? 11/22 PAX AMPS 94 - Huge drop from 431 after shot at vet.

Pax's Mom

Pax's Mom

Member Since 2019
Last post: http://www.felinediabetes.com/FDMB/...hest-they-have-ever-been.221955/#post-2480977
Ok, I still have the real AMPS to give, but I wanted to give myself some time to get feedback before the shot.
He was in the 400s yesterday at this time and now he is at 94. He did have a shot of Convenia at the vet yesterday morning at AM+3.

I am afraid to give his 2U dose as maybe the shot helped him and he doesn't need the high amount. What are your thoughts?
 
If he’s at 94 now and it’s time to shoot, I would skip this shot. You don’t really have any data to see how low he would go shooting this low and especially if you’re not home to test....
 
Myrtlesmum said:
If he’s at 94 now and it’s time to shoot, I would skip this shot. You don’t really have any data to see how low he would go shooting this low and especially if you’re not home to test....
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Thank you. I will skip now as I have to leave. It has only gone up 3 points in the last hour and that can absolutely be margin of error. He is eating and using the litter box. I will come back on my lunch and test (and shoot if he jumps). I can change his time shot time if needed. I may even be able to see if I can work from home the rest of the day to watch him if I do need to shoot (too many meetings this morning to do that :( )
 
Working from home the rest of the day to monitor. He is still in the normal range 141. If he goes higher than 150 do you guys think I should give him his PM shot? If so, should I start lower than 2U?
 
Sorry that I didn't see your tag sooner. I'm out of town and not reliably on the Board.

So here are my belated thoughts. The numbers in the 90s are safe to shoot with TR. It's especially safe if you're home to monitor. However, that doesn't mean you feel comfortable shooting those numbers. (FWIW, I would shoot anything above a 50.)

I would encourage you to start thinking about what numbers you would be comfortable shooting and as you become more confident, keep lowering the point at which you are willing to shoot until you get to 50. Most of the time, people expect that if Lantus drops their cat's numbers from 300 to 75, if their pre-shot number is 80 then their cat will be in extremely low numbers, need a ton of HC, etc. It doesn't usually work that way. A "typical" Lantus cycle is flat. It's why you'll see a cat stay in green numbers for extended periods.

150 is not a "don't ever shoot because your cat's life is in danger if your do" number. It's the number we use for new members to post and ask for help. So, I would say if you're anywhere in the neighborhood at PMPS, shoot! It's helpful if you're nervous, to see if there's an experienced member around to provide a bit of back up or coaching. We won't leave you hanging out there all by yourself.
 
Pax's Mom said:
He is still in the normal range 141. If he goes higher than 150 do you guys think I should give him his PM shot? If so, should I start lower than 2U?
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With the AMPS yesterday it's not surprising that BG at vet was up in the 400s. Vet stress plus pet meter/lab equipment vs. human meter difference could easily account for that 180+ elevation.
Normal range on a human meter is 50 to 120. With TR he doesn't earn a reduction until he drops below 50. Dose tonight would still be 2.0u and with the skipped shot, the cycle count at the 2.0u dose starts over.
 
MrWorfMen's Mom said:
With the AMPS yesterday it's not surprising that BG at vet was up in the 400s. Vet stress plus pet meter/lab equipment vs. human meter difference could easily account for that 180+ elevation.
Normal range on a human meter is 50 to 120. With TR he doesn't earn a reduction until he drops below 50. Dose tonight would still be 2.0u and with the skipped shot, the cycle count at the 2.0u dose starts over.
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My concern is that he was in the 400s prior to the vet, that is what prompted the visit. After the convenia shot is when his numbers dropped drastically. My concern is 2U is twice as high as the first time I got him to go into remission and if the Convenia helped fix what ever issue he was having that spiked the numbers, that the 2U may be too much. Maybe I am over thinking this.

Sienne and Gabby (GA) said:
So here are my belated thoughts. The numbers in the 90s are safe to shoot with TR. It's especially safe if you're home to monitor. However, that doesn't mean you feel comfortable shooting those numbers. (FWIW, I would shoot anything above a 50.)
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Would you do the same after a big drop after an antibiotic shot?
 
Sorry if I misunderstood but your SS comments say the 422 was the reading at the vet with a pet meter but the readings in the cells don't correlate. It also appears from the hourly cell entries, that BG dropped down to 280 after the 422 reading.

I presume the vet suspects an infection if he/she gave a shot of Convenia but that would have had very little time to work yet. If BG was elevated due to an infection I wouldn't expect to see any gross change in BG for at least a couple of days. Explaining a sudden higher BG is sometimes impossible. Did Pax see a squirrel or bird out a window and get all excited just before you tested? Did he hear a noise that scared him? Did you have a bad strip?

Any time you get a reading that seems out of the ordinary or expected, it's a good idea to retest.

As for never needing as high a dose before, it's quite common for a kitty to need more insulin if they fall out of remission and given the readings you've been getting at 2.0u there is no reason to think that dose is too high.
 
MrWorfMen's Mom said:
Sorry if I misunderstood but your SS comments say the 422 was the reading at the vet with a pet meter but the readings in the cells don't correlate. It also appears from the hourly cell entries, that BG dropped down to 280 after the 422 reading.

I presume the vet suspects an infection if he/she gave a shot of Convenia but that would have had very little time to work yet. If BG was elevated due to an infection I wouldn't expect to see any gross change in BG for at least a couple of days. Explaining a sudden higher BG is sometimes impossible. Did Pax see a squirrel or bird out a window and get all excited just before you tested? Did he hear a noise that scared him? Did you have a bad strip?

