2/10 - Sami PMPS 171; +2 195; +3 259 ???????

Status
Not open for further replies.
Tina & Sammy

Tina & Sammy

Member Since 2010
Good Morning All,

Yesterday's Condo

Well, I am not sure why Sami started to rise last night. It was probably because I decreased her dose when I shouldn't have, but I also gave the shot in the flank, and I have read that that area typically doesn't have as long of a duration. Although, She really didn't see much movement between +1 and +4 last night so I just don't know. Plus, I also gave Sami a different food last night because she didn't seem interested in the same thing that I have been giving her for a week. Too many variables to really know for sure.

I also don't know if the PINK PS this morning is bounce due to that long ride on the BLUE Wave last night. There are so many things to think about.

I am truly going to do my best to stick to protocol and only give Sami a reduction when it is earned. I am going to try to hold off on fluids until the weekend to see if we can't get some more good progress with her numbers. 2 units does seem to do wonders for her and without the fluids dropping her so quickly we might be able to determine if it is the right dose.

Thank you again for all the support, suggestions. and even the slaps on the hand.
 
Last edited:
The vet called again today to check in and she is still convinced that Sami is getting too much insulin. She wants me to back off to 1.75 units with tonights dose. I told her I would consider it, but after last night's BSC dose, I am not really in the same camp. I know she dropped from 445 to 195 at PMPS last night, but everyone keeps saying how the closer to the good numbers the cat gets the less likely they are to make huge drops. The vet thinks that Sami's spike this morning is because of too much insulin, but based on the testing last night it doesn't look like she got enough. And I really don't think that she went too low.

From PMPS to +4 she really didn't move much considering meter variance, and then it looks like she started to rise after that. I am assuming that since she is still new to those BLUE numbers that is what caused the bounce this morning, and not because she went too low last night. Now remember that I did give Sami a different type of food last night, so that could be part of the problem. I am REALLY going to try to stick to the same food tonight and not give the 9Lives Flaked Tuna and see how she does. I really HOPE that we are seeing some blue again this afternoon and possibly some GREEN tonight.

I would love to hear your thoughts on this and know if my thinking is correct or not.
 
Hope Sami gets good numbers today. I know like you the bouncing is frustrating. Think it's harder for us since our babies were in remission. I think I blocked all this from the first time.
Hope things go well for you today. I just keep trying to remember the people here are the ones who helped us into remission last time.
 
Your thinking is pretty right on!!

Those blues from last night are lower than her body has gotten used to, so between the short shot last night and the liver's reaction to the unfamiliar blues, you have a bounce today.

You tested more than often enough last night that you can see he didn't go too low so your vet is just plain wrong about that

Look at all that time she spent in better numbers though! The more time you can keep her there, the more her body is going to recognize them as being good and the liver will stop reacting so violently ...the bounces won't be as high and they'll clear faster

One of the first things I was told when we first started was "Cats bounce until they don't"....Unfortunately, this is something we just have to accept
 
FREAKING OUT AGAIN!

So I went back to 2.0 units this morning because of the bounce from last night. Sami has recovered nicely, but now I am even more nervous about shooting 2.0 units tonight. Especially if she is still dropping at her PMPS.

I have spent much time today re-reading all of Sami's threads from 2010. I was just as much a FREAKOUT CASE back then as I am now. WOW!

I still have a couple weeks to read through, but in the beginning I see how much more this group helped get Sami back on track then what the doctor recommended. I realize that most vets don't have Pet Parents like us here on this board, and they don't see the spreadsheets like we do here. I am trying to stay strong and stick to protocol, but let me tell you how nerve racking it is when you start seeing those lower numbers. I know I eventually settled down a bit back in 2010, because I was shooting numbers under 100 and it worked to get Sami into remission. I guess I need to keep telling myself that I can live a few weeks on the edge of the cliff with limited sleep if it means we will be able to get Sami back into remission. I just wish she would give me these lower numbers in the morning when I can monitor very closely and not miss out on sleep instead of at night when I think I am okay to head off to bed and then she decides to go crazy on me.

So please tell me what you would do? Would you shoot the 2.0 units and stick to protocol, or would you take a BCS and go for 1.75 units. If I take the BCS shot tonight I think I will stick with that dose for a few days before I decide what to do next. It just seems like Sami is recovering nicely from the bounces, but is that because she is getting too much insulin or is it because she is getting use to the lower numbers.

HELP!
 
Hi Tina.

I know it's scary to see what you consider to be a big drop, but really, it isn't that bad! You're just not used to it. I think you should do as you said - remember how the people on the board guided you and Sami to remission last time, and listen to their advice now. I promise you, there will always be someone to hold your hand if you get nervous. Hang in there!
 
@Wendy&Neko and @Tricia & Cinco Thanks for the support. I just gave a 2.0 unit dose. My hands are still shaking, but I did feel a little more comfortable since she had a rising number from +10.

