Picchu dropping from 250 to 85 in one hour

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He dropped til 58. I gave fancy feast plus treat wich was lower carb(8%/). I gave him kibbles which was proplan DM which is 16% carb. I gave him churro treat, which i think is mostly water? we finally gave him karo syrup, and some gravy from fancy feast which is the high carb version. He is slowly going back to 74 but he started at 260 2 hours ago and has not been below 225 for the last week outside of once at the ER where he dropped to 127 on fast acting insuline. He seems mobile, alert. less out of it than he was 2 days ago.
 
After your title please put 1-15 Picchu his AMPS # and all the other tests you just took and when you need to update your spreadsheet please.
Tap on Thread Tools to the right then tap on Edit Title and add the numbers , then tap save
 
Also worth mentioning, I think folks with Libre sensors double check the lower readings with a handheld meter. Hopefully a more experienced member will stop by soon.
 
Thanks, unfortunately, I had a human meter but apparently it is battery operated and not working right now. How inaccurate is the Libre? Are we talking about a possibility for inaccuracy that would be a few points or a 200?
 
Tim & Pookey said:
Also worth mentioning, I think folks with Libre sensors double check the lower readings with a handheld meter. Hopefully a more experienced member will stop by soon.
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YES!! the libre always reads low number 10-15 points (BG) less than reality, you can give 1ml of Karo syrup or Honey with a syringe without the needle on the side of the mouth, that should give a quick fix, then give 1-2 tsp of medium or high carbs every 1/2 hour testing before feeding again until safe numbers but do not give too many carbs all at once or he will spiral up too fast as well, and easily spiral down again ,:bighug::cat::cat:keep posting and follow Diane Tylor's Mom suggestion with the SS as soon as possible, for better advice
 
Hello, yes you want to have a handheld meter to double check low numbers.
And you will need to get to know how the Libre compares against your meter.
The Libre CAN read lower than a handheld meter but you cannot assume that's the case. Every cat is different.

When Ivy goes under 50 on her Libre 3, I am ready to test on a handheld (she is usually higher, but I have been using this system for 2.5 years). So you will need to see how your kitty does as a comparison.

Since I think you are using SLGS, you don't want kitty to drop below 90, or a reduction would be earned in your dose, but let's see what advice you are given.

Let's see if we can get some more expert eyes on you @Wendy&Neko @Angela & Cleo @Sienne and Gabby (GA) @Bandit's Mom
 
Thank you, I think we went over board with the carbs. He got karo syrup plus an entire gravy lovers can worth of gravy. so he has been shooting back up to 150 in the last 30 minutes, but it took him a long while for the carbs to stop the drop, usually when he eats any kibbles or wet food, even low carb his BG will go up even a bit. He just kept eating and dropping very fast. Now 60-120 minutes later, he is increasing fast but was plateauing at 100 for a while before that.

This is really concerning, we have not even reached +6 point yet, and I dont know what would have happened if I had gone to work today instead of staying home. of if we didnt have the libre to check every hour and had waited the +3 point. His behavior was normal ish. Now he is a bit tired, that is usual schedule since diagnosis.
 
lantuslantus1234 said:
Thank you, I think we went over board with the carbs. He got karo syrup plus an entire gravy lovers can worth of gravy. so he has been shooting back up to 150 in the last 30 minutes, but it took him a long while for the carbs to stop the drop, usually when he eats any kibbles or wet food, even low carb his BG will go up even a bit. He just kept eating and dropping very fast. Now 60-120 minutes later, he is increasing fast but was plateauing at 100 for a while before that.

This is really concerning, we have not even reached +6 point yet, and I dont know what would have happened if I had gone to work today instead of staying home. of if we didnt have the libre to check every hour and had waited the +3 point. His behavior was normal ish. Now he is a bit tired, that is usual schedule since diagnosis.
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OK! too much carb, the Karo syrup is a quick fix, the gravy can way too much, you are now going to get many high high BGs, , the procedure is test 1/2 hour after Karo wait 1/2hou test again feed 1-2 tsps of carbs , test again, then if Bg is not regulated to safe numbers you start all over again without the Karo. And please do not go by the Libre on low BGs under 70, it will always readd very inaccurately, as well as high numbers if it's too high over 365-400 it will judt read HI, so go slow on increasing the Bg, like I said now you will begin to see radical BGs, because all the High carbs given, this will probably happen all day long, just test every hour especially with a human meter preferably, if you can and compare with the Libre, you will se the gigantic difference in readings, and go by the human meter, we are here for you, take a step back breath in and breath out, cats are very sensible to stress, and he feels yours, And after the BG has risen some instead of high carbs give low or medium carb 1-2 tsp t a time, and no more high gravy carb, you want to stabilize. him:bighug::bighug::cat::cat:
 
