9/12 Olive BG 515 AMPS but had a good night

O

OlivesMom

Member Since 2020
Olive did well through the night with no drastic dips. It was more of a smooth wave than I'm used to. She was 360 @PMPS last night and her BG at nadir 165. She rose again, being 486 @ AMPS. Knowing the need to get weight on her and the fact she's not ready to eat larger amounts at any one time, I simply feed about once an hour after testing. I've noticed she's beginning to want a little more than the 2-3 tsps, so I tried 4 near the beginning of last night's cycle and again with her AM injection today. Once her levels begin to steady and I obtain more data, I might play with only feeding her every few hours but to increase the amount. I don't want to do anything too drastic and rock the boat like last time when she gorged and spiraled into a vicious round of puking up everything.

I did get some sleep between testing. If she had been in the black I would have kept my promise;) and gotten more sleep, but when her BG didn't respond as usual I wanted to monitor to see what the numbers were saying and in which direction they were headed.
 
Olive's back in the black, but I expected a spike at +2. Hopefully it will begin going down soon. She tested NEGATIVE for Ketones. :) :joyful:Question: Even though I push the plunger in fully when giving the injection, there always seems to be a speck of insulin left that surfaces at the tip of the needle when I double check the syringe to make certain all the insulin was injected. Is that typical? I also have some issues with air bubbles at times depending on the syringe that day. I always flick the needle to push out any air and I always see those teeny weeny insulin beads disperse as I slowly twist the plunger to the 0.01 mark, but that little bubble of air appears at times anyways. That's what happened this morning, so it makes me curious if it's displacing the insulin incorrectly to where I think she's getting 0.01 but maybe the little air bubble is throwing it off. Thankfully this hasn't happened but one other time and on that day too she stayed high. So it makes me wonder.
 
Tip:

* Draw up about 1 - 1.5 units more than the dose you need (e.g. if giving a dose of 1 unit, draw up 2 - 2.5 units of insulin).

* Hold the syringe with the needle pointing upwards.

* Flick the side of the syringe to move any bubbles up to the top of the barrel. If there are several small bubbles, try flicking until the small bubbles 'pop' and form a single larger bubble (easier to remove).

* Try to centre the single bubble directly under the needle if possible.

* Keep the syringe needle pointed upwards and express most of the excess insulin. This should remove the air bubbles.

* Finish by doing the fine adjustment to set the required dose.

The little droplet thing is normal.


Mogs
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No point in testing anymore until the PMPS. That stupid bubble in the syringe clearly has messed her dose up this morning and caused her to stay HI all day:(.
 
"Big storms coming through here so need to shut down my computer for the night due to lightning. Praying for a good night with Olive."

Critter Mom said:
Is everything OK with you guys? (Worried.)
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9/8 Last night's final post (see above) to you guys that I just realized NEVER got sent. Good grief. I'm sorry. The lightning was so bad I was scurrying to get the system shut down and I thought when I hit "post reply" that it actually posted. Looks like it didn't. I just found it sitting there unsent it seems. Didn't mean to worry you. We are looking at storms for the next 24 hours too so I'll so my best to pop on and keep things updated. I just entered last night's information. I kept PRAYING everything went well through the night knowing I couldn't simply pop on here to tell you know. We get some fierce lightning. It blew out the battery backup so will need to invest in a new one now. Grrr!
I need some advice. I'm not sure I handled last night effectively. She'd had a nice gentle dip going after the PM injection and once she hit a BG of 105 and I knew she had a ways to go still before the nadir, and KNOWING her track record for deciding to plummet 40-50 points within a half hour's time at this point, and the fact it was the middle of the night and I was so tired, I decided to try and halt the BG levels at that point. Was I wrong in not waiting a bit longer to see if the number was indeed going to dip again?? So what I did was try and offer more food but she'd decided for most of the night she didn't want more than a few licks and with her numbers in the 80 range I knew the only way to ensure she wouldn't drop lower was to get more carbs in her. But since she wouldn't oblige, I decided to offer some FF gravy in small amounts. I'd wait a half hour and retest and with no improvement I'd simply follow the same procedure of trying to get some food in her along the way on top of it. By +9 when all those added carbs hadn't raised her above 80 still, and going by her track record for creating a 1-2 hour stall come the AM shot due to her BG at this part of the cycle staying low, I decided I'd force 3 tsp of food down her along with 2ml's of gravy. Then I went to sleep for a few hours and hoped by the AMPS her BG would be above 200 so that we could keep her on the 0.01 IU schedule. I think what she needs most is stability in dosing for a while and I didn't want her to have to skip. Thus, giving her more carbs through the wee hours. Was I right in the way I handled everything or should I have just waited to see if her body would have indeed stopped on it's own before going much lower? Advice would be appreciated.
 
