4/15/19 AMPS 464, +2 HIGH, +5 HIGH / PMPS 466, +2 265, +3 182, +4 175, +5 200

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by CassandraCatface, Apr 15, 2019 at 8:20 AM.

  1. CassandraCatface

    CassandraCatface Member

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  2. CassandraCatface

    CassandraCatface Member

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    I mean as in no sleep all night, need a nap for an hour if possible....
     
  3. CassandraCatface

    CassandraCatface Member

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    It's half past. Already feeding. Needs to dose so I'm going to assume she still needs the 4u....
     
  4. tiffmaxee

    tiffmaxee Well-Known Member

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    Just checking in. You need to think about whether you want to follow TR or SLGS. With TR you don’t decrease until she drops under 50. Maybe that helps you relax a little about her numbers last night. :joyful: With SLGS the reduction number is under 90. As you both get used to lantus you won’t need to test as much as last night unless she’s in the 50’s. You also will stop feeding earlier and see if her numbers stay up for an hour or two without food. But that’s after you learn her patterns. Well done last night. I hope you can take a nap today. I never could. Max used to drop low at night so I had lots of pj parties. Hopefully Alice will be more considerate, lol.
     
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  5. CassandraCatface

    CassandraCatface Member

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    Thanks you for the deeper explanation. I needn't in learn this but I really want to try for a nap right now.

    She's grooming after her meal. Alert. I feel like she acted a little "off" when she was lower before........ Even though the numbers themselves weren't as low as low should be. I have to rest. Part of that sentence garbled up.

    +2 or +3?
     
  6. CassandraCatface

    CassandraCatface Member

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    Okay here's what is in the background of my brain, gnawing at me: having heard 4u is a rather large dose in the first place. I think that's what makes it sound more overwhelming.
    I was getting a feel for the NPH 3x/day thing, even with the aggressive dose. It wasn't what should in theory be best for her, so the change is worth it. But it all caught up to me that I have less initial control with Lantus. And I'm running a deficit on everything now, all of myself, broke, no sleep, half nuts.

    It always feels like a lot until it doesn't anymore though, and I know that! Onwards! Zzzzzzz
     
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  7. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I can only imagine how totally exhausted you are. Alice is lucky to have you and you need to keep you healthy for both your sakes. I think you can go grab a couple of hours of sleep and retest Alice at +3. Lantus doesn't onset as early as the Novolin and her pre-shot is pretty high today.

    You were giving Alice a lot more Novolin than Lantus and while 4u might be a higher dose than most, a cat needs the amount of insulin they need. I understand your concern about a higher dose as a Mom who was at one time shooting 16u twice daily. It's scary but 4u really isn't that high and Alice is getting some nice blues and dark greens. Right now the important thing is to keep Alice's BG as optimal as possible. Chances are her dose will decrease once she has fully recovered from the DKA.
     
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  8. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    The best dose for a cat is the dose the cat needs to get the numbers in a good place. It doesn't matter if the dose is 0.5u or 5.0u -- the cat needs what she needs. I'd also point out that Alice was getting a total of 10.5u on a daily basis. She's now getting 8u. In the grand scheme of things, she's getting a lot less Lantus than NPH.

    Given how much you are able to test, I want to encourage you to stick with TR. It is a more aggressive approach to dosing. However, given Alice's recent DKA history, we want to be aggressive in order to prevent ketones from recurring. (@tiffmaxee ) You want to stick with the current dose until you either see a drop below 50 (with TR) or for 6 cycles at which point we reevaluate the dose. We were considering increases after 2 - 4 cycles given how much more NPH Alice had been getting but it's looking like she's responding well to Lantus and her nadirs are in a good range at this dose.
     
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  9. Wendy&Neko

    Wendy&Neko Well-Known Member

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    As Linda said, 4 units may or may not be a high dose. My girl got to 8.75 units, we have seen some with secondary endocrine conditions that have needed over 80 units per shot, some cats do well on 0.1 units. Each cat is different. The numbers to focus on are the blood sugar numbers, the dose is just the thing that gets Alice into that good blood sugar range. And Alice is seeing some pretty nice numbers on 4 units.

    Sleep well, things seem more logical after a nap.
     
