? 7/10 - Mačka AMPS 503 - Vomited food - Ketones traces - PMPS 470 +2 347 Active cycle!?

Penelope and Mačka said:
1.75 units done. I think. It's very hard to pin point the .75 on the needle! I have syringes with 0.5 increments, however the lines are so close to each other, how do you all do this without errors?
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Not an exact science. Some people use a micrometer tool.
...meant calipers...not micrometer, worked with a bunch of engineers too long...
 
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Macka's PM +2 is 347. I guess it's a good thing, but now i'm worried about a low number in an hour or 2. :/ What are your thoughts? He's eating 1/4 of fancy feast right now.

Also, what number should make me act fast, and give some carb food? in the 100s? Last time the greens could have been avoided (maybe?) if I had fed him when he was at 151 at +3.

I feel like this is going to be a long night...
 
Penelope and Mačka said:
Macka's PM +2 is 347. I guess it's a good thing, but now i'm worried about a low number in an hour or 2. :/ What are your thoughts? He's eating 1/4 of fancy feast right now.

Also, what number should make me act fast, and give some carb food? in the 100s? Last time the greens could have been avoided (maybe?) if I had fed him when he was at 151 at +3.

I feel like this is going to be a long night...
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Remember while you are testing you are in control. And if you have medium and high carb food and honey or karo, you have the tools to stop any numbets going lower.
So 347 is quite a bit lower than the Preshot so I would get some more tests in to see what Macka has in mind. Give him a teaspoon of low carb food now.
I was going to suggest a test at + 4 but I can see you are feeling anxious so why don’t we do a test at +3 and see what he is?
Please try and not overthink too much. I do understand how you are feeling but you will make yourself sick and then you won’t be of any use to Macka.
I will stay with you as long as you need me.
 
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I have with me cans of Fancy Feast Chunky chicken (4%), Beef in gravy sliced (14%), chicken and liver in gravy (12%), Friskies shreds and meaty bits (both 14%), and honey. Are there good carb numbers in case of emergency?
 
Penelope and Mačka said:
I have with me cans of Fancy Feast Chunky chicken (4%), Beef in gravy sliced (14%), chicken and liver in gravy (12%), Friskies shreds and meaty bits (both 14%), and honey. Are there good carb numbers in case of emergency?
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These are all good. If we needed higher carb we can add honey to the medium carbs to make them high carb.
Next time you are at the shops try and get some higher carb foods around 20 to 22%carbs so you have high carb one too.

Penelope and Mačka said:
I gave him FF savory salmon feast, 1% carb, is it too low?
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This is fine for now. We are just feeding low carb for now, let's see what he is at +3
Remember you are in control when you are testing. And if needed we can slow down or stop the drop with food.
 
Penelope and Mačka said:
Sounds good. However, i'm still wondering if that dose of 1.75 wasn't a little too much. We don't want drops like that every day, right?
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He's dropping from a high number. Once they get into lower numbers they don't necessarily drop so much. The curve tends to be flatter.
Let's see how he goes this cycle first.
Are you working tomorrow?
 
No, I had to resign from one of my two jobs because I couldn't handle it all.
The one I work on the week-end for (starting this Monday), my sister-in-law is going to stay at home to look after macka, although she does not know how to take blood.
 
Penelope and Mačka said:
No, I had to resign from one of my two jobs because I couldn't handle it all.
The one I work on the week-end for (starting this Monday), my sister-in-law is going to stay at home to look after macka, although she does not know how to take blood.
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It is easy to teach her. I taught my then 9 year old granddaughter to test. It just takes a bit of courage!
I would definitely try getting her to learn to test if you can
 
Penelope and Mačka said:
Thank you! That's not how I feel. I'm tripping on my couch with palpitations etc... I already know I won't sleep tonight even though I need it so bad.
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I know it is scary in the beginning Penelope, but honestly, everything is OK at the moment.
Macka is in very safe numbers at the moment and you are testing them every half hour, so we are have this under control.
I will tell you if you need to worry, so please try and see if you can relax a bit and get rid of all that tension otherwise you will get ill.

Penelope and Mačka said:
@Bron and Sheba what are the next steps in case his BG continues to drop? At some point Macka will not be hungry anymore. He's very tired. Honey?
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The reason we are only giving him a teaspoon of food at a time is so we won't fill him up too much and hopefully he will keep eating. He's eating so that is a positive! I doubt he will stop eating as you said less than an hour ago he was eating like he was in hypo.
If he did stop eating we would rub honey on his gums.
But you must stop looking for problems....let them find you.
You are doing a great job of looking after him and he has come so far since that plane trip hasn't he?
Must be almost time for the next test?
 
