? Big John - 255amps;3uN;131+2

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Yvonne & Andy &BJ (GA)

Yvonne & Andy &BJ (GA)

Member Since 2015
I gave him abt 1/3 can of FF and had to coax him to eat. Any guidance on how to proceed now - not real familiar with N. I do think he is coming down too fast???
 
Yvonne & Big John & Andy said:
I gave him abt 1/3 can of FF and had to coax him to eat. Any guidance on how to proceed now - not real familiar with N. I do think he is coming down too fast???
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I'm REALLY glad I suggested a major dose reduction!! Yes, he's coming down quickly. Give him a small snack of his regular low carb food - not more than a couple of teaspoons. You don't want to fill him up. He's still quite far from the "take action" number of 50 on a human meter but nadir is a ways off - generally +4 to +6.

Here's the drill:
  1. test about 20 minutes after that snack
  2. if he's still dropping quickly give another small snack that's either higher carb gravy style food or add a little honey or karo to his LC food
  3. retest 20 minutes after snack and repeat if his BG is still dropping too fast
  4. if BG seems to be levelling above 50 wait 20 minutes with no snack and retest
  5. repeat #4 20 minutes later
  6. if he starts dropping again. go back to snack/test routine
  7. keep monitoring until after nadir.
Today's data will tell you how to proceed with his next dose. If you've changed him to a completely low carb wet food diet that can be whuy he's dropping so much. His previous diet probably saved his goose with that 6 u BIDF.

If you can get a spreadsheet set up for him it'll help us a lot to give advice. Shouldn't be a problem - there are several people here with two separate SSs in their signature.
 
Kris & Teasel said:
I'm REALLY glad I suggested a major dose reduction!! Yes, he's coming down quickly. Give him a small snack of his regular low carb food - not more than a couple of teaspoons. You don't want to fill him up. He's still quite far from the "take action" number of 50 on a human meter but nadir is a ways off - generally +4 to +6.

Here's the drill:
  1. test about 20 minutes after that snack
  2. if he's still dropping quickly give another small snack that's either higher carb gravy style food or add a little honey or karo to his LC food
  3. retest 20 minutes after snack and repeat if his BG is still dropping too fast
  4. if BG seems to be levelling above 50 wait 20 minutes with no snack and retest
  5. repeat #4 20 minutes later
  6. if he starts dropping again. go back to snack/test routine
  7. keep monitoring until after nadir.
Today's data will tell you how to proceed with his next dose. If you've changed him to a completely low carb wet food diet that can be whuy he's dropping so much. His previous diet probably saved his goose with that 6 u BIDF.

If you can get a spreadsheet set up for him it'll help us a lot to give advice. Shouldn't be a problem - there are several people here with two separate SSs in their signature.
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OK - I just retested after 30 minutes and he is at 56 so put a little Karo on his gums. He is not hungry - probably a bit homesick - so did not want to take a chance!
 
Yvonne & Big John & Andy said:
OK - I just retested after 30 minutes and he is at 56 so put a little Karo on his gums. He is not hungry - probably a bit homesick - so did not want to take a chance!
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So - from 131 at +2 to 56 at +2.5? That's a BIG drop and he's early in the cycle. Do you have any high carb gravy style food or even the dry food he was eating? I'd feed a teaspoon of high carb every 30 minutes or so and test just before each of those snacks. Now is not the time to try for a lovely flat curve with food steering. You need to keep him above 50. If necessary be ready to syringe feed a slurry of high carb food or low carb with karo added. Some people find karo works better than honey. Do you have any at home or someone nearby who can go buy you some, along with some cans of gravy style food?

I also suggest you be ready to take him to your vet clinic if you can't get his BG drop under control. I'm not trying to alarm you, just making a prudent suggestion. You don't know this kitty and he's been on a high dose of an insulin that can be harsh in its action.

How is he acting?
 
Kris & Teasel said:
So - from 131 at +2 to 56 at +2.5? That's a BIG drop and he's early in the cycle. Do you have any high carb gravy style food or even the dry food he was eating? I'd feed a teaspoon of high carb every 30 minutes or so and test just before each of those snacks. Now is not the time to try for a lovely flat curve with food steering. You need to keep him above 50. If necessary be ready to syringe feed a slurry of high carb food or low carb with karo added. Some people find karo works better than honey. Do you have any at home or someone nearby who can go buy you some, along with some cans of gravy style food?

