02.22.17 Chase AMPS @ +11.5 193, Shot at 6:30, +1 194,, +2 196, +3 183, PMPS 213, +2 163, +4 123

http://www.felinediabetes.com/FDMB/...1-75-144-1-186-2-148-3-2.173545/#post-1901766

Good Morning,

I hope I did the linking part right.

So here we are... another great day. I need to give Chase his shot ASAP. I'm going with the 0.1u unless someone says different. Thank you.

 

Good job with he linking , it works great. .1 sounds good. Have a good day Sandi.

 

Thank you. Because we got behind schedule yesterday by 30 minutes, and because of work, I had to shoot him 30 minutes early, today. I know that's not ideal, and I think I should do something a little different, but I've been fighting a migraine (left from last night).

I tested, shot and fed Chase (1/2 can of MC) all within 5 minutes of 6:30. I will test again at +1 and +2. I didn't give him all of his food, in case he dives.

 

I think he'll be ok and it's fine you shot 30 minutes early this morning.

 

Thanks, Karen. Now as long as I recorded in his SS correctly, I'm off to a good start.

I hope you have a great day, too.

 

Looks good to me!

 

Poor Chase. With the way I've been spoon feeding him and people worrying that he will eat too much early on, with low numbers, I think he didn't get fed enough last night. This has been a LOT, and with my job being what it is... I'm just spread so thin. I know... I know.... everyone else has gone through this, too. But last night I was in tears, because I just feel like I can't remember to do it ALL right. Having to feed him different types of foods... that is tripping me up. I would prefer to feed him MC, right now, until he gets more on track, unless it is obvious that MC is having a bad effect on him. Yesterday, when I thought I should be giving him LC, I was supposed to give him MC. And when I thought it was ok to give him MC, I was supposed to give him LC. Seems like I'm just not getting the numbers and how to feed according to them, with the exception of the HC gravy. I KNOW when to give him that. It's the food "spikes" that I really need help with, monitoring. I would just like to say that I would like to plan on making MC his main food right now, but if I need to go to LC because of something with his numbers, I would like to ask for help in choosing what I feed him. I'm not as worried about the amount, as I am the type. Like I said... he LOVES to eat. And is always crying for more. He's always been that way.

 

Sorry it is so confusing and overwhelming. It makes it harder when you have to work and can't monitor him.

Personally I'd be feeding him a regular meal of LC at shot time and leaving out LC or MC while you're gone depending on what his numbers are doing..."is he flat, was there a big drop etc." I think you're pretty smart are gaining the knowledge of how to feed/ what to feed Chase. If the +1 or +2 warrants MC because he gives you a big drop then give him some more food to keep him surfing. You know Chase and has foodie habits. Having a good eater is wonderful.

There is no "right or wrong with Feline Diabetes....Chase is in charge, you are do the best you can to follow his lead and safety is always first.

 

Thank you, Karen. His numbers have been dropping after insuin, and I guess that's why the MC. But... if they don't drop enough, I guess I'm supposed to do LC. It's when to decide that baffles me.

Thank you for your encouragement. I'm feeling quite overwhelmed this morning because I don't feel good.

 

Sorry you don't feel good and hope the day gets better.

 

At +1 His BG is only up 1 point to 194. I'm giving him 1/2 can of LC. Chase eats 4 cans of FF a day, so I try to do 1/2 a can right after AMPS and 1st dose, 1/2 can at +1, 1/2 can at +2, hope to get a +3 before heading out the door. At that time, I will have to decided if I leave the rest of the food down, being LC or MC. This morning, unless he dives (which he usually does) I think it would be safe to assume that I should leave down LC, when I leave. It's knowing the significance in the change of numbers that still evades me.

 

I just fed him 1/2 can LC. Let's see what he does at +2.

Isn't +2 very telling? I mean, by then the Lantus is taking effect? And he's had either LC or MC food, according to the numbers. I keep making what I think are educated guesses and have been right some of the time, and wrong some of the time.