Thank you, It was panic all around indeed. It is very impactful to see numbers drop in real time from 220 to 58 within an hour. with the straight dropping arrow next to it indicating a further drop.
Tested Ketones and they are showing negative now. Picchou climbed back up all the way to 226 within < 3 hours.
 
lantuslantus1234 said:
Thank you, It was panic all around indeed. It is very impactful to see numbers drop in real time from 220 to 58 within an hour. with the straight dropping arrow next to it indicating a further drop.
Tested Ketones and they are showing negative now. Picchou climbed back up all the way to 226 within < 3 hours.
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Like I explained too many carbs but you handled it, is the important thing Good job, go back to my last post on how to handle low numbers and memorize it ok?? And 58 BG can be handled at first with just 1-3 Tsp of high carbs(gravy) test 15 minutes later, it will have gotten a bit high then feed 1-2 tsp of low carbs test 1/2 repeat if necessary
Good for you!!:bighug::bighug::bighug::cat::cat:
 
CORKY said:
Like I explained too many carbs but you handled it, is the important thing Good job, go back to my last post on how to handle low numbers and memorize it ok?? And 58 BG can be handled at first with just 1-3 Tsp of high carbs(gravy) test 15 minutes later, it will have gotten a bit high then feed 1-2 tsp of low carbs test 1/2 repeat if necessary
Good for you!!:bighug::bighug::bighug::cat::cat:
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Could you please remove the 911 from your Thread Post, thanks
 
A request, could we all stick to this thread now. There were discussions about today's drop on two posts which makes it hard to follow.

His body is not used to low numbers, he's probably doing what we call bouncing. Annoying to us, but completely normal.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

You also did not need to give as many carbs as you did. But don't worry, almost all of us have over carbed at our first lows. Above 50 is still in the safe zone, so we don't need to give as many carbs at that point. The Gravy Lovers was a good choice, but next time do something like two teaspoons and see how he reacts to that. The karo doesn't need to be given above 50, and I never gave more than a drop. Cats do differ in how carb sensitive they are, so you will have to learn what works for Picchu. Those notes you have in the Remarks section will come in handy to tell you what his reaction is to food.

When you feed carbs, it can take 20-30 minutes to see that reflected in the blood glucose. You don't need to check his numbers every 15 minutes, stretch it out a little.

Since he went below 90 and you are following SLGS, that would mean reducing the dose to 1.25 units.
 
lantuslantus1234 said:
Thank you so much, i can absolutely stick to this thread. He is back to all the way back to HI, seemingly unbothered. Next dose is in 3 hours, i was coming back to ask what to do about dosage, you answered before i could ask!
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lantuslantus1234 said:
Thank you so much, i can absolutely stick to this thread. He is back to all the way back to HI, seemingly unbothered. Next dose is in 3 hours, i was coming back to ask what to do about dosage, you answered before i could ask!
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Stick around there are many more wonderful things to come for Picchu!!:bighug::bighug::bighug::cat::cat::joyful:
 
lantuslantus1234 said:
Thank you so much, i can absolutely stick to this thread. He is back to all the way back to HI, seemingly unbothered. Next dose is in 3 hours, i was coming back to ask what to do about dosage, you answered before i could ask!
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From the SLGS sticky
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately

So it your kitty falls under 90 you would then decrease the next dose by 0.25 units
@lantuslantus1234
 
I’m sorry I wasn’t around when you had all the action. It can be scary the first time it happens.
When it happened the first time with Sheba it was before I joined the forum and it was the middle of the night and she just seemed to be dropping lower and lower and nothing I did would stop it. My daughter had parked in behind my car so I could not get out to go to the vet. In the end I had the whole household awake and that is when Sheba decided to stop dropping. I had given her so many carbs she was feeling decidedly seedy all the next day. I later found she would respond well to a drop of honey. :joyful:
 
