Ducia PMPR 490 1U, AMPR 165 1U

Hi,

Ducia's numbers since last PMPR were out of control completely. The SS is updated including meal/water/sqf.
Can somebody please take a look at it and tell me what is it with her.

PMPR and AMPR 1U.

Ketones test consistently at the Trace level. She received 75 ml Ringer's at last night PMPR +1.

We are also not sure that our feeding routine is a good one.

She is in good condition, visible gain weight,active/sociable, eats and sleeps and litter box visits at her usual pre-diagnose schedule. Shows great appetite and get enlarged portions of 2/3 of 5.5 can at each AMPR and PMPR. Midday and midnight meals also between 1/4 and 2/3 of 5.5 can.

I cannot figure out her response to insulin shot. She is up and down and we are to new to the FD to understand clearly what is going on.

AMPR was 165. I am worried about hypo. Hypo tool box ready. What should I watch for?


Last thread
http://www.felinediabetes.com/FDMB/threads/3-5-ducia-ampr-262-1-25u-3-233-ketones-large.174308/

 

I know your situation is special because you're dealing with post DKA, etc. It's possible that the changes in Lantus dose are making her responses erratic. I might try leaving her at 1 u at least (maybe 1.25 u?) for several cycles. However, I'm still new to Lantus so it would be a good idea to get the experienced people to look at your SS.
@Wendy&Neko
@Doodles & Karen
@Bobbie And Bubba
@Sienne and Gabby (GA)
Sorry if I've missed others ...

 

Can you get a re-test of the AMPS number? If I am reading your spreadsheet correctly, you got a 328 at +11 from the PM cycle and then 165 at AMPS, which would be an almost 200pt drop in 1hr.

 

hi Kris, thank you for reply.
How to I bring others to look at this post? Also I do not know how to change prefix of my post.

 

You read it correctly. Her AMPR +1 is due in 30 min. I will retest then. Is it ok?

 

Yes, that's fine. I suspect that the AM number was a bad read (sometimes it happens)-- I'm really not sure how to explain it otherwise. Let's see if the +1 number is higher.

To get the attention of another user, we use "tags"-- type "@" and the username (if you start typing a name with the correct letters, usually you will get a pop-up list to complete it so you don't have to remember exact spelling of the whole name)

 

I've tagged some others already, Tanya. Nan pointed out something important that I didn't see at first - that big drop from +11 to AMPS. It's possible that the bouncing from last night is ending and that's why you got a blue this AM. So far, the 1 u dose hasn't given a really low number so it might be OK.

 

Where do I type it?

 

If you look at my post #2 up above you'll see a list of names in blue of people I've tagged for you. Notice how each name starts with the @ symbol. If you start typing with that and then type the first few letters of the person's screen name, a little menu of names will drop down and you click on the name you want. The menu works best if you type slowly.

 

Just in the body of a message, like this: @Tanya and Ducia

You should soon get an "alert" message in the upper right-hand corner of the page, telling you that I "tagged" you.

 

I've learned that the alerts don't always work, Nan.

 

AMPR 165, +1 91, 1 hour after large meal
?!?

 

@@Wendy&Neko
@Doodles & Karen
@Bobbie And Bubba
@Sienne and Gabby (GA)
New AMPR 165, +1 91, 1 hour after large meal
?!?

 

That drop tells you that this might be an "active" cycle. Is she eating on her own? Do you have some high carb food to give?

 

It did not work

 

Tanya, pleae start with some HC food right away The drop is too fast and too much

 

Don't worry about it now. You'll need to watch Ducia carefully and steer her BG with food.

 

Do you mean that her last night's PM shot is still working and that by giving AM shot after 12 hours can OD her?

 

Tanya--

First, follow Bobbie's advice and give HC food!

Then: can you give a quick summary of the food you have on-hand, and what you have given her this morning? I know that she got a large meal of canned food but it would be helpful to know:

brand (Fancy Feast, etc.) and variety ("Tender Beef Feast")

for whatever you have on-hand. Just so we know what you have to work with today-- there is likely to be a lot of "steering".

 

She ate at AMPR 2/3 can low carb. SHould we I give more time to absorb. Like until AMPR +2 retest?

 

We need to slow down the BG from dropping so fast so give HC food and retest in 20 minutes

 

High carb food now to slow her down

 

Don't think hypo or OD right now. Do you have any canned food that has sauce or gravy in it? The gravy by itself can be given a teaspoon or so at a time. Do you have honey or karo syrup in case you need it later?

 

If you don't have HC food, add honey to her LC food

 

Just a little so it doesn't upset her tummy. Try 1/16 tsp or 1/8 tsp.

