5/4 Sebastian AMPS 187 +3 110 +6 34 +6.5 40 +7.5 59 +10 79 +11 55 +12 40 +12.5 52 +14 89 +17 296

34@+6. Giving 1 drop of honey, no HCG because I don't want to risk him throwing it up.

Had a feeling that the 3.5 was going to be too much and considered go to 3 last night but decided I'd play it by the book, so going to take this reduction and go down to 3.
 
Sorry he's still feeling sick and vomiting. Hope it settles down.:bighug::bighug::bighug:

Justin, I just want to remind you of one more thing regarding Sebastian, and that's his IAA of 85. The IAA can break at any time, and when it does it can happen suddenly without warning.
If the IAA were to 'break', What does this mean in terms of BG? Well.... it means that his BG can drop even more unpredictably than for a normal FD cat, so please be vigilant of those low greens. It is really important not to become complacent with these low lime green numbers, it is like walking a tight rope, perhaps you haven't been around and visited a condo when a kitty has had a symptomatic hypo, it's very, very, scary, unfortunately it doesn't always end well, once they drop very low they can be really hard to bring back up, add to this a kitty that may, or may not be able to keep any HC food down, it becomes a very tricky situation.

FWIW I once got a BG of 33 with George (and my meter reads a little high if anything) and George was showing no visible signs of hypoglycaemia, he was being snuggly and nuzzly and all lovey dovey with me. It took 4hrs and almost 9oz of HC food (28%) spiked with honey to get him above 50(I thanked my lucky stars that BFG is a glutton and rarely pukes). It wasn't normal for him to drop so low, much less for it to take me 4 hrs to bring his numbers back up, we were on the verge of ending up at ER, I had phoned our vet and had her on standby (we are 40min from vet) because he started to get really full, at the last minute he came up and stayed up, so we didn't need to go to the Vets, I was a nervous wreck (also not normal for me). Here's the link to that day some 3 years ago
http://www.felinediabetes.com/FDMB/...ps-87-1-5-44-2-66-33-pmps-255-1-5-298.151719/


Looks like he is heading back down to green. Hope he surfs safely for you.
 
Justin & Sebastian said:
Had a feeling that the 3.5 was going to be too much and considered go to 3 last night but decided I'd play it by the book, so going to take this reduction and go down to 3
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Looking back at the numbers, he should have probably been dropped back to 3.25, that drop into the 30's yesterday, as per TR, is an immediate further reduction, from the 3.5u
But I see no harm in taking him to 3u, in fact it's probably a good idea given all that is going on. If it proves too much you can always come back up, and it might give you both some breathing space.
 
Gill & George said:
Looking back at the numbers, he should have probably been dropped back to 3.25, that drop into the 30's yesterday, as per TR, is an immediate further reduction, from the 3.5u
But I see no harm in taking him to 3u, in fact it's probably a good idea given all that is going on. If it proves too much you can always come back up, and it might give you both some breathing space.
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My thoughts exactly, I'd rather dose low and need to increase later on than give too much, especially with his eating being a little spotty right now.
 
32@+8.5 2 drops of honey. Tried to give him just the gravy from some HC and he only took a few licks, I think his stomach is just not wanting food. He's kept down the syringes I've given him but besides the couple that he licked up this morning he hasn't wanted to lick anymore.
 
I'm sorry you are having a tough time, unfortunately honey wears off quickly, it sure would be good if he would take some real food, more honey in tummy than food can't feel great, let alone you already have issues with him keeping food down. When was the last food he ate? I wish I could offer other suggestions, I'm worried that you are having such a hard time keeping him over 50. Ideally you need to get him up over 50 and staying there a few hours with no intervention. Please don't be offended, I'm just throwing this out there that if you continue to struggle to get his BG up, and he is not eating still by next shot due, I'd be careful about dosing tonight, and maybe a vet visit may be needed. As I said, I'm just worried that his BG isn't really stabilizing.
 
43@+9. 2 more drops of honey.

Christie & Maverick said:
it sure would be good if he would take some real food
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I've been able to syringe feed him some so he does have real food in his stomach and it's not just honey. I gave him about 30ml at +5.5, another 20ml at +7, and then the last 10ml just now.

Christie & Maverick said:
maybe a vet visit may be needed
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The vets are worthless. We've brought them to him so many times and they do nothing and have no idea. His labs are all normal and all they wind up doing when we bring him in for nausea is give him a shot of Cerenia, which I've already been giving him in pill form. The last thing they prescribed him was the Synacore which actually made him worse. This is starting to look like another pancreatitis flare up, which they're equally unequipped to deal with, so I just have to make sure and keep him syringe fed so he doesn't vomit, keep an eye on his ketones, and most likely scale back on the insulin. I'm thinking 3u tonight is still going to be too much and I might even go with 2.5
 
Hi Justin. We haven't met. I've been reading through your thread this morning. Looks like you're having a time of getting Sebastian's numbers up. Please don't hesitate to bring Sebastian in to your vet's office or an ER if necessary. This has become more complex than a normal low number event since Sebastian isn't eating. Things can go south quickly. Why not let a vet handle the appetite/nausea and the low glucose issue at the same time? The IAA issue may also be a contributing factor. Looks like it's time for some vet intervention.

What do you think?


ETA: I'm a slow typist. I read what you think.
What about their ability to put him on a glucose drip?
 
60@+9.5 Blood ketones: 0.2

So that's a decent bump, above 50 now. It has seemed like he's been nadir'ing late lately, so he might just still be trying to reach to bottom of his cycle and he's got too much insulin in him right now, and hopefully he'll start to stabilize and rise here at the end. I don't think it's ER time just yet, I'll just continue to check him every 1/2 hour and see what happens. If I don't ER him I'm thinking tonight's dose should only be like a token 1u or maybe none at all to drain the depot and then maybe a 2 or 2.5 in the morning.
 
