AMPS was 598, +3 is 595.

BG has been pretty consistent through the first week (300’s am and pm, he gets 1/2 unit of Lantus 2x day). Yesterday's AMPS was 220 and PMPS was 149. So, as per the information I had (from the vet and here), I did not give him a shot last night.

This morning's AMPS was 598. I called the vet and she said just to give him the shot and make sure he eats.* I just tested him again and his +3 was 595. I'm starting to worry that I didn't get the full dose into him this morning but I guess there in nothing I can do about that now. He has been nibbling on his food all day as usual.

Im going to test him every hour or so and if it goes up during the day I will call the vet again. But is there any food I should be giving him in this situation other than his normal?

Update to add that I just got a urine sample and it was negative for ketones.

Thank you in advance.

* she also said I probably should have given him the shot last night even seeing the 149 (I'm going to need to clarify this with my regular vet and get some firm rules to follow because I thought I did the right thing but obviously didn't).

 

The high AM PS is sort of expected since you skipped the previous shot. There is nothing you can do. Just give 1 unit tonight.
If you had experience than you can start shooting at below 200. I suggest you start a spreadsheet so you can share your experience with other. See:
viewtopic.php?f=6&t=50130

 

Thanks. I suspected as much.

 

"Better a day too high than a moment to low"

Ie a hypo can kill quickly; high glucose takes longer, so no need to panic.

As you get test data, you will be able to lower your no shot limit.

You want a dose which may be given safely every 12 hours, without going below 50 on a human glucometer, which otherwise keeps the glucose as low as it can.

 

Thanks. That why I didn't give the shot last night - I made sure before I took him home from the hospital that I should always err on the side of not giving it.

I use an Alphatrak so my numbers are probably a bit different, but I won't worry about that until I even get to the point where he is hitting double digits.

 

For the AlphaTrak, you don't want it going lower than 80. And your no shoot limit would be about 230 until you have data showing it is safe.

If you find you are often skipping doses, you may need to reduce the dose. Testing the nadir - the lowest point between shots, also helps determine dose adjustments. If using Lantus or Levemir, the nadir is crucial for dose adjustment. Unless going too low, you must wait 5 days for the first dose evaluation and 3 days for each change before determining if the dose needs an increase. This is because these insulins have carry over effects.

In the upper left of the web page is the user control panel. You'll want to edit your signature to note you are using an AlphaTrak.

 

Got it, thank you. Obviously I need a lot more data to see what is happening during the 12 hours after each shot and hopefully will be able to do that one day this week so I can get the numbers to my vet and discuss how to keep today from happening again.

 

I'd like to ask you to change the font size on the word Alphatrak in your signature so it appears larger and really sticks out for those of us advising you. When you are editing the text, do you see that box in the middle that says Normal? Highlight the text you want to apply the change to and then click on the drop down arrow and select large. Here is an example: large.

Thanks, that will really help us to advise. Fewer people use the Alphatrak meter because the strips are so expensive, usually $1 or more each. Most of us use human glucometers which read roughly 30 points lower thatn the Alphatrak. I got the Alphatrak from the shelter for monitoring Wink but bought a Relion Confirm from Walmart very quickly. I could do 3 tests with the Confirm meter for the price of a single strip for the Alphatrak.

Also, be sure you have plenty of test strips available for your meter. You do not want to run out of strips when your vet is closed.

 

Done.

I'm going to look into changing meters but there was so much going on this week I didn't really have a chance. But yes, the strips are brutally expensive. I have a bottle of 50 here but don't expect that I will order more and will switch meters instead.

 

Thanks, that really helps.

All of us here understand the "very full life". Work, family, friends, volunteering, hobbies, it's gardening season here in Massachusetts, spring warbler migration is getting into full swing, caring for my 3 cats, caring for my own home, etc........... the list goes on and on as I expect yours does.

Just do the best you can. Not expecting you to perform miracles unless you have a talent we are not aware of?

Someone wished on here just a little while ago that they had a magic wand and could wave it to cure their cat of diabetes. I thought that wand would make it around the world in about 2 nanoseconds flat, because the kitties would be using their special time warp capabilities to magically appear in unexpected spots. Why not dream!!!

Here is a reality. You will be able to regulate your cat. You may be able to have your cat go into remission. The remission was the dream part for me and my foster kitty Wink and guess what? He did go into remission and has been OTJ for almost 2 months now.

Hang in there and give it some time.

P.s. After my first skipped shot and seeing those high numbers the next day (bouncing), I decided 'never again' and learned to shoot low numbers, did tons of testing, ran frequent curves, learned how to manage hypos on my own and never skipped a shot again until I was ready to try an OTJ trial. I do not advise this method for anyone else, but it worked for me.

