Chloe going up all day

Here is your post from the main forum for continuity..
https://www.felinediabetes.com/FDMB/threads/help-need-advice-500-bg.237280/

I understand you are worried, Roberta, these higher numbers are not fun to see, but as alarming as 505 is, what comes up must come down. Do you think you may have given a furshot this morning? With past history of DKA, it is important to check for ketones, either via a meter or with Ketostix. If you don't have a method to check for ketones, I urge you to consider doing this more regularly. I believe we have had this conversation before, but high numbers don't necessarily mean ketones.

What about the other Ps, poop is off, but how is she doing otherwise , purring, playing, preening, peeing? Appetite ok?
 
Thank you. I feel a bit better now. She was eating and drinking. She jumped off the bed to get food and she was purring earlier when I tested her. Now she is resting near the water bowl. I don't think I gave a fur shot this morning. I've been getting better at getting the insulin to the right place on the syringe. I 've been checking for ketones when she pees outside the box and it's been negative. I've been careful to keep her away from the dry food, which is the only food Cheddar will eat. I have to keep Chico away from it, too, because he's on a diet. Poor Fuzma just gets the leftovers.
 
Butters & Lyla said:
Is everything ok? What is the 911 for?
Roberta, are you having an emergency?
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Sorry, I was panicking. She's had 4 DKA's and my vet said that they're caused by high numbers. So I worry about the high numbers more than the hypo numbers. It's easier to get the numbers up, but there's nothing one can do about getting numbers down.
 
Might be worth adding the ketones tests in the remarks, so people like me don't keep asking ;), I think you mentioned you use the remarks in the cells, but those aren't visible to us (well at least me, anyway). Glad she is feeling perky tonight, if there is a chance she sneaked some dry food that seems also a possible explanation for the higher trend today.
 
Christie & Maverick said:
Might be worth adding the ketones tests in the remarks, so people like me don't keep asking ;), I think you mentioned you use the remarks in the cells, but those aren't visible to us (well at least me, anyway). Glad she is feeling perky tonight, if there is a chance she sneaked some dry food that seems also a possible explanation for the higher trend today.
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I had no idea you couldn't see my writing in the merged cells. I'll put it in the remarks from now on. It's just that the far right of the page doesn't show up until you scroll over. Is there a way to get the whole page on the screen?
 
Roberta and Chloe said:
Sorry, I was panicking. She's had 4 DKA's and my vet said that they're caused by high numbers. So I worry about the high numbers more than the hypo numbers. It's easier to get the numbers up, but there's nothing one can do about getting numbers down.
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Poor you:bighug:. Don't apologize. I saw the "911" and my heart jumped into my throat. It's scary to see the 911 tag around here, because it generally means someone's cat has dropped way too low. I understand why you put the 911 tag, though. DKA is terrifying.
 
Looks like she’s bouncing. Based on the data you have, particularly the green AMPS, I’m not sure increasing the dose was such a good idea. I’m not sure how long ago you changed to lantus so sorry if I’m telling you things you already know, but lantus is a depot insulin (so it doesn’t work like ProZinc) and dosing is based on the lowest that the dose is taking the cat with very limited thought given to pre-shot numbers numbers. Unless the bounce breaks this cycle there will be no need to test as frequently as every hour - start with a +2 to see how much she’s dropped and take it from there.

And yes please edit your thread title to take the 911 prefix off that is for immediately threatening situations and it does get our poor hearts racing when we see it. Suggest you start posting a daily thread here for Chloe so we can keep an eye on her and provide the best advice in a timely manner - see the stickies at the top for how to go about the daily thread.

ETA it’s in the posting guidelines sticky at the very top
 
Roberta and Chloe said:
I had no idea you couldn't see my writing in the merged cells. I'll put it in the remarks from now on.
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I can see the notes in the merged cells. You could always put them in both places if you prefer — whatever works.

Also, I think you’ve mentioned shooting early on at least one occasion. If you’re doing anything other than a 15 minute shift, you’ll probably want to note that on the spreadsheet as well (it can affect how one interprets the readings, etc).
 
Butters & Lyla said:
Poor you:bighug:. Don't apologize. I saw the "911" and my heart jumped into my throat. It's scary to see the 911 tag around here, because it generally means someone's cat has dropped way too low. I understand why you put the 911 tag, though. DKA is terrifying.
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I don't worry about the hypo's. It's easy to get her to come up. She has a good appetite and if it's really low, I give her the honey and some treats. That brings her up fairly quickly. But what can you do if the numbers go too high?
 
Roberta and Chloe said:
I don't worry about the hypo's.
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Roberta, please don’t take this wrong, but that makes my heart stop. We’re all colored by our experiences — you by the terrible experience of pulling Chloe through 4 DKAs, me by watching a cat have seizures and die from hypoglycemia despite throwing everything (including syrup both orally and rectally) at the cat. He wasn’t my cat, but it was traumatic and leaves an indelible impression. BOTH situations are equally serious. Please remember, low BG kills quickly, high BG kills more slowly. That’s why a common mantra is “better too high for a day than too low for a minute.”

The other, not unimportant, detail is that you have to actually catch the low number to intervene, which is one of the reasons everyone is so keen on testing (even sometimes at incredibly inconvenient times, such as the middle of the night, ugh).

Roberta and Chloe said:
But what can you do if the numbers go too high?
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Sometimes we have to sit on our hands and ride it out, hard as that is. Another thing we can do is test for ketones so we can catch a situation early before it turns into full-blown DKA. We can do additional testing to see if there are hidden low numbers that are triggering a bounce. We can rule out infections — dental issues and urinary tract infections (UTIs) are common culprits in our diabetics that can elevate BG values. We can rule out other concurrent conditions that can complicate treatment and keep BGs high. We can wrack our brains for anything that has changed or any possible exposure to contraband foods — cats that go outside can find all sorts of things, and (ewww alert) other cats in the house might sometimes regurgitate dry food that Chloe then finds, etc.

And finally, we can pick a proven dosing method or protocol and follow it methodically to conquer the puzzle that is our diabetic cat. I believe you’ve chosen SLGS for now, and that’s GREAT. It doesn’t bring Chloe’s BG down in the moment, but it gives you something to have faith in that has worked well for many others who have felt exactly like you.

I don’t for one minute fault you for being super sensitive to the possibility of DKA. You two have been through a lot and it’s bound to influence your outlook. I believe you said Chloe’s last DKA was several years ago, correct? It’s still relevant, if course, I’m just curious about the timeline and over what period of time those DKAs occurred.
 
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