Spikes Still in the blues & low yellows even after getting into contraband last night♡

Spike saw the Vet at 4:30 cst yesterday and had a BG of 298 on their lab equipment. His kidney numbers crept up from 43 to 48 since his visit 2 weeks ago, so she wanted his AminaVast supplement increased to 300mg. twice daily. Yesterday morning he only had a token dose of .25u due to a low preshot reading of 149 BG even after stalling for nearly an hour. The Vet said that it was the right call and I give all the glory to @FrostD ... He climbed to 301 BG at PMPS time last night, so got the full 1.25u dose.

All of the above leads me to today. AMPS as follows: 185 BG @+11.75 then 173 BG @+12.5 hrs. I can't monitor today, so I gave him about .3 or .4 of a unit and left two different bowls of wet UTH food out for him to snack on. Those are weird numbers this AM that were going down rather than up and I think it could be my meters variance as much as Spikes BG. He was fasting since like midnight and woke me up starving today.

FrostD, please put eyes on my SS when you can and make it make sense for me. The Vet actually said that her job was a breeze because YOU are doing all the fine tuned hard work, as am I in keeping the spreadsheet. She said she only knows of one or two purebred puppy breeders that would do all of what we are doing here...She said that Spike is lucky to have y'all and me in his corner.

Please give me some fine-tuned dosing advice for when these weird numbers come up that I can follow on the fly like this morning. I'll make it the Screensaver on my phone for easy reading when it happens.

I am so saddened to hear all that Miss Claire is going thru with Kaz and I'm sure she needs your time and concentration right now. I'll msg you privately about a way to help her help Kaz and his bills. The whole situation is really tugging at my heartstrings.

 

Good! I'll take whatever compliments I can get lol

Yesterday he was likely high due to combo of vet and lower dose. But it does read a smidge like a bounce from the lower blues the night before, hard to say. When he bounces, he tends to have that long slide down and late nadir.

Hard to say if he was flat or dropping since meter variance, but I'll always tell you to err on side of caution when you can't be home, so whatever you are comfortable with.

And yes, unfortunately DKA is all too common in new arrivals here...it's a shame because diabetic pet caregivers aren't really told to watch out for that one (or the other things that prevent it...like home testing and appropriate increases). Majority of cats make it if caught soon enough and are relatively healthy, but can be very expensive stay (I've seen up to 10k). It is not very common when home testing and fine tuning dose, but it is why we stress ketone testing.

 

Please keep educating me to keep Spike out of trouble.

Any instructions or things I should be thinking about as you look at Spikes SS, feel free to give fine tuned advice.

 

Maybe you can ask for a refund from Vet and pass it along to @FrostD

Holy Moly! I'm am so proud of you Spike!

 

The Vet actually didn't charge me for his bloodwork or office visit, just The bottle of AminaVast supplement. I could pass the savings on to @FrostD .

His numbers are all over the place and I've had to shoot 20% token doses for two mornings in a row, then a full dose of 1.25u at PM. I doubt that all those various dosages is conducive to flattening his curve, but i recon he needs what he needs. More insight and advise from frostD is always appreciated

This am, I got the following numbers all from the same big drop of ear blood. 336, 322, 368, 346 !!!?!?!?! Wonder if my meter is out of whack or just cheap Chinese junk Relion crap.

I'm tagging @FrostD and wondering if I need to invest in a better meter. Spike is eating well, but wasn't ravenous starving this am like he has been. I did get 1/2 a can of food in him at 3 different sittings at shot time. He had been poking me and getting a blood sample from my chin at 6am to let me know he was hungry and to get me back for jabbing his poor lil ears.

 

Based on his numbers the token doses were good, almost perfect. I think he just bounced a bit from some lower (safe) numbers yesterday, and hence didn't come down as far as usual last night, so then ended up higher this morning.

If I were a betting woman, I'd say you may end up with blue preshots tonight.

Too funny about the poke!

 

I am pretty sure that you'll be right based on how you are usually right about Spike. I hope you are correct, because I wanna see him flatten out and fly right and I feel good when he is in the mid-blues, but the greens scare me because I always miss the nadir and never wanna see him go too low...it prolly makes him feel terrible too.

What do you think about my meter and the range of numbers from the same drop of blood. I deal with electronics all day that are out of calibration, so I always wonder how correct the thing is...lol

Yes, Spike gets me back by creeping up to my pillow and taking a single claw and tapping my chin. When I don't respond, he pokes it in and he got a blood sample the other morning...Lil turkeybutt knew what he was doing and I know it was getting me back for the ear pokes...lol

 

Oh sorry forgot that part! I've used the same ReliOn meter for 2 years now and it's always been good. Remember human meters are allowed 20% variance (I think FDA thing? Can't remember exactly) so all those numbers were within that

 

Good thing I didn't put money on it

 

Loving these blues and yellows!

