6/25 Rover AMPS HI temp 0.25 incr; HI until +10 432; PMPS 457; +2.5 347; +3.5 200;+4.25 306;+6.5 223

Discussion in 'Lantus / Levemir / Biosimilars' started by Red & Rover (GA), Jun 25, 2016.

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  1. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Yesterday http://www.felinediabetes.com/FDMB/...-pmps-333-4-hi-sigh-5-hi.160099/#post-1708981

    Have to get him down. Giving a hopefully temporary 0.25 increase and will be monitoring.

    Called vet. Couldn't get an appointment today but did manage to arrange to get Rover in for bloodwork, and will get an appointment to discuss bloodwork on Monday or Tuesday. Thyroid acting up, me thinks. Calcium/Phos ratio may be out of whack.

    Which means … that I just increased his dose and he's probably going to drop. He has the last 2 times he went to the v-e-t.
     
    Last edited: Jun 25, 2016
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I'm going to do a bit of teaching so forgive me if you know this.

    With Lantus, you really aren't able to "shoot down" high numbers. Lantus is what is called a "basal" insulin. It is great at maintaining a steady state. Short acting insulin, line Humulin R, is the kind of insulin that can shoot down a high number. In other words, if you try to give a temporary increase with Lantus, you are influencing the amount of insulin in the depot. If tonight, you drop the dose back, you effect the depot again. The depot doesn't like back-to-back changes and the result is wonky numbers.

    If you look at today and the numbers on the 21st, what you see is a drop into blues or greens followed by some ugly numbers. This is a bounce. Rover cleared the bounce from the 21st yesterday during the AM cycle. Because his system isn't used to spending time in the lower ranges, his liver and pancreas overreact by releasing a stored form of glucose along with counterregulatory hormones which act to cause BG numbers to spike. Bounces are hugely annoying but, the more time Rover spends in lower ranges, the more his system will get used to being in normal numbers again and the bouncing may slow down.

    When you're making a dose adjustment, you should try to ignore the pre-shot numbers and focus on where is the nadir falling. This dose is bringing Rover's numbers into the low 100s. You probably needed to hold the dose and allow the bounce to clear.

     
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  3. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Thank you. I do know. Unfortunately, I was not awake enough during the AMPS and panicked. I don't wake up easy. He has other issues going on as well. So regretting it now.
     
  4. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Feb 14, 2011
    Don't panic now. But, getting some early tests would be helpful. Because you test, you are in control and can intervene with food if you see numbers that are getting too low! When are you heading to the vet?
     
  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    No regrets. It's all data and something to learn from for the next time -- because there will be a next time!
     
  6. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Planning on leaving for bloodwork in 2 hours (+2.5). I have to wait for my vertigo meds to kick in before I can drive. Will do a test just before I leave. Also a.m. subq. Have all necessary food and strips on hand.
     
  7. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Feb 14, 2011
    You got this, you'll be fine!!! Just keep us updated as you can. Sending good vetty vines to Rover!
     
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  8. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Just had a phone call from the vet. Rover on her list of checking up callbacks because of the abscess appointment last Saturday. Told her I was coming in this morning for bloodwork. Explained what I thought the problem was in detail, and really, there's nothing they can do until Monday when they get the results. Clinic closes at 1 p.m. Darn. Now that she knows, maybe she'll get a chance to eyeball him while he's in the back, if she's not with another creature at the time.
     
  9. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    Have you ever noticed if there was a drop in Rover's numbers after you gave him fluids? I ask because some members says that's what happens with their cats. Something to watch for.
     
  10. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    No, I haven't noticed a pattern. His fluids are divided. Usually 2x75.
     
  11. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I hope the vet gets a chance to look at Rover while he's there.
     
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  12. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Rover started panting just as we pulled into the clinic. Rover never pants. Heat/stress? Doused him down. Explained situation to vet tech. Suggested she run urine as well but she said not required. I said it was, and mentioned ketones, if nothing else. I lost - didn't happen. Ride home uneventful. Rover wanted to sit in the yard and "be." Glad I didn't get an appointment this morning. The bad vet was working. She's messed up at least twice with Rover in the past.

    Appointment with the good vet Monday. Have put ice packs in the freezer for the bottom of the cage.

    +2 HI. Ran out quickly and did the Saturday things. Tested Rover at +4.5 HI. He was eating. Don't think we are going to see a drop like the last 2 times at the vet.

    Between the trip to the vet, the meds, the soaking, and the poking, I am so "person non cata" right now.
     
  13. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Wonky laptop.
    Looks as if starting to come down.
    Spent aft and eve on floor with Rover. Pushing fluids and bit of food any way I can. Think I just heard him eating or drinking. Not smelling sweet. Tried for ketones just because. Very affronted. He stops midstream. Both of us quite exhausted. Onwards ...
     
  14. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    That's a pretty significant drop for so early....Hope you can get another test in later in the cycle

    Hopefully Rover will continue to drop...but not quite so quickly!! Don't want to set off another bounce!
     
  15. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    I'm on the living room floor for the night. Just trying to keep him going. Will keep testing.
     
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  16. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You're a wonderful and caring bean :bighug:
     
  17. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    @3.5 200 Falling fast. Trying bit of both MC and HC to see if will eat. If not, can syringe gravy.

    Takes long time to reply as not all keys on DS battered old laptop work.
     
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  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    No worries about posting....it's more important that you take care of Rover

    At least you have most of the basics down and know what to do!! Hopefully the "treat" of the higher carb food will spark his appetite some so you don't have to resort to syringing
     
  19. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Yep. Licked a bit of HC. Will keep testing. And catcage already in car from a.m. Just needs cat.
     
  20. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Am positive about 1.5 unit dose. Checked 3 times before shot.
     
  21. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Well let's hope it doesn't come to that!! Good thing about keeping such a close eye on him...you should be able to keep him safe
     
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  22. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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  23. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    MC/HC obvs worn off. Finally got a ketone test. No ketones. Glucose quite high. Max fluid onboard. Doesn't feel enough. Ate LC +5.5. Have to sleep. Alarm set for +8. The floor was much more comfortable 40 years ago.
     
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