Diabetic cat with diarrhea

[marisofigia]

This is what I was suspecting, that the syringe was 100 i.u. and the caninsulin was 40 i.u, and so the 5 unit measure with that combination was appropriate and giving somewhere around 2 actual units of insulin. It is a relief to see 40 iu on the vial.

I wish that every vet would take the time to explain to pet parents just what they are instructing them to administer and how, when a new medication is prescribed. Thank goodness for FMDB.

I definitely agree with Mogs that it's imperative for your vet and you to be on the same page as to actual units of insulin, and not simply volume, due to concentration.

The chart she linked to will be very handy if you continue to use the 100 iu syringes and 40 iu Caninsulin.

I am very glad you came here.

I'm glad too! At least now I have an idea of what I'm doing...

 

[Critter Mom]

She seems to want to, but she's not eating enough.

Have another look at the nausea symptom checklist I posted above to see if there are any behaviours you recognise, and also keep an eye out for those behaviours going forward. Two very common signs are:

* appearing hungry but barely sniffing or licking the food before turning away from it.

* 'Yawny' lip licking - reminiscent of the 'yech!' face a human makes when they taste something disgusting.

Also, does Maya ever hunch into a tense 'meatloaf' posture after eating? If yes, that may signal GI discomfort/pain. Seeking out cooler floors to lie on is another thing to look out for.

The fTLI test, if positive, will only tell you that there's a problem with availability of digestive enzymes (EPI - exocrine pancreatic insufficiency). Usually when that's the issue the poop/diarrhoea stinks to the high heavens and the colour of the faeces has a sort of grey, 'ashen' quality to it.

It is possible for a cat to have pancreatitis and not to have EPI. Pancreatitis can also cause diarrhoea. When my Saoirse had her first flare I got to the stage where I despaired of her ever having a solid bowel motion again, so I really feel for you. Both of you! I think it would be worthwhile asking your vet to check for pancreatitis (SNAP fPL and Spec fPL tests). If result is positive then the vet would know to prescribe anti-nausea, appetite stimulant and pain meds to alleviate nausea and GI discomfort and hopefully help Maya to eat better. Indeed, if symptoms of nausea are present then, regardless of whether pancreatitis tests are positive or negative, I'd suggest asking your vet to prescribe anti-nausea and appetite stimulant meds to help Maya eat better. She needs to keep her food intake up. (((Maya)))

See my post above (#29) for relevant links and tips on meds.


Mogs
.

 

[CB Terri]

If it was a choice between eating cooked chicken and not eating, I would be doing what you are. If you didn't already, in future avoid chicken with garlic or onion, it causes issues for dogs and cats. A boiled chicken breast or leg minced is quite edible.
Diarrhea and / or vomiting over an extended period will dehydrate a cat and they lose electrolytes (important minerals and substances that regulate the heart and other organs) - if that becomes a concern, I have given flavourless pedialyte by needleless syringe into the corner of my cat's mouth every couple of hours during the day, over a period of a day or two. Also if you boil a piece of chicken, save the water and put is a very light sprinkle of salt if you did not salt the water when boiling and cooking the piece. You can syringe that to them too.

 

[marisofigia]

You don't need to find the vein, Marisofi. You need to hit the 'sweet spot' between the vein and the edge of the ear:

Testing tips and suggestions to follow...


Mogs
.

This was really helpful! I did it immediately this time! I'll keep on testing through the day...

 

[marisofigia]

If it was a choice between eating cooked chicken and not eating, I would be doing what you are. If you didn't already, in future avoid chicken with garlic or onion, it causes issues for dogs and cats. A boiled chicken breast or leg minced is quite edible.
Diarrhea and / or vomiting over an extended period will dehydrate a cat and they lose electrolytes (important minerals and substances that regulate the heart and other organs) - if that becomes a concern, I have given flavourless pedialyte by needleless syringe into the corner of my cat's mouth every couple of hours during the day, over a period of a day or two. Also if you boil a piece of chicken, save the water and put is a very light sprinkle of salt if you did not salt the water when boiling and cooking the piece. You can syringe that to them too.

Thank you! No garlic, no onion, no skin. She ate roasted chicken breast again today.
I'm also putting Rizolyte rice flour and electrolytes in her water.

 

[CB Terri]

Thank you! No garlic, no onion, no skin. She ate roasted chicken breast again today.
I'm also putting Rizolyte rice flour and electrolytes in her water.