As I am reading back through the threads from 2010 I am also looking at the spreadsheet and I think I am finally starting to see a trend. The vet keeps telling me that she is spiking because she is getting too much insulin, but she is also the one who suggested to increase from 1.1 unit to 1.5 unit without the necessary data, and she is also the one who, at the very beginning, suggested that I give 1 unit in the morning and 2 units at night (or vice versa). I know the vet's have a different way of dosing, because they don't typically have pet parents monitoring like we do. I am going to try to remember this and rank the advice I get here a little higher than what she is suggesting. Nothing against my vet, she is a great doctor and always listens to my concerns and is very attentive when have questions, but I am sure she doesn't have a ton of diabetes patients.

Thank you all for sticking with me and letting me get though my little freak out. I can't promise that it won't happen again, but I will do my best to keep it under wraps. I will monitor closely tonight and try to get enough tests to make sure Sami isn't going too low.

Does anyone have a suggestion on a testing schedule for tonight?
 
Way to go Tina! I'm looking forward to seeing what Sami does with this dose and a very nice PMPS.:cool:

Tina & Sami said:
Thank you all for sticking with me and letting me get though my little freak out. I can't promise that it won't happen again, but I will do my best to keep it under wraps.
Click to expand...
You'd be unique amongst us if you didn't have periodic freak outs! :bighug: Part of what we do here is provide support for those nerve wracking moments. I have so many people here to thank for helping to talk me down at the beginning. I've held a good pity party once or twice too.;) I stuck with my vet too, I just stopped listening to her dosing suggestions. And she saw my spreadsheet and is OK with that.

Since Sami is going up, I think you could wait until a +2 for your first test.
 
@Wendy&Neko I wasn't at my computer when + 1 cam around so I went ahead and tested at +1, she was the same as PMPS. Should I still test at +2, and the how often should I test after that. I sort of would like to give her ears a break, but I also don't want to wait too long between tests just incase she drops. Although without the fluids she does seem to be dropping a bit more steadily rather than those huge dips of over 100 points in an hour. So it might not bee too big of a problem.

I would love to see her ride this blue wave for most of the night and maybe dip in to the green.
 
@Vyktors Mum and @Wendy&Neko

+2 - 195

Do you think I can hold off until +4 to test again or should I test at about +3.5 or sooner?

I am just nervous because Sami has had a tendency to drop quick, but that was typically when she had fluids. I haven't given fluids today.
 
Well, I couldn't wait, and I just don't get it.

+3 259

Is this another bounce? Is it possible that her PM shot hasn't kicked in yet? Could this be food induced?

I just gave her another snack and will test one more time before I go to bed in another 30 minutes.
 
Last edited:
Tina, would you remind me which insulin you're using? Lantus or Lev? It'd be great to have it in your signature line or on the ss somewhere. All I'm finding is references to insulin, not exactly which one.

I'm not sure exactly what's up tonight with the +3 - more info will tell you if this is a new bounce. But when you adjusted the dose last night, and i'm not criticizing, just commenting, it interrupted the "flow" of the cycles.

The good news is that she cleared the bounce in just one day - so that's fantastic.

I think most everyone has been in your spot - what to do about dosing advice and the vet? Most of us have figured out that the people here do FD 24/7/365 and even the best vet may not have that level of experience with these two insulins and diabetic cats. If you love your vet otherwise, just resist asking for dosing advice. A good vet is a wonderful find, but not having a ton of experience in dosing with Lantus & Lev doesn't make a vet less good in my mind.

Personally, I'd stick with the 2.0u for a total of 6 cycles and if I didn't see green, I'd increase. I like to remind people that the goal isn't that a kitty dip her toe into green once a day, it's that all the blood sugar be between 50-120 on a human glucometer. Keep your eyes on the prize!
 
@julie & punkin (ga)

Sami is on Lantus. She is now up to 291. I know the vet is going to call again and tell me that Sami is still getting too much insulin. But even with the rise at +3 and into +4 there is no possible way she went too low, at least I don't see it.

I have an alarm set for +6, +8 and +10 to see what she does tonight. I would typically just let it go at this point, but I am curious to see if she drops back down tonight.

I am also wondering if it is because I started giving her the shot in the flank rather than the scruff. I moved the shot so that I can give fluids and hopefully not have it affect her drop as drastically, but I haven't given fluids in the last couple of days and I am going to try to hold off until the weekend so that we can get some good numbers and data collection without the fluid dropping her so fast.
 
My quick look through your earlier part of the spreadsheet seems like she got to 1.5u the first time around. Most cats coming back out of remission end up going over their previously high dose (from the first time round) before they begin to have dose decreases. It's also good if you know what brough her out of remission (i'm thinking you'd said it was pancreatitis) and that concerns gets resolved.

I don't think she's gotten too low at any point and I don't think this dose is too high. you've done a good job of being methodical about the increases. I noticed she skipped from 1.5u to 2.0u, but even that - if the dose is too high she'll tell us. I think you're just now hitting a good dose - she saw green on 2.0 and I suspect once things settle down that will happen again.
 
Status
Not open for further replies.
Back
Top