PMPS of 9.3 (around 167). Oh, and constipation.

[Becky and Toby]

Hello, we've just tested Toby and gotten 9.3/167. He's been doing so well and I don't want to miss a dose unnecessarily, but I'm not sure what to do - we've never shot this low. We gave him a measly .25 this morning and he went from 12.8 to 5.4, which is definitely contributing to my uncertainty (full disclosure; I am very paranoid about hypos, but I can't help myself). Should we test again in an hour or so?

Also, if anyone could tell me if I should be concerned, that would be great... I've just come home and have been informed that Toby vomited 'brown' earlier in the day. It's set me on edge (I know, that isn't hard) because he is a little constipated right now. I don't have a sample of the vomit to look at, but I do have a cat who had eaten around half an hour before that, who is eating very happily tonight, and who has managed to pass a very small poop. I'm thinking it was just brown due to food because the other factors point to 'perfectly fine', but I'd really love some input.

Thank you very much in advance.

 

[Amy & Papaya (GA)]

Hi Becky, I just happened to read your post and realized you are unsure whether you should shoot. It would help if you changed your subject line a bit to catch more attention, like "BG 167, should I shoot low? Stalling - Help!" then you'll get more eyes. When you say PMPS the PS part means Pre-Shot, which implies that you DID give the shot after you got that number so I don't think anyone realized you have a question about that. If you didn't shoot yet you can just use PMBG (PM Blood Glucose). Hope that makes sense!

You are doing well with testing so my feeling is you don't need to be too worried about shooting the 167, but I see you are using Caninsulin which I think hits faster and harder than the insulin which a lot of people here use (Lantus), so I'm not sure how much that needs to be considered. Hopefully some who are more experienced with your insulin will chime in, but as long as you are around to keep an eye and test that he doesn't go too low, you should be fine shooting that number. You can always wait half an hour or so and retest if that makes you feel better.

It's not uncommon for cats to vomit if they are constipated. Is he often constipated? Are you giving him anything on a regular basis to help with that?

Please do edit the subject line of your original post to make sure you get lots of help

 

[Elizabeth and Bertie]

Hi Becky,

Given that you don't yet have data about how Toby would respond to insulin at this number, and given the fact that we know he can sometimes drop low, my advice would be to either skip the shot or to test in an hour or so and see if he is at a shootable number then.

Just going to have a quick look at his SS. Back soon.

 

[Elizabeth and Bertie]

Hmmm...

Just looked at Toby's SS, and I'm thinking that even .25 of a unit could be too much to shoot here. This is one of those times where - if it were possible to measure a small enough dose, it could be worth trying a tiny weeny token dose here, just so he has something in his system overnight. But, that should only be done if you can be there to monitor, and presumably you want to go to bed at some point!

I'm in a similar situation this evening. Bertie has given me a PMBG of 7.5, which is not a shootable number for me. So...I'm going to have to skip it and just expect that he may be higher than usual in the morning.

Sometimes with Bert I've found that a tiny token dose can be really helpful in that - even if it's not enough to drop his BG - it can stop it rising too high at the beginning of the next cycle.

Maybe it's time to start playing with some U100 syringes, Becky...?

This is just my 10 cents, but I'm inclined to err on the side of caution...

Eliz

 

[Becky and Toby]

Hi Becky, I just happened...sure you get lots of help

Whoops, didn't occur to me that it would imply that I gave the shot, thanks for the advice. He definitely has some steep drops with the Caninsulin, however, so it's something I'll remember for next time; we're skipping tonight.

As for the constipation, it's an often enough occurrence and he gets Lactulose when he's having trouble, and I'm quite used to him vomiting with it, too - I was just a little concerned by the less than usual colour (for him).

Thanks for the input.

Hmmm...Eliz

He's around an hour and a half late now and I'm going to skip. If I gave him a shot now, it would throw him quite far off his schedule, and I still don't really feel safe doing it. It'll just be a shame if we lose these lower numbers, he's been doing really well... but hopefully that also means it won't be too much of an increase.

I have some U100s on the way to me

Thanks for the advice.

