Low numbers without shooting + Bruce’s Glucose Curve

Cheeserball

Cheeserball

Member Since 2019
I guess I’ll post Bruce’s glucose curve first from 7/9. He’s been a bit testy lately and we were in a rush, so I didn’t test him before the vet.

8:00-1.5 units
8:50–374 (ReliOn 224)
11:00-213 (ReliOn158)
1:30-126
3:30-149
5:30-191
7:00-206

Bruce was given Gabapentin at the vet because he was MEAN! (We also got a rx for more for transport). Our vet said she’d like Bruce’s numbers down a bit, and to try 2 units. She also told me that I know Bruce best and to use my best judgement if I think 2 is too high.

Since this attempt to bump to 2 units, I’ve missed more shots and glucose tests than ever! He’s definitely not acting himself. He’s hiding more often and just... off. Moving the location of his shots just a tad seemed to help—I was thinking maybe he was sore.

Anyway, today he has been GRUMPY! Fed and shot this morning. Hid under a dresser for dinner. I didn’t want to drag him out and stress him, so I offered him food and decided we probably wouldn’t shoot today.

He finally came out about 2 hours after normal dinner time. He had less than half of his food I’d say and was at 127. Yep, definitely thought right about not shooting. He ate the rest of his food, and two hours after that test, he was at 107.

I’m pretty new to this stuff... could anybody give me some feedback about Bruce’s curve? And why would a cat’s sugar drop AFTER eating if he didn’t even have an insulin shot? Thanks!
 
Hey cheeserball! I think that drop might be Bruce's pancreas able to take care of the high blood sugar on his own there.

Your spreadsheet is interesting because he dropped pretty hard on a 2.5u dose on 6/12 and then when the dose dropped to 1-1.5u all of a sudden it seemed like he bounced? I think those high numbers might have been because of a harsh reduction which made his levels spike temporarily. It seems like the 2u dose is finally starting to produce some good curves on his chart after his body has acclimated to the dose.
If you ever need to reduce the dose in the future because hes dropping too low, reducing by .25-.50u seems to be the gentlest way to reduce without our cats bodies freaking out. And I know that most vets always recommend a whole unit reduction, mine certainly did!

I found that consistency is key to getting the hang of diabetes, and unfortunately our furry friends don't always want to cooperate with us even though we know its for the best! If you can get that consistency for test/feed/shoot (either by really sitting down and figuring out the best 12-12 hour window that works for you and setting alarms, giving diabetic friendly treats every time before testing to start a positive association, etc.) then the numbers on your spreadsheet will start to make sense to you. Bruce's body is going from having the insulin and preforming well to having his pancreas take on all the workload after 12 hours and thats rough on his body, it might be why hes cranky!

A normal curve you're looking for is high PS number, then a couple hours when Bruce hits nadir his levels will drop (look like he dips at +4, same with my kitty on ProZinc!) then in a couple hours it will rise again for next PS.
 
Thank you! We try to stick to 8 am and 8 pm for our test-feed-shoot. It usually works for us, but after our vet visit, he’s always thrown for a loop.

He just tested at 212. I’m a bit nervous to give him 2 units because I’ll be at work in six hours. I’m also a bit nervous that he’d be at 212 this morning if he didn’t have a shot (but ate) last night.
 
You could try and reduce to 1.5u if you're worried he might drop into lime greens while you're at work, but then I'd try and stick to that dose for at least 3 cycles (12 hrs = 1 cycle). Try and get a test at +4 to see where he's at and if he's in blues at nadir you shouldn't have anything to worry about. If he's in greens, leave some low carb food out for him when you have to leave.
 
Do you have any high carb food on hand? (Fancy feast gravy lovers, regular cat treats etc.) 51 isn't terribly low, but we don't want him dropping lower than that, especially since you'll have to go to work soon.
 
Also I know this may sound terrible, but if you can, test him again in another 30 minutes after feeding him some high carb food. We want to make sure he's not getting lower than 51. If you can't get in a test that soon, then feed more high carb food to make sure that he won't be getting lower. Always better to be too high than too low.

What dose did you end up giving him? If he's getting this low, he might have earned a reduction.
 
How long till you have to leave for work? You want to know Bruce is in safe numbers and able to hold a safe BG without needing constant steering when you leave. I'd definitely give him some higher carb food and retest 20 to 30 minutes later.
 
+5.5ish (right before work) Bruce was at 89 (I think that’s what it was, definitely in the 80s). I gave him 2 units... I think I’m going to get some of the U100 syringes for a dose between 1.5 and 2. I definitely felt okay leaving him alone in the 80s at almost +6.
 
Cheeserball said:
+5.5ish (right before work) Bruce was at 89 (I think that’s what it was, definitely in the 80s). I gave him 2 units... I think I’m going to get some of the U100 syringes for a dose between 1.5 and 2. I definitely felt okay leaving him alone in the 80s at almost +6.
Click to expand...

Nice! Glad to hear that Bruce is just fine :) nice job!
 
I’m nervous about what he might be when I get home (it will be nom nom time for Bruce). I also don’t know what to shoot him at.
 
