52.2: Planning next dose to avoid hypos

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akbahsMum

akbahsMum

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I think I would benefit from some second opinions here. I changed Akbah's diet to wet low carb, and I think that changed his insulin needs, so I've been reducing his doses ever since. But every cycle, even with lowering doses, I've hit hypo.
He is at his goal weight (about 6kg)
insulin = protaphane (Similar to Humulin N, Humulin I, Insuman Basal)
Twice daily shots 12 hours apart.

I have a great hypo routine worked out and a tasty recipe for honeygravy, but can anyone have a look at his ss and suggest if I am reading the situation right?
My vet is away for another 8 days so i have to wing this alone (or, alone + FDMB)

While lowering to find the right dose, I don't want to make huge changes to his dose on the theory that slow and smooth is better
BUT his preshot bg has been changing pretty wildly, so sometimes I've had to go with that.
Trying to maintain some sort of curve in reductions, his shots have been: 3U, 2.75U, 2.5U, [1U, 0.5U anomalies], 1.5U. over three days

My plan for this evening is written on the spreadsheet in the blank space under today's readings.
Any comments would be most helpful.

In the long term I will ask for a longer acting insulin like Lantus, when my vet gets back (which will mean more of this intensive testing, sigh).
 
Re: What dose? Trying to avoid more hypos

Nat,
That looks like a good plan to me. I would make one adjustment....on the "pink" for tonight, you listed 1.25 or 1u. I think I would draw a line at 350, and say 350-399 = 1.25, and 300-349 = 1u. Other than that, I think the doses fit your ranges of BG.

Carl
 
Re: What dose? Trying to avoid more hypos

That looks like a good plan to me, except that I think I would skip a dose at the low end of the blue and test again in the morning. A skipped dose is almost always better than risking hypo INMO.
 
Re: What dose? Trying to avoid more hypos

Oh, one more.....if you get a low 200s, I'd go with .5, and go with .75 on the higher 200s.
Carl
 
Hypocat again 52.2: What dose? Trying to avoid more hypos

Despite our best laid plans, he hypoed again: 52.2 at +4. I was so confident he would be fine tonight, that I retested with the same drop of blood to be sure
I think he's out of the woods now and I'm going to bed, but laying plans for what to do in the morning for his next dose.
I really benefited from this afternoon's feedback.
If there is anyone out there who wouldn't mind looking at my plan for the morning? Same rationale, but starting to think that the endpoint of all this will be 0.5U.

For tomorrow's planned dose, please look at Akbah's SS.
This time I have laid out my plan in a new tab, called 'Dose Planning History". Scroll down to 22Jan, at row 15.

Any comments grateful etc. I dream of sleep, its been days. 4 days, to be precise. Please Ak, settle down those numbers! @-)
 
Re: Hypocat again 52.2: Planning next dose to avoid hypos

My vet said that some cats don't need insulin when they switch them to low carb wet food. You may be giving him way more than he needs now which would cause the hypos and the high numbers afterwords as his body tries to cope combined with the sugar you're giving him when he hypos. If it was my kitty, I would just stop insulin altogether and watch his BG and check for ketones for a few days. If his BG doesn't climb too high it might be better for him to be off it than to keep having all these hypos.

Any thoughts from more experienced people?

Good luck and give Akbah a scritch for me...

Lori
 
Re: Hypocat again 52.2: Planning next dose to avoid hypos

Really 52.2 isn't tehnically a hypo number, normal for a non-diabetic cat is between 40-120...I have one little civie here that will run between 40 & 47 consistantly.

What exact dose are you giving him now? If greater than .5u , cut it all the way back to .5u and see what that gets him number wise. If he still drops super low on that then just try stopping the insulin for a couple of days while still checking him often, and see if you got lucky and he is already diet controlled just by changing his diet.

If his regular dose is .5u stop his insulin and continue to test as you would if he was still on insulin and see if he can maintain normal numbers on his own with just diet alone. If he can maintain normal numbers with most of those in double digits for 2 weeks with no insulin you get to officially declare him OTJ and we get to pull out the party hats. However, if you need to be testing for keytones anytime you reduce or stop giving insulin.

Or at least the above is what I would look at for a course of action if he was my cat.

Mel, Maxwell, Musette & The Fur Gang
 
Re: Hypocat again 52.2: Planning next dose to avoid hypos

316.8 AMPS. I would have given him 0.75 according to my plan. But I have a feeling you could be right Lori.
I gave him 0.25. So far he has hypoed on any amount of insulin down to 0.5. If he's hyper, that's better today than another hypo.
And I desperately need sleep.