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  10. CassandraCatface

    CassandraCatface Member

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    +2 she reads "high" which is over 500 on her meter. Help!!!!!!
     
  11. Wendy&Neko

    Wendy&Neko Well-Known Member

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    That means she is bouncing. Test for ketones when you can. Then put on a pair of comfy patience pants and get some sleep. I am all too familiar with the meter greeting me “Hi”. The bounce will pass over time, it can take up to six cycles.
     
  12. CassandraCatface

    CassandraCatface Member

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    How do I know she won't go into shock? Do I keep feeding? It's helping her fluids as I'm mixing water with it still.
     
  13. CassandraCatface

    CassandraCatface Member

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  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Deep breathes! There is nothing you can do but wait it out. I like Wendy's idea...... comfy pants and some sleep. This too shall pass.
     
  15. CassandraCatface

    CassandraCatface Member

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    But when do I check? I can barely nap as it is. It took me this long to start falling asleep. How long can she stay like this? I don't want to put her through more DKA and hospital.

    I guess..... What can I DO? How often should I check in on her? I can't take her to bed because she's not set up and the herpes cat lives in there right now. :\
     
  16. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    This morning's dose of Lantus will onset soon. Feed Alice as you normally do and retest her at +5 and get some rest between now and then. You need to look after yourself so you can continue to look after Alice.
     
  17. CassandraCatface

    CassandraCatface Member

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    Okay then can she bounce too low today? Feels like such a roller coaster. Sigh. :\
     
  18. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    The likelihood that the bounce will resolve itself this cycle is next to zero. Take a nice, long nap. As annoying as bounces are, this is what you hope for if you're sleep deprived! Bounces are high numbers. Bounces breaking can put a cat in lower numbers. Typically, it takes up to 3 days for a bounce to resolve but it can also take less time as your cat gets used to lower numbers.

    We've not yet seen a cat go into "shock" as a result of a bounce. The biggest risk could be ketones but you're monitoring. You feed your cat as you would ordinarily do -- bouncing requires nothing special.
     
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  19. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Cassandra, as Wendy said, Alice is bouncing. It's a normal frustrating phenomenon that we've all been through and it can take several cycles to break. No she is not going to go too low. The "roller coaster" is unfortunately something we all had to get used to.

    If you feel uncomfortable leaving Alice, can you curl up on the sofa or wherever Alice likes to hang out for your own peace of mind? You really do have to make sure you get some rest while Alice is running high and doesn't need excessive monitoring. :bighug::bighug::bighug:
     
  20. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Here is a tip about Lantus. The +2 test can often tell you a bit about how the cycle will play out. If it’s around the same as the preshot number, you will have a typical Lantus cycle with some downward movement. If it’s quite a bit lower, you will have a more active cycle needing more monitoring. That was last night. If the +2 is higher, it will be a quiet cycle. Those are good times to catch up on sleep, shopping, housework or pampering you. Seriously, treat as a permission slip to do something for you. With a bounce like you are seeing, you don’t need another test unless you are just trying to gather data. And yes, I relate to hard hard it is stop being a helicopter for a bit. :bighug:
     
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  21. CassandraCatface

    CassandraCatface Member

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    Great timing, she peed!

    I checked twice, not really sure on ketones. These colors are hard for me for some reason???
     

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  22. CassandraCatface

    CassandraCatface Member

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    Thanks everyone. Okay. Deep breath. +5 is 1:30 CST today. I'll be back........
     
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  23. Wendy&Neko

    Wendy&Neko Well-Known Member

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    The ketones looks closer to negative, maybe a hint of trace. Sleep well.
     
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  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Pictures don't always convey colour perfectly and by the time you took the pics the strips could have been darkening more. I'm with Wendy....likely negative edging to trace.
     
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  25. CassandraCatface

    CassandraCatface Member

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    I timed them. Both pics are 15-17 seconds in. 15 is the view time. Thanks.

    @MrWorfMen's Mom unfortunately I can't curl up with her easily. She's in the bathroom for now for several reasons. :\ Maybe I'll curl in the floor with a blanket later like her.

    Nap attempt now. Thanks again!!!!!!
     
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  26. CassandraCatface

    CassandraCatface Member

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    I lied. Antibiotic time.
     
  27. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Looks to me more like... trace?
     