 

I'm thinking you might want to try a 0.25U increase...nadirs are pretty good but could use to be a smidge lower

 

I was actually thinking the same thing and was going to ask you about your thoughts on his recent numbers. I gave 1.25u tonight, but it was on the fat side, more like 1.35u-ish.

 

I increased him to a full 1.50u dose this am. Maybe his numbers will trend down better. It's easier to shoot too with no guesswork.

 

Spike is @102 actually down from 106 @+10.75 hrs. I have to leave for work so I'm going to skip his AM shot. I didn't test last night as I crashed as soon as my head hit the pillow,, so there's no idea how low he got b4 +10.75 hrs this AM. He woke me up with a single claw to the chin to tell me he was hungry. I tested then gave small snack (1tblsp) wet food....then tested at +12 and he dropped to 102....I hope I'm making the right choice in skipping this am.

@FrostD this is fyi. It seems that the 1.5u drives him low or way down whereas the 10 cycles of 1.25u wasn't getting his numbers into the blues very often. Pls put eyes on his SS and look into your crystal ball. What's my lil buddy up to???

 

Well back to 1.25U it is! Skipping absolutely the right thing to do

To be honest I think he's going to end up being a sliding scale cat, we don't usually have too many of those. He just gets an unusually long duration sometimes, plus you can't be home most days.

Give it another week or two at the 1.25U and see how he does. Obviously take a reduction if he earns one, but we'll reevaluate then.

 

Take a look at my spreadsheet from the beginning of 2020 and you'll sort of see what I mean. I was trying to figure out a sliding scale - normal dose above 175/200, lower dose in the 150-174 range, small dose in the 120-149 ish range. Wasn't perfect, by the time I had it almost fine tuned he went off the rails anyway.

For Spike, it seems 1.5 would work above 275. 1.25U in 225-274, maybe 1U in the 175-224 range. Hard to say, let's give.him some more time to settle down with a consistent dose

 

Thank you. Yes he stays all over the place and I just know he will be in the red or borderline black by 4pm this evening. I felt like we were making sum small progress but a skipped shot probably negates that and he starts all over way up high. I just hate that, because he was doing fairly well with the long cycle of 1.25u. I bet all this bouncing makes him feel terrible too. He climbed onto my bed last nite and gave me a look that said "daddy, this crap is wearing my butt out".

I know that you've got a full plate on here with other kitties, but I'd love to have a dosing chart with ranges for "can't monitor" and for "can monitor". I'll make it my cellphone wallpaper and be able to know what to shoot based on his numbers at a glance.

Thank you for your untiring work with all of us worried cat parents on here.

 

For now, I would give normal dose (1.25 U) if above 200.
150-199 and can monitor, try 0.75 U (half dose)
150-199 can't monitor, 0.5U (10-20% normal dose)
125-149 and can monitor, 0.25U (10-20% normal dose)
Anything below 150 and cannot monitor, I'd skip for now.

(I tweaked this slightly from last time, the "can't monitor 0.25U" in the 150-299 range wasn't quite cutting it)

I'm still not comfortable saying shoot something in the 125-149 range when you can't monitor. Realistically I think 0.25U would be ok but a gamble I don't want to take with someone's else's cat lol

 

Thank you. Please reread last msg just to make sure . Except for an obvious typo, it sounds like what I am comfortable with doing with Spike. And u r right, I can't feel good about shooting a low number if I can't be there to watch him. As a matter of fact, I would stay paranoid all day wondering if he would be ok while I'm gone.

Your the greatest Melissa. Thanks.

 

Vets and techs are human too and put up with loads of crap. I bake for mine, they love it and never forget it.

 

Yep! And no problem

 

I just got home and checked Spikes BG at 4:15PM cst. It is 193 and it's been 20 hours since he had that 1.5u last nite at 8:15PM cst. I was assuming that without his AM dose today, that he would be nearly into the black. What could be going on here???

@FrostD, what does the Spike crystal ball say is going on here?? Shouldn't he be skyrocketed high due to the missed shot? My gosh, did he possibly get so low last night that he STILL hasn't climbed back above 200 BG yet. Please educate me on what my buddy is up to today.

As far as I know, I'll just wait until his normal shot time of 7PM to give him his 1.25u.

 

It's a little hard to say, but I doubt he went below 50. I'd have expected a bounce if that were the case.

