? Markies PMPS 170 1.25u+2(79) (carbs) +3 (73) + 3.5 (67) +5.25 (224) +7.75 (498) DOSING?

Dear group,

Im writing to you in an emergency.

Markies yesterday night vomited. Today his Pmps was little low but I shot normally remembering all forum recomendations and also imagining that onset would be late. Well this didn´t happen. Onset was rapid and he drop very fast. I gave him carbs and little honey which I know is not the protocol since I have to go to the pharmacy to pick up some syringes (they are waiting for me). This trip to the pharmacy will take me two hours so just for my sake I gave him whiskas pouch which has carbs and sauce, raw chicken, and very little super little of hone.

Whell this didn´t work at all, BG kept going down. From 79 went to 73. He was at +3 so we have a long way and we are very far from nadir.

I know that I never have the ss ready. I will need to change things here. I still have complicated life, but there are no excuses. I have my hand written notes though but I know they are not useful for you.

I will sit down now and will work in Markies ss. I started to do that the other day and I messed it up.

Can you help me with Markies protocol. What should I do now?

 

By the way, Im not leaving to the pharmacy, I cancelled I call to the pharmacy and told them that Im picking the syringes tomorrow and they are ok.

 

79 and 73 are the same number and are still very safe numbers

Test again at +3.5 and see how he's doing

 

Since you fed him, you have to give it a little time to get into his bloodstream

He's still in safe numbers, so you just need to keep an eye on him and make sure he doesn't continue to drop

 

+3.5 (67)

 

dear as you see he es still dropping... so now what?

 

this is so so so desperating... so slow...

 

He's still safe......you can give him a little more medium carb food (or add a couple drops of honey to low carb) and test again in 30 minutes

 

good

 

Hello, hope you are holding steady, as Chris said those numbers are ok. I'm not so familiar with lantus but hypo protocols are always the same.

If you are concerned still, I'd squeeze some gravy out of the whiskas pouch and see if he will take that. The main thing is not to fill him up so you have some leeway to work with. About a teaspoon is plenty. If he drops lower after that you may want to offer him 2-3 pieces of kibble which take a bit longer to get into his bloodstream but will hold his levels for a longer duration.

 

listen Chris, some days ago he went through a mild hypo... he was under 50... and he was tight... NOT (IM EDITING) hungry and had to put honey in his gums... and he was even more far from nadir... so I know that he will keep dropping and as I see he will drop fast... Yesterday he vomit... and I feel insulin is probably too much now in his body... I feel he needs a bigger amount of honey and protein not so much but good portion he is prone to vomiting... thats why I need to use more honey and protein...

tell me what you think... if he goes under 50 he will start with his symptoms like the other day and that looks very bad.. now he has some sores in his nose... he is having some weird symptoms

 

I doubt if the symptoms you saw the other day had to do with his blood glucose numbers, but I guess it's possible

You know Markies best....if you feel he needs a little more honey, then use it. Extra protein won't help bring his numbers up quickly though....he needs more carbs/sugars to raise it quickly.

He's dropping, but he's dropping very slowly at this point.....the best you can do is just keep monitoring him and give a little extra food/honey as necessary

 

Ok this is finally what I did. I gave him little of whiskas pouch. Not too much. Little of chicken cut very little, little of honey (not too much, like 1/4 of coffe spoon). That also has a little of more protein since has a little of cow heart smashed (very super little). This time was less ammount but little more honey than previous meal.

Previous meal chinek was in chunks this time chicken was like smashed. The good thing is that he is still hungry. I don´t want him to loose hunger. But also don´t want him to feel full with food.

He had three meals in very little time so far. I need to be very careful not to prompt vomiting.

If that happens, what would be the next step?

 

I know dear, the protein is only to keep the BG up not to bring it up.

 

Let's cross that bridge if we come to it

But about the only thing you can do is to limit the amount you feed him and only give as much as necessary to keep his numbers safe (above 50)

 

shut what this means?

 

oh sorry...it's a saying ...it means that we don't have to deal with it unless it happens

do you have another test yet?

 

It's a figure of speech, it means you will figure out what to do with the vomiting when and if it happens (instead of before)

 

thank you dear!

 

ok there is a problem with my spread sheet. Seems corrupted. Cells paint from collors and shouldn´t. Date cells don´t recognize the date and get painted as if they were BG numbers so I need help with this. Can anyone help me tagging admins please?

