AMPS is 384, need dosing advice!

Hi, all. Squallie's AMPS was , and I don't know whether to go back to his 2 unit dose, or give slightly less. He got 0.5 last night, and his numbers stayed a little higher, and then obviously climbed this morning. Any help is much appreciated! It's already past shot time nd I don't know what to do.

 

@Critter Mom, @Shiloh & Rhonda , @Sue and Oliver (GA) , @Robin&BB, any of you on the site this morning?

 

Morning Lucy. Let me take a look real quick. BRB

 

Thank you!

 

I don't have any experience with Vetsulin, but I think if it were me, I would go with 1 unit.

 

That was kind of my thinking, too, I figured 1 or 1.5, wasn't sure which would be better.

 

He got pretty numbers yesterday with the 1.5, and he is higher this morning than yesterday, but he may be bouncing a bit.

 

That was my first thought when I saw 384, but looking at his SS I don't think he went low enough last night to be bouncing this morning, but since I don't really know yet what I'm doing I could be completely wrong! Obviously, I want to see him have good numbers again today but at the same time, I don't want to set him up for a bounce by giving him too much! This disease just makes me tear my hair out! I hope the day will finally come when I feel like I have some kind of handle on this.

 

It will. You are doing great. My thought was bouncing from the greens yesterday morning.

 

@BJM, can you take a look and see what you think?

 

Bouncing may happen when
1) the glucose goes very low, OR when the glucose drops to an unfamiar level
2) the rate of drop is very fast

 

Okay, that could be it. That's what I mean about not knowing what I'm doing, I didn't even know that he could still be bouncing this AM from yesterday's AM numbers.

 

My understanding is bouncing can last up to three days.

 

Thank you! I feel so stupid sometimes, I'd think by now I should have a better grasp of this.

 

Wow! I had no idea! Thank you, I will remember that!

I went ahead and gave him 1 unit, and I will monitor him for any sharp drops, or numbers heading too low.

 

No need to feel stupid! It is confusing, and with different insulins being dosed different ways, you see things that may apply to one insulin and not another.

 

This experience with diabetes certainly keeps me humble, lol. I consider myself to be a fairly intelligent person but when it comes to this I'm floundering way out of my depth and it makes me feel very thick-headed!

 

I guess if Squallie's well-being wasn't a direct result of my ineptitude I wouldn't be so anxious about it, but I never want to do anything that would put him at risk!

 

We all feel that way. Welcome to the club!

 

Please DON'T beat yourself up, Lucy ... I'm really proud of you for your determination & level of commitment to Squallie's treatment!
And bouncing is pretty darned confusing. I know how frustrating it becomes sometimes, but just remember what is so often said 'round here: "Kitties bounce until ... they stop."

 

By the way, what did you end up shooting this morning?

ETA: Never mind - just saw it in a post up above!

 

You are doing GREAT! Really! Just look at where you started, and where you are now. You understand more, you're taking all the right steps. It's just that diabetes is a constantly moving target, and all we can do is keep moving along with it.

 

Sorry I missed you this morning, Lucy. My guess is that the .5 might have been too big a reduction, but you needed sleep and wanted him to be safe, so I think it was the best plan. I like your one unit today. Let 's see how it works.

 

I'm of the same opinion as Sue. Squallie's numbers are improving so much that a 1.0 unit dose on a night time cycle represented a lot of risk. With the 0.5 unit dose Squallie was safely able to benefit from having some insulin last night. He had a nice dip in the lagoon and you got some rest. Marathon, not sprint!

Word of warning about high pre-shot tests:

When Saoirse got into better numbers sometimes she would have quite high AMPS if she didn't eat well during the night (impaired fasting glucose). Some mornings she might be WAY higher than recent trends might have pointed to, but when her dose of Caninsulin was given it would drop her numbers like a rock. For example, one morning when she was at only 0.5 units BID, her AMPS was over 400 and the Caninsulin dropped her BG by over 250 points within three hours.

Squallie is at the stage where you need to give much more weight to his nadir BG than his preshot values (higher numbers are more likely to be bounces).


Mogs
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Yes, I think you're probably right, but it was a good plan and would have worked, if my insane new baby Bengal hadn't kept me up till the wee small hours! She's like a hyperactive toddler on speed .

 

Thank you! I'm trying, but that darn target just seems to move faster than I do, apparently, lol!

 

Sorry I wasn't here most of the day to reply to posts , I slept in between test times until 5:30! Squallie didn't keep me up all night last night but my young rescue Bengal is completely insane and I spent most of the night awake and dealing with her.

 

Squallie has had a pretty good day, numbers a little higher but seem very consistent. Should I go back to 1 unit tonight?

 

How long till PMPS, Lucy?

 

About an hour, I usually test him around 8:00.

 

I have had that happen with Squallie, too. Scary! The big drops, I mean.

 

Squallie's PMPS was 205 tonight. His lowest number today after 1 unit was 158. I'm thinking maybe 1 - 1.25 tonight? Or does that sound like too much?

 

I would do one unit as it is over night. No greens today but a nice cycle.

 

I would suggest no higher than 1.0 unit, Lucy. I'd be inclined to stick at 1 unit for several cycles to let the dose settle (with the obvious caveat that if numbers go too low the dose should be reduced).

 

Squallie's PMPS was 205 tonight. His lowest number today after 1 unit was 158. I'm thinking maybe 1 - 1.25 tonight? Or does that sound like too much?

