Jenny 10/13 need help please!

JennyAnyDots said:
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Starting Jenny's new thread. Just gave her .75 on a 185 PMPS+1 reading. Will check her again in a couple hours. Thanks!
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Thanks for linking the previous thread!

I didn’t think that .75 would be enough since the PZ would not onset for a couple of hours (giving her time to climb even more) but I am glad you shot something because it helped keep her from climbing as high as she would have with a skipped shot. I know it’s nerve wracking when you are first shooting lower numbers than what you are used to seeing. But each time you can use the data gathered to help you with the next time— and you would know to give her a larger dose next time you have a similar situation.

How did you make up for the late shot last night? Did you shoot later this morning?

Good luck with the curve today. She’s making progress 🙂
 
I shot at the same time this morning, no change since the shot last night was only 1 hour late, and half dose. I hope that was ok. The curve today is interesting....very quickly went down from amps 379 to 175 to just now 66 at +4. I made sure she ate a bit afterwards, though she's not much of an afternoon eater. I'm going to test at 2, in about 50 minutes, instead of waiting until +6. I have sweet treats on hand if needed. She is active when awake, sleeping on her cat tree, mad when getting tested, pretty normal for a sunny afternoon. I'm keeping an eye on her.

Should I be doing something else?
 
JennyAnyDots said:
also, this means a decrease tonight, right? From 1.5 to 1.25?
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Yes. I would test her right now although it’s already been almost 50 minutes if I would do a 30 minute test normally if this happens again just to make sure I will test again in 30 minutes after giving a teaspoon or so of food she doesn’t have to eat a lot just a little.
 
Did she have a snack of a teaspoon or a tablespoon of wet food at least at +2 and +4 that would be important to know
 
Little snack at +2 after testing but not much. At +4 (1PM) after testing low she had about 1/4 can of FF pate. Tested again half hour later, +4.5 (1:30pm) down to 62. more treats, testing again in a minute. She has no bad symptoms.
 
I would not expect her to have any symptoms at 62 — not even on the Aloha Trak, because it’s not super low. However, if she is below 68 on the AT, you really want to stay on top of the BG by testing every 20-30 minutes until she’s above 68.
 
Then when she gets to 68 or above you still want to keep testing— although you can start to lengthen the time between tests — like from 20 to 30 minutes and then if she’s going up you can test again in an hour. Some of this is also dependent upon where you are in the cycle. If it’s earlier then you really must be vigilant.

Also, a drop below 68 on your pet meter would mean that you should give HC wet food (like Fancy Feast Gravy Lovers) and test in 20 minutes.
 
I strongly encourage you to give HC food and possibly a drop of karo syrup or honey mixed with FF Gravy Lovers of similar HC wet food until she’s above 68. And you must test frequently. You should not wait an hour.
 
Thanks Suzanne. At +5hr15min (after more high carb treats) she tested 68, and so we're giving it 45 minutes (3pm, or +6) to do the next test. I did give her some syrup, she didn't want it but I gave her a few fingers full into her mouth. So she's on the up. Hopefully at 3 she'll be in the 70's.
 
JennyAnyDots said:
after more high carb treats) s
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Dry HC food or treats take longer to raise BG. You want to use wet food that’s HC to raise BG quickly when you’re managing numbers below 68 on your pet meter.

Dry also impacts the BG for a longer time sometimes and it can cause a little wonkiness in numbers. It is better to use wet.
 
you can just rub a little bit of syrup on the gums. Sorry for italics. Anyway, what I did (because it’s not easy to get the syrup on the gums with a finger) was to take a 3 cc syringe (an oral dosing syringe for giving liquids meds or water) and I would make a mix of about 50 percent water and 50 percent karo syrup (same could be done with honey) and I would inject a small amount toward the gums just inside the cheek pocket. This was far more efficient and less messy and much better than sticking my finger in Darcy’s mouth— even though he was a sweetheart. It was nicer for him too.
 
Thanks so much Suzanne. I have the syringe, so I'll do the watered down glucose next time if necessary. I tried the HC food but she wanted nothing to do with it. She has never liked gravies, though her siblings love it. So I resorted to her favorite ex-treats which she hasn't had in almost a month. About to do +8, I'm late because life got in the way and I had to take my great-nephew home.
 
JennyAnyDots said:
Thanks so much Suzanne. I have the syringe, so I'll do the watered down glucose next time if necessary. I tried the HC food but she wanted nothing to do with it. She has never liked gravies, though her siblings love it. So I resorted to her favorite ex-treats which she hasn't had in almost a month. About to do +8, I'm late because life got in the way and I had to take my great-nephew home.
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She is picky, isn’t she!
 
This morning Jenny's ketones were 1.1. A bit concerning but, like all of the testing, it's just a data point. I'll test it again this evening and hopefully it will be back down. All else is good, getting a few days of 1.25 under our belts.
 
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Ketones will fluctuate with the BG usually. I am sorry to see the greens having gone away and a little bit of an upward trend in ketones. I know you will keep an eye on them. Keep her well fed and well hydrated!
 
