acro Allie's BG plummets

Allie dove to 54 at 5pm, just about to take another. Here's her sheet https://docs.google.com/spreadsheet...YUfUDXD-yY7iDwQLXoq0eLZGU/edit#gid=1182885903

Any thoughts appreciated. Happy Thanksgiving!

 

Have you given her a high-carb snack? How long has it been since the 54? Please test again asap, we definitely don't want her lower than that on an AT.

I do not have experience with high-dose conditions, particularly at the dose range where Allie currently is, but my generic advice is to err on the side of caution here as much as possible. It's good that it's in the second half of the cycle, at least; hopefully she'll start coming up on her own soon, but if she doesn't you want to know and intervene.

She's a cutie, by the way!

 

Previous post
https://www.felinediabetes.com/FDMB...ne-acromegaly-treatment-advice-sought.253338/

Can you please update your signature , what insulin are you currently giving
Also in your previous post you said
She is not on w/d. Just Purina DM and Weruva glam 'n punk.
You need to try and get more tests in after the PMPS



Could you update your signature to indicate you are now giving low carb food? I presume the DM is wet food.?
Thanks
You may want to post to also post on the

https://www.felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/

@MollyG

 

So, she's up to 104. We'll keep testing and need to decide on her pm insulin at 8:45.

 

Can you please update your signature See post #3
I will try tagging
@Wendy&Neko

 

updated, and now she's at 95

 

85, don't know what to shoot.

 

Any history of ketones or DKA? If not, I think I would skip the shot to be safe. You can stall for a little while longer, just in case she shoots up.

I see that you have updated your signature to show that you are now using Lantus. That means that the 21U comes with a substantial depot. Even if you skip the shot tonight, or (on the advice of a high-dose expert only) a reduced dose, that means that you'll have to keep testing for a while to make sure she stays in the safe numbers.

 

I agree. Let the depot drain a bit.

 

Ugg, waited til the last minute and had no replies. We gave her 5u. She's been eating well, every hour after testing and she's purring and happy. Thanks for your help.
Never seen ketones in her urine dipstick. no DKA. Yeah, we'll be up all night

 

OK, glad she's doing well and purring her way through the snacks! These numbers are in the normal BG range, she might be feeling good because of that.

Hopefully she'll start her climb back up, though, so you can get some sleep tonight!

 

Ah just saw this, I replied over in acro forum.

I don't think you needed such a small dose BCS or a skip altogether, though no real harm done. BCS is usually half dose, so around 10U would probably have been ok.

How long has she been on cab now?

It's possible you're starting to see some results from that, so I'd take a larger than usual reduction. From 21U you'd usually reduce to 18-19U, but I'd go 17U to be on the safer side. Hold it for a few days to let the depot stabilize after the 5U tonight, can always take her back up if needed. But please wait for Wendy to reply in the other thread.

More detailed explanation - if the cab is starting to work, it means more insulin is going to be suddenly getting through to the cells in the body. So you must be very careful here, when in doubt take larger reductions, and earlier reductions than the dosing method calls for if she really seems to be on a mission. The combination of such a large depot plus more insulin getting into cells can be a bad combination. Please feel free to tag Wendy and I whenever you need advice.

See my spreadsheet from July - that was our ride down on cab. 13U to OTJ in 2 week span.

Edit - I just saw the cab dates on your spreadsheet. At this point I would assume you're seeing cab results and proceed very cautiously. It takes most cats about 6 weeks to start getting some movement, plus you changed to daily last month

 

Please put "cabergoline 8/18/21" in your signature. I suspect it is starting to work. You do need to reduce the dose, at least by 15% (3 units).

Is there any chance you can get night time tests? Even a +2. Once cabergoline starts to work, you need to be very vigilant as her dose needs could drop quite quickly.

 

Thanks for all the replies, super helpful. Looking good.

 

Mollly --

It's perfectly fine to post here vs the acro forum. Many people who have acro kitties also post on the Lantus board since there are many people who use either Lantus or Levemir with their acro cat. The Lantus forum is active and there are usually members around 24/7. The acro forum is not as busy.

Thanks for updating your signature. The crucial issue was noting the cabergoline. The other information was not important when you were in the midst of trying to manage low numbers.