Smokey update, continuation from the Hello thread

Good morning all. First the ss isn't working. Will be on phone with Google, Amazon later today.

Smokey's BS this morning is 302. I'm extremely pleased with this. He has been on 4.5U since August 9. Big turnaround in last 48 hrs because of the hypo episode. Again well done to ALL who helped.

So Ss isn't working. Thought we had it. But could only get it on my phone. Very tiny to work with. I must have clicked a wrong button (fat fingers, miniscule keyboard) and bam it's gone. @Marje and Gracie set it up and attached. But Google closed account because of suspicious activity. Wait till I call them today. I downloaded sheets and drive to my kindle fire. Apps state they are free but I was charged. They credit me then tell me they are paid yet when I try to open I'm told no Google accounts. Hello I'm logged in to Google at the time. So a call to Amazon today to get me going. Desktop, well we won't even go there.

Anyway, Smokey seems stable at this time on 3U Vetsulin 2x day, 1/2 hour after eating. Wow what I learned and we been through in last 48 hrs boggles my mind. So he's not cookie cutter diabetic. Now I will test twice a day, give his little ear a break unless symptoms present (now I know what his symptoms are). Some of you might think it's to soon to cut back on the sticks . But I am confident enough to. His sticks where never the problem. I just didn't know to do them as often. I also didn't know about hypo episodes. His BS always ran so high, vet just kept increasing insulin. What did I know??? I acquired a diabetic cat with no instructions, traveled between states because his owner my mother was sick, work, husband not home 4 days at a time because he works out of state, eventually death of mother, and trying to help my father. Thinking vet knew better it was less stress for me at the time. Dumb on my part.

Off to get ss going I hope. Have a good day everyone. When ss is available I will let you know.

 

Good luck getting Smokey's ss going! Computers can be so frustrating sometimes!

Not dumb, at all! Don't kick yourself for that, I think we all believe the vet knows what's best - that's what hey went to school for, and what we pay big $$ for, right? My vet made several questionable calls, and didn't want me to home test at all; I now have a new vet, lol.

 

Yorr spreadsheet is not public. I get this:
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You are signed in as my GMail adress@gmail.com.

Request accessSwitch accounts

 

Larry that's a little to techie for me.

Did have permission

Am signed in

Have drive and sheets downloaded however "no Google account exists" yet I'm logged in and reading my emails

Don't know about switch accounts

Actually I thing to many clicks/downloads have been done and it's messed up royally. I need someone on the phone to talk me through. Working with Google an Amazon now.

 

Sharon, you have certainly had your plate very full and yet your devotion to getting Smokey better has never waived. You are an amazing woman.

 

Did you try just going back to your original and choosing Share in the upper RH corner? Then choose "Share with anyone with the link". (Once you get the original back with help from Google.)

 

Can someone let me know if this ss is working. You should see "test" in the first column.

 

It's working!

 

Hooray!

 

Here is the one I really like. It should include today's information. I hope I never have to do this again. The process did not follow instructions at all. And I have use firefox, how I hate it so. Can't figure out how to bookmark it or make a shortcut for easy finding. This could be the last time its updated.

 

Can you save it? If you have Google Sheets, that might work.

So we have a small picture of what has been happening. I hope maybe this weekend you can get some numbers in the 5/7/9 range to see where he is lowest and how long it lasts. I am especially curious about last night. He has dropped a lot by +3. I wonder if he continued to drop and this morning was a bounce?

 

Sue, do you mean +5/+7/+9 times at pmps? He seems to be high in the morning. Still fine tuning. Since his pmps was 341 I was afraid 2.5U would cause a very high am BS. If the 3U are working decently today, I hoping he will adjust some. Is that logical thinking on my part? Then it might be possible to lower if indicated. Please please give me your opinion.

 

Here is his newest BS 147. Now what do I do. 3U is to much. Would 2.5 be ok? His morning will be probably be high. This nite time seems to be the problem. I should be giving his insulin in 10 minutes.

 

@woodsywife what did you wind up giving Smokey?

 

I went with 2U. Thought high in morning was better than low overnight when I'm sleeping (if I sleep).

