Ducia PMPR 490 1U, AMPR 165 1U

If the insulin will kick in now while she is in her 70-80, what will happen?

 

You might want to go ahead and give her the OPTION to eat....after all she's had already, she may be full

 

Good! I thought she isn't supposed to get lower 80

 

That's why we're having you test more often.....to make sure that she's getting enough carbs to keep her safe while the insulin is "kicking in"

 

She is eating 1/8 of 5.5 can LC food now

 

Thank you, I am trying to stay calm and useful.
Bloody hypo impressed me beyond believe.

 

Good for Ducia!!!

I'd get one more test 30 minutes or so after this last meal and if she's still in the 80's or higher, I think you can stop testing every 30 minutes

 

I hope I can understand her BGs better

 

She was 91 at +4. I will test in 15m so its another test in +4

 

You'll get there. You've had almost all the worst things happen one after the other when you're still learning. You've done much better than many more experienced people would.

 

You are doing great Tanya. I have to sign off. @Chris & China snd @Nan & Amber , @Kris & Teasel , will y'all be around ?

 

I'll be here for the next few hours.

 

I'm here.

 

Thx , I'm getting sick and need to close my eyes for an hour. My mom is just getting over it. Now it's my turn

 

Thx Kris.

 

+4 BG 91, after 30 min BG 85 ?!
I need to run to Walmart for testing strips, just a few left. Is it safe to leave her for 20-30 min?

 

Kill it before it spreads, Bobbie!

 

I think so

 

She is 85. Can I leave her half an hour? Need BG testing strips. Walmart in walking distance.

 

Can you get back in no more than 30 minutes? Maybe give a teaspoon of HC if you think traffic, etc. might delay you. Do you have a neighbour who could go for you?

 

Yes, have a nice walk!! She's what we call "Surfing" and that's good....all this time in normal numbers gives her pancreas a chance to heal!!

ETA....91 and 85 are basically the same number....You could leave a little of her regular low carb food down while you're gone

 

Yep, better to go now than to run out of strips this afternoon!

 

ETA: You're close to mid cycle so she should be OK.

 

Tanya, I know how stressful and worrisome this is, but you are doing a great job!

 

I am back just before +5 test. Bg is 87

 

Thank you!

 

A-ha. We need it.

 

Please keep your SS up to date, Tanya because the helpers here will want to see all the numbers when you post later for what dose to give this PM.

 

Than is what we do not understand. We just dont know what to think about.

 

I will. We want to stay with 1U dose if possible, and collect data over several cycles maybe then it is possible to decipher

 

It's most likely that the bouncing that caused the high red/pink just before the AM drop stopped suddenly and Ducia responded strongly to the 1 u dose. It's often hard to know the effect of a dose when the high bounce numbers get in the way.

 

I have a question about her food.
She usually eats after +6, and normally behave hungry by now. That is not the case right now, 15 min before her +6. With all that extra carbs food in the morning should I do any changes?
Yesterday her PMPR 409, and PMPR +2 BG 464 and +3 439 were scary. The human medic here at home wants not to give anything at all, and skip until her next feeding time and fee only if the numbers are lowered. I feel it is wrong especially if she acts hungry. But that's how diabetes with high numbers was approached for humans in another country where he used to practice. So, why feed if the numbers are already sky high? The food will makes them greater.

 

They're hungry a lot when their diabetes isn't well controlled because they can't get glucose from the food into the cells very well. They're starving, lose weight and have high BG. They need regular feeding of small meals of LC food that doesn't raise BG (already high because of diabetes)and enough insulin to get glucose out of the blood into the cells, as it's supposed to do:

• Not enough insulin - too much glucose from food stays in blood
• Too much insulin - too much glucose is removed from blood causing BG to drop too low
• Food too high in carbs - BG stays too high because there's too much glucose for the insulin dose to handle
• Food low in carbs - insulin dose can do its proper work to keep BG at a good level.

 

I would offer her the usual meal. There are several things going on here, so I will make bullet-points.

1) Unregulated diabetics are "always hungry" because their bodies aren't using the food they are getting properly. While unregulated, cats will often need "extra" food-- it is OK to give it to them, they really do need it.

2) With a recent DKA, you always want to keep her eating well so that the insulin and food can work together to keep ketones down. Not feeding when numbers are high can send things in the absolute wrong direction, DKA-wise.

3) For today, there are still several more hours while this morning's shot will be active. I would not withhold food from her at +6, because it could accelerate any BG decrease that was already happening.

Between the extra food she's gotten today, and the fact that she's in "normal" BG numbers, she may not be as hungry as usual this afternoon, but I'd still offer her some food.

 

Tanya, I just saw that +6 was 73. If you haven't already fed the LC meal, maybe hold off while we consult-- we may want to give her another HC boost right now to make sure she keeps surfing.

