5/14 Pixie, PMBG= 140, +14=158

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caringcdn

caringcdn

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What a difference a good night's sleep makes - I feel like a whole, new person. Pixie is doing well this morning and his numbers didn't bounce too high. I will check at +1 to see how he's handling the dose today.

I had a little trouble giving subq fluids this morning. I poked about 3 times in different places and Pixie howled every time I started the fluids so I decided that it would have to wait until this evening. I wonder if anyone with experience with subq fluids would tell me if subq fluids can be stopped cold turkey or if it should be done gradually. I'd like to get to once a day which is what my vet indicated would be nice to see but I'm not sure when to do this. He's still peeing large puddles but they are getting better and he's drinking considerably less.

Thanks for your very informative posts, Julie. I really appreciate the information and the link as it allows me to go back and review the parts of the protocol that apply at that moment. I hope everyone has a good day. Anne

viewtopic.php?f=9&t=118668

So glad that I decided not to go to my meeting this morning. I had a gut feeling, Pixie might respond to this morning's dose which came from a new vial, not that it matters. I reread some of the earlier posts about what to do when I hit the lower numbers and I hope I'm prepared. I'm still using the Alphatrack 2 meter as I forgot to switch over this morning so my worry point is 68. Pixie dropped 70 points in 2 hours and he is currently eating some low carb food. I'll test in 30 minutes again. I also want to mention that in the last couple of days, I haven't noticed Pixie shake at all which I attribute to his more stable numbers. Interesting, hmmm!

I will write my updates in this post as I don't have much time. I am having computer troubles with this site and so please bear with me. I have given Pixie a tsp of his Sensitivity-VR(higher carb) food mixed in with his low carb food. He is eating it right now and I will test in 15 to 20 min. Any other suggestions. I figure if Pixie is still going down, I will give him the glucose solution.

Pixie is dropping a little too quickly for my comfort. He has eaten about 1 tsp of higher carb food but won't eat more. I have rubbed karo on his gums and will check him in 15 min. If he continues to drop even further and no one is able to respond then I will phone my vet (didn't have to luckily). Pixie is not showing signs of hypoglycemia - a good thing - but I don't want to wait for that point before I seek treatment.

Pixie's last reading at +3.25=77, above the alphatrack 2 threshold of 68. I know we're not out of the woods just yet but I'm breathing again. I will monitor closely over the next couple of hours until I get two consecutive readings above 68 that are not karo and/or food related. I know that the karo is short acting. I apologize to anyone following Pixie's updates if you notice, I keep changing the times. It's because in a bit of a panic, I didn't have the times quite right but they are now. Lastly, I understand that Pixie is automatically due for a lower dose so I wonder if someone would suggest if I go down by 0.25 to 1.5u or by 0.5 to 1.25u this evening. His body seems to be reacting so quickly to the insulin on this new food. Amazing what a change in diet can do.
 
Re: 5/14 Pixie AMPS=158, +2=88, +2.5=63, +2.8=59

Morning. ~O)
Those first greens can be scary but you are there with him. Try to breathe....
watching for that next test.....
 
Re: 5/14 Pixie AMPS=158, +2=88, +2.5=63, +2.8=59

Anne:

With the AlphaTrack, remember that the numbers are 18 points higher that what you'd see on a human meter. Most of our posts are referring to numbers on a human meter. You need to begin to intervene with food before numbers are in the 60s. If you are feeding HC food with each of your tests, you're on the right track. However, I'd go a little more liberally with the HC since numbers aren't coming up terribly quickly. At this point, Pixie's numbers warrant a dose reduction so there's nothing to prove. (Although, you don't want to over do the HC, either.) The goal is to get Pixie surfing in safe numbers. To me, that would be in the 70 - 80 range on an AT meter.
 
Re: 5/14 Pixie AMPS=158, +2=88, +2.8=63, +3=59, +3.25=77

Anne,
would you try to post a reply to your condo? I know the board has some difficulties but it's hard to know when you have added more and need attention
without you bumping yourself back up to the top.
 