Good for the chicken!!

You may want to check on the starch content of the Rizolyte. I am unfamiliat with it.

My understanding is that some rice flours are quite high in starch calories and the body converts starches into sugars/glucose. Exactly what you do not want when trying to control blood sugars.

If it turns out it is high, perhaps there is something else that can be found to give her if keeping her hydrated is the purpose?

 

[CB Terri]

And well done on a successful blood draw from the ear. As time goes by that gets soooo much easier. You learn how much blood your meter actually needs for a reading, and then you can gently pinch the pricked spot for 10-15 seconds as soon as you have enough. That helps prevent bruising.

 

[marisofigia]

Have another look at the nausea symptom checklist I posted above to see if there are any behaviours you recognise, and also keep an eye out for those behaviours going forward. Two very common signs are:

* appearing hungry but barely sniffing or licking the food before turning away from it.

* 'Yawny' lip licking - reminiscent of the 'yech!' face a human makes when they taste something disgusting.

Also, does Maya ever hunch into a tense 'meatloaf' posture after eating? If yes, that may signal GI discomfort/pain. Seeking out cooler floors to lie on is another thing to look out for.

The fTLI test, if positive, will only tell you that there's a problem with availability of digestive enzymes (EPI - exocrine pancreatic insufficiency). Usually when that's the issue the poop/diarrhoea stinks to the high heavens and the faeces has a sort of grey, 'ashen' colour to it.

It is possible for a cat to have pancreatitis and not to have EPI. Pancreatitis can also cause diarrhoea. When my Saoirse had her first flare I got to the stage where I despaired of her ever having a solid bowel motion again, so I really feel for you. Both of you! I think it would be worthwhile asking your vet to check for pancreatitis (SNAP fPL and Spec fPL tests). If result is positive then the vet would know to prescribe anti-nausea, appetite stimulant and pain meds to alleviate nausea and GI discomfort and hopefully help Maya to eat better. Indeed, if symptoms of nausea are present then, regardless of whether pancreatitis tests are positive or negative, I'd suggest asking your vet to prescribe anti-nausea and appetite stimulant meds to help Maya eat better. She needs to keep her food intake up. (((Maya)))

See my post above (#29) for relevant links and tips on meds.


Mogs
.

Spoke with the vet. She says that in her opinion the cat used to suffer from pancreatitis but has now moved to EPI. She expects that we will have the fTLI, B12, folate tests next week and says that we should wait for these before doing anything else. She also reiterated that the dose should be 5 units.
I gave her 2, as per usual and as we discussed. I will keep on testing throughout the day. Maybe if it keeps being over 400, I do need to increase the dose a bit.

 

[Critter Mom]

Καλημέρα, Marisofi.

Maybe if it keeps being over 400, I do need to increase the dose a bit.

That might prove to be the case, Marisofi, but gradual increases are safer. Now that you're able to get BG readings (congratulations!) you'll be able to use the information to move Maya to a safe, effective dose. We'll help you both every step of the way.

By way of general information on pancreatitis, it can be both an acute and a chronic condition. If chronic, there may be low grade nausea and discomfort present much of the time, with symptoms becoming markedly worse during a flare-up of the inflammation.

A few questions:

1. How long has Maya been on the 'actual' 2 unit dose?

2. What is the carb level of her normal cat food (when she's able to eat it)?

3. With regard to the lab results in her spreadsheet, were those tests run before or after Maya was treated for the UTI?


Mogs
.

 

[marisofigia]

Καλημέρα, Marisofi.


That might prove to be the case, Marisofi, but gradual increases are safer. Now that you're able to get BG readings (congratulations!) you'll be able to use the information to move Maya to a safe, effective dose. We'll help you both every step of the way.

By way of general information on pancreatitis, it can be both an acute and a chronic condition. If chronic, there may be low grade nausea and discomfort present much of the time, with symptoms becoming markedly worse during a flare-up of the inflammation.

A few questions:

1. How long has Maya been on the 'actual' 2 unit dose?

2. What is the carb level of her normal cat food (when she's able to eat it)?

3. With regard to the lab results in her spreadsheet, were those tests run before or after Maya was treated for the UTI?


Mogs
.

Καλημέρα *emojis not showing up on my smartphone*

1. For three weeks.

2. I give her m/d wet food and Royal Canin diabetic dry food. No specific mention of carb ratio on the products.
Before all this she loved eating Wellness Core.