I'm sure Bruce will be just fine and may even be a bit higher than you expect from bouncing after that low earlier today. Tonight because he went that low, I'd reduce the dose to 1.75u. If you don't have half unit markings on your syringes, you can try to eyeball it or go with 1.5u but getting some U100 sryinges would definitely give you the ability to finesse the dose much more finely and consistently.
 
You should be OK but if you are worried, don't feed Bruce and stall for 20 minutes and test again to see if he is rising on his own.
 
I gave him a 1.75ish unit dose this evening. I’m home for the rest of the night, so I can keep an eye on him. I am going to look into purchasing some u100 so we can fine tune that dose instead of eyeballing it. Honestly, he seemed to be doing better and more stable with1.5 units; I upped it after our vet suggested it after his curve last week.
 
Your vet had you go up by 0.5u. Maybe the 0.25u difference is what Bruce needs. It's amazing what a difference that 0.25u can make in some cases.
 
His +5 was 79 (or maybe 72... It’s late and I worked retail today, so numbers are a bit much right now ). There is currently a celebratory safe nadir cuddle puddle with him and his brother shoving their butts in my face in bed. I think I might stick with that 1.75ish dose until I get some U100s and can fine tune things.
 
So I didn’t feel comfortable shooting this am because of a 120 (I had work today). I just PMPS’d him, and he’s a 96. I’m really quite lost with this right now.
 
Well if you didn't shoot this morning and he's that low tonight, I think I'd be inclined to skip again and see what he does. Seems Bruce is on a mission right now. :joyful:

Can I ask you to bring your spreadsheet up to date so anyone trying to help can see what's been happening in a consolidated manner? It's much harder scrolling through messages. :)
 
Those numbers are looking really good! Don't let not knowing how to approach the dosing discourage you! My kitty would run higher in the morning and lower at night just like Bruce is reading. You've gotten some good cycles when he's getting consistent insulin and his body is responding really well to it!
 
There, I think the spreadsheet is updated correctly. It’s not always easy to do it on my phone. I’ll be home for a good chunk of tomorrow—at least until +5 of his AM dose, then heading out for a few hours and will be back before his PM dose. I have a good idea of what I feel comfortable shooting at.

I also used the control solution to make sure nothing funny was going on with the meter, and I’m within the range.

This cat has never made anything easy on me. Ever! Two PU surgeries! Diabetes! 25% of my cats has caused 95% of my grey hair. I always tell him that he’s lucky he’s cute. I am grateful that he’s the most pleasant out of my crew—except when he hears/sees the cat carrier. But honestly, he has every right to hate vets. I don’t. Lame him.
 
Edit: My mistake. It was 156.


He’s at 153 AMPS. Didn’t shoot him for two cycles. I’m stalling and checking in a bit.
 
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I'm not sure how much I would reduce, I'm not experienced enough for dosing advice, I'd wait for @MrWorfMen's Mom to chime in later. But I do think that skipping would be fine again since you've never given him a shot when he's this low (numbers are getting better day by day!) So skip the shot, feed him, and get in a test around +4 (if you can) to see if his levels are dropping on his own during that time.
 
Ok since it appears Bruce hits nadir possibly around +5 or so, I'd suggest a very BCS shot of 0.5u today to see what he does. Test at +3 and see if he is up or down. If he is dropping anytime near when you have to leave, you can always give him higher carb food to boost him up.
 
Good choice! Since we don't know what Bruce is up to these days but evidently still needs a little help with his BG at times, better to be very conservative and monitor to see what he does.
 
+2 is 53... his pancreas is a little brat! It’s a bit warmer here than normal; maybe that’s impacting him? Every time he’s been low, he has acted fine.
 
Just seeing this now. Assuming you have retested since +2. If so what was that reading? If not retest again now please. That drop is substantial for that early in the cycle and you need to prop his BG up. Did you give him food at +2? What % carbs? high, medium or low?
 
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Bruce hasn't been going lower than normal non diabetic cat's BG but don't rely only on observation because with the insulin we add, kitty can go from seeming just fine to having obvious symptoms quite quickly. When you get a reading like that 53, it's vital to give some food and retest in 20 to 30 minutes to ensure BG has risen. If it hasn't, then repeat the process. You want at least 2 readings of a higher safer BG without having to feed Bruce to keep him at a decent level before you let your guard down. I'd aim to keep get him around 90 and having him hold at roughly that level.

While I am sure the weather can have some effect on BG at times, I'd expect excessive heat would be a stressor and raise BG not lower it. On the other hand, sometimes appetite isn't as good in hot weather and that could cause BG to be a bit lower. In any case, Bruce is obviously sending a message and right now what that message is, is a bit fuzzy. Obviously 0.5u was a bit too much this morning so next time you could try 0.25u or just skip the shot at that level AMPS/PMPS and I think the decision whether to shoot or not has to take into account whether you can monitor Bruce or not.
 
If you have to leave in an hour, then I would try to prop that BG up a bit more with some more high carb food and definitely leave some food out for Bruce when you do have to leave. :)
 
I left him at 86. :) Not only did I leave out some dry high carb food, I topped off the bowl, which in Bruce language means it’s buffet time

Would you recommend I do two more cycles of the .5? Or go straight to .25? If his BG is high enough to handle a shot, that is.
 
