? 26 July AMPS 194 and not hungry: shoot or not?

Status
Not open for further replies.
Girlie's mom

Girlie's mom

Member Since 2017
Condo: http://www.felinediabetes.com/FDMB/...-amps-706-pmps-331-200-6.181176/#post-2007645

I'm in Australia, so this is my morning (3 pm est US), hence the new post. Have I put the link to the previous post in the right way?

This morning in Oz she is 194 (10.8) for her AMPS. In the FAQ, it says "Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value." I want her to get 1 U am/pm so we can see what's going on, so I guess I should check in a half hour/hour and if she's gone up, give her 1 U: would that be best? Or should I just give her 1 U even with under 200?

She really seems to drop during the day, but then go up at night - or at least that's her latest reaction (since 16 July). A while ago, the vet had said to give her the usual shot unless she's lower than 126 (7), but that makes me nervous in the am as she drops during the day...oh, what to do?

I will be home all day, so I can monitor. I just want to avoid having to give her glucose today if I can as I've done that 2 days in a row now: perhaps that's okay, though? I did get some HC wet food, so I can try that first.

New of note: her appetite has really gone down again (even with Mirtazapine; I'll see about the nausea meds with the vet today). This also makes me uneasy about giving an injection. She only ate 0.17 oz (5g) for breakfast just now.

I'm happy to see blues and yellows - they're just so unexpected for me after black and red for so long; plus she seems to be a diving queen, so I'm unsure re: the dose (even though it's been lowered to 1). :)
 
Yes, start a new post on your new day. We have people around the world here, not just the US. (I am in Canada so share a time zone with some of the US folk).

If you feel you can monitor today, that AMPS is barely below the cutoff. You do a great job of monitoring normally. Over time and as you gather data, you can lower that 200 no shot cutoff, though on SLGS it's recommended never to dose below 90. When cats start their cycles lower, they do tend to be flatter, less diving. If it's been 20 or so minutes and you haven't fed Girlie, feel free to test again and see if she is rising.
 
Wendy&Neko said:
Yes, start a new post on your new day. We have people around the world here, not just the US. (I am in Canada so share a time zone with some of the US folk).

If you feel you can monitor today, that AMPS is barely below the cutoff. You do a great job of monitoring normally. Over time and as you gather data, you can lower that 200 no shot cutoff, though on SLGS it's recommended never to dose below 90. When cats start their cycles lower, they do tend to be flatter, less diving. If it's been 20 or so minutes and you haven't fed Girlie, feel free to test again and see if she is rising.
Click to expand...
Ok! Ooops - I did feed her, but she's not eating much - only 0.17 oz. I offered a different food - not interested. She is really, really going to drive me to distraction.

I shouldn't shoot if she won't eat, right? That seems like such a tiny amount of food to then give insulin for; although usually an hour or so after insulin, she'll look for food.

Tried Parmesan last night; no go. Will ask the vet today about the anti-nausea drugs.
 
I mentioned not feeding her, because the carbs of the meal will raise her numbers, not giving you a true picture of whether her numbers are coming up on their own. In considering an iffy appetite (appy) and shooting, remember that the insulin dosen't onset for a couple of hours, so you have time to get food into her.
 
Wendy&Neko said:
I mentioned not feeding her, because the carbs of the meal will raise her numbers, not giving you a true picture of whether her numbers are coming up on their own. In considering an iffy appetite (appy) and shooting, remember that the insulin dosen't onset for a couple of hours, so you have time to get food into her.
Click to expand...
Ok - thanks for that, Wendy. She usually gets food at 5:45 am, then shot at 6 am; I offered her a different food (before you replied and as she'd already eaten a tiny bit already) and she decided to eat enough of that - 0.7 oz (20g - the usual amt she eats pre-shot) - so I gave her the 1 U at 6:20 am. What's done is done, but was that ok?

If this happens again tonight/tomorrow (pre-shot numbers under 200), should I just wait (and not feed) and see whether her numbers come up without food and then shoot after she's eaten?

I'm going to give my ticket for this Friday evening's and Saturday's day event away, I think, and stay home with her instead: she's just looking too entertaining right now to leave her on her own. Thank goodness I'm able to work from home at the moment and monitor her. I wouldn't know how to do this if I had to go in to work every day (although I'm going to have to do that very soon.
 
You are doing a great job gathering data on Girlie's cycles. Once you have that data, it will let you get out more. Do you have an automatic feeder for her? Or is she a grazer? It's always an option to leave food out for her to graze on to keep her safe - higher carb if you are worried.
 