3. As soon I saw blood in her urine, I rushed her to the clinic where they told me that it was probably a UTI and that they would confirm with tests. So, labs were taken after, but not much after.

 

[CB Terri]

Also consider this - if a vet in their expert opinion expects a pet owner to give *5 iu* to their pet then it follows she should ensure the pet owner has the correct method of delivery to do so. If she gave you the vial of 40 iu Caninsulin she should also have given you at least 1 correct syringe to go with it, shown you how to draw that amount out of the vial, how to give your cat the shot, and the right places on the cat's body to give them. There can be differences in body injection sites depending on the action of the insulin (fast or slow acting) and how quick the absorption is wsnted. Belly for instance can absorb faster than scruff.

In my eyes, a vet should set you up for success.
If a vet is telling you that you are giving '5 units of insulin' when you are using a 100 iu concentration syringe and a 40 iu bottle of insulin, that to me is a outright wrong. It may be a communication problem - I would want the vet or their reception or assistants to see that bottle and that syringe together with their own eyes to see if you and they can arrive at a perfect understanding of concentration vs volume.

 

[CB Terri]

Also what Crittermom is saying, I agree with, in that it is better to take a little time and deliver Maya's insulin right for her, than to go fast and risk damage to a kitty's health. Or worse.
When you have a good amount of readings you will see how the # of units you give affects the blood sugar, how much it drops for Maya.
400s are not horrible, and you will get them down soon enough. You can increase gradually over several weeks as you are balancing risks - is it better to have higher blood sugars for a couple of weeks more, or to overdose insulin and have to treat hypoglycemia? That is what you as Maya's caregiver will decide.
A lot of folks don't realize that high blood sugar increases the chance of bladder infections, so it not uncommon to be dealing with both a urinary tract infection AND diabetes. But you can treat them separately AND at the same time.

Meds for the uti should help with the blood in the urine, and give you are sufficient time to adjust the blood sugar safely/gradually and settle the insulin dosages.

 

[Critter Mom]

From Dr. Lisa Pierson's cat food chart:


Wellness Core Range - some of these are <10% carbs.

Hill's Rx Diets - Classed as medium carb for feline diabetics

RC Glycobalance Dry - according to chewy.com it's round the 25% mark, so very much a high carb food.

https://www.chewy.com/royal-canin-veterinary-diet/dp/29922


Safety Note: Please keep to your normal feeding routine for the time being until we get a better idea of what's going on with Maya's BG levels. Obviously if Maya's eating issues continue then for the time being feed her what she will actually eat. (((Maya)))


Mogs
.

 

[CB Terri]

This thread must be getting pretty close to being linked into a new thread, we're at 63 posts.

 

[Critter Mom]

How are things going, Marisofi?


Mogs
.

 

[marisofigia]

How are things going, Marisofi?


Mogs
.

Just updated the spreadsheet. Same thing basically.

 

[marisofigia]

Also consider this - if a vet in their expert opinion expects a pet owner to give *5 iu* to their pet then it follows she should ensure the pet owner has the correct method of delivery to do so. If she gave you the vial of 40 iu Caninsulin she should also have given you at least 1 correct syringe to go with it, shown you how to draw that amount out of the vial, how to give your cat the shot, and the right places on the cat's body to give them. There can be differences in body injection sites depending on the action of the insulin (fast or slow acting) and how quick the absorption is wsnted. Belly for instance can absorb faster than scruff.

In my eyes, a vet should set you up for success.
If a vet is telling you that you are giving '5 units of insulin' when you are using a 100 iu concentration syringe and a 40 iu bottle of insulin, that to me is a outright wrong. It may be a communication problem - I would want the vet or their reception or assistants to see that bottle and that syringe together with their own eyes to see if you and they can arrive at a perfect understanding of concentration vs volume.

Yes, you're right. In all fairness, I've seen three vets:
1.One who has known Maya since she was a kitty and has actually saved my other cats when others couldn't.
He made the mistake with the syringe, even though I asked him twice if I had the right one. Same with the pharmacist when I got the syringe, he said it's the right one.
2. A homeopathic one.
Because I was at my wit's end wanted to try something else. He had nothing to say about insulin, instead he suggested natrium and sepia.
3. The clinician where I brought Maya after she started peeing blood.
That doctor told me to give her insulin in the belly and showed me how to do it. She also asked me to make sure I have syringes specifically for insulin and use Caninsulin, but she didn't know what I already had in my possession.

