Nigel and I need help.

You can test on yourself too.
How is he now?

 

Well he’s at 296 now. I should say that I misread the instructions on the Karo earlier and he may have gotten a bit more than 1/4 tsp.

 

Any idea how much more than 1/4 tsp you might have given him?

 

Hoping everything goes well the rest of the night- time to get to bed here.

You're doing great

 

Well I dipped a finger into it and tried to rub it on his gums and tongue and that didn’t work very well so then I let him lick a a tsp of tuna mixed with it. I’d guess maybe 1/2 tsp.

 

Thanks! I appreciate the help!

 

@majandra Sweet dreams!

 

Alright then, I think it's safe to say that the sugar should be wearing off by now. Just trying to compile a list of reading times and actions. Be with you shortly.

 

It’s at 363 now, so not dropping quite yet. I’m feeling pretty exhausted. You think I need to stay up and keep an eye on him?

 

No. He's obviously rising and should be fine. I'm putting together a summary ...almost done. Just give me a couple of minutes.

 

Here is a summary of the evening. We need to get the spreadsheet updated so this info is clear for anyone helping. It's a good idea to keep the sheet as up to date as possible but I know it's late right now so it can wait till tomorrow.

Summary
PMPS - 115
@ +.25 - 108
@ +1 - 78 ( a little more food given)
@ +1.5 - 79
@ + 2 - 70
@ +2.25 - 65 (given 1/2 tsp of karo mixed with low carb food given)
@ +2.75 - 74
@ + 3 - 105
@ + 3.25 - 154
@ + 4 - 296
When we do more than one test in any given hour we stack them so they look like this in the spreadsheet.

Put notes about the food given and karo in the comments section.
Sugar should have worn off now. Looks like Nigel may have had a long cycle today. He should be fine. He may be bouncing now from those lower readings earlier. Sorry for the wait. It's after 2am here and my fingers are getting slow. Sleep well.

 

Thanks for all of your help, Linda! I’ll update the spreadsheet accordingly in the AM. Sleep well!

 

Good morning! He’s at 265 now. Should I give him a normal dose of insulin after his breakfast?

 

Good morning Grant. I think I'd be inclined to stick with 0.5u for this cycle for a couple of reasons.
You have started lower carb food (11 down to 6%) and it looks like those higher BGs on the 28th could have been stress influenced (Libre install = vet stress) and or a bounce that we couldn't predict due to lack of data. Last night looks like the stress subsided and/or a bounce was breaking, thus the considerably lower readings. I also assume you are working today and will not be available to monitor intensely like last night.

 

That would throw a bit of a monkey wrench into their use with cats who cannot tell us they feel off due to dropping/low BG and in knowing what to do (Low vs. medium vs. high carb food) when dropping BG is detected with a reading.

 

I just went ahead and gave him 1u before seeing your post. I hope that ends up being OK. Yeah, I’ll be here with him for a couple of hours but then I have to head to work.

So how many times a day do you feed your cat? Are two cans of FF/day enough? I need to figure out another food for him today and I’m not sure if it’s worth giving another type of Friskies a try when he wouldn’t even taste the chicken version.

 

You said Nigel is a big cat so I think he may need more than 2 cans of FF per day. How much does he weigh? My girl who is about 18 lbs, gets about 3 to 3.5 cans FF per day to maintain her weight. I calculated her needs at around 300 cals per day.

1u is a normal starting dose so he should be fine but to be honest, I'm hesitant to guess what he's going to do today given last night's drop. Test him in an hour post shot and let's see what this cycle is looking like.

 

He’s at 283 now.

Yeah, he’s a little over 15 pounds. Hmm, yeah I’d rather not have to feed him three times a day. Maybe I’ll try getting a variety of Friskies pates and seeing if he takes to any of them.

 

You can watch for sales on petsafe 5 meal feeders, and with those, you can set multiple meals, and also the 2 hr preshot fast. It's been a lifesaver for me with unpredictable work.

