Max’s numbers are high so I increase insulin And now he has dropped to 52 … am I not leaving him on one dose for long enough ? I have no idea on dosing anymore. We stopped Giving him snacks during the day because his numbers were high so often
I have to drive for about 10 minutes and will get right back to you. But don’t stop the LC snacks! Even when he’s high. They’re still important and also he needs the calories spread out during the day a bit. That’s probably why he dropped so much. More in a few…
Hi Katie. I have been looking at Max’s spreadsheet and it’s pretty hard to see what’s been going on because there are just so many cycles with no tests, both a.m. and p.m. Also the doses are all over the place. You will shoot a reduced dose based on a lower preshot, but then we can’t tell if that was a good decision or not because there are no tests after that until PMPS. We are kind of blind here. If you (or is there anyone else?) can’t get some more tests on most days, I would drop his dose down to a dose that you think you will consistently be able to shoot (even on days with lower preshots) and then you need to run curves (testing every 2 hours) on days when you are home. We need to know his nadir (with snacks) on his dose to be able to safely make decisions. Tell me again about your work schedule - even just for this week for now. Does it vary a lot? What will your schedule be today through Friday? I guess your mom went back to work?
Thank you for your reply . I didn’t want to personally msg as I know you have your hands full helping so many . The doses being all over the place is stressing us out and we have such a hard time deciding on what to dose based on his numbers because they fluctuate so high sometimes . This morning my mom dosed low because was unsure . It’s hard deciding what to do when numbers are lower. My schedule fluctoates a lot as I pick up shifts but generally I’m gone Thursday to Monday . When I am home I get a mid cycle test in . My mom can finally test and does so before pre shots . I can ask her to test mid cycle on Friday and Saturday when she is off . She is gone for 9 hours after the morning shot and in bed 3.5 hours after pm shot so it’s hard . I am back to work tomorrow but will set alarms and do a 12 hour curve tonight . What would you suggest to dose him tonight ? I can test more next week when I’m home also
Right now it looks like the .75 wasn’t enough insulin since he’s climbing - but unless we get a test later in the cycle we won’t know for sure. I totally understand the caution. He did have some similar AMPS back in April and did all right on a little more insulin. For tonight, if he’s around 200 you could try 2 units. If he’s around 150 you could try 1.5. He’s very bouncy it seems like- but it’s hard to tell since we have so many gaps. I certainly would like to have him at a dose where you could hold the dose for a week and the. Run a curve — so that probably means just lowering the dose overall and then gradually increasing based on what the curve tells us. Sorry this is so frustrating for you. It is really difficult to be gone so much and love your boy so much and try to do your best for him and keep him safe. We can do this, it’s just going to take a little extra time maybe. And don’t stay up all night to get a curve. Try to get one during a day off if you can.
Hey . I was running errands yeaterday but got some tests in last night . So we will leave him at 2 for a week or so . I am back home Monday for a few days so will do more tests and get a curve in to see we’re he is at and then touch base to get your thoughts . Max has a pretty severe skin infection and recently has a cyst on his neck that keeps filling with infection . We are wondering if that is affecting his numbers being so up and down . He sees the dermatologist on Wednesday so hoping we can get him some help . Thank you again for everything you do for all the kitties !
Hi! A very flat yellow cycle today could be an indication that he will drop lower tonight… hopefully just blues like last night. I am sorry to hear about Max’s skin infection. That sounds nasty. It could be elevating his numbers a bit.
You can tell that just by the yellows today ? I will have my mom make sure she tests him before his snack at bed time . That will be +4 hours into pm cycle .
Hey Suzanne . Maxs numbers have been pretty good today . He didn’t drop below 90 . I was a bit panicked when my mom told me she gave him 2 this morning with his number but he seemed to be ok during the day. I thought 2 units mite have been ok tonight but my mom felt more comfortable with 1.75. Do you think today was good ? I’ll be doing his curve on Monday
Sorry I didn’t see this last night. I think, in view of the daytime AMPS and the dose of 2 units where he did really well— and the PMPS being similar/a little higher — that you could have gone ahead with 2 units last night. But I understand your apprehension and it’s all good data for making dosing decisions in the future. Well done getting the +5 last night. Try to consistently give the 2 units if you can monitor him this weekend.
Hey Suzanne . I just got back from camping and max was 90 at pre shot last night and is currently 94 at pre shot tonight. My mom did not get any tests done mid cycle am going to hold off feeding and re test in 30 minutes and then debating on if I should give him .5 unit or not . He was very high this morning after skipping dose this last night . It’s really weird both nights he is so low at shot time . Tomorrow is when I’m planning on doing the curve
Yes. It wasn’t good skipping the dose last night. But the last few days we have just empty cells on the spreadsheet so we don’t know anything. You will test before bed tonight?
