Flying solo with Olive for a while

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Olive's BG didn't go down after the skinny 0.25IU at the 2nd cycle last night and remained consistently high all night. I'm thinking she's not getting enough insulin due to the tinkering to get the quarter unit right, so instead of trying to go skinny, I aimed for what I hoped was the exact 0.25 mark this morning. I spoke with a pharmacist yesterday and brought in my Walgreens syringes to show him how the zero line is so crooked. He said it definitely was and to throw out the syringes that are as measuring a quarter unit is difficult enough without adding crooked lines to the mix. But here's the kicker...I had to show HIM where the quarter mark was. He kept telling me that the half unit mark was the quarter mark, so I kept politely telling him it wasn't. When he tried counting the lines he said, "Oh yeah, you're right!" lol. Let this be a lesson to anybody who reads this post who is just starting out, that YOU have to do your research because even pharmacists aren't infallible. Here's hoping Olive's BG actually goes down today.
 
Yeah, this is a real problem at these small doses. The inconsistency in marking the "zero" line drove me absolutely batty! Maybe it doesn't matter much for human insulin dosing, where you're shooting 10, 20, 30 units, but it sure makes a difference for a cat!

There are a couple things you can do. The simplest is probably to make up a syringe with colored liquid to serve as the standard dose you want to give. Then when drawing up insulin, basically ignore whatever lines are on the new syringe and just compare to your standard dose. That will give you consistency from dose to dose, whatever the syringe manufacturer is doing!

To get even more precise, a lot of people use digital calipers to do basically the same thing. I never used them, so I can't offer too much advice here, but many people swear by them!
 
Nan & Amber (GA) said:
Yeah, this is a real problem at these small doses. The inconsistency in marking the "zero" line drove me absolutely batty! Maybe it doesn't matter much for human insulin dosing, where you're shooting 10, 20, 30 units, but it sure makes a difference for a cat!

There are a couple things you can do. The simplest is probably to make up a syringe with colored liquid to serve as the standard dose you want to give. Then when drawing up insulin, basically ignore whatever lines are on the new syringe and just compare to your standard dose. That will give you consistency from dose to dose, whatever the syringe manufacturer is doing!

To get even more precise, a lot of people use digital calipers to do basically the same thing. I never used them, so I can't offer too much advice here, but many people swear by them!
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A digital caliper...had no clue what one was until I saw a photo I just googled. So if anyone on here uses one, can you please send me a link to the one you bought and where you bought it? Home Depot has a lot of them but I'm clueless on which one is the right one to get and then how to use it. I'm going to try the colored liquid and putz around with the old syringe today to see what I can come up with. Good advice.
 
Olive & Paula said:
Here is the link to calipers. Even with whole and large doses, using them all the time makes for consistent dosing. Couldn't do without them especially when half asleep in the morning.
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Thanks so much. I just looked it up and then called our local store (yes! Actually have that store 20 minutes away! So I'm heading out now to pick one up. Then all I'll need to do is figure out the correct settings for my Walgreens syringes.
 
I'm monitoring Olive closely since I'm not so adept with the Relion meter as I am the AT2. She's still dropping at +7. Her BG is 56. Is that considered the low end of "low"? I just fed her the 1/4 cup she was supposed to get an hour from now. Would it be okay to offer her just 1 temptation treat along with that or would that be too much? I'm not sure how many carbs are in each piece.
 
50 is the 'take action' number on the human meter, Robyn.

Test again 30 minutes from the time Olive ate the 1/4 cup of food and post the result here, plus the time elapsed since the insulin dose was administered (in '+' notation, please). If more than 30 minutes has elapsed test straight away and post the result.


Mogs
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Okay, I'll go do that. My goal is to get her to eat more food in a day so she can start gaining some weight back. She's had more of an appetite today so that helps. I'll come back in about a half hour and post the results. I'm also keeping her spreadsheet updated as I go along through the day.
 
Thanks for the the result, Robyn.

Again, very little in the way of a rise thus far.

I know it's a fair way along in the cycle but I'd like to have seen Olive a little higher.

