? Monitoring Hypo Kitty Overnight (SUCCESS = REMISSION! THANK YOU FOR THE AMAZING HELP!)

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Wendy&Neko said:
Surfing means he's mostly hanging around the same numbers. It's a good thing, because the typical cycle is a curve. They drop at the beginning, then slow down the drop, sometimes surf for a while, then head up again. Once he's been surfing for a while, he's unlikely to drop anymore.
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Thank you Wendy. Does this mean when I give all of these numbers to my vet tomorrow we have a better start on managing him/regulating his insulin?
 
MrWorfMen's Mom said:
Ditto to Wendy's suggestions. I need to grab some shut eye and I think you are in good shape now. I'll check back in the morning to see how things are going. Deep Breathes and a :bighug:. You handled today very well and should be proud of yourself!
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Thank you so much...I have tears in my eyes for your compliments. I am going to try and get some shut eye for a couple of hours and test again. I will be in touch. So much LOVE to you all from me and my sugar baby! xoxo

He seems tuckered out. I'm sure this has been hard on his system. Rest for us both.
 
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Okay, alarm off, testing on....another 3.8--1 freeze dried treat/1 temptation (weaning off those temptations ;) ). Back to bed and will check again in another 2 hours or so....I'm guessing it's okay to hold off on food as we've been steady with this reading now since around 10:30 pm last night. I will aim for another test around what our normal feeding time is--6:45/7am...If you think I should feed, do tell...I will have my phone by my bed and can roll over and check the board from the pillow position...zzz...zzz...zzz.....z...z....z....
 
Up and at em...another 3.7--1 freeze dried treat and our regular meal feeding for Shamus. He is eating his w/d--I wasn't introducing even a small portion of the Friskies after what we've gone through last night. He hasn't eaten quite half a can but he has definitely had a lot to eat over the course of the last 24 hours so he's probably a pretty full kitty cat. Back to bed for an hour and then calling vet! I have a feeling we're not going to be giving any insulin at all today. But I'm new so perhaps this isn't a good hunch. Talk to you all again soon. Any feedback here is appreciated. xo
 
Good morning Sherri. A 3.8 and then 3.7 this morning. WOW!. I like those readings and your instincts about NO insulin are correct. I wouldn't consider it at a reading of 3.7 after yesterday's rollercoaster. This may be a very good sign of Shamus pancreas starting to sputter back into action! I can't help but wonder if his true numbers were ever as high as you think they were. If all the readings of 20 and even in the teens were at the vet's office, those could be/likely were elevated numbers due to stress and stress can raise kittie's BG a lot.

You had quite the day and night yesterday and I'm sure you are exhausted but you managed the situation with a cool head, mastered testing and have a cat who may be heading off insulin. As hard as it was, you achieved a lot.

I'd love to know what the vet had to say this morning so please let us know when you have minute.
 
Linda, your words bring me comfort. The vet agreed with everything all of you thought and the things I suggested too--even things in hindsight. We are not doing any insulin today--which was my feeling as well as I started to see the more stable numbers. I will test but not as frequently, (we both need a break) and give a few small meals throughout the day.

I will be in touch with the vet and as it stands no insulin until we see high numbers like in 20s and even then would be .5 iu dosage. He's been eating and appears himself. There are no guarantees he will not spike but at least now we know how to get a better handle on it and quite honestly, I feel things are heading in the right direction for us.

I need a few more hours of sleep before I tackle the rest of the day. Love and light to each and every one of you and I welcome any more comments while I attempt some shut eye. xo
 
Sherri, Sounds like you have a good plan in place to move forward. Now that you can test Shamus at home, you will be able to get a much better picture of exactly what his BG numbers are.