Yes I gave .5 . Do you think that was a good call ? . Yes I will test max tonight at +2,4 and 6 hours
I’m very frustrated with the lack of tests but I am really trying to stress the importance . I can typically get her to test 4 hours after pm shot though recently .After I get the curve in could you help me do out a general guide line of what my mom can give based on his numbers if she can’t get ahold Of me ? I’ve done out a rough draft for now telling her this 5.5(100) or less no insulin 6 (106) to 7 (126) I think 1.5 7 (126) to 9 (162) think 1.75 9 (162) or higher 2 units
Yes last night was good ! Numbers today seem odd he went lower at +8 Skin is not good . His cyst on his neck keeps coming back after being drained , it’s full again now. I do not want him put under but they think he may need surgery to have it fully removed. His dermatologist appointment is on Wednesday so hoping to know more then .
And yes, we can work out a guideline for your Mom about what to shoot. Today he had a flattish string of yellow after last night’s greens and then blue and this morning’s blue. He’s actually coming back down fast than I expected. I predict a green Pmps tonight. How many hours until shot time. I think it works out to be about 8 o’clock my local time? (Eastern)
Those cysts seem nasty. I am sorry. I do hope the dermatologist can help! Poor boy! I will have a cat at the vet on Wednesday too. Keep me posted on what the dermatologist says.
Hey . Yes insulin time is 5 pacific so 8 eastern . I just tested pre shot and he is 7.2 (130) How much insulin would you suggest ?
You shot a 124 with 2 units and a 146 with 1.75 units. Want to try the 1.75 again? He was good both times.
The 2 was my mom and had me really nervous , I was so surprised he was good . I think the 1.75 sounds good . I’m Home to test him tonight and see how he does at this dose too
Okay. But I thought it was interesting he was okay on that dose. I remember your mom shot that morning and you were nervous. I thought you would be more comfortable with the 1.75 tonight.
Good. That’s only a little drop from Pmps. Glad he’s getting the snack. He should reach green. I don’t think he will drop into an unsafe number. What are you feeding for the +2 snack. What carb percentage?
I think it is 2.6 % but I’m not sure if I’m reading it correctly . It’s his regular raw cat food . It’s called red dog blue cat venison . I’m trying to upload the screenshot I took of nutrional information but can’t figure out how to upload
I was just thinking of having some slightly higher carb options in case you needed to steer his numbers - but still 9 percent and under so still low carb. But I am sure he’s used to his raw food. I have considered feeding raw, but because of my FIV kitties I have hesitated. I was afraid it would not be good for them. How long have you had Max? He is a big boy!
I will have to look into tiki and some of the higher low carb options as I feed him that sometimes also . We have had Max since 2020 . He was a local stray we fed and eventually trapped him along with Sam a feral we were feeding . Both boys are fiv+ but love their lives indoor with us now . Max wasn’t diabetic till he gained so much weight being inside . He is actually down to 16.2 pounds now . I feed my dogs raw and was hesitent to switch Max but Our holistic vet convinced us about a year ago even though he is Fiv and he has done well on it other then the persistent terrible skin issues that started when he was diagnosed with diabetes
Look at that preshot this morning! He really is making progress and getting great duration from the ProZinc. This is good.
Have you been able to get any more tests this afternoon? Or was this one of your days that you’re not there in the afternoon?
I got called into work untill tomorrow morning. My mom is running late tonight but will get his pre shot test and then a +3 test in tonight . I’ll be able to get some tests tomorrow
Have her give snacks too! Hope she won’t skip the test(s). If she is at home, first snack should be at +2. He was about the same as last night so hopefully tonight’s cycle will be similar to last night’s.
We were gone most of the day at the vets today . Max has a bacterial and yeast infection on his skin aswell as likely allergies which they want an elimation diet to determine . I declined the prescription food because of his diabetes. Trying to figure out a novelty protein and making it myself possibly. They prescribed Terbinafine for the yeast infection but after reading about some body on here’s horrifying experience with the medication I am terrified to give it to him . he will be on Reactine twice daily and antibiotics for the next month once the bacteria culture comes back . ( Convenia was suggested and I also declined) I’m really stressed about the Terbinafine though
Hi Katie. Max has earned a reduction down to 1 unit, I would say. So going forward his new dose will be 1 unit. That’s fantastic! Looks like you did a great job last night taking care of him.
And yes, I would have gone ahead and given him a snack at +6 with the way his numbers were running. Just LC, but a snack.
Okay , thank you . With his number so low this morning should we still have given 1 unit ? At what number would we not shoot ?