 

I'm a bit confused. You said he was 265 in post #113 when you asked about dose. I'm guessing the 321 in the AMPS box on the SS was another reading just before his shot but after Nigel ate? The 283 would then be his +1 reading. Is that correct?

 

265 was about an hour before his first meal. The 321 was right before his first meal, and the 283 was about an hour after.

 

I take it he ate a reasonable amount this morning with no issues.
I'd test him before you leave and if his number is down, leave some food out for him to eat if he needs it later. When do you get home today?

 

I couldn’t get him to eat too much but kept putting him back in front of the bowl to see what I could do. I think he just prefers the dry food that he has been eating before, unfortunately. I don’t get home until 4. Hope he’ll be OK. He’s hiding under the bed now so I’m gonna have to drag him out before I go.

 

If you leave food out he'll go eat if he needs to. I'd make sure he has a full meal available to him just to be on the safe side. He seems to be a grazer which is good because multiple small snacks help keep food in his system for the insulin to work with. Does he usually hide under the bed?

 

He usually hides under there in anticipation of something he doesn’t like or if I’m bugging him too much, like I have been.

 

Grant sorry to hear you had a rough night, how lucky you had the Freestyle libre to give you readings I guess a lot of things got combined and thanks @MrWorfMen's Mom for your help during the night hope the both of you can have a nice night tonight

He will probably be a bit high for some cycles as a response his body has for being low, is what we call bouncing it usually takes about 4-6 cycles to clear the bounce but we do not know yet how Nigel will act so keep an eye on him but do not get alarmed if he's a bit high, do try and type all the readings you got when you have a chance because it will be valuable information later on

When you can, start practicing making a test with the other meter because from what I researched when I did my failed attempt at using the freestyle libre is that is precisely on the low numbers when it has the most inaccuracies so you may need to double check next time (hopefully not any time soon)

 

So, I just got home to him being at 63. Looked like he hasn’t really eaten much all day and that his numbers were dipping down over the past hour. Do I need to give him Karo again?

 

93 now after I got him to eat a little bit of his food.

So far all Friskies and FF flavors have struck out. He just “buries” them without a taste.

 

Hi Grant You are doing fine. Nigel is & was safe even at 63. Nigel has to eat so for the meantime it might be wise to grab some mor TJ that he likes.

 

How is Nigel acting otherwise? Being more his usual self still?

 

Given his tendency you may want to consider a time feeder so that he gets something to eat mid day when you are out so that he's not completely without food when you arrive and that may help him not to go down so much, you can divide the food he's getting into three or four parts, there are some that you can even get some ice or a cold pouch under the tray to keep it ok

This one is similar to the one I have, there are other more nicer ones you can get since you are in the US if your budget allows https://www.amazon.com/WOpet-Automatic-Multicolor-Arbitrary-Combination/dp/B07HSX1CY8/ref=sr_1_40/140-2629459-2775421?ie=UTF8&qid=1548891481&sr=8-40&keywords=time feeder cat

 

He’s generally not without food but yeah I might have to get him a feeder.

He’s at 80 now. Should I give him a half unit tonight?

 

He seems OK. Been pretty lazy which is one version of himself. Saw someone walking a cat on a leash tonight and thought about trying that with him.

 

I don't think it's a good idea to give Nigel ANY insulin tonight at a reading of 80. I'd skip insulin tonight and see what he does given the huge drops he has been showing us over last night and today's cycles. Both suggest that if indeed he does need insulin, the 1u may be too high a dose.

 

Oops, I gave him 0.5u. Should I skip tomorrow AM if it’s low then?

 

It's Ok we can work with it. I'm glad though you didn't give him the full 1u dose.
Lantus is a depot insulin., That means that each time you give a dose, a certain amount is kept in reserve for use even after the 12 hour cycle has passed. Lantus therefore works best if dosing is done consistently....same dose for a number of cycles to get a good picture of how the dose is working. It seems the 1u dose may be too high. Hard to say with the little bit of data we have yet with stress factors being in play but the events of last night and today are suggesting that the 1u dose may be too high.
Get a +1 and +2 reading tonight. How are you holding up? It was a long night last night and I know you were getting really tired by the time we called it.

