Help first time with low numbers

Status
Not open for further replies.
Ok...so you just don't have those numbers, right? You just started home testing with the curves?

I'd suggest that if the above is true, you still enter in the SS for the night values the amount of insulin you shot. Could you do that please?

I'm discussing his dose with a few other experienced members. Were you able to retest?
 
I dont understand the night and all that. could you help me understand after we get him settled?
 
sorry now refreshing and getting previous comments. so different then what i was told but i will change it that is for sure:)
 
And you are now 1/2 hour past shot time?

Here's the thing: His starting dose should have been 1u; we don't know where he's been "going" with his BG but with 3u, he really dropped. If we had more data, we could tell whether he's been getting too low.

I am concerned with taking his down down all the way to 1u because that could be too low. It's possible that he could need more insulin than that. I'm wondering if we should take him to 2u for now? Actually, I'd prefer 2.5u but since you just have the pen needles and you've got to get something into him, I'd say 2u. That way, if you can start getting some home testing numbers and shooting him more accurately with insulin syringes instead of pen needles, we could see what he actually needs. If he needs more, like 3u, it wouldn't be so much to take him up fairly quickly (but not 1u at a time).

What do you think? I know you are really new and don't have much info but you are his caregiver and I like to get some thoughts from you based on your experience today. He didn't go below 50 (which is when we reduce the dose) but you were definitely working to keep him up.
 
Let me clarify Chris' post.

With tight regulation, we encourage everyone to test at minimum 4 times each day -- once at your pre-shot time and at least once during both the AM and PM cycles. If you look at most of our spreadsheets, you'll see that many of us test substantially more than that.

As for your vet telling you to only test to get a curve, let me offer a different perspective. If your vet's infant was diagnosed with diabetes, do you think that the pediatrician would tell the vet to test only once a week and it wasn't necessary to test prior to giving an insulin injection? If any physician did that, it could be akin to malpractice. This is why glucometers are available in pretty much any pharmacy. The best way you can keep your cat safe is to home test. It gives you considerable control.

Just remember to give your kitty a treat every time you test -- no matter whether the test is successful or not.
 
I think 2 is fine. lets start there. i will give him food and do that now. I will be back in a few to ask questions.
 
I think that works for now. That gives us the option of being able to go up or down without making huge changes.

I'll be looking for your questions. I would have addressed some of the other things sooner but I thought it best to focus on getting up a SS and getting some insulin in him.

When you are done, you can list the questions and go back over info that Sienne and Chris have left for you as well as my and other responses.

I have to give my own cat insulin here shortly so I'll be back.
 
Okay I am back.

Why did he get sick. He really scared me i have never seen him do that before. also how come since he has been on 3u since Monday did it hit him so bad today?

I understand the syringes and i will be getting some tomorrow after work.

I do prick his paw. I cannot figure out his ear and i pricked it so bad before that i just cant do it. I do give him dried shrimp after. He usually just lays in my arms while i test him. and Insulin he doesnt mind either.

Am i doing okay with food? He is on DM because we do get it cheaper through the company since my husbands mom works for a vet. He used to be on CD dry for approx 12 years because he had crystals in his urine, Should i get some hi carb cans for him in case this happens again? this week he has had the biggest appetite like he has been craving carbs.

Now on to what confuses me most. Testing him.
Every morning before he eats i should test him.
Test him 5-7 hours after he eats. What if i cannot do that? i could probably do 8/12 hours after.
The evening i can get close to 5 hours but may be only 4
Also if his number at "bed time" is lower then i need to get up later and test again.
last but not least if i have any questions i shouldnt hesitate to ask.

if i do have questions how do i ask them? do i continue this thread or start a new?
 
The canned DM is fine, but most cats get tired of it and stop eating it after awhile. It's important that you keep him on foods that are less than 10% carbs. Here's a Food Chart that we use. Carb percentages are in Column C

Yes, you want to always keep some higher carb foods in the house, just in cases of these low or dropping numbers. Anything under 50 means a dose reduction, and it's good to have those higher carb foods in your "hypo kit", which should include an extra box of test strips as well. The last thing you want at 3am is to have to run to WalMart to buy strips when your kitty is testing below 50

Always test before shooting, and take up his food at least 2 hours before those Pre-shot tests. We don't want them influenced by food.

If you can't get a test somewhere between +5 and +7, get them when you can. If +8 is the best you can do, get those, and on weekends when you have more time, get more tests in. Dosing of Lantus is based on the nadir (the lowest point in the cycle), not the Pre-shot tests, and the nadir is "usually" around +6...although it can skip around from cycle to cycle.

One of the best tests I like to get, especially at night is a +2. If the test you get at +2 is lower than the Pre-shot test, it's important for you to get some tests later in the cycle, so at night, this may mean setting an alarm.

You may continue to ask questions here, but if it gets much longer, a new post is probably a good idea, but copy and paste the link to this one to include it in the body of a new post. If you copy the link address, and click on the URL tab, you just paste the link between the URL's. Looks like this YOUR LINK HERE[url]
 
okay i get that.

I do have one more question to go with the others. What do i tell my vet tomorrow when i call him with these numbers?
 