She's a confirmed and dedicated grazer. I might leave some LC and HC food out for her after seeing how she's going by Friday. I'll only be away for a few hours Friday night and Sat midday. It's a meditation workshop with a very special teacher from overseas: I hope Girlie will cooperate!
 
@Wendy&Neko and @Bron and Sheba
Great - at +10 she's 79 (4.4). I'm giving her some m/d dry (she's scarfing that down). I was looking back over my previous post but couldn't find it - how soon should HC food hit her system? Should I do the glucose now or try with the HC food first and test and see? Or is 79 too low to mess with and I should go straight for the HC?
 
Or am I panicking too quickly again? I know dark greens are good and healing for the pancreas (as you said, Wendy). And the drop in two hours is 79 (4.4), so perhaps that's not too fast? Or is that a steep dive?
 
Sorry - thought I'd get this in while I'm thinking about it.

I have to be gone for the most of the day tomorrow for work. Given how she's been the last few days, can I leave the house safely? I don't have a timed feeder yet, but I can leave m/d dry out and open some HC wet cans for free feeding. But if it's not safe, then please let me know: I'll find another way to stay at home if I have to. I want her to be safe.
 
Okay, so we don't know if she just surfed along at 79, or went down further and is coming back up, or went higher and is dropping again. My bet is that she either went lower or surfed. At this point, I probably wouldn't have given her any food, and retested in half an hour to see if she was on her way up or down. Since you did give her something, how about testing at +11 and seeing where she is? For future reference, if you get a number like that and don't know which way she's heading, try waiting and testing again after a short time, like 30 minutes. Then you can make a determination on whether you need to feed or not.
 
Tricia Cinco(GA) & Harvey said:
Okay, so we don't know if she just surfed along at 79, or went down further and is coming back up, or went higher and is dropping again. My bet is that she either went lower or surfed. At this point, I probably wouldn't have given her any food, and retested in half an hour to see if she was on her way up or down. Since you did give her something, how about testing at +11 and seeing where she is? For future reference, if you get a number like that and don't know which way she's heading, try waiting and testing again after a short time, like 30 minutes. Then you can make a determination on whether you need to feed or not.
Click to expand...
Ok - this is all really new; every day she does something interesting and I learn something new!
So +11 will be about 1/2 an hour after I gave her the food. How much does she have to go up to be okay, do you think? Or if she goes down, how far down is glucose syrup time?
 
Girlie's mom said:
Or am I panicking too quickly again? I know dark greens are good and healing for the pancreas (as you said, Wendy). And the drop in two hours is 79 (4.4), so perhaps that's not too fast? Or is that a steep dive?
Click to expand...
Perhaps just a little too panicky. Perfectly normal for someone new at this!

I am confused, though. You say the drop in two hours is 79, but you said you didn't get any tests between +4 and +10. Are you referring to the drop from +2 to +4? If so, that isn't really that steep of a drop, as her onset was probably shortly after you got the 158. We don't know for sure when nadir was, but obviously sometime in between +4 and +10.

Girlie's mom said:
Ok - this is all really new; every day she does something interesting and I learn something new!
So +11 will be about 1/2 an hour after I gave her the food. How much does she have to go up to be okay, do you think? Or if she goes down, how far down is glucose syrup time?
Click to expand...

Well, the +11 is really just for reference, especially since you did give food. We just want to make sure she is rising - we have no set number we're looking for there. We don't recommend syrup until kitty is under 50.

 
I know these low numbers are scary, but trust me, this is a good thing! :D

Girlie's mom said:
I have to be gone for the most of the day tomorrow for work. Given how she's been the last few days, can I leave the house safely? I don't have a timed feeder yet, but I can leave m/d dry out and open some HC wet cans for free feeding. But if it's not safe, then please let me know: I'll find another way to stay at home if I have to. I want her to be safe.
Click to expand...
Let's see how she does tonight. Is this something you need to decide in advance? Chances are she'll be bouncing, so it will be okay to leave her. BUT remember this is a cat, and they do not like to be predictable! :rolleyes:
 
Tricia Cinco(GA) & Harvey said:
Perhaps just a little too panicky. Perfectly normal for someone new at this!

I am confused, though. You say the drop in two hours is 79, but you said you didn't get any tests between +4 and +10. Are you referring to the drop from +2 to +4? If so, that isn't really that steep of a drop, as her onset was probably shortly after you got the 158. We don't know for sure when nadir was, but obviously sometime in between +4 and +10.