 

Silvina

Are you using Levemir now rather than Lantus? If so Levemir tends to have a later nadir. Do you know when Markies has his nadir?

 

Markies is on Levemir since a long time. His nadir was usually at +7 or +8. Lately his nadir was usually very early, too early at +4 +5

 

I finally created a new ss because it was crazy.. I will start all over with october data.

will test again

 

I have been using Levemir for a long time. In MY case if I get a big drop in the first 4 hours I will usually give a small bit of MC. For Maxie if I don't stop an early drop she will tend to go quite low by her nadir time...usually +7-+9 for her. Not sure if this might help with Markie

Have you done another test?

 

that´s exactly what happens with Markies when he has low numbers at the beggining at nadir is a desaster.. then obviously bounces

 

I know you have been treating Markie for a long time and you really know how he reacts. It might be an idea to do another test and if he is still dropping much more give a little MC food. This is more a technique that can be used with Levemir because of its later nadir. With Maxie I usually don't see much movement at all until at least +4. Also Maxie has had nadirs as late as +10-+12 so I don't want her dropping too low and then bouncing through the rood again

 

at +5.25 (224). Out of risk and may by starting to bounce. Not sure but Im breathing now.

 

Did you give HC or syrup earlier? That is a big jump from the +4 reading of 67.

 

yes, almost the same food he ate from 79 to 73 but with a little bit more of honey

may be previous meals were acting little bit slowly or not I dont know

 

OK if you gave honey around +3 or+4 it should have worn off already so that shouldn't account for the big jump in numbers. If you gave a HC food it could still be keeping the numbers up. I would test again in about an hour and see where he is at. It is unusual for a bounce to happen that quickly, especially when Markie was not in very low numbers.

 

ok great honey!

 

ALL RIGHT, LET´S SEE... AS I IMAGINED, HE STARTED TO BOUNCE QUICKLY AND TO THE SKY...

SO NOW... he is at almost +8 and 498, do you think I could give him a little bit of rapid? like 0.25? (Humulin R)

 

I am not familiar with using R insulin. I will tag @Wendy&Neko and if she is on she can give you much better direction on whether using R insulin would be the best approach.

Also if you could update your spreadsheet with the last tests you did it will be helpful for others to give you advice. Thanks!

 

I cannot stay on. Without seeing any recent data at all, much less previous R data, I would not recommend using R.

 

Thank you dear, I am a little familiar, but I see that this type of Rapid which is different from other type of rapid insulin than we used to use here in Argentina (no longer manufactured) it lasts longer, that´s why impacts longer in Markies. I learnt this by using it.

I just gave him 0.5 of Rapid.

 

Silvania

I know you have used the R insulin with Markie for a long time and you do know what you are doing. I just could not offer any personal advice because I am not familiar with using R insulin of any sort. Fingers crossed that Markie comes back down and levels out.

 

Ive been using Rapid lately

Markies was on Lantus and Rapid at the very beginning. Im still not finding the way to be able to complete the ss, which takes me time. I am thinking on having a tablet on the same spot of my hand written notes and using it in spite of using my paper notes. I know this sounds crazy but my brain is burned.

I end work at 9 Pm I rush to mom´s house for dinner, I come back for my cat´s rutine at 00am (cat 1, rutine, cat 2 rutine, Markies insulin, etc), some work reports, other reports, cats medicine, at 2 or 3 am I sit down to watch my Netflix serie. I wake up many times during the night since Markies makes me wake up for food.

Mom is close to her "due date" her cancer is growing and symptoms are appearing. Dad already died. So, Im going with her to doctors, planning to stay over night so I did that the other day and I took Markeis with me which was a mess since I forgot the syringe (I took the insulin but forgot the syringe).

So, I can´t even understand how Im even being able to being here.... but Im making my best.

I do understand that to get help from forum requires the ss... but its important to give this information.. probably can help you understand..

Anyway, I was never good with ss... since is not so handy, is not that simple for me. Hope I can find a way. I will ask mom to lend me her tablet. Hope it has excel.

 

Thank you dear. I actually know more the other Rapid insuline (the porcine one). Tha used to be fastest and shortest in effect. But Humulin R is longer so actually is not that I have a lot of experience.

