2/26 Rosie - AMPS 109 NS +11 165

Discussion in 'Lantus / Levemir / Biosimilars' started by Carol in Chicago, Feb 26, 2018.

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  1. Carol in Chicago

    Carol in Chicago Member

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    I made a "depot draining" reduction of one full unit because Rose went "Lo" (which is < 20 on a Relion Confirm so it is noted as 19 in SS). I was not expecting to see "Lo" again. I am testing every 15 - 30 min to confirm she is OK overnight, but I'm developing a fear of giving her insulin.

    Previous.
     
  2. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Hi Carol,

    I'm sure you know what to do - give HC, honey, etc. and retest in 20 minutes. Regardless of what you get for an AMPS, I'm inclined to recommend you skip the shot to drain the depot. If I am correct, Rosie has no history of DKA?
     
  3. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    There's definitely something going on with Rosie!!

    It's possible that the really low numbers (like on 2/4) might have kickstarted her pancreas into working again. We've seen it before where cats had symptomatic hypo's and afterwards never needed insulin again (or needed drastically reduced amounts)

    Unless she skyrockets by morning, I think I'd skip and let her depot drain some and then see how she does over the AM cycle tomorrow
     
  4. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    GMTA ;)
     
  5. Carol in Chicago

    Carol in Chicago Member

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    Thanks @Tricia Cinco(GA) & Harvey and @Chris & China. Rosie has no history of DKA (thank goodness).

    I am monitoring closely, but my nerves are fried, so I will look forward to skipping in the AM. Thanks!
     
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  6. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Carol, please post the next test when you have it. Watching and hoping Rosie is coming up. I'm sure you know that you need to keep feeding and testing every 20-30 minutes until she's over 50, then two more tests without food without a drop to be sure she is safe.
     
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  7. Carol in Chicago

    Carol in Chicago Member

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    She is now at 46. I'm going to break out the HC food, I'd like to limit the Karo.
     
  8. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Well, that's progress. Give her the gravy with as little of the meat as possible, as you don't want to fill her up yet. Keep us posted.
     
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  9. Carol in Chicago

    Carol in Chicago Member

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    So she is holding 46 (30 min after enjoying some HC gravy).
     
  10. Carol in Chicago

    Carol in Chicago Member

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    She dropped again to 39, so I'm back to another .5ml Karo.
     
  11. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Where are we in relation to the last shot (+what?)?
     
  12. Carol in Chicago

    Carol in Chicago Member

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    The last test was +9.
     
  13. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Is she eating willingly? I'm thinking you need to carb her up. Give gravy, some of the meat, and a little karo.
     
  14. Carol in Chicago

    Carol in Chicago Member

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    Yes. She is eating. She likes gravy. I'll continue to offer that to her.
     
  15. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    I'm watching for the next test.....

    I know you're not new at this, but it helps to have someone there when you're doing this in the middle of the night.
     
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  16. Carol in Chicago

    Carol in Chicago Member

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    Thanks. Just got a 51. She is enjoying more HC with a drop of Karo added.
     
  17. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    That's nice. Assuming the next test is the same or slightly higher, I'd try just giving a little of her regular food. If it's a lot higher, don't give any food and we'll see what that does.

    Looking ahead, skipping your morning shot definitely looks like the way to go, and then resuming at 2.75 Monday night, since she's earned a reduction. Something has definitely changed with Rosie lately, and she's needing less juice for sure!
     
  18. Carol in Chicago

    Carol in Chicago Member

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    Yes. I will skip in the AM, but I am already afraid to give 2.75 as a PM dose. Since she has a history of deep dives overnight I'm already in a panic. I don't think I can stay up with her all night two nights in a row so I might need to be a big chicken.
     
  19. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Let's get her through this first, then see how she does tomorrow. Can you test during the day, or do you have to be at work?
     
  20. Carol in Chicago

    Carol in Chicago Member

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    I'm pretty much a test-a-holic, so I do test frequently during the day but I may get off to a bit of a later start than usual after all this fun today. ;)
     
  21. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Hopefully, she'll come up and stay up and give you a chance to get some sleep. Even if you skip the morning shot, though, it's a good idea to get some tests in to see what's going on and help you make a decision about Monday night. I've asked some other veterans to stop by and give you their thoughts, too.

    Do you have any ideas about what is causing these low numbers? Could it have to do with the enemas?
     
