and Karo last night, it might be a good idea to give a reduced dose to drain the depot a bit.
 
@Bron and Sheba (GA) Thanks to your help! I am exhausted, yes, but could barely sleep for the anxiety and adrenaline.

OK, so his AMPS is 295. He's flying up fast. What do you think? I do like the idea of draining that depot, even though he's popping up as expected.

He ate a bit of dry around 6:45 AM. Will try breakfast now.
 
He just finished. He ate it all, albeit with less enthusiasm than normal, a few more sprinkles of FortiFlora, and didn't lick every last scrap as he usually would. Plus he wouldn't come down to the kitchen; he had room service.

I'm worried...is there any kind of "hypo-hangover" I should be watching for? He's not himself.
 
Ugh...now he is under the bed again, and it's time for his injection. :( (whatever dose that may be)
 
Purrberry said:
He just finished. He ate it all, albeit with less enthusiasm than normal, a few more sprinkles of FortiFlora, and didn't lick every last scrap as he usually would. Plus he wouldn't come down to the kitchen; he had room service.

I'm worried...is there any kind of "hypo-hangover" I should be watching for? He's not himself.
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That’s good he ate.
A hypo is when a cat has symptoms from the low numbers. From your description, I don’t think Fred had a hypo, but he certainly had low numbers which were slow to come back up. He may be feeling a bit lousy after the low then the higher numbers. His body isn’t used to low numbers any more.
I think a half dose, to drain the depot, if you are comfortable with it. I won’t be able to hang around though.
It is up to you, you hold the syringe and you must be comfortable with what you do.
I see @Gill & George is online. Hopefully she will see this. Can you hang on for a bit?
 
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I coaxed him out just enough to reach in and give him 3.5u. Thank God for chicken PureBites! He slipped back under the bed...and for now, I will let him be.

I'm tired, but I will be able to test, yes. My guess is he will remain high, and it will be tonight's injection that will be nerve-wracking!

Thank you again @Bron and Sheba (GA) Have a good sleep!
 
I hope you have a good day Kathleen and Fred feels better and behaves.
Don’t count on the bounce in case he decides to come back down again. I’d get a +2 to start with.
I’ll look in on you when I wake up.
I’m going to tag @Bandit's Mom and @tiffmaxee and ask them if they can keep an eye on you during this cycle. I know Bhooma is online atm and Elisa will be online in a couple of hours I think.
Goodnight!
 
Your getting some great advice, Kathleen. I think he will stay pretty high today too after last night but if you can just get a +2 to see if he is rising, falling or staying about the same, that should be a good indicator of where he is going this morning. I think the +2 will be higher but with the 1/2 dose who knows. Like last night, your +2 was lower than your PMPS which was a sign that he would be coming down. Good luck and I hope you have a safe, uneventful morning and Fred gets back to his normal self.
 
Sorry just saw the message.


I'm glad you managed to coax him out, as @Bron and Sheba (GA) said their is no guarantee that he won't come back down when the shot onsets, and even though you have reduced the dose significantly, the depot of the 7.5 units might still drive his numbers down in the early part of the cycle.

So if he is dropping at +2 that's a sign he may be heading into another active cycle.

Did he get a snack with his shot?
 
Oh, I'm so hoping I can coax him out again! I'm sure he's exhausted, as I am, for he didn't sleep all night, either! When I peek under to check on him, he's looking at me like, "Don't even try it, Lady".

Gill & George said:
Did he get a snack with his shot?
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He did eat his full breakfast about 15 minutes prior to his shot, yes. So that's a positive.

Summer and Susie said:
Like last night, your +2 was lower than your PMPS which was a sign that he would be coming down.
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I know...when I saw that I knew it was a warning sign. I always wake up around +5, (2:30 am here) so I was planning on testing him them. He beat me to it, though, jumping on me at +4.5. But I just about died when I saw that number!

Question for @Suzanne & Darcy. You mentioned in my last thread that Darcy does not react to HC during a hypo. Does he react if you were to give it to him just to eat? I've always assumed Fred would, and changing out his dry was one of the first things I did after he was diagnosed. But that change never impacted his numbers as I'd hoped it would. I have actually observed that Fred seems to be more food sensitive than carb sensitive. I've never wanted to put it to the test and pop his numbers up, but maybe last night was a good lesson in how carb sensitive he is!
 
Weeeelllll, I think we're OK going down again..

+2 543.

Have I mentioned Fred is a bouncer? :banghead::banghead: Now, of course, I wish I gave more insulin. But I think it was better to be safe than sorry, if 543 can ever be called "safe".