 

When is +1 for you?

 

I just checked and it was 105.

 

Probably a food bump from his shot meal. That is more normal than last night.

 

Thanks! I’m still pretty exhausted and fried feeling.

 

Just to confirm- that test was at +1? Just trying to establish your timeline on my clock.

 

Yup it was +1. Dang you're good at multi tasking!

 

+2 should give us a good idea of where this is heading after the food bump. Hopefully not down!

 

Yeah it’s down. He’s at 84 now. Do I need to do anything?

 

He finished off the rest of his dinner on his own (the fancy feast). Should I put another can out for him tonight?

 

He finished it after your +2?

 

What do you have for carb levels of food?

 

Yeah after about +2.5. It was a liver and chicken FF. Looks like 2%.

 

If you have a higher carb food, you could give a teaspoon to encourage him to surf safely, and test again in half hour.

 

I only have lower carb canned food and his older dry food, which I believe is 34%.

 

Should I give him a little dry food?

 

Nigel looks to be trying for another active cycle. Am I safe to assume you don't want to be chasing numbers for the next several hours? I can't stay up to night to monitor with you.....I already dosed off for a bit.

 

Yeah I should really get some sleep.As should you!

 

I'm fading out too :/

 

What's Nigel's sugar at now?

 

He’s at 111 now. Acting his normal self, being affectionate.

 

He’s in a playful & affectionate mood. Seems good but should I make food available to him for the night?

 

Yes

 

@MrWorfMen's Mom should he feed kibble with the wet?

 

@AmericanTemplar
can you make it to a store tomorrow to pick up some higher carb wet foods?

 

If you have 34% wet food mix 1/2 tsp of that with 1/2 tsp of the low carb food he's been eating and give him that. If the 34% is dry food then give him a tsp of it & we'll see what that does to his BG in half an hour. I don't want to send him to the moon but we need to get his BG up if you want to sleep soon.

Because of the depot, we are not just dealing with the half dose you gave tonight but also the 1u dose the morning and some residual depot still left from previous shots before the monitoring started. That is why I suggested 0.5u this morning and no shot tonight.....to help drain that depot.

 

Alright, I gave him a bit of dry food. So he’ll be good with no more food through the night? Also, should I not give him a shot tomorrow or wait and see where his numbers are?

 

You should check him again in half an hour, then see if more food is needed.

 

If it was my cat, I would grab a +11, post to the forum with the ? Preface on title and "dosing advice asap", and wait until advised. That gives an hour for eyes on your post.

Eta: with me being relatively inexperienced, I am not comfortable giving informed dosing advice, and will always err on side of caution and defer to those more experienced. Better to be high for a day than too low for a minute.

Eta2: what she said!

 

If we get his BG up for now, can you get up and grab a reading during the night to check on him? Sometimes folks set an alarm to check or simply check when they wake to use the facilities. In any event Nigel seems to be getting peak action later in the cycle which may be another indicator the 1u dose is too high and we really don't know what the 0.5u dose did last night with no readings between +5 and +11 when nadir would normally occur bt +4 and +7.

Nigel's BG today dropped over 250 points on the 1u dose and is remaining at normal levels late again tonight albeit at lot flatter so far.
Assuming you will be working again tomorrow, same hours , I suggest you do not give Nigel any insulin unless his BG is over 250 at AMPS until we figure out what is going on. If he is over 250, then I would give 0.5u, get a +1 and +2 test before you leave and leave some food out for him to eat while you are gone. You don't want to be using kibble unless absolutely necessary so as Majandra suggested, please get some higher carb food to keep on hand.

Let us know what the next reading is. I think it's due any time now.

 

You’re saying to make this post in the AM an hour before his scheduled injection time?

 

I need to crash soon, will check in once more before I shut my phone for the night.

 

That's what I would do if I didn't have solid advice already.
I think what Linda said sounds reasonable though.

