Nutella - Pancreatitis

Hi Suzanne and Darcy,

All is good with Nutella, she might have gained 100-200g, we use a human scale with her with us/without us, but its not exactly accurate, but she increased from 2.4ish kilos to 2.6 ish kilos, she is eating well, pretty hungry, some vomit in the morning, maybe because she don't have much to eat overnight compared to daytime.

Her BG is a bit all over the place, always over 300mg/dl but sometimes we have 300-350 range, but it can go up to 450-480 mg/dl, she still has two days of antibiotics, so Lantus will have to wait a bit
 
It's really good to hear that she's doing so well and feeling better. Just a few more days on the antibiotics! :-) The spreadsheet isn't up to date so I can't see anything recent... last time there was a blue number on April 18. But you said she's pretty high recently?
 
Suzanne & Darcy said:
It's really good to hear that she's doing so well and feeling better. Just a few more days on the antibiotics! :) The spreadsheet isn't up to date so I can't see anything recent... last time there was a blue number on April 18. But you said she's pretty high recently?
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Hii! Just posting some news, she recovered from the infection, no more bladder issues for now and we switched her to Lantus, first day she gave us a bit of a scare with a lower than-usual BG, but I must say her PM/AMPS are much better than before, some days she is sleepy or agitated but overall she is doing well, kept the weight, her numbers are in a second tab dedicated for Lantus tracking
 
She looks like she’s doing well. I’m happy to see it! Be sure to keep up with feeding her small amounts of her regular food at at least +2 and probably also +3 — and other snacks as the numbers warrant it. I like the lower preshot test from May 3. I am wondering how she’s been doing since then.
 
And actually, if you are continuing to follow SLGS then she earned a reduction when her BG dropped below 90 (it was 88 on May 3) - the reduction would have been to .75 units.
 
Suzanne & Darcy said:
And actually, if you are continuing to follow SLGS then she earned a reduction when her BG dropped below 90 (it was 88 on May 3) - the reduction would have been to .75 units.
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Hi! Yes I know, but we were waiting a week to stabilize and make a curve, we just did it and likely we need to reduce, sometimes it's in the 100s but often reaches below 90, then today at the usual time her number was quite low at 130mg/dl, we gave some food and waited now its 240mg/dl, and we did just half a dose to be on the safe side, I'll keep here up to date.
 
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hello,

she is doing ok, injections have been pretty easy since she put some more weight, she is 100g heavier compared to Prozinc time (now 2.7kg/almost 6 pounds), and we can no longer feel her bones, especially on the back, she is really playful, we got a bunch of fake mini mice that she loves, she pats them here and there and carries them to everywhere.

her belly is working ok, she is eating well, somedays she is a bit pickier, so we alternate between two wet foods, one for diabetes and one "normal" high protein, sometimes her numbers are high other it drops a bit lower, recently we reduced the dosage by 0.25, so she is taking 0.5IU lantus that seems nothing but is working
 
I am so very happy to hear that she's gained weight and that she's playful and eating pretty well. That's such heart-warming news. I wish I could see her with her mice toys!

I was looking at her spreadsheet and I do see that she has twice earned reductions (see the lime green numbers on her spreadsheet.) You are using a pet meter, and that means that, if you are following SLGS as it says on your spreadsheet that she would have earned a reduction if she dropped below 90. Even if you are following the Tight Regulation method for Lantus, she also would have earned two reductions because she dropped below 68 on a pet meter. (On a human meter it would be below 50.) So please be careful. She may still be getting too much insulin. When she hit 56 on May 26, her dose should have been reduced to .5 units. Then when she hit 65 on May 29, she would have earned another reduction. But if her dose had been reduced to .5 on May 26, she may not have ever had the second lime green number. You've taken care of it now by reducing her dose to .5 units, which is good. I only wanted you to be aware of the reduction points so that, if she drops below 68 you definitely want to give her the reduction -- unless following SLGS and then it is if she drops below 90 you should give her a reduction.
 
Also, I do hope that you are still keeping up with feeding her in the early part of her cycle. It still looks like +2 hour and +3 hour are good times to feed her a little wet food. It's still necessary on Lantus just like it was on ProZinc.
 
Suzanne & Darcy said:
I am so very happy to hear that she's gained weight and that she's playful and eating pretty well. That's such heart-warming news. I wish I could see her with her mice toys!

