Sophia's AMPS

Good morning - I want to thank Robin for helping us through last night's numbers. Sophia is at 296 this morning and I would love some guidance on her shot this morning.

 

Good morning Susan Let's hope @Rachel isn't sleeping in I probably would not give 2 units Can you wait a bit? Can you refresh our memories as to Sophia's dosing hx?

 

I don't know? Can I?

 

When is your normal shot time?

 

6:30

 

What time zone?

 

mountain, so it's shot time now.

 

Will you be able to monitor her today?
@Sue and Oliver (GA)

 

yes

 

Susan, I'm not comfortable giving dosing advice. (My cat is on a different insulin) I know that you can wait 30 min or so and get back on your schedule easily. Maybe Sue or Rachel will be on by then. The usual starting dose is .5 - 1u I would not give more than that. Please keep us posted.

 

We are just guessing, Susan, so we want to guess cautiously. She was in safe numbers last night with 2 units but dropped early. And I think you are just changing to wet low carb. If you can monitor, You could go with 1.5. It shouldn't take her too low but should still give her some good levels.

Until we have some data, it is hard to know how much she needs. That's why we suggest starting with one unit (usually a nice safe dose) and working your way up, as you get numbers. If you are nervous, you could always restart with one unit and, with your tests as a guide, work your way up as needed.

 

I'm so sorry no one is here right now. Have you given the shot? I see Sue is here-great!

 

I did just give her 1.5 units and will monitor as I can. I will be home most of the day but with 3 little humans also!

 

The important time to watch is +2 hours after the shot (just in case she would start to drop early like last night) and then 5-7 hours after the shot to see how low the insulin takes her.

 

(Just now have one eye open & having first .) Agree with this 100%! That's o Yay! @Sharon14 & @Sue and Oliver (GA) to the rescue. Don't you just love our little tag-team here, Susan?

That's one of the reasons I was asking last night about some details re: date of Sophia's diagnosis and what the BG # was that the vet got on the day he'd diagnosed her diabetes. And he started her at how much ProZinc on that day? Having that info, even though you hadn't started home-testing right away, is helpful to us in trying to figure out where she should be on dosage. (I'm assuming you probably fell asleep from exhaustion last night somewhere after that +4 test ...)

You did a super job last night, so yes --- please get a +2 after this 1.5u dose. And when you have a minute, put together your signature, too, ok?

 

You guys are great! I feel so much better having people to give me advise!
Sophie's BG when she was diagnosed was 460. Her vet started her on 1 unit that day. A week later, I took her in for a curve and that's when they increased her to 2 units.
I did put some info on my signature. I have a toddler to watch today so this is going to be tricky.

 

Oh boy, that'll be fun, huh? (If you have a playpen, maybe put little toddler-person in there when it's time to catch that +2.)

This is a typical start point for so many of us: Vet gets one high BG # in-clinic. Starts at a certain dose - in your case just a single unite - BUT does not then say, "Test BG at home before each dose and ... (the other instructions you can see on the ProZinc Protocol doc I posted to you last night). "

Instead vet has you bring kitty back in for an in-clinic curve (often they choose to run a fructosamine test at that time) and look at it and usually adjust the dose based on what they're seeing in that test. Only trouble with this approach is: Kitty can spike a higher-than-usual BG# during a vet visit. (Stress hyperglycemia, sometimes as much as 100+ points.) So without getting those pre-shot tests at home, right before dose time, as well as some mid cycle tests, you just don't really get to see a kitty's truest BG patterns before & during a cycle until you're doing those ear pokes there at home.

So ... aren't you glad you've learned to do those little ear pokes? (By continuing to do this and amassing the data in her SS, you will not need to put Sophia through more of those in-clinic curves - which will also save you lots of $$$ - because they will be totally unnecessary.)

Re: Signature - now I see it. (Now that I have both eyes open. Thank God for coffee...)

 

Sophie is not happy with my poking method yet, that's the only rub at this time. My little granddaughter loves the kitty and wants to help so we're going to try it together. She will not be caged! (my granddaughter, that is ) We will be testing here soon for the +2.

 

Do you give Sophia a snack - either while poking or right after? That is often the secret to this thing. They know a treat is coming so they sit still for the poke.

 

Okay, see that fast drop to 76? Please go ahead and give 1/4 can of the usual Fancy Feast now. Then I need you to test again 25-30 minutes after she's eaten it.