When you test at home over the next few days, try to get some tests when Shamus has not eaten for at least 2 or 3 hours so you get his true level without any food influence and keep track of his meals so you can see how he is doing both with and without food. Those readings are invaluable when kitty decides to test your stamina and devotion! :)

If you can take a few minutes this weekend to get a spreadsheet going and attached to your signature, it will really help everyone here provide you with the best support. Wendy put a link to the instructions in one of her messages here last night. The spreadsheet also keeps you from having to re-type past readings as folks fly questions at you in situations like this.

Since Shamus is off insulin right now, if you want to try adding just a teaspoon of Friskies to his w/d to slowly start the transition, you could do so. It's much easier to do the transition when insulin is not in the picture. He may very well go to some higher numbers but now that you can test, and you're starting to get some data, you'll have better tools to allow the transition to be done safely.
Obviously, much of this is going to depend on Shamus' taste buds!

Get some rest and do something special for yourself! You deserve it! Shamus is a lucky kitty to have you for a Mom! :bighug::bighug: to you and scritches to Shamus.
 
Sherri said:
Thank you for being our angel and getting this thread rolling. I'm not sure what you're dealing with at home but I'm humbled you would feel this way about someone and her kitty you don't even know. I hope your husband is okay. I'm praying for both of you. <3
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Good morning Sherri and Shamus! Looks like you did well overnight - good job.

No, not an angel - just paying forward what others did for me years ago.

Hubby has a rare genetic mutation that causes sudden extreme weakness and/or full body muscle paralysis from loss of potassium. It's the wierdest thing in the world....heart and breathing are muscles too, I have to monitor those to be sure I don't need to start either rescue breathing or CPR. Been doing THAT dance for many years. More info on it is linked in my signature.

Again, GOOD JOB!
 
Squeaky and KT said:
Hubby has a rare genetic mutation that causes sudden extreme weakness and/or full body muscle paralysis from loss of potassium. It's the wierdest thing in the world....heart and breathing are muscles too, I have to monitor those to be sure I don't need to start either rescue breathing or CPR. Been doing THAT dance for many years. More info on it is linked in my signature.
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Wow, tell him... something encouraging! That is awful and I've never heard of something like that.

"Hubby's in the middle of a full body paralysis so need to monitor breathing and heart...I don't want to leave Sherri alone either...".

Such great people on this forum.
 
Way to go Shamus! (and Sherri!) It may take a couple of days for the Lantus depot to be totally used up so his readings may still rise later but for now this is wonderful and encouraging news! Looking Good!:D
 
Sherri said:
I have a feeling we're not going to be giving any insulin at all today. But I'm new so perhaps this isn't a good hunch. Talk to you all again soon. Any feedback here is appreciated. xo
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I think you are right. Sometimes kitties become more sensitive to insulin after a hypo and it can kick start the pancreas to start working a bit. Today is looking really good for Shamus. :)

If you do have to restart insulin, and that's OK if he needs a bit of support for a while yet, I wouldn't wait until the 20's. Over 15/16 is starting to get a bit high. It depends on the kitty, but renal threshold where the kidneys have to work harder to get rid of excess sugar is around 13/14 and you don't want him spending much time above that. I'd agree with just starting at 0.5U if you have to. And all paws crossed here that this nice streak continues.

I hope both of you are catching up on your sleep today.
 
just checking back in on you - sounds like today's gone well! I agree with Wendy, i'd continue to check him 3 times or so a day for now, but if you see numbers over 10, please let us know. It's better to restart insulin at the "right" time than wait until their bodies become used to high numbers.

Just fyi, once a cat is diabetic, they are ALWAYS diabetic. If he can become diet-controlled, then great, but in my opinion, it's too soon to say that's happened. For now, I would not be complacent and I would continue to test his blood sugar. I'd also continue to feed him only canned low carb or raw cat food, and get rid of the temptations unless you need high carb.

As long as he hasn't had more shots he's not likely to become hypo now. There is a rare disease that can cause that, but I doubt you need to worry about - the main message is that his normal not-on-insulin blood sugar may be quite low and as long as he's not getting shots, you don't need to worry about him becoming hypo. Cats not on insulin might measure from 30's-120's or so (1.6 to 6.5).