I also suggest you be ready to take him to your vet clinic if you can't get his BG drop under control. I'm not trying to alarm you, just making a prudent suggestion. You don't know this kitty and he's been on a high dose of an insulin that can be harsh in its action.

How is he acting?
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He is acting just fine - I did put a little Karo on his gums - he ate a few kibble but he was a grazer and he just nibbles his food. I have other foods available (20 other rescues) so have some options. I'll be retesting in abt 15min. Assuming I get him under control today, we will be away most of tomorrow. Do you think I should forego any am shot just in case since we won't be there to test and not home until evening?
 
Yvonne & Big John & Andy said:
He is acting just fine - I did put a little Karo on his gums - he ate a few kibble but he was a grazer and he just nibbles his food. I have other foods available (20 other rescues) so have some options. I'll be retesting in abt 15min. Assuming I get him under control today, we will be away most of tomorrow. Do you think I should forego any am shot just in case since we won't be there to test and not home until evening?
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Let's see what his evening pre shot test (no food at least 2 hours before) is and go from there. We're seeing what 3 u can do if he's eating low carb food. He might have to be dropped down even lower - maybe to 1 u BID.

You don't seem to be in a panic and that's great. I'm glad he's acting normal but keep up the testing, snacks, karo, etc. until +6 at least.
 
Kris & Teasel said:
Let's see what his evening pre shot test (no food at least 2 hours before) is and go from there. We're seeing what 3 u can do if he's eating low carb food. He might have to be dropped down even lower - maybe to 1 u BID.

You don't seem to be in a panic and that's great. I'm glad he's acting normal but keep up the testing, snacks, karo, etc. until +6 at least.
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No panic yet - been here many times before - just different cat and scenarios! I am waiting to retest since he did finish his FF snack and ate a few kibble. Giving him a few more min. He is really taking all of this well considering he was never home tested - proud of him!
 
Yvonne & Big John & Andy said:
No panic yet - been here many times before - just different cat and scenarios! I am waiting to retest since he did finish his FF snack and ate a few kibble. Giving him a few more min. He is really taking all of this well considering he was never home tested - proud of him!
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Excellent! Now I can relax a bit ... ;) Time to go eat lunch.
 
Hi there!

Just saw this, figured I'd say hi while Kris is at lunch.

Two questions: are you at +3 now, or some other time point?
What kind of high-carb foods do you have apart from kibble and Karo? Any "gravy" style wet foods, for example?

Will be keeping an eye on this, going to go check out Big John's history...
 
Yvonne & Big John & Andy said:
Hi Nan - he is at 109 at abt +4. FYI - no history on him yet - no previous home testing - DM wet & dry. As soon as I get to know him better, will try to make some dietary changes and possibly try moving to Lantus.
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Nan/Kris - I am thinking maybe I should just go ahead and treat him like a new diabetic and start over with Lantus and diet changes rather than try to regulate on N. What I don't know is if he was tried on any other insulins. His records were supposed to be sent to my vet and I won't be going until 2nd week in March. His previous owner is 91 and just went into assisted living and she only did what her vet told her to do so can't ask her. But from past experience on FDMB, you guys always are more knowledgeable than the vets. Any thoughts??
 
Yvonne & Big John & Andy said:
Nan/Kris - I am thinking maybe I should just go ahead and treat him like a new diabetic and start over with Lantus and diet changes rather than try to regulate on N. What I don't know is if he was tried on any other insulins. His records were supposed to be sent to my vet and I won't be going until 2nd week in March. His previous owner is 91 and just went into assisted living and she only did what her vet told her to do so can't ask her. But from past experience on FDMB, you guys always are more knowledgeable than the vets. Any thoughts??
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That's a good plan. N is trickier in cats anyway. When would you start Lantus? The N data can still be useful in determining a starting dose. That 6 u is definitely too high. Why not post on the Lantus forum for advice? Give them the little bit of history you have as well as what happened today.
 
My only thought is to double-check about any history of ketones/DKA before stopping the N. Other than that, I agree that a fresh start with Lantus and a diet change is a great idea.
 
Kris & Teasel said:
That's a good plan. N is trickier in cats anyway. When would you start Lantus? The N data can still be useful in determining a starting dose. That 6 u is definitely too high. Why not post on the Lantus forum for advice? Give them the little bit of history you have as well as what happened today.
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I have the Lantus so any time - and I am familiar with it - I will post on the Lantus forum later - thx for the input.
 
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