? Stewie is 150 PMPS. Has been higher until today

Discussion in 'Lantus / Levemir / Biosimilars' started by Stewie man, Feb 18, 2018.

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  1. Stewie man

    Stewie man New Member

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    Feb 7, 2018
    Looking for advice. Stewie has been running high in spot checks previously to today. He normally gets 1.5u Lantus 7a and 7p. This morning he was 166 AMPS, 205 +1 (gave him 0.8U at +1), 183 +5, and 143 +7. Tried to get a +10 reading, but he got real snippy and refused. Think he was hungry. Ate most of half can of fancy feast pate then. Now PMPS at 8:01 was 150. I am hesitant to give him insulin as he has not been running game the same as he had been. Was doing curve for Vet today. Looking for suggestions. Should I give another 0.8U dose?
     
  2. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Hi and welcome to you and Stewie. :bighug:

    How are you measuring .8 units?

    These are just the kinds of numbers we want to see at preshot times, Lantus works better to keep numbers like this than it does to bring down really high numbers. That being said, you are just getting started and you don’t have a lot of data yet. We strongly encourage testing at least before every shot of insulin, sometimes the numbers are really low and you wouldn’t want to give insulin. Also, many cats go lower at night, is it possible for you to get a test in, perhaps before bed? It will help fill out the picture and see what the dose is doing.

    As far as shooting tonight goes, are you able to keep testing if you shoot? He could go lower and need monitoring, which would require you to test a few more times to make sure he is safe. Are you prepared for any lows should you encounter them (do you have a higher carb canned food or honey or corn syrup, plenty of test strips)? Many cats will also bounce when seeing these lower numbers they aren’t used to, which means he will go higher rather you give insulin or not, but the way Lantus works is that it builds a depot, skipping shots and changing doses frequently disrupts this depot and further confuses things. If you do decide to skip, still try to get a before bed test, it’s good data to have so that you can see what happens when you do skip a shot for the next time.
     
    Last edited: Feb 18, 2018
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  3. Stewie man

    Stewie man New Member

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    I was calling the dose 0.8, because it was just shy of the 1u mark on 3/10ml syringe. I am trying to locate and get some syringes with 1/2u marks. Stewie is a tough tester sometimes. He gets very irritated trying to claw and bite. I have been able to test him more today than any other day. I am new to this and have been overwhelmed at times. Testing takes two people. So today had a friend who he nows and later my husband when he was home from work. I would like to say I can get another reading before bed. I was going good to try at 10. I was afraid to give him his usual whole dose today as the AMPS of 166 was the lowest I had seen and dramatically lower than the 528 yesterday AMPS. I am terrified of him going low especially overnight. He has been eating fairly well today and just had another 1/2 can of food at 8:00. I also have noticed less drinking of water over the past few days. Also they were concerned about underlying heart problems when he had his crisis that led to the diagnosis in the beginning of Feb. He had fluid in his lungs at that time so put him on ace inhibitor, furosimide, and another cardiac med. All have been discontinued except furosimide as echo showed good heart function. Also was on antibiotic that was stopped last Sunday. I will try to test again at 10.
     
  4. Stacy & Asia

    Stacy & Asia Well-Known Member

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    It’s great that Stewie (sorry autocorrect keeps trying to make that Stevie for some reason) is starting to feel better and some of his heart issues have subsided. Testing gets easier, I promise. What you describe reminds me of @SueGeorgeandLuci ‘s early testing experience. It was also a two person job at first. Sue may have some helpful tips for you with that.

    The high numbers yesterday and low numbers today are probably the result of a bounce. Have a read at the new here sticky at the top of this forum, lots of great info in there.

    What did you decide to do for tonight?
     
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  5. Stewie man

    Stewie man New Member

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    I am going to test at 10 and hopefully get a number. And if up considerably I will shoot. Otherwise I would feel better holding til the morning. I am going to email my Vet all the data I have got so far. He is definitely a strong kitty both in will and determination.
     
  6. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Don’t know what time 10 is where you are, is that at +1? That’s what we call stalling, and usually you stall without food to see if numbers are coming up (because if you feed numbers can come up from food instead of insulin wearing off).