 

I would definitely get a +1 and +2. A little high is better than too low.

 

here is his +1 bs 155

 

Sorry I missed your dose question. We suggest new diabetics not shoot under 200. Was 147 your pmps? I am worried you will have a long night. He doesn't have a long ways to drop. Your +1 is probably food related. Be sure to get another test in an hour.

Do you have syrup? Higher carb gravy food?

 

I don't want it under 200 either. But not having anything he will be over 500 in morning. I will test about 9. I have syrup. Would it be good to give him some canned food after stick?

 

Sometimes you have to skip, even if it means a higher number later. I am worried that he could drop low again. If he drops 50% or so by your next test, then yes, I'd give him some of his regular low carb. If you see a 70, then either the gravy off high carb or a little honey mixed in with his wet food. You don't want to give him a whole lot of food at once because you want him hungry enough to eat when you need him to.

He is really moving down, every cycle. I would guess the insulin and food and lack of daily stress is doing its work. The 147 tells you the dose was too high. Anytime the insulin is still dropping them after 12 hours, it's too much insulin. Especially with Vetsulin which doesn't often last longer than 10 hours.

The goal is to have two shootable numbers every day. I think you might be reducing often. You might think about a restart at one unit. You can increase as the testing indicates. It's a safer way to deal with changing pre shots, rather than trying to guess how much less to shoot.

Check out Lucy's Spreadsheet (Squallie's mom). She was on a high dose, did a restart and now is slowing raising. But still a lot less than the dose she was giving.

 

Is it correct that you are using an AlphaTrak2 meter (as noted in your signature)? As the BG ranges at the top of your spreadsheet are for human glucometers.

So just making sure you're aware: We consider AlphaTrak hypo-alert zone at <69 on an AlphaTrak2 meter*. But for someone who is new to this, I would highly recommend that you give higher-carb food if/when you see Smokey hit 80. After feeding, you will test again in about 15-20 minutes to make sure his BG # is rising.

*(Please see the BG reference ranges on the tabs at top of Bat-Bat's SS. We can have someone help you change to those later on ...)

 

Good catch, Robin. I was worried about the low pmps and forgot the AlphaTrak. Will edit my post.

 

Please DO NOT wait to test until +9. Cats often nadir around +4 on this type of insulin - AND he could drop his number early on you. I recommend you monitor at +2, +3 & +4 - and relay those #s to us here as soon as you get them.

 

Sure wish we could highlight the Alpha Trak2 meters in bold red in our signatures like we used to. Totally agree that you will need to watch and test Smokey like a hawk tonight and keep in front of his "could be" low number tonight.

 

here it is 151. Is the sheet showing these? will stick again 1 hr

 

Yes, it's showing on your SS; very good - you're doing fine! (Keep in mind that his # is up a little right now because of the food he had @ PMPS.)
What is your first name, btw?

 

I'm Paula. Yes using alpha trac2. And Vetsulin. I don't know the range for Vetsulin. My vet would like to keep him at 200-300. I don't enough yet. I do know I don't like below 200 but I'm okay with 150 as long as it's not dropping. I don't like over 400 because then he becomes a quite a problem. I know the ss isn't the right one. Been having trouble getting the thing to work. The instructions here do not help me at all. Can't get it on my tablet or phone. @Marje and Gracie has been working with me. Google even closed my account because of suspicious activity. This is the only one that I could link for now. My desktop will only allow this sheet to work with Firefox which I hate. Ads keep popping up and freezing it and takes forever to load. Marj has come up with another solution but I'm waiting to hear from her on next step before I download and link.

 

I linked the SS I did for you yesterday. Today, I transferred the numbers from the SS you now have linked onto the one I did for you. I've sent you the link to that SS. There shouldn't be any reason why you can't open it and it should then go on your Google drive so you can continue to open it.

Because I don't know anything about your devices or your software, I'm not sure where you are having a problem or why. i can relink the SS I did for you with all his numbers but you have to be able to find it in your devices. You are the owner of it so it's got to be in your Google drive somewhere

 

I see it on drive "smokey's numbers" right? Is it linked? So now I just use that one?