 

I have 13% carb Soulistic pouch but I cannot fed it trhu the tube.
I doubt she will eat on her own.
Should I give more time for the LC food to absorb before testing?

Also have 23% Soulistic Autumn Bounty but it is not for etube.

 

please add honey to her gums if you thin she won't eat on her own an you are unabe to get the food into the etube We need to get the numbers up STAT

 

The onset is around +3 for Lantus and if she is a ready dropping this rapidly it could be a repeat of before

 

She is alert, grooming right now, does not seem hypo at this moment.
I'd ask again: should I give more time for the morning LC meal to absorb. I do not want to rush, but when ever Hypo is in horizon I panic. I don't want to mess up thing any further. So, is saf to wait another 45 m without giving HC immediately?

 

But she looks fine - groomes, alert, responsive. I do not understand the honey

 

When you get a chance, you want to pick up a high carb food, greater than 15%, that has gravy. With something like the fancy feast gravy lovers you can pop the can and squeeze out gravy. That might go in the etube.

How long ago did she get food?

 

No, we don't want to wait-- get some HC into her now. It's not panic time yet, we're trying to prevent the panic situation! So, HC now.

If she'll eat the Soulistic Autumn Bounty on her own, a tsp or two of that would be good to get her to eat. Other than that, listen to Bobbie-- a little honey on her gums to bump her numbers.

Bobbie, I'm also wondering about the huge drop pre-shot. I don't have an explanation for what could be going on with that.

 

It is way to soon in the cycle for her to be dropping this fast I want to boost her up a bit before the onset of the insulin. She is not hypo now but I don't want to get her that close to it

 

No, you can't wait when she's dropping this fast. She's not hypoing right now. What we're telling you to do is to slow down the drop in BG so she doesn't get there. That can be done with 1. LC food if the drop is not too fast or 2. HC food if the drop is too fast. The extra carbs with reduce the action of the insulin.

 

i hour and 10 min ago 2/3 Friskie Salmon Dinner

 

it is 20 min since last test.Should retest now?

 

Maybe carryover from the last cycle ? I don't now ......maybe @Wendy&Neko ?

 

Yes Please test again

 

This is a bounce breaking cycle, hence the downward movement in the numbers. That can give a lot of downward momentum. But we want to put the brakes on, hence the high carb food. She has had plenty of time to digest the carbs from breakfast and it didn't do the job. Hence the move to higher carb. You can retest if it's been 20 minutes, but will probably still need the carbs,

 

Maybe prolonged response from a dose that's too high? Maybe a bounce that cleared very quickly? Maybe heightened sensitivity after that green yesterday? Unstable responses to Lantus because of other health issues right now?

 

rest BG 90, 23 min after BG 91 test, 1 h15 m after meal.
I have Soulistic

 

Bg 90, 23 min ago was 91
I have Soulistic Island Illusion 23% carb per sr Pierson 2012 chart
I have Light Corn Syrop Karo

 

I am going to offer 2Tbs Island Illusion Soulistic 23%
Should I go ahead?

 

Do you think you can get any of the Soulistic into the tube ?

 

BG 90

 

Yes, if she eats it, great otherwise, do you think you can get some into her tube ?

 

Unlikely, rather no.
I have 10 ml LC syringe for tube ready

 

What food do you give by the feeding tube? Would it be possible to dilute some karo syrup with warm water and add that to some tube food? Will she eat anything on her own?

 

Offer it first first and see if she eats it. I am glad the drop seems to have stalled.

 

Please add all the BG numbers to your Ss when you have a minute so we can see what's happening at a glance.

 

8:096 am pacific. eats 2 Tbs Soulistic Island Illusion 23% card herself

 

Excellent. I think you can wait half an hour for another test now.

 

eats 23% carb Soulistic Island Illusion

 

I need to leave the board for a while to take care of my mom. I will check back in when I can .

Yeah!! test again in 20 - 30 minutes.

 

She just finished @8:14 am pacific 2 Tbs Soulistic Island Illusion.

 

She just ate 2 Tbs HC food Soulistic herself.
If god forbid she hypo I can dilute Karo and add to her LC syringe. What are the Karo/water proportion, and how many ml of it should I mix into the syringe?

 

You usually add a drop or two of karo to wet food if they will eat that. With a tube, I imagine you would add enough warm water so it flows easily. Hopefully you won't have to go there. It's great she ate!

 

Thank you good she ate!

 

How long does it 2Tbs to be absorb and affect BG?

 

Usually food will start to have an effect in 20+ minutes unless the insulin dose is still working against it.

 

I suggest you do some experiments to see how much dilution of karo gives the right consistency to mix well with the LC food and not gum up the feeding syringe. If it comes out of the feeding syringe well it should go down the feeding tube.

