? 7/15 - Mačka was high and now LOW AMPS 533, +2 404, +5 582, PMPS 92

Wendy&Neko said:
What happened is you gave him high carb food, please don’t give anymore unless he drops low.
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Of the HC, he only got 1 spoon, and I'm not even sure he ate it, it's covered in puke :/

What I meant was, what happened to have such a different scenario tonight, but you actually make a good point with cerenia. However, the dose looks small, but I am really bad with numbers. Here's what's in the report:
INV Maropitant Cerenia 10mg/ml (per mL) = 0.5 => to me it means he got 5mg
 
Wendy&Neko said:
Less food doesn’t make a 400 point difference. Start of sixth cycle after last blues, could also be breaking a bounce, there can be a lot of downward momentum when a bounce is breaking. Unfortunately, the greens will probably cause another one. :rolleyes:
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Yes, you're right, it's been 6 cycles.
 
Julie and Honey said:
See Penelope, it has been a bumpy week, but you should be encouraged he is seeing better numbers and you finally get a dose reduction, actually 2 now. Hoping he has smoother days ahead and can get to feeling better:bighug:
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Yes, I cannot believe it, a reduction!!??
DO I have to keep this new 1.25 dose for 6 cycles/ a week as well? Sorry, I read and re-read the sticky note, but I'm very lost right now.
 
Don't be surprised that he bounces high again, which is likely from the lower numbers and he could stay higher for a couple of days, just from bouncing, depends on the cat. So if you see higher numbers again tonight or tomorrow, don’t be discouraged, he is still making progress.
 
With SLGS, you hold the dose a week, unless he goes under 90:again.

I see that 255 on the spreadsheet. Let the bounce begin! You could shoot now, and get a +2 to start. If he is bouncing, he won’t be going low.
 
Wendy&Neko said:
I see that 255 on the spreadsheet. Let the bounce begin! You could shoot now, and get a +2 to start. If he is bouncing, he won’t be going low.
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But to be sure he's bouncing (very likely, I know), shouldn't I wait a little more? You know me by now, I am very scared of shooting tonight.

I wrote to my vet to give her an update and ask if they did anything special today, and here's what she said, which I find very interesting:

VET=> "My main wonder is whether the insulin is lasting more than 12 hours for him so we are ending up having more effect over time. I noticed you were having good readings in the evening and very high in the AM for a number of cycles.

Definitely correct to skip insulin tonight. If he is high in the AM (say, over 250) then I say stick with his normal dose but try him at once-a-day dosing for a few days to see what kind of numbers you get?"

ME=> What if Macka is holding insulin longer than others? And just very slow in everything?
 
Wendy&Neko said:
With SLGS, you hold the dose a week, unless he goes under 90:again.

I see that 255 on the spreadsheet. Let the bounce begin! You could shoot now, and get a +2 to start. If he is bouncing, he won’t be going low.
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Yes, take bounces when you can. I just checked my girl and +3 was 200 point drop, guess I will be up a few more hours. Lol.
 
Penelope and Mačka said:
But to be sure he's bouncing (very likely, I know), shouldn't I wait a little more? You know me by now, I am very scared of shooting tonight.

I wrote to my vet to give her an update and ask if they did anything special today, and here's what she said, which I find very interesting:

VET=> "My main wonder is whether the insulin is lasting more than 12 hours for him so we are ending up having more effect over time. I noticed you were having good readings in the evening and very high in the AM for a number of cycles.

Definitely correct to skip insulin tonight. If he is high in the AM (say, over 250) then I say stick with his normal dose but try him at once-a-day dosing for a few days to see what kind of numbers you get?"

ME=> What if Macka is holding insulin longer than others? And just very slow in everything?
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You already know what the consensus is on once vs twice daily dosing. Maybe Wendy has some thoughts on vets comments.
 
Penelope and Mačka said:
Oh no! Good luck! I saw that you actually cut the dose by more than 50% instead of skipping it. Is it because it was over 150?
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Last night her PMPS was a lot lower than normal for her, I stalled and it did not come up when I tested 30 minutes later. I could have skipped, but didnt want to drain depot too much, so I gave her a reduced dose per SLGS. Plus yesterday was the first day in 6 months I did not get a mid cycle test during day, so she could have been lower at nadir and I missed it, she may have possibly taken the reduction last night anyway had I been able to check her mid cycle and she had been below 90. Since I really did not know and could not wait any longer to see if she would come up, I wanted to play it safe with a reduced dose.

Macka is a little different with DKA history, that is why Wendy thought if you could wait long enough for him to come up to shoot tonight rather than skipping.
 
Penelope and Mačka said:
VET=> "My main wonder is whether the insulin is lasting more than 12 hours for him so we are ending up having more effect over time. I noticed you were having good readings in the evening and very high in the AM for a number of cycles.

Definitely correct to skip insulin tonight. If he is high in the AM (say, over 250) then I say stick with his normal dose but try him at once-a-day dosing for a few days to see what kind of numbers you get?"
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When Macka sees good numbers under 200, he doesn’t stay there long. That would lead me to think he has poor duration, not long duration. Good numbers in the evening and bouncy AM cycles are very common in cats.

Skipping is a bad idea. Even if you shoot, he will continue to go up until onset which is still hours away. Why don’t you test again now and see what is happening.

Once a day dosing in a cat with DKA history? :eek: No way! Our experience here is that once a day seldom works, and then only with kitties on very small doses almost in remission. In my 7 years here, I have seen it twice.
 
