? Shelley - going back on Caninsulin after hypo?

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Anthony Morgan

Anthony Morgan

Member Since 2017
Hi, I would just appreciate some advice on my situation please.
Shelley has had diabetes for 6 years which has been controlled with Caninsulin with no problems and a current dose of 1.8 units. Last week she had a hypo and her blood sugar fell to 1.1. She was in hospital for 2 days when she had another hypo after the vet injected 1.5 Caninsulin units. The hypos happened about 4 hours after the injection. So her insulin was stopped in the hospital and her glucose curves were normal over 24 hours, suggesting remission and no glucose was present in her urine. Since she came home I have been testing with Alpha Track and getting readings between 17 and 25, without insulin and glucose is present again in her urine.
I have given yesterday's curve to my vet and have been told to restart the Caninsulin tomorrow at 1.0 unit and the monitor her blood glucose and take her to the vets if it drops below 5.0.
I am just concerned that Shelley will have another Hypo as she is an elderly cat with high blood pressure and a heart murmur. The vet can't explain why she had the hypo after 6 years of being ok and this all seems a bit risky to me. Thanks for reading.
 
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Hello Anthony....I am not experienced in such matters but someone with much more knowledge than myself will be along shortly. Will be interested in hearing their input on this . To draw more attention to your thread u need to add a question mark icon at the beginning of your title . Hope that helps .
 
Can you post the BG values from your curve with respect to the time the shot (1 unit) was given?
What are you feeding and when?
Has that changed since Shelly had no problems with a hypo?
 
Beth 73 said:
Hello Anthony....I am not experienced in such matters but someone with much more knowledge than myself will be along shortly. Will be interested in hearing their input on this . To draw more attention to your thread u need to add a question mark icon at the beginning of your title . Hope that helps .
Click to expand...
 
Hi Larry, in fact the first 1.0 shot has not been given yet, it is planned for tomorrow. She has not has any insulin since the second hypo. Since the hypo she has had a mixture of RC Diabetes wet food, which she is not keen on and her normal food, Applaws, Felix, Lilys, all wet food.
 
Just checking about your last post - is she not eating well? If her food intake is down, it might be wise to start back on insulin at a lower dose - maybe .5 unit and see how she responds. Her bg is high so she needs some help, but we certainly don't want to send her plunging again.
 
Hi Just-As-Appy, thanks for your reply. Shelley is eating quite well, maybe a bit less than before the hypos. I think you are right about .5 unit. I asked the vet about changing to a different insulin, someone mentioned Prozinc but he didn't think that was a good idea. I just wondered if some insulins are less likely to result in a hypo.
 
Too much of any insulin will result in a hypo. Caninsulin action is generally a pretty steep drop and then an equally steep climb. Prozinc also has a fairly steep drop and climb, but not as dramatic as Caninsulin. The good (and bad) thing about these 2 is that they do not have a long duration in the cat - as little as 8 hours for some. The more gentle insulins like Lantus and Levemir have a much longer duration. Because the protocol for these 2 insulins is well developed and researched, hypos seem to happen less frequently. Unfortunately when they do they are more difficult to treat due to the longer duration of the insulin.

Whether or not to change Shelley's insulin is a tough call. I would think that Prozinc might be easier on her, but your vet probably has reasons for not wanting to switch. Maybe explore that with him to see what his reason are. It maybe as simple as he is not familiar with Prozinc, or he might feel that her body is used to the action of Caninsulin and doesn't want to change.

Do you have the numbers from a curve that you could share? It might help others who have experience with the insulin comparisons to provide you with thoughts.
 
I didn't mean to sound trite with that first sentence. Diabetes is a delicate balancing act between food and insulin, and even more tricky as a cat ages. You have obviously done a great job for many years.
 
Thanks again for your comments and the information on the insulins. Having to manage the after effects of the hypos is a new and rather unwelcome experience. I only started home testing last year and prior to that relied on the fructosamine tests when good or excellent control was reported, so really all I had to worry about was 2 injections each day.
But obviously the situation will have to be monitored very carefully from now on. The curve numbers from 15th February hourly starting at 0900 were as follows;
20.2/17.9/18.9/18.3/24.3/23.8/missed/17.9/21.1/17.5/19.7
 
Just wondering how Shelley is doing today. She (and you) have had a rough few days. Thanks for posing the bg numbers. If I understand correctly, these numbers are from a day without insulin - is that correct?