 

I see that. Ducia is at +6 but might have a prolonged cycle if this dose is too high - which I think it might be, DKA notwithstanding. Maybe a teaspoon or so of HC?

 

@Kris & Teasel , what do you think-- a Tbs of HC now? She's still surfing at the same level (essentially), but we don't want her dropping lower, and she has shown a late-nadir tendency in general, so I'd like to bump her up a bit at this point.

 

Cross-post-- we're in agreement. Tanya, let's try to tempt Ducia with a Tbs of that yummy high-carb food!

 

We cross posted, Nan.

 

Tanya, can you post an update? We worry when we don't hear anything for a while!

 

Thank you Kris,
I do struggle to understand, it may take me a while. I will re-read it.
But I look at the Ducia's SS from yesterday morning and I am thinking that on the same 1U dose she has enough insulin to do the job, but not enough in the PM hours. Food is spread over 4 doses. Main meals are the AM and the Pm shot time. Good appetite around mid day and midnight. All the same, not ideal yet of course but relatively the same and she went from yellow, blue and green in the morning to the pink and red in the afternoon. I am so confused.

 

I updated the SS right away.
At ampr +6 BG 73; she ate 1/4 LC of 5.5 can with 3ml water; her ketones@+^ are Trace level.

 

Sorry, I already fed 1/4 LC with water.

 

Some kitties are erratic in their response to insulin ans some are worse than others. Unfortunately, it's rarely a case of find a good dose, give it and that's the end of it. Also, Ducia's recent illness might have made her even more unstable in her response to insulin. All you can do is what you're doing already.

Did you give her a little bit of HC as we suggested? The goal is to keep her BG aas stable as possible until she's near the end of the cycle.

 

That's OK. Let's see what it does. Test in 30 minutes.

 

That's fine-- again, she's in safe numbers right now, we're just trying to gently nudge her to keep her going in the right direction. The LC may be just fine for that purpose, but since it has been (I think) at least a half hour since the +6 test, can you get a test to see where she is now? If she's started to head upwards, we're good!

 

Again, should I offer Tbc HC?

 

Wait and see what the next number is first.

 

Try testing first. Maybe the LC was enough.

 

Gosh, Kris, we are really speaking in stereo today!!!!

 

+7 BG 100.
She leaked some from HC bowl before I saw your post

 

This is a nice number. No food and test in 30 minutes.

 

That's fine-- with all the testing she's had to put up with today, she deserves to sneak a few treats!

Good number.

 

@+7 BG 100, @ +7.5 BG 135.

 

OK, great! I think you can stop testing so frequently for a while, she is on her way up. She's doing great!

 

Well done today.... numbers are still good.....

it is possible she will go into higher numbers in response to today's green cycle..... another bounce....
have to wait and see.......
it's okay if it happens.... that is perfectly normal.....

 

Should I do next test at +9?

 

She seems always go up and up and up after AMPR +9.

 

that's normal.
Her body is not used to being in normal numbers any more.
The liver gets panicky and dumps hormones to counter and protect her.
Over time, her body will get used to being back in the blues and greens and will stop bouncing up so much.
It is a process.
Many here like the saying, It's a marathon, not a sprint.

Today was good.... and a step in the right direction. That is progress....

 

It is so extremely sad.

 

That must be what a doctor in ER called angry liver. He maid sound somehow optimistic, as if resolvable but I wasn't paying enough attention, my bad. I got it in the sencse that better angry liver than liver damage.

 

But, hopefully, temporary! The more time she spends in those normal numbers, the more used to it her body will get. If you look around at different spreadsheets, you'll see that many of the cats on the L+L forum spend most of their time in green numbers, and some of them were major bouncers when they first started!

There's so much going on right now with Ducia, one step at a time.

 

I am really struggling with the entire concept of how bodies react to low/high BG, low insulin, insulin overdose, etc.
Why oh why was I skipping those science classes .
Can you recommend what to read as to get an idea how cycles work, how to interpret BG numbers?

 

I took a lot of science classes, and I sure didn't learn all of this stuff there!!!!

A good place to start is the "New to the Group" sticky at the top of the Lantus forum page. There's not only a lot of information on that page itself, but it has a ton of links (blue text, like what I did above) to other helpful pages and discussions.

Really, though, a lot of it is just experience and repetition-- there is sooooo much to learn, no one can get it all immediately, and you and Ducia definitely had a crash course right at the beginning, which didn't help!

 

+9 BG 306, 3 hours after 1/4 of 5.5 can LC and minimal HC licking

 

Tanya, I just got home from work and have to run to a meeting, so I just scanned your condo real quick and took a gander at your spreadsheet.
Those numbers are healing numbers and so much better for her ketone problem. I am so happy that her ketones are trace. Keep up the good work!
I know it's scary. Been there. Good Job!

 

@Nan & Amber and @Kris & Teasel and @Tanya and Ducia , you all did awesome today. So sorry I had to sign off and go to bed. Dulcia is looking good and good job keeping her surfing.