I suggest feeding another teaspoon and testing again in 30 minutes.

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I know I can't feed her for two hours before the PMPS and even though her numbers have gone up a bit, there's no way she's going to reach suitable BG numbers in order to give insulin for the 2nd cycle tonight. Unless I stall. But how long can I stall past their shot time?
 
That's better. Hopefully this late in the cycle Olive'll stay up. Just to be sure, to be sure, I'd suggest testing again in an hour.

Now, you have a problem. If you're following SLGS, Olive has just earned a dose reduction of 0.25 units because her BG has fallen below 90 on this cycle.

The best I can suggest to you, Robyn, is that you post on the Lantus/Basaglar/Levemir board and ask for advice on dosing. I've given you my two penn'orth before, namely that, for the time being, I think you need to seriously consider increasing the carbs in Olive's diet to a point where you're able to administer the insulin she needs safely and consistently. As Olive is underweight she also needs extra food to help her maintain the muscle mass she still has and to help her gain weight. I think your girl needs carbs and calories. Other FDMB members may have a different view.

Have you managed to start testing for ketones?


Mogs
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Critter Mom said:
That's better. Hopefully this late in the cycle Olive'll stay up. Just to be sure, to be sure, I'd suggest testing again in an hour.

Now, you have a problem. If you're following SLGS, Olive has just earned a dose reduction of 0.25 units because her BG has fallen below 90 on this cycle.

The best I can suggest to you, Robyn, is that you post on the Lantus/Basaglar/Levemir board and ask for advice on dosing. I've given you my two penn'orth before, namely that, for the time being, I think you need to seriously consider increasing the carbs in Olive's diet to a point where you're able to administer the insulin she needs safely and consistently. As Olive is underweight she also needs extra food to help her maintain the muscle mass she still has and to help her gain weight. I think your girl needs carbs and calories. Other FDMB members may have a different view.

Have you managed to start testing for ketones?


Mogs
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Well, I certainly do appreciate everything. I'm a stickler for testing, as you can see by her spreadsheet, so I'll retest in an hour. Yes, we are following SLGS. I'll have to post over on the LBL and get some extra feedback as you suggested. Yeah, hubby and I are thinking as much as we love and want her on raw food, that for now adding more carbs to the diet would only benefit her. How many carbs would be safe though? We have some RAWZ turkey and salmon which would provide her 1.22 carbs for the day and RAWZ Duck and duck liver that would offer 2.17 carbs for the day. As apposed to the raw she's eating that only offers 0.4. I'm certain that the raw food is filling her up too quickly and she can't eat as much at one sitting. You aren't the only one who's suggested she eat more carbs. So did the vet. But she wanted her on the Purina DM which we are reserving as the last straw since it's filled with poor nutritional ingredients. Yes, we tested her for ketones during the one and only time we caught her before she used the litterbox and that was day before yesterday and she was okay at that point.
 
Thanks for the info, Robyn.

First up, ketones. Daily testing for ketones is advisable in cats who spend a lot of time in high numbers and who are not getting enough insulin (for whatever reason) as a very important safety precaution. DKA is a life-threatening complication of diabetes and the simple daily urine test is a way of preventing it.

Sometimes cats need the food they need, and it might not be what we'd like them to be eating.

I don't think any ultra-low carb food is going to help this situation. There's only one way to determine the level of carbs that might help this situation and that is to feed them and see what impact it will have on Olive's ability to receive enough insulin safely. There may be some experimentation required. If it were my cat I'd be looking to start with a food closer to the 10% carb mark and take it from there. Again, this is only my take; other members may have very different views.

I'll be signing off for the night shortly. I hope that you'll get good help on the LBL board.


Mogs
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Critter Mom said:
I don't think any ultra-low carb food is going to help this situation. There's only one way to determine the level of carbs that might help this situation and that is to feed them and see what impact it will have on Olive's ability to receive enough insulin safely. There may be some experimentation required. If it were my cat I'd be looking to start with a food closer to the 10% carb mark and take it from there. Again, this is only my take; other members may have very different views.