Great job last night!
 
Ok so I thought he was good to go because all afternoon I checked and and he stayed at 3.8 range usually followed by a small meal and then 4.1 at 4pm but no food. I had to go out of town and had my vet tech come at 7 to feed and check BG and she got a reading of 2.4!--no symptoms and himself. He ate a can of w/d and then she came and checked him around 2 hours later and he was back to 3.8. She left food out for him. That was around 930 and I am due home in half hour to check again. What is going on? I didn't think he'd dip that low again but he hasn't had insulin since Thursday morning. I see the note above that perhaps these could be normal numbers now? Tips please. I don't want to have another night like last :(
 
Did you see Julie's post just before yours? Cat's not on insulin can test as low as 2.2 fairly regularly, sometimes a bit lower. I think Shamus is fine, and his pancreas is starting to work. :cool: You can test again tonight before you go to bed, but I think you are fine. Keep getting the odd spot check the next few days, just in case we see him start to rise. Otherwise, enjoy the holiday weekend!
 
Oh thank you thank you for the quick response. I feel so relieved. I will check when I get home. Should I be leaving food out. He's still on the w/d and yep I saw the post above mine.
 
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Morning all! 4.0 today and I did try to include the small amount of friskies in two different flavours with no luck. He is really stuck on this w/d. Any other suggestions? I will be calling the vet later this morning with the happenings of yesterday evening and this morning. I will continue to spot check. Any particular times in general that would be best?
 
Wonderful news Sherri. :DShamus is holding at a great level for now and Mom got some sleep. WIN! WIN!
Maybe Friskies just isn't Shamus' cup of tea. Here is a link to food information. Friskies and Fancy Feast Classic Pates are probably the most economical choices but there are other canned foods that would be ideal too.
I am over the moon that things are going so well for you and Shamus!:joyful:
I don't think it matters when you test him but try to get some readings when he has no food on board. Those will be his lowest numbers and will be the best indicator of whether he is remaining at normal levels or heading up again.
 
That is wonderful! And glad you got some sleep! My cat really likes the Weruva brand of wet food- The Cats In the Kitchen and the Truluxe- they are ALOT more expensive than friskies- but he gobbles them up:) He also likes the FF- but we switch them up. If you look on the food list here- http://www.felinecrf.org/canned_food_usa.htm
You can see which ones are the lowest in Carbs- most of the Weruva are under 10, but not all.

Have a great day!
 
Afternoon friends! Reported to Doc and he suggested checking periodically as all suggested here. We will be monitoring and I will call if numbers start to rise. If we can go a week without insulin then Doc says we can say he's in remission but will still want to check liver enzymes for the underlying hepatopathy, but suspects this should have improved and was most likely only due to the diabetes.
 
I would test first thing in the morning before you're given breakfast. That is often a high point of the day because of Dawn Phenomenon. I would encourage you to test daily for the next couple of weeks, and as long as he's in normal numbers don't worry about it. Keep reporting here so we can help you if his blood sugar rises and let you know what to do if you get a higher test.
 
Sherri said:
Afternoon friends! Reported to Doc and he suggested checking periodically as all suggested here. We will be monitoring and I will call if numbers start to rise. If we can go a week without insulin then Doc says we can say he's in remission but will still want to check liver enzymes for the underlying hepatopathy, but suspects this should have improved and was most likely only due to the diabetes.
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That's wonderful! Fingers and paws crossed for you and Shamus! :):):) Keep us posted!
 
Sherri, That was the best late night "party" I ever attended. Scary yes, but well worth it to watch Shamus start on the path to (paws and fingers crossed) possible remission! What a privilege this has been! Please keep us posted. I'm anxiously hoping for a wonderful conclusion to Shamus' diabetes story.:bighug: & Scritches!
 