All in all, a mess.

 

[marisofigia]

From Dr. Lisa Pierson's cat food chart:


Wellness Core Range - some of these are <10% carbs.

View attachment 58274

Hill's Rx Diets - Classed as medium carb for feline diabetics

View attachment 58276

RC Glycobalance Dry - according to chewy.com it's round the 25% mark, so very much a high carb food.

https://www.chewy.com/royal-canin-veterinary-diet/dp/29922


Safety Note: Please keep to your normal feeding routine for the time being until we get a better idea of what's going on with Maya's BG levels. Obviously if Maya's eating issues continue then for the time being feed her what she will actually eat. (((Maya)))


Mogs
.

Omg that dry food! Ok, are you sure we can't start switching to something with less carbs little by little? She does eat that RC dry food in the evening...

 

[marisofigia]

This thread must be getting pretty close to being linked into a new thread, we're at 63 posts.

Really, really appreciate all the help! I understand now how we were going in blind...

 

[Critter Mom]

You're doing a grand job with the testing, Marisofi.

Maya got a good drop from the dose this morning. The tests you get later in the day will hopefully give you info on dose duration.

Another couple of questions:

1. Did Maya get her 2IU of Caninsulin on the morning of 26 November?

2. Can you remember what she was eating during that morning cycle?

3. Is Maya just eating the rotisserie chicken today? If not, what has she been eating today?

Trying to get a feel for the carb load - especially for 26 November because her PMPS was lower that day. One of the tricky things about trying to regulate a diabetic kitty is the phenomenon of 'bouncing': when a kitty goes to a lower BG than they've seen in a while - even if the BG is in a perfectly safe range, just 'unfamiliar' - it can trigger the body to release counterregulatory hormones to drive up BG levels in response. Sometimes BG levels can remain in an elevated range for up to 6 twelve hour cycles before settling down into a better range again. It's something one has to be conscious of when assessing the safety of a dose. I am wondering whether Maya may have gone into an 'unfamiliar' lower level on the PM cycle of 26 November and therefore whether the reds and pinks might be a bit 'bouncy'. As you gather more data, it will become easier to understand Maya's pattern of response to her insulin.

There are a couple of problems with basing dose adjustments solely on periodic curves:

1. If the kitty is currently in the middle of a bounce on the curve day then the curve readings won't reflect how much better they might be doing when not bouncing.

2. If the curve is run at a vet clinic, stress hyperglycaemia may also skew the interpretation of the readings taken.

Both of the above increase the risk of setting a dose too high.


Mogs
.

 

[CB Terri]

Crittermom, Marisofi:
Marisofi are you giving the Caninsulin in Maya's belly now?
Crittermom, any thoughts about injecting to scruff instead, to retard the absorbtion because Caninsulin is quicker acting?

It is so easy so much easier to deliver to the scruff, you can just pull up the loss skin there a little bit and inject with almost or no discomfort and don't need them lying down.

 

[Critter Mom]

Omg that dry food! Ok, are you sure we can't start switching to something with less carbs little by little? She does eat that RC dry food in the evening...

Once you get a little more data to see how Maya's responding at the moment - on AM and PM cycles - you'll then be able to look at a slow, safe transition to lower carb food. Please don't change anything in her diet at the moment - especially with the GI issues in the mix. I urge caution because she's had that yellow PMPS a few days ago and might be bouncing. The higher carb food she got that evening might have been key to keeping her in safe numbers if she dropped a good bit when the dose was at its peak.

If you look back at post #20 above there's a link to information on safely transitioning a diabetic kitty to a lower carb diet.

One of the hardest things about bringing cats into regulation is the degree of patience required on our part. But we have a special line of pants for that!

Mogs
.

 

[Critter Mom]

Crittermom, any thoughts about injecting to scruff instead, to retard the absorbtion because Caninsulin is quicker acting?

Can't contribute anything useful on this one, Terri: I only ever gave injections in the scruff.


Mogs
.

 

[marisofigia]

You're doing a grand job with the testing, Marisofi.

Maya got a good drop from the dose this morning. The tests you get later in the day will hopefully give you info on dose duration.

