Update on Charlie!

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Katy and Charlie

Katy and Charlie

Member Since 2023
Good morning everybody! I am still working on trying to get Charlie regulated and I am so grateful for all the help this forum has provided. I was a little surprised to see Charlie was at 149 @ AMPS.

Trying to figure out if we should keep going with the 5 units or not. His BG is all over the place I have a hard time knowing what to do!
 
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@Wendy&Neko Your thoughts on how many units to give him this morning? I have to work today so I won't be home most the day. I will be able to test mid-day. I just worry about him getting too low.
 
If I’m understanding what you wrote in the amps column, he went under 90 so you’d go down to either 4.75 or 4.5. I’ll let @Wendy&Neko confirm which. Any way you can put that info in the right columns? It’s hard to read it and a bit confusing. Thanks!
 
Ale & Bobo & Minnie (GA) said:
If I’m understanding what you wrote in the amps column, he went under 90 so you’d go down to either 4.75 or 4.5. I’ll let @Wendy&Neko confirm which. Any way you can put that info in the right columns? It’s hard to read it and a bit confusing. Thanks!
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Sorry for the confusion! I thought I needed to put it in there since I didn't actually give him his morning shot... I'll move it over so it's easier to read. Thanks for the help!!
 
wow, well thank goodness you are no longer giving 18 units/day! Unfortunately skipping is also not great in terms of achieving regulation. But sometimes, it feels like you really have no choice.
 
Hendrick Cuddleclaw said:
wow, well thank goodness you are no longer giving 18 units/day! Unfortunately skipping is also not great in terms of achieving regulation. But sometimes, it feels like you really have no choice.
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I know! I am so glad we've been able to lower the dose that much. I've been skipping a bit the last few days... I really don't want to but since he's been dropping so low we have to. We are slowly figuring out how much to give him while also slowly changing his diet which is proving to be quite difficult. Charlie is acting great though! Playing a little bit and has good energy. It was just a week ago I really thought we might lose him. I'm happy he's still here. :cat:
 
Katy and Charlie said:
Charlie is acting great though! Playing a little bit and has good energy. It was just a week ago I really thought we might lose him. I'm happy he's still here. :cat:
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when they aren't themselves, and then start to feel a little better and you start to see the "old Charlie" again....well I just can't put it into words. Annnnnnnnnnnnd now I need a tissue, must be that onion factory just opened up next door or something :rolleyes: :oops: :joyful:
 
Sorry I wasn't around to reply. I am on the west coast and not usually up at your AMPS unless I'm on the water and away from the internet.

A skip was a good option today especially since you are continuing to test those ketones and they are staying away. :) However, I hope you took away that high carb food and dry food when you did that mid day test. The diarrhea you mentioned could be partly because of the food transition. What percent of low carb vs. his old food is he getting normally now?

Today is the 5th day since you last did 3 times a day dosing? How many days of 3 times a day dosing? The time on just twice a day plus the skips you have done should get rid of that ugly high 18 units a day depot. With the ketones staying out of the picture, I'd suggest trying 4.0 units. I'd rather you dose a little lower and have to work your way up, than have to keep skipping. That 75 you saw today tells me 5.0 units is still too high.

For those who want to read the original story, here it is: https://felinediabetes.com/FDMB/threads/new-here-5-months-in-and-still-not-regulated.286158/
 
Wendy&Neko said:
Sorry I wasn't around to reply. I am on the west coast and not usually up at your AMPS unless I'm on the water and away from the internet.

A skip was a good option today especially since you are continuing to test those ketones and they are staying away. :) However, I hope you took away that high carb food and dry food when you did that mid day test. The diarrhea you mentioned could be partly because of the food transition. What percent of low carb vs. his old food is he getting normally now?

Today is the 5th day since you last did 3 times a day dosing? How many days of 3 times a day dosing? The time on just twice a day plus the skips you have done should get rid of that ugly high 18 units a day depot. With the ketones staying out of the picture, I'd suggest trying 4.0 units. I'd rather you dose a little lower and have to work your way up, than have to keep skipping. That 75 you saw today tells me 5.0 units is still too high.

