Food struggles, hospitalization, and insulin

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Kris & Teasel said:
No foof. Wait 30 minutes. Retest. If he's still holding or increasing let him have an hour's break until the next test. How is he handling all the pokes? Poor baby ...
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After the ear vein issue, the last two pokes he's handled a lot better. While his BG was 39 and 43 he was vocal/mad. But for BG 62 and 70 he didn't make a peep.
 
JennC said:
That's no kidding, the last three draws I've gotten in one stick. We're at 86!!! :D
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You can leave him alone for a longer interval. Try for a +8 to fill in the BG profile for today. He’ll need a dose reduction tonight. Who knows? He might have been doing this on other days when you weren’t able to get data.

How about 2 u tonight? Get a +2 and +4 tonight. Doing a full curve on the 2 u dose one day this weekend should give useful data. It’s the usual AM/PM pre shot tests (no food 2 hours before) and then every 2 hours between them, feed normally. The 2 u might be too high but data is needed to know.
 
I'll only do 2u tonight. Given his AMPS and PMPS just yesterday, the only difference today is food. He's only had wet other than a few bites of dry during the hypo episode. I'm not sure if I should keep doing wet or give him dry tonight. I won't be able to do +4 after the PM dose, but definitely +2. Tomorrow, I'll definitely only do 2u and do a full curve. Also, should I let him eat now or wait until after +8, and then take it away 2 hours before the PMPS? Sorry for all the questions this time just wanting to make sure we get good readings.
 
JennC said:
I'll only do 2u tonight. Given his AMPS and PMPS just yesterday, the only difference today is food. He's only had wet other than a few bites of dry during the hypo episode. I'm not sure if I should keep doing wet or give him dry tonight. I won't be able to do +4 after the PM dose, but definitely +2. Tomorrow, I'll definitely only do 2u and do a full curve. Also, should I let him eat now or wait until after +8, and then take it away 2 hours before the PMPS? Sorry for all the questions this time just wanting to make sure we get good readings.
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Let him eat and take food away 2 hours before PMPS. You did great today! :smuggrin::smuggrin:
 
Kris & Teasel said:
Let him eat and take food away 2 hours before PMPS. You did great today! :smuggrin::smuggrin:
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Thank you so very much! It would have been very hard to handle today alone and I'm grateful you were online and so responsive. Thank you from the bottom of my heart! What do you think about wet versus dry for the rest of today?
 
JennC said:
Thank you so very much! It would have been very hard to handle today alone and I'm grateful you were online and so responsive. Thank you from the bottom of my heart! What do you think about wet versus dry for the rest of today?
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Is he eating with gusto or are you still worried about a waxing/waning appetite? If the latter, give him what you know he’ll eat willingly. If the former, maybe a little more of the wet.

Pleased to have been able to help! :)
 
How are you this AM? I suggest you drop the dose back to 1 u this AM. It can be slowly increased if necessary. He’s obviously responding strongly to the insulin now. That can be from increased sensitivity after the lows during the day or the change in diet.

What do you think?
 
My three are fed and watered so I can respond at length.

I'm sorry you had another harrowing cycle to get through. I hope you were able to get his BG up without too much difficulty. There are several things that made this harder and could have caused last night's surprise:
  • the BG testing/data logging is recent so you don't know whether this happened before you started. They don't always show symptoms when they drop low.
  • the health issues that put him in hospital have improved and any BG raising effect they might have had could be resolving
  • you've introduced more low carb food into his diet
  • the lows from the daytime caused increased glucose sensitivity and that resulted in another drop last night
  • the 2 u dose has been too high all along and he's been bouncing, leading to inflated pre shot BG numbers.
Here's what I suggest:
  • immediate drop to a 1 u dose. That is the typical starting dose for most insulins.
  • get +3 to +5 tests because it seems his nadir (low BG point) is fairly early with Novolin
  • post here often for now to get other eyes on your SS.
This has been really hard for you. It will get easier - I promise. You now know how to "steer" his BG with numbers and have two low episodes under your belt. That's valuable experience. Imagine if you had followed your vet's advice to not test! :eek:
 
I see your red AMPS. That's a bounce inflated number from those lows. I suggested a drop in dose to 1 u. How do you feel about that?
 
Kris & Teasel said:
How are you this AM? I suggest you drop the dose back to 1 u this AM. It can be slowly increased if necessary. He’s obviously responding strongly to the insulin now. That can be from increased sensitivity after the lows during the day or the change in diet.

What do you think?
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I'm a wreck. His BG is back up to 452 but I did leave a few bites of his dry down last night to bring up his BG. Gave 1u with his wet food this morning. He is pretty grumpy today. I'm going to check him at +2 and +5 today to see how he's reacting to 1u. I do think it's more diet related since he was so high on his dry food and when I switched him to wet with the same dose, so low.
 
JennC said:
I'm a wreck. His BG is back up to 452 but I did leave a few bites of his dry down last night to bring up his BG. Gave 1u with his wet food this morning. He is pretty grumpy today. I'm going to check him at +2 and +5 today to see how he's reacting to 1u. I do think it's more diet related since he was so high on his dry food and when I switched him to wet with the same dose, so low.
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Good plan. Poor you! :bighug: At least you've learned something about his carb sensitivity and how food affects his BG. o_O
 
Kris & Teasel said:
My three are fed and watered so I can respond at length.

