Elmo AMPS at 162 ...stalling food

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Beth 73 said:
Kris , I really don't know...have never skipped a shot and don't know what to expect.....and not sure about trying to eyeball that tiny of an amount(waiting on vet to ok u100)...what are scenarios of the no shot ??? Or looking at Elmo's recent hypo history what of giving the teeny eyeballed amount... just not sure
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If you don't give a dose tonight his BG might be higher in the AM but he'll be absolutely safe wrt hypo. Based on his records, it'll be easy for you to get back to where you were with him. It might be a worthwhile experiment for you so you find out what his reaction is under "no dose" circumstances.

I agree that it's hard to eyeball tiny doses with a U40 syringe but that's what you have right now. You just don't have the data for tiny doses after a hypo so it would be guesswork. While you're waiting you could take another syringe and put coloured water in it to find out/practice what tiny doses are possible by letting out drops, etc.
 
So u don't think he could go too high without a shot tonight....frankly, both options are intimidating to me...
 
Weird also that when I got the 150 I immediately rechecked the same blood with a new strip and got 27 points higher
 
Additional info,...he only ate the 1/4 can( ab 1.2 oz) and walked off...usually eats bit more before shot time...should I encourage him to eat or leave him be ??? What if he gets hungry later? Usually let him eat for up to hour after shot
 
If I skip shot tonight do I let him eat in the next hour as usual or withhold food til tomorrow ??
 
Beth 73 said:
So u don't think he could go too high without a shot tonight....frankly, both options are intimidating to me...
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If it were me, I'd skip. Reason? Better too high for a day than too low for a minute. (Other members may have different suggestions.)

It is looking more and more like Elmo needs less and less insulin.

If he sticks like this I think you may need to have the L-insulin conversation with your vet very, very soon (like Monday).


Mogs
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Beth 73 said:
So u don't think he could go too high without a shot tonight....frankly, both options are intimidating to me...
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We have no way of knowing how high he'll go Beth. I know going without insulin worries you because of his DKA. We also have no data on how effective a dose of "one drop" would be. I'd still go play with coloured water in a syringe while you give him more time to eat and you more time to think.

Unfortunately, situations like this where we have no past experience to draw upon can happen. All we can do then is make a decision we can live with and be prepared to react. Too much insulin could well drop him into hypo again and that can be immediately threatening. Generally cats don't drop immediately into DKA especially when they've been in good numbers quite a while and are otherwise healthy. DKA seems to be the lesser threat to me.

What is your gut telling you?
 
Kris & Teasel said:
We have no way of knowing how high he'll go Beth. I know going without insulin worries you because of his DKA. We also have no data on how effective a dose of "one drop" would be. I'd still go play with coloured water in a syringe while you give him more time to eat and you more time to think.

Unfortunately, situations like this where we have no past experience to draw upon can happen. All we can do then is make a decision we can live with and be prepared to react. Too much insulin could well drop him into hypo again and that can be immediately threatening. Generally cats don't drop immediately into DKA especially when they've been in good numbers quite a while and are otherwise healthy. DKA seems to be the lesser threat to me.

What is your gut telling you?
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Kris u r exactly right...that DKA back in July was awful.. the 3 days in hospital...them telling me he could die...not good....if I do skip shot tonight do I : 1. Let him eat within the next hour or withhold food ???? 2. Monitor BG and respond with food if it drops ??
 
As far as my gut goes , it is operating of two nights of little sleep and can be more prone to panic than my usual self( i know this is familiar territory to you and all here )
 
Beth, I understand your worry about ketones. Can you stay up to monitor Elmo through the night?

@Kris & Teasel - the board is very quiet today and I'm absolutely shattered. Would you be around to help Beth if she ran into difficulties with low numbers?

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Beth 73 said:
Kris u r exactly right...that DKA back in July was awful.. the 3 days in hospital...them telling me he could die...not good....if I do skip shot tonight do I : 1. Let him eat within the next hour or withhold food ???? 2. Monitor BG and respond with food if it drops ??
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If you skip his shot tonight, let him eat whenever he wants. You can monitor his BG once or twice before bed if you like. It shouldn't drop very much because his AM dose has worn off or is on the wane.

I understand your fear of DKA. Teasel was in ICU for three days at the end of March this year with a very scary, very $$$$ episode.
 