I'll be signing off for the night shortly. I hope that you'll get good help on the LBL board.
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Have a good night and thanks for all the help today. We definitely need to change her diet and see what happens. I wish her vet appointment wasn't a month out. Is there a food out there that's similar to the Purina DM? Until tomorrow.
 
Hi Robyn,

Just saw you're getting answers on your new thread. The members responding there should hopefully be able to help with food recommendations. I'm in the UK so apart from the typical hypo toolkit foods and one or two others I don't know what products are available in the US.

Wishing you all a good night too. :)


Mogs
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I'm shaking things up today while I wait to get what I need to make Olive's food at home. I just picked up a few cans of Fancy Feast classic pate, but I need to travel to find more flavors. They only had the salmon which she's not a huge fan of. I called a different vet and just enquired about carbs, ect. Of course that vet won't offer any advice whatsoever without seeing Olive, but the two techs did help. They agree that Olive needs to gain some weight and get some added carbs into her for the insulin to work effectively in her body and they know I'm not a fan of the Purina DM but said the Fancy Feast is totally similar to it in most every way but the cost. It has the calories she needs as well as the protein. So until I can get what I need to make her meals, I'm going to switch to the FF instead of the raw just to begin boosting her up. Maybe give her a tsp or so of the raw as little tidbit snacks through the day just to keep the benefits of the raw going. And as another member said, can offer raw chicken thighs too.
 
Very interesting...Olive reached 50 on the human meter@+5 so I took action and I couldn't get her to touch any food and she didn't want the FF gravy, so I quickly grabbed the honey. Talk about a cat that was ready to be shot out of a cannon! It was all I could do to hold her and I got honey all over her fur. I know you've told me to get a Tsp of food in her but she wouldn't touch her food so that's why I resorted to the honey just to spike her long enough so I could go to Plan B. After trying to get her to eat again without any luck, I had to force the food down her (maybe she was full or just isn't digg'n the salmon). Needless to say I'm not her friend right now. Her tail has been thumping and she wants nothing to do with me. I have continued to monitor her every 15 minutes. Did I jump the gun with the honey? The interesting thing is that I had enough blood that after testing with the human meter (BG71) I thought I'd see how close the AT2 was to her BG numbers and used the exact same sample of blood as it pooled on the test strip and the AT2 read her BG as 111. Now that's a huge difference. So now I wonder if I panicked too quickly. I'll continue to use the human meter, although I might get a different model as I'm having a lot of problems with the Relion Prime not reading that the test strip is inserted, but I just wonder why the AT2 was sooooo much higher than the Relion.
 
I suppose...It just freaks me out when I see her BG hit 50 on the human meter. I just tested again and she's at 74. So it's slowly going up. Oh yeah, she bathed herself for 10 minutes solid! Now how does this work with the insulin tonight? She's probably hit the peak for the day and if her numbers rise enough by the PMPS, should I give the same skinny IU I did at the AMPS or go even lower than "skinny" since her BG fell below 90 today?
 
Both my Human meter spreadsheet as well as the AT2 spreadsheet proved too confusing for folks, so I was asked to merge the two and only post that one. Should be clearly marked to tell the difference of when that switch happened.
 
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tiffmaxee said:
I’m wondering given the low numbers today and no tests to see how low last night you might be better skipping insulin tonight.
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She was 204@+3 during the night, I somehow forgot to record it on the spread sheet. I didn't test after that until the AMPS. Without insulin in her I took advantage of not having to worry about her dropping and got some much needed sleep. But I did get up in the middle of the night, which would have been around her Nadir had she gotten insulin, and checked her levels which was BG 204 +3. At this point I don't know what to do but allow time to pass as we try and build her up on FF. Even skinny 0.25 is causing way too low of BG. Without it she shoots above 400. Maybe the 0.1IU will be the trick in the meantime, providing I measure it properly and that she actually does get the dose I inject.
 
If you do shoot you need to give the 0.1 a real chance. It might cause high numbers at first. Then you wait to see what happens when she settles in. I think that’s a good plan. Just don’t freak if you see high numbers.
 
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