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  28. CassandraCatface

    CassandraCatface Member

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    Thanks. I've been confused because it looks nothing like the colors and I've had two different kinds of strips. Gray/lilac tone.
     
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  29. CassandraCatface

    CassandraCatface Member

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  30. Wendy&Neko

    Wendy&Neko Well-Known Member

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    That’s why I said not to test until preshot time. No chance she was going into the danger zone this cycle.

    Down please Alice.
     
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  31. CassandraCatface

    CassandraCatface Member

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    Thanks. I'm kind of catching on now. It's just so close to the DKA. I'm so worn out it's difficult to regulate my panic alarms. Arg. :b

    What are the long term risks and damage from this level of dysregulation? Kidney effects and neuropathy and other things...?

    I'm going to do a little self-care and I may have just found a local resource that offers caregiver support of some kind. A local vet started up something. Going to call.... :)

    What is typical (if there is a typical) after a bounce like this? What can I reasonably expect?

    Thank you all. :)
     
  32. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Self care is an excellent idea. Some people do yoga, go for walks, I do rowing, pick something that works for you.

    I asked Neko's internal medicine vet about the long term effects of high numbers, and he said as long as the spikes are short term, it's OK. Neko did a lot of black and Hi her first six months, took her over a year to ditch red from her spreadsheet. :rolleyes: She also had acromegaly, but still lived 5 years on insulin. She did get CKD, but acromegaly is also hard on kidneys.

    Do keep testing for ketones. If anything changes in that regards, there may be other things we can do. Fluids if OK by the vet, and plenty of water to help flush her out in the mean time. Also keep an eye on her appetite and let us know if that changes or she becomes lethargic.

    Bounces typically start out taking around six cycles to resolve. Numbers will wobble around during that time, but will come down afterwards, possibly back even to those lovely blues and greens. Once a cat gets more used to normal numbers, the length and height of bounces diminishes. ECID how long that takes.
     
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  33. CassandraCatface

    CassandraCatface Member

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    @Wendy&Neko , thank you for responding! Your signature actually got me poking around to learn about acromegaly in cats last night. It's a haze in my brain because of the tired, but it sounds... Like a lot. Also I like the name. I took Japanese in college. :) Alice is a calico cat and the kanji for it literally means three color cat. /off topic chat.

    It has been suggested that Alice will need someone in internal medicine. One of the ER vets suggested the mass that appeared on her belly that seems like a swollen nipple that has been there for months may be a mammary tumor? But I don't have those kinds of funds. Any info I can gather up to help me understand what is happening with her will help me get her whatever help she needs.

    It's comforting to know Neko made it through those rough six months, then. Alice was probably getting sicker awhile before DX, so she's been far too unregulated for far too long. I'd like to be able to hope I can nurse her back to something closer to her previous level of health and energy.

    Finally understanding that she isn't in a complete immediate danger zone right now has helped me back my anxiety down. I hope she's stable enough for me to crash some time tonight.

    I will be looking for advice again as I get her numbers later. :)
     
  34. CassandraCatface

    CassandraCatface Member

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    Oh and she is eating and drinking (mostly via my adding water to the food to make soupy mush) and sometimes I have to encourage her a little. She was purring earlier. She's feeling soft (clean?)... Good signs. :)
     
  35. CassandraCatface

    CassandraCatface Member

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    Does she look like she's standing a little low? I wouldn't blame her. She has so little muscle right now. :'(
     

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  36. CassandraCatface

    CassandraCatface Member

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    Got a urine sample. I don't understand why they never look like they match the colors? So I think this is between mild and moderate. Pic was taken at 15-17 seconds. Thoughts?

    PMPS in 15 min. She's thirsty and hungry.
     

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  37. CassandraCatface

    CassandraCatface Member

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    Do I start a new thread for PMPS? Or stick here?
     
  38. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Stay here....Edit the subject line as needed
     
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  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I don't think that strip is significantly different from the earlier ones but again, I am not sure the colour translates well in pictures. I agree it doesn't seem to really match any colour on the vial but it certainly doesn't appear to be taking on a reddish tone to me. Negative to trace would be my guess.
    As for the thread, one per day so just stay here and either add PMPS or change title and remove the earlier reading and retitle with PMPS.
     