 

Our range for regulated kitties is around mid 200s for pre shot tests and in double digits for nadir, but not below 50. We think the renal threshold (the level at which the pancreas can heal) is around 250, so any time spent below that is a good thing. I think your vet's range is high, but not surprising - they usually don't have beans who are willing to stay on top of things so they err on the higher side.

 

Hello again, Paula - Do we have a +3 test on Smokey yet?

 

!*#^! its 82. Some syrup given and he's eating which is his normal time to eat.

 

How much food (which type food) did he get in addition to the syrup? Please test again in about 20 min. & let us know what you get.

 

It takes 10 minutes to plug in the one number then get back to here. I will be so glad when I get a new pc or if I could get this on my tablet. But tablet keeps telling me no google account. I got 2 ?????????

 

You mean 2 on the meter? I hope not! Take another test. Oh, good. You mean 2 google accounts. I stopped breathing for a second there. Never mind about the second test.

 

his normal .75oz proplan can chicken & spinach entree pate. he throws up anything with gravy. certainly don't want that right now.

 

@Sue and Oliver (GA) - No, that's 2 Google accounts. Smokey's last BG was 82.
@woodsywife - Oh, I think Sue can tell you about the problems she's had with Google sheets on a tablet! Kinda "buggy" from what I've heard.
Just wanted to say: Sorry, Paula, if I sounded a little brusque earlier - was just wanting to get the info re: difference in hypo-alert # on Alpha Trak2/what you need to do to re: monitoring/ steering with food to you as quickly as possible.
And what's happening tonight is a good learning experience, as now you will know exactly how to handle the situation when Smokey drops too low in a cycle.

 

No. 2 google accounts. good lord if meter was 2 i don't think he would be here. Actually he is quite alert and playing with my kitten. He is just so unstable at night.

 

@Robin&BB its okay I didn't take it that way. I went through this for the 1st time Sunday night. Look in the intro site titled hello. sorry for inproper typing ettique its this firefox/google. I don't even know where spell check is on here. not that IE is better but I wish i could use it now.

 

What we normally do at AMPS/ PMPS when the BG# is under 200: Withhold food, then test in about 15-20 minutes to see if BG rises on its own (which it often does when a cat is getting agitated while awaiting a meal). And you may need to repeat this test (withholding food all the while) 2 to 3 more times before the # is high enough for you to safely shoot the insulin after feeding. (Which sometimes results in the shot being delayed by an hour; not always possible for someone who works outside the home, though.)

The other important thing to note: Do NOT feed your kitty in the two-hour window before AMPS/PMPS test time (unless, of course, you're in the middle of a hypoglycemia event). The reason we avoid feeding in that 2-hour window (@+10 to +12) is that you don't want his pre-shot blood glucose artificially raised by food before that test is performed.

(Maybe somebody already gave you this info, but I already typed it in before your post #39 showed up on my screen, so here it is anyway!)

 

47 more syrup and dry food given. still better than sunday though

 

Okay ... keep it up & keep us posted. (I am on west coast time - in AZ - so 3 hrs behind you in time; so will continue to hang in with you, Paula.)

ETA: Please test again in 15 min.

 

Time for 15 minute test intervals. Did you give a teaspoon of syrup? Glad you'll be around, Robin. I can't be tonight.

 

How do I put 15 minute ones in? Does the sheet allow 47/50/52 in one cell?

 

I'm not sure about how to put them in a single cell; but post them here on the thread anyway, with the actual time you took the test.
Can also list these in the "Comments" section of SS @ right.

 

Did you just now get that 52?

 

This statement really concerns me. I know of no place which states below 69 on an Alpha Trak is a hypo alert zone. It's certainly a "pay attention" number. But I'm not sure who the "we" is because most of us with experience don't consider that a "hypo alert" zone.

To stack numbers in a column, just put the cursor in the column and add the numbers using this as an example (let's say you are putting it in the +3 column with the first number being the +3 test:

70; 67 @ 3.25; 55 @ 3.5

You might need to reduce the font so you can see all the numbers.

 

No those were made up

 

58 now. At about 25 minutes. Should I feed again

 

Thank you have a good night.