 

Yes the +2 is usually a good indicator. Please, none of us are right all the time...they are cats and insulin is a hormone not a drug. You're doing better than you think.

 

I just went back and looked at his SS. He was very close to being in the yellow @ AMPS. I probably should have given him LC. the good news is... I only gave him 1/2 a can of MC. After this last test, I gave him LC. The +2 will be very telling, I think. His numbers has been in the blue since yesterday. Is it right to hope that they stay there, until he at least flattens out? Or is the goal, head on, to get him into the green? I'm happy to see that his numbers aren't jumping between ranges. Then again, I don't understand the significance of the food spikes. That may take me quite some time. It's easier for me to look at the color ranges and try to at least keep him in the same one. Am I right in assuming that's a good first goal>

 

Thank you, Karen. Unfortunately, my self confidence has never been good... hardly ever in my 51 years. That's why I rely so much on the opinion and guidance of others. I NEVER blame anyone for helping me make a decision, should the outcome not be the best. I'm just grateful that everyone here is so nice and so understanding. I can be such a pain in the butt... asking over and over and over again. Even when people write it out, that doesn't always make it make sense. It helps... and is crucial for my learning. But repetition is what this girl needs in order for something to stick.... and LOTS of it. Thank God for this group.

 

Pretty sure that's how most of us learn. There is a lot to learn with this so keep asking. Over time you confidence will build. This group has saved Doodles and me too!

 

Hi there Sandi, just wanted to say you are doing much better than you give yourself credit for.

With the food, it's really about learning how chase responds.
Something that might help you with that, well it helped me when I was learning, is to make notes on what I fed and when, I made those notes on the comments, I kept those notes in the ss, you could record them in the remarks section. Often when George was diving and I was feeding, I would record it on a notepad as I fed, then when things calmed down I would pop the info on the ss, where I could easily and quickly refer to them when needed. It also meant that others that were helping me at the time could see what I had done and what worked and what didn't.

George is also a very good eater, a little to good, so I didn't need to worry about him not eating, I would usually feed him his usual meals and on days he dropped, if he needed it he would just get extra, with more carbs in it if his numbers looked like it needed it.

 

So at +2 Chase is at 196. Gosh... I hope he doesn't go into the yellow. That will break his blue streak.

Maybe I should have fed him LC to start. I'm going to give him 1/2 can of LC right now, and that will allow me to leave out a half can when I leave at 9:30. Will have to see what his +3 is but that's the best I'll be able to do. Will have to run out the door right afterwards.

 

Great idea, Gil. I just made notes for today, so far. I wasn't even thinking about using that section on the SS.

So he doesn't appear to be moving much. Is that good or bad, being that he's very close to the yellow. I SO hope I won't be advised to change his dose back to .25u. Maybe if he only gets LC, that will take him down a bit. Then again, this has not been very predictable yet. Unless you guys can tell me what you think of his SS.

 

This group has definitely saved us, too. The vet I had taken Chase to twice, and who was advising me, could have killed him with the amount of insulin she prescribed, and the fact that she didn't think testing needed to be done often. Aye aye aye.

 

That's good that he is still flat at +2.

Because the number is about the same as amps it would usually indicate an active cycle(but not crazy because he hasn't dropped like a stone at +2)

So that means that his BG will probably, gently slide down during the day and then come up, giving you a nice curve.
If I had to guess I would think his numbers will head gently down today.


He seems to be in safe numbers and i think your plan for feeding is a good one.

 

Both is +1 and +2 is food influenced and it's good that he's not dropping but remaining flat. His +3 will also be food influenced. Looks like you can go to work without much worry today.

 

Just wanted to add that if for some reason chase decides to be a cheeky monkey at +3 and throw you a curveball(ie he drops a lot) then instead of giving him LC at that point give him some MC or HC.