Wellness is a food that I've used with success. It's more expensive than Fancy Feast or Friskys but if you buy the large cans it's not horribly expensive. They do make small cans that you can try. It tends to be higher fat and thus more calories so you may not need to feed as much. Both weruva canned (not the pouches, most of them are higher carb) and Tiki Cat have a lot of moisture and low fat so you need to feed more and they are expensive. For Weruva the 6 oz cans are not much more than the smaler ones. Check the ingredient list. Many of the Weruva have fish even if it's not in the name. Tiki cat is very low carb. Maybe you could mix it with the w/d to bring down the total carbs. Another thing you might want to try is raw. You can make your own, buy it frozen or get it freeze dried (you add water). I've had good success with Primal freeze dried turkey. You can usually get samples at pet food stores. I like the freeze dried because you don't have to open a big can and hope you finish it before it goes bad.
 
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MrWorfMen's Mom said:
Sherri, That was the best late night "party" I ever attended. Scary yes, but well worth it to watch Shamus start on the path to (paws and fingers crossed) possible remission! What a privilege this has been! Please keep us posted. I'm anxiously hoping for a wonderful conclusion to Shamus' diabetes story.:bighug: & Scritches!
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You have been an amazing coach! Sending out intentions for all positive improvements from here in! :)
 
Here's a morning report for all those who have been following and/or helping us along. Went 12 hours over night from around 6:30 pm to 6:30 am and the BG before the 6:30 am feeding was a steady 3.6! He ate a small amount of friskies turkey and giblets mixed with the w/d but he did leave some left in the bowl which he usually doesn't do so I know he's not totally digging it, but maybe it's a start?
 
Yay! That is wonderful news! So good to hear:) And glad he ate some of the other food too- sounds like a great start to the day!
 
Whoo Hoo! Keep those great reports coming! Go Shamus! He might not be feeling as hungry now that his sugar is down so much! Might not be the food!
 
Also, is there any chance I could be missing a spike in sugars throughout the day (I'm still home testing before meals)? I'm just curious. I know cats are very routined and he goes under the bed pretty much the same time each day for a few hours nap. I wonder if this became part of his routine when he didn't feel well and he has kept it up even though feeling better. Again no signs of any generally ill feelings--in fact he is as playful as ever--caught him spinning his ball on the scratch post, and playing with his mice and cat nip knots! Also, it was never unusual for him to go under the bed because he has been a skittish cat and finds comfort under there when people come over that he doesn't know too.
 
I think if you are testing before meals and specifically in the morning as Julie mentioned, you are getting a good indication of his lowest glucose levels. Insulin dosing should be based on the lowest not the highest reading of the day so as long as Shamus stays at his current levels you and Shamus are golden. It wouldn't hurt to get a few readings an hour or so after he eats to see how he is influenced by the food but the lows are the most important and critical numbers! Spikes can happen for all sorts of reasons (exercise, excitement, stress) in all cats so you don't need to be concerned about missing them. Sounds like Shamus is being a normal healthy Shamus! :bighug: and scritches!
 
Actually, a mid-cycle test in the +5 to +7 hours post-shot will show how low he may be going (the nadir period). That is the primary number used in dose adjustment for most insulins - how low the glucose goes.
 
@BJM Shamus is off insulin at this point and testing is continuing to see if he is actually in remission. I thought a nadir would only occur in a cat receiving insulin??
 
Awesome thank you! We just did our before evening feed at it as another steady 3.6 so I will check him in two hours to see how high he goes. :) And....he enjoyed a lil bit more of the Friskies turkey and giblets too so I'm mixing it in with his w/d.
 
Looking GOOOOOOOOOOOOOOOOOOOD!:joyful:

Just a thought.....I think it would be a good idea to remove the question mark and "Help Please" from the title now. We'll find you!
 