For those who want to read the original story, here it is: https://felinediabetes.com/FDMB/threads/new-here-5-months-in-and-still-not-regulated.286158/
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No worries, Wendy! I appreciate any help you can give. :) I have been leaving dry food out for grazing throughout the day, let me know if I should stop that. He is still getting roughly 25% dry and 75% wet. I haven't changed feeding since we changed to 2x/day. That transition to wet food is something I have struggled with. I know you said 10% change per day and I feel that is hard to gauge. I also feed Charlie and Annie together. Even if I give them separate bowls they end up sharing a bowl which makes things a little tough too.

The mid-day test was 312, then 15 minutes later 291. I expected a higher number since I skipped this morning, but I found it weird it dropped a little in those 15 minutes. My husband should be getting off early and can hopefully test some more soon.

We only did 6 days of 3x/day. Before that stay at the vet and DKA diagnosis, we were doing 5 units 2x/day. I wasn't testing and keeping track of things like I am now.

I agree with trying 4 units and working our way up if needed.

EDIT: Husband just tested Charlie at 385, so he is still rising. Which is expected since I skipped this morning. He is due for another dose in 4.5 hours. We'll see what the 4 units does for him tonight.
 
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312 and 291 are withing the margin of error on BG monitors. They differ by 15-20%, which can be a larger amount in higher numbers. So essentially the same number.
 
Sorry no one was around to help you this morning. I too suspect the dose is still too high; thankfully the ketones are staying away and you’re finally getting some good data that can help you make sense of what’s happening and help you find a good dose.

By the way, today’s AM +1 should be colored green. :)
 
JL and Chip said:
By the way, today’s AM +1 should be colored green. :)
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Fixed! No worries! Looks like I made the right decision this morning anyway. Posting here and starting the spreadsheet has been extremely eye-opening. It's going to be tough starting out, trying to find the right dose, and also switching to wet food but we are on the right track!
 
Good morning friends!! Charlie tested at 159 for the AMPS. I went back and forth on if I should give him his shot or not. I hate that we've had to skip so much. He was at 149 the morning before and I skipped his shot, by + 6 he was at 312, and at PMPS 561.

So based off that, I decided to give him 4 units this morning. With the hopes it will slowly kick in and keep him from getting too high today. I'll test as much as I can before I leave for work to make sure we aren't dropping too low. I sure hope I didn't screw up by doing that! Let me know your thoughts!
 
flat at 1.5 hours, well that's good. If he isn't plummeting at this point he might just surf in the mid-100s for a while. (flat meaning he hasn't dropped or gone up, 140 is essentially the same as 159)
 
Hendrick Cuddleclaw said:
flat at 1.5 hours, well that's good. If he isn't plummeting at this point he might just surf in the mid-100s for a while. (flat meaning he hasn't dropped or gone up, 140 is essentially the same as 159)
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That is what I am hoping for! I'll test him again mid-day and see where we are at. Thanks, Hendrick Cuddleclaw! :)
 
Lantus onsets, or kicks in, around 2-3 hours after the shot. If you can test again somewhere it that time frame, it'll give you an idea where this cycle will be an active one that needs more monitoring. When you can't be around, leaving food out for him to munch on is a good plan.
 
Hendrick Cuddleclaw said:
325 @ + 5.5

shot right back up. what a rollercoaster with this one!
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I know!! What the heck! I was kinda surprised to see it that high. It really has been a rollercoaster.

@Wendy&Neko Do you think we should adjust dosing again or keep with the 4 units for a little bit? I still need to remove more of the dry food from his diet, so that will change things.
 
He's bouncing, could either be from a steep drop last night or going lower than he's used to. We determine how to change the dose based on how low the dose is taking the cat. What we've seen so far, 4.0 units isn't taking him too low. I'd like you to be able to stick with the same dose for at least 6 cycles to stabilize the depot. With SLGS and dry food in the diet, you hold the dose for 7 days. So I would stick with 4.0 units for now unless he shows a low number, or ketones creep up.
 
