charly | mpzm

not sure what to do this morning. she was very high at mid point of last nights cycle but was at 12.3 at amps. i stalled 20 minutes and she is now at 11.6. i'm not feeling comfortable about shooting the planned increase at new low amps.

at the moment i'm stalling for an indication that BG is rising rather than falling and then thinking to shoot the current 2.25 dose. does that sound like a good plan?
 
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shes now at 10 / 180 at 1 hour after preshot. still stalling without food.

now 8.7 / 157 at 1 1/2 hours after pre shot

and 8.3 2 hours after pre shot

7.7 2 1/2 hours after pre shot

6.7 / 121 3 hours after pre shot

7.4 / 133 3 1/2 hours after pre shot

6.7 / 121 4 hours 15 minutes after pre shot

shes been looking very happy all trhough this but shes just vomitted yellow liquid.

7.5 / 135 5 hours after preshot

Back in yellow at +8 . I havent increased but gave her full current 2.25 dose and fed her.

Looks like we have a new shot time of.....4am!

But she is looking very very happy. She even has jumped up on that radiator was waiting to see her on.

Will watch this next cycle closely. I'm mentally preparing myself for the bounce!
 
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I’m not sure I am following all that. You didn’t feed her for all that time? And you didn’t shoot? So how many hours late was her meal and how many hours late was the shot?

Sometimes stalling without feeding can be a double edged sword. The BG continues to fall due to lack of food. Many times it’s better to shoot a reduced dose and keep on schedule and then gather some tests to see how the reduced dose worked so that next time you have a similar preshot number you will know if you need to shoot a little more or a little less. Most times if they’re hovering around 200 like that, it’s okay to shoot the full dose. It’s scary at first. I usually get people to work their way up to shooting lower and lower numbers.
 
Yes it was about +8.

I didn't know what to do but the pro zinc sticky said you can stall without feeding for as long as necessary.

Yes by the time I'd figured out it wasn't likely to go up much higher without eating it was plus +8 and she was back in yellow so I fed and shot then.
 
I get it. You can stall for as long as your schedule allows, but many times it creates more problems than it’s worth and since the BG tends to drop without food it can make the decision of whether and how much to shoot even more difficult. But the main thing is … she’s doing great and jumping up on the radiator is a big deal! That’s great. She must be really a sweet cat if she waited that long for her breakfast. By +8 I would have just skipped the shot and stayed on my regular schedule You have a lot of fortitude! (Charly too! :cat:) I am sorry I didn’t see your message earlier (not feeling well.)

You can work your shot time back to whenever you like it to be now — by moving it in 30 minute increments per day— either forward or backward depending on which way you need to move it (I would think you’d need it to be later than 4 a.m.)
 
i'm not sure its fortitude. it just seemed like the least bad option available! yes we will move it slowly from 4 towards 7:30 again.

no worries about not seeing messages earlier. i know you can't be on here all the time!

i think i would probably have been ok shooting the amps number if i knew she was on the way up. but last night she was black and red at mid cycle so i didnt know what was happening and I wanted to be sure her numbers were on the way up rather than down before giving her shot.

but for future reference it should be OK to shoot around 200 regardless if I am around to monitor?
 
DavidJ said:
no worries about not seeing messages earlier. i know you can't be on here all the time!
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True. Especially at 3 a.m. when your message cane in. Ordinarily, I would be checking for messages around 5:30-6 a.m. but this morning it was such heavy rain that we were wondering if we would be able to go our to feed the community cats that it was very distracting. There were thunderstorms.
 
DavidJ said:
but for future reference it should be OK to shoot around 200 regardless if I am around to monitor?
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Well not yet - if you are not going to be able to get any tests during the cycle. We need data to support that. Right now, we don’t have that much data to see how she does at 200 preshot with the full dose. If you are going to be home, then yes. Are you ready to see green? I think she’s ready to give us some green. It looks like it could have happened this morning if not for the stall. But it’s okay because she’s going to be there again! And do you know what I am really happy about? It’s how great she’s feeling in these new lower numbers! That’s what it’s all about!
 