Well you shot a 97 with 1.25 recently so he probably would have been okay. But let’s see how the cycle goes today, and we will have a better idea of whether you could have tried a .75 or 1 unit dose.
We are both at work today so won’t be able to get any tests done during am cycle so I had her go kind of low . I was a bit unsure about how low his numbers are recently . At what pre shot number for Max would we skip a dose ?
How is Max doing with his skin? I am sorry I didn’t see that on Wednesday. I took one of my cats to the vet on Wednesday as well. And Thursday I took 4 kittens to be fixed which takes most of the day because the spay/neuter clinic is an hour away and I had to return home to take care of my heart kitty because she has so many meds and I have to feed her or she won’t eat almost anything. Then later back to the clinic. Anyway, I just saw your PM this morning and came here to the thread to reply. Have you been giving him the Terbinafine? When my cat Delilah had a yeast infection last year, she had topicals and Ketoconazole 200 mg. for 4 days- the topicals last longer. From what I’ve read, the Terbinafine should be used with caution in cats with kidney disease or liver disease.
Well hopefully his PMPS will give us an indication of how things went. Since you were not going to be home and neither was your mom then it was a good idea to be conservative.
Oh that’s ok , life gets busy and we all have things going on I appreciate you getting back when you’re able . Do you rescue or TNR? I hope your kitty with the heart issues is ok . Max’s recent blood work showed his liver and kidney levels being good . I have not used the Terbinafine yet no . I am honestly a bit freaked out after I read somebody’s 3 cats all had major reactions to it . However others have used it and said there cats are fine. I’m so on the fence and unsure . The dermatologist is limited on treatment options for max with his fiv and diabetes and I don’t want to resort to steroids . He has started his reactine and waiting on culture results to start the antibiotics . I may try the terbinafine on a day when I’m home and can monitor him . He’s supposed to be on it for 15 days
Well it kind of depends on whether you will be home. But you’ve already shot a 94 and a 97 and the cycles were decent. You also skipped with a 92 and that gave him a pink preshot in the 300s next morning. So I would try to at least give some insulin if he’s in the 90s. Before I recommend a dose if he’s lower, I would like to see how some of these cycles in the 90s go. There could be some instances where a dose of .25 is given- as opposed to a complete skip.
Hey Suzanne. He is good . He is starting his antibiotcs and and terbinafine this morning. He has a staff infecfion. His numbers may start to lower if the infection starts healing up . With his number being so low after a skip last night do you think she should give .75 again or .50?
What kind of antibiotics? They did a culture, right? And it came back as staph? That was the reason for the delay? I feel like you made the right choice of .75 units today since his AMPS was pretty much the same as yesterday. He really is doing great! But I feel confident because I know you will be watching him closely today. If he needs another reduction it will probably be evident today. I will check back in on his spreadsheet later today.
So far so good at 77. Be sure to give frequent snacks. I am sure you already are. He has a while until nadir.
Hey Suzanne . I am at work . My mom is testing today . He usually gets 1 snack 3+ in but only when we are home . When we’re both at work he doesn’t get one untill we can get the automatic feeder going . He always gets a snack +3 hours in the pm cycle before my Mom goes to bed though . We are working on the automatic feeder rite now and learning how to use it and teaching him to use it when the beep goes off without the other cats figuring it out . He only gets 1/4 pound of food a day and with his meds he needs a full belly at dose time so we’re trying to figure out portion control to give him the 2 snacks a day with out gaining his extra weight back also .
Yes a culture was done and it came back as a staff infection . They want him on a month of clavaseptin . she just tested now and I will ask her to test when she gets home in a couple hours too . Mom accidently slept in so he got his shot 2 hours late this morning . It can be hard balancing life and Max’s needs sometimes he is the best though so we try
She could have given him a teaspoon of food when she tested and got the 77 and then the 67 — before she left for work, right? If he’s in green then he surely needs small amounts of food - a teaspoon or two - before or at nadir time. I understand about the automatic feeder and other cats - that’s a problem. It sounds complicated with your work schedules. Fortunately it doesn’t look like he will drop too low since he was only at 67 at +6 and that’s probably his nadir for today. I am proud of your mom for testing. With the morning shot being two hours late, I would not shoot at his regular time tonight but would only shoot 1.5 hours after his usual shot time. Then in the morning I would shoot one hour late and the next day 30 minutes late and the next day on time. So you would be moving back to his regular shot time by 30 minutes a day. If he should happen to be really high at PMPS time then maybe ot would be okay to shoot — but I can’t see that happening.
Okay . Thats perfect schedule . I will let my mom know . Im sort of expecting his pmps to be around what it was this morning . If it is should she give .75 again ?