 

+2 is 76 @Robin&BB

 

She is having some now.

 

Do this, please.

 

Haha ... we are cross-posting! Good, I'm glad you're feeding her. Will await your next test result & we'll go from there.

 

It does take some time and cooing and cuddling before and during ear poke time - you are doing such a great job, Susan

 

Robin - you are giving BatBat such a tiny amount of insulin - what happens if you don't give any?

 

And it would appear to me, based on that drop, that we may actually be reducing the dose again a little bit for her next cycle ... (this is all good news, btw).

 

I was thinking the same thing, Robin. seems like 1 (or even 0.5)

 

Darn. It looked like 1.5 would be a good dose, not taking her super low. The diet change must be really kicking in and lowering the numbers also. As Robin said, this is good news, but may take some steering on your part to keep her in safe ranges. Do you have some gravy based food? Sometimes just a teaspoon of gravy can bring the numbers up a little.

Robin, will you be around this morning? I have to go out in a half hour and will be gone a couple hours.

 

Yep. We'll be watching this cycle carefully to see how things roll out for Sophia by PMPS time ...

Well ... Bat-Bat's been riding the see-saw (dose 0.05/skip/dose 0.05/skip, ad nauseum), putting her bean between a rock & a hard place. Last night, giving Bat just that 0.05U resulted in a lengthy steering session. Rather than skipping altogether this morning, I used the "create-vacuum, suck-it-up" method" with the syringe. I may know by +3 whether any insulin actually got into her ... at this point, I just wish we could be all done with it.

@Sue and Oliver (GA) - Yes, I will. Maybe let me know when you're back later? (I might need to go for a 1.5 hr nap after that ...)

 

I should be back by noon Mountain time.

 

PERFECT!!!

 

Susan, at first I had a hard time testing Murphy as well - at times he'd get so angry - once he bit me quite badly - it's still hard to test him when he is very hungry but I just wanted to let you know that it does get a lot easier for both you and Sophia

 

30 mins and she's at 46!

 

Ok, we need the higher-carb gravy-based food right now, with about a 1/4-teaspoon on syrup on it. Just a little bit of food, but gravy + the syrup.

 

You may be steering her for a while, so don't want to overfill her with the food. So go for just 1/4 can FF gravy-type (pour out a little extra gravy, and add a few drops (abt. 1/4 tsp.) of syrup, ok?

 

You will test again in 15-20 minutes after she's finished that.

 

Oh she quite likes that

 

That's great! (That's she's happy to eat, I mean.) I'm not real thrilled that she's learned Bat's bad cliff-diving skills already, though. (I feel for you!)

And yes, we will most definitely be going down to 0.5U dose at PMPS tonight, provided she's even showing us a pre-shot number of AT LEAST 200.

 

Just so you know ... the reason I'm asking you to test her BG a little earlier this time is twofold:
1) That 46 result you got;
2) Adding syrup + gravy should bring her BG up faster than if it was just the food alone.

 

Nothing quite like starting your Saturday off with a bang when you have a toddler to watch, too, huh?

 

yes, I'm not able to answer or ask as much as I'd like right now either

 

Totally get it - just make sure you get that test & post the # for us right away so we can get her back up into safe #s asap ...

 

Just did a test after 20 minutes...she's at 60.

 

That's good!
You will test in another 30 minutes to make sure she's holding and/or continuing to rise. (We want to make sure she doesn't start dropping on you again.)

 

Robin, seeing as it is so early in the cycle, should she feed her a little more low carb wet now or hold off for now?

 

Well, we went through this type of thing with Sophia last night; as we've added syrup & gravy + food to the mix, I'd rather get a second result 30 minutes after that 60 - because we're doing the balancing act: Don't want to overfeed quite yet, just in case we need to keep feeding for the next hour or two.

 

okay - I always seem to overfeed very early in the cycle (or since Murphy will hardly ever eat anything when he gets low, I feed him when he'll eat)

 

Well, you have a special situation with Murphy, too, given his pancreatitis & IBD. That certainly makes it more complicated for you.

 

Do, we have a new test result yet, Susan?

 

Just got a 76 again, yay!

 

Excellent. You will want to check BG again in about an hour (no longer than that) to make sure her BG doesn't start falling again. (Does this sound a little "familiar" to you?)

