Help with stabilising blood sugars - frequent hypos and hyperglycaemia
- Thread starter IduraH
- Start date
Suzanne & Darcy
Very Active Member
Well, we all learn from our mistakes. Even I was looking over her spreadsheet last night and getting impatient and thinking…. Well maybe we need to move back up to .75 …. but I knew it was too soon and we needed to hold on and wait longer at .5 and let her clear the bounce.
IduraH
Member
Now she's going to have another bounce and start feeling awful and nauseous again
She's so insulin sensitive, do you know if there's any needles with that's more precise than the one with half units?
Suzanne & Darcy
Very Active Member
Hopefully you got her up to stay? The BG dropping back down after some carbs does happen a lot as the carbs wear off. That’s why we have the hypo management strategy to test every 20-30 minutes until the BG begins to rise on its own and then you can extend the time between tests. Also there’s the “don’t stop testing for two hours after high carb food is given” rule because in some cases (depending upon where you are in the cycle) the BG can drop again. In Tiger’s case, I am sure that this low BG episode (and depending on how steep the drop was) has set off another frustrating bounce.
IduraH
Member
Suzanne & Darcy
Very Active Member
Ar
I know. we were both writing about the bounce at the same time.it's at 9 now. I'm bracing myself for the bounce
IduraH
Member
@Suzanne & Darcy , though frustrating, a part of me is also glad this happened whilst I'm home and now I have objective evidence to say to the vet that 0.75 is definitely too high for her and is not an anomalous event. It's happened consistently now for at least 3-4 times.
Suzanne & Darcy
Very Active Member
Now, about the syringes, you can use U-100 syringes in conjunction with the conversion chart if you want to make smaller dose changes. It’s a little easier to draw the doses.
http://www.felinediabetes.com/insulin-conversions.htm
http://www.felinediabetes.com/insulin-conversions.htm
Suzanne & Darcy
Very Active Member
I agree. Surely the vet will understand that. And what if it happened when you were not at home (or no sitter?)
Suzanne & Darcy
Very Active Member
How many carbs are in the Lick E Lix? Those seem very popular with cats, but I don’t know if they are low, medium or high carb.
Suzanne & Darcy
Very Active Member
At least for now she’s surfing in green numbers. It looks so good on her spreadsheet. It’s another chance for her body to adjust to normal numbers.
I wonder if the RVC vets will suggest switching her to another insulin- one of the depot insulins like Lantus (glargine?)
I wonder if the RVC vets will suggest switching her to another insulin- one of the depot insulins like Lantus (glargine?)
IduraH
Member
Ooh re Lickalix, I read it on the UK thread that it's good for a hypo box as it's a high carb treat: https://www.felinediabetes.com/FDMB...ther-need-to-know-stuff.137376/?_params=Array
Ooh, thank you for the U-100 syringes conversion options, I actually bought some when I thought we were going to be on Lantus. So I've put her on 0.6 units now (1.5 units on u-100 syringes); also, even though she is bouncing, she is not unrecordably high. woot woot.
Ooh, thank you for the U-100 syringes conversion options, I actually bought some when I thought we were going to be on Lantus. So I've put her on 0.6 units now (1.5 units on u-100 syringes); also, even though she is bouncing, she is not unrecordably high. woot woot.
Red & Rover (GA)
Very Active Member
When/if you switch to U100 syringes, put the U40 syringes far away ... in another room ... in another house. Yes, we have had people use the wrong syringe.
U100 syringe caps are usually orange. U40s are usually red.
Suzanne & Darcy
Very Active Member
Hi Idura. I am thinking about you and Tiger. Is all well? How is the .6 dose going? Can you update her spreadsheet so I can see? I worry if I can’t see.
IduraH
Member
Hi Suzanne, thank you for the reminder, I've updated it now. She's doing okay, it was quite high overnight, but the cat sitter was the one who gave her the PM insulin shot (so it could have been a ?fur shot) as I was on call and only back at 11.30pm. But she has better numbers today.
ooh, also, I got a litter robot as I was unable to keep up with how much she's peeing every day. It's looking she pees between 8-11 days everyday
But she hasn't lost anymore weight though in the last two weeks, which I'm relieved by (as she lost 1 kg/16% of her body weight in a month) and it seems to plateau now. She does need to lose weight (she's 5kg), but I was worried at the rate of it all.