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so we are shooting 200 this morning. I didn't quite have the nerve to increase the dose at the same time. what with it being 4am and that we are off to the vet at 9am. I will increase this evening I promise!
 
too high for the glucose meter at +4!

so now i'm wondering after all if we should increase this evening or hold the current dose for another cycle or two?
 
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DavidJ said:
so we are shooting 200 this morning. I didn't quite have the nerve to increase the dose at the same time. what with it being 4am and that we are off to the vet at 9am. I will increase this evening I promise!
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I agree with that! We don’t have to increase just because she’s completed a certain number of cycles. We will only increase if the numbers tell is that it’s necessary. We slow down the increases when they start having blue nadirs and she had a lot of blue last cycle. So I would have said to hold the dose anyway.
 
feels like we are more or less back on track this morning. looks like she was flat and pink through most of the pm cycle. at amps she was low red and meowing for food.

shes been eating more slowly than usual this morming, but she is eating her low carb food again and slowly she is getting through it.
 
but yesterday has made me more nervous about shooting low. although now i'm worried about huge high bounces rather than low numbers!

i don't know. maybe i am drawing the wrong conclusion from yesterday? but im thinking she went low after the morning shot and bounced very high by the +4 and then felt too poorly at the high BG levels to eat? the disruption to the routine with the long stall without food the day before i'm guessing probably didn't help at all either?
 
as above. better. eating a bit. but nothing like she has been. seems like she wants to eat but she takes a few mouthfuls and then gives up. like her mouth is too sticky to eat or her mouth or teeth are sore or something.

the only thing she is keen to eat is the 14% stuff. not sure why that seems to be OK with her.
 
just reading up on ketones dka etc. putting two and two together it feels like she might have a mouth/tooth/gum problem of some kind
 
she eating more comfortably now. small amounts at a time but it seems much less difficult for her. and i've found some 6% carb food she seem happy with in the cupboard
 
DavidJ said:
Yes! Shot full dose the right time:)
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She’s breaking the bounce I think so I expect better numbers, although I have seen some unexpected things happen with cats whose SS looks like hers has since yesterday. She’s getting back to lower numbers fairly quickly so I think she’s making progress in adjusting to lower numbers.
 
DavidJ said:
but im thinking she went low after the morning shot and bounced very high by the +4 and then felt too poorly at the high BG levels to eat? the disruption to the routine with the long stall without food the day before i'm guessing probably didn't help at all either?
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And about this from earlier today, I agree except that “low” is a relative term. Any number a cat isn’t accustomed to is perceived by the cat as being too “low.” I see cats bounce from reds when they’ve spent most of their time in blacks.

I definitely agree that she feels horrible in black and won’t eat as a result.

If you don’t shoot lower and lower numbers then she won’t be able to make progress and will be stuck in higher numbers. But I feel confident that we will see her cycles smooth out with less extended bounce time. You are doing brilliantly, and I know she’s had you worried lately.
 
Suzanne & Darcy said:
Yes. I was going to ask you about her tooth/teeth…. when was the last time they were checked?
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she has an annual check up. which is overdue because shes been poorly for a few months now and she missed the last one. so just over a year ago. we are off to the vet on Monday now so we will get them looked at then if we can.
 
she's back in black at +7 tonight. but completely different presentation this time. last time she lay on the floor and barely moved. this time she is strong, lively, vocal. vomited a little but otherwise she gives the appearance of feeling fantastic.
 
black this morning. strange looking cycle last night. she was very vocal for food and woke me up at +7 and +9. i gave her teaspoon of food each time mixed with water. I hope that was a good decision.

she was on the 6% carb food last cycle which I know is considered low carb but is much higher carb than what she has been eating previously which is zero carb. I'm not sure how much difference this might make.

she seems to be happily eating the zero carb again this morning.

you mentioned seeing unexpected things in cats with similar spreadsheets? what kind of unexpected things?!
 