Critter Mom said:
Beth, I understand your worry about ketones. Can you stay up to monitor Elmo through the night?

@Kris & Teasel - the board is very quiet today and I'm absolutely shattered. Would you be around to help Beth if she ran into difficulties with low numbers?

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Please take care of yourself, Mogs...I see @Chris & China are currently online too...I am in great hands with the Kris/Chris es...
 
Kris & Teasel said:
If you skip his shot tonight, let him eat whenever he wants. You can monitor his BG once or twice before bed if you like. It shouldn't drop very much because his AM dose has worn off or is on the wane.

I understand your fear of DKA. Teasel was in ICU for three days at the end of March this year with a ver y scary, very $$$$ episode.
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Glad u understand ab DKA...that was gut wrenching
 
I know I blubber this with regularity but I sincerely do not know what I would do without u all....this board is a gift and blessing to Elmo and I.....thank you just doesn't cover it
 
With Kris around to help you if numbers go low you might be OK to give as skinny a dose as you can manage.

Another question, Beth: would you be OK to get Elmo to an ER should the need arise?

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Beth 73 said:
I know I blubber this with regularity but I sincerely do not know what I would do without u all....this board is a gift and blessing to Elmo and I.....thank you just doesn't cover it
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We WANT to help, Beth, because we all understand how scary and confusing this is - especially when things go awry.
 
Speaking of DKA...do I run to ER vet if I find ketones ? Crazy as it sounds, a hypo scares me less cos I know what to do and can do it...I'm not complacent but hypo doesn't scare as much as DKA...
 
Beth 73 said:
I know I blubber this with regularity but I sincerely do not know what I would do without u all....this board is a gift and blessing to Elmo and I.....thank you just doesn't cover it
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I feel exactly the same way about the members of FDMB. If I were to live several lifetimes I would never be able to repay the kindness and help of the people here.

I've not been through DKA but I have been through major pancreatitis episodes and also an absolute nightmare when Saoirse developed uveitis. I fully understand how such things haunt you afterwards.

(((Beth)))

:bighug::bighug::bighug:

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Beth 73 said:
Speaking of DKA...do I run to ER vet if I find ketones ? Crazy as it sounds, a hypo scares me less cos I know what to do and can do it...I'm not complacent but hypo doesn't scare as much as DKA...
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The stuff where one is powerless is much harder.

:bighug::bighug::bighug:

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Beth 73 said:
Speaking of DKA...do I run to ER vet if I find ketones ? Crazy as it sounds, a hypo scares me less cos I know what to do and can do it...I'm not complacent but hypo doesn't scare as much as DKA...
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If the keto strip is negative, you're OK. If you get "trace" the usual advice here is to call a vet for input. Anything over trace warrants a trip to the vet immediately. On my Bayer KetoDiastix, the colour difference between negative and trace can be very hard to distinguish.
 
Kris & Teasel said:
If the keto strip is negative, you're OK. If you get "trace" the usual advice here is to call a vet for input. Anything over trace warrants a trip to the vet immediately. On my Bayer KetoDiastix, the colour difference between negative and trace can be very hard to distinguish.
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I use Bayer strips too... I was at fault in July for the DKA...it was early on in diagnosis, I hadn't found this board/oasis..I had no idea about home testing...just blindly gave the shots...he started acting ill so my inexperience thot hypo and I gave way too much syrup in a panic....it was totally my uninformed fault...awful
 
Beth 73 said:
I use Bayer strips too... I was at fault in July for the DKA...it was early on in diagnosis, I hadn't found this board/oasis..I had no idea about home testing...just blindly gave the shots...he started acting ill so my inexperience thot hypo and I gave way too much syrup in a panic....it was totally my uninformed fault...awful
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You did what you thought was right at the time and now you have more and better information to guide your actions. Don't be too hard on yourself, Beth. :)

Have you decided what you're going to do - no shot or a tiny drop of insulin?
 
Beth 73 said:
I was at fault in July for the DKA...it was early on in diagnosis, I hadn't found this board/oasis..I had no idea about home testing...just blindly gave the shots...he started acting ill so my inexperience thot hypo and I gave way too much syrup in a panic....it was totally my uninformed fault...awful
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Not your fault, Beth; your vet's fault. S/he didn't give you enough information (and s/he's not the exception, unfortunately :mad:).