During my first low episode (not recorded on Zorro's SS, it was before I had joined any forum or board) I drove to our vet's practice with Zorro, with his food, tester etc. and asked them if I could "ride out the wave" there! They assured me he wasn't going to "crash" like I kept saying but I asked if I could linger around with him until I myself felt it was safe. I was shaky and with palpitations the entire time :)
Each time gets easier (of course we don't aim for these events but they do happen.)
You are in good hands with someone like Bron to guide you like this.
 
You don't need to feed really high carb food when he's in the high blues. Save that for lower greens. Just regular low carb food is fine now. He barely moved at all since the last test, well within meter variance.
 
Wendy&Neko said:
You don't need to feed really high carb food when he's in the high blues. Save that for lower greens. Just regular low carb food is fine now. He barely moved at all since the last test, well within meter variance.
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We were just feeding some higher carb foods Wendy to slow the drop. Penelope was getting very distressed by the fall in numbers. We seem to have slowed it right down now. I meant to tell her to change to low carb again.... Thanks for picking that up.
I've been caught up with three kitties with dropping numbers.
 
Penelope and Mačka said:
+5 = 152 (despite all the food, the high carb, the honey).

Should I give him something?
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That's a very safe number. We have to expect a bit more of a drop at this point as we are only at +5. I would have been surprised if he hadn't dropped a bit more.
You can give him just a teaspoon of low carb and then I think we could test in 1 hour.
How does that sound?
 
Checking in.

Penelope, I feel bad you have been up all night. Did not expect this much excitement from Macka. Sometimes these kitties like to surprise us. I really think he will get this figured out soon, just sorry he is moving so quickly for his mother’s sake. I don’t want you to be scared off.

On the plus side he is getting away from those ugly high numbers. And it is possible he may bounce back up some after this and then settle back down, but once he gets in a good place consistently, you will wonder what all the fuss was.

Please know it will not be all this drama all the time, unfortunately you have gotten more than your share the last week and I know this is very stressful.:(

Things will get better soon.

Hugs:bighug::bighug::bighug:
 
Julie and Honey said:
Penelope, I feel bad you have been up all night. Did not expect this much excitement from Macka. Sometimes these kitties like to surprise us. I really think he will get this figured out soon, just sorry he is moving so quickly for his mother’s sake. I don’t want you to be scared off.
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Hi @Julie and Honey , thank you! I have to admit I am not totally surprised. I had a feeling it would happen with the 1.75 dose. You are right, I am scared off and I'd rather have my cat in the yellows than in the blues, at least at night. I can't stay awake non-stop all night every night, I feel like I'm fainting and my heart is beating off my chest. I am SO tired.

I am also worried about the bounce, the last Three days were no fun at all, Macka was totally off, and this morning he was dehydrated and super sick. Fluids helped a lot, but what if we have to revive him after each bounce?
 
According to this cycle and my understanding, without the carb food help, he would have dropped dramatically. My take is that I should reduce (again) to 1.5 units, shouldn't I?
 
Penelope and Mačka said:
I mean that an hour ago, I did not give him the low carb food but the higher one. I was so scared of the drop, which reflects in the 178 I suppose.
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If you are not happy with what I or others suggest, or you think it should be something else, it would be much better if you say something at the time, than to go ahead and do something different. No one would mind that at all. We are quite happy to discuss options. We are only giving you what we think is the best course of action for Macka in our experience.
I understand your anxiety, I truly do, but you have to start to learn to trust someone and not second guess every decision, or look for problems, otherwise you will not be able to cope. I can promise you it will get much easier. You had a bad start with DKA in the picture but that is behind you now and you can move forward.
Macka was most likely reaching nadir at +5 or +6 and would most likely not have dropped any more.
Penelope and Mačka said:
According to this cycle and my understanding, without the carb food help, he would have dropped dramatically. My take is that I should reduce (again) to 1.5 units, shouldn't I?
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When a kitty is in high numbers, and the insulin dose is effective, he will most likely drop quite a bit. That is what Macka was doing. I suggested feeding the curve for two reasons. One to slow it down and try and prevent a bounce and two because you were so anxious about the cycle and low numbers.
I don't think he would have dropped really low if we had left him. He might have dropped into greens and bounced, but greens are healing numbers. Once we can get him down into lower numbers so that the preshot is a lower number, he will not drop as fast.
Also he was probably coming off the bounce and kitties often drop faster when they are coming off the bounce.
So in my opinion I don't think he should go back to 1.5 units. That would be a backward step.
Remember he has had DKA and he needs the insulin and the food to get better. With kitties with DKA in the picture we sometimes vary the protocol a bit so that the kitty can get enough insulin and food to combat ketones reforming. That can mean giving higher carb food sometimes so a higher dose of insulin can be given. Not always but sometimes. I am not saying give higher carb food. I am just telling you some of the options available to help DKA kitties recover.
You can see from the curve tonight how you can manage the drop with food and if necessary honey. Normally I would not use honey unless a kitty went under 50.
I think you should stay at 1.75 units.
But for now, please just feed low carb food if needed. At the moment he doesn't need any more food. Let's see what his next BG level is.
Here are some hugs :bighug::bighug::bighug:
 
