8/26 Max AMPS 586 PMPS 482+1 449 +2 499

I had a hard time with Max this morning. At first I couldn't get him to eat. Tried different things and he finally ate some 8% Weruva. I checked for ketones and they were 0.9 on the keto meter. I know that's not too high, but he almost died from DKA before I joined this forum and yes, I do freak out when I see him like that. I have stressed out to the point I cannot think straight over my cat. I know I won't have him forever, but I try so hard to give him a good life because he has been there for me through so many hard things in life. That is why I am the way I am over him. So this morning when I found him very lethargic, laying by the water bowl and couldn't get him interested in food to begin with, I called the vet. She said to try increasing the insulin. I went by the office and she gave me a bag of sub Q fluids to take home and some more Cerenia and Bupe topical, but I opted instead for the by mouth.
I feel so confused because I don't know if he's getting too much insulin to cause the deep dives, then big bounces. Then again, he's not done well on 5 units before so I can't help but wonder if this is not enough. He will be probably over 500 at PMPS, so am I still supposed to feed MC at +1 and +2 to prevent a dive? Should I go back to the 5 units? I'm really trying here, but I'm tired and so stressed. @Wendy&Neko
 
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Fed Max MC (12%) @ +1 as recommended. He’s over 400, but I suppose we are trying to prevent a dive. That sounds a little crazy to me, but the past few days have been crazy as well for Max. I didn’t have any MC here so when I went to pick up an antibiotic for myself (sinus infection), I got Fancy Feast grilled chicken in gravy which is 12%. That’s all I could find at the pharmacy. I hope it’s not going to bother his GI system more. I ordered some Weruva MC from Chewy that hasn’t arrived yet.
 
Sending pawsitive vibes to you and Max. The bounces are so frustrating. Just so hard to understand, predict, prevent. I’m trying to experiment with feeding the curve and prevent the steep dives but right now it’s a bit of a crapshoot! Hang in there!
 
Amy & Herman said:
Sending pawsitive vibes to you and Max. The bounces are so frustrating. Just so hard to understand, predict, prevent. I’m trying to experiment with feeding the curve and prevent the steep dives but right now it’s a bit of a crapshoot! Hang in there!
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This early diving he’s been having is new to us. He’s always been bouncy but haven’t seen it this bad in a while. It complicates things because he’s been having some SRT action recently so honestly I’m not sure what’s going on. His vet seemed like she didn’t know either. He has chronic pancreatitis that the slightest thing flares it up, especially high numbers and also the extra carbs as well when he dives. I feel so bad for him. It’s hard for me to know what to do for him lately. I’m trying all the suggestions so maybe we will figure it out soon. Thank you Amy for your support and concern.
 
Poor Max.

Wish I had seen this a little sooner!

To clarify the higher carb feeding - you only want to do that when it looks like he's going to slide. So far (knock on wood), that happens when he is very flat in the latter part of the AM cycle and coming into PMPS. So with the rise from to 200 to 400+ PMPS I would have said feed regular LC.

Bright side, I think you get some sleep!
 
So last post tonight. I apologize for my drama today. It doesn’t look like Max is going to dive to me. Matter of fact, I can’t believe that +1 was accurate because he had been going back up through the afternoon, therefore no downward momentum. So the MC was a bad idea this time. Trying to understand what’s going on, so please excuse my ignorance at this point. I have lost my way in this somewhere down the line. I’m going to bed and hope tomorrow will be a better day.:)
 
FrostD said:
Poor Max.

Wish I had seen this a little sooner!

To clarify the higher carb feeding - you only want to do that when it looks like he's going to slide. So far (knock on wood), that happens when he is very flat in the latter part of the AM cycle and coming into PMPS. So with the rise from to 200 to 400+ PMPS I would have said feed regular LC.

Bright side, I think you get some sleep!
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Sorry Melissa, I just figured that out and posted at the same time you did. I have lost my mind lately. I understand now what you meant. I think my anxiety has taken over my sensible thinking lately. Plus I haven’t felt the best. I’m going to bed in a bit and just start all over again tomorrow hopefully with my head on straight. Thank you for being patient with me and your help! I think Max is having some pancreatitis issues too.
 
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Max & Lori said:
I feel so confused because I don't know if he's getting too much insulin to cause the deep dives, then big bounces. Then again, he's not done well on 5 units before so I can't help but wonder if this is not enough. He will be probably over 500 at PMPS, so am I still supposed to feed MC at +1 and +2 to prevent a dive? Should I go back to the 5 units? I'm really trying here, but I'm tired and so stressed
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Lori, where do you want his nadirs to be? How low was 5.0 units taking him? Fast drops don't tell you the dose is too much, it's going under the reduction point that is the signal.

As for PM carbs, one additional thing in addition to what Melissa said. If you need to add extra carbs to slow a drop, you want to do it about 1/2 hour before the drop starts. Since he seems to dive at +2, I'd try moving that +1 feed to +1.5 when you can.
 
Wendy&Neko said:
Lori, where do you want his nadirs to be? How low was 5.0 units taking him? Fast drops don't tell you the dose is too much, it's going under the reduction point that is the signal.

As for PM carbs, one additional thing in addition to what Melissa said. If you need to add extra carbs to slow a drop, you want to do it about 1/2 hour before the drop starts. Since he seems to dive at +2, I'd try moving that +1 feed to +1.5 when you can.
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I understand that. I was just curious as to how low he would have gone without the carb interference and if that would have required a reduction. I also know the carbs were needed to stop the diving a causing a bounce. I was looking at the whole picture and trying to determine why he has started this early diving so much lately. The diving and bouncing makes it more difficult to see where he actually needed to be and that was frustrating to me. I have been and am trying feeding 20 minutes ahead of the drop. Of course, I have always known that we go by the nadirs. Trying to get this whole thing more manageable that’s all, but I understand and thanks.
 
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