I *think* what you might be seeing is yesterday's bounce break...he was so flat that last half of the cycle, I think he probably got closer to 14+ hours duration out of that AM shot - just enough to offset his breakfast and possibly a snack (it also means his pancreas is somewhat functional and pitching in a bit).

Now the question I don't have the answer to is the mystery of his onset after these bounce breaks, just simply "bad luck" because you haven't been home to test when it happens. In that situation some cats onset at the usual time and it's like a double whammy (the low hang around PS, plus onset at +3 and they go even lower), but some cats onset a little later.

 

There's another cat here that was slightly similar...I looked but couldn't find the post quickly, I'll dig again later when I have more time

 

I found some wet food dried vomit in the utility room shortly after i sent the above msgs to you. I can't say spike did it during the day or even last nite as there have been 3 cats inside all last nite and today while I was at work. Spike seems fine this evening tho.

If you have any special instructions for me at PM shot time, I'd love to hear them. My education continues....lol

 

No additional thoughts, just the usual lol

https://www.felinediabetes.com/FDMB...-skipped-cant-test-today.260106/#post-2924009

Pinky - seems like a similar situation. The bounce breaks put him at a +15 nadir - and then the next shot after the break was 12 hours from that, so a later onset for whatever reason.

 

I can see that I need to step up my testing game. This "bounce break" situation is a lot to learn and figure out...just when I thought I knew what was going on...lol

I left his wet food out today in case he needs it. He's a chilled out "grandpa kitty" so it's hard to tell if he feels good or bad usually, but I hope he gets used to cruising in the mid-blues. A couple days ago, he looked haggard and tuckered out from it all, but yesterday and today he seemed like his old self again.

 

Look at those flat blues!

 

And look how he only got up to 183 for his PMPS causing me to give him a half-dose of .75u. I'm going to check him at 11Pm (+4) and hopefully again at 1AM (+6) to see if he will drop below 90 around that time. I'd love to wake up and test at 5AM (+10) to see if there is anything I should know about. I guarantee he'll get a blood draw from my chin at 6AM-ish wanting to be fed.

Thanks for checking in on us. What do you think is going on with him? Could he be on the path to being under control and his danger level going down somewhat??? Or is he just having a blue day or two? I wish I knew more about the mechanics of what my lil buddy is up to....lol

Have a pleasant evening, and thank you so very much. I wish I could upload pics but I only have my phone for the internet...I live in the sticks...lol

 

He's breaking through some glucose toxicity it seems. Lot more blues/yellows, less pinks/reds. Still bouncing here and there, but they're pretty small, more infrequent, and he eats them pretty quickly.

I just embed current pics a few lines below the current date/last test in my SS

 

I'll need a quick education on this new phrase called "glucose toxicity". Is Spike doing a good thing and headed in the right direction for now, or is there trouble lurking around the corner according to the crystal ball? Lol

I'm type 2 diabetic, and when I was first put on metformin and glimeperide, I felt like hammered dog crap for a couple of weeks or a month actually, until I got used to being on the upper end of normal. Nowadays, I am basically ok except for some general lack of energy, but hey, I just turned 57 last month.

 

Glucose toxicity is essentially when they're in higher numbers for so long their body sees it as the new normal, and kind of gets stuck there. So as you increase dose and/or they spend more time in lower numbers, that starts to go away.

It can set back in repeatedly for some cats, more often the cats that are harder to regulate (due to underlying conditions, etc). Sometimes they bounce, and the bounce lasts so long they kind of get stuck back up there again and creep back up, so have to play a game of increases and decreases. I don't quite see that being the case for Spike yet, though there probably will still be some fine tuning his dose

 

Well, I brought inside the "barn kitties" dry food bowl & put it on a high shelf. Well, at 4AM I heard a crash in kitchen and there is Spike sitting on shelf and dry kibble is scattered on floor. I think he had been munching for a while b4 he knocked it down. Tested at 4AM & he was at 303. He climbed to 339 by 8AM. It's my fault not his that he is back in the pink. I gave his full dose of 1.25u, so no telling where he'll be at 5pm. I've got to develop a better system and yes, I'm trying to transition everyone to wet food, but 3 of 5hem simply aren't trying to hear of it.

I could just kick myself in the teeth for spikes setback. I'm so scared of DKA on one end of the scale and of a hypo event on the other end.

 

These carb addicts i tell ya ...

Im fortunate the dog gets the downstairs and the cat stays upstairs no contraband for him unless he wants to risk a playful dog

The risk of DKA really is very low with these numbers he's seeing. If he hasn't had ketones yet, he's not very ketone prone and he should be pretty good in this range.