    Sounds like a solid plan. Remeber if you do shoot late, you want to slowly move back your shot time so you don’t shoot 13 hours apart and then 11 hours apart, it’s too shocking for most cats. You would either make a once a day shift back 30 minutes, or shift 15 minutes earlier at both shot times until you arrive back at the time you wanted.
     
  7. Stewie man

    Stewie man New Member

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    I am EST zone and it would be +2. Thanks for your advice and help in thinking it through. Also thanks for tips on moving the time back.
    Will be trying to get a reading soon.
     
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  8. Stacy & Asia

    Stacy & Asia Well-Known Member

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    You’re welcome. Hopefully Sue will see the tag if not today, tomorrow and chime in with testing tips that worked for her. It does get easier, granted I have a very cooperative cat, so I thought it would be better to hear from someone who doesn’t. ;)

    If you’re stalling, just for future reference, a +1 can usually give you the info you need, and it’s way easier to get back on schedule with a one hour stall than a 2 hour stall.
     
  9. tiffmaxee

    tiffmaxee Well-Known Member

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    Hi and welcome. I’m a little confused. Are you shooting every 12 hours? If I’m understanding correctly you shoot at 10:00 your time but fed him two hours before? It’s recommended to not feed two hours before shooting so the results are not food influenced so maybe that’s why you feed at 8:00?
     
  10. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Normal shot time is at 8:00, it was a stall and not sure Stewie’s bean knew not to feed when stalling.
     
  11. Stewie man

    Stewie man New Member

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    No I usually shoot at 7:00, but this morning stalled til 8:00 then gave a reduced dose as these numbers today have been a lot lower than he has been. So tried to get number after 2 hour stall from 8:00, but Stewie is done. He would not put up with me sticking him and got a good swipe to my face. He also started chasing his tail which he does when he gets upset so I think it is best to not stress him out anymore tonight. I will not shoot and wait til morning for AMPS.
     
  12. Stewie man

    Stewie man New Member

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    I did not know, but he has been hungry tonight. He is kind of a grazer even on the wet food.
     
  13. Stewie man

    Stewie man New Member

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    I also think he will have to be a before shot tester. And then maybe slip a couple more in at different times on different days to get a better picture. Today I was trying to get a curve for the Vet. I tried yesterday and he refused me and I had no help as my husband had to work.
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    I was going to suggest you skip tonight because it would really mess with your shot time. Enjoy the evening and then you can shoot whatever time you want to be shot time in the morning.
     
  15. tiffmaxee

    tiffmaxee Well-Known Member

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    Most test, feed, and shoot all within 10 minutes before shooting.
     
  16. Stewie man

    Stewie man New Member

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    Thanks. Tomorrow will go better.
     
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  17. Sue and Luci

    Sue and Luci Well-Known Member

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    Hello and welcome to you and Stewie Man!

    My girl Luci was definitely a two-person test event when we first started. She was not happy about being poked in the ear at all! She would scramble around and would not cooperate at all - much less allow me to take a hand off of her to pick up the lancet or the meter -or anything else for that matter! The minute I'd lift my hand off she'd go...the first day I think we tried five times to get blood from her ear - it was an exhausting experience for all of us. So my husband and I determined that this was definitely a two person job. He'd hold her and I'd do the testing.

    We started out by laying a clean towel on our kitchen counter where the light was the best and we could see what we were doing - it's kind of a breakfast bar/island thing and he'd get on one side and I'd get on the other. That went on for about a month or so - then he started telling me that he was testing her at night - ALONE! I asked how did you get her to stand still - he said, she just seems to know that she can't leave...really? So the next day, I tried testing her alone as well - and she just stood there on her familiar towel - with the lancet, the meter and a washcloth nearby. My most important tool (I felt) was a clean white sock filled with about a half cup of rice - warmed for 14 seconds in the microwave - just warm enough to help promote the blood flow and keep me from poking myself in the finger when I'd poke her ear. I'd hold her ear propped on the warm sock, massage it for a few seconds and rub her head a bit - talking to her about having her snack. EVERY test is always followed with a snack - either FF pate or freeze dried chicken or salmon (she loves that stuff!) Sometimes she gets a piece of string cheese - another treat for her...and now I do 90% of the testing, DH tests at night until midnight and then I get up if her numbers are decreasing to get another test - when she sees me coming - it's all about the food...so she waits for me to pick her up and put her on the towel with all the equipment already laid out...