It seems that many vets in the UK favour Caninsulin so it is not a surprise that her vet prefers to stick with it. If she has been doing well for 6 years then it may well be that she will continue fine with more careful monitoring and fine dose adjustments.

The fructosamine test gives an indication of the average of the bg numbers over the past few weeks. If you are testing at home, you don't really need a fructosamine test as you can see from your own numbers how she is doing.

Many of us use a spreadsheet and share the 'read' link so that others can see how the insulin is working. Would this be useful for you? It requires a google account.
 
Hi, thanks for coming back to me on this. Shelley seems her normal self today, bright and eating OK. But I had to go out unavoidably this morning, so I didn't restart the insulin. Spoke the the vets office, the vet I've been dealing with is off today. They said it should be OK to wait till tomorrow, I didn't want to start it late in the day in case something goes wrong. I just checked her glucose level and it is high, 25.2. But the hypos have made me very unsure about injecting her, I know I will have to of course.
The numbers are all without insulin. I will look at setting up a spreadsheet, I do have a google account.
I'm very grateful for your comments, thanks again.
 
Take a look at Sky's spreadsheet - in a way she sounds similar to Shelley in that she is very responsive to Caninsulin. I came to the conclusion that her dose lasts longer than the 12 hours it is supposed to and when I dose her she probably still has some acting in her system. It's possible that Shelley had hypo episode for similar reasons - that her dose had become unsuitable for whatever reason.

The only way I can manage her is on a variable dose and missing it if I don't feel safe dosing her.

I would definitely restart on a lower dose - I switched back from Prozinc earlier this year and was initially on a 1 unit . I had to increase slightly as it wasn't doing much but now she has more of it in her system the 1 unit would be too much for her sometimes.

Testing before injecting is by far the safest way to go if she will tolerate it.

Good luck :)

Karen
 
Hello Karen,
thank you very much for your message, I do see what you mean on the spreadsheet. Actually Shelley is a placid cat and is very compliant, except if it is every hour, then she does start to get fed up with it.
I will definitely test before any shot, my worry is that it causes another hypo but I am going to have to start the caninsulin again and monitor carefully.
Very grateful, Anthony
 
if you know how she is likely to react to each dose then it does make knowing what to give her easier and will reassure you into having faith she won't hypo. There can obviously be other things going on that could impact her reaction to insulin but most of the time she would probably react the same. Sky hypo'd in the first week - I know what you mean about worrying it would happen again but through testing I have a rough idea of how she reacts a lot of the time and if ever I'm unsure I will leave her without a dose.

Sky used to drop down 10 "marks" on a 2 unit dose and 5 on a 1 unit but I haven't checked for a while to see if it has changed. I need to do another curve on Sky to see how she reacts to her smaller dose. Sky usually continues dropping until the 6 hours so I do think she has a slow metabolism.

I think the general advise is keep her on the same dose as far as possible for 6 cycles which may not be possible for Shelley if her needs are changing.

I would definitely get her started again but keep an eye on her numbers.

Karen
 
Hi Anthony
Cats can be very sensitive to insulin after a hypo so you are wise to consider dosing conservatively. Those numbers you're getting are pretty high and a lot of cats would tolerate 1u of Caninsulin at that level, but I agree with the suggestion above to give 0.5u for the moment - test before you shoot though and then an hour later if you can, to make sure Shelley hasn't dropped too fast. If you can do further tests during the cycle it is always a good idea to see what the dose is doing. Hopefully she will be fine on 0.5u and if she is still on the high side on that dose for a couple of days, that would give you the confidence to increase to 1u - but do keep checking to be sure.

We can certainly all understand your apprehension but as you are home-testing you have the means to monitor Shelley and make sure you are doing the right thing. So re-start on a low dose and keep testing. Keep a note of numbers and post here so people can see what's happening. If you can, set up a spreadsheet to record this data (there are tech gurus here who can help with that) and for now, can you post in this format so we can see what BGs are at the different times in the cycle (you don't have to test every two hours but collecting data is what it's all about so if you have the means to do so, it is not wasted effort):

AMPS (morning pre-shot BG: ??
+ 2 hours - ??
+ 4 - ??
+ 6 - ??
+ 8 - ??
+10 - ??
PMPS (evening preshot): ??