 

Yes, and I have an appointment at 1:30, after which I will need to stop at Walmart and stock up on test strips! Which is quite all right. We will do what ever is necessary.

 

Ok, after you get that test, if she is still hovering around that 76 mark, you could go ahead and give her another 1/4 can of her regular low-carb FF right before you leave for that appointment. (I don't know how far away your departure time is, but that way you wouldn't have to worry while you're out and about.)

 

Well I miss all the excitement! Sorry, ladies, its been a tough morning (for my stomach). Sophia, you are doing a fabulous job! And of course, Robin and Sue are excellent at helping out in these situations (and all situations!).

So you h ave an appointment to get to in a bit? I agree, a bit of food woudl be good so that you can be sure she stays up while you're out

 

@Rachel - Gee, I'm sorry to hear that ... can you tolerate some ginger tea? (Really helps me with nausea.) Hoping you feel better very soon!!!

 

I'm probably going to have some tea and maybe a bit of toast and hopefully lay around on the couch for awhile! With luck, I'll be around for a bit this afternoon. I do feel a bit better, thanks Robin! If I could get some snuggles from some kitties, I think I'll be in good shape!

 

I second that, Rachel!!!

 

I'm back. Looks like you are getting good at this, Susan. The nice thing is that she seems to come up well with food. Robin, are you ready for a nap? I am happy to take over.

 

I decided to reschedule my appointment and stay home with Sophia. I'm done with my human baby duties for now. I'll test Sophia again in a minute.

 

She's at 116

 

Looking good, Susan. So the pattern we are getting is that she drops early and that food is good at bringing her back up. I am sorry I guessed too high this morning. With her high blues last night, it seemed like a 0.5 reduction would be about right, but she obviously needs less insulin.

One more rising test and you should be good.

 

Yes, I am definitely ready. Thanks, Sue! (And so glad to see that Sophia is @ 116, too! Hooray!!!)

 

When should I test her again? and can she have a protein treat sometime this afternoon?

 

I'd get a test within the hour of the last one.

I think you could give maybe a small treat. I usually gave one small piece of freeze dried chicken at test time. I'd think a tiny treat like that should be okay.

 

just checking in, Susan. Is it about time for that next test?

 

I posted the number in her chart, 176.

 

I realized I don't have chicken that's no carbs. I need to get some of that freeze dried kind. She really wants something to eat right now. She's hovering over the empty bowl.

 

Nice number - no big bounce , at least yet.

My kitty likes PureBites - it is low carb, freeze dried chicken or beef treat. If she likes it, you can get it in the dog department in a big bag and scrunch it up into smaller pieces. Some people boil chicken breasts (with no seasonings) and cut it into tiny pieces, freeze it in a Baggie and take it out as needed.

 

She could have a small snack of her regular low carb, if you want.

How much are you feeding, total, during the day?

 

This is what I thought I had but it is commercially processed diced cooked chicken breast and has some carbs. I will make my own when I can get to the store. I give her one 3 oz FF plus about 1/3 to 1/2 of another at each feeding, so twice a day. She has a great appetite

 

I am using U-40 0.3 mL syringes that don't have marks for 0.25 or 0.5. So when it's time for her PM shot, I'll be kind of judging how much I'm giving her. Should I be using a different syringe to dose more accurate in small doses?

 

You can buy U100 needles that have 0.5 unit markings and use the conversion chart we have (because you will be giving U40 insulin with U100 needles). Lots of people here use them - it lets you give 0.1/0.2/0.4 unit doses, which may prove valuable in the future.

http://www.felinediabetes.com/insulin-conversions.htm

For tonight, you could try this. It isn't terribly scientific but should work. With an old syringe, pull up one unit of water. Let it out by drops, counting. When you know how many drops are in one unit, you can pull up one unit of insulin and let out 50% or 75% of the number of drops. Make sense?

If that sounds too complicated (and it can be) you could eyeball pulling up 1/2 of one unit and letting out a few drops. Again, not very scientific, but we are just interested in her getting a tiny bit of insulin tonight.

I am thinking, as it nighttime and you need a rest, try for something around 0.25. Maybe tomorrow, you can get some U100 needles (available at the drug store) and we can get more precise. I think mini doses are in her future (anti jinx)

AS LONG AS SHE IS OVER 200.

 

I have a box of syringes that say they are to use with U-100 insulin. They have orange caps. A friend with a diabetic pup gave them to me. Are these the same thing you are talking about? Because they look much bigger.