Suzanne & Darcy
Very Active Member
She did have better nadirs today. Last night I suppose could have still been part of the bounce or maybe a fur shot. How is she taking to the litter robot? I hope she likes it.
Suzanne & Darcy
Very Active Member
And you are right about not wanting her to lose the weight too quickly! I totally agree.
IduraH
Member
She does. I was worried she wouldn't take to it, but she was so eager to try it that she used it while I was still setting it up. Her episodes of incontinence (which used to happen only on my bed) have also gone down now. Tiger is quite a clean cat, and I think she was probably quite distressed at how bad I was at catching up with cleaning her litter box—so we're both happier now with the litter robot around.
We have a two hour journey to the RVC hospital next Thursday, I've booked a cab as I can't drive, I'm quite worried about her having an accident on the way there and back because of how long it all is. I've bought some incontinence pads to use in her carrier, but do let me know if you have any other tips and tricks.
Suzanne & Darcy
Very Active Member
Oh that is a long trip. That can be stressful. I had to make a two hour trip with my cat, Ginger, this week. Of course we have a playpen set up in the car where she has room for a litter box and bed. I usually do put “puppy pads” in my cat’s carriers though — when they are just going to the regular vet 30 minutes away.
IduraH
Member
Hi @Suzanne & Darcy
Tiger's graph is doing something weird today (link here), she's also a bit more off her food today and has been peeing a lot more than usual. It appears she's used the litter robot 10 times today, and it's only 9pm.
Her ketones were 0.8, and alpha trak is 24.9 at 8.30pm today.
She's drinking and eating (even though less), and is still playing with her toys. I am a bit worried.
Tiger's graph is doing something weird today (link here), she's also a bit more off her food today
and has been peeing a lot more than usual. It appears she's used the litter robot 10 times today, and it's only 9pm. Her ketones were 0.8, and alpha trak is 24.9 at 8.30pm today.
She's drinking and eating (even though less), and is still playing with her toys. I am a bit worried.
Suzanne & Darcy
Very Active Member
Can that be right? That crazy up, plateau, and down pattern? Have you ever seen this pattern before? How old is the Libre? Have you gotten any manual readings from an ear prick today?
Suzanne & Darcy
Very Active Member
Sorry. I see you did check with the AT. I was thinking of any other readings.
IduraH
Member
I haven't done any other reading today. But she had this same pattern the night before when I thought it was a ?fur shot, but not to this extent. I'm more concern about her being slightly off her food, but tbf, she is eating the kibble more.
Suzanne & Darcy
Very Active Member
It is natural for her to drink a lot and pee a lot when she’s in these high numbers. I really hope the RVC vets will recommend Lantus for her and write you an Rx. I think we could smooth out the cycles a bit at least, because of the depot — but she may continue to be bouncy but hopefully not with such high bounces.
I don’t like the ketones being a little higher than normal. But she’s not over 1 so I feel good about that. She probably just feels really bad in these high numbers (nauseated?). Has she vomited? The fluids are good for her and I think as long as she keeps eating periodically that’s a sign.
I don’t like the ketones being a little higher than normal. But she’s not over 1 so I feel good about that. She probably just feels really bad in these high numbers (nauseated?). Has she vomited? The fluids are good for her and I think as long as she keeps eating periodically that’s a sign.
Suzanne & Darcy
Very Active Member
Sometimes when they are in a bounce the numbers will bobble around a bit. I think she is due to break this bounce either tonight or tomorrow morning.
IduraH
Member
oooh, do you think this bounce is caused by the hypo a few days ago, or because she got in the blues yesterday?
Suzanne & Darcy
Very Active Member
Ketones can also fluctuate. So if you test again in a couple of hours they will probably be different.
Suzanne & Darcy
Very Active Member
Bouncing from the blues. When you saw the blues, that meant she had broken the bounce from the greens before. And then she started another bounce. She seems to bounce for around 4-ish cycles depending on how you count it (from the cycle when she starts to rise after low numbers or the next full cycle.)
Suzanne & Darcy
Very Active Member
And I wish she weren’t eating kibble because it’s got no moisture— but as you say she is drinking— and the most important thing is that she does eat — so if she doesn’t want the wet food it’s important that she takes in nutrients.
Suzanne & Darcy
Very Active Member
Keep me posted if you can because now I’m going to worry about Tiger, too. But I do think she’s about due to come down from these high numbers.