I was looking at her spreadsheet and I do see that she has twice earned reductions (see the lime green numbers on her spreadsheet.) You are using a pet meter, and that means that, if you are following SLGS as it says on your spreadsheet that she would have earned a reduction if she dropped below 90. Even if you are following the Tight Regulation method for Lantus, she also would have earned two reductions because she dropped below 68 on a pet meter. (On a human meter it would be below 50.) So please be careful. She may still be getting too much insulin. When she hit 56 on May 26, her dose should have been reduced to .5 units. Then when she hit 65 on May 29, she would have earned another reduction. But if her dose had been reduced to .5 on May 26, she may not have ever had the second lime green number. You've taken care of it now by reducing her dose to .5 units, which is good. I only wanted you to be aware of the reduction points so that, if she drops below 68 you definitely want to give her the reduction -- unless following SLGS and then it is if she drops below 90 you should give her a reduction.
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thanks
you're right, 0.75iu is indeed too much, I guess there were a few FS, I was sure that it was properly applied but still got higher nadir numbers, so we went back to 0.75, same day we got a low number and changed back to 0.5, so now we are monitoring her, she is ok, I guess its too hot lately for her.
 
Suzanne & Darcy said:
What kind of BG numbers have you been getting lately on the .5 units? The spreadsheet isn't updated so I can't see.
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just updated the table, you can see that lately nadir was high, then we changed it got low and now its a bit bouncy, we just skipped PM shot as her number seems to be lowering
 
Normally skipping shots with the depot insulins like Lantus is not usually recommended. Consistency is best. Skipping shots depletes the depot, which then takes a few more cycles to rebuild and your numbers may be wacky for a while. You will probably find tonight that the depot will carry her along a bit in lower numbers for the early part of the cycle, but by morning she will be high. It's not like ProZinc where you can chop and change the dose based on preshots. Having said that, I don't see any tests for the a.m. cycle today so we don't really know what her nadir was and that makes it difficult to know what to do.
 
Suzanne & Darcy said:
Normally skipping shots with the depot insulins like Lantus is not usually recommended. Consistency is best. Skipping shots depletes the depot, which then takes a few more cycles to rebuild and your numbers may be wacky for a while. You will probably find tonight that the depot will carry her along a bit in lower numbers for the early part of the cycle, but by morning she will be high. It's not like ProZinc where you can chop and change the dose based on preshots. Having said that, I don't see any tests for the a.m. cycle today so we don't really know what her nadir was and that makes it difficult to know what to do.
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thanks, we found only strange that it still cycles, so goes up and then down during nadir and back up so this is making us confuse as it looks just like ProZinc, it lasts longer for sure, in the initial curves her period of lower BG lasted for around 8 hours while on ProZinc it was only 1 or 2 hours,

I just gave her half dose 0.25iu and tomorrow we measure her more often, our work has been busy and we were unable to check on her so often lately.
 
hi again

another update, today she had a low number 65mg/dl, what I'm supposed to do? she is already taking 0.25 which is almost nothing, should I half it? it gets really tricky to measure, maybe heat is not helping with the numbers, idk, she is eating and drinking normally
 
Oh. Hi there! Can you update the spreadsheet? I was trying to look at it to see what was happening. So she's down to .25 now?
 
So at what point in the cycle did she hit 65 on the Alpha Trak meter? How long after her shot. It looks like she is doing so well. With a 65, she has earned a reduction. I'm attaching photos of how to draw a dose smaller than .25. Yes, it can be done and some cats need just that tiny of a dose - some while they are headed toward remission :) and some cats, believe it or not, need what we call a "drop" dose. These small doses can really help support the cat's pancreas while it is in the healing stages and can help to ensure a long-lasting remission (if that's what Nutella is up to !)
Fine dose gradations:
  • 0.5U = exactly half a unit
  • 0.4U = skinny 0.5 touching the line
  • 0.3U = skinny 0.5 with daylight under the line
  • 0.2U = fat zero with daylight over the line
  • 0.1U = fat zero barely touching the line
Pictorial guide using a U-100 syringe marked with half units:
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49822973598_f0540f7a37_w.jpg

49822973683_0559ae843a_o.jpg
 
Okay, I can see now that is was +5. Definitely cut her dose down to the 0.1 unit tiny tiny dose. And keep checking her and making sure she's eating (you said well, so that's great!)
 
We just need to keep her on a safe dose, but she still needs to get those preshot numbers down. It definitely looks like she still needs some insulin support. What do you think? Do you think you can draw up the 0.1 dose?
 
Suzanne & Darcy said:
Are you able to give her a snack at +3? Or is she just free-feeding?
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Hi Suzanne & Darcy,

I just would like to let you know that my sweetheart went to her final sleep today, thanks for all the help! she had a good life with us and we loved her deeply, I created a grief support post with some details of the latest weeks that led to today

Thank you again!
 
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