I everyone, I am back with some updates. We reduced Picchu's dose to 1.25 and he has not crashed since, but he also not improved much. A few concerning things that our vet picked up on: He is starting to lose balance and the full use of his hind legs, his BG drops quite a lot within 90 minutes of the insuline shot but then climbs back up and just stabilizie around 250-300 for the remaining of the cycle. He seems to be struggling. The last two nights we had to reduce the dose to 1UI (from 1.25Ui) because his BG was dropping fairly quickly prior to injection time.
He is eager to eat at least at some point during the day, but eats very small quantities. He does graze through the day but he is eating very little wet food (that takes a lot of coaxing and tricks which is not sustainable for us) but again in small quantities. I cant spend an hour trying to feed him every meal time, which is what was happening. As a result he probably eats more kibbles (50/50 mix of Purina DM and Dr Elsey, as we transition it to Elsey) than he should, and less wet food.
Today his numbers dropped under 250 for the first time in several days, after a vet visit. and tonight again they dropped to 177 for the first time since he crashed. But the timing of these drops (nadir?) was within 90 minutes of insuline, and it climbs back up fairly quickly (although he does eat when this happens)
I am wondering if anyone would have a take on this pattern. Our vet has shared this is concerning to her and that this could indicate his conditions may be more harder to treat or complicated by other health factor. She indicated we may need to consider making some tough decisions in the near future.
 
Some cats do drop early in the cycle. It doesn’t necessarily mean there is something else wrong. Picchu is still very early on this FD journey and most cats take a while to settle down. I certainly don’t think you need to be making any tough decisions in the near future.
If you find this is happening (dropping early in cycle) you could try feeding a higher carb food at the beginning of the cycle to see if that slows the drops. It is a matter of trial and error to see what works for you. keep asking questions and don’t get disheartened. Remember it takes time. :)
 
Bron and Sheba (GA) said:
Some cats do drop early in the cycle. It doesn’t necessarily mean there is something else wrong. Picchu is still very early on this FD journey and most cats take a while to settle down. I certainly don’t think you need to be making any tough decisions in the near future.
If you find this is happening (dropping early in cycle) you could try feeding a higher carb food at the beginning of the cycle to see if that slows the drops. It is a matter of trial and error to see what works for you. keep asking questions and don’t get disheartened. Remember it takes time. :)
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It took me 3,years to stabilize Corky his numbers have been in 70-90 sine only mid las year. he went to bed last in the low 70’ and woke up this morning with 161 and it has happened the opposite as well, consistency what I am feeding and dosing, the same quantity on each shot is what has worked for me Corky’s, but it has taken 3 years so not give up or despair I know it can be frustrating thinking what are we doing wrong or what’s wrong with our cats, every cat is different and react differently when dosed, they like to keep us on our toes they are like a Pandora’s box . :bighug::bighug::cat::cat:
 
lantuslantus1234 said:
Thanks, unfortunately, I had a human meter but apparently it is battery operated and not working right now. How inaccurate is the Libre? Are we talking about a possibility for inaccuracy that would be a few points or a 200?
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Very inaccurate when it comes to low numbers, it can easily be 80 and shoe 50's I went thru that experience, and I found it out when I got the ReliOn human monitor and strips (no batteries), I tested with both and the difference was overwhelming I had the libre monitor alarm on 90, and before I knew It was going off and reading low 50-40's
 
I think most cats take a while to even out—certainly NOT a reason to make “difficult decisions”. This is even more true if you are basing his numbers on a Libre which is notorious for having huge differences at both high and low readings and if the cat lays on the sensor—and as a human meter it isn’t going to be completely accurate for a cat. These values should be checked with a hand held meter. IMO if the numbers are what’s driving a “difficult decision” then it should be a hand held pet meter since they are much more accurate and if you are even considering “difficult decisions” I’d be accurate.

I have a cat with an adrenal tumor which makes him very difficult to regulate. While rare, he is my second cat with such a tumor. My previous boy, Erik, was never well regulated and lived a happy three years but died during surgery for his tumor. My current boy Methos I hope makes it at least that long.

lastly if it is not libre error, but your cat actually is having a big drop at +1-1.5 and then poor control the rest of the cycle you should have the vet clinic supervise you give some shots. Injecting Glargine into muscle (as opposed to sub q) results in a sudden use of the entire dose rather than a delayed release, so you get a huge drop of short duration. That can be fixed with lessons in proper technique.

finally a cat with a history of dka needs to eat especially when glucose so high. It is more important that they eat than that they eat “the right food”. Please make sure he is eating even if not wet food.
 
