Tye now eating wet food, numbers down, not sure what to do!

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tye

Member Since 2010
Hi all,
Have had great success in getting Tye off the dry food - found some Fancy Feast flavours he likes (Chicken + Liver and Turkey + Giblets) and he is now happily eating 2 cans per day without any dry at all.

As you can see in the chart we dropped his dose to 0.75 2x a day as suggested in the other thread, but then even that seemed high so in the past few days went down to 0.5.

NOW there is something different going on - he is consistently in the high 100's (10's) in the morning before his shot... but then before the evening shot he is even lower - last night 83 (4.6) and the day before that 99 (5.5). We haven't given him his evening shot at all in the last few nights for fear he would get too low.

Just FYI he gets his wet food after each shot, twice a day.

What should we be doing now? I have no idea if we're doing the right thing or not by omitting the evening shot... am very confused as I didn't expect his numbers to drop so quickly, and I find it strange they are so low at night (even before omitting the night shot).

I can probably do another curve on the weekend but would love any thoughts/advice on what is going on here!

Thanks!
Michelle
 
Re: Tye now eating wet food, numbers down, not sure what to

Breakthrough is what you have here! Even without mid cycle numbers it's obvious he's getting stable numbers. That is the magic of good, steady Levemir dosing and low carb food.

I highly urge you to get that curve this weekend, but he needs some insulin in the meantime. So, what to do? He's not going up very much even without the shot and you are at the point where you decide on a shot/no shot BG level because he looks very close to going off the juice (anti-jinx). You've already done that really, by not giving shots if he's under 100. And that was the right choice.

But again, Levemir likes stable numbers, so giving even smaller amounts of insulin instead of skipping will maintain stability and allow the pancreas to heal. Sometimes that means an irregular shot schedule, as they get closer to staying under 120 all the time, but times when it's over 150 (Sheila, help me here) you may need to give a token amount.

Hopefully Sheila will be by sometime this evening, as she's weaned Beau off insulin successfully (and Jeddie too but he must have liked the attention too much so he's FD again) and can probably guide you better about shot/no shot BG levels and dose. .25U would probably be safe if you could set an alarm to test in the middle of the night, maybe +6. If not, then food needs to be left out. Food not being available to a diabetic makes me nervous. Does he eat all his food in one sitting? Perhaps a timed feeder could help.

I'm very impressed that you've done such a good job making the decision to lower dose without curve numbers!! The spreadsheet really helps, doesn't it? Even with only preshot numbers you can se the trend. Way to go!!
flip_cat party_cat
 
Re: Tye now eating wet food, numbers down, not sure what to

tye said:
Hi all,
Have had great success in getting Tye off the dry food - found some Fancy Feast flavours he likes (Chicken + Liver and Turkey + Giblets) and he is now happily eating 2 cans per day without any dry at all.

As you can see in the chart we dropped his dose to 0.75 2x a day as suggested in the other thread, but then even that seemed high so in the past few days went down to 0.5.

NOW there is something different going on - he is consistently in the high 100's (10's) in the morning before his shot... but then before the evening shot he is even lower - last night 83 (4.6) and the day before that 99 (5.5). We haven't given him his evening shot at all in the last few nights for fear he would get too low.

Just FYI he gets his wet food after each shot, twice a day.

What should we be doing now? I have no idea if we're doing the right thing or not by omitting the evening shot... am very confused as I didn't expect his numbers to drop so quickly, and I find it strange they are so low at night (even before omitting the night shot).

I can probably do another curve on the weekend but would love any thoughts/advice on what is going on here!

Thanks!
Michelle

Good for you omitting the wet food and good for Tye for cooperating!

It would be good since you are home during the day (if I remember correctly) to get in a few more spot checks. Then we could see a better picture since it does seem with those lower numbers at his PM preshot that he may be going much lower during the day.

But it really does appear that a reduction is needed here with the diet change. I would suggest .25 and try to get some more spot checks in to see how it is working. You may even need to go lower than that but let's see how it goes.

