5/27/21 Apple - Numbers not stabilizing

I have no advice for you, as I'm still new to this, but Apple and my cat, Alphyne, are playing the same game (and at the same dose). I'm hoping someone has some advice for you, as I know how very frustrating this is! :bighug::bighug:
 
I would try and get a test in at least once every cycle if you can. In the pm cycle I would recommend getting a before bed test in every night. If that test is lower than the Preshot number, I would set the alarm and test again later.

If he is needing a full dental extraction ( are you meaning all his teeth out) he will most likely do better afterwards.
 
Bron and Sheba (GA) said:
I would try and get a test in at least once every cycle if you can. In the pm cycle I would recommend getting a before bed test in every night. If that test is lower than the Preshot number, I would set the alarm and test again later.

If he is needing a full dental extraction ( are you meaning all his teeth out) he will most likely do better afterwards.
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Hi-Could you define "every cycle", please. I can definitely do that and then what report back? Yes on all of the teeth, which brings me to another question if you can answer. I was advised on the day of his appt to cut his a.m. dosage in half, then wait 5 hours for the actual procedure. Does that sound dangerous to you?
 
A cycle is 12 hours so you give the dose of insulin and then the next 12 hours up until the next dose is one cycle. Then it starts again with the next dose of insulin. Around about the middle of the cycle (+6) is when the lowest point (nadir ) is ... nadirs can vary from +4 to +8 or longer so if you can test during that time, it gives us an idea of how low Apple is going.

Did they mention when to last feed Apple before the procedure? A lot of cats get half a dose of insulin on the day of the procedure. They usually tell you when to last feed as well. I would also take the insulin in on the day in case it is needed, but remember to bring it back home afterwards. And ask them are they going to monitor the BGs while he is at the vet. I will tag @Wendy&Neko in case she has some other information about pre op insulin and fasting
 
Bron and Sheba (GA) said:
A cycle is 12 hours so you give the dose of insulin and then the next 12 hours up until the next dose is one cycle. Then it starts again with the next dose of insulin. Around about the middle of the cycle (+6) is when the lowest point (nadir ) is ... nadirs can vary from +4 to +8 or longer so if you can test during that time, it gives us an idea of how low Apple is going.

Did they mention when to last feed Apple before the procedure? A lot of cats get half a dose of insulin on the day of the procedure. They usually tell you when to last feed as well. I would also take the insulin in on the day in case it is needed, but remember to bring it back home afterwards. And ask them are they going to monitor the BGs while he is at the vet. I will tag @Wendy&Neko in case she has some other information about pre op insulin and fasting
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Thank you, I'll try testing at +4, 6 and 8 to pinpoint his nadir, then post so you can take a look. I'll follow your instructions for the vet. Thanks again, see you in a couple of days with results.
 
Vets differ on when they want the last food cutoff. Depending partly on when in the day the operation is scheduled, what anaesthesia protocol they are following. I would listen to what the vet says. If they no food after 10, remind them he is a diabetic and to check with the vet if you are talking to the receptionist.
 
Wendy&Neko said:
Vets differ on when they want the last food cutoff. Depending partly on when in the day the operation is scheduled, what anaesthesia protocol they are following. I would listen to what the vet says. If they no food after 10, remind them he is a diabetic and to check with the vet if you are talking to the receptionist.
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Caren & Apple said:
Thank you, I'll try testing at +4, 6 and 8 to pinpoint his nadir, then post so you can take a look. I'll follow your instructions for the vet. Thanks again, see you in a couple of days with results.
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Please excuse my replying to this message, I have help setting up posts and that help isn't available. Here is a recent view of Apple's spreadsheet. As always, the numbers don't make any sense, can you look and possibly see what we are doing wrong? https://docs.google.com/spreadsheet...5EC6CbekoWcUyJS9TE3P59Ybc/edit#gid=1683978764
 
Hi Caren - so sorry no one saw your latest note yesterday. If you are following SLGS (link here), Apple earned a 0.25u reduction to 1u with those dips <90/ Instead of increasing to 1.5u this AM, I would have decreased per SLGS. Perhaps @Wendy&Neko or @Bron and Sheba (GA) can stop by when they are on next to advise to dosing.

And I realize you may have challenges posting but if you start a new thread with today's date, you'll get a lot more eyes on your questions. Go to the board - link - and click on 'Post New Thread' in the top right hand corner (under your user name).

Hope that helps :bighug:
 
Bron and Sheba (GA) said:
Hi Caren, Susanne is correct. Apple earned a reduction in dose when he dropped under 90 3 times in the last 5 days under the SLGS dosing method.
At the moment he is bouncing from the green BGs. I would reduce the dose to 1 unit at the next dose.
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Oh my...my fault for not knowing how to post. I went over to the facebook page and one of the admins said she would increase to 1.50. Now that we did that for a whole day, it's safe to drop down to 1.00 tomorrow? Sorry I didn't come over here sooner, I thought my reply on the old post wasn't going to work.
 
As was mentioned previously, there have been a couple of cycles where the dose should have been reduced, given that you are following SLGS. Anytime you get a number under 90, the dose needs to be reduced immediately next cycle. To be honest, I'm not sure which Facebook page that is, since my understanding is that the one affiliated with FDMB is not supposed to be giving dose advice. In any case, it is most definitely bad advice that you were given to increase.

I would go to 1u next dose. More importantly, Caren, I would also get a +2 tonight, and continue to monitor and intervene with higher carbs if Apple is continuing to drop. He's been coming down all day, which says to me he's breaking his bounce. Post if you need help.
 
Christie & Maverick said:
As was mentioned previously, there have been a couple of cycles where the dose should have been reduced, given that you are following SLGS. Anytime you get a number under 90, the dose needs to be reduced immediately next cycle. To be honest, I'm not sure which Facebook page that is, since my understanding is that the one affiliated with FDMB is not supposed to be giving dose advice. In any case, it is most definitely bad advice that you were given to increase.

I would go to 1u next dose. More importantly, Caren, I would also get a +2 tonight, and continue to monitor and intervene with higher carbs if Apple is continuing to drop. He's been coming down all day, which says to me he's breaking his bounce. Post if you need help.
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Well I screwed up royal. I didn't test Apple until +5 and he was 43. I immediately gave him a couple of rubs with Karo and opened a can of Fancy Feast. 5 mins later he was 56 and I set the alarm for 15 more for another test. I have no excuse, I'm usually pretty good checking but I fell down horribly this time. Thank you for the info on dose reduction. I'll be testing him all night..
 
It's ok! It happens. Don't beat yourself up, hope he stays safe, since he should be getting close to nadir. It seems he agrees that the increase was a bad idea ;)

I'm around still for a couple of hours if you need help. You'll want to be able to have a couple of tests after that 56 over the span of about 1.5-2 hours where numbers are stable or rising without intervention.
 
I hope Apple stays up for you tonight. Sounds like you got some bad advice from the FB group. Suzanne, Bron and Christie know what they are talking about.
 
Christie & Maverick said:
It's ok! It happens. Don't beat yourself up, hope he stays safe, since he should be getting close to nadir. It seems he agrees that the increase was a bad idea ;)

I'm around still for a couple of hours if you need help. You'll want to be able to have a couple of tests after that 56 over the span of about 1.5-2 hours where numbers are stable or rising without intervention.
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So far I've tested, in 15 min increments and the numbers have been 56/78/131. I've set the alarm for 45 mins for another test.
 
I think you are safe now to go to bed, his BG levels have been steadily increasing. Don't be surprised if he has higher numbers for the next few days, he'll likely be bouncing again from going into the 40s.
 
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