Long time libre user here! :) I know these drops are very scary, but take them with a grain of salt. The libre tends to read much higher if the bg is high and much lower if the bg is in a lower range. It's good if you start to double test with a handheld to get a feel for it. Most likely the 85 was something well over 100. And on the other hand the 250 could have been lower on a handheld. If you take that into account, the drop is not that scary anymore. Use your time with the libre to get the hang on testing with a handheld and start comparing numbers. Please don't make any decisions based on libre numbers, as @SmallestSparrow said.

You can also have a look on Binies SS. You will see that most of 2024 we measured with a libre. In December we had to change to handheld because Binie developed a skin condition which has to heal, before I put on a new one. You will see her curves are much more flat now with the handheld. You will also find many readings in 2024 where I compared handheld and libre. So it demonstrates what I was writing above. Hang in there. It will get easier! :bighug::bighug::bighug:
 
Hi everyone, It has been a rolller coaster of a week. First the vet visit which seemed to be pretty bad news. Then in the same day his number dropped much lower than they had in a while. (<200, but at a very rapid pace, and not for long, and early in the cycle. We had a couple nights where we had to reduce the dose to 1UI from 1.25 UI as he was much lower than usual and was dropping rapidly, not eating great.
Since then,
  • I cant seem to really see a pattern in his numbers anymore, outside of they are back to higher, and dont drop under 350 very frequently or at all
  • Had to stop Dr elsey kibble which was making him vommit (Anecdotaly: the first time he got hopistalized was also because he vomitted a lot after eating a sample of Dr Elsey kibbles)
  • Potential signs of his pancreatits flaring up: he did vomit once more over the weekend, but was hungry, ketones were testing fine.
  • He is either fine eating some wet food/hungry or is refusing wet food altogether and only wants kibbles. It could be based on the variety but also seems to be depending on how he is feeling.
  • He is licking his new sensor quite a bit, worried he will pick at it. Appointment at the vet for it made him miserable but we have no doubt at home pricking will be worse so we will have to stick to Libre for now.
  • He is hungry but not eating a lot, grazing, no large portion at once (usually 1/4 oz of wet food or 1/8 cup of kibbles) . Drinks a lot, but started needing company when drinking.
  • There are days where he does not seem to feel great, sleeping a lot/lethargic, sometimes looking like he may be in pain or out of it, etc.. where we wonder if it is worse than just what we know and can tell. and then right after, he will play a bit with us, explore, walk around. Today is not so great energey wise, yesterday was a decent day. I have not yet seen a pattern between his numbers and how he feels, although maybe when he drops super quick he is more out of it.


    I am not sure what our next steps should be. It has been 12 days since we reduced from 1.5UI to 1.25. In that time frame we had 3 occasions where we reduced to 1UI due to lower numbers pre shot. Not sure if we should try 1.5 UI again or if we should wait and let him settle more. I will be going back to work next week and wont be able to monitor as closely.. this is making me really nervous.
 
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lantuslantus1234 said:
Hi everyone, It has been a rolller coaster of a week. First the vet visit which seemed to be pretty bad news. Then in the same day his number dropped much lower than they had in a while. (<200, but at a very rapid pace, and not for long, and early in the cycle. We had a couple nights where we had to reduce the dose to 1UI from 1.25 UI as he was much lower than usual and was dropping rapidly, not eating great.
Since then, we have had :/
  • I cant seem to really see a pattern in his numbers anymore, outside of they are back to higher, and dont drop under 350 very frequently or at all
  • Had to stop Dr elsey kibble which was making him vommit (Anecdotaly: the first time he got hopistalized was also because he vomitted a lot after eating a sample of Dr Elsey kibbles)
  • Potential signs of his pancreatits flaring up: he did vomit once more over the weekend, but was hungry, ketones were testing fine.
  • He is either fine eating some wet food/hungry or is refusing wet food altogether and only wants kibbles. It could be based on the variety but also seems to be depending on how he is feeling.
  • He is licking his new sensor quite a bit, worried he will pick at it. Appointment at the vet for it made him miserable but we have no doubt at home pricking will be worse so we will have to stick to Libre for now.
  • He is hungry but not eating a lot, grazing, no large portion at once (usually 1/4 oz of wet food or 1/8 cup of kibbles) . Drinks a lot, but started needing company when drinking.
  • There are days where he does not seem to feel great, sleeping a lot/lethargic, sometimes looking like he may be in pain or out of it, etc.. where we wonder if it is worse than just what we know and can tell. and then right after, he will play a bit with us, explore, walk around. Today is a day without, yesterday was a day with. I have not yet seen a pattern between his numbers and how he feels, although maybe when he drops super quick he is more out of it.