So relieved to hear from you, Robyn! :bighug:

Sorry to hear about the storms you're dealing with.

You handled last night like a boss. :cool: And you got to see a little of what those extra carbs did to keep Olive in a good range - and a nice sunny AMPS to boot! With Olive's history I think I'd have made very similar decisions were I in your situation. Had you not intervened with the food Olive might possibly have drifted further down during the late part of the cycle and then been too low to dose at preshot.

I still think it's worth considering upping the carbs in Olive's regular food to around the 10% to help even things out for you both and make consistent dosing easier. Unfortunately there's no crystal ball: the only way to find out if it will work is to try it.

@tiffmaxee - Thoughts?


Mogs
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Critter Mom said:
You handled last night like a boss. :cool:
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Big sigh of relief. Thank you! I'm so glad to know I did the right thing.
Critter Mom said:
I still think it's worth considering upping the carbs in Olive's regular food to around the 10% to help even things out for you both and make consistent dosing easier
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I agree. I've been on the phone with Purina since I read your post. I wanted to double check the carb content in Olive's Turkey and Giblets pate as compared to the Purina DM the vet swore by as an excellent source for diabetic cats, giving them the best chance to get off the insulin. This is what I learned once they handed me over to the Purina Vet's line. I didn't even know they had a vet line. Talking to an actual person sure beat trying to figure out the "As fed" to "dry Matter" ratio when trying to figure out all this time what carb content Olive has actually been getting. She said the Classic Turkey Pate contains 3.9% carbs and 53% protein a can. So far I've gotten about 1 1/2 cans in her daily...or close to it. Certainly not the 3 cans a day her needs require. The Purina DM is 7.14% carbs and 56.9% protein. They said for her to gain some weight back she needs a can of this a day. They said the FF Turkey and Giblets is quite similar which is why it's suggested as an alternative, however, ZERO research has been done on it with diabetic cats so that's why they suggest the DM as it's been tested up the wazzoo and shown at this exact analysis to not only help diabetic cats but often it gets them off the insulin altogether. So, knowing Olive needs more carbs and I thought she was actually getting more in the FF than she is, I've decided to go pick up 3 cans of the DM shortly and just see if Olive will even like it. If she does, then we'll need to take back the 4 cases of FF turkey and giblets hubby just bought last night on his way home from work. lol. He wanted to make sure she had enough...bless his heart. When I figure out the price difference, yes it's more expensive, but she won't need to eat as much to gain weight and then at least I'll know she's getting "enough" carbs to balance out the insulin. So that's where things stand at the moment. I need to run to the vet's office. ...Hoping Olive LOVES the food. She's a picky eater these days.
 
BG 107+4. Initiating same protocol as last night, only adding the DM into the mix now.

Yeah, I certainly don't have all the right answers, but at this point all I know is something has got to change. I threw all "MY" wishes out the window buy getting the DM, but if it helps stabilize her then so be it. I'll think about our future goals for her later. Right now she needs more than what she's been getting because obviously things aren't working, and the only thing I know for sure does help (although I don't know why but I've done the research into it) is the Purina DM. Just got to work her up to being able to eat a can a day. That's going to take some time.
 
Since things are going so well think I'll give Olive a break from testing and won't test again until +9 and then the PMPS.:joyful:
 
OlivesMom said:
Since things are going so well think
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;)

Heading off shortly. I'll check in on you tomorrow, Robyn. :bighug:


Mogs
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tiffmaxee said:
When do you sleep?
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I'm really not. I try and sleep between testing/feeding and that usually takes 15 minutes, then I set my alarm for 45 minutes later and the cycle begins anew all night long. Steve has to get up at 3am for work each morning so I'm on my own through the night and most of the day as he's gone 10-12 hours. I wish I could nap during the day but I've got too much going on. This is just one of the reasons I decided to at least "try" her on the higher carb DM food, to see if this small change really would stabilize her BG levels enough that she doesn't have to get tested all the time and that I can get some solid sleep without worrying she's going to drop too low.
 
What a strange night after what I thought was a fairly good day. She simply didn't want to come down after the PM injection and played yo yo between black and red. I simply couldn't get her to eat much, so it's either she's filling up on the raw or doesn't like the taste of it with the DM. I'll slowly reduce the raw over the next few days until she's completely on the DM and go from there I guess. For now I'd have to say she's not a big fan of the DM. Time will tell. I simply can't wait until the holistic vet takes a look at this SS and all the info that goes along with it and offers more info for us to play with. Although she needs more carbs at this time and I get that, and she needs to put the weight back on, I can state emphatically that she was doing much better over all (BG numbers NOT factoring in to the equation) when she was strictly on the raw. She seemed like a much happier cat. So I'll be happy to hear what thoughts the vet will have on better food alternatives that will still provide the added carbs and calories she needs. Here's hoping she comes down to a nice steady level today.
 