Another couple of questions:

1. Did Maya get her 2IU of Caninsulin on the morning of 26 November?

2. Can you remember what she was eating during that morning cycle?

3. Is Maya just eating the rotisserie chicken today? If not, what has she been eating today?

Trying to get a feel for the carb load - especially for 26 November because her PMPS was lower that day. One of the tricky things about trying to regulate a diabetic kitty is the phenomenon of 'bouncing': when a kitty goes to a lower BG than they've seen in a while - even if the BG is in a perfectly safe range, just 'unfamiliar' - it can trigger the body to release counterregulatory hormones to drive up BG levels in response. Sometimes BG levels can remain in an elevated range for up to 6 twelve hour cycles before settling down into a better range again. It's something one has to be conscious of when assessing the safety of a dose. I am wondering whether Maya may have gone into an 'unfamiliar' lower level on the PM cycle of 26 November and therefore whether the reds and pinks might be a bit 'bouncy'. As you gather more data, it will become easier to understand Maya's pattern of response to her insulin.

There are a couple of problems with basing dose adjustments solely on periodic curves:

1. If the kitty is currently in the middle of a bounce on the curve day then the curve readings won't reflect how much better they might be doing when not bouncing.

2. If the curve is run at a vet clinic, stress hyperglycaemia may also skew the interpretation of the readings taken.

Both of the above increase the risk of setting a dose too high.


Mogs
.

1. She did.

2. She was eating Hill's m/d wet food (force fed) and RC diabetic dry food (by herself).

3. All of the above, plus the chicken.

 

[marisofigia]

Once you get a little more data to see how Maya's responding at the moment - on AM and PM cycles - you'll then be able to look at a slow, safe transition to lower carb food. Please don't change anything in her diet at the moment - especially with the GI issues in the mix. I urge caution because she's had that yellow PMPS a few days ago and might be bouncing. The higher carb food she got that evening might have been key to keeping her in safe numbers if she dropped a good bit when the dose was at its peak.

If you look back at post #20 above there's a link to information on safely transitioning a diabetic kitty to a lower carb diet.

One of the hardest things about bringing a cat into regulation is the degree of patience required on our part. But we have a special line of pants for that!

Mogs
.

LOL love them! I'm teleworking these days because Greece is on lockdown, so I'm walking around in similar gear all day long

 

[CB Terri]

Once you get a little more data to see how Maya's responding at the moment - on AM and PM cycles - you'll then be able to look at a slow, safe transition to lower carb food. Please don't change anything in her diet at the moment - especially with the GI issues in the mix. I urge caution because she's had that yellow PMPS a few days ago and might be bouncing. The higher carb food she got that evening might have been key to keeping her in safe numbers if she dropped a good bit when the dose was at its peak.

If you look back at post #20 above there's a link to information on safely transitioning a diabetic kitty to a lower carb diet.

One of the hardest things about bringing a cat into regulation is the degree of patience required on our part. But we have a special line of pants for that!

Mogs
.

Ahhh the 'Patience Pants' I have read about lolol!

 

[Critter Mom]

I understand now how we were going in blind...

You would not be the first member here to feel like that, and alas! you won't be the last.

I was so grateful and relieved to find FDMB. The education and support I received here transformed my ability to manage Saoirse's diabetes - and her other health issues too. The vets we were registered with when she became diabetic actually refused to run any diagnostics when she was first presented to them with symptoms (constantly hungry and drinking/peeing for Ireland). I learned here that she was very likely diabetic. I brought her back to them within a fortnight, armed with data about exactly how much she was drinking and eating. She was going downhill at that stage, BG was so high the meter couldn't measure it. She could have tipped into DKA. FDMB helped save my girl's life (more than once). Their subsequent approach to her treatment was, putting it mildly, equally abysmal and very poorly informed.

What matters now is that you're here, you'll be able to learn all you need to help Maya, and hopefully things will start getting better for the two of you.




Mogs
.

 

[marisofigia]

You would not be the first member here to feel like that, and alas! you won't be the last.

I was so grateful and relieved to find FDMB. The education and support I received here transformed my ability to manage Saoirse's diabetes - and her other health issues too. The vets we were registered with when she became diabetic actually refused to run any diagnostics when she was first presented to them with symptoms (constantly hungry and drinking/peeing for Ireland). I learned here that she was very likely diabetic. I brought her back to them within a fortnight, armed with data about exactly how much she was drinking and eating. She was going downhill at that stage, BG was so high the meter couldn't measure it. She could have tipped into DKA. FDMB helped save my girl's life (more than once). Their subsequent approach to her treatment was, putting it mildly, abysmal and very poorly informed.