Well, the +11 is really just for reference, especially since you did give food. We just want to make sure she is rising - we have no set number we're looking for there. We don't recommend syrup until kitty is under 50.
Click to expand...
Good grief - I'm losing what's left of my mind! I was thinking of time and put the + sign instead.
Her numbers:
AMPS: 194
+2 = 158
+4 = 79
Not much sleep in the last few days here in Australia so mind is still a bit foggy...

So 79 is not too steep a drop in 2 hours? What would be too steep?

Thanks so much for jumping on board to help me! :-)
 
Tricia Cinco(GA) & Harvey said:
I know these low numbers are scary, but trust me, this is a good thing! :D


Let's see how she does tonight. Is this something you need to decide in advance? Chances are she'll be bouncing, so it will be okay to leave her. BUT remember this is a cat, and they do not like to be predictable! :rolleyes:
Click to expand...
OK: 6.8 x 18 = ca 122.4 (number hasn't automatically shown up on the US chart)
So it's blue - and this is better, right?
These low numbers TERRIFY me because she ended up in hospital early on for 8 days after going hypo (with no symptoms). I trust you when you say these low numbers are good, but she has dived down from all black to blue and green, so I'm confused and a bit scared.
Re: work and my physio: I do need to tell them today if I can't go in tomorrow. There's no way to be away from her right now (in the next three days) safely, is there? She's been so unpredictable - or at least has appeared pretty unpredictable to me. :eek:
 
Wendy&Neko said:
Quick question, did you buy any higher carb wet food yet?
Click to expand...
Yes, Wendy: I gave her some HC m/d dry and then some FF chicken with gravy (ate the gravy, left most of the chicken).

When I'm giving her food to try to pick her up, are we talking small amounts like a tsp or tablespoon here? Or a 3.5 oz can? I know you mentioned that somewhere, but I can't seem to find it just now...

I'm online now trying to order Ziwi Peak and Holistic select and Wellness so I can have some other LC to tempt her with...
 
Tricia Cinco(GA) & Harvey said:
So don't feed and check again in an hour. let's see if she'll surf in those numbers. Yes, blue is good. Since you gave her some HC, she might just keep going up.
Click to expand...
okay. What do you think about tomorrow and the next few days? I'm supposed to be going to a meditation workshop on Friday pm and Saturday all day (today's Wednesday in Oz). I'm assuming I shouldn't go as I'll need to monitor her, and I can try to give my tickets to someone else. It's either that or board her at the vets on Friday night and Saturday day and insist that they check her BG every two hours. What do you think? I want her to be safe... I won't risk her...
 
Thinking aloud, one option is to temporarily reduce her dose. Maybe back to 0.5 units, for the days you can't monitor. On SLGS, she just earned a reduction to 0.75 units anyway. Reducing down next cycle to 0.5 will help reduce the depot for the days you are gone. I wouldn't trust the vet's office to test every two hours. Emergencies come in .... When people go on holidays we suggest reduced doses to keep kitty safe. And leaving lots of food out, even medium or higher carb wet if you are nervous.
 
Okay - I can't tell you how glad I am that you all and the FDMB is here. I would be certifiable by this point if I didn't have you all to turn to for advice and support.
 
Was looking at her SS, and she is doing better, I see she likes to bounce but they seem to clear quickly. She will probably start bouncing now, will be interesting to see what her next BG is. You are doing fine, deep breath, hug kitty, tell her you love her.... repeat... :bighug:
 
Wendy&Neko said:
Thinking aloud, one option is to temporarily reduce her dose. Maybe back to 0.5 units, for the days you can't monitor. On SLGS, she just earned a reduction to 0.75 units anyway. Reducing down next cycle to 0.5 will help reduce the depot for the days you are gone. I wouldn't trust the vet's office to test every two hours. Emergencies come in .... When people go on holidays we suggest reduced doses to keep kitty safe. And leaving lots of food out, even medium or higher carb wet if you are nervous.
Click to expand...
Okay - so I wonder if I should give her 1.0 U tonight (if her numbers are over 180 (?) 190 (?) (yellow) and then try 0.5 am/pm tomorrow?

So every time they go green (even if within a new cycle), they earn a 0.25 reduction?

So far she's only had one complete cycle on 1.0 unit of insulin - but I'm happy to reduce her if that might steady her out. She does seem to be swimming in the low blues and lower in the past few days. Do you think the 1 U am/pm might be too much for her, or is it too soon to tell?