In basically the cutest thing, when I went to check on him under the bed, his "sister" Sadie came over and went under the bed to sit next to him. They used to be very bonded, but not so much in the past year or so. So it was so sweet to see. Of course, that's what made Fred move out from under the bed. :rolleyes:
 
Don't forget to enter the +2, and any other other test, on the spread sheet. That is sweet that Sadie went to keep him company. Too bad Fred did not appreciate it. We'll get you back on track with the insulin at PMPS but I don't know what will be recommended. Do not be surprised with a bounce after last night.
 
Purrberry said:
Weeeelllll, I think we're OK going down again..

+2 543.

Have I mentioned Fred is a bouncer? :banghead::banghead: Now, of course, I wish I gave more insulin. But I think it was better to be safe than sorry, if 543 can ever be called "safe".
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Wish there Fred! No need to get a rocket to the moon!

He would have bounced irresponsible of what you shot, and with the substantial depot of the 7.5 units that usually helps them get over the skipped or reduced shot pretty quick, and it gives you a bit of breathing space.
 
Purrberry said:
And hopefully sleeping space!


He is channeling Greta Garbo today...he wants to be let alone. Poor buddy.
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He had a really difficult time last night as well as you. I don't blame him for needing some space and you need some sleep. What are you going to do tonight at PMPS? You might want to ask for advice on how much to shoot.
 
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Summer and Susie said:
You might want to ask for advice on how much to shoot.
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Thanks so much for checking in. I just signed on to do so. I tried to nap but literally could not calm my own heart rate enough. What happened last night has severely freaked me out. And it doesn't help that Fred is in the blacks and clearly feels like sewage today.

@Wendy&Neko I was hoping I could grab your eyes on this as well since you are familiar with Fred. I'll have to decide his evening dose. Fred is clearly massively high which is the bounce, or the reduced shot, or both. The last thing I want is for him to all of a sudden slide down overnight again. Additionally, I HAVE to be out most of the late morning/early afternoon tomorrow, leaving about 90 minutes after his AM injection. Obviously, we'll see what he is at PMPS, but I thought some preliminary thoughts would be beneficial.

As mentioned above, Fred feels awful. He ate his breakfast, but nothing since other than a few PureBites. He'd usually have had 2 snacks by now. So I'm worried about what he'll eat for dinner and overnight.
 
I am 2.5 hours away. I shoot at 9:30 and 9:30 EST. I have a little wiggle room today, since his morning shot was a half hour late. But I also hope I can get some guidance soon as well! Thank you again for following us today.
 
@Butters & Lyla Kathleen needs some help. She doesn't know what to shoot tonight at PMPS after a very low, scary night last night and a super high day today. I know you don't like giving advice but the others are not responding. Can you help with this? I would think after a 1/2 reduction this morning and the super high numbers today that maybe a dose of 6 units might be safe but I just cannot know. I hope others will come on really soon because Kathleen needs some good advice.
 
My two cents so you have a reply - when he bounces, based on past data, he stays high for about 3-5 cycles. If it were me, I would shoot the full "new" dose of 7U. You do still have the depot to contend with, but given the half shot and being so high right now I don't think it'll pose much of an issue.

If you desperately need sleep and for your nerves to recover, do a reduced dose.
 
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I do suspect he might break this bounce pretty hard, so just be sure to do the +2/+3 and midcycle checks over the next few days. When Mr Kitty breaks a bounce he comes down hard and lower than usual.
 
Thank you for your response, Melissa! Kathleen, are you comfortable going back to the 7.25 units? He is really high and I don't think you will have the same problem as last night but I do wonder if going from 7.5 to 3.5 and then back to 7.5 is really good for the cat? You are much more knowledgeable than I am Melissa so if you think it is safe then Kathleen should trust you. My opinion would be to go to 7 units only because Fred had a nightmare last night on 7.5 units and I think a .25 unit reduction would have been a good call.
 
Oh Kathleen, I am just catching up on your horrendous night. I do hope you managed to get some sleep today, it's like the worst combination hangover/jet lag after one of those nights. Fred's situation is my worst fear, you have this adrenaline panic - want them to eat, don't know how much to give them for fear of them overeating...and then this ongoing dread of what's ahead and waiting with baited breath for advice on what to do. You did wonderfully and I hope he lets you have a decent night's recovery sleep.

Have you thought of underbed storage to blockade Fred's hiding place? I have a bedskirt and left a little area at the edge that's easily accessible so I can drag (cough, sorry...coax).

Hope you get some additional guidance, though I am also a grateful and appreciative recipient of Melissa's wise input!

Hang in there. :bighug:
 
Okay, Kathleen. You got some good advice for the PMPS shot. 7 units. Just make sure you do a +2 to see where Fred is. I have a feeling he will be high all night but I just don't know. I'm going to bed soon but be sure to ask questions if you have any concerns during the night. Thanks to all of you that got back with Kathleen. I don't want her to go through another night like last night nor do I want to see Fred in the blacks or reds.
 