Hi @Bron and Sheba, his +7 is 214. I am not feeding him anymore for the rest of the night (I think). It looks like he's okay, right? I need to go to bed for 3 hours or so, until my husband wakes up.

Bron and Sheba said:
If you are not happy with what I or others suggest, or you think it should be something else, it would be much better if you say something at the time, than to go ahead and do something different.
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So sorry, please don't think I was not happy with your suggestions, I followed them all and I am so grateful that you spent all this time with me, helping me in a period of great anxiety (and this every day!!). I had a moment of weakness dictated by fear and gave him another spoon of gravy. My fears come from what happened to Macka recently of course, but also from experiences with my other cats, decisions that were made, mistakes etc. I question myself even more than I question others! I now rely almost exclusively on what I read in this forum and what you wonderful people say.

Bron and Sheba said:
I suggested feeding the curve for two reasons. One to slow it down and try and prevent a bounce and two because you were so anxious about the cycle and low numbers.
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I know and I thank you so much for it. He did not get that much food all in all, my spoons are small :)

Bron and Sheba said:
You can see from the curve tonight how you can manage the drop with food and if necessary honey.
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Yes! Although, I can't do this every day/night which is what worries me. I need breaks to sleep, but with such emotional curves, I don't know how I can!

It might not look like it but today I decided to trust the people of this forum more than my vet. I realized that, as good as she is, she is overwhelmed by Macka's diabetes too and does not have the knowledge and experience that you have (she referred me to a specialist, we'll see what this specialist says).

Big hugs to you too in return!!! :cat::cat::cat:
 
There is absolutely no need to apologise. We are all here for one reason and that is out FD kitties and their welfare.
I completely understand your anxiety... it must be hard to deal with and I am so sorry you are dealing with it.
Do you have lots of support at home?
I understand the sleepless nights....we all do ....but they will not happen every night.
Do you have any other cats? I ask this because I was thinking that an automatic feeder would be good for Macka when you were not at home and at night. I had one for Sheba and to get her used to using it I fed all her food until she associated it with her meals which only took a few days. Then I used it every night to give her food while I slept. Even when I woke to test her on the nights she was low,I left the food in the feeder for her to eat unless I needed to give her extra to bring up her numbers and then she got both lots

Getting used to lower numbers can be scary, but you want Macka to be in lower numbers as much a possible. Getting down there can sometimes take a while and he might bounce up and down a bit and sometimes drop fast but he will get there.
I don't know if the specialist is going to be able to help you. I found the specialist I went to, knew less than me and she was asking me questions to get information, so don't be disappointed if he/she cant help.

Macka is not going to drop any more tonight. Please go to bed and try and get a bit of sleep.
See you tomorrow :bighug::bighug::bighug:

ETA yes you did trust us today and gave the increased dose and that was fabulous. You can be proud of yourself!
 
It looks like quite the night. The thing to remember Penelope is that he was in nice safe numbers even when he started to drop. The lower carb food is just to get the numbers from dropping to quickly as a fast drop can cause a bounce a big as a too low number.

I am glad Bron was there to help you. You will get more and more comfortable with it all, I promise. The more informed you get the more prepared you will feel. You are in control with your meter and food. Let that be your mantra. We have to get him into better numbers and as soon as he gets into them an can surf in them for longer periods of time, the more healing done for his pancreas. And remember, a DKA event is a much scary and dangerous thing that a low number. Your are in control. :bighug:
 
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