Newbie needs advice this evening please

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Kelley & Phattie

Kelley & Phattie

Member Since 2015
Hello!

I am pretty new to the glucose testing, still learning about all of this and I have a question on how to proceed.

I just did a pre-shot test and Phattie is at 132. She has pretty much been high with her daily dose of 1.5 twice a day, so I am scared if I give her that dose tonight that it will put her down too low..

I work all day so I don't have an accurate NADIR yet.

Does anyone know how to decipher this little bit of data I have? I really appreciate your help.

Thank you!!

Kelley

https://docs.google.com/spreadsheets/d/1wfx3xrPFN_RE0ZpVC8ZCtDZ5wAbaOjVqvhyoR6bJ9qo/pubhtml
 
What insulin? (if you put it in your signature, folks won't need to search for it)

Lantus.
OK.
You've not got a lot of test data, so stall 30 minutes without feeding and retest, then post.

Also, Lantus works best when shot as close to 12 hours apart as possible. When needed, adjust times by either 15 minutes per shot, or 30 minutes once per day.
 
Hi BJM,

Thanks for the quick response.

She is on Lantus. I'll test her again at 8:50 and post results.

I'll figure out the signature in the mean time. Just joined yesterday.

Thanks again! :)
 
Hi Kelly and welcome to LL. I noticed that last night she got her shot 2 hours late. Was her morning shot 12 hours after that or did you shoot at the regular time?
 
Hello TiffMaxee!

She got her a shot around 11.5 hours after her shot last night.
That was 12.5 hours ago.
Just tested her again, she is at 107.
 
Still dropping, so I wouldn't shoot. You may need to drop the dose in the morning, if she' s shootable then.
 
I know you can't test during the day but can you get a test at +1 or 2 before you leave for the day and one at +2 or 3 or before you go to bed? Any other tests you can fit in will be very helpful.
 
I won't be able to get another test in the morning, but I should be able to get a +2 or +3 most nights.

I can get more data on the weekends. Just started testing 2 weeks ago, 1st weekend I had trouble getting blood to test, then I went on vacation for a week. My dad gave her shots, but I couldn't talk him into testing her.. So this is the 1st week of a semi-regular schedule..

Hoping the data becomes more consistent...
 
You are doing great. It took me longer to start testing. I was sure Max would go into remission fast but it was not to be. Random tests whenever you can get one will help figure out how he is reacting. Don't stress over it . Just do them when you can. I learned that Max goes lower more at night than during the day which helped explain why he was bouncing around so much. That makes for me not getting much sleep, lol. Have a great night.
 
I am getting an error message when I try to click on your spreadsheet.
So, I'll just say Hi and Welcome Kelley & Phattie :)
 
Welcome Kelley and Phattie! It looks like Phattie is responding nicely to Lantus. Getting a few more random spot checks will help fill in the picture. Keep asking questions!!
 
Hi Julie & Punkin, Dyana, and Amy & Trixie Cat! Very nice to meet all of you.

Not sure if I need to start a new conversation for each question or not....

I stayed home all weekend so I could test her every two hours, but I messed up on the shots so the numbers aren't too accurate..

The last 2 mornings Phattie has been down in the green. Yesterday she was 88 so I didn't give her a shot, that night she was at 366. I lowered the dose last night to 1.25, and this morning she was at 47. I took her blood one hour later after she ate 3/4 a can of food and she was up to 99. I didn't give her a shot again this morning. I leave soft food out for her all night, so I don't know if she isn't eating and that is why her numbers are so low.

I'm a newbie, but it doesn't seem healthy to not give her a shot in the morning so that her blood sugar goes up so high at night. Is there something I can do to even it out a little better? Really confused by the numbers..

Thanks for all of your help!!

https://docs.google.com/spreadsheets/d/1wfx3xrPFN_RE0ZpVC8ZCtDZ5wAbaOjVqvhyoR6bJ9qo/pubhtml
 
Hello and welcome from me. You got some good data on the weekend. Looks like Phattie needs a dose adjustment. Could you tell me how much she weighs and what the vet thinks her ideal weight should be?
 
Hi Wendy & Neko!

Phattie was around 11.5 lbs when I brought her in for the Fructosamine test a month ago. The vets have never mentioned her weight, even after her hospital visit. So I am not sure where she should be.
 
What food is she eating now? I see that you said it's soft/wet food now, but wondering what brands. We like to feed something less than 10% carbs. The food chart here, lists most common commercial foods. Changing foods to lower/different carbs can impact the dose. How is her appetite now? One of the factors in DKA is not eating enough, so we want to make sure she's getting enough food as well as insulin. Is she on any antibiotics? Usually infection is also a factor in DKA.

I've noticed on the spreadsheet that there were some differing shot times. Lantus does like to be 12 hours apart. You can move it around up to 15 minutes a shot time or 1/2 hour once a day to get back on schedule. When I know in advance of an event, I'll move Neko's shot time up or back slowly until the day. Shooting earlier can act like a dose increase and shooting late can act like a decrease so it's important to keep track (as you are) on the spreadsheet when that is done. Here's a post on Getting Back on Schedule.

Sorry to ask so much, but with a kitty that's been DKA we have to be more cautious.