Here's the insulin lately just fyi:
23 July: 1.5 am/ 0 pm: lowest point 88 (PMPS)
24 July: 1.0 am/ 1.0 pm: lowest 119 (PM+3)
25 July: 0.5 U am/1.0 pm: lowest 103 (AM+3)
26 July (today): 1.0 am : lowest 79 @ AM+4
 
At AM+5 = 122 (6.8)
AM +6 (just now) = 121 (6.7)
So holding a bit steady...
:nailbiting:
I usually take the food away at AM +7 because she's such a picky eater - especially the last two days - and I want her to eat before her PMPS. Should I let her eat past +7 and monitor her to see if she'll keep going up or drops again?

I just don't want her to not eat in the evening and then need to be careful to monitor all night to make sure she's okay.
 
quick question, I noticed that on your signature you mention that she is constipated. Are you giving her anything for that? that maybe why she is not eating, very uncomfortable for them. Marvin has the same problem, i give him "Lax A Day" daily, my Vet recommended it as it is very mild (1/8 - 1/4 tsp), it's for human's I got from the pharmacy. It worked well for him. Not sure what the equivalent would be there but you may want to ask your vet or some pharmacist may know which would be safe for pets .

Girlie's mom said:
So every time they go green (even if within a new cycle), they earn a 0.25 reduction?
Click to expand...
Do you know which meathod you decided to use SLGS or TR? Since you are nervous, I would recommend SLGS. With that method your cat earns a reduction when she reaches BG 90 mg/dL (5 mmol/L) if using a human meter, I am not sure how this converts to the Alfa Track meter.
Some of the greens numbers are a bit higher than the 5 mmol reduction number.
 
I think you should test at +7 and if she is still surfing, take the food away. It's always best to give less to no food in the second half of the cycle.
Girlie's mom said:
Do you think the 1 U am/pm might be too much for her, or is it too soon to tell?
Click to expand...
Too soon to tell. I think, unless she is way high tonight (over 200 or so) at shot time, I would shoot the .5 so you can go to work tomorrow and not worry. I would stick with the .5 through Saturday so you can go to your meditation event. After that, evaluate and determine if you should go up to .75. That's just my opinion. Others may feel differently.
 
Marvin's Mom - Nat said:
quick question, I noticed that on your signature you mention that she is constipated. Are you giving her anything for that? that maybe why she is not eating, very uncomfortable for them. Marvin has the same problem, i give him "Lax A Day" daily, my Vet recommended it as it is very mild (1/8 - 1/4 tsp), it's for human's I got from the pharmacy. It worked well for him. Not sure what the equivalent would be there but you may want to ask your vet or some pharmacist may know which would be safe for pets .


Do you know which meathod you decided to use SLGS or TR? Since you are nervous, I would recommend SLGS. With that method your cat earns a reduction when she reaches BG 90 mg/dL (5 mmol/L) if using a human meter, I am not sure how this converts to the Alfa Track meter.
Some of the greens numbers are a bit higher than the 5 mmol reduction number.
Click to expand...
I'm doing SLGS. I'm still at home recovering from ankle surgery, but I have to go back to work full-time in the next two weeks or so, so I won't be able to monitor her every day. I have no idea how that's going to go! I don't want to sit at work watching the clock and biting my nails every day, wondering how she's doing.

Constipation: She's doing better now. I ran out of Cisapride the other day, so we're seeing how she goes without that. She also gets Osmolax (Macrogol 3350 (PEG 3350)) which is the Aussie equivalent of Microlax, apparently. I put that in her food and that seems to be helping. It's getting easier for her and she's becoming a little more regular.

She also has a Drinkwell Avalon water filter, so she gets plenty of water - drinking too much since diabetic, but slowing down a bit in the last day or so. I put her water levels in the Comments section of the chart.

Also, yesterday her Urinalysis was ketones negative (she's never been positive in any of my tests from the start) and for the first time, glucose negative! Usually she's 3+. So that's good, isn't it?
 
Tricia Cinco(GA) & Harvey said:
She is doing SLGS. The reduction point is still 90 with a pet meter.

Nat has a good question. Is she still constipated? Have you tried giving plain canned pumpkin or squash baby food to help with that?
Click to expand...
I'm having trouble getting to a store as I'm monitoring her so closely. I'll have to do an online order and get some things delivered...
 
Girlie's mom said:
She also gets Osmolax (Macrogol 3350 (PEG 3350)) which is the Aussie equivalent of Microlax, apparently.
Click to expand...
that is probably the equivalent to Lax a day here in Canada. If she is not regular you maybe able to increase that a bit, how much are you giving? I notice a lot of people on this site swear by the pumpkin, so that may work even better to get her to poop regularly, cause if she is not she probably won't be eating much.