I'll try to be around for when you get that ps, have some errands to run, but hopefully will be back before you get +3.

 

Yes... if he were to drop, the next meal would be MC. I'm just not sure when a "drop" warrants HC. Marje probably told me, but I can't remember. How many points, in one hour, is too much of drop and warrants HC?

 

+3 is 183 No dive, today. Yay Chase. Am off to work, now, and will leave down some frozen LC so he can nibble today.

 

Sandi

I put this info last night on the 2/21 condo to explain the food questions you've been having but I was having board issues and it didn't post. It saved and posted this morning but I'm going to put it here.

But first, remember that the MC feeding was an experiment so we could see if we could flatten him out. It wasn't meant to continue. Once we had him flatter, like now, we would switch to LC. I also wanted to give the depot some time to drain. The experiment was to try and find a way to feed and allow you to leave for work and not worry he would drop.

Here is the post from last night:

Let me see if I can explain this a little better.

Insulin is not a drug....it's a hormone so that means we are potentially going to get a little different reaction each cycle. It's not only that it's hormone but it's also that absorption can vary up to 50% from cycle to cycle, the syringes are inaccurate, and you are trying to be consistent with a very small dose.

Our goal was to get him to stop dropping from mid blue/yellow to green in a couple hours. This is called managing the curve with food. The goal with managing the curve with food is to stop fast drops and keep numbers from going too low.

In managing the curve with food, we feed the normal total portion of food over several hours to slow the drop and raise the nadir so we get a flatter cycle. Sometimes when we do this, we, eventually, need to raise the dose a bit to get the entire curve to come a little lower. It's something we will have to talk about if Chase stays in blue numbers. We usually manage the curve with the kitty's normal, LC food but sometimes we have to be flexible and that's what we've tried to do with Chase to keep him safe while you work.

We've seen the MC has worked really well to slow the drops and flatten Chase's curves. What I would suggest, and what I think Gill suggested, is that you keep really good notes in the Remarks section of the SS indicating what, how much, and when you fed food. Then you can see what worked and what didn't. If you look on Gracie's SS, you'll see we kept really detailed notes on how we fed her because managing the curve with food is an art as much as science.

We can give you ideas and thoughts but it really comes down to you learning about Chase's reaction to insulin and food. Look at his SS and see if you can identify when his insulin onsets, when is the lowest point of the cycle (or the peak caution) we call the nadir; how much duration does he get from his shots? These are things you should study and when we ask, you should know. There might be a time when his feeding schedule needs to change so its really important you have a feel for it.

Please let me know if you have questions.

And I will add this today that if you think about the "normal" action of the insulin, it might help on how to feed him:
AMPS: insulin should be waning from previous shot
+1: hopefully we see a food spike as you will have fed breakfast and insulin has waned
+2: insulin onsets and numbers drop
+3: insulin continues to work and numbers drop until nadir and then start to rise

I'm just putting those first times because that is what is most critical for you in determining what to feed in the mornings and before you leave.

Now think about what you have learned with our experiment: Chase responds well to MC food. The next step is for you to learn what his patterns might mean and how to put his patterns in line with feeding and get all his food in him.

Many members determine how many calories kitty needs and then they divide the portions up into a set number of feedings. You can do this with Chase. If he gets four cans of Fancy Feast, start by giving him 1/4 can at AMPS, 1/4 at +1, 1/4 at +2, and leave 1/4 out. You might and likely will have to adjust this at some time.

The ultimate goal in managing the curve with food can be summarized below:

Manage the curve with food ----> flatten the curve ------> adjust the dose (if necessary)

Does that help?

 

Chase's # is in the yellow, tonight, so can I just give him 1/2 of his evening food instead of spoon feeding it to him? It's LC.

 

That's sounds fine Sandi. Do get a +2 though.

 

Really? I don't have to get a +1? YAY!!! LOL

 

No, you can skip the +1. You're home and he's a wee higher tonight. What time would you normally give him the rest of his food?