    I am not sure what our next steps should be. It has been 12 days since we reduced from 1.5UI to 1.25. In that time frame we had 3 occasions where we reduced to 1UI due to lower numbers pre shot. Not sure if we should try 1.5 UI again or if we should wait and let him settle more. I will be going back to work next week and wont be able to monitor as closely.. this is making me really nervous.
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@Sienne and Gabby (GA)
 
lantuslantus1234 said:
Hi everyone, It has been a rolller coaster of a week. First the vet visit which seemed to be pretty bad news. Then in the same day his number dropped much lower than they had in a while. (<200, but at a very rapid pace, and not for long, and early in the cycle. We had a couple nights where we had to reduce the dose to 1UI from 1.25 UI as he was much lower than usual and was dropping rapidly, not eating great.
Since then,
  • I cant seem to really see a pattern in his numbers anymore, outside of they are back to higher, and dont drop under 350 very frequently or at all
  • Had to stop Dr elsey kibble which was making him vommit (Anecdotaly: the first time he got hopistalized was also because he vomitted a lot after eating a sample of Dr Elsey kibbles)
  • Potential signs of his pancreatits flaring up: he did vomit once more over the weekend, but was hungry, ketones were testing fine.
  • He is either fine eating some wet food/hungry or is refusing wet food altogether and only wants kibbles. It could be based on the variety but also seems to be depending on how he is feeling.
  • He is licking his new sensor quite a bit, worried he will pick at it. Appointment at the vet for it made him miserable but we have no doubt at home pricking will be worse so we will have to stick to Libre for now.
  • He is hungry but not eating a lot, grazing, no large portion at once (usually 1/4 oz of wet food or 1/8 cup of kibbles) . Drinks a lot, but started needing company when drinking.
  • There are days where he does not seem to feel great, sleeping a lot/lethargic, sometimes looking like he may be in pain or out of it, etc.. where we wonder if it is worse than just what we know and can tell. and then right after, he will play a bit with us, explore, walk around. Today is not so great energey wise, yesterday was a decent day. I have not yet seen a pattern between his numbers and how he feels, although maybe when he drops super quick he is more out of it.


    I am not sure what our next steps should be. It has been 12 days since we reduced from 1.5UI to 1.25. In that time frame we had 3 occasions where we reduced to 1UI due to lower numbers pre shot. Not sure if we should try 1.5 UI again or if we should wait and let him settle more. I will be going back to work next week and wont be able to monitor as closely.. this is making me really nervous.
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A good step would be confirming what appears to you to be low numbers in light of the inaccuracy of a Libre. I suggest: if you think it’s low, look at the cat. How is he acting? If he’s laying down, shift his position so he is definitely NOT on the side with the Libre. Does the number rise? If he’s wearing a shirt or top, remove it. Does the number rise. As I’ve said, any amount of pressure on or around the Libre makes it report as a low number when it is not low. Ideally, you would confirm this perceived low number with a hand held meter (and since there is so much concern over low numbers, make it an Alpha Trak or other pet meter because any human meter will give you falsely low numbers and just make you anxious over nothing). Just because he has a Libre doesn’t mean you cannot continue to try to improve your skill at testing with a meter. Because the low numbers in a Libre are a false reading due to using a human meter on a cat, plus reading interstitial fluid rather than blood, plus the fact that any pressure on the sensor make it read low—you are going to continue to be nervous about numbers when they are likely normal.

also are there missing numbers? Because I see only one green number —and it’s surrounded by much higher numbers so could easily be libre error.

I don’t know what they will suggest to you regarding your dose—it’s too bad it wasn’t increased this past weekend so you could have stayed home for reassurance. Good luck with the testing with a hand held meter—if you have problems ask and lots of people can give advice. I think you confirming for yourself it’s Libre error with a hand held meter is the only way you are going to believe that the Libre reads falsely low.
 
There’s another alternative. I’m getting the impression testing Picchu is stressing you out. And seeing the Libre numbers is stressing you out. Have you considered that rather than following the dosing schedules here, that require testing and adjusting Pichhu’s dose, that you instead talk with his vet and explain you just can’t manage testing? Many vets don’t require it. They can set a dose for Picchu that would be safe for you to give and lead a less stressful life. It wouldn’t be as perfect perhaps as the dosing here (that could be debated ) and as time goes on you could always start to home monitor.

many cats lead long happy lives on insulin with less tight control —it does have some risk to their health perhaps, because it may stress their kidneys a bit more—but it isn’t etched in stone that you’d have to remain using loose control.

you are not a bad pet parent if you can’t handle the testing. You can give him a happy life without stressing over hourly glucose readings. Consider telling your vet the problems you have—he may be happy to just put a Libre on whenever he needs to adjust Picchus dose and the rest of the time let you give the shots, and perhaps check his urine occasionally for ketones and glucose.
 