79!!! Awesome!
Justin & Sebastian said:
If I don't ER him I'm thinking tonight's dose should only be like a token 1u or maybe none at all to drain the depot and then maybe a 2 or 2.5 in the morning.
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I've been looking at his spreadsheet. If you're interested I'll offer an honest opinion. :)

I'm all about tight regulation and am not scared of low numbers. In fact, high numbers scare me more than low numbers. That said, Sebastian's numbers are making me squirm and that doesn't happen often... and I'm squirming big time right now. IMO, you're running him too low... you've passed the point of risky and entered into dangerous, potentially fatal territory. It's time to pull back.

Skipping tonight's shot to drain the depot is a good idea... even if you see the beginnings of a bounce prior to shot time. For safety's sake and in an effort to figure out where his dose 'should be', I would drop the dose back to at least 2.5 in the morning and go from there.

I'm basing this advice on my experience with Alex. While the circumstances are not exactly the same, I learned when to push the envelope, how far to push it, and equally important... when to pull back. Taking a step back will also allow you to breathe and give him a much needed break.

My thoughts for your consideration...
 
Jill & Alex (GA) said:
I'm all about tight regulation and am not scared of low numbers. In fact, high numbers scare me more than low numbers. That said, Sebastian's numbers are making me squirm and that doesn't happen often... and I'm squirming big time right now. IMO, you're running him too low... you've passed the point of risky and entered into dangerous, potentially fatal territory. It's time to pull back.
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I 100% agree. I've handled it so far but I definitely have not been comfortable with how often we run in the 40-60 range. I would really love to get him in like an 80-120 range, we just have only managed to hit that for a cycle or two here and there since it seems like his dose needs keep dropping.

So yeah, I think we're at the point where we can take some bigger full or half unit steps instead of quarter unit drops. I'd much rather see him in the 200s and tweak from there than ride so low, so often.

Jill & Alex (GA) said:
drop the dose back to at least 2.5
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Just to clarify, is that a literal "at least" like 2.5 minimum or a colloquial "at least" like 2.5 maximum? Because I'm kind of thinking 2u.
 
55@+11. Looks like the honey is wearing off. I'm not going to dose him tonight so I won't worry about stalling if he's still dropping at PS, he's probably just doing another +12 nadir and should start to rise around then.

Jill & Alex (GA) said:
Sorry for the confusion. I was thinking about taking the dose down to either 2 or 2.5u and working it from there.
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Okay that's what I though. I'm going to go with the 2u
 
Tense cycle! Glad he came up and hope that draining the depot some can give you and Sebastien some much needed rest.

You might want to add into your signature the IAA number of 85. I am not sure how Gill knew that...
 
Justin & Sebastian said:
55@+11. Looks like the honey is wearing off. I'm not going to dose him tonight so I won't worry about stalling if he's still dropping at PS, he's probably just doing another +12 nadir and should start to rise around then.


Okay that's what I though. I'm going to go with the 2u
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As a precaution, continue testing even though you won't be dosing tonight because we *could* be seeing a prolonged hypo. Usually, they're over by +16, but I have seen a vet induced hypo carry over into the next day.
 
Jill & Alex (GA) said:
As a precaution, continue testing even though you won't be dosing tonight because we *could* be seeing a prolonged hypo. Usually, they're over by +16, but I have seen a vet induced hypo carry over into the next day.
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Yeah, I was planning to continue testing him until I saw a definite upswing approaching the 100s. And since I'm syringe feeding him right now I'll be up at around +5 and +6 to feed him anyways and I'll test then too
 
40@+12. I was half expecting that, with him nadiring late and the late cycle honey wearing off. He did this same thing 5/02 PM and 5/03 AM. Anyways, no dose, got a couple syringes of food in him and I'll test him in about 15 minutes once the food has settled in to make sure he's rising like he should be.
 
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Justin & Sebastian said:
nyways, no dose, got a couple syringes of food in him and I'll test him in about 15 minutes once the food has settled in to make sure he's rising like he should be.
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Sounds good. Stay on top of these numbers. You know what to do.

I have friends here for dinner, but it's casual. I'll be checking in on you.
Again, if you can 't get his numbers up, don't be afraid to take him to an ER. We are not dealing with a 'regular' cycle. Better to be safe than sorry. Actually, you may want to think about going to an ER anyway. You've had quite the day. They can put him on a glucose drip for a few hours and bring his numbers right up.
 
89@+14. Got 5 of the 6 syringes in him so far and he's rising nicely. Wanted to give him a break between tests to let his stomach settle a bit. A threw up a little right after the first test because I jostled him. I still test him on his paws so if is stomach is especially upset he'll ralph if I flip him over right after he eats. So I put another syringe in him to make up for what he refunded, let it sit for about a half hour, then put a few more in him, then let him sit for about an hour and then got the +14. So he seems to be doing good now. Keeping the food down and is rising nicely. I'll still be up and keeping an eye on him but don't think I'll be testing him again until +5 right before I start giving him his second meal. No PM onset to worry about so he should just continue to rise from here.
 
You know him well! That helps (except for when they decide to surprise us. Ha!)

I'm glad he seems to be doing better. He should continue to rise, but I'm glad you'll be keeping an eye on him. It's *possible* he could drop again so stick with him for now.

Tough day and you've managed it well. The skip tonight and drop in dose tomorrow should stop this from happening again any time soon. I don't know if 2u will be enough. Time will tell. Let your meter be your guide.

You have a host of cheer leaders poised to offer guidance and assistance should you need any. Take advantage of their help. They know what they're talking about.

I'm curious to see what Sebastian does with his new dose. See you around.

Good luck! :)
 
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