Ketones were down to .7 this morning. Her BG cycles seem a bit smoother; we haven't had spikes either way in a couple days. I've probably jinxed myself :)
 
JennyAnyDots said:
Ketones were down to .7 this morning. Her BG cycles seem a bit smoother; we haven't had spikes either way in a couple days. I've probably jinxed myself :)
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I noticed the .7 ketones this morning. I am not concerned about a DKA with anything around 1 or under.

I also noticed that she hasn’t had a red preshot. That’s good. Her nadirs are too high though. I would let her settle in for a few more days with this dose, of course, although she was doing better overall on the 1.5 unit dose. She’s been on ProZinc for a month now — so I would consider moving to the Modified ProZinc Method where I could get her better regulated. It really would not be much of a change.
 
What I especially want to know is how is she feeling and behaving? Is she happy amd enjoying herself? 🙂 How is her drinking and litter box use? Does she have a good appetite? Does she play?
 
Yes to all of the above. She seems more engaged, plays, interacts, than just a few weeks ago. I'll read the modified method again; as I recall it's a matter of changing doses much more quickly in order to dial it in.

Tonight ketones at 1.2. Ugh. I gave her some tuna water to get some more liquids in, though I think she's drinking just fine, and ate heartily twice today. The only real change this week is I'm trying to get her food on the schedule suggested, which is no food between 3pm and 9pm. She used to eat around 5-6pm, now I feed her at 3 then hold until 9. She follows me around meowing for food all day long. Then when she finally gets some at 9 she's not eating as much. I'll check again in the morning but if they stay high I'll likely set up a vet visit to run blood tests. Does that sound right?
 
JennyAnyDots said:
Yes to all of the above. She seems more engaged, plays, interacts, than just a few weeks ago. I'll read the modified method again; as I recall it's a matter of changing doses much more quickly in order to dial it in.

Tonight ketones at 1.2. Ugh. I gave her some tuna water to get some more liquids in, though I think she's drinking just fine, and ate heartily twice today. The only real change this week is I'm trying to get her food on the schedule suggested, which is no food between 3pm and 9pm. She used to eat around 5-6pm, now I feed her at 3 then hold until 9. She follows me around meowing for food all day long. Then when she finally gets some at 9 she's not eating as much. I'll check again in the morning but if they stay high I'll likely set up a vet visit to run blood tests. Does that sound right?
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Well, if you test her ketones when she is at nadir, they should be lower.
 
This morning after her shot, when I petted her, I got a little hint of moisture and thought, darn, did I furshot? It would be the first time. I wrote possible fur shot in my notes. Then at nadir test, she had hardly moved from this morning, when she's been consistently mid100's. Now I'm sure I did. Can't believe it, when I'm trying to get so precise and testing, etc., that I do a bonehead thing like that. OK, nothing to do but wait for the next shot. She's eaten great today.
 
Her ketones at pmps was 1.5 which is concerning. I'll test again at pmps+3. I think I'll call the vet in the morning to get her in next week for blood tests again and urinalysis to rule that out.
 
She needs the increase back up to 1.5 units. I would advise increasing to 1.5 with this morning’s shot. That will help the ketones as well. Her numbers haven’t been as good on the 1.25 dose. She will go below 90, but honestly that’s what she needs to do. Her numbers have not been as good since the reduction to 1.25 (not even considering the fur shot, which I am not talking about) and her ketones are trending upward (even considering the daily fluctuations that are typical of ketones in general.)
 
Good morning Suzanne. I didn't look here before our morning routine, so didn't see your recommendation to increase. I already shot this morning at 1.25 so I'll start the 1.5 tonight. She is alert, eating, drinking, etc., so all is good. This morning BG 391 and Ketone back to 1.

And of course in the midst of this I've been called as a juror in federal court next Tuesday, reporting an hour away at 8am. I'll get my husband up to speed on everything this weekend. He's been the Assistant all this time, so should be easy enough.
 
@Suzanne & Darcy , when I move Jenny back to 1.5, what will be my marker that she is too low? Last time on 1.5 we moved down when she hit the 60's. Do I still use 90 as the movement, or we'll play it by ear?
 
JennyAnyDots said:
@Suzanne & Darcy , when I move Jenny back to 1.5, what will be my marker that she is too low? Last time on 1.5 we moved down when she hit the 60's. Do I still use 90 as the movement, or we'll play it by ear?
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You are still using the Alpha Trak meter, right? If so, then we would use 67 (anything below 68) as the reduction point. If you have any higher carb low carb food (anything around 7-9 percent carbs, it would be good to start out with those at breakfast time. Some cats do better with a few more carbs, especially early in the cycle. I would first just see how she does on the 1.5 dose. Those early snacks are important and she doesn’t always like to eat them. Another thing to try would be to give her half her normal breakfast and then give her the other half two hours later.
 
I am using the alphatrak. Bad news, at PMPS ketones were 2.2. I was so sure they were coming down. BG was 345. She ate over 2oz of pate with her shot of 1.5u.