Wendy&Neko said:
He's bouncing, could either be from a steep drop last night or going lower than he's used to. We determine how to change the dose based on how low the dose is taking the cat. What we've seen so far, 4.0 units isn't taking him too low. I'd like you to be able to stick with the same dose for at least 6 cycles to stabilize the depot. With SLGS and dry food in the diet, you hold the dose for 7 days. So I would stick with 4.0 units for now unless he shows a low number, or ketones creep up.
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That sounds great. We have been changing so much, that I thought it would be good to keep it the same for a bit so we can really see the data. I'll keep updating the spreadsheet and will post an update on here in a few days. Thank you so much for all your help so far!! :bighug:
 
Katy and Charlie said:
That sounds great. We have been changing so much, that I thought it would be good to keep it the same for a bit so we can really see the data. I'll keep updating the spreadsheet and will post an update on here in a few days. Thank you so much for all your help so far!! :bighug:
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How are you and Charlie doing?

Please remember to try to get in those before bed tests if possible. Many cats go lower at night and it’s possible today’s high numbers are a clue that he went low last night (or perhaps even lower than the 89 you recorded mid-cycle yesterday).

Speaking of that 89… SLGS guidelines are to reduce dose immediately whenever the BG goes below 90. That means yesterday’s (Feb 7) PM dose should have been reduced to 3.75u. @Wendy&Neko agreed??
 
Good catch JL, and thanks for snooping the spreadsheet. :) Katy, you need to reduce the dose to 3.75 units. He's been on the 4 units long enough for us to know it's still a bit too high a dose.

And given how much he came down today, you really need to try to catch that before bed test tonight. Looks like his numbers are racing down.
 
@Wendy&Neko Charlie’s spreadsheet shows lime green numbers from PM +2 to PM +2.75 tonight, including a 21, LO, and 44. Do you think a 0.25u reduction is enough? Or should it be a larger reduction given the dosing history and potential for large BG swings?

@Katy and Charlie I hope you see these posts. Have you been testing for ketones? How is Charlie doing? Remember that syrup is a temporary fix and can wear off quickly.
 
Wendy&Neko said:
Agreed, I would do a larger reduction, based on the history. However, recent ketones tests results is important.
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Good morning All!

Sorry I am just seeing all these posts. It's been a rollercoaster as usual with Charlie but he is still acting normal. He even jumped up on the couch last night which he hasnt been able to do for a long time! On 2/7 we had a great day when he stayed below 300 all day. I felt like we were on the right track. Then 2/8 was bad. Maybe he was bouncing? Cause he went high and then really low, had to give him honey and treats until he started rising. On 2/8 I felt like I needed to give his ears a little break. I tried to test at night but he is really resisting it lately... but this weekend I'll be able to do some good testing. I'm not trying to make excuses but I struggle with some health issues that causes fatigue and at night im exhausted. I get easily stressed and Charlie and feel it. But im trying!! I haven't tested ketones but I will. I'm off to work now but will test BG and glucose during lunch if he let's me. I did 4 units this morning because I didn't see these posts yet. Please advice on if we should go to 3.75 or less.

Thanks so much for checking in and continuing to help me!!
 
Any time your kitty goes below 90, you need to reduce the dose. Much less LO on the meter. He is done with 4 units. I hope you can monitor today during the day, he could go low again. If not, please leave lots of food out for him to eat.

Try 3.5 units next.
 
Wendy&Neko said:
Any time your kitty goes below 90, you need to reduce the dose. Much less LO on the meter. He is done with 4 units. I hope you can monitor today during the day, he could go low again. If not, please leave lots of food out for him to eat.

Try 3.5 units next.
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Since I'm working, I am unable to test all day. But I will when I can. He has a bowl of dry food out at home and I gave him quite a few treats before I left. I'll go with 3.5 and test as much as I can over the next couple of days. Thanks, Wendy!
 
Katy and Charlie said:
Since I'm working, I am unable to test all day. But I will when I can. He has a bowl of dry food out at home and I gave him quite a few treats before I left. I'll go with 3.5 and test as much as I can over the next couple of days. Thanks, Wendy!
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Please stop in every day and post an update. I (and I’m sure others) will be watching for them.

