sorry i'm late to the party. i'm one of those who hasn't received email notifications when a PM arrives since Robert changed the board over to a new server. :roll:
in response to your PM...
i don't have much to add to the advice libby and marje have given. if i were in your shoes i would try these things in this order:
- withhold insulin immediately... regardless of the numbers you're seeing. it's possible KT is telling you he's done with insulin and is simply stuck in a vicious circle of dropping and bouncing. trust me, it happens. when withholding insulin you'll want to withhold for a minimum of 3 days (6 cycles) to allow the bounce to clear and the insulin depot to deplete. fyi: not too long ago we saw a cat take around 5 days to clear a bounce before going otj. trust your gut and use what you know about KT to help in making decisions.
- try feeding higher carb low carb foods. the extra % of carbs could help him tolerate even that small dose you're giving him. don't be afraid to experiment to find a food that works!
- try to measure even smaller doses of insulin to give consistently. it doesn't matter what you call it as long as you know what it is. for example, right now alex is getting the smallest dose i can consistently measure with any semblance of accuracy. i'm calling it "half a drop" which is absurd because any drop is still a drop. lol! the important thing is i know what it means... it's the smallest dose i can possibly measure... a dose that's smaller than 0.1u, 0.05u, or "some" insulin.
- skip shots whenever you're not comfortable shooting. you can try shooting at more than 12 hour intervals intervals. after shooting quite a few 18/18s, i've pretty much come to the conclusion that alex would do best on a 15/15 schedule. i'll switch to it if i have to, but a schedule like that is a killer.
- another option not yet brought up...
it's possible to dilute the insulin in order to make measuring a smaller dose easier. i haven't gone this route and probably won't because to me it sounds like more trouble than it's worth. i know nothing about it and the big turn off for me is the diluted insulin only lasts a few days before you have to throw it out and start over. if you choose to go this route, please work closely with your vet and your pharmacist. i don't think there's anyone who posts here any more who has hands on experience when it comes to diluting insulin.
the only way i've been able to make sure alex gets as much food as she needs every day is to supplement by assist feeding whenever necessary. in the past, syringe feeding was always a chore, but i think i've found the secret to syringe feeding effortlessly... i don't use any liquid when preparing the syringes. i only put canned food in my Ninja when making up a mixture for syringes. adding liquid to the mixture tends to make it splatter all over me, on alex, and everything within 5 feet of where i'm feeding her. syringing small amounts of food only tends to stay in her mouth. i now syringe solids and liquids separately. it's made syringe feeding so much easier. alex is so comfortable with it now that she'll eat the solids off the top of my hand! :mrgreen:
is there any chance you could syringe food sometime between +6 and +8 at night? feeding then might be enough to stop those late cycle drops at night. i can syringe 20 - 30 ml and be back in bed within 10 minutes now. i take the syringes up with me when i go to bed, set an alarm, feed her, and hop right back into bed.
most of all, you want to keep KT safe. when any kitty gets to where KT is now and there are other circumstances to consider... throw "the protocol" out the window. only shoot when you feel comfortable shooting. it doesn't mater if no one else understands what you're doing. you know your cat better than anyone else. you know the consideration you have to give to real life events when it comes to monitoring KT. if you can't monitor, no one can fault you for not shooting. weigh your options with what KT is doing and proceed accordingly. what i'm trying to say is follow KT's lead and don't become discouraged if it takes awhile to make it all come together.
good luck!
Edited to add:
Always check for ketones at least once a day when withholding insulin.