Good luck!
Diana
 
Thank you Karen,
I will keep that in mind. I have had a further look at the spreadsheet and its given me more idea about managing this. I didn't think to have high carb food and treats in for example so that is all very helpful.
I will start the insulin tomorrow and keep monitoring.
Much appreciated, Anthony
 
Diana&Tom said:
Hi Anthony
Cats can be very sensitive to insulin after a hypo so you are wise to consider dosing conservatively. Those numbers you're getting are pretty high and a lot of cats would tolerate 1u of Caninsulin at that level, but I agree with the suggestion above to give 0.5u for the moment - test before you shoot though and then an hour later if you can, to make sure Shelley hasn't dropped too fast. If you can do further tests during the cycle it is always a good idea to see what the dose is doing. Hopefully she will be fine on 0.5u and if she is still on the high side on that dose for a couple of days, that would give you the confidence to increase to 1u - but do keep checking to be sure.

We can certainly all understand your apprehension but as you are home-testing you have the means to monitor Shelley and make sure you are doing the right thing. So re-start on a low dose and keep testing. Keep a note of numbers and post here so people can see what's happening. If you can, set up a spreadsheet to record this data (there are tech gurus here who can help with that) and for now, can you post in this format so we can see what BGs are at the different times in the cycle (you don't have to test every two hours but collecting data is what it's all about so if you have the means to do so, it is not wasted effort):

AMPS (morning pre-shot BG: ??
+ 2 hours - ??
+ 4 - ??
+ 6 - ??
+ 8 - ??
+10 - ??
PMPS (evening preshot): ??

Good luck!
Diana
Click to expand...

Hi Diana,
Thank you, I am going to do as you suggest. I will look into setting up a spreadsheet but in the meantime post the numbers in that format. I have to make a start again and having joined this site is going to be a great help.
Most grateful, Anthony
 
OK Anthony - what was the pre-shot number and what is the number at +2? This is what we need to know to comment so yes, post these numbers and any further ones when you can. Hopefully she has gone down a little at least, even though 0.5u is a small dose... we need to see some data over the course of the day on that dose, in order to suggest raising it... or not.
 
OK, thank you:
AMPS 22.7
+1 hour 21.8
+3 hours 17.1
+4 hours 16.9
+ 5 hours 15.1
+6 hours. 17.3
This is what I have so far.
 
Well done, Anthony! That's pretty much what we might have predicted I think. The half-unit drop did have an effect, nice and gentle, and carried on dropping Shelley until nearly halfway through the cycle, so actually she has had quite good duration from this small dose. It looks as if she is climbing again now so you can expect any further numbers to be higher. On pre-shot numbers like this you probably could have given 1u but it is always best to stay safe. Let's see what her evening pre-shot is - as I said, it looks likely she is rising again and you could go for 1u - or you may prefer to stay cautious, especially on the evening dose, and stay with 0.5u for today.

It looks as if Shelley will not need large doses of insulin going forward, in which case it would be a matter of getting her numbers down a bit more and then finding the right dose to drop her and keep her into acceptable numbers for most of the cycle...that might be the tricky part but with careful monitoring and dose adjustment as necessary, it can be done.

I wonder if one of our most experienced UKers has any comments on this @Elizabeth and Bertie

Diana
 
Hi Diana,
thank you very much for your comments and I really do mean that! I am so glad I joined the FDMB, I had no idea I would get this level of help and advice.
It makes such a difference having someone else's opinion on this to reassure me that I am doing the right thing.
The +7 number was 18.3, as you anticipated.
Thanks again,
Anthony
 
You're very welcome, Anthony - all of us have been where you are and understand the anxiety and uncertainty, so you are certainly not alone. Feline diabetes does seem a bit mysterious at first but when you get your head round the logical part of it, you're halfway to working things out for yourself. It does take commitment on the part of the caregiver but it sounds as if you are willing to stay on the case, so hopefully this should be manageable.

Do read others' threads on this forum though and you will learn a lot that way too.