Hope that helps. Post here often so we can see your progress and if you have any further questions. This is looking good for Tye. :)

Edited to add, just saw that Vicky was posting at the same time! Good luck and let us know how it goes.
 
Re: Tye now eating wet food, numbers down, not sure what to

Haha, Pamela, great minds think alike, don't they?

Although I don't know that he's going too low during the day, I would think he'd have some orange or red numbers in there if he were. Spot checks are definitely needed, but if you can't get to it till the weekend, Michelle, lowering to .25U when you can't be home would be good.
 
Re: Tye now eating wet food, numbers down, not sure what to

pamela and tigger said:
Good for you omitting the wet food and good for Tye for cooperating!
I think she meant omitting the dry food! :mrgreen:

You might try a skinny .5u or maybe .25u right now to even out those PS numbers. The longer you can give a consistent dose, even if that dose is dropping, the better it will be. So, .25u bid is better than .5u in the am and nothing at night. Make sense? Then maybe both PSs will be shootable.

I found that I had to decrease the dose in .1u increments, stepping Beau down every time he dropped below 50. Eventually, he was on .05u bid, but I found I could not shoot below 130 or something near that, or he would drop to the 30s. So I started skipping shots when he was below 130 (except for one time I shot 89 because someone said "shoot low to stay low", but he dropped to 35, so that was that.

If you look at Beau's SS for the last 10 days of Aug 2009, and through Sept, you can see how I worked the numbers. Some of that was guessing - or gut feeling. Because he was on so low a dose, when I was out of town I set a higher do not shoot number for my sitter, who was testing. I think it was 180, but David went over that 4 times and Beau still brought himself to 104 on his own. I would not have let those numbers go without insulin, but since he could drop into the 30s with no warning, it was better to let him be a little high since no one was going to be there.

I can't really take credit for "weaning" Jeddie off insulin. I just recognized that he didn't need it anymore, or more like it wasn't safe to give vetsulin when I could not consistently test him and he had no excessive drinking/peeing... and when I could test, I found I was right.
 
Re: Tye now eating wet food, numbers down, not sure what to

"I can't really take credit for "weaning" Jeddie off insulin. I just recognized that he didn't need it anymore, or more like it wasn't safe to give vetsulin when I could not consistently test him and he had no excessive drinking/peeing... and when I could test, I found I was right."

Sheila, did you mean Levemir? And who else weaned him off insulin? By recognizing when he didn't need it, you weaned him off of it, silly. Sorry, but that's my old farm girl term for it :roll:

And this: "The longer you can give a consistent dose, even if that dose is dropping, the better it will be. So, .25u bid is better than .5u in the am and nothing at night. Make sense? Then maybe both PSs will be shootable." is the best advice of the evening! Thank you for saying what I knew but couldn't explain.
 
Re: Tye now eating wet food, numbers down, not sure what to

No, I meant vetsulin. Jeddie was on vetsulin when I got him - 1u bid, no testing (at all for a month) after dx and a food change from dry to MD canned. When he needed insulin again last Feb, I started him on Lev.
 
Re: Tye now eating wet food, numbers down, not sure what to

Hi Michelle! Just looked at Tye's spreadsheet. That .25 is working nicely so far.

Be interesting to see what his number is tonight. I hope it is something you are comfortable shooting.

If you can, try to get in a +10 and/or a +11 test. Then if his preshot number at +12 is higher you will know that he is likely on his way up and you will feel more comfortable shooting the number.

Is your Dad still helping out with the testing? :)

Edited to add - just saw your latest number at +6. That 36 is getting a little too low for comfort. Please post so we can help.

It would be a good idea to feed some higher carb food. Not necessarily dry, but if you have some higher carb gravy type food in the house.

Here are three printouts that you should read and post on your refrigerator if you haven't already:

http://felinediabetes.com/FDMB/viewtopi ... =14&t=1122

http://www.felinediabetes.com/phorum5/r ... msg-925783

http://www.felinediabetes.com/phorum5/r ... sg-1661798

Please post and let us know how it is going.
 
