A little worried

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Lisa and Smoky

Lisa and Smoky

Member Since 2016
OK, I tested smoky AMPS and his BG was at 274. I checked it again at +3.5 after am shooting and it dropped down to 134. Isn't that sort of a big drop in a couple of hours? What if it drops a lot more while I'm waiting to test him again? 'm nervous and chewing my fingernails off.:nailbiting:

I gave him two teaspoons of FF classics and he ate that and is laying in his spot under the coffee table in bedroom. BTW what is a meatloaf position?
I only started home testing him this past Saturday on the 17th so don't have a lot of data to refer to yet. Should I be worried or is this normal for cats?
 
Since you don't have a lot of data on how Smoky's cycles go, I would test agsin in 20-30 minutes and if it is still falling more you could give a bit of HC gravy and retest in 30 minutes to see if the drop is slowing.


ETA The 137 is still a safe number, but that is a larger drop, and with not having much data at this point I tend to err on the side of caution.
 
:bighug: Lisa :bighug:

Huge, fast drops like that can be a real problem with Vetsulin/Caninsulin.

As you know, things are tricky with me at the moment so I can't write much to explain reasoning so here's the abridged version:

1. Precipitous drops are common but the curve tends to flatten out from +3 (NO GUARANTEE - check anyway).

2. With such a drop, any time you can get preshot and +2 tests on ANY cycle (AM or PM) will help you to learn when onset happens and if there's a big drop by +2 nadir may be by +3 - not the more common +4. Given that you can't test during the daytime cycle much then every PM cycle test you can grab will be extra valuable. Try to get PMPS and a before bed (+2-+3) every time you can.

3. It must be really scary not to be able to check nadir every day.

If I were in your position and it were my cat then on days when I could test throughout the cycle I'd get preshot and then start testing from +2 (unless clinical signs indicated the need to test sooner). On days when you can test, if there's a significant drop by +2 but Smoky is in safe numbers with a VERY comfortable safety margin it might be a good idea to start testing every 30 minutes without feeding (assuming no hypo) up to at least +3 (when Vetsulin really kicks in) and perhaps to +4-+4.5 to see how far the dose will drop him without any food influence (but don't take any risks - if nadir <100mg/dL even on a human meter consider giving a little food). Gathering this type of data could give you the information you need to know he's likely to be safe on that dose when you're away from home.

4. On days when you're home test at +7, +8, +9 and +10. (The crystalline fraction of Vetsulin kicks in during this period and numbers may drop a little.)

Sorry I'm not able to write more just now.


Mogs
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Lisa - can you put the meter type you're using into your signature, please? (Human or pet meter.) We need that info to correctly understand the BG readings.


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If you're on a human meter with 134 at +3.5 and able to monitor closely if it were me I'd try feeding low carb first, monitor clinical signs like a hawk and test every 30-60 minutes (sooner if any worries). You need to get data for how safe the dose will be for Smoky on the right food (low carb) while you're out of the house. If numbers dip below 100 post for more advice and hopefully members will post to give you a steer through the cycle. If you are in any doubt whatsoever err on the side of caution and give higher carb food. Better too high for a day than too low for a minute.


Mogs
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Smoky was not being a good patient, he jerked his foot so had to prick the other foot. I gave him 3 low carb snacks. His BG at +7.5 was 186. I don't know if I shld feed him again or not. His AMPS testing will be in another 3 hrs and 45 minutes. I shld be able to test him before bed too. I still have to learn how to prick his ears.
 
My Callie is on Vetsulin and her numbers are a lot like Smokeys. So far, he is having good numbers. Once you have a history on your SS, you will have a better feeling about how his numbers change.
 