 

@Marje and Gracie - I really don't have time to argue this point with you right now. Just trying to keep her kitty safe.

Yes, please; feed again.

 

@woodsywife - Paula, did you feed again? Will need another test in 15 after that feeding.

 

Really, that low is alert zone? I would think higher like 100. Surprised he is so alert and active though. Sunday he was 32 but lethargic and didn't come when popping the can open. It was also 11pm. I had a feeling something was wrong then but didn't know about all this. I had just found this site and had been reading most of the day. When ok let's test.

 

Actually..I'm not arguing. I'm just giving the facts. It's a number that needs attention and certainly for a new member it needs an action. But for an experienced member, depending on where it is in the cycle, it could be a surfing number that just needs to be watched closely.

Paula...it would tell me the dose needs to be reduced.

 

Paula, I suppose that some would rather we call this a "pay attention #" than a "hypo zone alert #." Matters little what you call it, it is BEST that you keep your cat from approaching a number that could be indicative of hypoglycemia - and this can, in fact, differ from cat to cat. This is why I wanted you to err on the side of caution tonight and start steering with food & retesting at 80, rather than a lower number.

 

He's eating now. Is 15 minutes enough time to get into his system

 

I don't disagree with you, Marje - but Paula is not yet an experienced member; she is a new member with a kitty on Vetsulin, using an AT2 meter.

 

It should be, especially if he's eating the higher-carb formula.

 

I would have started testing. Now I know 2U at BS of 147 is to much. I hope I can get more strips at the vets tomorrow. All most out of them.

 

Hey Paula - just fyi - no need to give any dry food. It doesn't increase the BG as quick as the wet, high carb food or syrup does. So eliminate the dry food and just stay with the wet food or syrup. You do not want to fill him up with food that is not helping you now (the dry food).

 

Losing cable connection. Got to switch to phone. So don't know if you'll get the sheet but I will post here by phone. Having a much needed storm. If I lose power, thanks everyone. We'll get through it again if not hospital is 45 minutes and hubby is home to drive since I'll be a basket case if it comes to that.

 

Paula, as you're new to this, we recommend that you do not shoot at an AMPS/PMPS that is under 200. As you can see from what's happening tonight, even when you lowered his dose by a full unit, he has dropped low too quickly, requiring that you steer with food & retest over & over again. As Sue had said earlier, we want to keep your kitty below the renal threshold (roughly 250+) as much as we can; however, dropping too far down in the cycle (more than 50% of the preshot blood glucose test #) can result in "bouncing" - which means that the cat's body reacts to the super-low BG # by producing even more glucose. And then you see a much higher # at the next pre-shot test. So we try to avoid having that happen. (Sometimes the bounce anyway, despite our best efforts!)

Just saw your note re: bad connection - hope you can keep us posted. If not, you know what to do now.

 

ok it's actually 73. I put 72 on sheet by accident.

 

I'm totally aware of this. I made up her SS and put the large red bar across it. As I said, a new member certainly needs to pay attention and take action.

I just don't like blanket statements which could be read, and misinterpreted, by anyone. The normal range on an AT is 65 to about 160.

If Smokey is eating HC wet food and syrup just fine, I would continue that. But dry food can also be used, if necessary. It's listed in JoJo's hypo toolkit.

 

It's such a fine line. During day he is fine. Have to figure out the nights.

 

Above message is in wrong spot. I left reply but it got put in the quote box when power surge hit.

 

That's happened to me before, too!

 

I think we'll be okay now. Thank you all. I don't want to "meet" for this reason again, but I think we will.

 

You're welcome, Paula. I can fix the stacking numbers for you.

One other thing I want to add is that it actually does take almost 30 minutes to see a food spike even from HC. You would probably see some increase in 20 mins from syrup or honey. But typically, it's 30 minutes to start to see an increase from food and an hour to see the full result.

 

Okay, Paula - you're doing great! Will be interesting to see what Smokey's # is at AMPS. It's all a process, remember ... I will be around until about 11 pm Pacific time, just in case.

 

Good to know. Just lost connection to tablet. Have a good night and thank you.