SmallestSparrow said:
A good step would be confirming what appears to you to be low numbers in light of the inaccuracy of a Libre. I suggest: if you think it’s low, look at the cat. How is he acting? If he’s laying down, shift his position so he is definitely NOT on the side with the Libre. Does the number rise? If he’s wearing a shirt or top, remove it. Does the number rise. As I’ve said, any amount of pressure on or around the Libre makes it report as a low number when it is not low. Ideally, you would confirm this perceived low number with a hand held meter (and since there is so much concern over low numbers, make it an Alpha Trak or other pet meter because any human meter will give you falsely low numbers and just make you anxious over nothing). Just because he has a Libre doesn’t mean you cannot continue to try to improve your skill at testing with a meter. Because the low numbers in a Libre are a false reading due to using a human meter on a cat, plus reading interstitial fluid rather than blood, plus the fact that any pressure on the sensor make it read low—you are going to continue to be nervous about numbers when they are likely normal.

also are there missing numbers? Because I see only one green number —and it’s surrounded by much higher numbers so could easily be libre error.

I don’t know what they will suggest to you regarding your dose—it’s too bad it wasn’t increased this past weekend so you could have stayed home for reassurance. Good luck with the testing with a hand held meter—if you have problems ask and lots of people can give advice. I think you confirming for yourself it’s Libre error with a hand held meter is the only way you are going to believe that the Libre reads falsely low.
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Your frustration is understandable I had the Libre as well while Corky had the Libre at first, those sensors are extremely unreliable, I went thru 10 the first 2 weeks, I had the monitor alarm for low numbers on 90 and in the middle of the night the alarm would go off reading in the 30s 40s and 50s, nit until I purchased the ReliOn monitor and strips, that he had the last one on, I tested with both and the libre was either too high or too low, so many sleepless nights, and so much crying. it is not my intention of making you feel bad, but if you want to have sleep and less stress, home test with a human monitor, you are going to be a much happier person believe me:bighug::bighug::bighug::(:cat::cat:
 
Thanks everyone, really appreciate the time you are spending helping us. Based on your feedback, I will check his position when the numbers drop. We did hear from the vet when they placed the new sensor that the libre was reading 50 higher than their regular meter. We will consider manual checking. Our vet is actually not super familiar with the Libre, that was installed at the ER, and she is much more comfortable with a low tech approach so that is also an approach we could consider. In fact, when he first started on Insuline, there was no mention of us having to test him at home. That only became a thing after he got discharged from the ER. The new sensor is good til 2/6 so maybe that will be the time to drop the Libre.

I heard back from our vet who gaves us 2 options: going up to 1.5UI and monitor very closely and getting him tested at the office (fructosamine) or sticking to 1.25UI and get him tested after he has been on that dose for 2 weeks straight (02/05). She also agreed that as long as he continues to have more good days than bad days, it makes sense to keep up with the treatment. I wonder what effect the insuline has on him too. Often after he gets his injection, he is very sleepy. Maybe it is a question of time of the day (8 am, 8pm) though.

As far as numbers missing, I am not sure? If anything I thought I was tracking too much. He has only been below 100 once and that is when he was crashing very quickly from 250 to 58 within 1-2 hours (and he was not laying at the time). Historically, his "normal" labs showed him around 100. His diagnosis labs showed him over 500. He now tends to hover around 300-350 with insuline. We have seen him drop to <200 not for very long a few times and usually at the beginning of his cycle. He also started to drop about at +11 if he has not had food for a while.