And the other thing is that in the ER´s they gave me instructions to use it diluted already charged it in the syringe, and here in the forum they told me that this was not necessary so things are not super clear, I do remember that the dose should be very little and probably Im not using it correctly.

So Im not sure Im doing things correctly, I have to correct myself, probably Im doing what I can.. may be I have to start all over considering how my brain is at this point right now.

 

I can´t erase the new thread I opened. Thought this was a different subject and that I was going to be told to open a new one. But well, I will copy my last edition of that message.

I guess I should reduce dose.

Im working with Markies ss now. Some days ago happened something similar than today, low numbers at early hours I mean, close to shooting time and Markies nadir usually was arround 8.

this is the message.

============================
Dears,

This is Markies previous thread.

http://www.felinediabetes.com/FDMB/...3-5-67-5-25-224-7-75-498.186034/#post-2066003

To make long story short, should I reduce dose in 0.25?

Two days ago something similar happened. Low numbers happen soon. Usually Markies used to have his nadir at +8, now everything happens very quickly and then he bounces.

 

Hi Silvi,

Are you doing SLGS or TR? If SLGS, then Markies earned a reduction. If TR, then he did not.

I'm going to tag @Marje and Gracie to look at your SS and see if she can fix it. She's very good with them.

 

hi dear!!!! nice to see you! I have no clue on what is the name of what Im doing.
Im not exactly doing TR but my feeling is that his dose is being a little high

And also it varies according to his different stages of his different health issues... if his gingivitis get worse, his BG goes up, now he was better, he was under abs to prevent hemobartonella since all hospitalizations were related to that and he was on DKA and received blood transfussion so I gave him doxicicline.

So who knows. I feel Markies is a guy that I will allways have to adjust insuline according to his current state of health, stress or whatever thing happens... even my own things. (mistakes includded, and my own stress)

 

Hi Silvina

I can fix the old SS for you. Looks like you just started a new one and I can move that over to the “corrupted" one so it’s all together. I’ll send you a PM so you’ll know what I need to fix it for you.

I’m really sorry things have been so stressful and Markies has not been doing so well. Once I am able to fix the SS, I’ll study the numbers and see if I have any input for you.

 

THANK YOU SO MUCH!!!!!!!

 

You’re welcome!!

 

Thanks, @Marje and Gracie.

 

@Marje and Gracie YOU ROCK!!!!!!!

I have a real ss now not a shitty fruit salad number excel whatever sheet.... Im so happy!!! now I have to commit to use it, obviously!!! NO EXCUSES.

Thank you @Tricia Cinco(GA) & Harvey for tagging her and THANK YOU ALL FOR HELPING ME.

Im now rethinking Markies dose. I put some info there so you can see. I feel his dose has been too high and that he has been bouncing. That is my feeling. Onset has been very fast and then always high numbers at shot time, usually bouncing. Thats why I had to use Rapid like when I used to use Lantus. This is not the treatment I was accustomed with Levemir at the beginnign.

Levemir was much more smooth. Used to have a later nadir. Now seems that effect starts much rapid and wares off also rapid. Also I feel that Markies is very sensitive to low numbers and numbers in the hundreds can prompt a bounce.

Markies is delicate, has many health issues. So I feel his dose will have to be adjusted according to the moment he is in. For example gingivitis get worsens at time. Then hemobartonella comes and go (that´s why this time I didn´t wait to have him get hospitalized, I gave him doxicicline) however I want to make a consultation just to see if there is any other more effective treatment for haemobartonella.

And on the other hand Im kind of suspiciuos of tumor in his abdomen so I need to make an ultrasound (I have been touching his abdomen and I touched something rounded). And seems it hurts. And now black buggers after visiting moms house. As I want to start sleeping over mom´s house and don´t want to leave Markies here (I may be doing it, rather than taking Markies and exposing him to stress and sickness probably that day I may change protocol for example doing a 18 hours cycle).

Much information I know.

THANK YOU GUYS!!!

 

You’re welcome!!

You are very, very welcome. I”m happy to help you. It’s late here and now my eyes are blurry from those SSs I’ll try and take a look at his numbers closely tomorrow and get back to you when I can. I have a busy day until the early evening.

Have a good night, my dear.

 

KISSES!! and thanks again!!!!