Update on Teddy

[shawna]

It's important to know the nadir for a couple of different reasons. The first reason is safety: Since the nadir is the point in the cycle when the BG is at its lowest, knowing the BG number at that point tells you if the cat is in numbers that are safe, or if he's going hypoglycemic. Hypos can happen at any point in the cycle, but if a cat hits nadir at +6, and a person only tests at +3 and +8, they might think that the cat is doing fine, when really he's hitting hypo numbers every day, just not when he's being tested. If that goes undetected enough times, or severely enough, it can kill the cat. Conversely, if you assume a cat is going lower, but aren't testing at the right time, he could be sitting in numbers that are too high every day, and that's bad too.

Second, knowing how much change there is between the pre-shot number and the nadir tells you if the dose is working or not. For cats in higher numbers than Teddy gets, they would want a drop of about 50% for a "good" cycle. As the pre-shot numbers get lower, you don't need or want that much of a drop. So the difference between the pre-shot and the nadir can tell you if the dose needs to be increased or decreased or maintained.

Finally (well, there might be more, but this is the last one I can think of right now), if you know the nadir, you don't have to test as many times/day. This one does depend on how consistently your kitty responds to insulin though. If a cat is inconsistent and bouncy, this last reason doesn't apply because on kitties like that, their nadir will move around, and they can sometimes drop early or late in the cycle, so those kitties need to be tested more often anyway. But if you have a cat like Sam (my cat), he gets pretty consistent responses, so I only need to test him around his nadir most of the time. I just test to keep an eye on how effective a dose is. Sometimes I'm a little before or after his nadir, but I get as close to it as I can. Also, his nadir doesn't move around very much, so that helps too.

Oh this is great information and you explained it so well. Thank you!

Oh wow a cat could be going hypo every day without someone knowing it. Well if a cat gets in the hypo numbers and by the time the cat gets tested his numbers are higher...does it hurt the cat? I would never want this to happened, but I'm just trying to understand....I thought it only hurt the cat if the cat didn't go back up on his own?

And yes that makes complete sense about the dosing.

I'm going to check out your kitty's spreadsheet. That makes sense too. I need to do a lot more testing to figure out teddy still.

Thank you for all of your help!!!!!!! It's so nice to be understanding all this stuff better now!!!

 

[shawna]

To add to the second reason: knowing how low he drops tells you if his numbers at preshot are bounces too. If you have preshots in reds and blacks, and the cat is getting into blues and greens at nadir, you can pretty much tell that's a bounce.

Basically, while depot insulins like Lantus and Lev are dosed on nadir, Prozinc is dosed on nadir AND preshots. We take the two numbers together and, using that and any data we have on the cat, decide on a dose.

Ok thank you!! That makes sense! I appreciate you explaining that!!

 

[Djamila]

Oh wow a cat could be going hypo every day without someone knowing it. Well if a cat gets in the hypo numbers and by the time the cat gets tested his numbers are higher...does it hurt the cat? I would never want this to happened, but I'm just trying to understand....I thought it only hurt the cat if the cat didn't go back up on his own?

Not for very long. If it was mild, and the cat is generally healthy, then they can dump stored glucose into the blood stream and bring themselves back into healthy numbers, but it is hard on their bodies. And if the stored glucose is used up from it happening repeatedly, then that's when it becomes deadly. If the hypo is severe, then one episode can be enough to cause long-term damage or death.

 

[Yong & Maury GA]

The only thing is that when I'm at work I don't know if he eats or not (I doubt it) and when I am home I give him some snacks because I want him to get stronger since he had lost so much weight. So that's the only confusion to me....if the food will mess his up. Or if maybe I should just only feed him AM and PM meals and then he can have snacks after PM test....

Don't give him too many snacks before PMPS when you get home. You don't want to food influence his BG PS reading. Feel free to give him extra food between after he gets shot (if numbers are permitting, 95 is not ) and up to 2 hours prior to next PS test. Maury still needs to gain weight too so I understand wanting to get some calories in them . He gets his AM and PM meals, if I don't have to stall, for his shots (numbers permitting) and then he gets a "lunch" between +3 and +4. It's in my signature

 

[shawna]

Don't give him too many snacks before PMPS when you get home. You don't want to food influence his BG PS reading. Feel free to give him extra food between after he gets shot (if numbers are permitting, 95 is not ) and up to 2 hours prior to next PS test. Maury still needs to gain weight too so I understand wanting to get some calories in them . He gets his AM and PM meals, if I don't have to stall, for his shots (numbers permitting) and then he gets a "lunch" between +3 and +4. It's in my signature

Ok thanks, the part that doesn't make sense is why isn't 95 a good number to give a snack after testing? You mean we need to see if the 95 goes lower or higher on its own? But for pm if I give zero insulin after a pm reading of 95, isn't it good to give food during the evening? I just can't get him to ever eat all his food at once.

And one other question (for now lol)
I can't give him lunch since I get home at 10+ usually from work - so should I just wait to feed him after his pm shot? And then can I give him one evening meal later?

 

[Yong & Maury GA]

Sorry for confusion. Was saying 95 is not a good number to give insulin, OK to give extra food after such a Preshot since you will skip dose. When I won't be home to give Maury fresh lunch, I freeze his portion the night before then set it out as I'm about to leave. Takes a couple hours to thaw so it's ready by his lunch time.

 

[shawna]

Oh ok I had read that wrong about the 95. Sorry about that!
Oh that's interesting about freezing the food! Actually I don't think Teddy would even bother with the food until I get home. Well maybe he would when he is feeling better. But since February I've been serving him his food right to him.
Thanks for all your help!

 

[Yong & Maury GA]

Wow Shawna! Teddy is doing awesome! Halfway through your OTJ trial! (antijinxing) *paws crossed*

 

[shawna]

Wow Shawna! Teddy is doing awesome! Halfway through your OTJ trial! (antijinxing) *paws crossed*

Awww paws crossed LOL too cute!
Sorry I didn't get to reply sooner...tomorrow is our last day of school and this week has been so very crazy!
But yes do you think Teddy's diet change helped him? I wonder if I should try my alpha tracker for awhile to give the vet my numbers? Once cats go off the insulin so they need to be monitored daily forever and maybe having insulin once in awhile?

I hope you are doing well!!

 

[Djamila]

A diet change can make a huge difference! Many cats go OTJ as soon as the food is figured out. Usually people will monitor once/week for a month, then every two-three weeks for life. And always and forever keep him on low-carb food (kind of obvious, but worth saying).

If you get one wonky number, you don't need to give insulin, but do start monitoring more often again, and if you get a few wonky numbers, it usually indicates he needs some insulin support. If you suspect that, just post here and people can help you figure it out.

Congrats on getting him OTJ!

 

[Yong & Maury GA]

What Djamila said . I've heard of some people going to testing once every few months but personally, if Maury gets a remission, I don't think I could wait every few months .

He still has 4 days for two weeks but is looking good