I’m concerned that even 3.5u might be too much. Remember that any time he goes below 90, you need to reduce the dose immediately, even if his BG bounces high.

Remember also the importance of doing ketone tests. With Charlie’s possible DKA (even if it was a questionable diagnosis), we need to keep on top of the status. It also weighs in to dosing decisions.

I don’t want to exacerbate your stress, but I do want to be clear that low numbers are dangerous. Just because Charlie seemed ok with those lime green low numbers and nothing bad happened, it doesn’t mean that he’ll be ok next time. He’s had a harrowing dosing history and is on a much better dose now, but the body’s compensatory mechanisms can eventually fail. Low BG is nothing to mess with.

Given your stated medical, sleep, and stress issues, and Charlie being a bit more averse to testing, I think it is wiser for you to continue to take larger reductions than normal. At least for now. Post here and we will be glad to help you.

(Also, I always found it harder to get blood when BG was running in normal to lower ranges. Not always, but it can be a clue, so really try to get those values, even if it’s difficult)
 
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JL and Chip said:
Please stop in every day and post an update. I (and I’m sure others) will be watching for them.

I’m concerned that even 3.5u might be too much. Remember that any time he goes below 90, you need to reduce the dose immediately, even if his BG bounces high.

Remember also the importance of doing ketone tests. With Charlie’s possible DKA (even if it was a questionable diagnosis), we need to keep on top of the status. It also weighs in to dosing decisions.

I don’t want to exacerbate your stress, but I do want to be clear that low numbers are dangerous. Just because Charlie seemed ok with those lime green low numbers and nothing bad happened, it doesn’t mean that he’ll be ok next time. He’s had a harrowing dosing history and is on a much better dose now, but the body’s compensatory mechanisms can eventually fail. Low BG is nothing to mess with.

Given your stated medical, sleep, and stress issues, and Charlie being a bit more averse to testing, I think it is wiser for you to continue to take larger reductions than normal. At least for now. Post here and we will be glad to help you.

(Also, I always found it harder to get blood when BG was running in normal to lower ranges. Not always, but it can be a clue, so really try to get those values, even if it’s difficult)
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I appreciate your words and understand how serious it can be. I'll do the best I can to test BG and ketones as much as I can. It would be life shattering if I lost Charlie so I need to step up my game.

I'm sure you can already tell but I overthink too much. I worried about posting on here too much and being annoying. I'll be sure to post daily updates.... it helps me feel better to get advice from this community everyday anyways.

@Wendy&Neko +5.5 is 349, probably bouncing from the low last night. Ketones are 0.2mmol/L. You still think 3.5 units is a good idea?
 
Wendy&Neko said:
You are NOT being annoying. :bighug::bighug: You are one of our FDMB family now and we worry about sweet Charlie.

Ignore the bounce, shoot 3.5 units. We don't stay on a dose that's taking him too low.
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Perfect, we'll start with 3.5 units tonight. Thanks to everyone for easing my anxiety.
 

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Good morning Katy and Charlie!

I see Charlie was heading down at a fairly good rate last night, when I was testing Hendrick late at night and his numbers were continuing to drop it always made me a little nervous to go to sleep. You might want to consider setting an alarm for another hour or so when you see that steady downward momentum, just to check and make sure he is not going too low. Cats often go lower at night for some reason then during the daytime insulin cycle.
 
Hendrick Cuddleclaw said:
Good morning Katy and Charlie!

I see Charlie was heading down at a fairly good rate last night, when I was testing Hendrick late at night and his numbers were continuing to drop it always made me a little nervous to go to sleep. You might want to consider setting an alarm for another hour or so when you see that steady downward momentum, just to check and make sure he is not going too low. Cats often go lower at night for some reason then during the daytime insulin cycle.
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Good morning Hendrick! That's not a bad idea!!
He was back up to 374 at AMPS, gave him the 3.5 units. We'll see what today has to offer! I have some things to do today but should be able to get some good testing in today and tomorrow! Ketones are still 0.2 this morning.
 
I see Charlie made it down to 127 so far today. This could be partly the result of the 4 units depot, but also is a good sign that he's getting rid of bounces quickly.:)
 
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