Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4 43!!

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Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Hi there!!! You're doing just fine. It looks like Nala gets a good bump with the HC. Check her again in another 20-30 minutes and see where she's at. You can give some more HC now, but it might bump her up a lot. My cat, Champ, is very carb sensitive and I give him medium carb (MC) food to bump him up and I tend to only give him a tsp every hour. It''s up to you and how comfortable you feel. Take a look at Champ's SS from the last few nights and you'll see he's gotten down to the 30's and he doesn't exhibit any signs of hypo...he acts completely normal. Which is why you need to check at least every 30 minutes until they're in the 60s or so.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I am new here and by no means do I have much experience with FD but I am a type 1. My advice, until someone with more knowledge about FD comes along, is to keep checking her until she is a little higher and you know she is going in the right direction and not down. If she hasn't peaked yet, you need to keep a close watch on her until the insulin peaks. I think I would give her a little more HC food since she is just +4 into this cycle. Hopefully someone else will give more advice. meanwhile, my philosophy about my own hypos is to overtreat it rather than undertreat it and keep checking her BGs every 20 minutes or so..
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Go ahead and take the 911 off your subject line now. We try to reserve that for cats who are in crisis, in active hypoglycemia, etc., and since you have help now you can take it off. :-D

Have you tested again?
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Thank you Patty & Champ and skybar22! I'm really scared about this and I can't thank you enough for your answers.

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57

Nala is still acting perfectly fine.

Rosanna
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Don't be scared. There's no danger right now, trust me!!! Go ahead and give her another tsp of HC and test again in 30 minutes.

ETA: What are you feeding for HC?
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I notice you signed off so I'll be going, too. Just keep checking her BG every 30 minutes until her numbers get into the 60s/70s (whatever you're comfortable with) and feed HC if her numbers are below 60. I usually keep testing until I have a couple of rising numbers that have no HC behind it...meaning I haven't fed any HC for a couple hours at least and I have two rising numbers since the last time I gave any. Good luck!!
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Hey, guys!! Rosanna, you and Nala are doing great and are in good hands!! You're feeding the right food in nice small amounts. It may wear off, so unfortunately, you may want to monitor for another hour or two. Looks like Nala is on the fast lane down the dosing ladder!!

Patti and Skybar, are either of you around for a bit... just got back from the little brother's wedding, so I'm nodding off a little, but can stay up for a bit if needed!
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

HC wet is Fancy Feast Grilled Chicken and Beef Feast in Gravy
I decided to give her just 1/2 tsp so hopefully her numbers don't shoot up too fast (I'm thinking in advance that I'll be at work in the morning for a long shift and I don't have anyone available to do testing).

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57
+4.9 Gave a 1/2 tsp of HC wet
+5 59

I will test again in 30 mins.

Rosanna
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I'll be up for a few more hours. i am in AZ and stay up very late so I can check in and will recieve any replies to this condo. I can help keep the kitty out of danger anyway.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I'm still up. Champ is giving me ANOTHER long night so I have a little while to go before I feel comfortable going to bed.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

sounds good, Skybar!!

Rosana, you may want to check in before shooting tomorrow morning. Just looked at Nala's spreadsheet, and WOW! Something just started clicking!! Usually we don't do back to back dose decreases... in many cases back to back low numbers can be the result of the shed needing to drain a bit. But given Nala's prior numbers, her lack of bounce is somewhat surprising, and if you're going to be out tomorrow, I know you won't want to be worrying about low numbers. Others will likely be available to chime in tomorrow morning before you shoot if you need any feedback.

The big thing is, Nala has proved her point tonight, so I wouldn't worry too terribly much about over carbing her... get her numbers up into a safe range so you can get some rest. You can add a drop or two of karo to the food if you need to.