    If you'd have told me when Luci was first diagnosed that she was going to be this cooperative I would have said 'NO WAY' - she's a wild thing with a mind of her own - she's a Manx and has never been a lap cat...she's aloof...but she responds to FOOD...it's all about food with her...so get your snacks lined up...talk gently to Stewie - if it takes two people for now - it won't always. You also may want to try putting Stewie in your testing place, do some gentle petting and talking and reward him with a treat - just for allowing you to put him the 'test position'. He'll get the idea soon that you're not always going to hurt him (although many have said to me it doesn't hurt, Luci used to flinch a lot - I had to have a firm grip on that rice sock and her ear - otherwise she'd shake the blood off - all over me, etc. Then I'd have to massage and squeeze the edge of her ear a bit more to express another blood drop - or heaven forbid, stick her again - have had to do that a few times too...but we're getting lots of practice. I test Luci about every two to three hours and she cooperates every time now.

    If you're patient and work with Stewie - have his favorite treats nearby for a quick reward - and go through the motions lots and lots of times he'll catch on.

    You're doing a lifesaving thing for him...it's worth it. Best of luck to you!! Please write me back if you'd like - there is so much help on this board - wonderful people helping us save our cats. The vets mean well...but they're not the experts when it comes to diabetic cats...I just think they're spread too thin. I have a wonderful supportive vet here...but his answer was to give her 2 units right off the bat...I would have killed her had I followed her advice...gotta take this thing slow...she'll come along when she's ready - and so will Stewie!
     
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  18. Stewie man

    Stewie man New Member

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    Thank you for sharing your story. I do have hope that he will get more accepting and that my skills at getting a good blood sample will improve. This is all new and a work in progress. He is worth every bit of it. :cat:
     
  19. Sue and Luci

    Sue and Luci Well-Known Member

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    I was a nervous wreck when I first started - I know exactly how you are all feeling! I found the testing to be utterly exhausting! It was an overwhelming time - we were upset by the diagnosis - and there was just so much information on here - I could barely keep up! People were telling me things and then there was so much to read - but if you can just try to take it one test, one day at a time - do the best you can.

    The truth of the matter is you're doing 'something' - which is better than 'nothing'. Our first vet told us that if Luci were his cat, he'd put her down. I was devastated to hear that...until I started searching the web and found this hopeful web site.

    Is it a lot of work? Yes, it is. Does it require time, money and commitment? Yes, it does. Is your fur baby worth it? Oh YES - she is. I will give her my very best efforts - and hopefully will save her life. Will she bite me? Run and hide? Not understand what I'm doing or why? Oh yes...but mom knows best on this one. I've got the war wounds to show for it...but I'm determined and I'm going to keep trying - because I'm not very fond of the alternative (letting her die a slow death of starvation OR putting her down like vet #1 suggested)...I'm in this for the long haul..it'll take time for Stewie to calm down and accept what you're doing - but you keep trying...and reward the heck out of him for being a good kittie...and then reward him some more for even showing up for the testing and/or the shots...Luci actually hangs around the test area - waiting for food of course - she sure isn't waiting to be lifted up to the towel for that poke in the ear - it's all about the food for her...after all, she is just a cat - my fur baby...and if it's food she wants...it's food she gets...at least a teaspoonful of FF pate or salmon freeze dried treats after each and every session - whether I'm successful or not at getting blood - she was rewarded - me, not so much..but we got there...we get a good test every time...up to 12 times a day -- late nights and all...she's worth it to me.

    Stewie will catch on...soon...keep the rewards handy. If you need to order the freeze dried chicken, salmon, etc. you can find it on Amazon...a few of those and your kitty will be hooked - the salmon stinks to high heaven IMHO, but Luci is wild about it! Go figure!
     
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  20. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Very nice cycle for Stewie yesterday! :cool:

    Did you skip the shot last night? If so, you can put NS for no shot in the U column.
     
  21. Stewie man

    Stewie man New Member

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    Yes I skipped it. He was too upset to let us get a reading at 10:00 last night and started in on his tail chasing he does when stressed out. I figured best to let it go. Got pre shot readings today with less fuss. Not great numbers, but at least I know. Thanks for all the support and encouragement.
     
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