Lisa and Smoky said:
I don't know if I shld feed him again or not
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186 isn't a number where we'd worry about him dropping too low and he's in the last half of the cycle so he'll probably continue up until the next PS time so unless it's a "usual" snack time for him, I wouldn't worry about feeding

We don't want them eating for the 2 hours prior to Pre-shots so that the number isn't influenced by food. You know Smoky best....if it's +7.5 now, that's 4 1/2 hours until PMPS......if he's going to drive you crazy if he doesn't get a snack in that time, go ahead and give him something between now and +10
 
Chris & China said:
186 isn't a number where we'd worry about him dropping too low and he's in the last half of the cycle so he'll probably continue up until the next PS time so unless it's a "usual" snack time for him, I wouldn't worry about feeding

We don't want them eating for the 2 hours prior to Pre-shots so that the number isn't influenced by food. You know Smoky best....if it's +7.5 now, that's 4 1/2 hours until PMPS......if he's going to drive you crazy if he doesn't get a snack in that time, go ahead and give him something between now and +10
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When you start counting a cycle is it from his AMPS or at the time I'm shooting? I started my +3.5 and +7.5 right after I shoot. I'm on eastern time so 8 am and 8 pm if that helps.
 
A cycle is the 12 hours between the actual shots

You should be testing, feeding, waiting 20-30 minutes and shooting. With Vetsulin, they should have a food on board so that when it "hits", there's something for it to work on
 
Just had a quick gander at Smoky's spreadsheet. Until you know his pattern it is better to be extra-cautious with dosing and to resist the urge to panic both when numbers are higher than we would like and then upping the dose to try to 'force the numbers down' (the body won't let you) or panic even worse when they get lower.

As Vetsulin goes, getting numbers in the blue range on 0.5iu is a good response; it's under the renal threshold. I see you gave a dose of 0.75IU last night. For reference, I think the majority of cats here tend to run a bit lower at night so if it were my cat I'd be extra cautious about the size of the dose on PM cycles until I had a lot of data to help me learn my cat's pattern of response.

Based on my experience with Saoirse the 134 in the +3 range today would prompt me to consider Smoky might be a cat who metabolises Vetsulin quickly. As you gather more data you'll find out whether that is the case for Smoky. In the interim, I'd recommend that if at all possible you could get a +2 and a +3 test on the night time cycle. The first test will give you an idea of whether onset is in progress and the +3 should give you a heads-up on how far down the low part of the Vetsulin cycle will be for about 3 hours or so. If you get those tests it will gradually build up a better picture of how Smoky is responding and that will better inform any future dosing adjustments. If Smoky were mine I'd stick with the 0.5IU dose for the time being and gather more data before considering a dose adjustment unless, of course, his numbers started going lower and a dose reduction was needed.

Another thing to watch is Smoky's clinical signs. Watch for any odd behaviours, e.g. his becoming subdued or withdrawn, or seeking to avoid injections. Vetsulin can cause quite big swings in BG and that can make some cats feel really lousy. Should that happen it's not the end of the world; a change to a gentler-acting insulin (i.e one that does not produce wild BG swings) can make the world of difference to how comfortable the cat feels.


Mogs
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PS:

As Chris advises above it's vital that Smoky has a good bit of food on board prior to giving the dose so the insulin has something to work on. Is Smoky a natural grazer? Does he ever throw up clear liquid if he doesn't eat every few hours? Or is he a large meal, twice a day kind of kitty?


Mogs
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Chris & China said:
A cycle is the 12 hours between the actual shots

You should be testing, feeding, waiting 20-30 minutes and shooting. With Vetsulin, they should have a food on board so that when it "hits", there's something for it to work on
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Thank you, that's a relief to hear. I have been doing it that way. I can test him before bed which for me is +2 after pm shooting.
 
Critter Mom said:
PS:

As Chris advises above it's vital that Smoky has a good bit of food on board prior to giving the dose so the insulin has something to work on. Is Smoky a natural grazer? Does he ever throw up clear liquid if he doesn't eat every few hours? Or is he a large meal, twice a day kind of kitty?