Re: 5/14 Pixie AMPS=158, +2=88, +2.8=63, +3=59, +3.25=77

Pixie's last reading at +3.25=77, above the alphatrack 2 threshold of 68. I know we're not out of the woods just yet but I'm breathing again. I will monitor closely over the next couple of hours until I get two consecutive readings above 68 that are not karo and/or food related. I know that the karo is short acting. I apologize to anyone following Pixie's updates if you notice, I keep changing the times. It's because in a bit of a panic, I didn't have the times quite right but they are now. Lastly, I understand that Pixie is automatically due for a lower dose so I wonder if someone would suggest if I go down by 0.25 to 1.5u or by 0.5 to 1.25u this evening. His body seems to be reacting so quickly to the insulin on this new food. Amazing what a change in diet can do.
Click to expand...
 
Re: 5/14 Pixie AMPS=158, +2=88, +2.8=63, +3=59, +3.25=77

HI guys .. no advice from me, but just wanted to say you're doing a great job with pixie, and I like hearing his shakiness is going away! Have a great day guys!
 
Re: 5/14 Pixie AMPS=158,+2=88,+2.8=63,+3=59,+3.25=77,+3.75=1

Sorry, I'll update posts from now on with new replies. Pixie's numbers are going up now and I may have overshot a little more than I was hoping. I gave less Karo this time but I agree, Sienne, if I had started intervening with a little HC food before he hit the 60s then I may not have had to use karo.

Pixie's not interested in eating right now but I will continue to coax him to eat. Interestingly enough, he has his head over the water bowl again.

Quick question, how does everyone keep track of the additional tests we take on the spreadsheet? Every time I try to put numbers in the comments section, it reads as an error. I'd like to keep a record of these numbers for future reference and the spreadsheet would be nice as it is so easy to read and use to reference back to prior episodes.
 
Re: 5/14 Pixie AMPS=158,+2=88,+2.8=63,+3=59,+3.25=77,+3.75=1

I'm watching you for the next hour. Sienne is at work and can't really hang out.

You are definitely to go to 1.5u ....
someone may suggest more after we see how Pixie continues onward.
It always depends on your ability to monitor and you seem to be there with Pixie.
 
Re: 5/14 Pixie AMPS=158,+2=88,+2.8=63,+3=59,+3.25=77,+3.75=1

You manually put in the numbers.... stacking them.... and then you have to manually put the color in the square....
look at Sienne's spreadsheet for an example...
 
Re: 5/14 Pixie AMPS=158,+2=88,+2.8=63,+3=59,+3.25=77,+4.5=65

Hi, I was too complacent this time around. Pixie went from +3.75=115 to +4.5=65. He won't eat so I rubbed his gums with karo but a little less this time. I will definitely retest at 4.75. Thanks for your help Rhiannon.
 
Re: 5/14 Pixie AMPS=158,+2=88,+2.8=63,+3=59,+3.25=77,+4.5=65

looks like the syrup wore off...

do you have any food with gravy in it....
it helps in situations like this.... you give them a spoonful of gravy.... not food....so they aren't full and not wanting to eat.

Remember you are there with him..... you are doing great....
 
Re: 5/14 Pixie AMPS=158,+2=88,+2.8=63,+3=59,+3.25=77,+4.5=65

you don't need the 911....
I'm here with you and will continue watching. My dgm is having a difficult morning so I decided to stay home from work.
 
Re: 5/14 Pixie AMPS=158,+2=88,+3=59,+3.25=77,+4.5=65, +4.75=

Sorry about the 911, I wasn't sure if I needed to draw attention to my condo.

Pixie won't eat and I do have food with gravy. He probably won't eat it because he didn't last time. I have a syringe now and I'll try to get a tsp into him. He's trembling again.
 