 

[Elizabeth and Bertie]

Hi Becky,

Missing this shot won't mean that Toby will lose the nice numbers (which are looking great BTW!). This is just one insulin cycle, so no biggie. ;-)

He's responding really well to the insulin at the moment (anti-jinx!) so if he's a tad higher in the morning it's likely the next shot will bring him back on track. (Hurrah for sliding scales!)

Sleep well!

I'm off to bed too. I-)

Elizzzzzzz.......

 

[Becky and Toby]

Hi Becky,

Missing this shot won't mean that Toby will lose the nice numbers (which are looking great BTW!). This is just one insulin cycle, so no biggie. ;-)

He's responding really well to the insulin at the moment (anti-jinx!) so if he's a tad higher in the morning it's likely the next shot will bring him back on track. (Hurrah for sliding scales!)

Sleep well!

I'm off to bed too. I-)

Elizzzzzzz.......

I think he'll appreciate the night off from his +4, too

He is. He's also just discovered that he can get on any side in the kitchen now, so the old neuropathy can't be feeling too bad either :lol:

Goodnight

 

[Deb & Wink]

Constipation resolution ideas.

1. Miralax (or generic polyethelene glycol 3350) start with 1/8 teaspoon once a day. Increase as needed to twice a day. My vet told me I could go up to 1 teaspoon twice a day if needed. Increase to the point where the stools are a little loose, then back down on the dose.
2. Psyllium fiber powder. Unflavored, no sweetener. Start with 1/8 teaspoon once a day. Increase dose and or frequency as needed.
3. Plain canned pumpkin or squash. Start with 1 teaspoon once a day and increase to 1T if needed. Never helped my Wink with his constipation but works great if he has diarrhea.
4. Add more water to the canned food. Until the food is the consistency of applesauce (2:1 ration food to water) or even soupy (1:1 ratio) Keeps your cat hydrated and can help with the constipation.

 

[Becky and Toby]

Constipation resolution ideas.

1. Miralax (or generic polyethelene glycol 3350) start with 1/8 teaspoon once a day. Increase as needed to twice a day. My vet told me I could go up to 1 teaspoon twice a day if needed. Increase to the point where the stools are a little loose, then back down on the dose.
2. Psyllium fiber powder. Unflavored, no sweetener. Start with 1/8 teaspoon once a day. Increase dose and or frequency as needed.
3. Plain canned pumpkin or squash. Start with 1 teaspoon once a day and increase to 1T if needed. Never helped my Wink with his constipation but works great if he has diarrhea.
4. Add more water to the canned food. Until the food is the consistency of applesauce (2:1 ration food to water) or even soupy (1:1 ratio) Keeps your cat hydrated and can help with the constipation.

Thank you for the suggestions. I've tried pumpkin before, and it doesn't seem to do anything for Toby either. I may try the psyillium fiber powder... it's also known as pysillium husk, no? I already have some of that, too.


Toby was up to a whopping 10.9 this morning I'm generally happy enough to shoot at that, but as luck would have it we wouldn't be able to test until around +5 and he's definitely being a little odd with his numbers right now, so we skipped again. Going to see what PMBG gives us, and give him at least a 'token' shot... he'll almost definitely manage at least a .25 by then though.

 

[Becky and Toby]

he'll almost definitely manage at least a .25 by then though.

He just loves to prove me wrong :lol: I'm a little bewildered, to be frank... 6.8 this evening. Checked him again, 6.6, so it's legit.

 

[Deb & Wink]

Yes, the psyllium fiber/husk is the same thing. Just be careful not to give one that has any sugar in it. It was hard for me to find one at my local store that was sugar free and unflavored. They had like 10 different kinds but only one without sugar and/or orange flavoring. ohmygod_smile

 

[BJM]

Feline Constipation - a web site devoted to the end of the feline GI tract!

Great explanations of how it all works, plus information for those whose cats have this issue sometimes or all the time.

 

[Elizabeth and Bertie]

...I'm a little bewildered, to be frank... 6.8 this evening. Checked him again, 6.6, so it's legit.

Oooh, lovely stuff! Toby's pancreas is having a nice long run..... (Go Toby!!! bcatrun_gif )

Eliz