It's been a crazy month, and especially week for us, so I've been lucky to just get a condo posted. Consider this my official welcome to Lantus Land!! :mrgreen: :mrgreen:
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

(I'm thinking in advance that I'll be at work in the morning for a long shift and I don't have anyone available to do testing).
Click to expand...
Based on these numbers, I think you need to be very careful with her AM shot if you are not there to test her. Again, I am no expert on FD but if I were unable to test my kitty with these low numbers, I might skip the AM shot altogether and risk her going high rather than risk her having a full blown hypo while no one is there to assist her. She won't die from going hyper but she could from going too low. Again, I am no expert on FD and i am sure others have more knowledge and experience but hypos can kill. Also, i am not trying to scare you but I am trying to be very practical and cautious. If you can not be there to test her after giving insulin then I say hold off on the insulin with low numbers like these. Also, there is very little data in the AM cycle so all we can do is look at the latest lows.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Thank so much Skybar and Patty & Champ! I feel so much better not knowing I'm not alone in this. I'm trying to stay strong and not freak out since I know Nala needs me. In fact, she's just snoozing away in my lap right now while I'm trying to get a few winks of sleep before I have to test again. I had considered it, but I absolutely cannot call in any absence in the morning or else I would.

I'm in CA so it's not terribly late for me at this time, but thank you again for staying up to help me.

@ Christie & Willie: Yes, looking through Nala's SS, something started clicking right about the 4th of July. I think the main thing is that I transitioned Nala to almost a full wet diet at this time. I also bought an automatic timer to go off +4.5 after her shot that has 1/8 cup Wellness Core dry. Since my days are so long, I'm more comfortable knowing that she has a minor snack in the middle of her cycle in case I'm running late home.

I'm also concerned about what to do in the AM when I have to give her another shot. She is due to have a shot at 6:50AM PST and I'm really worried since I won't be able to check her until maybe close to 4-5PM. :(

Thank you all again! I will do Nala's +5.5 in a few minutes.

Rosanna
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I agree with Rosalie... skipping is definitely an option to consider, and might be a wise one. Would allow you some breathing room and would allow Nala's shed to drain a bit, which I think she needs at this point. That assumes that she isn't prone to ketones.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I just took a good look at Nala's SS. I know Sienne has already told you that you should get more spot checks in, especially at +2. I would also try to get them at a variety of times...one night get a +3, +6, and +9, on other nights get some +3, +4, +5, +7, and +8 (doesn't have to be all in the same night). Right now, you really have no idea where Nala's nadir is because you've only checked a +6. Champ has never been a +6 cat and he tends to change his nadir around from week to week. Knowing when Nala nadirs, or around about the time she nadirs, will be helpful in a situation like tonight because you'll know when her numbers should be starting to inch upward and, therefore, you'll be able to know when her numbers should naturally start to rise and you don't need to give HC anymore. If she usually nadirs at +7, you probably wouldn't feed a +6 of 60 because she would start to rise naturally and wouldn't need it.

Also, and I know Sienne mentioned this too, make sure you don't change her dose based on her preshot numbers. She has to earn her reductions by going lower than 50. Make sure you read the protocol often so you get very familiar with all the little nuances in there. Increasing the dose has very specific rules too so if you see a number in the 400's, don't increase the dose.

You may see a bounce tomorrow because of these low numbers. If so, just hold the dose (unless she earned a reduction) and wait for the bounce to clear which can take up to 72 hours.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Before skipping the shot in the morning, check Nala's BG a half-hour before her shot time and post that number (as +11.5) in your subject line (make sure you start a new condo for tomorrow, but link this thread to it so people can see what happened tonight). A lot of east coasters will be up and about at that time of the day since they're three hours before us. In the subject line, put "SHOULD I SHOOT?" and make sure you check the "?" icon so it gets noticed. I think you already know that Nala earned a reduction to 0.5u tonight so if you give a shot, that's her new dose. You might be instructed to just give a BCS shot (big chicken sh!t shot), or reduced dose.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57
+4.9 Gave a 1/2 tsp of HC wet
+5 59
+5.5 66

Will check again at +6

So much information to try to absorb before her AMPS. I haven't checked for ketones before. I cannot remember if her vet mentioned she had any ketones when she was first Dx. I'm looking at Nala's blood lab results - I don't see anything marked as "ketones." I'm assuming that is something checked through a urine test.