Re: 5/14 Pixie AMPS=158,+2=88,+3=59,+3.25=77,+4.5=65, +4.75=

You can take out some numbers in your subject line as you need to always keep the latest number up where we can see it.....

Come on Pixie,
eat some gravy....
 
Re: 5/14 Pixie ,+ 5=97

No he won't eat but I used the syringe and I definitely got some in his mouth. I will retest in a few more minutes but I will try getting more gravy into him. He's unhappy with this method but can't be helped.
 
Re: 5/14 Pixie ,+5.25=142

I gave him a little more gravy before this last test and I'm wondering if I need to continue the gravy or just monitor. He probably won't eat for me at this point as he's getting annoyed with all the poking and force feeding.
 
Re: 5/14 Pixie ,+5.25=142

so how long has it been since any syrup?

I see on his ss that his usual low for the day is around +6.... but if it dose is too high after the food change, he could drop again later in the cycle....
you can probably wait an hour to test again....
you don't want to be complacent.... but they do get tired of all the attention...
 
Re: 5/14 Pixie ,+5.5=139

It's been since +3=59 that Pixie had his last karo. I gave him a little more gravy when I saw that his numbers are slightly decreasing again.
 
Re: 5/14 Pixie ,+5.5=139

that 139 and 142 are pretty much the same.... just meter variance...

You do what you feel comfortable with.... give him longer breaks in between pokes....
you know how to steer....when needed....


all those nice greens and low blues are healing moments for Pixie's pancreas.....
 
Re: 5/14 Pixie ,+6=139

Thanks again for all the support Rhiannon. I'm sorry for all the changing on both my spreadsheet and my subject title. Even though I have all the numbers and times written down, in the moment, I was confused many times and wrote down wrong times. I think they're all correct now but I'll double check later when I am more focussed. This last reading was definitely at +6 which is usually Pixie's nadir however I will continue to monitor as I know the numbers are due to the karo (if there is still some residual effect) and the gravy. I didn't give Pixie any gravy this last time which means that his last shot of gravy was at +5.75. I want him to start eating again soon.
 
Re: 5/14 Pixie ,+7.25=103

I gave Pixie a bit of gravy, using a smaller syringe at +6.8=106 and when I retested 25 minutes later at 7.25=103, at which time I gave him a little more gravy with the larger syringe.
 
Re: 5/14 Pixie ,+8.5=115

Good job today, Anne, and Rhiannon did a super job of helping you and Pixie!

I see at +10 that he's at 135. A few of us are discussing what you should do for tonight. I'd give him a break until about +11.75 and then test and post. Is that possible? We want to see if he's still rising or drops back down before we decide on the dose or whether you should possibly skip again and drain the depot a little more. That 59 on the AT would certainly earn a reduction, normally, but it could still be some depot effects from the 2.5u dose (although skipping yesterday morning should have drained it some.

So take a break and please post the +11.75 so we can see where he is. Thanks!!
 
Re: 5/14 Pixie ,+9.25=135 Dosing question

I'm looking at Pixie's numbers over the last few days and the diet change made a great difference in Pixie's BG levels. I am almost wondering if Pixie is one of those cats that can be regulated by diet alone. Regardless, I'm a little concerned about this evening's dose. Pixie definitely showed signs of hypoglycemia so I waited too long. What throws me is the spreadsheet because the numbers are for human blood glucose meters and I'm using the AT2. I wonder if I should switch over to the Accu Check this evening? In addition, the AMPS was from a new vial of insulin, not that it should matter but I'm not absolutely sure. I really don't want a repeat of this morning as I found it exhausting - I have chronic fatigue and my energy stores are being quickly depleted. Maybe with the diet change, I'm going about it backwards - trying to reduce to find the right dose instead of starting all over again. What would happen if I start at a minimum dose and work my way back up? I'm open to suggestions. Anne
 
Re: 5/14 Pixie ,+9.25=135

Anne

You can switch to the Accu Check any time you are ready. Please just be sure and let us know that you are and mark it on the SS.