IduraH
Member
Will do, I'll test her with the alpha trak before bed.
She also bled quite excessively when I used the alpha trak earlier, I'm probably just catastrophising, but she had mildly deranged liver function (ALP) on her last blood test, and this sudden excessive bleeding is really worrying me. The cat sitter will be with her tomorrow till Wednesday though, and I'm off Thursday and friday, so at least she won't be alone for much at all this week. I really hope she gets better soon because I'm running out of annual leave
Diane Tyler's Mom GA
Very Active Member
Suzanne & Darcy
Very Active Member
Maybe you nicked the marginal ear vein instead of just going to the outside of it?
IduraH
Member
She's been a bit more bleedy today on both ears, tried the other ear too, usually I have to milk it but it's enough for two ketone check and also one BM check, and some was dripping onto the floor. All very odd - but maybe her ears have just learned to bleed by itself? (I heard that happen sometimes)
Also, her current BM 4 hours post insulin is 20.2 on alpha trak and 24 on freestyle. Ketones are now 0.7 (down from 0.8) - looking at her food plate, it looks like she's had a bit more of the wet food too (she had a few spoonful with her insulin, but now it looks like she's had another 30-40% of it)
I need to remember on Thursday to ask the RVC vet for some oral antiemetics if they have any.
I'm off to bed now, but thank you for your help today!
Suzanne & Darcy
Very Active Member
I’m going with the Alpha Trak 20.2! I’m happy she ate more.
Suzanne & Darcy
Very Active Member
And it is possible that she has developed the capillary bed more with the ear pricking.
Suzanne & Darcy
Very Active Member
How is Tiger this morning?
IduraH
Member
Her numbers are better today! She was even in the blue for about an hour or so today.
Still not eating as much and looking a bit nauseous (gulping sounds, licking lips more than usual), but she only went to the toilet 6 times so far today - she used it 9 times already around this time yesterday.
Suzanne & Darcy
Very Active Member
I knew she was due to break the bounce, but I just hate that she is already in another one! Such a brief time in the lower numbers.
IduraH
Member
ooh, do you think she's bouncing again?
How can I stop this, it seems to be an endless cycle of getting to better values and then her numbers going up again. I'm really hoping she's not in another bounce...
Suzanne & Darcy
Very Active Member
Well if she goes high and stays high for about 4 cycles or so where she doesn’t come down much (she can bobble around a little bit, but by and large she will stay high) it’s her bounce. Sometimes cats will start to clear bounces faster and that’s a good sign too.
I’m so sorry for everything that is happening now. I feel your anxiety and almost despair. I can relate.
I’m so sorry for everything that is happening now. I feel your anxiety and almost despair. I can relate.
IduraH
Member
Hi @Suzanne & Darcy , I think tiger is having a DKA
she vomited twice, she's off her food, and she's peed so much her whole litter box turned to clay in one day.
Her ketones are 1
she vomited twice, she's off her food, and she's peed so much her whole litter box turned to clay in one day.
Her ketones are 1
Suzanne & Darcy
Very Active Member
OH my. I would take her to the vet for evaluation. I'm so sorry. I hope that it is NOT a DKA. I pray not.
IduraH
Member
I just came back from the vet; they think she has DKA, and they're admitting her for IV fluids and a few other tests. I'll update you when the vet calls me tomorrow for further updates.
Suzanne & Darcy
Very Active Member
And I assume they will check for and correct her electrolyte imbalances? I'm so upset this is happening to Tiger. And you, Idura, I'm sending you lots of hugs. This has been so stressful on you and now it's worse. I'm so sorry. Wasn't she supposed to go to the RVC tomorrow (Wednesday?) No wait... it was Thursday, right? She may still be in hospital.
https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11372&meta=Generic&id=5709925
IduraH
Member
It'll be okay, hopefully once we get through this bump she'll get better. They're doing a blood test, an ultrasound for ?pancreatitis, and also testing her urine. Her appointment is on Thursday but the vet said we can make sure she gets there even if she's still admitted, it might mean I pick her up, take her there, and then if she needs further admission, she's just transferred there altogether.
This vet looks quite knowledgable. The last time she was admitted at a different practice there was no repeat blood test etc so I feel quite reassured with this vet.
Suzanne & Darcy
Very Active Member
Oh good. I’m relieved to hear that this vet is competent to check/treat DKA.