@SmallestSparrow you could not be more right, the situation has been really really stressful and we are naturrally anxious people. Neither of us have had a good night sleep in 3 weeks, there are nights where I will sleep a couple hours, wake up because he seems unwell/there is some issue/worry about his eating and try to fall asleep again only to not be able to. We have not left the house much either. Emotionally, he goes from looking ok to unwell and it is really weighing on us. We worry frequently about whether he is eating enough, the right food, not too many carbs..We constantly hover between feeling guilty for even thinking about having to make a tough decision, and feeling guitly for not considering it enough.. I dont want him to suffer needlessly. Preparing ourselves while giving him a fighting chance. He is behaving so differently from 3-6 months ago, or even a month ago. I see the advice on the board and that diabetes is very treatable and it makes us feel positive and then I look at how he is behaving and I wonder if I am wishful thinking. With the pancreatits and the mass on his liver, we know it is an uphill battle and a potential ticking clock (his sister passed away from a tumor a little more than a year ago) and then I remember some of the members also had cats with a mass on their liver and they were fine for several years. I am also going away for work for 2 weeks next week and that is weighing on me (my spouse wil handle the care).

What is for sure, is we need to make some changes so that we can be calmer caregivers for him over the long term.
 
I’m so sorry for the loss of Picchu’s sister. I’m sure that’s adding to the stress you feel now.

Caring for a cat with diabetes can make anyone despair and be obsessive —even more so those who tend toward anxiety. This is so normal. I’m not generally anxious but I cried nearly nonstop for a month. I felt certain my cat would die because I wasn’t good enough. A lot of it was motivated by seeing his numbers. Thirty years ago I had another diabetic cat. Back then the vet set a dose after a curve, and we just gave it. We’d check urine occasionally at home for ketones and glucose (don’t want to see ketones, do want a trace of glucose) and come in for dose adjusting every 6 wk or so for dose adjustment, sooner if I saw a change in his weight or drinking/peeing. In fact I drove across country with him a couple of days after his diagnosis. I gave him his shots twice a day—in the am I’d shoot, kiss his head and walk out the door for work. I’d return before dinner, and sleep after his pm shot. Ignorance was bliss.

My goal for methos is to get him to a dose that’s good enough (which is more difficult without testing because of his tumor) and then be a lot more loose. You might start out loose and stay there, or maybe try tighter control later.

following the tighter control here you want to know the numbers but vets are usually happy to just give you a safe dose that lets you and the cat relax. You can still come here for support and advice (other than dosing)

I have another suggestion (not sure if I mentioned before): consider looking for a pet sitter with cat diabetes experience —many are also vet techs—(or seeing if you could pay for some visits by a tech from your vets office) for a few visits. When methos was first diagnosed I asked my sitter—who is a vet tech—to come give some of his shots because I felt his numbers meant I was doing it wrong. I would have paid anything to know he was actually getting his insulin.

the first night she came I cried in relief to know he got a correct shot. I slept for the first time in days. She was leaving town but arranged for a coworker to come three more nights spread over a week. It made all the difference. I knew even if I messed up his shots he would definitely get a good shot in X amount of hours. The tech would always look at him and reassure me he looked hydrated and healthy (and that sound is just purring :rolleyes:)—I got to see them give shots and have them see me give shots. I slept so good the nights they gave him his shots.

I also got to see that his sugars were all over the place even when they gave the shots. Because it was early in his treatment. Marathon remember. This may be good when your spouse is by themselves with this.

you can do this —let your vet help you.
 
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Oh I also meant to address the drowsy after shots. This is just anecdotal, based on Methos. I was used to him being super active in the morning—jumping on me, pacing around etc. (he was about 17 when he started insulin). The first morning after he started I woke up before he did. I was alarmed. I looked over and he was just sitting there looking at me. I gave him his insulin that morning and he fell asleep. Of course I worried I’d killed him. I was constantly shaking him awake. Or I’d shake the treat box and he’d look up expectantly (sorry buddy these are only for the other cat now)—I’d apologize and say “just checking”. Something had to be wrong, right?

i texted my vet—“what am I doing wrong?” I asked. “He’s sleeping. He’s just sitting there in the morning before breakfast and he falls asleep after his shot!”

she replied “he’s a cat. He’s an older cat. He’s now more comfortable. Before, with the uncontrolled diabetes, he was starving. Of course he was more active, he needed food all the time. Now he can rest”

perhaps this applies to Picchu—you can ask your vet
 
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lantuslantus1234 said:
We have not left the house much either. Emotionally, he goes from looking ok to unwell and it is really weighing on us.
Click to expand...

I can totally relate to this. Petey is newly diagnosed too and I often have to remind myself that before he crashed I didn't question everything he did or didn't do, we didn't even know he was sick until he was really sick.

I'm a naturally anxious person too, this is very stressful but I'm less stressed than I was, doing things I didn't think I could do (so many ear pricks) and with the help of this group I'll stress less and less while Petey gets better.