What were the signs of hypoglycemia that he showed? His numbers did not appear to get so low as to cause clinical hypo signs but ECID. It's important we know what you saw so we can be cognizant of this with him and use caution.

It's possible to reduce him to 1u and see where he goes. But first, let's see what he is in the next hour or so and what he does. And please be sure and let us know which meter you are using with the number.
 
Re: 5/14 Pixie ,+9.25=135

I must have missed the last 2 posts before I posted. I'm so glad that some of you are discussing his next dose. Yes,I can test and post around +11.45. I've taken away his food because I want him to eat at PMPS. He really hasn't had much today, maybe 2 oz, besides the gravy and glucose I gave him.
 
Re: 5/14 Pixie ,+9.25=135

Great. And that's +11.75.....so 15 minutes before your normal shot time. thank you for picking up the food. We don't want a food influenced number and we want him to eat later.
 
Re: 5/14 Pixie ,+9.25=135

Regarding subq fluids, have you seen this video we made on how to do them? [youtube]TtSzMuDgx78[/youtube]

If you haven't been giving them long and your vet wants you to stop, you can just stop. If you've been giving them a long time, I'd just go to every other day for a few days. Do you know that giving subq fluids can lower the BG? You want to be sure you give the subqs at a time that it is least likely to cause a big drop in the BG.
 
Re: 5/14 Pixie ,+9.25=135

Pixie's hypoglycemic signs were a very pronounced trembling of his legs. I'm kind of used to his shivering and shaking but this was different and you couldn't mistake it. He was standing at the water bowl and his legs looked like they wouldn't hold him up. For the next, maybe 4 or 5 hours, he was parked by the water bowl with his head leaning on the rim. Since he's stabilized, he's back to laying on his cushion, away from the water bowl and no shaking, shivering or trembling. I sensed the urgency just after the +3 =59 test and that's when I gave the Karo. It took a little while for it to kick in but I believe he was still shaking by the +3.25=4.3 test and I gave more karo. I believe his shaking subsided by the next test 15 to 20 minutes later.
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

I will use the Alphatrack 2 to monitor as I want to be sure of what I'm doing in case we have a repeat of this morning. I put some food out and he is eating but he doesn't usually eat 1 or 2 oz at a time.
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

I didn't know that subq could lower the BG. For months now I've been giving the subq fluid at the same time as I give the insulin but I don't inject in the same spot. I use the hind legs for his meds and the scruff of the neck for the fluids. Thanks Marj for the video and as soon as I have a chance I will have a look at it. Do you want me to hold off on the subq fluids and give them later. I can do that.
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

I see he is at 140 and that's with the AT right?

It would be a lot to drop his dose to 1.25u because we don't know how much of this is depot and how much isn't. We don't want him to lose too much momentum but we do want to keep him safe and keep you from having too many of these cycles.

The other option because he hasn't come up much at all is for you to skip again, let the depot drain a little more, and reassess in the morning.

What would you feel best about doing? And yes, I'd hold off on the fluids until we decide what to do.

When you say you are shooting in the hind legs.....you are shooting subq and not in the muscle, right?
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

Hi Marje, my preference is to skip the dose this evening and reassess in the morning if everyone is in agreement that we won't set him back too much. Somehow I don't think so, I think his dose is still too high for his new diet.

I shoot the subq fluids in the scruff of the neck and the insulin and other needles under the skin in the area of his back legs - not in the muscle.
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

I think it's fine for you to skip, drain the depot a bit more, and see where we are tomorrow.

My suggestion would be to check at +2 and see where he is. Then you can decide from there on the fluids. Regardless of the fluids, we want to be sure he continues rising and doesn't come back down. If his depot is large, he has the potential to dip again so we just want to see a rise or flat.