Mogs
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Smoky tends to eat small amounts at a time. He rarely vomits so when he does I know he is quite sick. My roommate or I had to feed him a teaspoon or two at a time every 3 to 4 hours for a few weeks now. Thank goodness we work different shifts. He dropped from 14 lbs down to 8.5 in about a months time.
His vet at the time told me to try to get him to eat more. I switched to a new vet who did bloodwork and dx of diabetes. I was so mad, he was barely eating anything in the two weeks before that. I worry about what that did to his body, he is only up to 9.2 lbs as of yesterday. Sorry, I'm rambling again, do that when I am tired or worried.:banghead:
 
Lisa and Smoky said:
P.s. I can do a test before bed, would be +2 after pm shooting.
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That'd be brilliant, especially with Vetsulin; generally the curve tends to be cup-shaped - relatively steep drop in first 3-4 hours, then hovering at that level for 3 hours or so before climbing back up again. Getting the +2 may give you a better picture of where the cycle's heading.

Lisa and Smoky said:
Smoky tends to eat small amounts at a time. He rarely vomits so when he does I know he is quite sick. My roommate or I had to feed him a teaspoon or two at a time every 3 to 4 hours for a few weeks now. Thank goodness we work different shifts. He dropped from 14 lbs down to 8.5 in about a months time.
His vet at the time told me to try to get him to eat more. I switched to a new vet who did bloodwork and dx of diabetes. I was so mad, he was barely eating anything in the two weeks before that. I worry about what that did to his body, he is only up to 9.2 lbs as of yesterday.
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For peace of mind and safety, as soon as you can manage it I strongly recommend that you ask a vet to run B12/folate and pancreatitis tests in order to rule out nutrient malabsorption/pancreatitis issues - REGARDLESS of whether or not the vet thinks they are necessary. (Just like the rest of us mere mortals, vets are far from infallible.) Play nice, but always remember you're paying for the food in their belly. ;) It is perfectly reasonable for you to request diagnostics.

Sorry, I'm rambling again, do that when I am tired or worried.:banghead:
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You and me both!

:bighug:


Mogs
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Critter Mom said:
That'd be brilliant, especially with Vetsulin; generally the curve tends to be cup-shaped - relatively steep drop in first 3-4 hours, then hovering at that level for 3 hours or so before climbing back up again. Getting the +2 may give you a better picture of where the cycle's heading.


For peace of mind and safety, as soon as you can manage it I strongly recommend that you ask a vet to run B12/folate and pancreatitis tests in order to rule out nutrient malabsorption/pancreatitis issues - REGARDLESS of whether or not the vet thinks they are necessary. (Just like the rest of us mere mortals, vets are far from infallible.) Play nice, but always remember you're paying for the food in their belly. ;) It is perfectly reasonable for you to request diagnostics.


You and me both!

:bighug:


Mogs
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Smoky has an appt next week for some bloodwork and a follow up appointment, I'll ask about the tests then. Just did his pm test about 15 min ago and it was 280, up from 186. He is eating now and will get his pm shot after that.
 
Another 25 minutes and I will squeeze in one more test for Smoky. He usually eats around 10:30 pm and then again at 6:30 am after testing of course.
 
For Vetsulin, those are really not bad numbers at all so far....we expect it to reduce the blood glucose about 50% from the Pre-shot level
 
OK....when you do tests on half hours, you'd put 203 @ +2.5 into that +2 cell to show you tested 2 1/2 hours after.....but when you put something other than just the one number into a cell, you have to manually color the cell yourself

To do that you just go to the icons along the top and find the one that looks like a little bucket of paint tipping over and then choose the correct color (in this case, yellow)
 
Chris & China said:
OK....when you do tests on half hours, you'd put 203 @ +2.5 into that +2 cell to show you tested 2 1/2 hours after.....but when you put something other than just the one number into a cell, you have to manually color the cell yourself

To do that you just go to the icons along the top and find the one that looks like a little bucket of paint tipping over and then choose the correct color (in this case, yellow)
Click to expand...
Thanks, not very PC savvy but I'm learning.
 
I did the same thing tonight on my +2.5 if you want to look on my spreadsheet (but my color was green, not yellow)

The paint can is in the middle of the icons....to the right of the big "A"
 
If you get up that early in the morning, you might want to consider shooting earlier so you can get some PM tests in without staying up past your bedtime (unless you really NEED to)....you can change your shooting schedule up to 30 minutes a day

I'd say he's pretty safe tonight....he's not diving very fast so it's probably going to be another cycle resembling the last ones
 
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