 

Grant please check Nigel's BG now. And can you get up to check him again later tonight?

 

He’s at 89 right now. Yesterday during the +7 to +11 time frame his average was around 280.

 

Yeah I’ll check him when I get up to use the bathroom.

 

He's dropped again. Did you give him the tsp of kibble?

 

When you test during the night .... If his numbers are 70 or below, give him some food with a DROP of karo mixed in to make a medium carb snack and retest 15 minutes after he has eaten to ensure BG has gone up. He's in no danger unless his BG drops below 50. If you get a number below 50 get Nigel to lick some karo off your finger and post for help with the prefix "911" to get some help to keep him safe.

 

Goodnight, and hope he surfs safely

 

Goodnight @majandra Thanks for your help!

 

Thanks to both of you @majandra & @MrWorfMen's Mom and good night!

Yes, I gave him the kibble.

 

Give him another tsp of kibble and call it till bathroom break. Good nights.

 

Done. Thanks! Nighty night.

 

Alright. He was good though the night. Should I not give him any insulin this morning then?

 

Grant, let's see if he is going up or down at AMPS but yes I'd be leaning toward skipping with that +11 reading. He's done some pretty quick changes before. I'll be watching for the AMPS.

 

Can I feed him? I can tell he’s wanting food.

 

Better not to right now. Hold him off 15 minutes, test and then feed him. Shot time is about 9:30 right?

 

Looks like I might have the times off a bit. If it is now an hour since the +11, get the AMPS and then go ahead and feed Nigel.

 

It’s at a little past 6 my time (right now). I usually feed him when I get up at 6 then give him his shot right after.

 

Ok get the AMPS, let him feast and we'll make a decision whether to give shot or not.

 

He’s at 118.

 

I think I'd skip and see what he does without the shot today. Stick to the low carb food and get a test before you leave for work just to see what he does without the shot.

 

Alright, sounds good!

 

Just put an "NS" or "Skip" in the U column beside the 118 reading for this morning so we know it was a skip.

 

Good morning!
Looks like he stayed safe last night. Good call on the skip. Now you get a worry free day at work

 

Oh my Niegel is really keeping you on your toes , good call to skip right now, stick to all low carb food and let's see how he does during the day, if you can when you get home tonight take a reading at +11 and maybe the graph and post it so that we can see how he behaved without the insulin before you decide what dose to give and shoot

 

Thanks! Yeah, I wanted to post a picture of the graph but it looked like it needs a url. Guess I’ll need to upload it somewhere.

 

That would be cool but if you can't maybe a picture of it with your phone (faster and easier than dealing with all the high tech )

 

Ok, think I figured it out.

 

That graph is indeed interesting and helpful. It looks like Nigel didn't go much if any lower than we thought during yesterday's day cycle which is good. He then had a second smaller drop just around PM shot time. Since he was given higher carb food during the first couple of hours of the PM cycle last night to slow him down and allow you to get some sleep, it looks like he either had a big food bump from the HC food or he bounced from the lower BGs earlier or a combination of the two in the latter half of the cycle and then started dropping off again this morning. The high carb food would be wearing off (although there might still be some small influence at this point) and a bounce could be clearing as of AMPS. The picture is still not clear but I definitely think the 1u was too high a dose.
Please take a shot of the graph again when you get home today. It will be interesting to see what it looks like having skipped this morning's shot.

 

Wow, really glad there was no shot this am!

 

Yup! That makes two of us. When I saw the post over yonder a few minutes ago, I started to wonder if someone would tell him to shoot at least the half unit again and we'd be no further ahead figuring him out. He may need some insulin....it may even be less than half a unit but I really hope Grant is right and Nigel was incorrectly diagnosed.
It gives me chills to think what might have happened if he had just blindly kept shooting the full unit waiting for the vet to download the information in 10 days.

 

Yeah, that would be a huge weight off my shoulders to find out that he doesn’t need insulin at all. I’m keeping my fingers crossed!