? 4/14, new, recent DKA, 4 doses into switch, PMPS 390, +2 248, +5 136, +6 149

Alright for where she is at now, when can I try to go to bed? I've barely been sleeping since DKA last Friday.

I have 0, 2, 4, and 14% wet food. She's tired right now and just had a 3-4% mix snack.

I need ideally about 5 hours to ensure I can medicate, fall asleep, and get one proper sleep cycle. My partner will do AMPS but it will probably still wake me up.

http://www.felinediabetes.com/FDMB/threads/bg-73-time-to-shoot-recent-dka-help.213159/ This is my last thread.

Please feel free to correct my posting structure or subject line or whatever needs. I'm tired and trying to remember the rules of this ISG. Thanks!

 

Where are you up to now Cassandra? Are you about +6.5? I d like to see one more test at some point Just to see Alice is definitely on the way back up. Nice to see the blues.

 

+7 just happened two minutes ago. 183

 

Perfect timing! Lol. Thanks. I feel better too as she is back up. The next issue is going to be dosing. Continue with 4u AM?

I'm not sure who to discuss that with.

I'm going to lay out some 4% and try to nap.

Also SS is acting weird and I can't pull it up to update BGL. Maybe it will work later.

 

I think you are safe to sleep for a few hours now. She looks like she is on the way back up. Leaving some food out for her is a good idea. Remember to get someone to take the food up at +10
Yes stay with the 4 units at AMPS. If Alice happens to be under 200 at AMPS stall, don’t feed and ask someone for help with deciding what to do. You can test again 20 minutes later to see if the BSL is going up.

 

***oops 3 doses in, not 4. Dose 4 will be 8AM CST (US).

 

Try and get some sleep!

 

It's good to see those healthier blue numbers.
I hope you get some rest.

 

Nice numbers!

 

AMPS 290, thoughts?

 

Ended up barely being able to sleep, an hour or less. Trying to catch a little more form a couple hours. Gave 4% mixed with water. Test at +???? If any has a rec for ba testing schedule today. Looks like her peak was around +5-6 last night..... But her PMPS was exactly higher by 100.....

 

Welcome to the Lantus and Lev board!

Great job last night and lovely numbers!!

I would test at +2 or +3 at the latest. If you look at the New to the Group sticky at the top of the Board, you'll see how numbers "typically" play out over the cycle. This can give you a sense of when to test. That said, this is another ECID thing. Not all cats have their onset and nadir where indicated. For example, if you look at Gabby's SS, she had an early onset and nadir. The more data you have the easier it is to know what to expect -- until your kitty throws a monkey wrench at you. Last night, your +2 was markedly lower than your PMPS. This early drop usually indicates that it may be an active cycle. In Alice's case, this meant a run of very nice numbers.

You asked for housekeeping details. We use a particular format for new threads: Date ---- Cat's Name ---- AMPS-#, +hour-#, etc. We also suggest starting a new thread (we call them "condos") each day. Just like you linked your thread from Health, we ask that you link your post from the previous day. This helps both you and us if we need to go back and look at what information was in a previous condo vs having to search the forum.

As to who to listen to, that's harder. Anyone is welcome to post to your condo and offer their insights, opinion, support, etc. We encourage peer review since no matter how experienced the member, anyone can make a mistake, not be completely up-to-date with respect to Alice's progress or history, or any number of factors. Many people consider themselves not yet experienced enough to offer suggestions about dosing. Others have been around for a while and will chime in. Looking at member's spreadsheets may help you get a feel for the experience level of members. Reading other members threads will also allow you to see what input members are providing. While we encourage everyone to post on this board especially with regard to a dose recommendation, you are welcome to send a PM (private message) if there's someone who's input you value and they haven't posted. Most of us have our settings configured so if you send a PM, we get an email message. If you look at the top right corner of the board an click on "Inbox," it will open your PM box.

 

You are doing SUCH a GREAT job. A special person you are...