 

Well the past few nights I have spreading it out over the glucose checks, because he was lower and we didn't want to take a chance on him not eating, should he need to in a jiffy. Now I don't know how to feed him.

 

Looking good in blue, Sandi!

 

Hmmm. If it were me I'd probably put the food down around the same time you do when leaving the house in the morning. Maybe after your +2 test? Just a thought. I like to try and feed the same way during the day and night for consistency unless you need to "feed the curve" like you have been. What do you think?

 

He "was". Tonight he's in the yellow, Kris.

 

Well... he's not gobbling it like he was the MC. He doesn't care as much for the LC. Unless I run it through the Nutribullet.

 

Oh yes, the foodie thing. There are tons of LC options out there. Many keep a bit of variety on hand. He's eating though, right?

 

Oh yeah, He ate a little bit of it, then acted all casual like he wasn't interested. LOL. Then I made it mush and he's gobbling. He's so weird. LOL

 

We like kitties with "personality" Ok, good. Give him some scritches and I'll look for your +2.

 

Thank you, Karen... thank you for looking out for us. Almost time for the +2. Fingers crossed. He sure will be happy to get the rest off his dinner. LOL. So funny.... I often call Chase "Chaser Doodles".

 

My Doodles is not a good example do don't let Chase hang out with him

 

Awwww... come on now. Be nice. He's your baby. They would probably go to big kitty parties are raves. LOL

Ok... so he is at 163... back down into the blue. I like his numbers tonight. I'm going to put the rest of his food down. He's been a very good boy.

 

It's a good drop. Can you test him at +4 and good to give him food. I usually go to sleep about 10pm. Will you be ok? There are others who watch the board. Keep your title updated.

 

Oh... I didn't know I was gonna need to test him at +4. I took my evening meds that make me very sleepy. I'll try.

Sweet dreams, Karen.

Yes. I'll be ok. Thank you so much. Sweet dreams!

 

Not to worry - that's a low yellow and it's less stressful for you.

 

He'll probably be ok. One more test before you go down for the night would be good if possible. Sleep well

 

+4 123

 

Is there anyone here on the board?

 

Sorry I wasn't up yet, that looks like a nice cycle.
Did you go to bed?
I think he will be fine, but for future reference, as he was still dropping at +4, and if I needed to go to bed, I would have perhaps given him an extra bit of food, LC, because his numbers are nice and safe and he's already approaching the halfway mark in his cycle.
The extra Low carb would be as a precaution to try and have him level out.
I'll watch for you in the morning.

 

Hi Gil. Yes... I fell asleep in my chair, as I often do. When I woke up I did a test. And yes... I gave him some food at that time... I think. That's what happens when I fall asleep and then wake up. Getting ready for the AMPS. Hoping for a blue number. Come onnnnnn blue. LOL

 

Chase has a (re)mission in mind.

 

163 giving 0.1u and LC food

I haven't started a new thread, yet. My mouse isn't working and and the pad on the laptop is touchy. Where are 2 double A batteries when you need them?

 

Is anyone here?

 

I'm around Sandi. Get your +1 & 2. If he's flat or dropping at +1 then give him some more food.

 

I would just add to what Karen said, if he is dropping significantly(lower than 140) at +1 I would recommend you give him some MC for his meal, to flatten him out, as you have to go to work.
If he is the same or has come up a bit after the food then stick with your LC meal.

 

Thank you.

 

Thank you for giving me that 140 number. That helps me more than anything, right now. OK... about to test.

 

+1 155

LC or MC

 

I think a snack of LC is fine to keep him flat and test again at +2

 

Oh wait... he's above 140, so LC? I have the other half of his can ready to go.

 

I think LC is fine.

 

OK... well he eats 4 cans of FF a day. In the morning, especially, I have been giving him half a can at a time. Remember.... if he drops I have MC food and HC food, which he LOVES, and he will eat at ANY given time.