Julie and Honey said:
Macka is a little different with DKA history, that is why Wendy thought if you could wait long enough for him to come up to shoot tonight rather than skipping.
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This is so scary. But I feel like she is in good hands and you both will be alright :)

As for Macka, what if he goes down again during the night? In the morning before I wake up (if I do go to sleep)? If I don't skip the dose, it means that tomorrow night I'll be shooting at 9pm, meaning that I will be checking a +5 at 2 am. I was actually working towards the opposite in order to check a +5 at 11pm and feel safer :/
 
J.J. and Phoebe Squeak said:
I have noticed that with Phoebe Squeak. Any idea why it happens?
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My thought on the vet visit was a little different - Macka got fluids at the vet, and I've certainly seen a decrease in BG due to receiving fluids. Maybe that was a part of this too?

Also, I disagree with your vet about ondansetron as well, it as helped our 18-year old civvie when nothing else would. It's been a miracle drug for her. Just FYI.
 
I gave him a late shot of a skinny 1.25 (maybe a 1.15) at 9:15PM.
Now, how am I suppose to monitor him? Every 2 hours? Does it mean he can't eat until 9am tomorrow?
 
Penelope and Mačka said:
I gave him a late shot of a skinny 1.25 (maybe a 1.15) at 9:15PM.
Now, how am I suppose to monitor him? Every 2 hours? Does it mean he can't eat until 9am tomorrow?
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I don’t know if @Wendy&Neko is still on.

I think she suggested a +2 and as long as he is still high and bouncing, I think you should be safe to go to sleep, unless you want to set an alarm for +6 to just see he is okay and maybe give him some LOW carb food mid cycle. I would not keep food from him until tomorrow.
 
It’s ok to feed Macka through his cycles Just feed him LC :)

Because Macka is starting to bounce I would give his poor ears a break... you have to take advantage of the small wins of a bounce while you can. The small wins are: less poking for Macka and more sleep for you ;)

If it were me I would grab a +2 and go to bed :)
 
Also Penelope remember, he got a reduced dose and it was later, both of those mean less insulin in the kitty, so less reason to worry tonight.
 
Yes, give his ears, and you, a break. Get a +2. As long as it is above 400, go to sleep. Do NOT get a +6. Sleep.

Try getting a +11 tomorrow morning. If he is above 500, you can shoot one hour early. Note, you can only do this once if he is high. Note to any lurkers, this suggestion is only for Macka and Penelope.

Shooting late can act like a reduction, plus you gave him a reduced dose, plus he is bouncing. Enjoy your sleep.
 
J.J. and Phoebe Squeak said:
I have noticed that with Phoebe Squeak. Any idea why it happens?
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Some cats tend to go lower. I'm not sure of the answer. The first vet visit after Rover was started on Lantus, I thought he'd be jumping over the moon high. I tested him and he was quite low. It's a situation of know thy cat - and get a test in shortly after you get home.
 
The high was based on feeding higher carb well after nadir, when the insulin was losing it’s effectiveness for that cycle.

Go to sleep. He won’t go low on you tonight. The worrier in you can leave some low carb food out for him to snack on. But I bet he’ll just sleep through the night too.
 
Hi just logging on. 4.20 pm here Tuesday pm.
Looks like I missed all the action and you will get a nights sleep Penelope.
I also disagree with the vet re ondansetron. It is a really good drug for nausea.
Hope you and Macka sleep well.
 
Sho Penelope, I only saw this thread now. Macka is still acting out all the drama for you hey!? :cat:

You sound in much better and stronger spirits though. So happy to see that :bighug:

All the best for tomorrow.
 
Zorro's mom said:
Sho Penelope, I only saw this thread now. Macka is still acting out all the drama for you hey!? :cat:

You sound in much better and stronger spirits though. So happy to see that :bighug:

All the best for tomorrow.
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Thank you! Stronger, I am not sure :) I am still awake, fighting against sleepiness, because I worry so much he may go loooow again. I just don't know anymore with this guy. I wish I was more confident.
 
Shame I know...the sleepiness can be hard to fight.

I myself actually slept right through my alarm for Zorro last night (actually, I'm sure I set it but I must have turned it off in a zombie daze and fallen asleep again :facepalm:)

You are doing very well under the circumstances, with Macka pulling all these tricks out of his hat. I am certain he will ease up on the dramatics soon.

Hang in there!
 
Zorro's mom said:
Shame I know...the sleepiness can be hard to fight.

I myself actually slept right through my alarm for Zorro last night (actually, I'm sure I set it but I must have turned it off in a zombie daze and fallen asleep again :facepalm:)

You are doing very well under the circumstances, with Macka pulling all these tricks out of his hat. I am certain he will ease up on the dramatics soon.

Hang in there!
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Oh wow, I saw that on Zorro's SS. You slept through it! But he was fine.
 
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Yup...I'm very ashamed of it now. I don't know what woke me up eventually (my subconscious maybe) but as you can imagine I was so afraid of taking that next reading.

Besides his usual food for the evening I did feed him an entire 3oz sachet of low carb food 2 hrs prior, when he was still dropping fast, so I can only hope that he didn't dip too low. His readings just before I fell asleep at least showed an easing up on the drop / slight rise.
:oops:
 
Keep in mind that he wasn't actually experiencing a hypo episode; He was in the ideal range of numbers that we're all aiming for. It's just that he got there too soon and was dropping very rapidly and probably would have dipped into the lime green numbers if I didn't feed him the extra 3oz.

I only recently learned on here about feeding early in an active cycle to slow down a drop and I think last night it worked well. Personally I prefer to catch the drop early and stick to low carb as far as possible, however I will absolutely pull out my Fancy Feast with gravy stash if he gets into actual lime green numbers. However I think Zorro is quite carb sensitive (from previous experiences with gravy FF) so you'll have to see what works best for Macka.
 
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