Re: Tye now eating wet food, numbers down, not sure what to

Hi all,
Tried lowering the Lev dose to 0.25 twice a day but as you can see per the curve I did yesterday even that was too much... he got as low as 36 (2.0) at +6 yesterday... no hypo symptoms except he barfed a tiny bit of hairball up (I notice he does that mid-cycle when he gets too low). Gave some extra food (with sauce) at that point but he didn't seem to like it so I don't know how well that worked... I will have to experiment to find some back-up high carb foods that are not dry. He seems pretty set on 2-3 flavours of the Fancy Feast and that's it.

Anyway - not sure if it was the right thing to do, probably not, but last night gave 0.25 of the Lev again as suggested (and he was at 130 (7.2) pre-shot so thought it would be ok) . This morning he was VERY low when tested - back down to 2.2 again.

So we haven't given any insulin today - just tested and he's all the way up to 187 (10.4) now.

Any suggestions on what to do? I would like to keep him stable at a low dose 2x a day but it seems like even that is too much... should we just be doing 0.25 once a day now and see how that goes?

Michelle
 
Re: Tye now eating wet food, numbers down, not sure what to

First off, I think you were RIGHT not to shoot the 40 this AM...having written that, when I got my Paul off vetsulin, I shot really low numbers and got yelled at alot for it, but I was home to test his little ear off, which I did and feed the snot out of him if I had to, which I didn't.

I think a better model of going OTJ for you to follow might be Sheila and Beau with Lev...I think she shot every other shot or only when he was over a certain number...I think that is where you guys are heading, so see if Sheila will weigh in.

In the meantime, I know you are little frustrated and maybe a little worried, but I think you are doing superb and have 53 paws crossed here for you and Tye for OTJ!!! ( Knockwood,antijinx!)
 
Re: Tye now eating wet food, numbers down, not sure what to

tye said:
Hi all,
Tried lowering the Lev dose to 0.25 twice a day but as you can see per the curve I did yesterday even that was too much... he got as low as 36 (2.0) at +6 yesterday... no hypo symptoms except he barfed a tiny bit of hairball up (I notice he does that mid-cycle when he gets too low). Gave some extra food (with sauce) at that point but he didn't seem to like it so I don't know how well that worked... I will have to experiment to find some back-up high carb foods that are not dry. He seems pretty set on 2-3 flavours of the Fancy Feast and that's it.

I did see your spreadsheet yesterday and posted to you here in this thread. And then again in a new thread that I started:

viewtopic.php?f=10&t=35045

tye said:
Anyway - not sure if it was the right thing to do, probably not, but last night gave 0.25 of the Lev again as suggested (and he was at 130 (7.2) pre-shot so thought it would be ok) . This morning he was VERY low when tested - back down to 2.2 again.

I tried to get your attention. ohmygod_smile I am glad it all worked out though because I was really worried after seeing that 36 at +6 yesterday. :) and when you shot the .25U at a 130 preshot last night, well, I was a little worried. nailbite_smile

But I was relieved when I checked again this AM to see that everything was fine. I would imagine though, and as you probably have figured out too, with that 40 low preshot this am, that he must have gone pretty low overnight. Not good but glad everything is okay. :)

tye said:
So we haven't given any insulin today - just tested and he's all the way up to 187 (10.4) now.

Any suggestions on what to do? I would like to keep him stable at a low dose 2x a day but it seems like even that is too much... should we just be doing 0.25 once a day now and see how that goes?

In the new thread I started yesterday, Sheila did suggest how you might want to reduce the dose:

by Sheila & Beau & Jeddie » Sat Jan 22, 2011 9:40 pm
Michelle, you might try just drawing so the top of the stopper just barely overlapping the zero line - that should be about .15u, it might be .2u.

Look at these photos viewtopic.php?f=10&t=34424#p360982- middle photo, middle syringe that shows .15u dose. Just a little overlap.


I see you have already shot the .25 dose tonight on a 209 preshot. You will need to get some spot checks in to make sure he isn't going too low again.