DavidJ said:
black this morning. strange looking cycle last night. she was very vocal for food and woke me up at +7 and +9. i gave her teaspoon of food each time mixed with water. I hope that was a good decision.

she was on the 6% carb food last cycle which I know is considered low carb but is much higher carb than what she has been eating previously which is zero carb. I'm not sure how much difference this might make.

she seems to be happily eating the zero carb again this morning.

you mentioned seeing unexpected things in cats with similar spreadsheets? what kind of unexpected things?!
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Oh, I was just thinking that this might happen— that just when it looks like she’s coming down and going to get good numbers (like just before and at PMPS last night) she goes back up again. And I just was checking her spreadsheet this morning and was not happy seeing that black because I was worried about another bout of not eating. I see she’s already come down a bit into red.

The 6 percent carb should be okay. If possible feed her the lowest carb you can in the latter part of the cycle (like +7 and +9 last night) but if she needs food and won’t eat the katkin then it’s okay. I am glad she eats the food mixed with a little water to help her hydration.
 
it seems less extreme than last time. shes down a little more and into pink at +4 and shes eaten all usual meals this cycle enthusiastically. im hopeful she might drop into yellow again by end of cycle and we can have another try tonight.

it looks like maybe we are repeating this pattern until she hopefully, eventually breaks lower from a shot given around 200 rather than higher?
 
shes on her chair rather than under it now after the +4 meal. which seems always to be a good indicator she is not too high.

she had a good couple of hours mid cycle. went out hunting then curled up in front of fire for half an hour. shes not done that since diagnosed.

back in red at +7 though and ketones 03. gave her a teaspoon of katkin with water
 
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DavidJ said:
it seems less extreme than last time. shes down a little more and into pink at +4 and shes eaten all usual meals this cycle enthusiastically. im hopeful she might drop into yellow again by end of cycle and we can have another try tonight.

it looks like maybe we are repeating this pattern until she hopefully, eventually breaks lower from a shot given around 200 rather than higher?
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This is my hope as well.
 
Depending upon where she is at PMPS, we should probably go ahead with the planned increase. Although as I am typing this I am remembering that you are taking her to the vet tomorrow, so we should wait until after that because her whole routine will be disrupted and you don’t need to worry about low numbers while traveling with a cat. This will give her a little more time on this dose. Maybe she will show us some better numbers tonight? (We can hope)
 
Yes let's increase tomorrow night after we are back from vets. We should have additional info re any possible dental issues by then

I'm a bit nervous about increasing after last few days. It's been a bit of a rollercoaster. some of best moments since diagnosis but also some of the worst.
 
At least she’s recovered well after feeling ill. It hasn’t lasted for a long time. It is worrying when they won’t eat. I get very anxious about, but hr ketones didn’t go over 1 and they came back down. What a relief.
 
What I am concerned about is holding the dose too long which gives glucose toxicity a chance to set in and it makes it harder to shift her out of higher numbers. Clearly, her body is already accustomed to high BG, but she feels terrible when she’s there.
 
Suzanne & Darcy said:
What I am concerned about is holding the dose too long which gives glucose toxicity a chance to set in and it makes it harder to shift her out of higher numbers. Clearly, her body is already accustomed to high BG, but she feels terrible when she’s there.
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Yup understood. I'm not suggesting we shouldnt do it. Just saying it makes me nervous.
There have been a couple of occasions recently when I just didn't know what to do.
Having said that I've learned a lot last few days so I guess I'm better prepared for the unexpected now.
 
DavidJ said:
Yup understood. I'm not suggesting we shouldnt do it. Just saying it makes me nervous.
There have been a couple of occasions recently when I just didn't know what to do.
Having said that I've learned a lot last few days so I guess I'm better prepared for the unexpected now.
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Oh. I completely understand the nervousness. Sometimes we get the unexpected for sure. We just have to be prepared, and I feel like you are.
 
I’m just checking in on her before I go to sleep. I am happy to see some yellow numbers. If she’s back higher again at AMPS, think this confirms the need to increase (after the vets of course).
 
charly is having quite a good day. yellow again at +6 despite a visit to the vets. and seems to be feeling more comfortable than she has for a good few days.
 
she has REALLY surprised me with that black number at +9. She was looking wonderfully relaxed yawning and stretching in one of her favourite spots. I was absolutely confident when i went to test her she was going to be yellow at the highest and maybe into blue again. but no i tested twice to be sure and she is deffo back in black.

better news is the blood ketones are reading LO again which I think means < 0.1 on my meter.
 
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