Overwhelmed Mom

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Georgesmom said:
Ok skipping shot and he has the most terrible squishy poo. Just ordered some FortiFlora, hope it arrives soon.
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Food changes done quickly may cause diarrhea. The FortiFlora may help, as may a teaspoon or two of plain yogurt with active cultures in it (if not milk intolerant!)
 
Had a few good days, but we seem to keep hovering in the mid 300's. I know I need to get some night numbers. Will attempt this week to do so.

George's Sheet

Recommendations?
 
Definately want to know whats going on at night - last night he went to 149 and I wonder if he kept dropping. Next time you see something like that drop I would strongly recommend you set the alarm for another test in an hour or two because its very likely he is dropping low.. and if he goes under 50 then we dont want to increase his dose - we will be decreasing!!

Plus if he did drop low last night then he may be bouncing for the next day or two

Wendy
 
I will get some additional numbers today and tomorrow.

He is putting on weight and his coat looks great.

Not drinking or peeing nearly as much as he was. Seems like this aspect is almost normal now.
 
Well, sounds like some of the clinical signs are improving. Now, if we could only get the BG's to come down. :YMSIGH:

Come on George, we know you have it in you to show your mommabean what you can do with that insulin! Work that juice!
 
Would be wiling to add a teeny bit more data to your signature? Like insulin you are using, and meter. Diagnosis date, your name and cat's name , food you are feeding would be nice to see also. Thanks for considering this.

You've gone to a second page, so it takes some hunting to find out this information.

Looks like George is still bouncing from that furshot. He get's down to the blues ok, but then shoots back up. Because of that fur shot, I think you need to hold the dose for a bit to see how he settles out. I do think an increase is in George's future.
 
I am thinking too that George may be consistently going low at night...The thing is that if he is dropping low at night you need to know how low - is it under 50? If so , he would need a decrease. If not, he may need an increase. But without knowing for sure its hard to know.

Like last night you saw two dropping numbers - its a shame you didnt get another test around +7. Maybe next time you see that trend? Or for a couple of nights get a PMPS +3 and sleep till + 9 and get a test then?


Wendy
 
Hmm.. If he did drop low the night of the 8th then he could be bouncing for up to 72 hours. (bounces explained below). So I would wait one more day. If you start to see him drop into blue I would strongly recommend you start to test every couple of hours, more if he hits green. Even if its overnight (sorry).

Reason I say test more is we need to see how low he is going... because if he is dropping below 50 we would want to decrease!. However if he isnt going anywhere under 100 then on Thursday morning I would increase.

Wendy

Bounces - what are they and is my cat doing them?
When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
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Wendy - thanks for the info on the bounces.

I am trying to be real vigilant with our schedule and I will do my best to get some overnight numbers. Should have gotten one at 3:00am when he woke me up for food!
 
I uploaded new numbers.

I have not been able to stay up over night with him to do overnight readings. Will try in the next few days.
 
OMG. I just got a green reading on George at +5 today!! I am shocked! I checked it twice to make sure the meter was right. :shock:

I guess I need to do over night numbers asap to see what is going on!

He is maintaining his weight and acting a lot more playful lately. Peeing is down and his drinking is as well.

Keeping my fingers crossed we are on the right path here.

On a side note, what do people feed/give their cats for hairball prevention?
 
;) Can you get a test in an hour? It may drop further!

I put a small dab of vaseline on my cats paw to help with hairballs. He licks it off.
 
And now you have an estimate of where his nadir is likely to be.

Nice green!!!
 
Been a while. I have updated our sheet and did a few overnight readings. (Which seem to be mixed).

Clinically he is doing great. Eating well and gaining his weight back. He is drinking, peeing, pooing all normal. He is playful and has started sleeping in our bed again.

His numbers seem to be consistently in the 300s, which is still high, but he acts like his old self..... I am not sure which way to go with the insulin at this point. The overnight readings don't give me a real clear path. I am going to try to get some more numbers. What are good intervals to do overnight?

Thanks for the assistance!!
 
You really need to see how low he is going, as that is how Lantus doses are usually adjusted.

Any tests you can get from +5 to +7 hours after the shot are helpful in checking this. (Some folks set the alarm clock to check!)
 
I agree with BJ, he may well need a dose increase but its impossible to tell without checking he isnt dropping too low during the day or night..
 
ahahah!! so its unlikely that the 95 is the lowest number he had all day. I think you need to do more tests during the day to try and see how low he is going! I would have gotten another test in an hour if I had seen that 95. You want to see how low he is doing because if he drops under 50, you want to decrease the dose by 1/4 unit! And decreases = good.