Diana
 
Thank you Diana. As you probably saw from my first post, Shelley has been diabetic for six years and has been well controlled and never had a problem. So I have had it relatively easy, until the last week or so.
I would add that the last fructosamine test result was 312 and the lab report stated that some cats may show periods of hypoglycemia at this level, that was 1 12 16. Thinking back the vet told me we had excellent control but didn't say anything about reducing the dose. It actually says in the report that a doseage reduction may be appropriate. None of this was mentioned and I only found out because I asked for a copy of the report. The vet, who I have had a good relationship with for many years did encourage me to home test and I obviously have not done that enough as I expected all to be well.
The report also stated that Shelley has pancreatitis, this has come up in reports before, but she doesn't seem to have symptoms. I don't know if this would affect the response to insulin? Incidentally, my regular vet is now at another branch and I have been dealing with a younger less experienced vet.
Anthony
 
The thing with diabetes, Anthony, is that nothing is certain... insulin requirements can go up and down.... this is exactly why home testing is so vital. The fact that you are doing this now should mean, hopefully, that you are always aware what Shelley's BG is and therefore her insulin requirements... knowledge is power!

A good relationship with your vet is also very important and if you are now dealing with someone less experienced there is even more reason to inform yourself as well as possible. Many of us here have taught our vets a thing or two about FD. The fact is that most vets are like GPs and have one day's training if that on FD... they hopefully learn more as they go along, but they are not specialists in the field so if we can educate ourselves and pass things on to our vet, everyone benefits.

I'm sure pancreatitis could affect BGs too so if there has been a flare-up of this, we could be looking at a reason for the higher numbers.

I would keep a diary with Shelley's BG numbers and insulin doses, noting any symptoms she may show, and take this to the vet at your next appointment. Some people come to an arrangement with their vet where the vet is happy to be emailed with questions between consults - you could ask about that perhaps.

Diana
 
Thanks Diana, I am going to keep detailed records from now and set up the spreadsheet. I will post the rest of the days numbers as I go along.
Kind regards, Anthony
 
Anthony Morgan said:
Shelley has been diabetic for six years and has been well controlled and never had a problem.
Click to expand...
Hi Anthony (waving to you from Surrey!).

Insulin requirements can change a lot over time. Sometimes the need for insulin increases. Sometimes it decreases. (My own cat started out on a high dose of insulin and now (10 years later!) only has a teensy weensy amount of insulin every 2 - 3 days.)

A hypo can make cats much more sensitive to insulin. So you are wise to be cautious with the dose.

I wonder why your vet is reluctant to prescribe Prozinc...? ...It may simply be that your vet doesn't have much (or any) experience of it because it's only been available in the UK for a relatively short period of time... But Prozinc typically drops the blood glucose more gently than Caninsulin does; and lasts in the system longer.

Some people use food to try to slow down the rate at which the blood glucose drops. With Caninsulin it can be helpful to feed the kitty about 20 - 30 minutes before giving the insulin shot, so that the cat's body has food on board for when the insulin starts to work. And it can also be helpful to give a snack (or part of the main meal) about 1.5 to 2 hours after the insulin shot, so that there is also food on board for when the insulin is at it's most active.

Do you know when Shelley usually has the lowest number of the cycle? In many cats this will be around 4 - 4.5 hours after the Caninsulin shot. But it could be earlier or later.

And what exactly are you feeding Shelley at the moment?

Eliz
 
Hi Eliz,
Thank you very much for your message. Waving back from Hull, East Yorkshire!
The vet that I have been dealing with is fairly new and refers to his more experienced colleagues. When I mentioned Prozinc, he said he had heard good accounts about it but as Shelley had always been on Caninsulin, he did not want to experiment at this stage.
Shelley used to have a big appaetite and weighed about 6.5 kg when she was first diagnosed. Now she weighs about 4.5 kg and asks for food every 1.5 to 2 hours but only eats a little. But during the course of a day does eat a reasonable amount.
Something I have been thinking about is that on the day of her hypo I had been out for an hour or so and when I came back in was sitting having a coffee when I thought, ' I am surprised Shelley hasn't appeared yet asking for food'. You see my living room is at the back but Shelley usually sleeps in the front room. So I went to check on her and gave her some food but she didn't seem to be interested in it. It was about an hour later when she seemed to be wobbly and weak and when I checked her blood sugar it was down to 1.3.
I am at home most of the time but she is a cat that will not often eat food that is left out. She seems to want to see me bringing fresh food before she is interested.
From the curves I have done before the low point has varied from around 1300 t0 1400. These are todays nubers;

AMPS 22.7
+1 hour 21.8
+3 hours 17.1
+4 hours 16.9
+ 5 hours 15.1
+6 hours. 17.3
+7 hours 18.3
+ 8 hours 16.7
+ 9 hours 22.6

