Woody BG!

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Mum of two felines

Mum of two felines

Member Since 2015
This a.m. At Woody's +11 he is 283! It looked likes he slept through the night too! No kibble gone . So, I know I am not suppose to look at that number to base his injection (well I know I will sometime, but I know I need to look at his lowest) but do I give this injection?

I know I won't be home tomorrow or Friday to monitor him, I will be today. Someone can pipe in!
 
I feel like I've done so many dumb mistakes. The vet was only worried with the high numbers and I am struggling to get off that bus! Woody was 363 at +1
 
It's definitely a learning experience! We've all made mistakes, it's almost impossible not to when you are new to this sugar dance. We all expect our vets to be fonts of knowledge, and in many ways they can be, but not every vet is experienced in dealing with feline diabetes.

What did Woody eat this morning? Did he have breakfast just before his shot?
 
I second Lucy's comment...... You are doing a great job! Those high numbers are very hard to ignore but ignore them you must and focus on the lowest numbers. Interesting that Woody didn't get into the kibble. I'd try to keep it out of the mix from here on unless absolutely needed for an explicit reason!


@Squalliesmom So glad you were here to help with the morning dose! Much appreciated!:)
 
I assume you're feeding w/d canned in which case that AM+1 pink is highly likely to be a food rise.

Much better curve overnight. Flatter. A nice sunbathe with a brief dip into the lagoon. :)

The smoother curve should also be much gentler on Woody's system than the recent roller coaster rides.


Mogs

ETA - +2 may also be food influenced.

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Critter Mom said:
I assume you're feeding w/d canned in which case that AM+1 pink is highly likely to be a food rise.

Much better curve overnight. Flatter. A nice sunbathe with a brief dip into the lagoon. :)

The smoother curve should also be much gentler on Woody's system than the recent roller coaster rides.


Mogs

ETA - +2 may also be food influenced.

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Ditto!
 
Buzz will also knock the food can down, paw the lid off if it's not on good enough, he's just a stinker. Woody was out climbing around on the windowsills, we haven't seen that for awhile either. I am so glad we enclosed the porch 2 years ago! The sun comes in, they have windows and the slider to look outside, and the best of all they love it and neither minds going out and being out there. So, feeding separately is easier!
 
Let's wait a bit and see how his numbers shake out before making a decision. Are you able to monitor him through the night?
 
Great job so far today with Woody. :) Hopefully he'll be able to level out a bit over the next day or two, clear any bounce that's still hanging around from yesterday and then you'll be able to see where his numbers really are on a low dose. :)
 
Another member posted a link to this forum sticky. Study it ASAP because it will help you better understand the Novolin insulin and give you key pointers to consider when making dosing decisions (and also show you that others have had similar problems to yourself with this particular insulin).

Humulin N Primer (Humulin N is the same as Novolin - different manufacturers)


Mogs
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Novolin is same as Humulin N (different manufacturer).

Key points from Humulin N Primer for immediate consideration:

  • FOOD. Always make sure kitty eats about an hour before his/her shot.
  • [Humulin] N, in [author's] experience, can peak at anywhere from 2 to 6 hours.
  • You cannot adjust a dosage on preshot alone. Preshot numbers can be deceiving in that if you are going too low at peak, you will have high numbers at preshot.
  • Consistently high preshots without knowledge of your nadir number could mean rebound, at which point you don't need to increase your dosage you need to DECREASE. [Possibly where your vet went wrong.]
  • If kitty is going too low ([author didn't] like Bunny to be anywhere under 100 [NB: HUMAN METER VALUE - Alphatrak equivalent BG would be HIGHER than this] and [author], personally, [did] not “shoot” under 250 [HUMAN METER - again, Alphatrak equivalent BG would be HIGHER than this]), definitely decrease your dose. [@mrworfmen's mom - any idea on possible Alphatrak guidelines for these thresholds?]
  • Many people have found that ½ a unit BID or 1 unit BID ends up being the perfect dosage to keep kitty in the 100-300 range. [HUMAN METER - again, Alphatrak equivalent BG would be HIGHER than this.]
[Emphasis & comments mine]

The primer also features the following cautionary tale:
HORROR STORY: When we were newbies and our vet was learning this right along with us, we kept increasing Bunny's dose based on high preshots and vet visit readings. He was up to FIFTEEN UNITS OF N BID!!! Makes my stomach flip flop thinking about it now! Posted on this board that I was at my whit’s end because I could not get nice preshots. The posts I received back said, "That is WAY too much N! Start over and check your peak numbers!" He was going down to 26 at peak! YIKES! If not for the fact that Bunny free feeds, and can thus bring his numbers back up by eating, he would have died. ALWAYS FIND OUT WHEN YOUR PEAK IS AND CHECK THOSE NUMBERS BEFORE ANY INCREASE!
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Ring any bells? ;)