Girlie's mom said:
Also, yesterday her Urinalysis was ketones negative (she's never been positive in any of my tests from the start) and for the first time, glucose negative! Usually she's 3+. So that's good, isn't it?
Click to expand...
Ketone negative is great, I would assume so is glucose negative, I still have a lot to learn so not sure on that one :) I think that probably means that her urine is less sticky (Marvin was peeing on floor for months), color is probably back to yellowish, and smells like pee now ;)
 
Marvin's Mom - Nat said:
that is probably the equivalent to Lax a day here in Canada. If she is not regular you maybe able to increase that a bit, how much are you giving? I notice a lot of people on this site swear by the pumpkin, so that may work even better to get her to poop regularly, cause if she is not she probably won't be eating much.


Ketone negative is great, I would assume so is glucose negative, I still have a lot to learn so not sure on that one :) I think that probably means that her urine is less sticky (Marvin was peeing on floor for months), color is probably back to yellowish, and smells like pee now ;)
Click to expand...
I need to clone myself - that's the answer! Then I can go to work and go to the store... :D

Marvin's wee situation sounds like it was pretty dodgy there for a while...I'm glad he's doing better now.

She was first diagnosed on 20 June because I was concerned about her being constipated. BOY was she constipated - hence the enema under anesthesia, which led to pneumonia, which led to those first few weeks being very touch and go. But the Osmolax/Miralax/ plus Cisapride seems to be working. I will get pumpkin and try that out though.
 
I agree with Tricia, reduce tonight. A few cycles in slightly higher numbers will be OK. And hopefully give you time to breathe and do other things for yourself, like sleep or shop. You have to take care of you, so you can learn to take care of Girlie. One of the hardest things I had to learn about FD, was when it was OK to not test and to quit hovering like a helicopter momma. You should be able to have a life and a diabetic cat too. :bighug: Typically the back half of the cycle after nadir, when they are rising, is a good time to stop testing, and get out, like now.
 
Wendy&Neko said:
I agree with Tricia, reduce tonight. A few cycles in slightly higher numbers will be OK. And hopefully give you time to breathe and do other things for yourself, like sleep or shop. You have to take care of you, so you can learn to take care of Girlie. One of the hardest things I had to learn about FD, was when it was OK to not test and to quit hovering like a helicopter momma. You should be able to have a life and a diabetic cat too. :bighug: Typically the back half of the cycle after nadir, when they are rising, is a good time to stop testing, and get out, like now.
Click to expand...
Thank you for that advice and for the hug! I've been run ragged since she was diagnosed: lack of sleep (or no sleep), not eating (still haven't managed to eat today and it's almost 1:30 pm, and spending money like you wouldn't believe: things are SO expensive here in Australia (test strips, lancets, and monumental vet bills). Not that I care - she's the most important thing in the world to me - but at some point I have to go back to work so I can pay off my Visa card. :-)

At +7 she's 145 (8.1).

If she's less than 200 for her PMPS tonight, should I just give the 0.5 or skip the shot?
 
Girlie's mom said:
Thank you for that advice and for the hug! I've been run ragged since she was diagnosed: lack of sleep (or no sleep), not eating (still haven't managed to eat today and it's almost 1:30 pm, and spending money like you wouldn't believe: things are SO expensive here in Australia (test strips, lancets, and monumental vet bills). Not that I care - she's the most important thing in the world to me - but at some point I have to go back to work so I can pay off my Visa card. :)

At +7 she's 145 (8.1).

If she's less than 200 for her PMPS tonight, should I just give the 0.5 or skip the shot?
Click to expand...
I think it will depend again where she is at. My no shot number is 100, I had to get used to it, before that it was 200 hundred. It also depends how I am doing, sometimes I am available to monitor, but way too too tired to do it. I have had to give myself a break a couple times, so I didn't shoot. If she is between 150 to 200 and you feel you can monitor than you can give her the .5, other wise you can skip the shot. It's takes a while to feel comfortable, and confident that you can handle the lower BGs.
 
Tricia Cinco(GA) & Harvey said:
I see you got a PMPS of 270 and chose to shoot a reduced dose of .5. Can you get a test or two in before bed so you'll know if you need to leave food out?
Click to expand...
Did that, Tricia - thank you! She was 218 @ +2 and 220 @ +4. I didn't leave food out as I wanted to make sure she ate in the morning. The effects of Mirtazapine seem to be waning, and she's going back to her incredibly picky ways, eating only a little bit at a time and turning up her nose (even if she's hungry) if the food doesn't appeal to her. Drives me absolutely nuts! :-)
 
Status
Not open for further replies.
Back
Top