What matters now is that you're here, you'll be able to learn all you need to help Maya, and hopefully things will start getting better for the two of you.




Mogs
.

That's amazing and it gives me hope...
Unfortunately, I feel it's a similar story when humans need a doctor too. You can't just trust one or two. You have to do your own research as well.

 

[Critter Mom]

I'm teleworking these days because Greece is on lockdown,

There are worse places on the planet to be teleworking. I've only visited the mainland once, many moons ago, but I've also visited Rhodes and Cyprus. Love the food, love the place, and love the people!


Mogs
.

 

[Critter Mom]

Unfortunately, I feel it's a similar story when humans need a doctor too. You can't just trust one or two. You have to do your own research as well.

There's an old saying in Ireland:

Doctors differ, and patients die.


Mogs
.

 

[CB Terri]

So in regards to scruff vs belly as injection site, this thread helped me decide on scruff injection because I wanted the insulin effect to cover more of the 12 hour period between AM and PM shots:

https://www.felinediabetes.com/FDMB/threads/injection-sites.20980/

 

[CB Terri]

There's an old saying in Ireland:

Doctors differ, and patients die.


Mogs
.

That, and 'nobody will look after you better than you can'.
Advocate for yourself (and those you care for and love).
Educating ourselves and understanding keeps us safer.

 

[Critter Mom]

General info:

'Ideal' Curve for Cat on Caninsulin

Mogs
.

 

[Critter Mom]

@JanetNJ, @Deb & Wink -

Hi ladies,

If you have a moment later, I'd be grateful if you could start keeping an eye on Maya's spreadsheet now that Marisofi is able to test her at home.

Potted Hx:

* Diarrhoea for some time now and losing weight. Maya currently on Metrobactin (metronidazole) and FortiFlora - not helping much thus far.
* Some eating difficulties.
* UTI at time of Dx, treatment given.
* Possible previous pancreatitis flare, currently awaiting results for B12/folate and fTLI (vet thinks maybe EPI?).
* Caninsulin treatment commenced October after new diet failed to bring Maya into regulation.
* Vet prescribed 3IU starting dose but then stepped it up to 5IU.
* Marisofi was given U-100 insulin syringes in error, so Maya has been receiving an 'actual' dose of 2IU since the vet instructed Marisofi to increase the dose.
* 2IU dose has already been held for 3 weeks.
* Vet wants Marisofa to increase dose to 5IU straight away.

I'd be grateful if you could weigh in on dosing for Marisofa as soon as there's enough data to make a sound assessment. My particular concern is the weight loss issue and I am wondering whether there might be a case for an initial dose increase of 0.5IU rather than the normal 0.25IU advised in the FDMB Caninsulin guidelines with a view to helping Maya better use what nutrients she is currently able to absorb. (Basing this idea on the results of today's curve thus far, but I'm also mindful that Maya had a yellow PMPS a couple of evenings ago and she might be bouncing today.)


Mogs
.

 

[Critter Mom]

Marisofi, when you have a minute could you please add the 2IU dose for the AM cycle of 26 November so that members reading Maya's spreadsheet will know that the yellow PMPS came after she had insulin that morning.


Mogs
.

 

[JanetNJ]

Hi Marisofi! Welcome. I hear you are struggling a bit. I'm glad you sought help before trying 5 units! Since you are doing 2 and need a bump I would suggest raising it now to 2.5 and let's see what you get! Great job testing! You came to the right place. Remember that while stessfil in the beginning, it is not a death sentence and they can live long healthy lives with diabetes.

 

[Critter Mom]

@JanetNJ - Thank you, Janet.

Quick question: is there ever a case where it may be OK to do a 0.25IU increase in Caninsulin dose sooner than the standard 14 cycles?


Mogs
.

 

[marisofigia]

There are worse places on the planet to be teleworking. I've only visited the mainland once, many moons ago, but I've also visited Rhodes and Cyprus. Love the food, love the place, and love the people!


Mogs
.

I know, I'm thankful. I actually work in the US and after lots of tries, I've managed to make it back here for teleworking. Difference is night and day...