I just gave him half of one can.

 

Ok, when are you leaving for work..after +2 or +3? I assume you will also leave food out for him while you're gone...correct?

 

All of a sudden I can't update the SS. And it's missing today's date... it must have gotten hidden, somehow.

 

This week I have been getting a +3 before running out the door. Yesterday I left some frozen LC down and it was gone when I got home. LOL

 

I just got it working. Using the pad on my laptop slows me down a LOT. I need my mouse back..;

 

Oh good, glad you got it working. He is looking really good and glad you can stay through the +3 which is around onset of the insulin. You will then get a good idea of what type of food you need to leave for him before you go to work.

 

+2 is 99

HC gravy or MC helping of food?

Seems like this is going to be a fine line between LC and MC food.

 

OK time for the MC, give him a good helping.

 

I'd try MC because when the gravy wears off he could come back down. Get the +3 and see where he is then.

 

Marje said that 50 - 120 is a good number, but that is a big drop, for only an hour.

 

Thank you, so much. He's gonna like this. LOL The MC is his favorite.

 

That's why we're suggesting to give a MC snack now and get a +3

 

Love that he's a good eater!

 

It is a big drop and he has probably just onset.

Because you have to leave at +3ish
Can you check him again at +2.5?
If his numbers are still dropping, then some more MC then, and it will give you one more chance to check before leaving.
He is in safe numbers and if you were able to stay then I would go for just the test at +3, so being a little bit more cautious, so you can steer him with the food a little more proactively.

 

I have NO idea how my dates in the SS got off. Today is the 23rd, not the 24th. I don't have time to figure it out and fix it. I have to get in the shower. Must leave immediately after I get the +3. Can you tell me what I should leave down, LC or MC.... like an example of a number. I have frozen MC and LC, so I can put either down when I leave. I will have to leave within a few minutes after his +3 because yesterday I was late to work.

 

I will do my best. I have to get ready for work. Tomorrow I will start getting ready for work earlier, just in case this happens. I will jump in the shower and then test at +2.5.... will then post.

 

If for some crazy reason he was around 60, because you have to leave, I would bump him up with some HC,

If he has dropped at +3 I would leave MC at +3 so if he is lower than 99.
If he has dropped at +3 and is between 85-70, I would leave some MC out for him to nibble on through the day. Better to be safe.

If he has levelled out at +3 you could go with MC at +3 and LC snacks to nibble on.

If he has come up, over 110 @ +3, then LC at +3 and LC snacks.

 

Given the amount of food you've given him this morning and he still dropped to 99 I would leave out MC since you can't be home. Honestly I think you should reduce his dose to a "drop" tonight. Having to constantly feed MC says to me he needs a lower dose. Having to give MC all the time is not allowing to see the real picture but is needed since you need to work. Sure others will disagree about reducing but that's my opinion. The other option is to keep the .1 dose, keep using the MC and over the weekend while you home just got to all LC when you can monitor to see what he's doing.

Don't worry about any of this now Sandi, I'm just putting thoughts out there.

 

+2.5 72

 

Sandi, I think I would give him some HC now, that 72 is awful close to the cutoff, a decent amount to abort this cycle.
Check at +3, give him some HC then as well, then and then leave out some MC for him to snack on.

 

And on SLGS he earned a reduction to the "drop" of insulin tonight. Basically Sandi, you will push the plunger in firmly, insert the needed into the Lantus and release. It will suck up a "drop" of insulin. This is all good stuff, nerve wracking but he's super close to being OTJ.

 

OMG... OTJ?? Could it be? I'm crying, now. This has been very nerve racking but SO worth it if it means he will be healthier. I guess his pancreas has healed some.

What must his number at PMPS be in order to give him the drop of insulin? And... what will I feed him?

 

With the HC and the MC snacks he may be high at PMPS, so wait and see what number he gives you.