Okay. I think if you shoot .75 tonight— based on his previous numbers— he will be fine as long as you (or mom) can feed and monitor him (and give snacks at +2 or +3) then go ahead. Otherwise I would try a .5 dose.
Katie, what kind of work do you do? You do such a great job with Max, and I am impressed how you and your mom are really trying to work as a team to help Max.
Okay she is going to give .75 and feed at +3 . If his number is pretty low I will try and get her to set an alarm for mid cycle . We are so shocked his numbers are getting so low and insulin is so low . I think that’s why she is more willing to test because she sees the improvement ! Thank you so much ! I work in residential youth care . It’s 24 hour shifts for 3-4 days in a row but can change weekly so fluctuates a lot . I also work in a vets office very part time but helps with all my rescues with weird ailments lol my mom is retired from government job but works full time at Walmart now
And thank you ! She calls me every morning at 5am to find out what to shoot lol . But we love him . From being a feral to now he is the most loving and loyal cat <3
Your work sounds really demanding. That’s a beautiful story about Max. I do rescue too and pretty much have my hands full all the time with feral trapping and kittens, etc. He is doing really well, and I have high hopes for him. It sounds like a good plan for tonight — as long as your mom will be able to set an alarm and wake up to test/feed Max if necessary.
I love that you do that ! There are so many cats in need. I wish more people were educated in spaying and neutering. I’m really hoping for the best with Max too . Hoping this infection clears and his BG stabilizates . It would be so nice to get him into remission one day .
I hope Max will be able to tolerate the Clavaseptin (what we call Clavamox here in the states). It can be so hard on the GI tract. I have some cats that do fine on it though— and some who can’t tolerate it. The vet should be able to come up with an alternative drug that will still be effective against staphylococcus if he can’t
Max was on clava for 6 weeks a few years ago for these skin issues and then 10 days a few months ago . I’m a bit frustrated the regular vet and dermatologist suggested it again because I don’t personally think it’s ever made a difference for him . last night was good . His numbers are higher this morning but it’s difficult to get my mom to test all through out the day
And it does seem like they might try a different antibiotic to see if it makes any difference. I would like to see the culture and sensitivity report where the laboratory lists different antibiotics that the staphylococcus is sensitive to. It’s almost always more than one antibiotic and frequently mentions an antibiotic or two that should not be used. Meanwhile, of course, you are paying for all this and they keep trying the same drug.
My mom didn’t test him mid cycle today but I will be home tomorrow and can . how do I upload a file ? When I click on upload file it tells me I don’t have permission
Yes. That method doesn’t work. I either take screenshots of stuff or take a photos or use the copy function on my phone and then “copy and paste” them into the thread.
I can’t figure out how to send it . I tried copying but doesn’t seem to paste anything when I try . That’s so weird
I just got home from work , tested max . He was 227 which was really weird … I still gave him a little tiki snack and then walked into the kitchen and saw he ate through almost 1/4 Loaf of bread ….. what is this going to do with dosing later if he is still high ?
Hey Suzanne . Max has been to low to give insulin to for 24 hours now. We have been testing and giving snacks . Does this mean there is a chance he could be going into remission ? Or I’m wondering if the infection and medication are causing this . I’m not really sure what to do with these low numbers or what this could mean for him He is 65 rite now . The dose I skipped on this morning was 72. I’m reading up on the guidelines . Should I be considering micro dosing ?
You are doing great. Just keep testing so we can document what’s going on. Hopefully he will stay in the greens! Maybe the an are helping clear an infection that was causing him to have high blood glucose. Let’s keep checking and make sure.
I am back at work now untill Thursday . My mom will be at work during the day but I will make sure she gets tests done when she is home . It starts to get nerve racking so low but he is acting totally normal. Without insulin is he at risk of ketones ?
Have your mom test at the usual preshot times and when she gets home and before she goes to bed then. Can she do that? Is she the one giving him his medication? I would not worry about ketones because he is in green numbers and doesn’t appear to need insulin at this time. Those green numbers are very normal numbers for a cat and with him not receiving any insulin right now, he will not hypo. How did he seem to you when you were at home? Thank you for getting all those tests while you were home.
Mom can do the regular pre shot tests and evening but she is not home till 1 hour before pre shot so day time tests are not likely . Yes she gives him his medications daily. He seemed like himself . Not lethargic , still chasing us constantly for food . Going into the yard with my mom. The only thing I noticed is he seems more hungry . He is always wanting food but he actually knocked the lid off the pan to get into some rice and then chewed through the bread … the bread part isn’t unusual really he will chew through things if he can but the rice was . His poops are a bit runny rite now but I’m thinking that’s the medication