 

[marisofigia]

Marisofi, when you have a minute could you please add the 2IU dose for the AM cycle of 26 November so that members reading Maya's spreadsheet will know that the yellow PMPS came after she had insulin that morning.


Mogs
.

Done!

Again {thank you} all!

 

[Critter Mom]

Great job getting the curve readings today, Marisofi. As you can see from the diagram I posted earlier, Maya's response seems to be quite typical of Caninsulin.

Going forward:

1. Make sure that Maya doesn't eat for 2 hours before preshot, AM and PM.

2. If preshot BG is less than 200, stall for 20-30 minutes without feeding to see if it will rise above 200. While you're waiting you can post for help.

3. If preshot BG is OK then give a substantial feed, wait 30 minutes then give the insulin.

4. Grab a mid-cycle test each day on AM cycle - between +3 and +5 hours after dose admin time is where nadir is typically expected (although sometimes it may be later).

5. Each evening grab a 'before bed' test to get an idea of how low the dose is likely to take Maya during the cycle (many cats run lower at night). A +3 is very helpful but if you can only manage +2s then those can give you at least some idea of how low Maya's likely to get. If there's a big drop at +2 then additional monitoring is likely needed to make sure she stays in safe numbers.

Have you seen Janet's recommendation about dosing in post #86 above?

Are you OK to increase the dose to 2.5IU on tomorrow's AM cycle? In particular, which syringes are you now using - U-40 or U-100?


Mogs
.

 

[marisofigia]

Great job getting the curve readings today, Marisofi. As you can see from the diagram I posted earlier, Maya's response seems to be quite typical of Caninsulin.

Going forward:

1. Make sure that Maya doesn't eat for 2 hours before preshot, AM and PM.

2. If preshot BG is less than 200, stall for 20-30 minutes without feeding to see if it will rise above 200. While you're waiting you can post for help.

3. If preshot BG is OK then give a substantial feed, wait 30 minutes then give the insulin.

4. Grab a test each day on AM cycle - between +3 and +5 hours after dose admin time is where nadir is typically expected (although sometimes it may be later).

5. Each evening grab a 'before bed' test to get an idea of how low the dose is likely to take Maya during the cycle (many cats run lower at night). A +3 is very helpful but if you can only manage +2s then those can give you at least some idea of how low Maya's likely to get. If there's a big drop at +2 then additional monitoring is likely needed to make sure she stays in safe numbers.

Have you seen Janet's recommendation about dosing in post #86 above?

Are you OK to increase the dose to 2.5IU on tomorrow's AM cycle? In particular, which syringes are you now using - U-40 or U-100?


Mogs
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I did see Janet's recommendation (many thanks Janet!) and I will follow that tomorrow. I am using the U-40 syringes for the U-40 Caninsulin bottles now.
I will also make sure she doesn't eat 2 hours before preshot and test her in a bit.

Food stays as it is or should I ease her into something else?

 

[Critter Mom]

I'd suggest sticking with the current diet for now, Marisofi. With the current GI disturbance ongoing, it's likely best to keep things on a bit of an even keel food-wise for now to avoid the risk of exacerbating matters in that department. [ETA: If GI upset were to worsen it could potentially lead to greater eating difficulty, which in turn could potentially make insulin administration more difficult and increase vulnerability to ketones]. Also, it would be better to wait till you have gathered some more data on how Maya's responding to her current insulin/food regimen (will help with planning/safe execution of a food transition).

Sound OK to you, Marisofi?


Mogs
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[Critter Mom]

BTW, please can you confirm which syringes are you now using, Marisofi?


Mogs
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[marisofigia]

BTW, please can you confirm which syringes are you now using, Marisofi?


Mogs
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Sounds good about the food.
I am using the U-40 syringes for the U-40 Caninsulin bottles now.

 

[Critter Mom]

Hi Marisofi,

I see Maya had a better AMPS this morning, so the prior reds look more like they may have been a bit bounce-influenced, so she may have dipped a fair amount on the PM cycle of the 26 November. It's great that you're now getting the tests in. It will help you both much better as the picture builds up.

Housekeeping note: When threads get over 50 posts long it apparently makes the server run slowly, so when next you post it would be great if you could start a new thread and include the URL for this thread in the first post so that members replying to you can check back if they need additional info.

Hope the day goes well for the two of you.


Mogs
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[Critter Mom]

Nice catch on that lovely sunny yellow this afternoon, Marisofi!


Mogs
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