 

BG 81 after 24 min 2 Tbc HC?!

 

It depends on the cat, some can take half an hour to react to carbs. When kitties are still fairly high greens, I would wait that long before testing after food,

 

I would see if she will eat a litte bit more of the HC food since this is only +2 and I liked Kris suggestion to experiment with the Karo syrup and warm water getting it to a good flowing consistency just in case it needs to go into the feeding tube later.

 

OK, I think now that her AMPR +2 81 is in I should wait until +3 and test her.
But here is what scares me: while I wait for another hour she can go into hypo, drop to the lower #yet

 

No, please do not wait an hour , test her again in 20-30 mins as the onset of insulin is around +3 and see if you can get her to eat a bit more of the HC food

 

sorry, I take a break for short - international cal have to take it

 

Tanya, when you're in one of these "steering with food" situations, your normal BG testing routine goes out the window along with the normal feeding routine. You might have to test every 20 - 30 minutes until you see the BG stay level for several tests or start to rise. You have to also be ready to give small amounts of carbs periodically to control the BG.

 

Her +3 is due in 20 min.
She appears to be quetly sleeping, responsive to talk unlike it was during the hypo event. I think I'll wait 20 min to her +3.
I have LC 10ml syringe ready. I want to prepare Karo+water syringe too. Is 1 drop Karo diluted in 3 ml water sounds good in case she is lower that BG 81. I can give both syringes immediately via tube.

 

HC food is ready is wants to eat it.
LC syringe ready for tube.
I am going to prepare water and Karo syringe.

 

I will test every 20-30 min after +3 is known and which is due in 6 min

 

Lower than 80 is still OK, you just don't want her dropping a lot. Hopefully the HC she ate earlier will kick in.

 

+3 BG 80

 

Great! You can do a little bit of low carb food.

 

I just gave another 2 Tbs HC, she is eating now

 

Should I add 10 ml LC after she is done with 2 Tbs HC?
She eats HC with interest. We try to avoid feeding via tube, only the meds, unless it is really an emergency

 

She is at 80 now. Ate HC. It is 2nd portion of in 1h30m.

 

I don't know if 2 Tbs HC is enough in this situation.
I have 10ml syringe of LC food ready for tube feeding.
But don't want to overdo with feeding.
She seems to be doing ok now - grooms, responsive.

 

BG 77, 30 min since last test at +2
WHat should I do?

 

BG 77 , 30 min after +2 and 2Tbs HC. WHat should I do?

Hi Bobbie, are you there?
Ducia +2 was 80, she ate 2Tbs HC x 2 since but shown BG77 at +2 +30 min.

 

I'd give a little more HC now if she'll still eat it. Maybe 1Tbs for now-- I'm a little worried about filling her up so early in the day.

She's still in safe numbers, we just want to keep her there!

 

If you think she'll eat it, you can try to mix a drop or two of honey onto the high-carb food. Just a drop or two, for now.

 

she ate 4 Tbc HC 23% since +2. Her +4 due in 16 min I will test.
But she shown BG 77 after all that food and itis lower than BG 80 @+3.

 

I doubt. Her +4 due in 16 min but she seems breathing faster than normal

 

Have you tried giving a bit of sugar (karo) water in her feeding tube?

 

I have 1 drop Karo in 5 ml water to go thru etube.
Going to check +4 now.
Please stay in to post.
I am beginning to panic

 

She may be picking up on your stress. When was the last test? If the test was 30mins or more ago, I'd go ahead and test now rather than waiting for +4.

Did you offer her the Tbs of HC?

 

We'll start to think about that soon, I think, but let's see what the next number is first.

 

+4 BG 91

 

It is +4, BG 91

 

Try to stay as calm as you can, Tanya. We're all here to help.

 

Great! She's still surfing along in the good numbers.

We're still going to have to keep a close eye on her for a while, but she's doing great, as are you!

 

had to take care of my mom and computer is giving me issues, I will switch to my phone

 

Excellent! You still need to monitor but the food steering is working.

 

Tanya....Ducia is doing well so far and you've done a good job with her!!

As long as her numbers stay in the 70's-80's,(or higher) just keep testing every 30 minutes for a little while longer

No need to feed her more of anything unless it's a "scheduled" meal

 

She is surfing which is good but we need to keep her surfing. I think you can wait 30 minutes from now to get the next test and let's see what number we get .

 

I thought Blue are the good once.

 

It is scheduled meal. Should I offer?

 

Blues and greens over 50 are good.

 

Green numbers above 50 are safe....blue numbers are good, but we hope to keep them under about 120

50-120 are normal blood glucose numbers