 

I think those are right. You can only use them with our conversion chart though...have we given that to you?

@Sue and Oliver (GA) can you weigh in? Are there different needles for dogs vs cats or will they work?

 

https://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7252. You want the ones that measure 1/2 unit. Dogs usually get more insulin than cats so they may measure by one unit or more - like the ones on the right in the picture.

 

The box I have is the second from right, 50 units. Definitely too big.

 

The syringes the vet gave me are UltiCare U-40 and seem to be specific for Prozinc.

 

They are. Someone figured out years ago that we could dose tiny amounts with U100s as long as we converted - that page I linked explains how to do it. It is hard to dose tiny amounts (which lots of cats end up needing) with the regular U40 needles. It's up to you whether you want to use them or not. You do have to make a concentrated effort to remember to convert each time. The other way to do small does is by drops (never terribly accurate ) or eyeball. Are your U40 measured in half units?

 

Walmart carries U100 syringes in the pharmacy if you are interested. A box of 100 was just under $13. Some may require "proof of need" but the pharmacist here told he if I brought the box or flap off the box that the prozinc came in that would work as proof. The ones I got were 3/1oml 30g and they worked great, had half unit marks on them for smaller dosing. Sorry for the bad pic, my tablet doesnt take very good pictures...

 

No they aren't.

 

We have a PMPS number of 236.

 

I like that she hasn't bounced. Well, we know 1.5 was too much. To be safe, overnight maybe 0.5? Can you measure that? If that isn't enough, you can raise it next cycle. @Robin&BB?

 

Hi, drinking looking at the SS; hang on just a minute ...

 

Yeah, I agree with that 0.5U, Sue. And you've given that - right Susan?

 

I did

 

@ssblackcat Sophia & Susan - I'd recommend you still start with a check at +2, even though you've reduced by a full unit. We really need to know what her pancreas is doing, and the only way to see that is ... testing. Once we've seen that one, we'll have a better idea of where she's headed tonight and (hopefully) you won't be dealing with another cycle of test/steer/test/steer, etc.

 

Will do

 

And I have a question, as I'm seeing your pre-shot #s appearing in the +11 column on the SS: Are you actually testing @ +11 hours (after the earlier shot) as her PMPS or are you testing at the +12 mark? Because if you are, in fact, doing the test right @/around +12, you need to put that number in the PMPS column. (Don't want anyone to be confused about your timing - like me! - so thought I'd better ask you about it.)

 

You're correct - I'm using the wrong column. I've adjusted it. I'm on a steep learning curve this weekend! Thank you

 

Wanted to show everyone how peaceful Sophia is right now...she's been having a tiny bit of back leg weakness since her diagnosis but today, she's spry as a kitten...jumped up onto the window sill to birdwatch.

 

YAY!!!

 

Robin, how's BatBat doing today? Do you live in the US?

 

All right Sophia! She looks super peaceful and happy there.

 

She's doing just fine today. Had to go back to this method of dosing her Lantus: Push black plunger in very hard inside the syringe (to create a vaccuum), hold it & insert syringe in the Lantus pen cartridge, then release my hold - thereby sucking just the tiniest drop of insulin back into the syringe. (Yeah, can you believe this??? I call it the "suck-up" method.) Because when I dosed her at 0.50 last night ... well, you know all about that.)

Yes, I'm in AZ, the only state in the union that does not do Daylight Savings Time. So when the rest of the country is on DST, it's like I'm in California; when the rest of you are off DST, it's as though I'm back in Colorado (where I had lived for many years). Arizona is a very weird state ...

 

Sophia is at 314 at +2 pmps. I'm not sure what to do.

 

Here's a side note: I've been home alone since about 4:00pm mst until about 8:15pm mst. Then 4 adults and 3 children (2,5,8) came roaring into the house. This may account for some stress but there are often people about, she's used to it. She hangs out in my room, alone or with me for the most part.

 

Could be stress. If she ate after the shot, could be food. Could be a bounce - she has had several low numbers. Nothing to do right now - it's just one number, just one cycle.

 

I wouldn't worry yet. Could be stress, could be something else. As Sue said, it's just one number.

 

We have company tonight so my 8 yo grandson is sleeping with me to give his bed up to a guest. We are going to have to hope for the best as I won't be able to test much later.