 

Last question for the day, I hope. At +10 he is 514 and has been nibbling food all day. Would it be safe to give him his PM shot at 10.5 or 11 hours if he is so high anyhow (which would make tomorrow morning's shot at a much better time for me).

 

Lantus dosing can be moved 30 minutes once a day or 15 minutes for each cycle ( a cycle is a 12 hour period).

An early dose acts as a dose increase, a late or delayed dose acts as a dose decrease.

You can do another time adjustment tomorrow morning, until you get to your desired time and staying at the 12 hour interval.

I'm not sure you have enough test data to see how low he goes overnight so I don't feel comfortable having you give the shot 2 hours early.

 

Sounds reasonable. Thank you.

 

Time to create that google spreadsheet we like so much and link it into your signature. Here is the how to: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 from over in the Tech Support forum. This is where you enter all your test data, dosages given, food given if you want to. Things like that. It helps us to see patterns and to advise you better.

If you have problems or are not computer savvy, there are people here that can create the spreadsheet in link it into your signature for you. Ask for help if that is the case.

 

Created the spreadsheet and linked to it in my signature. I added a line at the top saying I was using an Alphatrak so there would be no confusion (if I switch monitors I will remove it and put a marker in the sheet so it's clear when the change is made).

It will take me some time to enter the numbers I have from last week.

His AMPS today (which was an hour late, so really a +13 from last night) was 104, so I didn't give him the shot. I had to leave for work so I wasn't able to wait and retest, but I will try and get some +9, 10 and 11 readings this evening. I didn't want to take a chance on him going hypo while I wasn't home. Because he is only on 1/2 unit, I'm not sure how to give a reduced dose. But because this is the second time in a week that I have had to make this decision, I will call my vet tomorrow and see what he has to say.

I wish I was able to test more frequently to get a handle on what was happening but work has really suffered in the last 2 weeks (I know I need to balance caring for him with the rest of my obligations, but because of how sick he was and how suddenly it happened, I got a little wrapped up in his issues). So, I may not be able to really establish a good cut off for shot/no shot for another week or two. In the meantime, I guess I will just have to accept that his numbers may be a little erratic because I would rather err on the side of caution until I have more data.

On a positive note, he has gained back a little weight (he was skin and bones when he got home from the hospital), has been regularly eating the Fancy Feast Chunky Chicken (which the chart from this site indicated had much lower carbs that the Natural Balance LID he was previously eating), and not protesting the removal of dry food from the diet. His energy level is back to normal and he is acting like his old self again.

So, hopefully we are at least moving in the right direction even if his progress is slower than it could be if I was home more often.

I can't thank everyone enough for the answers, advice, and responses I have gotten in the last 10 days. I was really in a panic when he first came home and having someone say "you don't need to be crazy about that" or "that happens to everyone" was fantastic.

 

I did this same thing yesterday (with a 90) and I've often shot even lower numbers. If I'm not going to be around, I figure that the safest for him is to run high a bit than to drop potentially and dangerously low. To reduce the dose, here's some info on "microdosing."

As we like to say around here, "he didn't become diabetic overnight." So, if it takes you some time to settle into things, don't worry! It took all of us time to adjust. :YMHUG: And from the sound of things, he's already doing better. :thumbup You're doing great!

 

You are doing are great job here. Yes, I was able to access your spreadsheet just fine. You need to take care of other things in your life, like work so you can buy your guy lots of good food and toys :lol: , and yourself so you can still take care of your cat. Remember to pamper yourself a little. This whole diabetes sugardance is so stressful and time consuming that you need to remember to "take care of the caregiver".

Yes, you were right to skip the shot this morning. You were not home to monitor and you do not have enough data yet to see how low he drops to shoot that low yet. In time, you will gather more data and then learn to shoot those low numbers and earn those balls of steel, but you are not ready yet.

Good choice! Yes, he will bounce after not getting any insulin but you know to expect that and know his numbers will be erratic.

Our suggested shoot/no shoot number at the beginning of this sugardance is 200. Post for advice if below that and don't feed yet. If you don't hear anything back from one of us, it's always safer to skip the shot and expect the bounce.

Once you get those numbers in the spreadsheet, let us know and we'll take a look at it to see what is going on. See if any patterns pop out at us and we can suggest changes.

I'm glad to hear he likes the canned food switch. Some kitties refuse it endlessly because the are dry food addicts and it takes a lot of tricks to switch them over. Glad to hear he has been gaining some weight back and is starting to act like his old self.

That always lifts our spirits when we can tell what we are doing for them with this diabetes treatment is working and making them feel better.

You are definitely moving in the correct direction. He told you so.

Don't worry about what you think is slow progress. It's only been two weeks, which is not a lot of time yet. It takes time and you are doing great. Hang in there.

ETA: I'm having a serious 'senior moment" here, totally blanking on your name and your cats name. Would you please add your cats name and your name into your signature on the user control panel? Thanks.