Beth, you are a wonderful kitty mama. Don't ever for even one second think otherwise. :)

:bighug::bighug::bighug:


Mogs
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Critter Mom said:
Not your fault, Beth; your vet's fault. S/he didn't give you enough information (and s/he's not the exception, unfortunately :mad:).

Beth, you are a wonderful kitty mama. Don't ever for even one second think otherwise. :)

:bighug::bighug::bighug:


Mogs
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Thank u, dear Mogs...really shook my over 15 year confidence in the practice...I have my own mind but did trust them pretty much...not so much anymore...that combined with the homeopathic vet I phone consult with from time to time
 
Kris & Teasel said:
You did what you thought was right at the time and now you have more and better information to guide your actions. Don't be too hard on yourself, Beth. :)

Have you decided what you're going to do - no shot or a tiny drop of insulin?
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To shoot or not to shoot.....hmmmmmm....he is currently eating more....have been playing with color water, per ur suggestion...am amazed at the might those tiny drops contain.....still not sure....isn't 140 the number below which u don't shoot??? And he was at 150....
 
Here's a technique for drawing up and administering a very tiny dose of insulin:

1. Push the syringe plunger right the way down to the bottom of the syringe barrel.

2. Insert the needle into the inverted insulin vial/cartridge as normal and then push hard on the plunger.

2. Release the plunger while the needle is still in the vial. It should sip up a tiny droplet of insulin.

4. Withdraw the needle from the vial.

Have a few practice goes at this technique. On the practice runs after you have removed the needle from the vial squeeze down hard on the plunger to make sure that your technique is OK; you should see a very small droplet of insulin appear at the end of the needle.

If you're OK with the technique and wish to actually go ahead use a fresh syringe and draw up another microdose. Insert the needle into the skin tent as normal, push down hard on the syringe plunger and keep it pressed down for a count of 5 seconds (one-elephant, two-elephant, etc.) to give a chance for the droplet to be absorbed. Then retract the needle as normal. Test at the usual times.


Mogs
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Reading over and taking quick notes on U and Mogs posts to summarize in my head...also going to take aBG just out of curiosity here when he stops eating....
 
Also thot of his nadir today of 93 as being another indicator of shot needed or not....both his AM nadir and PMPS BG were low....still not sure....would giving him a tiny a drop as I can be a good middle ground ??
 
Beth 73 said:
Also thot of his nadir today of 93 as being another indicator of shot needed or not....both his AM nadir and PMPS BG were low....still not sure....would giving him a tiny a drop as I can be a good middle ground ??
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Yes, I think so and I really like Mogs' method described above.
Beth 73 said:
To shoot or not to shoot.....hmmmmmm....he is currently eating more....have been playing with color water, per ur suggestion...am amazed at the might those tiny drops contain.....still not sure....isn't 140 the number below which u don't shoot??? And he was at 150....
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The no shoot number can vary once you have a lot of data/experience. Sometimes, a microdose will be suggested instead of no dose.
 
Beth 73 said:
Just took BG...172... just ate 4carb...has been 2 hours since pmps
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The BG is a bit higher because he ate within the last 2 hours. He hasn't had any insulin so there isn't a drop as you've seen recently at +2. Have you decided about giving a tiny dose? You could wait longer and do it when he's closer to 200.
 
Playing with water...there r approximately 5 drops in the syringe when placed at .25 and squeezed out drop by drop...what would be a micro dose considering current BG of 172...
 
Kris & Teasel said:
The BG is a bit higher because he ate within the last 2 hours. He hasn't had any insulin so there isn't a drop as you've seen recently at +2. Have you decided about giving a tiny dose? You could wait longer and do it when he's closer to 200.[/You mean at 200 could give the .25 ??
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Beth 73 said:
Playing with water...there r approximately 5 drops in the syringe when placed at .25 and squeezed out drop by drop...what would be a micro dose considering current BG of 172...
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Highly inaccurate, but let's say that if 5 drops = 0.25 u, then each drop is about 0.05 u. Your choice - one drop or two drops?
 
Are you going to be able to adjust your shot schedule? If it's already been 2 hours since PMPS, you're going to need to adjust the shot for a few cycles
 
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