Having a hard time with occasional low preshots

Clarence & family

Clarence & family

Member
Starting a new thread as the last one was getting long. Link to previous thread:
https://www.felinediabetes.com/FDMB/threads/clarences-bg-continued.294132/

Clarence seems to be improving, we suddenly got over a week of blue and then green nadirs, however I’m running into some problems.
His nadirs are heading into the right direction but he usually doesn’t seem to get very good duration and his BG starts going up around +8 most times, ending in the 300-400’s with the occasional 500+ mixed in. Also his +2 is usually already lower than his PS, so insulin works quickly for him.
Occasionally he has a much lower PS, and those make me a bit nervous as he tends to drop low when given the full dose with a low PS. I’ve given him 50% two times in the past week with what was a low PS for him, but then I noticed his numbers slowly trending upwards over the next few cycles.
After being high and flat all days yesterday this morning I suddenly got a AMPS of 223, so low for him, and decided to give him the full shot as I’m able to watch him today. +2 was already down to 144, so I gave him an extra snack, but by +3 he was down to 67. More snacks and he’s at 74 now at +4. He seems absolutely fine by the way.

What I’m mostly worried about is that I’ll have to be away from home a lot more in the near future. For the past couple months I’ve been able to either go home and back to work quickly during the day to check or to work from home. That’s not going to be possible that much anymore. I can leave wet food out for him (and there’s always LC dry food for our other cat), but he will just eat all the wet food right away as soon as I put it out and then won’t eat when he drops low.
What would be my best option to handle this when I have to be away for longer? Give him a reduced dose and risk his numbers going up again, or will he be fine with occasionally dropping below 90 (or even 70) despite me being so worried?
 
I think yesterday was a bouncing cycle that he broke today. Today’s cycle looks really good. Since you said he eats all the wet food at one time, would you consider getting an automatic feeder to dispense food for him at +2, +4? This could work for him, and of course he would still have the dry food available if he needed it.
It looks like you are doing a good job managing him.
 
Also, today’s cycle is a safe one. The 67 is a safe number on your human meter so he is far away from danger. We don’t want him dropping below 50. Now, you are doing custom dosing, so you will have to decide what your reduction point is. It is good that you shot the full dose today because your tests show that he did well with that AMPS and the full dose. It’s good to know. If you are not going to be home at all on a day where he is lower than you have ever shot a full dose, naturally you will want to reduce his dose for that cycle. I see you have tested 1.25 and 1.5 units. When will your schedule begin to change? Will you be away from home for the entire day from one shot time to another?
 
I wasn’t too worried about today’s numbers, I know he is safe and feeling fine with these, but what made me worried about not being home is that I think he would have dropped further if he didn’t eat, I fed him when he was at 67, he went up a little to 74 but right after back down to the 67, I’m afraid he’d drop lower if I didn’t put food in front of him.
He doesn’t ask for food or or goes looking for it, he didn’t even before he was diagnosed. The steak he gets with his shots is the only thing he’ll beg for.

The automatic feeder is a good one, somehow I had it in my head those were for dry food only, but I now see there are feeders suitable for wet food. I’ll order one and try it out before my schedule changes, which will be in 2 weeks from now. Hopefully he’ll use it, I used to have an automatic litter box and he was soooooo scared of it, same with an automatic microchip activated cat door. He never managed to figure out how normal cat flaps work either :facepalm: which is why we got the automatic one. But the fact that door opened without him touching it made him hide under the coat rack, lol.
 
Oh and I indeed didn’t want to reduce his dose yet even though he went below 90, his numbers tend to start creeping up after a while, I thought about reducing when he spends at least 3-4 days below 90 or when he starts going towards 50. Would that be reasonable?
 
If he needs a lot of food to bring up his numbers— and low carb food is more likely to just stabilize numbers with maybe just a tiny rose like you saw today —so hopefully he will not be afraid of the automatic feeder. I would actually hate to see him get a reduction right now, but if you can’t be at home as much then you may need to.
 
Suzanne & Darcy said:
If he needs a lot of food to bring up his numbers— and low carb food is more likely to just stabilize numbers with maybe just a tiny rose like you saw today —so hopefully he will not be afraid of the automatic feeder. I would actually hate to see him get a reduction right now, but if you can’t be at home as much then you may need to.
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I hope so too, and I’ll definitely give it a try with the automatic feeder.
It helps that he isn’t acting any different when he’s in lower numbers, so he’s feeling good which makes me less worried. I don’t want to reduce now either unless I absolutely have to. He’s back at 380 for his PMPS now.
 
So Clarence went into high numbers again from two days ago, and yesterday stayed even higher. But I noticed him shaking his head and keeping one ear flat against his head, so I took him to the vet, poor Clarence has an ear infection. No mites fortunately, it seems he has scratched his own ear (he always has a lot of wax buildup) and that got infected.
Today he already had a much better AMPS of 265, and at +5 he was at 90. But it’s Clarence so he did something crazy again…. Just now at +6 he’s dropped to 47 :confused:. He’s acting fine, but I did just give him some medium carb food and will be testing…
 
I’m glad you took him to the vet! And glad you reduced his dose. He may need a little less insulin as his infection gets under control. What is the treatment for his ear infection? Some of the drops have a steroid component to them which actually can raise BG.
 
He’s doing a little better today. I wish for a little more green, but blue is good. You may decide to take his dose back up. How many days until your new job hours begin?
 
Suzanne & Darcy said:
He’s doing a little better today. I wish for a little more green, but blue is good. You may decide to take his dose back up. How many days until your new job hours begin?
Click to expand...
I was thinking about that until this morning, but Clarence did one of his random dives again… I got an AMPS of 83 all of a sudden! It’s rising, from 83 to 126 in just over 30 minutes, but I’m stalling again. And Clarence is mad about not getting fed yet, he’s running around the house as fast as he can and bringing me all of his toys, I think he’s trying to trade, lol
 
Suzanne & Darcy said:
I’m glad you took him to the vet! And glad you reduced his dose. He may need a little less insulin as his infection gets under control. What is the treatment for his ear infection? Some of the drops have a steroid component to them which actually can raise BG.
Click to expand...
He didn’t get anything with steroids this time, he got acidic drops and an antibiotic ointment. So far his ear is looking good and clean. He’s always been really fussy about his ears, it’s something he’s been to the vet for a lot in his life because he’s regularly shaking his head or keeping one ear flat. And before it has indeed always been treated with steroids. No parasites or fungi have ever been found, so the conclusion was ear dermatitis.
 
So I stalled for an hour and gave him a fat 2U, so just a tiny bit shaved off his dose for my peace of mind because I have to be on call for a family member who is in hospital and is probably getting discharged today but we don’t know what time. And of course he has now done a steep climb to 409 within an hour….

He seems to have huge food spikes, even though the food he eats is low carb. I’ve been doing a bit of testing to see if certain variants of his food give a bigger spike, but his ear infection kinda ruined that… the food he got this morning (almo nature chicken and shrimp) has 7.5% carbs.
I have to start my new schedule in 6 days. The good(ish) news is that I got the automatic feeder and he does eat from it, but I still have to sit next to him while he eats :facepalm: otherwise it’s still a bit scary. Hopefully over the next few days he’ll learn that it doesn’t eat him when I’m not there.
 
How is everything going, Alice? I’m sure you have been busy. I was just checking Clarence’s spreadsheet to try and see if all is well in that regard. I hope your family member who was hospitalized is recovering well.
 
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