Thank you! One unit is probably best, as he tends to go lower at night, anyway.

 

I agree, I think that's a good idea. Thanks, Mogs!

 

Off topic here - I have a current Bengal house guest who is here, along with another cat, while her person has some work done at her home.

 

Wow, she must be really something! Btw, you were in good company last night/ today, Lucy - I didn't sleep at all last night, either. (And just woke up a little bit ago myself.)
Although I don't have anything nearly as interesting as a Bengal kitty keeping me up at night; just plain, old insomnia ... <sigh>
Here's hoping you get in some good zzzz's tonight!

 

How are you getting along with your Bengal visitor? They tend to be a little "different" from other kitties, not necessarily to everyone's taste, lol. I have two; a 3 yr old male and an 11 month old female rescue. I had hoped they would be playmates as they both have much higher-than-usual energy levels, but they pretty much hate each other, and go around the house all day and night making perfectly ghastly, blood-curdling noises at each other. Then there's the fact that I'm discovering that my rescue girl is quite insane; she's a kleptomaniac, steals everything she can get her teeth on, from all over the house, and drags it under my bed; she is a treat thief, she finds them no matter where I hide them, even inside other things, and chews the bags open to eat all the treats; when she's hungry, she's frantically hungry and can't get enough to eat; she gets the zoomies at 2:00 AM, and just after bedtime is her favorite time to start antics or trouble in the bedroom, when I'm trying to sleep. She's like a hyperactive toddler on speed. She drives me crazy. And I love her to death! I love ALL my kitties to death, and feel very blessed to have them in my life.

 

Jazzy, the Bengal and Echo, her housemate are living in the basement, which seems to be having a positive effect on Bits and Smudge who are being braver (they're semi-feral) and coming out to eat when I bring food. Jazzy chirrups a lot. She is exceptionally thin and bony - I suspect she was not well bred. Echo got his name when he was a baby - he howled and it echoed throughout my friend's home.

 

Oh, you have no idea...,lol! She's a whole other topic, unto herself! (see my previous post) I suffer from insomnia, too, so I can definitely sympathize with you. I hope you get some sleep tonight, too!

 

Lol, I love their names. Candy is also very thin and bony, and I suspect poor breeding, as well. Khoji is extremely well bred but he is an "early generation," which comes with it's own set of problems. They both make some lovely and some not so lovely noises, chirrups and trills, lovely; and then screaming and screeching, not so lovely! They are both love bugs, just not toward each other; they are sweet and fun and charming to the rest of the world!

My Squallie got his name in a similar fashion to Echo; he "squalled" for attention at the top of his lungs when he was a baby, lol!

 

Squallie's AMPS is down, 317 today. Yay!

 

That's better. Are you thinking one unit again?

 

Yes, I am, does that sound appropriate? Or should I give a little more?

 

I like one unit. Yesterday on a higher amps, you got a nice cycle and a nice pmps.

 

Me too! He got 1 unit; I'll check him around +2 to get a feel for where his BG is headed. It would be nice for him to have a day where I could give his poor little ears a break, too!

Thanks, Sue!

 

Hi Lucy,

I really, really think that you should not go higher than one unit again. Squallie's numbers are much improved and he also hit nadir early in last night's cycle. Saoirse's nadirs got earlier when her pancreas started getting better, so it's definitely something to prompt caution. It is MUCH more likely that you will need to reduce his dose again if he keeps up the current trend. Please concentrate on nadir and not pre-shot numbers. It is safer.

I suggest that you hold the 1.0 unit dose until such time as you get a nadir low enough to reduce the dose again. Because of the harsh nature of Vetsulin, if Saoirse was getting these numbers I would reduce the dose sooner rather than later for safety. If it was Saoirse I would be very uncomfortable with nadirs below 90 on a human meter and I would decrease the dose if she went below that value.

My two penn'orth. Other members may have a different take.


Mogs
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Thanks, Mogs! I gave him one unit this morning, and will undoubtedly give one unit or less tonight, depending on how he does today. Like you, I get very nervous with very low nadirs and I am fully prepared to reduce his dose if/when necessary. And I always appreciate your two penn'orth!

 

Hmmm...Squallie's numbers have been a fair bit higher today. Don't know if it's because of too little insulin or something else going on. I would suspect a food issue but there's nothing in the house for him to get into, now. He had FF Savory Salmon Feast for breakfast, it only has 1% carbs and is only getting his mid-day snack now.

Can anybody give me any advice re: the spreadsheet? Every time I try to enter something in Remarks I get this: #ERROR!

I tried to add to the Remarks section that at+6 he first tested at 355, I retested and got 278. Don't know which is right or why the discrepancy.

 

Is it the first time you've given Squallie the FF salmon variety? Also what were the carbs in the other food you've given?

Re the meter readings, there is a +/- 20% variance allowed. The 355 and the 287 are within that tolerance range.

Re the spreadsheet problem, are you by any chance trying to put a '+' sign as the first character? If yes, then the spreadsheet will think it's a calculation formula. If it is a 'formula' problem, you can solve it by putting an apostrophe as the first character in the cell.

.

 

He has had the Savory Salmon lots of times before, it's the only one I can usually guarantee he will eat. That's the only food he's had today.

I probably was trying to put a + in as the first character, if I click on #ERROR! it tells me it's a "formula parse error". Is there any way to clear #ERROR! from that cell so I can puy info in?

 

I'd suggest moving to the cell and pressing DELETE. Try it and let me know if it works.