Kathleen, something else to consider. Had he stayed quite low today even after the BCS shot this morning, it may have been warranted to do another reduced shot again at pm. Since he's quite high, I would suggest going to 7u which is his new dose, given the proper reduction of 0.5u which he earned last night. With SLGS you'd hold this dose for 7 days unless he earns another reduction with numbers under 90.
 
Purrberry said:
I was hoping I could grab your eyes on this as well since you are familiar with Fred. I'll have to decide his evening dose. Fred is clearly massively high which is the bounce, or the reduced shot, or both. The last thing I want is for him to all of a sudden slide down overnight again. Additionally, I HAVE to be out most of the late morning/early afternoon tomorrow, leaving about 90 minutes after his AM injection. Obviously, we'll see what he is at PMPS, but I thought some preliminary thoughts would be beneficial.
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I agree - 7 units is his new dose. Given Fred's history, you have a few bouncy cycles ahead of you. Of course there are no guarantees, but I'd almost wager on it. The reason he's not feeling great is that he's not comfy in blacks (thank goodness!!). You probably didn't need the depot drainer BCS this AM, given he'd gone up 70 points in 1/2 an hour, but it's give you yet another safety margin for time away tomorrow. If you want to test at your regular shot time today (11.5 hours after his AM shot), feel free to shoot early if he's still sky high.
 
Gosh...thank you everyone for chiming in!

Christie & Maverick said:
Increases and decreases at this dose (above 5u) are typically by 0.5u.
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Yes, I do in/decrease by 5 units, so no matter what, the most I'd shoot would be 7 units. But gaaaahhh! I'm not sure what to do for tonight. Because....

FrostD said:
I do suspect he might break this bounce pretty hard, so just be sure to do the +2/+3 and midcycle checks over the next few days. When Mr Kitty breaks a bounce he comes down hard and lower than usual.
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This is Fred. When he breaks, he breaks. (as evidenced by last night) He DOES usually stay in a bounce for 2-3 days, sadly. But a weird thing happened when I was traveling in March. I had a great pet sitter who was a master tester, but she did not test overnight. Something must have been happening with his numbers (I shudder to think what), because all of a sudden, she was getting these insane readings of 700. But just as fast, in the same cycle, he'd drop nearly 600 points. It was unbelievable. I ended up reducing twice in 6 days to keep him safe. I'm fairly certain it was because he ate less while I was away, but it certainly is my fear it could happen again.

Liz & Minnie said:
it's like the worst combination hangover/jet lag after one of those nights.
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Ha! Yes, exactly! I told my husband that I feel like I do when we've just traveled 30 hours to Australia. And I thought of you, because I know you're going away and are worried about this very thing. But you are being very smart with the vacation dose! And good idea on the under bed storage! Never thought of that!

I'll see what he is at PMPS. He ate very well just now. I'm leaning a bit towards 6.5, just because I'm now completely paranoid. If I see any indication he's moving down fast, then I definitely won't do 7. But then I may regret it if he stays super high. :banghead:

@Bron and Sheba (GA) @Christie & Maverick Just saw your responses as I was typing. Ack..my stomach is in knots over this!

Will report in with his PMPS.

@Summer and Susie You sleep well tonight, and thanks again for all your support today!
 
Thank you @Wendy&Neko ..Just saw your post as well. I was having trouble getting my reply to post.

I will test at 11.5/his normal time, and shoot early if he's in the stratosphere. Must get out of these blacks!
 
Summer and Susie said:
@Butters & Lyla Kathleen needs some help. She doesn't know what to shoot tonight at PMPS after a very low, scary night last night and a super high day today. I know you don't like giving advice but the others are not responding. Can you help with this? I would think after a 1/2 reduction this morning and the super high numbers today that maybe a dose of 6 units might be safe but I just cannot know. I hope others will come on really soon because Kathleen needs some good advice.
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Got your tag. Sorry, I'm not comfortable giving dosing advice in this situation. I don't have enough experience yet to do that. FWIW, with regards to shooting, I would've suggested waiting and seeing what the PMPS is and unless low, shoot the regular dose of 7u. But I would've wanted other more experienced people to weigh in, which they have:)
 
Butters & Lyla said:
Got your tag. Sorry, I'm not comfortable giving dosing advice in this situation. I don't have enough experience yet to do that. FWIW, with regards to shooting, I would've suggested waiting and seeing what the PMPS is and unless low, shoot the regular dose of 7u. But I would've wanted other more experienced people to weigh in, which they have:)
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Thank you. That was the consensus. 7 units. Hey, if others do not see a post then I will come to you for advice. You seem to be very knowledgeable and would serve better than to not have anyone around to advise since I cannot.
 
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