I'm sorry you had another harrowing cycle to get through. I hope you were able to get his BG up without too much difficulty. There are several things that made this harder and could have caused last night's surprise:
  • the BG testing/data logging is recent so you don't know whether this happened before you started. They don't always show symptoms when they drop low.
  • the health issues that put him in hospital have improved and any BG raising effect they might have had could be resolving
  • you've introduced more low carb food into his diet
  • the lows from the daytime caused increased glucose sensitivity and that resulted in another drop last night
  • the 2 u dose has been too high all along and he's been bouncing, leading to inflated pre shot BG numbers.
Here's what I suggest:
  • immediate drop to a 1 u dose. That is the typical starting dose for most insulins.
  • get +3 to +5 tests because it seems his nadir (low BG point) is fairly early with Novolin
  • post here often for now to get other eyes on your SS.
This has been really hard for you. It will get easier - I promise. You now know how to "steer" his BG with numbers and have two low episodes under your belt. That's valuable experience. Imagine if you had followed your vet's advice to not test! :eek:
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I completely agree with you on what you said about following my vet's advice. Quite honestly I'm glad he didn't eat wet food for them while they had him hospitalized since they blindly gave 3u on his last day there instead of his normal 2u. That could have killed him. As much as I hated seeing those low numbers again in the evening I felt worse for him. I'm sure these large swings in BG have to be hard on him. I agree with all of your bullets above. :)
 
Look at how fast you're moving along the learning curve! Stressful times like this teach you a lot and teach you fast. :smuggrin:
 
+2 looks really good, I wish I was gonna be home at +3 to see how 1u does. I'll be sure to get that reading after his pm dose
 
Good, as soon as you get home. I've been following along. Did you leave any food out for him?
 
Thank you both!! This site has truly been a Godsend with his diagnosis.

Kris & Teasel said:
Wow! This boy is astounding me! This might be premature to say but he might become a diet controlled diabetic.
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I completely agree! I will say he must have been a little low because we came home and he knocked over our trash can which he's never done to get some food. I separated him and gave him his leftover wet food, while I took his BG. He also did something earlier that I haven't seen him do in quite awhile which was so nice to see. He wrapped himself around one of my table legs and started kicking it with his back legs. I'll say today he's almost a whole different cat. I think we're headed in the right direction. :)
 
JennC said:
Thank you both!! This site has truly been a Godsend with his diagnosis.



I completely agree! I will say he must have been a little low because we came home and he knocked over our trash can which he's never done to get some food. I separated him and gave him his leftover wet food, while I took his BG. He also did something earlier that I haven't seen him do in quite awhile which was so nice to see. He wrapped himself around one of my table legs and started kicking it with his back legs. I'll say today he's almost a whole different cat. I think we're headed in the right direction. :)
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:D:D:D
 
You're welcome. I was following yesterday too, so was already on top of the story ;).
Him getting in the trash tells me that he knew he needed food. He could feel his BGs coming down fast and knew what to do. Please remember this today, and leave food out next time you see him diving like that.
Okay, I'm off..
 
Dyana said:
You're welcome. I was following yesterday too, so was already on top of the story ;).
Him getting in the trash tells me that he knew he needed food. He could feel his BGs coming down fast and knew what to do. Please remember this today, and leave food out next time you see him diving like that.
Okay, I'm off..
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Thanks a million, Dyana! :)
 
One area I'm struggling with is what I should do on Monday when I have to leave him through the day. I already separate him at night because prediagnosis he was peeing outside of the litterbox. Now, I still separate him just to keep an eye on how much he's urinating, so I hate to separate him during the day also but it's obvious he must eat between +3 and +5 and as I mentioned above the other two cats will gobble down his wet food if I leave it out and it's obvious the dry is NOT good for him. Thoughts?
 
JennC said:
One area I'm struggling with is what I should do on Monday when I have to leave him through the day. I already separate him at night because prediagnosis he was peeing outside of the litterbox. Now, I still separate him just to keep an eye on how much he's urinating, so I hate to separate him during the day also but it's obvious he must eat between +3 and +5 and as I mentioned above the other two cats will gobble down his wet food if I leave it out and it's obvious the dry is NOT good for him. Thoughts?
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The only thing that comes to mind right now is one of those $$$ electronic feeders where he wears a collar with a chip so the feeder opens only for him.

The other possibility down the line is that you'll have him on a dose where you get data showing that he stays safe in the middle section of the cycle. For Novolin you'd want nadir BGs in the 90-110 range on your meter. Maybe tonight and tomorrow at 1 u will give useful information.
 
+5 = 110 :D

Kris & Teasel said:
The only thing that comes to mind right now is one of those $$$ electronic feeders where he wears a collar with a chip so the feeder opens only for him.
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Maybe I'll separate during the day for a few days so he can eat, do another curve on Wednesday this week at 1u to see how he's doing without food during the +3 - +4 times. The good thing is I usually work from home 2 days a week and then home on the weekends, so it's only 3 days that he would be separate during the day & night.
 
JennC said:
+5 = 110 :D



Maybe I'll separate during the day for a few days so he can eat, do another curve on Wednesday this week at 1u to see how he's doing without food during the +3 - +4 times. The good thing is I usually work from home 2 days a week and then home on the weekends, so it's only 3 days that he would be separate during the day & night.
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Love the 110! Was that after regular food only, no syrup?
 
Just took his PM BG and it's 226. I'm not sure if I should give his insulin. He's starting to eat right now, should I test again in 30 minutes.
 
Based on today's numbers that didn't require heroic interventions, I'd stick to 1 u tonight.
JennC said:
Just took his PM BG and it's 226. I'm not sure if I should give his insulin. He's starting to eat right now, should I test again in 30 minutes.
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You've been through a lot. I suggest you drop him to either 0.75 u or 0.5 u. You can decide. I wouldn't skip insulin.
 
Well, would you look at that 103 on only 0.5 u?! :) You could try 0.5 u again this AM if his pre shot BG is similar to last night’s pre shot number.
 
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