 

@Marje and Gracie - Sorry if you perceived what I'd said earlier in this thread as a blanket statement that could be misinterpreted by anyone; really was not my intent. ("Hypo alert zone" means - to me, anyway - to "be alert for possibility of hypo symptoms occurring somewhere below this number.") My "watch it" # (<69) as appears on the far right tab of my SS is all of 4 small points above the <65 you mentioned. From my current vial of AT2 strips (exp. 10/2016), the insert from manufacturer Abbott reads:

Unexpected Results
Low or high blood glucose readings can indicate a potentially serious medical condition. If the blood glucose is unusually low or high, or if the animal does not show symptoms consistent with the results, repeat the test with a new test strip. If the reading is not consistent with any symptoms, or if the blood glucose result is less than 65 mg/dL (3.6 mmol?l) or higher than 250 mg/dL (13.9mmol/L) for dogs and cats, contact a veterinarian/ veterinary surgeon.

I'm simply not understanding why you chose to interject any concern about a "blanket statement" in the middle of this particular situation, as anyone could see how quickly and sharply Smokey was dropping after +2. This would have made more sense to me if I were, for example, telling Paula it was just fine to let her kitty drop to 50 (which was the human glucometer "watch it" number that was sitting atop her AlphaTrak2 SS). And yes, I know that an 80 - or even a lower number - can be considered a "surfing" number at some point in a cat's treatment journey ... but not in this particular situation; not at that moment in time.

Btw, was really great of you to help Paula get her SS up & running ... and adding that red band to it later on was a smart touch, too. Everybody using an AT meter should probably have a red band like that across the SS. (I want one! How do I copy that?) Makes it clear to anyone who is helping someone out that they're using the "less-oft-chosen" type of meter, which has a reference range that differs from that of the human meters more commonly in use among FDMB's membership.

My veterinarian has viewed my cat's AT2 SS countless times over the past 6+ months and considers the AT reference range prudent, as shown on the tabs at top.

I, for one, would rather err on the side of caution when giving advice here, whether I'm dealing with a newbie or not. As some cats can go hypoglycemic at higher numbers than other cats and/or be asymptomatic when going hypo, why take the chance? (Especially when a cat is dropping as quickly as Smokey did tonight.)

Finally, as someone who came close to killing my own cat by shooting her at too low a number on Lantus back in 2013, I will always encourage a new member to be on alert/steer with food at a somewhat higher "low" number than some others might. What is it that has so often been said around FDMB: Better too high for a day than two low for a moment? (Or something to that effect...)

Anyway, no offense taken, Marje - and none intended. Have a good night!

 

His AMPS is. 407. I'm staying with 3U. Let's hope I can get strip from vet. I only have 5 left. My order hasn't come yet. This bottle was new but I rarely tested. Didn't know to. When I first got him I did because he was so off.

Smokey seems to be an asymptomatic cat. At the 32 he was just laying behind chair which he doesn't normally do. At the 47 he was wrestling with the kitten. And then washing kitten's head. Does it sound as if he's not feeling well?

I will be at my own doctor today late morning and be gone about 2 hours. Not worried about his amps.

 

Wow Paula another sleepless night! Lots more info to help figure out your dosing though. I think I read somewhere that you can use other strips in the Alpha trak meter -Freestyle lite maybe? Maybe someone can give you that info. If I'm remembering correctly they are cheaper and can be bought at any pharmacy.

 

Good morning, Paula. I know this whole thing is hard to get your head around. Your problem last night was that you shot at a pre shot that was too low. And may have been still dropping. (That is a good sign that 3 units is too much insulin) This early in the sugar dance you don't want to shoot under about 230 or so with your AlphaTrak (200 with a human meter). It wasn't necessarily that your overall dose was too high - it was too high for that number. So he dropped too low and you had to give high carb syrup. Predictably this morning he bounced.

You want to lower the dose from the dose that gave you the low pmps. It looks like a higher amps This morning, but it isn't a "normal" high number. It's a bounce. When you get that low a nadir, you can expect a high the next time, but you want to lower the dose. Or you risk that today's cycle will be a repeat with an unshootable pmps.

