9/20 Zephyr AMPS 414 +2 327

Discussion in 'Lantus / Levemir / Biosimilars' started by labyrinthos, Sep 20, 2019.

  1. labyrinthos

    labyrinthos Member

    Joined:
    Jul 19, 2019
    We went out of town from 9/11-9/16 and in that time Zeph decided that Red was the great new color of the week, after giving us blue right before we left. We boarded him with my friend who has a mini Yorkie, so he was in a strange place, with a dog, and without the other (non-diabetic) cat who stayed at home.

    I wrote off his first crazy high reading as stress the first night away. His numbers were high while being boarded but not crazy, and she didn't test as much as I do. But since then he really hasn't dropped back down. He came home the night of 9/16 and he's spending way too much time still in those hot colors.

    He also developed diarrhea while we were away, and that is just finally clearing up. So maybe he's had a separate illness as well? There hasn't been any vomiting, and his stool firmed up as of yesterday.

    I know it can take a few cycles for him to come back to normal, but it seems like he was high all of last night. I don't know if I should increase his dose or give it another few days?

    I mean, there are so many variables that it sure seems like this is probably due to one of the external factors. But I'm worried that maybe he's getting worse but I'm writing it off. Oh, and he's gained 2 more oz so he's continuing to improve in terms of weight and his grooming is impeccable.

    Any ideas/insight would be appreciated!
     
  2. Penelope and Mačka

    Penelope and Mačka Well-Known Member

    Joined:
    Jun 13, 2019
    It could have been many things... He could have gone low during the cycles, but there's no way to know. He could have eaten the dog's food, he could have had diarrhea because of an upset stomach due to stress yes, and it can probably influence the numbers. Is there any way you could get a test at +5/+6? And also before bed?
     
  3. labyrinthos

    labyrinthos Member

    Joined:
    Jul 19, 2019
    Thanks for affirming that there are all sorts of factors. I think I just needed someone to confirm that it isn't as bad as it seems :) Looks like we're doing much better today!
     
  4. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Hi! it looks like you're doing a curve! if you are able to finish it today and don't see better numbers for the nadir, I don't think it would be a bad idea to increase by 0.25u, especially since Zephyr has been on this dose for two weeks. Are you following one of our dosing methods on the board? if so, could you add it to your title? That way we can give you more specific and relevant feedback :)

    I agree with Penelope! getting a before bed test is really important, cat's often dive at night (just look at Mowg's numbers last night) and it is good to get a +2 and / or a before bed test to see if Zephyr is safe :)
     
  5. labyrinthos

    labyrinthos Member

    Joined:
    Jul 19, 2019
    We're trying to do the SLGS technique, I'll make sure I include it in the title next time! We got a bit off track due to travel.

    He is on kind of a late in the day shot schedule, so the pre bedtime number is only an hour after his PMPS. Looks like I should probably set an alarm and get up in the middle of the night to do a late night check. He's going to love that, probably as much as me. :rolleyes:
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Just put SLGS in your signature, not the title. I agree with the others, looks like time for that increase. At least he was safe while you were gone.
     
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  7. labyrinthos

    labyrinthos Member

    Joined:
    Jul 19, 2019
    I'm a bit nervous to up his dose since he did hit a blue just before we left. With so much that he just went through, I feel like I should let his system settle a bit more and get another real curve in a few days before changing his dose.
     
  8. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    I understand that you’re nervous, but that blue was 10 days ago. You did a really good curve yesterday and according to both methods Zephyr qualifies for an increase. Even that blue you had 10 days ago is far from a dangerous number :)

    Additionally, if you don’t give increases when they’re needed, your cat can develop glucose toxicity. When that happens it makes it harder and harder to get kitty back into healing numbers.

    I know it’s scary but you can handle it! Especially if you can be home to monitor. I recommend trying the increase, use a +2 test to predict where the curve might take Zephyr. If the +2 is the same or higher it probably won’t be a dangerous curve. If the +2 is way lower, then get another test in an hour. If you are unsure if there is an issue post for help.
     
  9. labyrinthos

    labyrinthos Member

    Joined:
    Jul 19, 2019
    That makes a lot of sense. Thank you.

    I haven't even HEARD of glucose toxicity. I feel like there's so much to know and every time I feel like I'm getting a handle on it there's an entire new piece of info that I've missed. At least I like learning!

    Do you think going up to 2 units would be OK? We were misinformed when we started and our syringes are whole unit measures. It's definitely an eyeball technique. We've got half unit syringes on order but they're at least a week away. I just don't know how quickly cats can drop.
     
  10. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    I don’t think 2u would be a good idea, cats are very sensitive to insulin, that’s why we only increase by quarter units at a time here. 1u is too much

    When some kitties are spending a lot of time in high numbers sometimes I’ve seen members boost by half units at a time @Wendy&Neko @Sienne and Gabby (GA) do you think Zephyr could qualify for this type of increase?

    I do think Zephyr needs an increase but I definitely wouldn’t recommend more than 0.5u. Let’s see if others weigh in and have suggestions on a dose :)

    Some people use callipers to measure dose accurately, That might be an option for you.
     
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  11. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    I agree with @AmandaE...stick with the .25 increments for now - I think the yellows you got yesterday in the curve and the fact that it has been quite a while since she's seen a blue -it's certainly time for an increase. Testing while you were away just indicated the AM and PM numbers which we saw were quite high...if she made it to blue at the mid-cycle we don't know - all you can do is give it a try - she's got quite a bit of ground to cover to get there.

    As long as you're home and prepared to monitor closely you'll get a good idea of how she's going to respond to the increase...do you have your hypo kit ready as well (some MC, HC foods, karo syrup, plenty of test strips)?
     
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  12. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I agree that an increase is needed by only by 0.25u. You are still seeing nadirs in the 200s. Even with TR, you would not increase that aggressively if nadirs are in the 200s. The highs today are from a bounce due to the big drop from the 400s to the 200s.

    The other reason to not raise the dose by 0.5u is that you're following SLGS. Stick with your dosing method!!

    And please get a before bed test routinely.

     
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  13. labyrinthos

    labyrinthos Member

    Joined:
    Jul 19, 2019
    Thanks everyone for your guidance. We increased the dose by .25 and he seems to be doing well on it. I think he might be bouncing a bit (I still don't feel like I have enough data to really know) but hopefully we'll see some leveling out in the next couple of days!
     

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