About 10 days since diagnosis. Looking for guidance interpreting the BG numbers and dosing. Here's the link to my previous thread on the Main Forum. bouncing-need-advice-interpreting-bg-numbers.286494
This is perfect. We will continue the thread over here now. I left several more replies to your thread over on the feline health forum so you can check those, but now I will reply over here.
I also had some additional posts over there… possible trace ketones (may not be accurate though). Liberty acting very hungry now, and he hasn’t eaten since +4. So far only about 50 calories, not enough! Didn’t want to feed past +6 as suggested. Guessing he’ll eat a good dinner. Gotta get those calories in him.
What do you suggest? Not feeding past +6 or feeding to get calories throughout the day? He doesn’t seem to like bigger meals- he is a grazer. But I do worry about the calories- he’s just not getting enough right now.
Did you try the magic chicken dust? A pure bite chicken treat crumbled on top? Have you ever tried sprinkling a little bit of Forti Flora on top to get him started?
Well he needs to eat. We can’t have him losing any more weight. I would say that we may have to sacrifice the better BG for him and let him eat when he will eat. If it’s low carb he can even graze through the early portion of the cycle. Normally, I would want his meals and overall calories divided up into smaller meals given at meal time and every hour or two hours. But he’s a special case. Just don’t forget to withhold food for two hours prior to the pre-shot BG test— for his safety— so that the preshot number is not food influenced.
He eats, but just small frequent amounts. I feel like I withheld food from him today trying to just feed early in the cycle. His numbers came down, but he was wandering around looking for food.
Okay. So let him eat. It’s low carb wet food so just let him eat. How do you handle it with your other cats?
Right! Before his diagnosis he (and the other kitties) got fed twice a day with maybe a midday snack if we were home. Since he’s been diagnosed he’s gone to wanting smaller meals. I’ll try to find a happy balance!
I’m actually transitioning them (slowly) to an all to a wet diet. Twice a day, sometimes midday snack. Sadly, before Liberty’s diagnosis he was on Rx urinary dry food (I often discussed it with the vet, but as expected they said he “had”to be on it. Now I know better.). So he’s been on a high carb dry food for years.☹️
And with his +10 level 125, I have a feeling his PMPS number might be below 200 and that would be a NS.
Okay so coming up soon! Then he can eat. I’m concerned about his lack of appetite. You had bloodwork done recently? At diagnosis? Did you get a copy? You say he had a good appetite before diagnosis and starting insulin?
His recent labs are recorded on lab tab on spreadsheet. His appetite had been off for a while. That’s why we took him in early for his annual exam. After his high BG level and fructosamine test I switched to the low carb wet food.
Okay 211. So no worries. Gradually you will learn to shoot lower preshot numbers. You have options depending upon the number and other factors (stalling, reduced one-time dose, etc.)
Right. I can see that. I’m going to give him more food over the next few hours just to get some calories in him.
Okay. Thank you. I will look there. And yes, you are doing everything right! Maybe he’s just not liking the new low carb food?
He seems to like it, he's just not eating much of it. I’ll work with him. Maybe he is constipated and not feeling great with that. I can’t be sure that the poop in the litter box earlier was his. He just seems “off” again.
Yes. I was only suggesting a starting point. No offense. I can see how dedicated you are to testing him. You’re like me a testaholic. I’m so impressed with how you have, in such a short time, gotten up to speed on everything and have really taken the bull by the horns.
Oh goodness, no offense whatsoever! I am so grateful for your help in this journey! I feel so much more confident with your guidance! I can’t tell you how much more calm I feel knowing you are there! I should have added a smiley face about testing through the night, lol! I reread that “I’ll test through the night” and I think it came across as snippy… absolutely not! Again, I value your advice so much!
No offense taken! But wow, it looks like he has had a big bounce and you will be able to get some rest tonight. Let’s hope it won’t last long.