Course, it is a sugar dance and he may be high and flat today. But generally after a hypo episode, I would lower the dose even on a high pre shot test the next cycle. I think 2.5 is a good dose for now, unless you get a low pre shot test. Then you do the stall thing. Wait 20 minutes and retest without feeding. If he has come up and is high enough, then shoot (but a little bit less than the dose that gave you the low pre shot number)

I know this is a steep learning curve and it seems like we keep throwing info at you. You are doing great. You have literally saved Smokey's life twice. I am just trying to let you get some sleep at night.

 

Gosh Paula, Smokey is getting you acquainted with everyone. Hope you got a good night's sleep after the hypo event.

 

Don't you need a script for them? I never see any on the shelves. My co-worker says they needed scripts for her husband.

 

You should't need a script for the test strips.

Yes, thanks to @Mogmom and Goofus, I use Freestyle Lite strips with my Alphatrak. They are made by the same company, and the BG readings compared to the Alphatrak strips' seem to be very close. The Freestyle Lite strips are a good bit cheaper!

 

Ask behind the Pharmacy counter; that is where the Relion strips are at Walmart.

 

It was 2U that gave the drop, but pmps was low. Let's say tonight if pmps is 200-250 give 1.5u or 1u would be safe? This is where I wrestle with my self. When do I give less or none at all????? And try to avoid the amps high. I want even keep is that to much to ask for!!!!!

How did you learn all this info? I read and read but it jumbles together. The correlation between reading on meter and if it the same as drawing and running sample at a lab, different meter have different levels.

What is normal for a cat and then what would those numbers on the alpha Trac 2 be. Then if he borderline low say 160-200 do I shoot or not and if so how much???? I question myself.

Thought giving insulin 1/2 hrs after dinner would be good so when he starts to drop the food would be kicking in. It works in the morning why not at night.

Just venting don't mind me. Stay tuned for tonight's episode. Pmps will be @ 7pm eastern time. You won't want to miss it. Set your DVR. I will need to know how much if he's low.

 

Where is PA are you? We are right outside of Doylestown.

 

I know some of you have run tests using your AT with Freestyle Lite strips and have gotten results that make you feel comfortable using Freestyle Lite strips in the AT. I have an AT2 and I also use it to do spot checks on the Micro, especially at lower numbers because I know my Micro runs low. But I would never use a human strip in a pet meter regardless of how close the results might be on testing. I'm sure if you called Abbott, they would tell you the same thing. I know the AT2 strips are expensive and if they are too expensive for you, then buy a human meter and use the appropriate strips for it and spot check your human meter with the AT using the AT strips.

I just wouldn't put Gracie in any danger by using strips that are not appropriate for the meter I'm using.....I don't care what anyone else's tests or any vet would say. IMHO.

@Robin&BB ...thank you. Normally I would never intrude on a condo when someone is working low numbers but putting a statement like that in bold in a new member's condo is unwarranted. And the info was incorrect. Yes....I could have waited until later when the low numbers were coming up and I probably should have but I wasn't sure I'd have the chance to get back around to it and people (e.g. lurker) tend to not read comments after numbers come up. The remainder of your comments, I'll address in a PM instead of doing a condo hijack.

I can also help anyone who would like a red line inserted into their SS indicating use of an AT. What I strongly recommend against is using the AT SS that has been developed or changing the ranges on the current SS for the AT. The majority of the ranges on the AT SS developed are not based on any science and could result in members making incorrect dosing decisions.

 

Jefferson Township. 12 miles north of Scranton.

 

Please please please no fighting here. I need all of you. I read inserts of meds even my own. Can't say I agree with everything printed. Never thought once on insulin you can ever go back to not needing it. This I have learned here. Not sure I have wrapped my head around that possibility yet. It would be great but scares me not to give any at all. That's where my conflict is. So I need my hand held through this.

 

I have just picked things up from others and stored the info away. At first, I ran off the pages and put them in a 3 ring binder! I had a diabetic cat over 8 years ago, started posting then and never stopped. So it's a lot of time learning. And seeing what doses do for other cats. Luckily, ProZinc - the insulin I am most familar with - behaves a lot like Vetsulin so I can help. There are lots of people here more experienced than I. My knowledge is old but refined with daily experiences. They may have a diabetic cat and have years of experience treating him. We have few experienced Vetsulin users.