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  40. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Did you get some fluids to administer sub-q?

    As long as she's eating well, she's probably not working towards DKA but keep your eyes on it
     
  41. CassandraCatface

    CassandraCatface Member

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    PMPS 466

    I going to shoot 4u Lantus now.
     
  42. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Well I'll take that over "Hi"!!
     
  43. CassandraCatface

    CassandraCatface Member

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    ME TOO!!!!! Although she started today out similarly. She's had nothing but FF 2% today and lots of watery water and some freeze dried chicken.
     
  44. CassandraCatface

    CassandraCatface Member

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    I feel like it's an abusive "HI" when it comes up. It's my least favorite greeting ever. Haha.
     
  45. CassandraCatface

    CassandraCatface Member

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    No I did not get fluids. But then there's an issue there... Supply costs. I was too out of it today with the stress and tired to focus. I'll try again tomorrow.

    Here's hoping tonight is an easy low-moderate safe zone. I'll test at +2 then decide from there? I'm desperate for a real rest.
     
  46. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Yes, let's start with that +2.
     
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  47. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Try testing it on yourself as a comparison. Hopefully you aren't on some keto diet. :p
     
  48. CassandraCatface

    CassandraCatface Member

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    Nooo, nope. I'm eating cake in bed right now. Haha! You know I tested the meter on myself multiple times but didnt think of trying with the strips! Thanks!
     
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  49. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    That was good Wendy :joyful: ;)
     
  50. CassandraCatface

    CassandraCatface Member

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    +2 is 265

    Sigh. Oh kitty I need a break!!!


    She is showing significantly increased thirst right now.
     
  51. CassandraCatface

    CassandraCatface Member

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    Feed and test recs please?
     
  52. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Give her a little snack and test again at +3
     
  53. CassandraCatface

    CassandraCatface Member

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    Oh no is it one of those nights? :eek: I'm about to crash so hard.
     
  54. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    I hope not but that's a pretty big drop for so early in the cycle
     
  55. Crista & Ming

    Crista & Ming Well-Known Member

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    Re: Ketone strips - A few times when Ming was high, I'd get a weird colour that didn't match anything on the box. I duped it up as Ming almost having trace amounts. Testing on yourself is a great idea that I also hadn't thought about!

    But if it's negative, it should pretty much look exactly like the ones that haven't been used.

    Hang in there. I'm sorry you're going through this. We've all been there and it sure is tough. Get naps in between if you can.
     
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  56. CassandraCatface

    CassandraCatface Member

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    @Crista & Ming thanks, more encouragement for me to try it! Needed and appreciated. :)

    ^^^exactly what I was afraid of. Why is this happening?
    I really have to sleep more than an hour or two at a time. Someday. I need a crash. Sigh. So if her numbers are up it means what? Same means what? Down means what? I know its not that simple but....??????
     
  57. Crista & Ming

    Crista & Ming Well-Known Member

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    Do you mean from PS to +2?
     
  58. CassandraCatface

    CassandraCatface Member

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    No, I think I mean what to anticipate from +3.... But now it sounds silly because I mean.... I need the data first. Sigh. I'm just at a rough point. What do you do if you crash? :(
     
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  59. CassandraCatface

    CassandraCatface Member

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    Oh no my Lantus pen I accidentally left out for 3 hours. ! How bad is that?
     
  60. CassandraCatface

    CassandraCatface Member

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  61. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Don't worry about it....we've all done it and it doesn't make a bit of difference....Humans use the pens and just throw them in a pocket or purse
     
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  62. CassandraCatface

    CassandraCatface Member

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    I have read this but bit helps to hear it directly. Thanks. Okay now what? I am physically in bad shape. I need to get her more stable.
     
  63. Wendy&Neko

    Wendy&Neko Well-Known Member

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    One question on the ketostix. How old is the container? Most of them are only good for a certain number of months. Testing against yourself should at least let you know what negative is.
     
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  64. CassandraCatface

    CassandraCatface Member

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    If this is anything like 4/13 PM maybe she'll surf the blue?
     
  65. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Hope so …..I know you have to be dead tired, but I hope it makes you feel a little better when I tell you that you're doing a magnificent job taking care of Alice.