I just can't figure out what is going on. Struggling a bit. Liberty had been constipated, really seemed "off". I've been trying to get him to consume enough calories, so finding the right times to feed him and not affect numbers has been challenging for me. Finally got a nice big poop yesterday (never so happy about poop before!), and he really perked up after that. But his BG numbers kept going down throughout the day, and with a 104 PMPS, I did not give PM shot. I was discouraged because I feel like we are just bouncing all over with having to skip shots. Gave a snack at 10:30 pm (+2.5), got a 174 BG.He woke me early this morning seeming very hungry. Checked BG and got 471. (he was absolutely frantic to get his freeze dried treat). I think I'm in information overload trying to think through everything. I considered feeding him since it was still about 2 hr before normal shot time. But I thought that would really send his BG up, so I didn't feed him. Feeling discouraged because I can't seem to get a handle on this, and I feel like I'm not making the right choices ,and consequently his numbers are all over the place.
Hey, stop beating yourself up about this! You are a wonderful caregiver to Liberty. A lot of people could not be bothered to do all that you do for your cat! It’s all new. And a lot of cats can be wonky at first. Let me look at his spreadsheet now and comment in a minute. Fantastic news on the eating this morning (and the pooping too )
Look at that much improved cycle yesterday! That’s great! He only was diagnosed on February 2 and you are already getting some good blue numbers. I would have been so happy to get numbers like that so soon in our diabetic journey! Last night, I would have tried a token dose of .25 to keep Liberty from going too high and perhaps mitigate the bounce. You could already tell at +2.5 that he was on his way up. We don’t have quite enough data yet for me to recommend a .5 token dose. Maybe later. Also it would depend upon your ability to monitor the cycle periodically last night. The bounce that we see this morning was probably inevitable though due to those beautiful blues yesterday. Hold on, keep doing what you are doing and focus on making sure he keeps eating and pooping too! He is going to be so much happier and healthier when we get a better handle on his diabetes. One of my favorite things about helping people on this forum is hearing people tell me how much better their cats are acting, eating, etc. It’s going to happen for Liberty too!
Would the token dose of .25 have been given at +2.5 when his numbers were rising? Not at PMPS of 104 because at that point I wouldn't know if his numbers were going to continue to drop, right? And yes, in the first cycle yesterday I got excited by those blues!
If you shot a token dose at +2.5 that would really mess up your schedule for the next day. No, I meant to give the token dose at regular shot time. I would not have expected his numbers to continue to drop that late in the cycle, but if in doubt, stall without feeding and test again in 30 minutes to make sure he’s either stable or rising before deciding.
Now, will that higher carb food (I gave a big Tbsp, not tsp-too much?) cause a spike and then a drop? Is it best to keep testing through the night after a drop like that? I know it wasn’t super low, but it seemed to be heading downward.
Usually when you see it going up your in the clear. I would test at +5 to be safe and if it has gone up again you can relax and get some sleep.. if you look at my chart I just did that and now I can relax and go to bed. I did feed him one last meal to get thru the night.
I gave him to 2 tsp of low carb Fancy Feast Chicken Classic. He's on his way up so no need for Medium carbs anymore.
Gosh, Julie. I wish you had posted earlier about Liberty’s numbers so I could have been there with you. I’m sorry. I was over with Shawn trying to stay awake and watch Sir Maximus. (I only slept 3 hours the previous night.) It looks like Liberty really needed to be tested right at +2 (I always recommend a snack at +2 regardless of numbers.) Not every cat onsets at the same time. Some cats don’t onset until +2, but some get to work more quickly. That half hour can make a difference. You did a good job of monitoring, and he ended up having a nice cycle. I’m glad you waited and did not stop testing until you were sure that he didn’t drop back down (+7) even if you may have had to set an alarm to wake up and test. Whenever you are using carbs to steer their numbers, they can drop back down as the carbs wear off. Just in case you don’t know this — seems like a good time to mention it — whenever you have to use high carb food or karo to raise BG, you need to keep testing for a full two hours after any HC was given. This is for safety- making sure kitty does not drop back down. Liberty had a pretty nice cycle though; well done. I’m encouraged by his numbers. He’s earned another reduction down to .5 units. Congratulations!