Cats always sleep a lot, and they need to sleep even more so their little bodies can heal, so it's not necessarily a bad thing and I remind myself it will take time.

When I first got here someone sent me this, and it was just what my heart needed at the time :bighug::bighug:
http://www.felinediabetes.com/dear-mom.htm
 
lantuslantus1234 said:
We worry frequently about whether he is eating enough, the right food, not too many carbs..
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More things I forgot to address. If you are stressing over food, in the beginning if your vet is ok with his diet then please stop obsessing. Make any changes the vet needs then let him get settled on his insulin dose—if he tolerates a very gradual diet change that’s great—if he doesn’t then let him eat what he will. Let your vet know if you’re changing his food because that will influence the “safe dose” she is setting for you since you won’t be monitoring his BG. But make sure he’s eating. Cats who’ve had DKA and arent controlled yet need to eat because their bodies aren’t getting what they need yet from their food.

what did they say about the liver mass? Did they say it was benign? Methos has one (it’s not the tumor that’s causing his problems) and I was told many cats have benign (not cancer) tumors in their livers. Maybe this is what Picchu has. I was told those don’t bother the cat. In humans often we find small abnormalities on ultrasounds or CT/MRIs. We call them incidentalomas, meaning we find them on tests and they don’t mean anything significant.

Picchu is getting over a major illness, being treated for a major illness (that is very treatable), and isn’t young anymore. The older a pet (or human) is, it takes more time to bounce back—give Picchu time. If you’ve ever been really sick, or had surgery, you know it takes a while to be back to your old self. The body heals in its own time, so do what you can to support him but don’t see it as a failure (by you or him) if it’s a long process.
 
SmallestSparrow said:
More things I forgot to address. If you are stressing over food, in the beginning if your vet is ok with his diet then please stop obsessing. Make any changes the vet needs then let him get settled on his insulin dose—if he tolerates a very gradual diet change that’s great—if he doesn’t then let him eat what he will. Let your vet know if you’re changing his food because that will influence the “safe dose” she is setting for you since you won’t be monitoring his BG. But make sure he’s eating. Cats who’ve had DKA and arent controlled yet need to eat because their bodies aren’t getting what they need yet from their food.

what did they say about the liver mass? Did they say it was benign? Methos has one (it’s not the tumor that’s causing his problems) and I was told many cats have benign (not cancer) tumors in their livers. Maybe this is what Picchu has. I was told those don’t bother the cat. In humans often we find small abnormalities on ultrasounds or CT/MRIs. We call them incidentalomas, meaning we find them on tests and they don’t mean anything significant.

Picchu is getting over a major illness, being treated for a major illness (that is very treatable), and isn’t young anymore. The older a pet (or human) is, it takes more time to bounce back—give Picchu time. If you’ve ever been really sick, or had surgery, you know it takes a while to be back to your old self. The body heals in its own time, so do what you can to support him but don’t see it as a failure (by you or him) if it’s a long process.
Click to expand...

Early in the beginning I was told " take a step back, Breath in and Breath out, cats are very sensitive to stress, we stress they stress" I apply these wise words as often as I need to, so far so good!
 
I have a couple of thoughts.

First, in response to Colleen's suggestion, home testing, regardless of whether it's a Libre or a glucometer, is the only way you can keep your cat safe. Cats are not people and don't tell you if their blood glucose is dropping and they generally can't go into the refrigerator or cabinet to get a snack. Yes, home testing can be stressful for your cat and for you especially in the beginning. The alternative can be heartbreaking. We had a member who's cat went into remission. A couple of years later, the cat fell out of remission. The member was not diligent about home testing figuring she knew her cat. We were screaming about her lack of home testing. She returned home to a cat who died from a symptomatic hypoglycemic episode. I may be a fanatic about testing but I never want that to happen to another member. You and Picchu will be able to manage the stress and get comfortable. Home testing can save a cat's life.

Looking at Picchu's spreadsheet, you're not really following SLGS. You need to evaluate the dose every seven days. It looks to me like your cat needs a dose increase.

Can you keep track of what the variety of food is (e.g., chicken, beef) that you're feeding when Picchu vomits? Also, check to see if the food contains gluten. He may have a food sensitivity.

And finally, (I know I'm nagging), can you note that you're using Lantus on your spreadsheet in the block for Current Insulin? You don't need the dose -- the spreadsheet needs to indicate which insulin you're using.
 
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