Any relationship between times when Olive ate a little and the colour coding, e.g.:

* Fed on a black number, next reading was red.

- OR -

* Fed on a red number, next reading was a black.


Mogs
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Critter Mom said:
Any relationship between times when Olive ate a little and the colour coding, e.g
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Good question. I've been trying to figure out if there is indeed a relationship between the colors. "Something" is creating this zig zag pattern. Here's what I noted:

Red on PMPS-Fed
+1 NO TEST
+2 NO TEST
+3 Fed on Black
+4 she was up. Skipped Food
+5 she was down. Fed on Red
+6 NO TEST
+7 She was up. Fed on Black
+8 NO TEST
+9 She was down. Fed on Red
+10 NO TEST
+11 NO TEST
AMPS She was up. Fed on Red
+1 NO TEST
+2 Up from PMPS. Fed on Black
+3 She was down. Skipped Food.
+4 She was up. Fed on Black
+5 She was down. Fed on Red
+6 She went up. Fed on Black
+7 She went down. Fed on Red
+8 She went down. Fed on Red

(I skipped food a few times to see how it effected the BG)
 
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OlivesMom said:
(I skipped food a few times to see how it effected the BG)
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You're gettin' the hang o' this. ;) :D


OlivesMom said:
AMPS She was up. Fed on Red
+1 NO TEST
+2 Up from PMPS. Fed on Black
+3 She was down. Skipped Food.
+4 She was up. Fed on Black
+5 She was down. Fed on Red
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@tiffmaxee -

Elise, could this be the pancreas sputtering, perchance? The two feeds after dose onset led to a lower BG 1 hour after food. I ask because I've never observed this phenomenon at such high BG levels. Bearing in mind Olive's apparently exquisite sensitivity to insulin could a teeny weeny pulse from the pancreas be doing this?


Mogs
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I doubt the variation can be attributed to the pancreas. Remember, meters can be 20% out in tests. 20% of 500 is 100. She was bouncing and bobbling around the same range. Mid 400's to mid 500's - basically all the same. Numbers do wobble around during a bounce.

One you get a +2 or +3 that is higher than the preshot, save your strips and stop testing. Go to sleep, or do something for yourself. Save the intense testing for greens like the night before.
 
Robyn,

Can you confirm exactly what you fed Olive at +2 and +4 - food type(s), carb level(s) and amount(s) - on the AM cycle above, please?


Mogs
 
I believe I've gotten enough data for the time being. I kept going until I could see a pattern develop. The interesting part is that this all began just hours after I started her on the DM food (9/8 +4) I've been mixing a half raw half DM ratio since and her appetite has picked up. At +8 she'd finished off the can I opened just over 24 hours earlier at +4 on the AM cycle. That's 5.5 ounces of food In addition to the raw! That's more food than her body has seen since diagnoses. So I attributed this weird bounce to the food somehow.

Critter Mom said:
Can you confirm exactly what you fed Olive at +2 and +4 - food type(s), carb level(s) and amount(s) - on the AM cycle above, please?
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At +2 she ate 3 1/2 tsp of a half and half mix of raw and DM. As to carb levels what I know is the raw contains 0.04% carbs and 93% protein and the DM 7.14% carbs and 56.9% protein per 5.5 ounce can which is what they said to give daily to make her gain weight.

At +4 she ate 4 tsp of the mix of raw and DM with about a tsp of bone broth.
 
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She gets a little broth through the day so I make sure she stays hydrated. There's hardly even a trace of carbs in it. It's more just for hydration purposes.
 
Wendy&Neko said:
One you get a +2 or +3 that is higher than the preshot, save your strips and stop testing. Go to sleep, or do something for yourself. Save the intense testing for greens like the night before.
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I really need to. I've gone through a container of strips since the AM cycle of the 7th. Wow. I was more curious than anything and wanted to see where the data took us today. I'm just afraid when I give her the 0.01 IU 3 hours from now that like the 2 cycle shots before it, her numbers will stay high. Since I KNOW she's had enough food in the last 24 hours, I think I'll feed her every 2 hours tonight and do some spot testing at those times to see what results that might have. I don't know, gang, I'm just trying to make some sense to things and see what works and what doesn't. Thoughts??
 