Sound good?
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

Thanks, Marje. It sounds great and I will check at +2. Quick question - if Pixie has a large depot and starts to dip down, do I treat it the same way as we did this morning? Push the LC if he'll eat - push the HC if he starts getting into the 70s and - use the karo if he gets to the 60s.
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

I'd try the LC as much as possible but if he gets into the 60s, I would give him a drop or so of karo or HC. Because you didn't give him another injection tonight so he won't onset, as his depot drains, the food should be a little more effective. you might need just HC for the lower numbers if he decides to dip.

Just post if you need help. I'll be around for a bit and then back later.
 
Re: 5/14 Pixie, Using AT 2, +11.45 - PMPS= 140

(((Anne))) sounds like an overwhelming day. I'm so glad Rhiannon was on to stay with you through this morning's low numbers.

Usually when people skip a shot they aren't still fighting low numbers in the next cycle - not that it couldn't happen, but it's not typical. Hopefully skipping tonight is going to give you a break. Getting the +14 (2 hrs after when you would've given the shot) will help us see what's going on. We'll keep counting now from the last shot this morning, so +14, +16, etc.

I think i'd switch over to your other meter asap. Mainly because most people here "read" the human meter numbers more easily and will recognize when you need help, and because you can easily refer to the protocol for when numbers are a concern and when they aren't.

When you get below 50/68AT, that's not a danger zone but it is the "take action" zone. cats that are not diabetic might test in the 40's (human meter) and be perfectly fine. Punkin got into the 30's (human meter) and didn't show symptoms. But when we're giving insulin, we use that line (50/68AT) to say "gotta take action now."

You've done a great job today! You're getting a bit of a baptism by fire and there is some merit in your suggestion of dropping a bit and going up the dosing scale.

We are talking about the dose, but one thing for you to consider is that when a newly-diagnosed cat (under 1 year) has his numbers held in non-diabetic numbers (roughtly 68-160AT or 50-120 human meter) their pancreas can heal and kick back into gear and begin producing its own insulin again. So while this is hairy for you, there is likely some good happening in Pixie's body with him being in these under 160 numbers. I just want to make sure you understand that. If your goal is for him to go into remission and become diet-controlled, it's helpful to have him in this blood glucose range. He doesn't need to spend time under 68AT of course. The goal of the Tight Regulation Protocol is to hold their glucose tightly regulated into the normal cat's blood sugar range so that the healing can happen.

Anyway, does that all make sense? I just want to make sure you understand about the benefits so you can weigh the whole thing. We can drop back the dose, of course, but it might take him higher out of these numbers - it's hard to predict. If he could skate along at 80-120AT that would be ideal, but it's easier said than accomplished.
 
Hi Julie, that absolutely makes sense. I really don't want to lose a lot of the progress we have made with Pixie. In three months, these last few days are the most progress he has made and I'd like that to continue. That said, I must say that getting a reprieve this evening is a good thing for both Pixie and myself. I need the time to reboot my own energy supplies and Pixie needs a breather from me. This morning's episode has taken its toll on him - he's not as perky as he has been and his eating is so so.

I hope everyone has a great evening and once again, a big, big thank-you to Rhiannon who guided me through. She was great and I hope I didn't take too much time away from her own little kitty who wasn't feeling well. I hope he's better this evening. Kisses and hugs to everyone, Anne.
 
Anne

Sometimes we just need a break and so do our kitties.

He's coming up very slowly. We've been discussing a 1.25u dose. Would you feel comfortable with something like that for tomorrow if he stays flat here or just gore up a little?
 
a big, big thank-you to Rhiannon who guided me through. She was great and I hope I didn't take too much time away from her own little kitty who wasn't feeling well. I hope he's better this evening. Kisses and hugs to everyone, Anne.
Click to expand...

hey... Shadow is fine... she's otj.... :mrgreen:

and you are welcome! :mrgreen:
 
Yes a 1.25u dose for tomorrow morning sounds good. I'll test again at +14 to see if he stays flat or continues to rise slowly. I didn't give subq because I thought the break would do him more good.
 
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