+11 (well, more like 10.5) was 151. I’ll test right before dinner, but I’d feel more comfortable shooting a low dose if it was a shade higher.

I work tomorrow morning, so I can keep good tabs on him until about his +5 or so tonight. After that, I’ll need to have some sleep. I won’t be able to watch him tomorrow during the day, but again, the evening I can keep a better eye. I’ll just see how he is right before shot time. I’m a bit frustrated because I felt like we were doing solid on 1.5 units. Then we had the vet glucose curve and the suggestion to bump up the dose to 2 and ever since then, it feels like chaos.
 
Since you had to steer him by +2, today I'd be wary of sticking with the 0.5u. How about trying 0.25u and see what he does. He may be higher tonight because of the 50s today not to mention the higher carb food, but if that +11 is any indication, he's not going to be THAT high.
 
PM +2 of 51. Eye roll. (that’s not towards Bruce; just this situation).

In our defense, he didn’t clean his plate like normal for dinner. Feeding him now. He now comes over when I have the glucose meter because that means treat time. I will test in 30 minutes to see if there’s improvement.
 
What a little monkey Bruce is being! Doesn't seem to matter what you give him, he still drops low enough to need steering and he's dropping off quickly. His pattern right now almost looks like post prandial low BG. Did he eat well pre-shot this morning?

ETA You haven't changed his diet recently have you.....to anything with less carbs than the FF?
Thinking out loud .....wondering if Bruce might be one of those kitties who needs a bit more carb in his diet.
 
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For the most part, yes. A few licks were left over, but he ate more this morning than this evening.

After feeding him the rest of his dinner that he didn’t eat and waiting 30 minutes, he’s up to 65. Right direction, Bruce... just the wrong direction, too!
 
Interesting. He doesn't seem to be getting much if any food spike. Try to keep him surfing along with LC food if he needs more food to keep BG up. Of course when you need to got to bed, you can up the carbs so you can get some sleep.
 
MrWorfMen's Mom said:
ETA You haven't changed his diet recently have you.....to anything with less carbs than the FF?
Thinking out loud .....wondering if Bruce might be one of those kitties who needs a bit more carb in his diet.
Click to expand...

Prior to mid May, Bruce’s diet was Royal Canin SO moderate calorie dry and Royal Canin SO wet, just a spoonful + water in an and pm. After diabetes diagnosis, he gets one whole can of FF + a FF can worth of water twice a day.

Now that you say if diet changed, I did change something, but it was pre-diabetes diagnosis. I started using a Catit tree feeder in late April, I think. Because I have multiple cats and sometimes work long shifts between my two jobs, I leave Bruce’s prescription kibble out in the feeder. Bruce was the first one to figure it out. I think his diabetes hunger motivated him! Everyone has eaten significantly less dry food since then, especially Bruce. I still have it out, but I have a fraction of the food in it compared to pre-diabetes diagnosis.

I checked out the SO diets, and they are so carb heavy. So he did go from a pretty carb heavy diet to much lower carbs (and wet food that he loves!).
 
Hmmmm! So if Bruce has been eating a wee bit of the dry SO food all along, is it possible he's had less of it on the days when his BG has been dropping to lower range? Rhetorical question because obviously unless you have cameras to monitor the feeder, you won't know who is eating how much when you are out and even then you'd only have time at the bowl vs real volume to judge by. What about trying Bruce on a slightly higher carb wet food? I'd have t check the food list but FF has some medium carb food and maybe a mix of LC and MC would give him just a tiny carb boost to keep him from dropping off so early and so much all at once. Something to think about.
 
Okay! +5 of 93. I feel alright with that. Bruce’s mom is going to sleep well tonight!

The dry food theory could be true. However, I know there are days that if he’s with me at boyfriend’s, I won’t put out dry at all. I’ve never felt the need to do +2s there, but maybe I should just to see.

Two of his siblings eat moderate carb (if moderate is 13/14ish) Friskies. Maybe I’ll experiment with a small spoonful of their food in Bruce’s breakfast. I still have two cans of his rx food which was 20% carbs. I also got two cans of FF gravy lovers tonight at the store. The problem is I won’t be home during the day to monitor him. I think shoot vs no shoot depends on his BG tomorrow morning
 
I’m not shooting. I won’t have time today to run home and check on him at lunch. I will reassess tonight at PM dosing when I’ll be home and can check on him.

Do you have any experience at giving cats a drop of insulin? I read about it on someone else’s thread.
 
Well at least he's being consistent. It will be interesting to see what he does without insulin today.
Yes you can give a drop of insulin or even a tad more. It's very finicky but can be done.
For a drop, you push the plunger of the syringe in as hard as you can and insert the needle into the vial while still tightly holding the plunger in. Once the needle is in the vial, you let go and withdraw the needle. There will be some insulin (a drop) in the needle shaft but you won't see anything. Might help to try this out with a used syringe and coloured water to practice.
 
+9 (since food, no shot today) is 180. Because I just got home from work it’s entirely possible that he ate before I came home.
 
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