Nermal's SS finally posted. Bouncing all the time. Please help.

R

Robin1

Member Since 2020
I just did Nermal's SS this morning, and it's just cringeworthy. Knowing what I know now, I see much mismanagement and missed opportunities. Could someone please take a look and maybe offer some perspective? Sweet Nermal deserves the best care possible.
 
Nice job on your thread aka condo. I'm going to include the link from your prior post. http://www.felinediabetes.com/FDMB/threads/lantus-pen-mystery.228098/
I hope you can get some opinions on what Nermal seems to be up to:)
Be good for mom Nermal...she's worried about you.:cat:
I hope you have a great evening Robin. Look forward to seeing more posts and Nermal progressing through the sugar dance.

ETA: Here's a helpful link that defines the different slang terms used on the forum.
 
Couple comments first. There are some spots in the spreadsheet where the number of units shot at PMPS is blank. Could you put either "skip" or "NS" for no shot in there if you deliberately missed the shots. Or if it's just a data entry issue, fill in the numbers.

Nermal's numbers are "all over the place" because he's bouncing. Bouncing is extremely and annoyingly normal for recently diagnosed cats, and even some that aren't so new. For example, my girl took over a year to stop bouncing to red - I considered that progress. :rolleyes: It's a normal protection mechanisms for cats, who aren't used to normal blood sugar numbers yet. He's become used to higher numbers and his body dumps stored sugars when he sees a number lower than he's used to. The bounce, as we call it, will resolve in up to six cycles. It's annoying, but completely normal. Not much we can do but try to get to a dose where he sees more normal numbers, and gets used to them again.

We determine how to change the Lantus dose based on the nadirs, or how low the dose takes the cat. If you take a look at the yellow starred Sticky Note on Dosing Methods, it describes the two dosing methods we use here. if you pick one, it'll help you decide (with our help of course), how to change his dose.
 
WOW! That's a lot of testing! And then I saw the Freestyle - nice to have all that data...So taking a breath, you've done really well so far...if you could please post daily and set your title like this 4/11 Nermal AMPS ###.

I see that Nermal hit the lagoon late today - nice job there! It's going to take some time to get him to settle down...and it takes time. So just keep posting those numbers and posting her so you can get some more feedback and support. Is Nermal eating, acting well, etc? Bouncing is normal...he's just gotta get used to those low numbers...
 
Hi, everyone. She just went down to 48 right before dinner time. I fed her and she ate some, but was very slow in eating it and she didn't come running. I had to take it to her. Her BG came up to 63 as of a minute ago. YIKES!
 
Robin1 said:
Hi, everyone. She just went down to 48 right before dinner time. I fed her and she ate some, but was very slow in eating it and she didn't come running. I had to take it to her. Her BG came up to 63 as of a minute ago. YIKES!
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What meter did you test her with to get that 48?
 
Robin1 said:
It's the Freestyle Libre. Every time I have backed it up with the Alpha Trak it has correlated.
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I don't know how the Freestyle compares with AT2 meters but I would not try to use comparisons to make decisions about dosage.

If the numbers you're getting now are food influenced, she may go down again. You may want to try a reduced dose tonight. Are you well prepared for lower numbers just in case the numbers you're seeing now are food influenced? This is a time to be cautious because we typically say, when you get a low number, hold food, test again in 20 minutes and if the number is under 50, you would skip this dose. Or at the very least, check to see if her numbers are coming up on their own...then make a decision on shooting based on several tests without food inflence.
 
She is coming off the bounce and sometimes they can have a strong cycle as they come down.
I would wait another 20 minutes to see what her numbers are doing and then decide what to do
 
I just meant that the numbers are from the Freestyle Libre, and the times when I have checked it for accuracy with the Alpha Trak, it has been close.
 
She only ate a little of her food, and it's canned salmon day (0 carbs), so I would think that it would be unlikely that she would shoot up so quickly for that. She's 181 on the AT, and 166 on the FSL right now.
 
Robin1 said:
She only ate a little of her food, and it's canned salmon day (0 carbs), so I would think that it would be unlikely that she would shoot up so quickly for that. She's 181 on the AT, and 166 on the FSL right now.
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Looks like she might be going to bounce after that 48.
Is her appetite good and do you have all the supplies needed to monitor and high carb food and honey/karo?
 
Her appetite is not good right now. She still has the rest of her dinner sitting in front of her as she is laying on the bed. She is usually an enthusiastic eater. Yes, I have supplies to monitor, honey, and I do have Greenies (high carb treats), but no other high carb food.
 
Robin1 said:
Her appetite is not good right now. She still has the rest of her dinner sitting in front of her as she is laying on the bed. She is usually an enthusiastic eater. Yes, I have supplies to monitor, honey, and I do have Greenies (high carb treats), but no other high carb food.
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You really need to make sure you have some high carb food in the cupboard at all times. You just never know when you might need it.

How do you feel about giving the reduced dose of insulins she earned...0.5 units?
If you don’t think she will eat, you may not feel comfortable about shooting. You are there with her, I am not.
You can give the 0.5 units, give a reduced dose or skip. I don’t think I would skip though.
It’s up to you what you are comfortable with, with her reduced appetite.
 
Right now she is licking at some Purely Fancy Feast, also no carb. Up to 211 on the Freestyle Libre.
 
Robin1 said:
Right now she is licking at some Purely Fancy Feast, also no carb. Up to 211 on the Freestyle Libre.
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She is bouncing. I think you could give her the 0.5 units, if you are ok with that
You can make higher carb food by mixing low carb with some honey if you need to, or rub honey on her gums.
 
I don't think I should skip, either. It was 211 and rising a moment ago. It makes sense to give the .5. Every time that I've skipped or delayed, it has whacked things out for days.
 
Yes, it is. I cannot imagine doing this without it. It gives me peace of mind. Thank you all so much for helping us. I have been making these decisions off of everything I've read on this message board. It's very nice to have people to speak with about it all.
 
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