 

I’m glad we are a little closer to a better dose. We should let this dose continue for at least six cycles, unless she drops below 50 and then you will need to reduce by 0.25u.

You’ll get a feel for the group and whose advice you can rely upon and trust. There’s a lot of great support and a strong cheering section for you both.

Never be afraid to ask a question. They are all important. Hope you get some rest!

 

AM +3 240, AM+7 136 (fasting a couple hours I think). Feeding 2%+4%=3%, with warm water mix. She was very hungry! Ketones look close to trace. Weight gained.

Obviously last night and today indicate +5-+7 are blue. At night, tonight, I really want to sleep and I have some needed medicine coming my way so I actually can. Hah. I desperately need a proper cycle and all I can do right now is two hours max.

Of course without PMPS we don't know for sure, but with her current pattern, can anyone lightly suggest a good test and feed schedule. To repeat, I have 0% freeze dried, and 2%, 4%, and 14% (this one gravy) wet, and Purina DM 14% I think (dry, for emergencies only). My goal is five uninterrupted blissful hours.

Thank you all. I'll be able to give a little more back on here when she is feeling a little better and I am too.

 

@Marje and Gracie is helping me add a weight tab to my SS too. Alice is very underweight and it has been one of my valuable pieces of data since early February.

 

It's really too early to tell for sure, but let's plan on feeding anything under 5% at PMPS time and then get a +2

If the +2 is a lot lower than the Pre-shot (as you saw last night) that's your "early warning system" that tells you Alice may be going lower later in the cycle and you'd need to set an alarm (if you need to) and get at least another test in later in the cycle.

Take every opportunity you can to nap during the day!!

 

I am napping in and out, but it won't help me recuperate if I can't find at least 5 hours somewhere with appropriate medicines (I don't have yet). The amount of benzos and hydroxyzine I tried for myself last night, still failing to actually sleep fully when I needed..... Arg!

@Chris & China (GA) , so basically, +2 every time, compare to PS, then decide? As a general rule? Is it bad I waited to +3 today??

 

We have seen in lots of cats that the +2 test can act a little like a crystal ball and almost predict how the rest of the cycle is going to be (but in some cats, the +3 is a better indicator....but we don't know which one Alice is going to be yet)

If the +2 is about the same as the PS, it's usually a pretty normal cycle....gradually down to nadir then gradually back up to the next PS.

If the +2 is higher than the PS (by more than meter variance), it can signal the beginning of a bounce and it's usually safe to take a break in testing

If the +2 is lower than the PS, that's your "early warning" that they may be dropping lower later in the cycle and it's important to plan on getting more tests in.

Unfortunately, sleep deprivation comes with the territory....we have to grab sleep when we can!

ETA...Nice to see Alice responding better to the Lantus!!!

 

I'm grabbing what I can. But this is... Day 10 I think since DKA and I'm eventually going to end up sick. Trying to balance my own minimal self-care.

I'll do a full on proper curve here in the next few days. That little rice pouch is amazing! The one from DCIN. Makes it super easy to bleed those capillaries. Mwahaha.

@Chris & China (GA) "signal a bounce" ?

 

Bounces are caused when 1. they drop too low, 2. they drop too quickly, 3. they drop into numbers their body isn't used to (or any combination of all 3)

The liver releases stored sugar and hormones in response to what it perceives as too low to bring the BG back up quickly. It's kind of a "survival mechanism" …..like in the wild, if a cat hadn't been able to catch food and their glucose dropped too low, the release of those stored sugars and hormones would keep them alive so that they could (hopefully) kill and eat. In our sugarcats (who don't have to worry about their next meal), the liver still works like that so even if they're not "too low", it will release those stored sugars/hormones when they drop quickly or even when they drop into a number their body isn't used to anymore.

As they spend more time in "normal" numbers, the body usually re-learns that it's OK to be in those numbers and they don't bounce as high or as long.

A bounce can last for up to 6 cycles.

 

Oops! I counted hours wrong. Here's the exhaustion mistakes. :\

136 was +5. +7 is 94!