Things only happen to my cats on weekends or holidays, or both as this week is. I may be wrong but I don't feel like we need emergency vet, and can wait until Tuesday if things get no worse.
 
Don't know which is the chicken or egg, but I highly suspect Jenny has a UTI. Ketones this morning back to 1.3. "Someone" peed right outside the litter box last night, and this morning already Jenny has been 3 times. Definite vet tomorrow.
 
Today's vet trip for Jenny's possible uti and high ketones was about as I expected. I called early today and they said to just bring her in, got there and they took her back for tests and told me they would call when they were finished and the vet wasn't available to talk so I gave all information and her spreadsheet to the receptionist. In about an hour they said she was ready to go home, they had taken urine for a urinalysis and a bladder sonogram. Bladder looked good mechanically. I asked if they took blood to check levels related to ketones or white blood count and they had not but said they could if I wanted. I said yes, please. Got there, they brought her out, and it was ok, bye! I said wait, I have questions...what about the ketones being so high all of a sudden? What about the 2.2 ketone? What tests were run? When will I know anything? Vet again not available so the tech came out. They said urine culture in 24-48 hours, bloodwork on Wednesday probably. Not worried about the ketones (!). I asked when should I worry then? 3.5 or so was the answer. Asked if there is anything I should be doing or watching for? Was told that my spreadsheet looked like she did good at 1.5u so probably just stay there. OK, she's been there for 3 days and all number are high, BG and ketones. They were not worried. At least the vet via the vet tech were not. So $500 later, I really hope she has a uti because that at least is something I can understand and treat. It's pretty discouraging dealing with the medical side of feline diabetes. The DID like my spreadsheet.
 
@Suzanne & Darcy I need help. I'm on jury duty all week so can only check in intermittently. My husband is doing Jenny's bg, ketones and dosing. This morning AMPS was 325 but ketones are back up to 2.3! I got the urinalysis back and it is all clear, no uti. Blood work has no concerns. I texted the vet during jury break and told her Jenny's ketones, and she told me to raise the prozink dose from 1.5 to 2.5! I'm not going to do that, especially with my husband doing the testing, which he was only able to do at amps today because he is not very experienced at it and said he kept messing up. So I'm off to jury duty at 6am tomorrow, won't get home til 7pm, and don't know what to do. I think stay at 1.5 another day or two because I know it's "safe". The vet is just not concerned about the ketones, which is something I'll battle later.

I've found a board certified internal veterinary internal medical specialist who specializes in cat with difficult diabetes. It's not much further than her vet. When I get this jury duty over I'm taking her there for a consult. But tonight I need some advice, please.
 
I would increase her dose also, but only by .25 units. He nadirs have mostly been in the yellow range which is too high.

Increasing by a whole unit at a time is too much.

Even with you not being able to test, a .25 increase is not going to put her in danger amd I would feel comfortable with that even if you are away at jury duty. It’s a shame you weren’t able to get out of it!
 
Remember that the higher ketones are probably only when she is in higher numbers and don’t reflect where she is in lower numbers. You should check when you can to make sure though. She isn’t lethargic or vomiting, is she? Do you think she’s eating a normal amount of food? If not, I would encourage you to feed more. Is your husband giving the planned snacks during the cycles?
 
Thank you Suzanne. I felt like I was getting this down pat, then it's like it all broke loose last week and this week, and now jury duty, so I'm just a mess of nerves trying to do the right thing. I just don't understand why a feline vet would tell me to go from 1.5 to 2.5, it really decreases any trust I have in their care. Also, no test for ketoacidosis, said they look fine. Really?

argh. So thankful for you and the information here. I'll go up to 1.75 tonight and test pmps+3 also.
 
I agree that it sometimes can be difficult to get vets to pay attention to your cat’s ketones. I had the same problem. When Darcy’s ketones were high, I would sometimes take him to the vet for a day of IV fluids. Darcy was prone to high ketones for a long time (much higher than Jenny’s). It wasn’t until we finally started giving enough insulin that they went down. Fortunately, he never had another DKA, even with super high ketones. That’s because an infection is what had pushed him into DKA (combined with being in higher BG.)
 
She is not lethargic at all, she's normal, alert, playful. She was eating fine, then today my husband fed her at amps then not again until I called him at 540 after jury duty to check on her, and he didn't know he needed to feed her again. omg. I'll just let that go, so I had him feed her asap and he said she ate well. I'm making a detailed feeding chart for tomorrow.
 
It’s going to be okay. You and I will make sure of that! We really can safely fast track Jenny if we need to get her ketones down. Of course, it would be better if you could get at least one mid-cycle test. An evening test would be just fine for that too, since you are gone during the day right now.
 
JennyAnyDots said:
She is not lethargic at all, she's normal, alert, playful. She was eating fine, then today my husband fed her at amps then not again until I called him at 540 after jury duty to check on her, and he didn't know he needed to feed her again. omg. I'll just let that go, so I had him feed her asap and he said she ate well. I'm making a detailed feeding chart for tomorrow.
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Good. I do want to make sure that she gets the snacks though.
 
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