20 Nov| Girlie AMPS 187; PMPS 313; +4=76; +6=58; +9=99 Reduction earned

Condo: http://www.felinediabetes.com/FDMB/...pmps-562-awful-numbers-nausea-no-appy.186865/

Broke the bounce last night and went into blues, and still blue this AM: whoop whoop!

Nausea better after second 4 mg tablet of Cerenia in PM. Appetite not huge, but holding off on Mirtazapine for now.

I wonder how long it takes a tablet to be absorbed? I'd love to let her out into the garden, but she'll go straight for the grass and might vomit, as she did the other day. Hmmm....

Thanks for all replies and info in yesterday's thread! See my replies below.

Hope all kitties surf safely tonight and all moms and pops get some sleep!

 

Thanks for those tips, @Bobbie And Bubba ... the feeding syringe we can do for sure as she's used to liquid meds.

Yes, I can, and I might be able to get it from another company that ships to Oz. I'm taking an extra suitcase to D.C. over the holidays just to bring back other supplies that won't ship to Oz : so many things on my Amazon wish list for Girlie! Thank you, @LizzieInTexas !

 

@rawia , I'm so sorry to hear your kitty has ended up in the vet clinic when she's been nauseated and wouldn't eat. That's no good! Nausea is hard to deal with. I use Cerenia now - that helps. I'm going to try Slippery Elm Bark. I hope you can find a way to help your dear cat at home!

 

So nice to see Girlie back in the blues

 

At least she's actually clearing bounces and doing that a little more quickly on Lev so far, thank goodness, @Gill & George !

I'm still trying to forget the Lantus stuff that was drilled into my brain and replace it with Levemir requirements: hard to break old habits. @Marje and Gracie , I have started just giving her a little bit for the AMPS, although she's never been big at eating for either AM/PMPS anyway. Without Mirtazapine, she eats when her BG drops. I think some of this might be partly due to her age, as well: I have to do all sorts of creative things to get her to realise that food is there and she might want to eat it. I've been wondering for a while now whether her sense of smell is declining a bit.

 

Yay, Girlie! Let's do this today and no more bounces and rainbow dives, okay?

 

Alright, back to business, Girlie. Glad she is feeling a little better, and hope you have a few days of calm instead of frustration.

 

Sorry she's bouncing again, hope she clears it soon.

Sending appy vines.

 

She's not listening! She jumped up to 400 while I was with Maxi at the dentist. Hmmm...what are you thinking, Girlie?

 

I wouldn’t be surprised if her sense of smell has declined with age. Maybe a little dab on her tongue will let her taste the food.

I’m hoping the 187 was her nadir, the 300 is end of cycle, and she will come down slowly when she onsets. Paws crossed.

 

I'll try that with the dab on her tongue...good idea.

Re: the 187 AMPS: can a pre-shot number be a nadir for that cycle - the AM cycle? I didn't know that... interesting! I thought her nadir from the night before would be the 101 at PM+6...?

 

It's been 6 full cycles since we saw green (AM of 17 Nov, Cycle 3 of current dose of 0.75). She's been bouncing, but lots of high numbers. It's now Cycle 10: I'm wondering whether I should be considering a dose increase, or hold this dose for a little longer to see how she does if she stops bouncing so high? Not sure...

 

Neko's Lev nadir was often at preshot or +12, occasionally +13-14. That's why you have to be prepared to shoot low.

Let's see how Girlie does tonight. She did get to 70 on this dose and almost green last night.

 

Can I borrow your crystal ball? I could have sworn I got a PM+3, but that must have been a dream...or me sleeping through the alarm... Her PM+4= 77; PMPS was 313.

 

Turns out she wants a reduction instead: 58 @ PM+6: she was sleeping through it and I almost did, too!

 

The dosecrease threat worked!

 

Looks like it! She's come up quickly with 14% gravy: now 95. I wonder if this means that she didn't really earn it?
I hope she can hold the reduction this time!

 

At this point I always get a little confused: if she gets two readings over shark territory for AT2 (e.g. over 68), when do I stop feeding or switch to lower cal food to see if she can hold it on her own without food?

I know the steps say the following, but from previous dives, I understood that I had to see whether she could hold safe numbers without food for two consecutive tests to know that she was out of danger territory; I'm just not sure when you do the no food part. This also becomes interesting with Levemir, as we're almost at PM+7, which is when I'd usually stop food:

• Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
• Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
• Test in an hour and follow the same steps.

 

130 @+7
I've clearly created a gravy addict: she doesn't want 12%, 8% or 9% food: she wants the 14% gravy. Guess we're doing the no food test now!

 

I wouldn't have given more food after +6.30 to see if Girlie could surf safely after that 95. If she went lower, then I would have restarted the count and fed her again. Know Thy Cat.

 

Well, she doesn't want to eat the foods I've offered since her +7 of 130. Now at +7:30 she's gone down to 86 - still a safe green number, but does the fact that she went down mean I restart and - well, I guess I have to offer her gravy as she doesn't want the solid foods. The lowest gravy I have is 12%.

 

I am not very knowledgeable about Levemir. I know nadirs are very late so I wonder if you are right around the nadir time now and Girlie should start going back up. It's up to you what you are more comfortable with .. wait and test again in 20 minutes or go ahead and feed.

 

99 @ +9: I'm off to bed for a few hours.

 

That would be logical but the 101 was at +6 which, while possible for her to nadir that early, would be atypical. But heck....nothing about FD is typical, is it? I believe I was incorrect about 187 being her nadir; I didn’t see the 113 and so it’s more likely that was her nadir and then she was on her way up.

I hope she will hold this reduction. Because she dropped early (she was definitely clearing a bounce), I’m that the reduction won’t hold. I think, with Girlie, the longer you can hold her at a dose safely, the better.

Once they stop dropping fast, the goal is to teach their liver to surf with only LC food, if they need to eat. You did a good job last night getting her to stay right around upper green with no food. With Lantus and Levemir, feeding around and after the nadir (if it’s not necessary to keep them safe) slows the action of the insulin and can also put the brakes on duration. With Girlie, it might be that stopping her food at +7 works just fine as long as she doesn’t continue to drop to +12. That’s the tough part. I often had to feed Gracie at +10 because she got great duration and would nadir at +12 or after.

I hope you got some rest and she kept surfing. I’d give her a chance to clear any bounce and if she doesn’t come back down to green, I’d take that dose right back up. She needs to learn green = good!