The vet recommended RC Diabetes wet. I have tried it but she wasnt eating much of it. So I have gone back to her usual food; Felix Pouches, Gourmet Solitaire Pate, Applaws Senior Chcken and Lily's Organic Turkey. A general variety but I have tried to find the low carb ones.
With grateful thanks,
Anthony
 
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Felix caused Sky problems - if it is the As Good As it looks it has vegetable proteins (I think) and various sugars so even though the carb content was low she was responding to something else in the food. I took her off that and she is on Sheba fine flakes now. Within a few days of stopping the felix her numbers were much better/lower. Not that that is related to the hypo issue, and a lot of cats do fine on Felix, but may be worth considering whether that could be increasing her glucose levels. @Elizabeth and Bertie has done an invaluable food resource spreadsheet.

The half unit you have given Shelley has resulted in a nice and gentle drop and whilst it hasn't taken her very low it's giving you an idea of how she reacts. I wouldn't worry that it hasn't had too much of an effect on her - you can increse slowly when you know how she is responding. I also wouldn't be in a hurry to rush into increasing.

Sky this morning was at 18.4 (I think). I tested just before her tea and she was at 7(ish). I hate the big drops - nothing has changed for her, her food is the same, she's eaten the same amount. Just for some reason she has gone too low for me to be comfortable injecting - especially as I don't know for sure how she is responding. I do wonder sometimes whether Sky just needs one dose a day.

You're doing the right thing. I do think that Caninsulin does work and it is obviously working for Shelley but she just needs monitoring more now to try and avoid problems.
 
Hi Karen,
Thank you for your further comments. It is actually the standard Felix pouches not the AGAIL. I tried that with my cats years ago and although they liked it, they would get diarrhea with it. I have generally avoided the cheaper brands but I just saw somewhere that it was low in carbs and the jelly seemed to satisfy Shelley for one of her many snacks. She never eats the hard pieces. But I would prefer her to have something better, it has been mainly Applaws Senior and Lily's Organic today.
I was surprised to see the drop at 8 hrs to 16.7 but she had been asleep and not eaten. In the next hour she ate, so presumably that's why there was the big jump to 22.6 and also getting to the end of the cycle. I certainly don't feel inclined to increase the dose for the time being, although the vet said start on 1.0.
I am sure I am going to be the same if I see large drops. Prior to her hypo, 3.6 had been the lowest number and then it came back up on the next test. I mentioned it to my vet at the time and he said it was alright but I think Shelley's dose should have been reduced in December when her fructosamine was 312.
Thanks again,
Anthony
 
You are obviously a very caring owner, Anthony, and you're saying all the right things... instinct plays a part in how we treat our kitties so stay with the dose for now. When you have time, think about getting a spreadsheet up and running and you can then keep that up to date and link it to your signature (you will need to go to your profile settings to say something about Shelley) - then we can all see at a glance what's happening without you having to type numbers within a thread or repeat things so everyone can catch up.

Can someone add the link to the spreadsheet here please? Sorry I can't do so.
 
Thank you Diana. Yes, I will do that once I get the opportunity. I will just repeat todays numbers for information;
AMPS 22.7
+1 hour 21.8
+3 hours 17.1
+4 hours 16.9
+ 5 hours 15.1
+6 hours. 17.3
+7 hours 18.3
+ 8 hours 16.7
+ 9 hours 22.6
PMPS 24.4, injected 0.5

Many thanks, Anthony
 
Hello,
Just wanted to seek comments on recent numbers. Early hours BG seemed to drop very fast and I was worried about possible hypo;
PMPS 20.6
+3. 14.8
+4. 11.8. Fed Dreamies
+5. 15.8

I know these are not really low but out was the speed of the drop compared to Sunday that worried me.
Should I continue on the 0.5 dose or reduce?
Many thanks, Anthony

Cc @Diana&Tom @Sootyca
 
That is quite normal I believe - Caninsulin can be fast acting and cause a rapid drop. Her numbers were okay though and well within safe levels- I know you are worried about hypo but at 11.8 I would not have been concerned. If you had tested at +5 and +6 and the numbers were still dropping I would have intervened at that point. The increase at +5 was probably due to Dreamies - your previous post suggested she would drop again at +5 before starting to increase.

It's a real balance but I would stick with the 0.5 and test again at +4/5/6 just to be sure.

You're doing a great job.