Rosanna
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Just be sure to mention the fact that you won't be able to test her or check on her for close to 10 hours or so. That is almost a full cycle.

I haven't checked for ketones before. I cannot remember if her vet mentioned she had any ketones when she was first Dx. I'm looking at Nala's blood lab results - I don't see anything marked as "ketones." I'm assuming that is something checked through a urine test.
Click to expand...

You can and probably need to purchase some keto stix. You can buy keto and glucose combos. diastix makes them as do other companies and they are not terribly expensive. go to a pharmacy and pick some up. You dip them in fresh urine and they will change color if the urine contains any ketones or glucose. Any diabetic or diabetic cat owner should keep these handy.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

Thank you again for all the responses!

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57
+4.9 Gave a 1/2 tsp of HC wet
+5 59
+5.5 66
+6 72

Will check again at +6.5

I think I will do a +11.50 check and then post it on the boards to see if I should give a reduced shot or skip the shot considering I will not be able to check Nala for another 11 hours.

I will go to the pharmacy tomorrow to pick up some keto sticks. Does it need fresh urine? Do I just put it in the litter where she peed at before she covers?

Rosanna

Rosanna
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I will go to the pharmacy tomorrow to pick up some keto sticks. Does it need fresh urine? Do I just put it in the litter where she peed at before she covers?
Click to expand...
I use the combo sticks so I can also check for glucose in the urine. There are several ways to get the urine sample so I would ask others what they do. I use Feline Pine and a sifting box so I clean the bottom box where the sifted used litter normally goes and I wait for Morgaine to pee. I then have fresh urine in the bottom box after it goes through the pellets. I just dip the stick in that. Others have other clever ways to get a sample. If possible, you can stick the dipstick in her stream as she urinates. Many cats won't allow that.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I think the main thing is that I transitioned Nala to almost a full wet diet at this time.
Click to expand...

When morgaine was first diagnosed she was eating Hill's R/D wet and dry food for weight loss. as soon as I switched her to all wet FF, she went into remission for almost a year. changing to wet food can really make all the difference. Keep this in mind as you look at these lower numbers. It is very important to be aware of the possibility that Nala may actually just need a wet, low carb diet as things progress or just a little insulin for a while.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57
+4.9 Gave a 1/2 tsp of HC wet
+5 59
+5.5 66
+6 72
+6.5 78

I will test again at +7.0
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

I think Nala is now in a safe place. I will check back before i go to bed and see if things remain calm. Good luck with the AM cycle and hopefully you can get some sleep.
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57
+4.9 Gave a 1/2 tsp of HC wet
+5 59
+5.5 66
+6 72
+6.5 78
+7 79

I'm debating if I should check one more time at +7.5 or sleep for a bit and wake up for the +8.0 ?
I'm fairly sure Nala is OK now, but maybe for my own peace of mind I would like one more check.

Thank you again for all the support! It's been a tough night especially when I have no support physically in my household. I feel that I can do this with all of your advice and well-wishes.

Rosanna
 
Re: Help pls - hypo? 07/09 Nala PMPS 125, +2 68, +3 50, +4

PMPS was 125, gave 0.75u
+2 68
+3 50
+4 43 Gave one teaspoon of HC wet
+4.33 (20 mins after 1 tsp HC wet) 59
+4.5 Nala ate her regular scheduled meal of 1/8 cup Wellness Core dry from automatic feeder (67 cal)
+4.67 57
+4.9 Gave a 1/2 tsp of HC wet
+5 59
+5.5 66
+6 72
+6.5 78
+7 79
+7.5 91

I believe Nala is fine now! Thank you all for the help and staying up with me! :-D

I need to get some sleep before waking up in less than 4 hours to check Nala's +11.50. I hope the next cycle will not be so eventful.

Good night!

Rosanna
 
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