So I suggest, over a period of 3 days try and test every 3-4 hours (more often if you see blue or green). The reason I say do it for 3 days is that if he is dropping too low he could bounce for up to 72 hours and you want that bounce to clear.

Wendy
 
I upped his insulin thinking that was the correct thing to do because I was getting some high numbers in between the shots. Don't think it is doing any good.

He is doing so well clinically, if I was not taking readings I would not think he was diabetic. Everything seems almost back to normal for him. Perky, wants to play, pee and water consumption is normal. Sleeping the bed with us again on a regular basis. Seems like his normal self.

I am going to be more vigilant this week and take more readings. I really need to get him under control.

My vet and I just had words. I am mad that a vet would be mad at me for taking control of my cat's diabetes. Sorry that we have not been in to do your expensive curves lately.... Finding a new vet that will work with us.
 
Since you are home testing, you can do your own curves and save yourself a lot of money and get more accurate readings in that less stressful home environment. Vets don't like it because of the liability issues plus it's a loss of revenue for them.

Sorry to hear your vet is not cooperative and on board with your diligent care of George and your desire to get him feeling his best. New vet on the horizon as you said.

The clinical symptoms, or what we call the 5 P's (purring, preening, playing, pooping, peeing) do sound like they are improving and George is sounding more like his old self. Remember, a cat is more than their BG readings.

How is his appetite these days?

It's difficult to know what to suggest without seeing some more mid-cycle numbers, to see how low the insulin is dropping George. Even sometimes, a test at night, just before you head off to sleep can help to fill in the big picture and give us more of an idea of what is happening here and see some sort of pattern.

Do you think you could try for a regular before bed test?
 
Thanks for the support. I just cried my eyes out this afternoon.

His appetite is good. Eating and pooing are normal. I would say all 5 Ps are pretty much back to normal.

I will definitely add a routine night time reading. I hope to be able to do some overnight numbers as well this week.

Thanks to all for the help and guidance!
 
Updated his numbers from last night - 58 at +4!!! I took it a few times to make sure.

This morning was a good number. I went down to 2 on his insulin as I don't think that pushing him up last week did him any good.

Going to keep getting more numbers at night, as I think that is when he dips the lowest.
 
Those low numbers can be a shocker! Not surprised you retested to double check.

Good catch on that +4 58 BG last night! George probably dropped even lower later in the cycle, so a drop in dose today was a good call. Personally, I'm not a stickler for a drop below 50 to earn a dose reduction. We don't know for sure, but I suspect George did drop below 50.

Don't be surprised if George has high numbers for a few cycles. With the low of 58, it's very likely he will bounce. A bounce can take up to 72 hours or 6 cycles to clear. Be patient and try to hold this dose for a few more days. Well, that is unless George has other ideas and drops below 50.

My crystal ball sees more tests at night to find how low he is dropping.

I see you have been noting suspected fur shots on your SS. Any way we can help you to try to reduce the number of those fur shots? Perhaps, review what you are doing for the shot or suggest a different needle length or tenting method?
 

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I had a few lousy shots this past week. I swear I get the needle in and get a good shot then I pet the area I just shot and smell my hand for the insulin, and if I smell it then I give myself a big smack angry(2)_cat and figure it was a fur shot....

I just need to get his fur better matted down so I can better see the needle.
 
I always preferred the shorter needles. Less chance of poking the needle out the other side of the tent of skin.

You could always try cutting or shaving a small patch of fur along his sides, to help you see better.

I think I was lucky with Wink. He was in such horrible shape, the shelter had cut out some patches of fur, plus his BG's were so out of control that his fur was patchy and spotty because it had just fallen out. Very easy to see down to the skin. Once his fur started to grow back, it was more of a challenge. Plus, Wink was skinny so it was easy to tent up the skin. That tenting is harder to do when there is more of a fat layer.
 
Met our new vet today and she is very supportive of our test at home method!!

She agrees with getting more overnight numbers and suggested a reduction in the insulin as well.

So happy!
 
I updated his sheet. Numbers are still high and all over the place.

Vet wanted me to reduce his dose which I did. We went down to 1.5.

He is at the vet overnight tonight until Thursday for medical boarding (have a business trip and hubby doesn't do shots). :sad:

I like the new vet, just still worried about the numbers. (Even thought clinically he is doing great!) The vet even said he was in great condition for being a diabetic.
 
I am glad he is doing well but I honestly think his numbers are too high and I hope you are regularly checking his urine for ketones.
We want him spending more time in yellow blue and green. However he could be doing this at night and bouncing up again for pre shot. Remember the lantus curve... and many cats drop lower at night than during the day as you have seen...

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.


Wendy
 
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