Karen
 
Hi Karen,
Thank you very much for replying so quickly. +6 was 3 am, I was still awake and could have tested but Shelley was sleeping peacefully and I decided to leave it as +5 had shown the increase.
But thanks once more, will continue with 0.5
Anthony
 
Hi Anthony, I agree with Karen - these numbers are actually rather nice and not cause for concern. The drop may *look* steep but that's after three hours - numbers at +2 might have been somewhere in the middle and you wouldn't have been so worried, probably. The increase at +5 may have been due to the Dreamies or she may have been rising then anyway, we don't know - but another time there would be no need to give carbs at that number. So try not to worry, this is looking good. I do understand that it's scary when you start to see better numbers and dread another hypo, but you have the knowledge and tools at your disposal now to ensure that such a thing is unlikely to happen.

And yes, stick with 0.5u for now and see how the next couple of cycles pan out.

Keep going, you're doing just fine!
Diana
 
Hi Diana, thank you for getting back to me. I can see that now but in the middle if the night I'm afraid I overreacted, worrying that what looked like a steep drop would continue.
I will press on with the 0.5.
Very grateful,
Anthony
 
Anthony Morgan said:
Hi Diana, thank you for getting back to me. I can see that now but in the middle if the night I'm afraid I overreacted, worrying that what looked like a steep drop would continue.
I will press on with the 0.5.
Very grateful,
Anthony
Click to expand...
Very understandable, Anthony. Everything looks worse in the middle of the night. Everything looks fine, just carry on keeping a close eye.
 
Hi, thanks for asking. Shelley seems quite well, her numbers today were;
Amps 21,7
+4. 14.8
+6. 18.2
I haven't tested so often today as the pattern seemed to be the same as the last few. I will perhaps have to think about a gradual dose increase though, as the numbers need to be a bit lower.
Anthony
 
Shelley's numbers have crept up today.
Amps 26.0
+5 18.7
Pmps 28.7
I have had some trouble getting the samples today. Gave up at +4. Took about 10 attempts at +5 and 3 testing strips.
Shelley was getting really fed up, so thought I would leave it until the pm shot.
28.7 is the highest reading I have seen. I have increased the dose to approx 0.6/0.7, it is hard to judge these small changes.
If the am test is high I think I better increase to 1.0.
I found out that Shelley likes Applaws Tender Chicken in Tasty Jelly. This is new for her and does have quite a lot of vegetable gelling agent. I don't know if this is anything to do with the spike in numbers.
Grateful for any comments.
Thank you Anthony
 
I've just suggested this elsewhere but possibly keep a food diary of what type and flavour you have fed to se if it correlates with an increase? took me ages to work out what was causing Sky's spikes and eventually narrowed it down to the Felix.

Maybe if she is getting fed up give her a bit of break from the testing? I know it's good to do it and get numbers but it's a marathon not a sprint and if she is showing signs that she isn't happy with it then just do morning and evening and maybe 1 between +4 - +6 if you can't relax.

I think I would also be increasing to a 1 unit. She has been on a low dose for a few days without it bringing her very low. Of course, increasng the dose does increase your worry by the same amount especially when the numbers start dropping!

I've had to increase Sky to a 1 unit - as she was high after her injections. She has dropped a massive amount from her morning test so I need to keep an eye on her.
 
Sootyca said:
I've just suggested this elsewhere but possibly keep a food diary of what type and flavour you have fed to se if it correlates with an increase? took me ages to work out what was causing Sky's spikes and eventually narrowed it down to the Felix.

Maybe if she is getting fed up give her a bit of break from the testing? I know it's good to do it and get numbers but it's a marathon not a sprint and if she is showing signs that she isn't happy with it then just do morning and evening and maybe 1 between +4 - +6 if you can't relax.

I think I would also be increasing to a 1 unit. She has been on a low dose for a few days without it bringing her very low. Of course, increasng the dose does increase your worry by the same amount especially when the 'numbers start dropping!

I've had to increase Sky to a 1 unit - as she was high after her injections. She has dropped a massive amount from her morning test so I need to keep an eye on her.
Click to expand...

Thank you. It would be easier if Shelley had a more consistent diet. But something she is keen on one day, she will pick at the next. A diary is a good idea though.
I haven't tested so much the last couple of days but just had a real struggle this lunchtime. I will keep it to a minimum but look out for any large drops.
I see Sky's number shot up, similar to Shelley's, it's not an easy illness to manage by any means. I think I will have to get something to test for ketones also. Very grateful for your comments!
 
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