Any time you get a reading that seems out of the ordinary or expected, it's a good idea to retest.
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Correct, the 422 was at the vet, but 4-6 hours before that he was at 442, 413, 431. That is with three different strips.
 
Ok I see the 400+ readings but you also said you woke up to Pax coughing and he vomited. That would stress him out and cause temporary elevated BG. What did the vet think was wrong that resulted in the Convenia shot? Did he suspect a URI?
 
I don't agree with the vet on that choice. Convenia is meant for skin conditions not URIs. Has Pax had any other signs of a URI such as sneezing, runny eyes, more coughing? I see he threw up clear fluid on the 14th and again on the 22nd. From your avatar, he looks like a very furry guy. Is it possible he was just trying to evacuate a hairball? My girl sounds like she's being hacked with knife when she's had a hairball but then she is a diva.
 
Hi Sorry I wasn't around earlier this afternoon, and will not be round much over the weekend.

I completely agree with Sienne thoughts on this mornings numbers.
I found it useful to remind myself that I was not shooting the number I was seeing at PS but rather the number he was going to be at onset, once the previous dose has run it's course.
So when you see 94, the numbers are likely to start rising, because you are at the end of the cycle, additionally you are feeding so that is going to contribute more to that rise, you can see that's what happened this morning, with the 141.

Pax's Mom said:
My concern is that he was in the 400s prior to the vet, that is what prompted the visit. After the convenia shot is when his numbers dropped drastically. My concern is 2U is twice as high as the first time I got him to go into remission and if the Convenia helped fix what ever issue he was having that spiked the numbers, that the 2U may be too much. Maybe I am over thinking this.
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they did, but this was also cycle 4 on the dose, not unusual to start to see what the dose will do for a cat four cycles into a new dose. I would think it's unlikely that the AB's sorted out any infection that quickly so as to affect BG.
Don't get hung up on what he did before, George's patterns changed when he came out of remission. You've taken the dose up slowly and consistently, have monitored carefully, I don't see where you would have missed a dose.

Now you have skipped you may find he experiences higher cycles until the depot restabilises, try not to worry too much if that's what happens.
 
MrWorfMen's Mom said:
I don't agree with the vet on that choice. Convenia is meant for skin conditions not URIs. Has Pax had any other signs of a URI such as sneezing, runny eyes, more coughing? I see he threw up clear fluid on the 14th and again on the 22nd. From your avatar, he looks like a very furry guy. Is it possible he was just trying to evacuate a hairball? My girl sounds like she's being hacked with knife when she's had a hairball but then she is a diva.
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I know that know about convenia now, but didn't when the vet gave it to him. Ok, his numbers are jumping a lot now (as you guys predicted. Should I shoot now and just have him on a different cycle? or should I wait another 6 hours for his normal time? It could have been a hair ball, but it isn't the normal sound he makes or the position he sits in.
 
Sorry I've not really been on much over the weekend.

How are you getting on, I see he had a big drop tonight (sunday night), are you still up? I think you should be checking the BG again at +4 at the latest. He may well bounce, but when they are dropping like that it's important to make sure that they don't continue to dive.
 
Gill & George said:
Sorry I've not really been on much over the weekend.

How are you getting on, I see he had a big drop tonight (sunday night), are you still up? I think you should be checking the BG again at +4 at the latest. He may well bounce, but when they are dropping like that it's important to make sure that they don't continue to dive.
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Thank you for the follow up. The spreadsheet has been updated. At this point I have not had a full nights sleep in over 3 weeks and I basically passed out just after PM+5. This is really hard to do alone when he is all over the place with numbers.

I am not sure why he never went down after 11/24 AM shot. I am 99% sure it wasn't a fur shot. I will test again right before I leave for work and update the chart.
 
Pax's Mom said:
I am not sure why he never went down after 11/24 AM shot.
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He bounced of the greens, that's what it looks like, it was a bounce that just lasted one cycle, so he is clearing them fast.
Pax's Mom said:
Thank you for the follow up. The spreadsheet has been updated. At this point I have not had a full nights sleep in over 3 weeks and I basically passed out just after PM+5. This is really hard to do alone when he is all over the place with numbers.
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You're welcome.
I hear you, DH was working away, so I was his sole carer when George was first on insulin and it was hardest when George's numbers were all over the place.
You are doing a great job.

Pax's Mom said:
I will test again right before I leave for work and update the chart.
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Good plan he's clearing his bounces fast.
 
Before work update. He jumped 70 in the last hour. Lets hope he comes down. I am off to work, but I have someone who is able to come by and check on him in a couple hours. i will update the spreadsheet when I get home.
 
@Gill & George,
My friend said his number was 345 at AM+3 (cant update SS until I get home). Looks like he is going to have another day of high numbers. Any idea why he would stagger dropping a lot on once dose and the next not at all?
 
Looks like another bounce from those beautiful greens last night. Pax has forgotten that those greens are good safe BGs and his defences are kicking in to get his BG back up to higher levels that he now perceives as normal. As Pax spends more time in those lower numbers his body will get used to them again and the bouncing will ease off. He seems to clear bounces quickly which is great. This is the most frustrating part of dealing with the diabetes but it will get better with time.
 
I agree with Linda, it looks like a bounce, he's just got used to being a little higher, with time he should hopefully get used to those lower numbers, see them as normal and stop bouncing.

He doesn't seem to be bouncing for long (recently just one cycle), it wouldn't surprise me if he saw green soon, I'd look for signs of him starting to clear the bounce tonight.
 
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