Woke up this morning to a 3.4 and eating way more Friskies! Wahoooo! Changed the title too! Thanks Linda! Happy Labour Day to you and your furry babies! <3
 
Shamus is looking good! Here are the OTJ Trial Instructions that we use in the Lantus/Lev ISG. Your situation is a little different since you never even got to the point of having a spreadsheet or getting into the insulin support group. But since you have questions about when to test, this will answer them for you. The "normal test times" referred to below mean the test in the morning, prior to the normal shot. We call that the "preshot" or "PS" test. I also want to make sure you have (and keep) the last paragraph and understand that you always will need to treat Shamus as a diabetic. Hopefully he will stay in remission with the change in diet, but too often we see kitties do come out of remission. You want to always keep in mind that he's diabetic, just diet-controlled for the time being.
Start the trial on the next green pre shot.

If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
After 14 days of no insulin, we have a party!!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on. Good luck with the trial!!!

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!​

From the Lantus/Lev ISG's Tight Regulation Protocol:

Remission:
  • From Tilly's Diabetes Homepage:
    Phase 5: Remission

    "14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs. Don't stop feeding low-carb and try to avoid cortisone if possible. Test the cat's BGs once per month.

    Approximately 25% cats that achieved remission using this protocol relapsed and required insulin again (frequent causes are hyperthyroidism or bouts of pancreatitis). Therefore, it is important to keep your diabetes kit up-to-date. Then you can react immediately by giving insulin and home testing. Importantly, the sooner you react to a relapse (i.e. preventing hyperglycemia and initiating other necessary veterinary treatment), the more likely a second remission will become.

    The longer a cat has had diabetes, the less likely it will go into remission. Many long-term diabetics get stuck in Phase 3 or 4. Yet there is a benefit of using this method for such a cat as well: keeping the cat's BG levels as normal as possible is much healthier for it long term. Insulin requirements will often decrease to very low levels too."
  • Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission
 
Wow! Thank you Julie! Because it was such a whirlwind I never did get to a spreadsheet (although I have a tracked everything in a book) so can you direct me to where that is? (I'm sure someone has but I have received so much info I'm not sure where it would be at this point. My apologies :( I have been testing twice a day before each meal. I have even done some tests 2-3 hours after eating. When you say go ahead and feed small meals I'm not sure what this means as I had to change the schedule to only two feedings a day to correspond with the insulin injections when we first began. I am hesitant to change this routine should we need to go back to insulin. Is it okay that he (and his brother now) are being fed twice a day? I am also unfamilar with the colour coding and only understand the BG levels in the Canadian unit of measure (moL?) so what is considered normal range?

I understand that Shamus will always have to be monitored and I am 100% devoted to doing that. I printed your info above to be added to my book! :)
 
If someone gave you advice to only give 2 meals per day with the shot, that was probably someone familiar with other insulins, not the long-lasting ones like Lantus and Levemir. It's more appropriate to give frequent smaller meals with those insulins. Giving smaller meals more frequently is less of a burden on a healing pancreas. That's not defined anywhere, but I would probably try to give him 4 small meals spread out from the time I woke up til the time I went to bed.

Here are the directions on creating a spreadsheet. I don't know if you need to do it at this point or not - it's up to you. You might find it handy to have the info in a google doc, and certainly, we encourage people to have one and keep them up to date since precious time can be lost if you need quick help and information is in a notebook at your house. It probably would be a good idea (I'm talking myself into you doing one as I write this post, LOL.) Use the world template for the spreadsheet so you enter the #s in mmol and they are translated into mg for the rest of us. The "common language" on this board is mg. Normal range in a cat not getting insulin is considered under 120, primarily in the 50-80ish range. Divide by 18 to get your mmol numbers. 120/18 = 6.66 mmol, so everything under that is considered.

You don't need to test that much. He's not getting shots so he's not going to go hypo. Just follow the directions that I gave you above on testing once a day for now, first thing in the morning before breakfast. As long as he's under 100 (100/18=5.5mmol) you don't need to test him again til the next morning.
 
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