 

If he's high enough to shoot tonight regardless of how high you'll be reducing the dose to a drop at PMPS. Lets wait and see then decide on the food.

 

She could hold the dose if he was high(high yellow or more perhaps), and shoot through the bounce? Reducing in the morning?
Just thinking of trying to give fragile Mr P as much support as possible to give Chase the best chance at a strong remission, with yellows still in the picture so recently just thinking of trying to molly coddle those Beta cells.

I used MC a lot to manage George's early part of the curve to control the bouncing and flatten him out, it is nerve wracking, even more so for Sandi because of work, but I do think that by keeping hold of doses for as long as it was safe to do so has really helped with his remission.

 

+3 is 78 Do I feed MC and then leave MC down, Gil? Or Feed MC and leave out LC?

I'm so sorry... haven't had time to start a new thread. Will try to fix this at work.

 

78 at +3 So I will give him some more HC (he will ONLY lick the gravy off), and leave down some frozen MC? I hope that's right. I have to leave in 5 minutes.

 

I would give him some HC and leave MC down, he hasn't come up yet from the HC, so I think giving a little extra HC might be just the ticket for safeties sake.
The gravy is where the carbs are.
Maybe leave some MC down as well for him, something more substantial for him to munch on while his food defrosts.

 

Respectfully Gill, I understand your suggestion and the points about using MC. However I disagree in the case for Chase and it's just my opinion for the following reason.

1- we don't know if that yellow was a result of a bounce yesterday considering he dropped pretty good last night.
2 - Chase is a very newly diagnosed kitty that was eating dry but was removed 3 weeks ago
3 - I would not shoot through the bounce tonight because Sandi cannot monitor much during the day or late at night. If tomorrow was Saturday and she could watch him more I might think differently
4 - This morning's AMPS could also be a bounce as he was still dropping at +4 last night
5- Today is the 7th cycle on .1 and he's obviously holding the dose just fine

 

With talk of reducing or withholding his dose tonight, altogether, I will make a point of getting on her at work to read this again and try to absorb. Although... I'm VERY busy at work. Thank you BOTH for staying with me through the morning.

 

Fingers crossed for Chase!

 

I agree with all your points @Doodles & Karen , I just think that she should see where he is before deciding.

Ability to monitor is a very important factor.
FWIW, given his response this morning I do think the reduction is worth trying, but if he was in the pink tonight...... I would err to shooting through that, and taking the reduction in the morning.

I don't think the number this morning was a bounce, it looks more like the end of the cycle, and judging by the +1 and +2 it looks like Chase was getting good duration and overlap.
As for yesterdays yellow pmps, the preceding cycle looks pretty flat, (of course we can't be sure), but given again that he dropped at +2, looks like he came in flat and then dropped at onset.

Knowing Chase, he'll be low blue anyways, so shooting through a bounce may be a mute point.

At the end of the day Sandi holds the syringe and she can make an informed choice.

 

Exciting stuff. This boy definitely wants OTJ and I can't wait to see what his number is tonight. I think he is ready for a drop of insulin too because of dropping this fast and early in the cycle even with MC and HC food.

 

You guys are doing awesome! Congrats on progress and hopeful for remission, Chase!

 

Hi... oh my gosh... I hope someone is here. Chase's BG at PMPS is 232.

 

Been waiting for you Sandi I would still bring his dose down to a drop tonight. You had to give him quite a bit of food this morning including MC & HC and he earned the reduction by going below 90 today. With the drop dose...push the plunger in firmly, insert into Lantus and release. Feed LC food.

 

Ok. And then test again in 30?

 

No, you can wait until +2

 

Cool Beans Sandi! As I said a few days ago, I think this boy could be off the juice before you even know what his patterns are. That's my story and I am sticking to it.

 

Sandi, if you see this before you shot, when you do shoot hold the plunger into Chase skin and count to 6-7 and keep the plunger depressed as you pull the syringe out of his skin. This prevents the drop from being sucked back into the syringe.