Mogs
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Its
Critter Mom said:
(Novolin is same as Humulin N. Key points from Humulin N Primer for immediate consideration:

  • FOOD. Always make sure kitty eats about an hour before his/her shot.
  • [Humulin] N, in [author's] experience, can peak at anywhere from 2 to 6 hours.
  • You cannot adjust a dosage on preshot alone. Preshot numbers can be deceiving in that if you are going too low at peak, you will have high numbers at preshot.
  • Consistently high preshots without knowledge of your nadir number could mean rebound, at which point you don't need to increase your dosage you need to DECREASE. [Possibly where your vet went wrong.]
  • If kitty is going too low ([author didn't] like Bunny to be anywhere under 100 [NB: HUMAN METER VALUE - Alphatrak equivalent BG would be HIGHER than this] and [author], personally, [did] not “shoot” under 250 [HUMAN METER - again, Alphatrak equivalent BG would be HIGHER than this]), definitely decrease your dose. [@mrworfmen's mom - any idea on possible Alphatrak guidelines for these thresholds?]
  • Many people have found that ½ a unit BID or 1 unit BID ends up being the perfect dosage to keep kitty in the 100-300 range. [HUMAN METER - again, Alphatrak equivalent BG would be HIGHER than this.]
[Emphasis & comments mine]

The primer also features the following cautionary tale:


Ring any bells? ;)

QUOTE]
Mogs
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This is a repeat!!
 
So, probably keep him on .5 at least until Saturday am so I can monitor Saturday Sunday and at +5 on Monday. I could slip home at +2.75 but I'd have all but 5 minutes!
 
I have no way to catch his urine. We have no aquarium rocks available in this town. His eye is red but he doesn't have the goop coming out.
 
If the infection's still on the go and you have no idea of ketone status then you don't have as much wiggle room in terms of dosing flexibility because you need to balance risks.

Can you monitor till +5 or +6 tonight?

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I was worried that he was getting constipated because I had seen his pudding poo, but he and Buzz are separated today and I just saw that he almost back to normal. It's not pudding, but it's also not solid. And his urine output is not so much the last 3 pees
 
Mum of two felines said:
I can do that for Woody!
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He has a good mama. :D

You've got a bit of a balancing act going on here. With the infection you need to be a little extra careful with the high numbers. With the harsh insulin, major history of hypos and treatment of the infection all going on you need to make sure that Woody doesn't go low (quadruply so when you need to be out during the day and can't test from +2 onwards).

Here are some options to consider:

1. Give 1 unit and see if it takes him too low tonight. (This will make sure he has insulin but carries the risk of him going too low.)

2. Give ½ unit and see if he levels out and dips down a bit during the night (hence the question about monitoring). There is a chance he may stay in the pinks but there's no way of knowing until you try and test. (Because Woody has an infection the smaller amount of insulin may increase the risk of his developing ketones.)

3. Give 0.75 units as a 'compromise' and test to see if this will lower his BG better than the 0.5 unit dose. (Don't know if you can measure this dose relatively accurately with your syringes - plus it's an unknown quantity.)

If I were in your shoes and working with a harsh in-out insulin like Novolin N (and I'm just speculating here) if I knew that ketone risk was higher than normal I would possibly look to keep numbers higher and safer when I could not monitor and perhaps just a little bit lower (but still in the high 100s at nadir) when I was home at night and knew I could monitor to keep my cat safe over the night time cycle.

Conjecture, but that would be the 'flavour' of my approach. Other members may have different suggestions.


Mogs
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ETA: The infection causes two issues:

1. Greater risk of developing ketones while it is ongoing.

2. Risk of numbers dropping unexpectedly if it resolves.

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Chris & China said:
I had this problem too! Ended up putting all bread products in my microwave or in the oven (of course you have to remember if you put it in the oven and make sure you take it out before you start pre-heating it.....Oops.....LOL)
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I've got severe OCD. Before I can dish up Saoirse's grub or set out her treatment accoutrements I have to make sure there's absolutely nothing containing any carbohydrates on the same surface. I can't even use the microwave because I need that to warm up the water for her tests or to take the 'chill' off her grub. :oops::oops::oops:

Thank gawd for the oven. :rolleyes:;)

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He's been on antibiotics since Monday evening. They gave an injection and I've been giving him 1 ml twice a day since yesterday morning. Buzz's eyes are clearing up and he is on the same treatment. I know that Clavamox isn't the drug of choice among members but I couldn't remember at the vets what the name was :(.
 
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