Now I really do need some advice please. This is her lowest.

 

@Chris & China (GA) so how does that mean a bounce is safe to take a break in testing? Bouncing sounds unstable in theory to me and unstable sounds to me like more testing.

 

Because when they "bounce", they are going high......when the liver releases those stored sugars and hormones, they bring the blood glucose up fast....and usually high.

When they're running high, it's OK to do less testing because they aren't in danger of a hypoglycemic crisis

High numbers take time to do damage.....it's the low numbers that kill quickly.

 

94 is still a nice safe number, but I'd plan on testing again at +8

If she'll eat for you, you could give her a small snack of low carb food now

 

She will always eat for me. I worried for a minute. 1/2 tsp friskies 14%, 0.75oz ff 2%, and 1.3ish oz friskies 4%, with lots of water mixed in. My estimated carb average from that is about 5%, roughly. How yellow should an average hydrated cat's urine be? I know that is a general health ??, but yeah.

Will retest again in 40 min.

 

Now that's a hard question to answer! ….but it should have a yellowish color....not very pale yellow/clear or VERY yellow/orange

 

So just.... Normal? Hah. The number of cat poop pics and now urine collection pics on my phone is getting hilarious. That thing on fb, "post the x# picture blah blah"....

No one but the vets and techs appreciate my cat poop photos. No one :'(

BGL aside, I feel like there are many additional health indicators that I can pay attention to regularly.

 

And on that note, she just had a bowel movement with a fecal score of about.... 5.25, I would rate. And her BMs have been much better lately so that makes me wonder the why, what mechanism, how. I do my best when I understand, vs just being told.

 

And is this all getting too off-topic? I can reel myself back in for now but I will always have issues with rambling and off-topic. Those of you trying to keep things organized, I beg of you to let me know when I'm astray. In PM.

 

We love poop pictures here so post away!! (of course we're crazy sugarcat ladies)

A good poop is worth it's weight in gold!!

 

+8 100

 

Great number....this is a nice cycle for Alice

But I wouldn't be surprised if she bounces at some point....that 94, while a perfectly safe number, is new to her body and it may react like it was "too low" and release those stored sugars and hormones to bring her BG back up to where it's "used to" living at.

 

She's appearing a little shaky? Maybe?? When I just came in to check. So.... When she went into DKA she had that tongue blep but like.... It just kept going and her tongue was sticking really far out. Now every time I catch her blep I panic a little. She just got up to finish her snack. Maybe I'm being over.... obsessive, anxious, who knows. But my heart just jumped out of my chest. Is 4u going to keep being safe? Ahhhh /roller coaster emotional dump.

 

Will this increase her ketone risk?

Thank you for being so attentive with me today.

 

No, it won't increase her ketone risk any more than she's already at risk

 

Thanks.

 

+9 102, after feeding 1/4 can friskies 4%

Feed and dose advice are preferred! I'm a little nerved out by her demeanor even if I can't say why. She's hungry. Anyway.

 

Fed 1 tsp 14% gravy friskies. The amount of food and carbs she has had and how long she is this low (while good, not usual for her and with the new Lantus and dose and so on). Feeding another 1/4 can 4% and water.

Oh and urine about two minutes before BGL. She peed straight out again (she has not been crouching as much) and straight into the cup.... Looks slightly increased? Maybe closer to moderate? But I have a little trouble with the color differentiation.

 

She can eat until +10 and then you want to withhold food until it's PMPS time

Why did you feed the 14%? She's not running too low....we usually save the higher carb foods for when we need to bring their numbers up.

 

Try to read it in a good light...sunlight is best but it's not always available so wherever you have the best light is going to be the best place to read the strip

 

She was already as low as she was having already had some mixed in before.

 

@Chris & China (GA)

Fed 14% then. Was +7

 

http://www.felinediabetes.com/FDMB/...-to-lantus-pmps-165-help.213250/#post-2362488

Continued