In my post I linked some really important info regarding having a 'hypo tool box' ready and other important information.

It is really looking good for Tye. :) Post often with questions, okay?
 
Re: Tye now eating wet food, numbers down, not sure what to

Michelle - PLEASE LOWER HIS DOSE. This is very important.

.25u is too much now. He is probably rapidly going into remission so numbers will be unpredictable. But you can't shoot .25u if he is below 250.

Please practice drawing .15u - that would be just a hair at the top of the syringe - the stopper top will not even clear the zero line. Then, only shoot that from 150 to 250. You can shoot lower ONLY if you will be there to test him and feed if necessary.

Like tonight, I think that .15u on the 209 and that might have given his just enough to get down to 70-80, which would be good. But that 209 is at least partly rebound.

Please get some tests in tonight.
 
Re: Tye now eating wet food, numbers down, not sure what to

Told my dad to shoot only 0.15 tonight... Tye got nothing this AM as I unfortunately didn't see the board in time before we gave 0.25 last night (and so he was too low again this morning to get any insulin at all). I didn't realize even a 0.25 dose every other shot would affect him that much - wow. Anyway, tonight he's up again to 216 (12) so will see where things are at in the morning with this teeny tiny dose. I won't be able to do another curve until the weekend as I am not there with him right now, but have left my dad clear instructions not to give anything if he's under 150 (8) and when he does shoot to only give the 0.15 dose. But to be on the safe side I'm making my dad call me at shot time every day just so I can be sure :-)

Thank you all for your help and concern - I would never have believed that he could show such results so quickly if I didn't see it with my own eyes! I will update with more results soon.
 
Re: Tye now eating wet food, numbers down, not sure what to

tye said:
Told my dad to shoot only 0.15 tonight... Tye got nothing this AM as I unfortunately didn't see the board in time before we gave 0.25 last night (and so he was too low again this morning to get any insulin at all). I didn't realize even a 0.25 dose every other shot would affect him that much - wow. Anyway, tonight he's up again to 216 (12) so will see where things are at in the morning with this teeny tiny dose. I won't be able to do another curve until the weekend as I am not there with him right now, but have left my dad clear instructions not to give anything if he's under 150 (8) and when he does shoot to only give the 0.15 dose. But to be on the safe side I'm making my dad call me at shot time every day just so I can be sure :-)

Thank you all for your help and concern - I would never have believed that he could show such results so quickly if I didn't see it with my own eyes! I will update with more results soon.

So glad to see you on here Michelle! We have been trying to get your attention. Sheila and I also sent you a Private Message.

I wondered if you were there or not or if it was your Dad. You guys are doing great, you just have to check in here more often so we don't worry! Just happened to check your spreadsheet on Saturday so when we saw the last few days...well, we were worried.

The best thing is to be able to give a small enough dose twice a day, but even sometimes that is too much with these kitties that are ready for remission. So spot checks are important. If you can get your Dad to do more of these it would be great. :)

I can see you are online so I am typing quickly. Please post questions.
 
Re: Tye now eating wet food, numbers down, not sure what to

Good, Michelle. Hold the .15u even if he is above 200 tomorrow - unless he drops low on it - then he probably needs to skip shots if he is too low at shot time or drops below 40 during the cycle. Will your dad test in the middle of the cycle? At this point its better to skip insulin if he is unsure.

There are doses smaller than .15u. Beau was on .05u and when he dropped into the 30s on that I started skipping shots. It's a hard dose to draw, just barely nothing at all... so, lets see how Tye does on the .15u dose.

Have you told your dad to check the syringe and make sure it is printed correctly? The zero line is AT zero? I always check to see if any of the stopper can fit above that zero line and if it does I take that into consideration and "subtract" that amount from where I normally set the dose. Last week I had a syringe with a half unit above the zero line! That's the worst I have seen.
 
Re: Tye now eating wet food, numbers down, not sure what to

Hi Michelle, would it be possible for your Dad to get some spot checks in so we can see how this new dose is working?

Also, you might want to start a new thread since this one is getting long. :)
 
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