Ok, so for the last 3 cycles her numbers have remained high regardless of the 0.01 IU and to me this is all too coincidental since I started the DM switch at the same time. If this is this case and she's now getting more carbs, is this why the 0.01 IU seems as though she's not getting anything at all? And even though I cringe at the words "INCREASE", should we try and increase the insulin now? I know she kept tanking in the past at any increase, but she's stayed high for days now and testing her as I did last night was very enlightening too. I did things totally different last night. She was 495 PMPS and I fed her, gave the 0.01 shot, did a +2 and +3 without food, then tested again at+7. She was still exactly the same BG of 471 as she was @+3 so I offered some food of which she only ate a few tsp. Then I went to bed and didn't test again until the AMPS. Her BG is 432. So she has come down a tad, but nothing to write home about. Should we consider a small increase of IU at this cycle? I'm stalling her AM shot already due just to get some feedback. Thanks. *Although 432 is her lowest BG in a 3 cycle time frame*
 
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It could very well be but also she might be bouncing from those nasty lows. I would give it more time. Seewhat others think. Are you testing for ketones?
 
tiffmaxee said:
It could very well be but also she might be bouncing from those nasty lows. I would give it more time. See what others think. Are you testing for ketones?
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Yes, I'm testing. She was negative at midnight. I'm just afraid to keep her so high for so long. She's buzzing around me right now wanting fed. I'm stalling with hopes of getting all the advice possible.
 
Ok, I'll shoot the 0.01 then and feed her. Thanks! Oh, and since she's been on the DM/Raw mix since 9-8-20 +4, I'm going to increase the ratio of more DM to raw today. I wanted to transition slowly so hopefully this has been enough. No signs of tummy upset. If anything, her appetite has shown signs of increasing since the DM.
 
Thus far, a slower steadier descent from the blacks over last couple of cycles than has previously been the case. Watching with great interest...


Mogs
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Critter Mom said:
Couldn't find a new thread for 10 September. Is all OK with you guys?
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I thought I changed the date this morning on the thread when I mentioned a possible IU increase. Ugh. I didn't mean to concern anyone. I've been trying to keep better notes in my Remarks so if I'm not around you'll be able to check on Olive's progress through that. I've not been on much today because for starters, Olive has given MOM a much needed break from the constant worry and second, I've been playing nurse to my injured hubby. He fell at work and had to spend the day home. He's been in a lot of pain and the chiro said he'd have faired a lot better had he not tried to stop the fall. So I'm on now to update the SS and that's when I found your messages.

Critter Mom said:
Thus far, a slower steadier descent from the blacks over last couple of cycles than has previously been the case. Watching with great interest...
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You and me both. I find it quite intriguing because all that's really changed is her diet...and as of last night how often she gets fed. Up till now I've been trying so hard to get some weight back on her that I've offered food constantly with hopes she'd eat enough by nickel and diming it that she'd start to gain some weight back. But now I'm confident that she'll still get what she needs by eating bigger portions spaced out. Hoping to eventually get her to eat her two larger meals AM and PM with small snack once or even twice a day.
Critter Mom said:
Will be very relieved when next I see you online.
tiffmaxee said:
Ditto
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(((Robyn, Steve, Olive)))
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Thank you both! I really thought I changed the date of this morning's thread.:oops:

I actually got some sleep last night and I tell ya, it felt so good! I know you guys were right, but like I said before, it's the mom in me and I simply can't rest when worried about one of my babies. :bighug:Once I know her+3 BG I look forward to another appointment with dreamland. :D As luck would have it hubby gets up for work around the +6 so that's why I mentioned just testing her at the mid point and feeding her for the last time until the AMPS. I'm a light sleeper and he always wakes me anyways, so might as well. I know I really don't have to test then but the more data I have at the AMPS +3, +6, and PMPS the more I like it.
Okay, I'm off until the morning. I'll try and be more careful that the dates are changing in the threads.
 
I'm just now able to jump on here between testing. Everything was going GREAT, then Olive decided to throw up @+3 just 15 minutes after she ate 3 tsp since the PM injection when she ate 3 tsp as well. I knew I was in for a sleepless night at that point. It's been downhill since. I know Olive well enough that her "take action" number is 100 because she'll drop by 40-50 points in a half hour time, so I've been fighting to keep her from dropping from the 136+4 which resulted after she threw up+3 with a BG at that time of 265. I've been using protocol with the FF gravy, trying a nibble of DM/Raw mix, and some honey too. It's been an hour since this started and she's only 113. I'd like to be able to feed her more but on the heels of her throwing up been afraid to force too much for fear of having her throw up again. I'm testing every 15 minutes until I see a noted rise in BG. I'm not using the 911 as I've got this under control for the time being. I was so hoping we were done with her bouncing low. Although I have to wonder what her BG would have been had she not thrown up. Going to be a long night...I'll have to sleep later so if I'm not on in the morning, you know where I'll be.
 
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