Thanks Suzanne! It took me a minute to process what was starting to happen last night. I also wasn’t sure how to reach out to get help. (I’m always worried about bothering people). I could see you were helping with Sir Maximus, and there were similarities, so I tried to follow along and adapt it to what was going on with Liberty. It’s amazing how the brain goes kinda fuzzy in the middle of the night. I need to get going with Liberty’s morning, and then reread your reply, and process it all. I’ll keep you posted. Thanks!
I’ve wondered about the accuracy of the smaller doses I’m giving. I’m just eyeballing it (full unit syringes- half unit ones arrive today), and I’m thinking my 0.75 might actually be between 0.75 and 1.0. Hard to tell. But I think 0.5 will be easier to see (such a small dose!).
In your case, I would like to have seen how Liberty did without the MC. (Which Fancy Feast gravy lovers is 14 percent, by the way?) Since Liberty’s rate of drop was not too steep, I would like to see in a similar situation how he would do with using only higher end LC food (something in the 8-10 percent range.) Many times cats will surf in the desirable green numbers with just LC but sometimes you need to use a few more carbs while still sticking with LC. Obviously sometimes we need to use more, but when you are testing you can easily find out if they are surfing or dropping because you are going to want to test again 20-30 minutes after you give the food if you have concerns, right? I hope this is making sense. In fact, (and I feel like I am pointing a fire hose at you right now with too much information— sorry) with Liberty’s numbers yesterday trending downward from a brief bounce that had started the previous evening, it probably would have been a good idea to feed a few more carbs at the PMPS meal (still LC but not necessarily the lowest LC.). This is just another strategy that you can try.
You’re right that eyeballing it is tricky and he may be getting slightly different doses each day. I am so happy that the new syringes will arrive today!
That’s enough “Monday Morning Quarterbacking” for now! But let me know if you have comments or questions
I was incorrect on the food. I used FF Grilled (in gravy) Salmon Feast which, on my food list, is actually 12%
Question about reductions... I noticed the phrase "earned a reduction" is used. Is it a good thing? I think I was looking at it as a setback...
That’s okay. Still medium carb but on the lower end - probably that’s why he didn’t go up a lot - but that’s good in this case. Some of the gravy lovers go as high as 20 percent (useful at times to have around and sometimes you just need a little of the gravy from it because most of the carbs are in the gravy.
I also try to keep the phosphorus in his food below 300 because of Liberty's Hx of urinary obstruction. So many pieces of the puzzle!
We consider reductions to be a good thing. It hopefully means that progress is being made and less insulin is required. So that’s why you will see a lot of people saying congratulations on the reduction. Now we know that not all reductions will hold, but we try to keep it positive, I guess.
Oh boy do I appreciate this! I try to keep my cats’ food as low in phosphorus as possible because it’s easier on their kidneys. It’s so hard finding food. If I had a dollar for every hour I have spent researching cat food….. So you may need to prioritize his phosphorus over other things, just like we talked about prioritizing him eating enough calories to gain weigh over the timing of meals (except the two hour window before AMPS and PMPS tests.)
Yes, me too! So trying to look ahead and think this through (with my very tired brain). I went ahead with his AM shot (lowered dose) with AMPS at 182. He’s been in blue all day (so far). Eaten snacks after each check. Wondering if I should hold off food now until after his PMPS to see what it does? Also thinking ahead of options if he is below 200 at PMPS. I know the protocol options (NS, stall without feeding and recheck, or token dose), but wondering what will be best in this situation. Just trying to prepare so I don’t have a last minute dilemma.
Have you had luck finding low phosphorus/low carb foods? The low carb FF pates I’m using are still higher than I would like. (no idea what I did there with those multiple responses!?!)
Since I skipped tonight, do I need to test anymore before tomorrow’s AMPS? I honestly am so tired. The thought of a night of sleep sounds glorious.
It should be okay. What about snagging a “before bed test” and giving a snack? Hopefully we can all sleep tonight!
Yeah he didn't eat as much for dinner as I anticipated. I'll do the test and snack, and call it a night! Hope you get some sleep, too. Thanks, as always!