Most of us don't bother telling our vets much of anything anymore, but if you want to include him/her, just tell him the truth. That it's a good thing you tested him at home over the weekend because he went so low, and that you found the FDMB online and that we helped you with it.

Tell him you're going to home test from now on, and if he'd like to follow along, you'd be happy to send him the link to your spreadsheet.

If he'd like to learn more about the Protocol, here's the Roomp/Rand Tight Regulation Protocol that we use here.
 
I have a few answers, some different than Chris's, but that is the beauty of this forum :-D :-D

I don't know of anyone feeding DM if you are referring to Purina DM. The carbs are only 3% but the ingredients are not good. Most everyone here feeds their cats either the low carb varieties of Fancy Feast but others feed LC Wellness, Evo, Before Grain, etc. Some feed raw. I'd look at the link Chris gave you and also consider your budget. We find that cats typically do best when getting somewhere between 4-7% calories from carbs. You will see this phrase often here: Every Cat is Different (ECID). So you'll have to figure out what might work best for him. You can continue feeding DM if you like but it's just not a good quality diet.

Yes, you should always get a test before you shoot insulin. Always. Most of us test and then within 15 minutes shoot while kitty is eating. If you work, I would get a +2 or out the door test and an in the door test. At night, you can do a +2 and/or a before bed. As Chris said, the +2 test will give you great info about what Nava might do for the day.

If he is dropping at bedtime, yes, I would get up and test.

I would keep this thread/condo for today; sometimes first condos are long and it's ok. Tomorrow, you can start a new one as we do one condo per cat per day and that day starts with your AM test. All of your questions go in that one condo for that day.

On the vet......you can tell him you reduced the dose because of the numbers. Many of us have great vets; most of us do not use our vets to manage FD. We live and breathe it 24/7. As hard as our vets work and as good as they might be, they don't typically get a lot of diabetic cats and most are not able to keep up with all the changes in treatment. They also will be ultra conservative and likely want to keep kitty in the 200-300 range. For us doing tight regulation, that is too high and we want Nava and other kitties to have the best chance to get into remission. So you will need to find a way to work with your vet so you can get prescriptions from him (like insulin). My vet is awesome; she knows I know way more about FD than she does. She loves to learn and she's great at listening. When I wanted to change Gracie from lantus to levemir insulin, I asked for the script, she asked some great questions, looked it up in Plumb's, wrote the script.
 
Becky --

Many of us work or go to school or both (or work 2 jobs, etc.). What Chris is suggesting when it comes to getting a test between +5 and +7 is that you get a test at your cat's nadir. That would be ideal if you were home and, more importantly, if Nava's nadir (lowest point in the cycle) fell between +5 and +7. Theoretically, Lantus nadir is at +6. And now for the big, "however..." Many cats' nadirs do not fall at the expected time. The value of doing a curve is that it may tell you when the Lantus nadir is and when insulin onset is. Based on a very limited amount of data, Nava's nadir (at least today) is at +10. My kitty's nadir is typically at +3 or +4 except on those days when it's not. The nadir can and does move around.

This is my long winded way of saying that it's most useful to test at different times. If you always test only at pre-shot and +6, that's a lot of white space on your spreadsheet. It's helpful to test at different times so you have a sense of what's going on when. I tend to test a lot early in the cycle because Gabby has an early nadir and is prone to big drops early in the cycle. The more data you have, the more you will see patterns in Nava's data. Having that data is critical. The better you understand Nava's patterns, the more data ready you will be and you will be able to shoot low numbers which is the goal we all have.

I also want to strongly encourage you to start getting at least a before bed test every night. If you don't test at night, you're missing half of your data. In addition, if Nava's numbers dropped low today, it's a fair bet that they are dropping low at night. Testing during the PM cycle is the only way to insure your kitty is safe.

As for your vet, you can share this journal article with him. This is the research publication from a leading vet journal that describes the Tight Regulation Protocol that we use. You'll also note that home testing figures prominently in the title of the article.
 

Attachments

okay thank you for the info. What if i get some new food and mix it so i dont waste the dm?
I am hoping this vet will go along with me. I am pretty sure he will.
Thank you all very much i am going to do my best to get his testing done when needed but tomorrow will be a little difficult since he didnt get his meds till 8pm. exactly how early can i push his meds tomorrow morning? I am out the door by 645 and my husband normally by 8.

Thank you.
 
What meds? His insulin?

Can you change his shot time to earlier than 7:30....say maybe 6/6 and then your husband could check him right before he leaves at 8?

For tomorrow, if you shot 30 minutes late tonight, you can shoot on time in the morning. If you want to move his shot time earlier than 7:30, we need to help you with a plan.
 
I would like to move it closer to 6 so he can test him. I know I have an hour leeway but don't want to push it too soon.
 
You can move his shot time either by shooting early 15 mins every cycle or 30 mins early one cycle a day. If you have a cycle that he's rising quickly, like tonight, you can shoot one hour early but you can't do that too often.

This weekend, daylight savings time changes and so you will also have to change shot times for that. We post instructions on how to do that as well.
 
Status
Not open for further replies.
Back
Top