On the cute side of things, this morning when I came out for his AM test, I noticed him asleep on one of the dining room chairs, just his bum visible under the table cloth. I started getting my kit ready, new needle in the lancet, folding up a tissue, test strip in the thing. He came out, and jumped up onto the couch where we sit for tests. What a love! Ready for his test. Amazing. One thing I would like is to test him less for awhile, give those black ears of his a break.
 
Re: Hypocat again 52.2: Planning next dose to avoid hypos

Hi Mel, I didn't see your post this morning. I'm a bit confused about missing it, looking at the time stamps. Maybe I was blind.
MommaOfMuse said:
Really 52.2 isn't tehnically a hypo number, normal for a non-diabetic cat is between 40-120...I have one little civie here that will run between 40 & 47 consistantly.
Click to expand...
Oh good. I was going by the numbers here viewtopic.php?f=28&t=15887 where they give two ranges, "VERY LOW NUMBERS" (under 40 mg/dL or 1.9 – 2.2 mmol/L) and "LOW NUMBERS" (40 – 60mg/dL or 2.2 – 3.3mmol/L).

In Rebecca's new post, it says "(Low numbers are under 50mg/dL or 2.8 mmol/L.)"

Anyway, Ak's numbers are all shown on his spreadsheet. I was down to 1.5units. I don't know if Rebecca's new posts tell me to slow down with lowering Ak's decreases? I'm a bit confused about everything this morning, really. About to give him a test for +3.

(edited to fix URL)
 
His BG so far seems alright though there could have been a low point I missed or one yet to come.
AMPS 316.8; dose=0.5U,
+3~ 165.6
+5~ 99

I had the loveliest test just then. I was setting up on the couch. I could see Ak in the next room sniffing his bowl. I called him, and he came trotting over to the couch! I warmed his ear, got blood with first go. We're both a bit the worse for wear, my emotions and his ears. So we needed this.
 
Just saying hello and well done from Melbourne. You are doing so well! My girl friend in Qld got a new kitten on the weekend. I just emailed her about what to feed him (he looks a lot like Vyktor) and she wrote back to say she would love to make his food for him rather than buying tins of food. I suspected as much as she made her own fruit mince pies from scratch @ xmas time. pastry, fruit mince, the lot! So I'm on the net searching for Dr Lisa's page. As I told her if she feeds him right she will save a lot on vet bills later on.

Marilyn
 
I might have to get her to read your thread. When I told her "no dry" she said what a bummer as she hates the smell of the tinned food. I told her if she makes her own there is no smell. BTW I dont make my own coz my boy is allergic to loads of foods - and he's currently unwell and I'm giving him anything he will eat. I'm hoping that he picks up soon so we don't have go go thru the blood tests and the ultra sound. Suspect pancreatitis - so letting him eat anything - weirdly he's not itching too much. confused_cat I have a freezer load of ground rabbit that he won't touch at the moment. ohmygod_smile
 
Hey Nat, I am cheering that you didn't have a hypo today!!!! Great news!!!! I spent all afternoon out and about but worrying about Scout having a hypo while I was gone. This is so stressful! I'm happy for you that Akbah is cooperating with the pokes and jabs. I've been making sure to give Scout lots of love and cuddles and to call her just to give her a cuddle so she doesn't start associating me with only pokes. So far it seems to be working, but really I'm lucky she's such a good-natured cat. I'm averaging 3 pokes to get a blood test and both her ears are bruised. :(

Take care,
Lori
 
:-D Isn't it fabulous!?? I'm really happy too! :-D Hooray!!!!! Akbah is happy, but he's noticed he didn't get any of that yummy honeygravy today, and I think he was a bit disappointed about that.

I think I'll even get some sleep tonight (fingers crossed).
I hope that this is the end of hypos and close shaves. Now that I'm down to 0.25U, I'm going to stay there awhile. Follow the advice from here, which might have been partly aimed at me (or maybe I'm nervous from lack of sleep)
viewtopic.php?f=28&t=61800
Start Low Go Slow.

Well I'm low now (low unit dosage) so its go slow. I'm going to give it a week or two (need to look at that post again already) on 0.25U, and see how he settles down.
He's a bit red tonight, but I actually prefer that to too low just for the moment :-|
I got a ketones tester today too, so I'm ready for some long slow work.
and some sleep!

Also I want to give Ak's poor ears a rest, I looked at them with the torch tonight, they're a bit blotchy. Ay-yah!
 