Your meter does make things complicated. We have set ranges for human meters and feel they are pretty reliable. There hasn't been a consensus on AlphaTrak so in a pinch we just think it's maybe around+ 25-30 points higher than human. So a 40 on a human meter might compare to something around 65+ on an AT. That is far from perfect, but in a hypo situation it may be the best we can do. It is the range we are generally looking at - not so much a specific number - but sometimes, like with a hypo, you want to be more precise. I have to say whether the number you pick is 69 or 65 or 67 is unimportant; what is important is that when you see your cat in that range, you pay attention fast. Your AT should match your vet's AT on the same sample of blood at his office at the same moment. Other than that, it's all a grain of salt thing. Humans complain that meters are imprecise and meter manufacturers even say their meters have a +/- variance of 20%.

You decide a range you are comfortable with. I wouldn't want to shoot below the 200 range for a preshot until you know how he will react. What we know so far is that he reacts to a lower range by going into very low territory. That could change, but for now it seems a good baseline

Giving the insulin 1.5 hours isn't awful. We set an arbitrary 2 hour no food before preshot rule because we need some guidelines. We do say, test, feed (with Vetsulin in case he has a harsh drop) and dose, within a few minutes. If his tummy is empty at shot time, then it's possible the insulin will hit harder. It is fine to give him a snack about +2/3. In fact, good with Vetsulin as it can avoid a fast drop.

Glad you are keeping your sense of humor. It is vital to the process.

 

I can always tell now when Squallie's BG takes a sharp drop, he comes begging for food, usually around +2. I test him, give him a snack, and all is fine in his world, lol!

 

Please know we aren't fighting. It's discussion and it's important because you should know that on a peer reviewed forum, everyone is not going to agree on dosing, on meters, on many things. That's the beauty....you read it, you decide what works best for you and Smokey. We aren't here to make your decisions for you. We are here to offer a breadth of experience and information to consider and perhaps discuss with your vet ....and then you make the decisions. We understand all new members need some hand holding ....we've all been there.

 

Well vet had strips so I'm ok with that. Asked them to allow extra time on his visit so we can talk. The office staff mentioned the have seen a rise in hypo episodes lately. Said they just had another yesterday a pug puppy. Wonder if it's them advising blanket doses or what ever insulin being used is a bad batch.

Me personally would use a pet specific meter as long as they have one out there. I never mix brands for appliances or parts. To me things work better if coordinating parts are used.
At my doctors today. I asked about test strips for humans. A script is needed if going through insurance. At the drug store I asked them. They said the same.

Back to Smokey. Does anyone have an opinion about possibly switching to another kind of insulin. Just looking for opinions here. I would think a new curve would have to done to figure out a dose. I would definitely let a vet do it. Maybe even a new vet. I will see how his visit goes and if they are open to ideas and willing to work with me.

When I lived in NJ I had a vet I'd been with for over 30 yrs.. He came in on his day off to see my 20 yr old over the bridge. We bottle fed her from 3 days old. And he took care of her from 3 days old. He knew me and my cats. That's what I'm looking for. When we moved here I tried all the area vets until I found one I liked. The one I really like stopped working on the days I could go.

 

That might explain Smokey at +3. Never really put that together. He would beg a very short time but I ignored him and he go way. Because he had just eaten I didn't think he really needed it. I tried to keep his feedings even intervals at 12 & 6 hrs. I give him 1 oz boiled chicken. Just learned something new again. Thank you.

 

Hi, Paula - The only trouble with having a curve done in the vet's office is that a cat's stress from being there can elevate the BG levels; then you end up with the vet advising you to put the cat on a dose of insulin that is too high for him when he's at home and more relaxed. I wonder if this isn't what happened with Smokey when he was first diagnosed? As you had the first bout of Smokey dropping to low on your very first night.