We have two methods for dosing here, the Tight Regulation (TR) Protocol or the Start Low Go Slow Method. You might want to give those a read and see which would suit your circumstances. TR uses a weight based formula for starting dose, so that's why I was asking.
 
That food chart is a lifesaver! Went through all the brands at Chuck and Don's and found the lowest carb options and brought them home. I've been experimenting to see what she prefers. Right now we are trying the BFF, seems to enjoy it as long as it isn't cold. If she likes it, she gobbles it down. This morning she was begging and ate 3/4 of a can before I left. Pretty sure she ate during the night.

She seems to be feeling well. I haven't seen her play so much in a long time. She basically ran around from when I got home last night until I went to bed, then became really active again at 3 am.

That is very good to know about the Lantus. The vet at the emergency hospital told me 11 hours, so I have been doing that when necessary.. Not sure about the little bit of information they sent me home with, so far it hasn't been incredibly helpful - which is why I am here. :) I will read those articles tonight about the dosing methods and hopefully I'll be able to figure something out. I am trying to keep the schedule as close as I can, but my schedule varies a lot, so I am having trouble with that. :(
 
How about trying 1.0U tonight? The 1.25 after a skip got her below 50 which is our reduction point. We'd like to find a dose that you can shoot two times a day. The recipe for ketones is not enough insulin + not enough calories + infection. Good to hear Phattie is eating well. :) You can always add a little warm water to warm up the food - added water for diabetic kitties, and especially those recently DKA, is a good thing. For the food chart, it isn't necessary to get the lowest carb food, a lot of cats here are eating in the 3-5% carb range. Some cats do better with a bit more carbs.
 
Perfect! I will reduce it to 1.0 tonight and see how that goes for the next few days.

I have to stop at Chuck and Don's tonight, so I'll see if there are some more food varieties I can add to her diet.

Thanks for your suggestions Wendy! You have been very helpful!! :)
 
Kelley, just to let you know what might be happening.

Some cats just need a switch to a low carb canned food diet along with a little bit of insulin support to allow their pancreas to heal. As the cat's body gets back into normal non-diabetic blood sugar numbers, the healing can happen. When it heals it can sputter back to life. As it begins putting out a bit of insulin, we decrease the dose to compensate for the cat's own insulin. You may be seeing that happen to Phattie. The dose that was just right before can become too large.

Just like the 1.5u that was good before is now too much.

It's really good you're testing in the middle of the cycle as much as you can. If he goes below 50, you want to carb him like you did today, but then recheck him in 30 minutes instead of an hour. The reason for checking in 30 minutes is to catch him in case he is still headed down.

You're doing a great job - keep it up!
 
Hi Everyone!

Thank you all so far for your advice and support. It has been reassuring and has helped make this a little less confusing. Hopefully you can hep me with the next step in the Phattie diabetes saga. :)

A week and a half ago, Phattie was starting to get a few greens with her shots being at 1.5 or lower. This last week, and weekend, she is up in the 300's with a swing into 413. I nudged her dose up a little, I think to close to 1.75 (hard to tell since I don't have 1/2 units on the syringes) and it didn't do anything. She has little energy spurts, but for the most part she is pretty subdued. This has been going on for the last week.

I finally found a soft food that she likes, Puka Puka Luau by Tiki cat. It has low carbs and fat and high protein, so I have been giving her that whenever she wants it.

There were a few days where her shots were off because I had stuff going on, but otherwise I have been sticking to the 12 hour schedule pretty tightly.

She is a rescue kitty, she lived in a cage for 2 years, so she has some nervous habits when she get stressed... I've noticed that coming about this last week, so guessing something is stressing her out. Not sure what, maybe all of the recent changes, or she is picking up on me being stressed about this. She has a history of pancreatitis and I know stress can bring that on, so wondering if her pancreatitis is acting up and causing the higher numbers? Now I am getting worried about the DKA coming back because I can't get the numbers down.

I am really frustrated, and worrying about her constantly. I'd appreciate any input you guys might have as to how I can steer things in a better direction..

Thanks in advance,

Kelley
 
Kelley:

It may help if you start a new thread with a new subject line. I think you'll get more people stopping by to provide input that way.

Looking at your spreadsheet, one thing to keep in mind is that Lantus likes consistency. The more consistent you are with dose and with shot time, the less goofy the numbers will be -- or at least it eliminates the effects of time and dose change on the numbers. You might want to consider purchasing a set of digital calipers. Many of us use these to improve the consistency of our dosing even when using syringes with half unit markings. It sounds like life was effecting shot time and sometimes, that's unavoidable. You may need to give it a few more cycles to let the effects of the shift in shot time wear off.

As far as pancreatitis, are you seeing any signs of Phattie being uncomfortable? Marje wrote an excellent Primer on Pancreatitis. It may help you to sort out if that's a factor.

If you're worried about ketones, are you testing Phattie's urine for them? If not, you can find Ketostix at most pharmacies.
 
Thanks for the help Sienne & Gabby.

I started another thread to get a few more hits. :)

I'll read the Pancreatitis article you linked right now, I appreciate that. She is acting like she has in the past with the pancreatitis, being subdued and unhappy. She isn't sitting funny like she has in the past though.

I will look into a digital caliper, that sounds like it would be a huge help. I haven't heard of that before, so thanks for suggesting it.
 
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