Lori&Scout said:
I've been making sure to give Scout lots of love and cuddles and to call her just to give her a cuddle so she doesn't start associating me with only pokes. So far it seems to be working, but really I'm lucky she's such a good-natured cat. I'm averaging 3 pokes to get a blood test and both her ears are bruised. :(
Click to expand...
I meant to add big love to Scout. I think 3 pokes is about my average too. But I'm starting to notice that blood comes easier too.
Isn't this WIERD?? wanting to get blood out of our cat? I looked at my father in law's bald head today, all I could see was a vein on one side, I thought, "you could get blood out of that". Oops.
Head scritches to Scout and comfort to you ~O)
you are a good catmother.
 
I looked at my father in law's bald head today, all I could see was a vein on one side, I thought, "you could get blood out of that". Oops.
Click to expand...
Love your sense of humour and you are doing a fantastic job. By the time your vet gets back Akbah might not need insulin. At least you'll be able to teach your vet a lot of new things.
 
I'll second that ^^^ thanks for making me giggle!!!

Scout says "purrrrr" as she likes scritches. :) Fingers crossed we both have stress free days!

Lori
 
Don't think I've posted a response before, but I have been following and I'm so glad that you got to sleep!

And I also got a laugh about that...I look at my civvie Misty's pink little ears with fine white fur and can see ever little blood vessel and think to myself "if only Charlie had your ears..."
 
How is our little Akbah today?

I was checking out your spreadsheet - do you really feed him kangaroo? That is hilarious!

Lori
 
Hello there Lori!
Akbah is doing well today! His numbers are looking a bit steadier, and I'm happy with that, though maybe he was still a bit low today.
I'm giving his poor old ears a bit of a rest, so there's only going to be four readings today.
But when I looked with the torch, already some of the blotchy bits are healing in the veins. Thankfully.
He actually comes over to the couch now when I call him for test-time. My cat! Still loves me!!!! :-D
And last night, he was on the scamper. He opened the bin with his claw and got pork bones out (got them back before any harm was done there, lucky he made a loud noise)... he rattled the door to get out, he skidded around the house yowling, he chased Hannah, he was a SCAMP. I haven't seen him like that for months.
cat_pet_icon
And I got almost a full nights sleep. (I'm working to a deadline, so there's not early nights or late mornings for me just yet... catching up from all those days spent testing my cat and reading about feline diabetes...phew!!!)

and yes, it really is kangaroo in a can. Kangaroos are lovely, but they are a plague (we are told) and so there is an industry in roo meat for humans (its rich) and, I discover, pets too. NaturesGift is a bit of a high class pet meat, I'd never looked at it before actually, so I'm surprised too. The cats love it.
 
Hey Nat,

That's great news all round! I'm laughing at Akbah's antics, he certainly is a scamp!!! :lol:

On Sunday night, Nipper batted at Scout as she walked by and Scout turned and chased Nipper across the room and cornered her under a chair. I was glad to see them playing together again.

I totally understand about giving his ears a break, and yourself! Now he's on less insulin you don't have to worry about staying up with him all night. I'm very happy for you that he comes to you to get his poke. Scout has been good about it too (aka not running away or hiding under the bed) but not exactly enthusiastic. I think she's caught on that she gets fresh wet food after every test, so now it's not so bad. Also, I'm getting a bit better at it. She still has bruises on both ears though, poor soul.

It's really good to know there's someone clear around the world who's going through the same stuff I am. Though I am still really tickled by the kangaroo food. Have you always lived in Australia? I've never been but I hope to check it out some day.

Lori
 
Heya Lori! I had a look at Scout's sheet, that's a nice low number this morning.
I've always lived in Australia. Its not a bad place ;-)
Better get to work. Talk soon!
n
 
Nat, try to find out what exactly is in Natures Gift. Serryn in Perth wrote to them and it sounded good but I find that the chicken one sends LBs bgs up too much. I will check it out with Serryn coz I think she did further investigation after I told her about LBs response. I can't feed LB Roo meat coz he's allergic to it. You can buy roo meat from pets stores but I think there is a question over it with regards toxoplasmosis. The cats love it though - some of the pet shops sell it minced fresh in vacuum packed bags - 1 kilo in size for $6.50. You can make it up into small bags and freeze it. But I'm not sure how much of a risk toxoplasmosis is. I used it until I realised LB was allergic. It is much, much cheaper than Natures Gift.

I too think it's a bit sad about the Kangaroo's being killed for human and pet consumption. They are the most magnificent animals - but then so are all animals. Serryn is a vegetarian because she can't abide the slaughter of animals for us to feed and I am full of admiration for her stand on not eating meat but she too has to feed her cat meat - what a dilemma!

Marilyn
 
Hi Marilyn. Will do. I contacted a few places tonight: VIP petfoods re: FussyCat; FancyFeast re their Australian varieties, and so it was easy to send another email to Natures's Gift. I'll let you know what I find. Make a new thread about Australian brands, and PM the URL to you.
 
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