  22. Carol in Chicago

    Carol in Chicago Member

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    She is now at 88 (this is +10).

    She is having a problem with constipation, but I have always thought that would raise the numbers. She was doing great both in terms of BG and LB up until the last several days when things started to slow down in the LB department. My current theory is that she is feeling "full" because of the constipation and enemas being used to treat constipation so she is eating less. She is still eating, but just not as much. There are other cats in the household, so I can't measure / weight her food to determine how much less she is eating, but I'm not seeing her be as interested in food she usually would be. She loves food and really enjoys a good heist - she will steal food from the other cats especially if it is not as healthy and doesn't have supplements. I caught her doing this several times today. Her new nick name is Bandit.
     
  23. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Eating less can certainly cause a drop in BGs. Do you feel like she is getting "enough" to eat? You're right about constipation causing them to not eat. It's a vicious circle.

    Don't give her any more food and test again in 30. If she's the same or higher, test again in 1 hour, and if she's still up, you can call it a night (or a morning :rolleyes:). I would test her when you get up and once or twice during the day to help determine what you should do at PMPS. She should bounce from these shenanigans, but she didn't do so after Friday night's lows, so o_O:confused:?
     
  24. Carol in Chicago

    Carol in Chicago Member

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    Yes. I believe she is eating "enough" and she still enjoys stealing so I wasn't thinking this was a major drop in food intake. I will re-test. She has already picked over everything I have offered her and also her regular auto-feeder LC food, so no more food planned. Technically we are already within 2 hours of what would normally be AMPS. :eek:

    Rosie likes to know what the rules are - then she breaks them, so I will go along with your sentiment! o_O:confused:

    Thanks for your help tonight!
     
  25. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Apparently, she has read the cat manual. Mission statement: Do everything in your power to keep your bean on his/her toes!
     
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  26. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Looks like Rosie has decided to swim away from the sharks. I'm off to bed. Hope you are, too!
     
  27. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Harrowing times for you, Carol, but Rosie's SS looks wonderful! :D
     
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  28. Alicia & Maggie (GA)

    Alicia & Maggie (GA) Well-Known Member

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    Sorry for such a nerve wracking early morning. :bighug: Rosie's SS is a thing of beauty with all those blues and greens... except for those neon greens. :rolleyes: Sending poo vines and I hope she surfs for you today.
     
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  29. Carol in Chicago

    Carol in Chicago Member

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    Kept the plan - NS today and she was 151 at what would have been +5. I'm already a mess thinking about what to do tonight. @Chris & China - if we assume that prior low numbers kicked her into gear, how do you "reset" the dose?
     
  30. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Wow! Rosie really like to put you through the wringer. :eek::bighug:

    Last night's dose still would have had some impact from the 4 unit depot - the depot can last 4-6 cycles after a reduction. Likely longer since you did such a big reduction. Any chance you could post a +11 to give us time to think about tonight's dose. I'd be inclined to be conservative again, and go down to 2.5 units. But let's see what her numbers are like later first.
     
  31. Carol in Chicago

    Carol in Chicago Member

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    Thanks Wendy. +11 is 165. I'm thinking I might be able to do 2, but I'm still afraid.

    Just got back from Walmart. Had to re-stock everything. Chocolate, coffee, and test strips. I cold brew coffee which is supposed to be good for extra caffeine, but can be a problem in terms of lead time. First order of business after a nap today was to get a double batch going.
     
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  32. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Do what you feel comfortable shooting. Tomorrow is another day. :bighug:
     
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  33. Carol in Chicago

    Carol in Chicago Member

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    PMPS was 154. She is eating well. I shot 2u. I hope this is uneventful. I would like to "reset" her dose to be more conservative and relaxed.

    In other news, a few nice LB deposits today. Not all in the LB, but at least I'm seeing some action here.
     
  34. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Rosie....be a good kitty and surf safely for your mamabean tonight!

    Unlike you kitties, we beans can't sleep 20 hours a day, so it's really nice if we can get a few uninterrupted hours at night!!
     
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  35. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Rosie! :eek:

    You must be exhausted, Carol! I'm sorry Rosie is messing with you in the wee hours, I hope you figure out a dose that works well for her soon. :bighug:
     
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  36. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Hi Carol.

    Looks like Rosie is being a little more reasonable tonight. Hopefully she will surf in low blues/high greens and let you get some shut-eye.
     
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