We generally recommend going slow with the insulin dose, then increasing as indicated by the #s you're getting with careful home monitoring (just like you've been doing lately). My concern it that the dose you started out with may have been estimated at the vet's office based on stress-induced higher BG #s; do you think that may have happened with Smokey? I don't know which hour your at in today's cycle, but maybe would be good for you to go ahead and do a spot-test now? (Unless you've already done one & just hadn't gotten around to posting any new #s on his SS.)

I don't think you have a bad batch of Vetsulin; I just think his dose has been too high, IMHO.
ETA: This is why some of the others who posted here last night were recommending that you reduce the dose this morning, even though we knew you'd be seeing a higher number due to bouncing from the extreme low #s last night.

 

Wanted to add: My vet actually told me he prefers that I do BG curves myself at home, specifically because the stress of a vet visit can really raise BG levels pretty sharply! (Yep, I love my vet!)

 

I don't remember seeing the posts about lower dose for this morning. Since it was higher than yesterday I just kept to same dose.

@Robin&BB. Smokey was dx in 2012. Put on 2u. I believe they kept him 4-5 days doing the curve. Then he was increased to 3u but don't know when. But has not seen a vet since 2012. When I got him he stayed on 3u for quite awhile. Over the past year he started vomiting more often, going outside of box and constantly begging and crying. Would take him to the vet. They knock 20-30 points of his reading (some meter some vein) for stress. But always raised his dose usually 1/2u but one time raised by 1u twice a day. Started feeding smaller feedings every 2 hrs + medicine for vomiting. When they did his crying stopped, vomiting stopped, going purposely on floor stopped. About 2 months ago he had vomiting and diarrhea don't know why, BS was 596 if I remember. Started 5u twice a day. They said they can't go higher. They said he could be insulin resistant, maybe change insulin (which they didn't want). I suggested cut out all dry food and giving boiled chicken in place of dry and continue with canned. They said try it. Started that about 1 1/2 months ago when the vomiting and diarrhea stopped. I set up regular quarterly appointments and of course anytime in between if needed. Made him medically exempt for rabies (whole story in itself). Because of his age his routine vaccinations aren't needed. And we didn't want to start them from beginning again. He had not received them for about 3 yrs prior to me taking over. And now here we are. So combination of different food, scheduled feedings, monitoring more often, strict timing for insulin in the last 1 yr is now making a difference. A lot has changed for him this past year and even more change last 6 weeks.

 

Wow, Paula - that's been quite the ordeal, for both Smokey and you! (Amazing that it had to be you to suggest cutting out all the dry food - rather than the vet, I mean. Great call, Paula!)

So ... does Smokey have any other health issues besides the diabetes? And what's his weight? Is he overweight/underweight at this time?

 

Hi Paula--just saw this, don't know the entire story of your recent scare, but it sounds pretty rough. So glad you had help here and that Smokey is doing OK. I have to repeat what someone else said about your incredible devotion to this wonderful old guy. Hope he stays stable and happy and that you get some rest!

 

Ok here is his latest BS 449. Haven't give shot yet. Thinking of keeping it at 3U But on 9/7/15 he was 431 and got 3.5 and did well. of course that was the following morning after his episode.

 

It is so hard to figure today out without the mid cycle numbers. Yesterday, you gave 3 units on a lower pr shot and got the low pmps. If I have to guess, I'd guess there is a low mid cycle today and both amps and pmps are bounces. If he were mine, I'd give 2.5. Get some sleep and see how he looks tomorrow. What do you think?

 

No other issues. Vet is surprised how well his labs were except his BS in April 2015. I'll get them on the spread evenutly.

His top weight was 22-25 lbs. He has always been large. When i acquired him he was down to 12.13 pounds. Since January he is holding at 18.06-18.63.

 

Have you dosed Smokey yet tonight? Were you planning on a slight reduction for the overnight cycle or will you be holding the dose at 3U? (Keep in mind that he is probably bouncing a bit.)

 

It is so hard to figure today out without the mid cycle numbers. Yesterday, you gave 3 units on a lower pr shot and got the low pmps. If I have to guess, I'd guess there is a low mid cycle today and both amps and pmps are bounces. If he were mine, I'd give 2.5. Get some sleep and see how he looks tomorrow. What do you think?