Oscar update- keeps dropping lower and lower

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Chloe007

Chloe007

Member Since 2019
Previous thread:
http://www.felinediabetes.com/FDMB/threads/help-dka-kitty-preshot-147.226355/#post-2540039

Updating SS now (should be updated by the time any of you look).

So I keep having to pull back on Oscar's dose, and every day he keeps going lower and lower. I don't like seeing him under 80 (I know you all don't consider that a hypo, but it's lower than I want him especially since I have to leave him for hours at times). Today he dropped into the 50's and it took over an hour of gravy, Karo and stress (drove with him to the ER parking lot just in case I couldn't bring him up). I know I over reacted but he just wasn't coming back up even temporarily from the Karo. Tried honey too. This all happened at the +5/6 mark.

He's at 4u right now, that's what caused the low numbers today so I'm going to pull back even more. Thinking 3.5u, I can't risk this happening again and it feels like everyday he becomes more and more sensitive to his insulin. I think it has to do with the pancreatitis healing, his pancreas is starting to work a little better everyday so we're seeing these drops go further and further despite lowering the dose. Before he got ill, it took 6u to get him to yellows. Now at 4u were getting dangerously close to hypos.

His BG has been climbing since, unsurprisingly. He had a lot of gravy. Really didn't want another ER bill.
If anyone has any further advice on what I should do, or if anyone has experience with numbers dropping quicker than normal after DKA or pancreatitis, please chime in!

On a side note, he saw the vet for a check-up yesterday, she said he looks great. So happy about that!
 
Also, ketone tests have been negative. Except today, I had trouble telling if it was trace or negative. I have a meter coming in a couple days, but until then I'm not sure if maybe I should do fluids or not? I think I may be looking too hard, but it seemed to look a little lighter than a negative would. A little more peach perhaps? This is with ketostix btw. When I tested it against my own urine, it did look almost exactly the same. But I'm still worried since it looked almost between negative and trace.

Wondering if I should do fluids to be safe? He's been eating and drinking like a champ, but I'm just very paranoid these days.

Edit: in fact he's drinking a lot of water. Should I hold off on fluids and just retest next time he urinates in this case?
 
For Prozinc, we don't want to see Oscar <90, or any other cat for that matter.
<90, is an automatic dose reduction for Prozinc SLGS protocol. Reduce dose by 0.25U

With the Prozinc version of SLGS, Oscar should have had a reduction on 3/5 when he dropped to that 80 during the AMPS cycle. You missed this reduction.

3/7 AMPS cycle 78. You should have done a decrease of 0.25U immediately. And you did. You took the dose from 4.25 to 4U
3/8 AMPS cycle 54. You should have done a decrease of 0.25U immediately. You need to decrease again from 4 to 3.75U for this PM cycle.

And if you are comfortable incorporating the "missed reduction" from 3/5 into tonight's reduced dose, you can go down to 3.5U.
 
Deb & Wink said:
For Prozinc, we don't want to see Oscar <90, or any other cat for that matter.
<90, is an automatic dose reduction for Prozinc SLGS protocol. Reduce dose by 0.25U

With the Prozinc version of SLGS, Oscar should have had a reduction on 3/5 when he dropped to that 80 during the AMPS cycle. You missed this reduction.

3/7 AMPS cycle 78. You should have done a decrease of 0.25U immediately. And you did. You took the dose from 4.25 to 4U
3/8 AMPS cycle 54. You should have done a decrease of 0.25U immediately. You need to decrease again from 4 to 3.75U for this PM cycle.

And if you are comfortable incorporating the "missed reduction" from 3/5 into tonight's reduced dose, you can go down to 3.5U.
Click to expand...
I just seen this, but I did reduce to 3.5u, actually a little less. I've read they can be more sensitive to insulin after low readings like he had today. So I wanted to be safe and did closer to 3.25u.

We're at +2.5 and he's already dropped over 200 points. He was above 500 at shot time (came up as HI, I only know it's over 500 but pretty close before that reading he was 471 so I assume he was around 500 and not drastically higher than that). And right now he's at 296. Hopefully he slows down. I should mention he eats throughout his cycle too, food doesn't seem to slow him down. If he's dropping at this rate an hour from now (in the blues) I'm going to offer MC or HC to stop him from dropping into the greens again, I'd like to get some sleep tonight.
 
After that low he had, some med carb food before you go to bed might be a good idea. And leave a little extra out for him. Cats will naturally want to eat if their sugar gets low. Deb has given you the good dosing advice. I think you just might be right and Oscar's pancreas is starting to heal. Just keep an eye on those number and drop the dose as you need to.
 
Yeah he managed to still drop to 90 by +4 on 3.25u (from a BG of 500 at that). And that was with offering him high carb food starting at about +2, I saw how fast things were headed and was looking very close to his last cycle so I wanted to get a head start. It seems to take him a good deal of time to actually work with the carbs he gets from food. It's +6 now and through all the HC I have him safely back up in the 200's, a bit of overkill, but I'd rather that since he's been so unpredictable.
Lowering him to 2.75u tomorrow, not messing around anymore. If I need to raise him later I will, but these huge drops while still eating HC are just not okay with me. I have one more day before I need to leave him during his AM cycle again and I need to know he'll be safe.
@Juls and Billy definitely his pancreas healing, no other way to explain the sudden change in his insulin needs. He's never reacted to insulin like this before..at all. Took 6u to see our first blue before all this. I'm taking this as a good sign though, that he's not as severely diabetic as I first thought when he was diagnosed. I wish the first vet had tested him for pancreatitis, a lot of trouble could have probably been avoided. It'll be interesting to see what his new dose will look like once the inflammation has completely cleared, we get a handle on his numbers and he's off high carb food. Definitely thought Oscar would forever be a "high dose cat".

Didn't get that good sleep I was aiming for, but for sure calling it a night now!
 
It's hard to get good sleep when you're worried about your furbaby. Good call on the 2.75. You're right. If needed, you can always raise it again, but you need to keep him safe from hypos.
 
With that 90 and propping Oscar up with HC food, definitely a good idea to drop the dose again.

He'll undoubtedly bounce for a while.
Chloe007 said:
If I need to raise him later I will, but these huge drops while still eating HC are just not okay with me.
Click to expand...
Those huge drops are not ok with those of us watching from the "bleacher seats" either.
 
In general, cat's are sensitized to the effect of insulin after a symptomatic hypoglycemic event. I'm assuming that Oscar was fine despite lower numbers. As for the "why", sometimes you hit on what is a good dose and all of a sudden, the spreadsheet snaps into lots of greens.
 
Having a small emergency over here.

Oscar got a fur shot this morning. Pretty confident that none went in. I know the rule is to NOT give a second dose, but we're just barely out of the woods on a DKA. He got 2.5u this morning (updating spreadsheet now, this dose only took him down to 180 yesterday from the 400's). But I was being careful with the dose in case he still had some HC in his system.

So anyways, called his vet and explained the situation. They wanted me to give him another 2u right now. He's at 545 at +3. He was at 398 at preshot. Normally he's dropping quite a bit by now. I was too nervous to do 2u, so I gave him another 1.25u. I decided I'll wait another 2 hours and if he isn't at least in the 300's, I'll either give him another .75u, or I'll push back his shot to 5pm instead of 8pm. I know both these are risky, so I took the day off and will be home with him all day. What do you guys think I should do?
 
Monitor. Closely. For at least 12 hours past the time you gave the additional insulin dose.

I'd do hourly testing at least.
Note what you did on your SS.
Please.
 
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