Shaikha - dose suggestions after hypo?

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wombat88

wombat88

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At +9 she's already up to 237, an increase from 125 at +7. I think we're likely on the start of a zooming trend as her liver kicks into gear after her hypo this morning. I didn't give insulin at +8. Should I wait until the PMPS to give her insulin after her ordeal this AM? And if so, what should I give? I'm thinking about 0.5 or 0.6U. I don't want to cut her back too much, but on the other hand the hypo sheet says they can be more sensitive to insulin after a hypo episode. I've never had to deal with one so do not know what to expect.

Advice welcome. I assume it is okay to feed her even if I don't shoot now?
 
What a crazy day Wendy! Is some planet in retrograde or something? Glad Shaikha came up for you pretty quickly. It prob felt like a long time to you tho :(
I have no dosing suggestions (you tid folks amaze and confuse me ohmygod_smile ) but I wish you both all the best.
 
Yup, go ahead an feed her. At your regular pmps time I'd think about going down to 0.4u. It might not seem like a big decrease, but it is over a 30% decrease in dose and should give you a difference. I wouldn't call hitting 50 today a hypo, but you sure did steer those numbers away from a hypo scare. A number below 40 is what I personally deem a hypo. A number around or below 50 requires a reduced dose to keep kitty from going hypo.
 
I know when Shakes hypo'd I think it was because for 24 hours he was low in the 50's, then all
of a sudden he was 36...so I would definately go down..how much I am not sure though, sorry
 
Kelly & Oscar said:
Yup, go ahead an feed her. At your regular pmps time I'd think about going down to 0.4u. It might not seem like a big decrease, but it is over a 30% decrease in dose and should give you a difference. I wouldn't call hitting 50 today a hypo, but you sure did steer those numbers away from a hypo scare. A number below 40 is what I personally deem a hypo. A number around or below 50 requires a reduced dose to keep kitty from going hypo.
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Will do. She's up to 331 though at +12 and I'm sure she'll be in the reds another four hours given the lack of insulin. She tends to be a mega-zoomer anyway, even without a hypo. I'm afraid though with a dose that low she'll likely be pretty high and flat tomorrow, but we'll see how it goes.

One kink in all of this is that she's not eating well at all again. She's got pancreatitis right now and appetite loss is always a problem. I can sometimes perk it up with strong anti-nausea meds but often I have to resort to assist feeding or switching foods to get her to eat. I'm not sure what else I can give her if she refuses both of her normal canned foods that agree with her IBD, other than the dry food I also have on hand. I hate to do that though because it will just feed her addiction and will make her glucose levels even higher. Will see how she does later tonight. I know if I have to go to dry food it will be even a greater challenge re-balancing her glucose levels - not to mention the problem of trying to wean her off of it again after this flareup is past.
 
Oh wow, big day - great job getting through it and giving her a nice surf. Guess she is on a dose reduction path already, tho it may be from the low eating. Is she eating any better today? I would definitely give her some insulin if you haven't already - you could either try lower TID doses, or try BID, or maybe +10s or something, if her duration is good enough that TID is seeming too nerve-wracking. For TID, 0.4 makes sense to me - she may well need more than that, but seems like a safe bet to try that.
 
Bleah -- I lost another post! I hate when that happens. It always happens when I forget to copy it before pressing submit too.

That is the dose I'll try, Joanna, though I'm afraid she'll be pretty high by the time I could dose her tonight. If I shoot now, she'd be several hours before her normal PMPS time. I'll probably try to shoot in about two hours, which would be a little earlier than her usual PMPS time but not so late that she's deep into reds or even blacks. This way too if she has longer duration than expected I can still shoot at her normal AMPS time without it causing a schedule meltdown.

Unfortunately her appetite is still off. She's hungry, but definitely nauseated so getting food into her will be a challenge unless it seems novel. I'm afraid she may be a problem to feed even with the higher dose of anti-nausea meds on board. I tried giving her the canned food she usually eats later this afternoon and she looked at the bowl, nibbled a little very unenthusiastically, then looked back at me as if to say "Where the REAL food you gave me earlier?" I let her eat when I could get her to this time since she had all the dry food earlier today, but she's got to eat a lot more tonight when I give insulin. I'll first try crumbling some crushed dry food on top to get her to eat the canned. If she won't, I may have to resort to dry food even though I don't want to. There are few foods she can eat without them causing IBD issues. If I assist feed her when she's really nauseated like this, she tends to develop long-lasting aversions to those foods. If she feels ill on anything, I'd rather it be the dry food I don't want her to eat regularly than the canned food she needs to. She has a very long memory. She has several foods she adored in the past that she turned off entirely after past attacks. I don't want to have to go through the long painful process of trying to find another food that won't give her long-lasting puddle poo. Ideally foods should be changed very slowly but I probably won't have the chance to do that given how she is doing.

I know if I have to start adding back dry food though, we'll have much higher BG levels to contend with too so her patterns will likely be very different than what they have been.
 
If she is high you may want to stick with a 0.6. I think today was from the lower PS combined with low eating, is that what you are thinking? 0.4 sounds skinny to me if she is up in the pinks already. What do you think? You are much closer to her numbers than I am.
 
Joanna & Bix (GA) said:
If she is high you may want to stick with a 0.6. I think today was from the lower PS combined with low eating, is that what you are thinking? 0.4 sounds skinny to me if she is up in the pinks already. What do you think? You are much closer to her numbers than I am.
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I think that's exactly what happened. I got food into her, but not as much as she usually eats. She's a real problem when she gets as nauseated as she is right now. I may try to split the difference and give her 0.5U if she's in the reds, especially if I end up having to use dry food to entice her to eat. We've been lucky so far that she doesn't tend to throw ketones, but given her history let's just say I wouldn't to bet the farm that it will never happen either! I don't want to end up with problems because of her not eating, whether they be hypos, liver problems, or DKA.
 
Okay, I ended up giving her 0.4U but we'll have to see how she is in the AM. I tested her at about +10 and she was at 256, so what I may have been seeing with the earlier 311 number was her coming off a food spike. I tested again at nearly +11 and she was up to 300 so I decided to give her a shot then.

Unfortunately, she would not touch even a bite of her canned food. So, to avoid the same problems we had today I gave her a larger dose of anzemet and a bowl of dry food. :shock: It actually is a dry version of the canned formula that agrees with her, but obviously it is higher in carbs. I'm afraid we may have to bend and feed dry while she's sick like this and wean her off of it again after I've got her more stable. I'm afraid to push the canned because I don't want her to stop eating it, so if she's going to develop an aversion I'd rather it be to the dry food. I will continue to offer the canned, though. Maybe she'll feel better in the AM. She's been through a lot today too. I don't think her not eating the canned is 100% the fact that she tasted kitty crack today, though that's part of it. I think she's just feeling badly right now, similar to yesterday. She looks like she feels miserable, poor thing.

If her appetite still is bad tomorrow I'll likely take her to my vet. She just is not acting well, though don't know what much we can do other than the usual fluids and bupe. Checking to ensure she doesn't have an infection coming on or fever would be prudent given the approaching weekend. Though if she was getting a fever I'd think we'd be seeing much higher numbers than she's got now.
 
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