    If you have some of the 14%, you could give her a little and hopefully slow her down a little so you aren't up all night again
     
  66. CassandraCatface

    CassandraCatface Member

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    Okay will do. Testing frequency? When will a test give me indication that I can crash? I'm starting to work into a decent amount of pain/inflammation. I'm just worried I'll crack too soon. :'(
     
  67. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You won't.....We sugarcat mama's are a lot tougher than you think....but I totally understand how tired you must be.

    Get a +4......hopefully she'll stop dropping and you can get a +5 and call it a night.....Would be nice for you to get 6-7 hours of sleep tonight
     
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  68. CassandraCatface

    CassandraCatface Member

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    6-7? I can't imagine.
     
  69. CassandraCatface

    CassandraCatface Member

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    She is hungry, eating, purring and otherwise communicating, weak but standing and willing to exert herself. Friendly.
    I just want to cuddle her in bed but herpes cat Majyk is there. :(
     
  70. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    I have to get off the computer for tonight but I've asked @Crista & Ming to keep an eye on you.

    I know you'll do whatever you need to for Alice....You're an all-star sugarcat mama!

    If you have to, you can always abort the cycle, feed a bunch of high carb food and once you're sure she's heading up and staying there (usually at least 2 cycles of rising numbers) call it a night
     
  71. Crista & Ming

    Crista & Ming Well-Known Member

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    Is it almost time for +4? :)
     
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  72. CassandraCatface

    CassandraCatface Member

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    +4 is 175 and she is ready for a nap. What next? Thoughts? Por favor?
     
  73. Crista & Ming

    Crista & Ming Well-Known Member

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    I’d do one more test at +5 as Chris suggested. Although judging from Alice’s past cycles, she’s been her lowest at +5. These blue numbers are safe though and nice :)

    How are you feeling?
     
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  74. CassandraCatface

    CassandraCatface Member

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    I've noticed so far too +5 seems to be about being where she drops most. Which if she stabilizes out like that, I'd be fine with! Alright one more I can do. Beyond that.... The problem is it takes me a long time to fall asleep and if I accidentally get less tired then I won't be able to nap at all. It's absurd. I am feeling... Cracked. But determined. So let's keep going! Onwards. She got a little more gravy and some 4% with water. Turned off her light. Hoping she will nap for a bit too.

    Is this how it always is?
     
  75. Crista & Ming

    Crista & Ming Well-Known Member

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    I think if Alice's next number is lower but still reasonable, I'd be okay to sleep and put down some food for her to munch on. Have you fed anything after doing Alice's +4 test?

    It won't always be like this but there will be nights where you have to stay up/get up to test frequently. Once you know Alice's routine, you'll feel more confident and in control and even though you may need to get up every hour/half hour, not feeling crazy and without all the anxiety helps lol!

    What is your shooting schedule right now? I used to do 8 am/pm but now I do 6 am/pm. I'd rather get up early to shoot and have more time before bed to test. My +5 is 11 pm so it worked really well for me when Ming's nadir was at +5 on Lantus.
     
  76. Bron and Sheba

    Bron and Sheba Well-Known Member

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    Hi Cassandra
    Looks like Alice is coming off the bounce. I’m around if you need any assistance.
     
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  77. CassandraCatface

    CassandraCatface Member

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    I've been shooting for 8-8. She is +5 200. I honestly don't think she will get any worse.
     
  78. CassandraCatface

    CassandraCatface Member

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    I have to crash or I'm going to get sick and this looks like my best opportunity. I fed more and if I do wake up for some reason she's the first thought and first thing every time. Thanks all for the support for the day. We are grateful.
     
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  79. Crista & Ming

    Crista & Ming Well-Known Member

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    Yes get some sleep :)

    Hope tomorrow and tonight allows you some rest and your mind some peace :)
     
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  80. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    The bounces into high numbers drive us crazy in one way and the bounce breaking can be trying on the nerves as well. The good thing is that the quicker a kitty is clearing the bounce, the more the cat is getting used spending time in lower numbers.

    I know this is hard on you right now. It does get easier the more you get a feel for Alice's patterns. Just keep in mind that cats are inherently unpredictable. As soon as you think you can figure her out, she'll throw you a curve. She's a cat. It's her job.
     
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