 

Tanya, my Squallie spends most of his time now in green (low) numbers, but if you go back and look at his spreadsheets from 2015 and parts of 2016 you will see he spent a whole lot of time in higher numbers!

 

She's already bouncing from the lows of earlier today.

 

Wow! I can see a lot was going on with him.
I have some questions about it. Might I sent you a pm later on today or tomorrow?

 

Thank you!

 

One interesting Sticky Note is the What is the Insulin Depot? Lantus (and Levemir) insulin are both depot insulins and you can get odd results if you skip doses or change the dose, both of which you've done in the last while. Not blaming you, just explaining that it can cause odd results.

And by feeding her all that high carb food today, you probably shortened the insulin duration for this cycle, which will also contribute to the numbers zooming up. That's OK, you will eventually learn by studying her patterns, what food you need when. Today it was important to keep her safe. Most people only give high carb food if their cat goes below 50, though it's often used if kitty is diving fast at the beginning of the cycle, like Ducia was today. After the initial high carb, you might have been able to just give low carb. But take good notes on how much of what you fed and when. This knowledge will help you in the future. Each kitty varies in how carb sensitive they are, so you have to learn what works for Ducia.

And don't worry about her body not being used to normal numbers. That is extremely common for newly diabetic cats. Neko took 4 months on insulin before she first saw green. Squallie's numbers at the beginning looked way better than Neko's but over time I too got her to spend most of her time in blue and green.

 

Sure can!

 

Hello everyone,
Before it gets too late on the East Coast and other places I wanted to thank you all for the help and support!
Ducia and I would not go thru this morning without you.
Thank you all so very much!
This message board is God sent.

 

We're glad to help, Tanya. I'm glad to see that you reduced the dose to 0.75 u tonight.

 

Hi Tanya,
I see that you had some bouncing and a little bit of blue last night. Trace ketones are good. Keep aiming for "negative" ketones. You're doing all the right things. As I said yesterday, I'm glad you lowered the dose to 0.75 u.

 

Hi Chris,

Thank you!

I too am glad to use the lower dose as it decreases the hypo threat at least in my mind. I am too ignorant on the matter of FD, and do feel as if navigating in uncharted waters when dosage and jumping BGs are involved and the memory of symptoms of hypo are still vivid. I worried that my fear might have played some role when we were deciding whether to decrease or not. I know that high Bgs are bad for Ducia’s DKA and the sooner we bring in down to good # and keep them there the better. That’s why I was glad to hear you would do the same.

We’ve seen some disgusting bouncing yesterday. If you take a look at her SS you’ll see that she went up from BG 135 @+7 to BG 423 @+11. We looked at her SS and wondered what was going on. My husband although a human med has no real diabetes knowledge, never dealt with it practically. It’s like having a problem to fix but the manual instruction as to how to fix it is written in Chinese Mandarin language.

Another thing is today’s AMPSof BG 333 + regular size watered LC meal = BG 402 @ +2. I don’t know if the dose was too small or it hasn’t taken any effect yet or if yesterday’s HC still in her system. Though to be ignorant.

 

This bouncing is to be expected after the lows yesterday. Just keep on with this dose and all the other things you're doing.

 

Hi Kris,
I am glad you are here! Ducia has vomited a little , about 4 hours after her last meal.
It is about her reg feeding time but am holding on on food and water.
The vomit stopped after 2 short bouts. She seems all right but sleepy. Usually by now she is alert, sociable and asks for food.
I know vomiting is connected to DKA. Should I worry?
We have Cerenica anti-nausea med but we never gave it to her because there was no reason to. It's the first time.
She is fitted with E-tube.
What do you think?

 

I would try offering some food and water before getting worried. There are some classic signs of nausea, such as starting to eat then turning away, that might indicate the need for Cerenia. It's good that you just got a "trace" ketones readings-- there is a delay before developing ketones show up in urine, so it's still possible that she's going back to that, but let's not worry about that just yet.

Has she eaten anything new today?

[I apologize that I probably won't be on long enough to see replies-- I am at work right now and have a meeting coming up in a few minutes, but I will check back when I can, and I'm sure Kris or someone else will also be here]

 

Thank you for reply Nan,
no, she ate her reg Friskie Classic Pate.
Whatever got out of her looks like yesterday HC meal

 

Sometimes HC food upsets some kitties bellies. As long as she is eating well for you , I wouldn't worry about it. If you haven't all ready today, get a ketone test

 

I have, @+3 ketones were at Trace level

 

Very nice green today.

 

Ok, about the vomit - probably fauls alarm. Dr. Google said it might be the fresh grass that she chewed on yesterday and this morning. Grass removed.
She finished reg food about 15 min ago, no signs of nausea (knock, knock n the wood).
We have Cerenia if need be.

 

I wish you a quiet day with Ducia today, Tanya.

 

Good to know. I wish it upset her much earlier as it was her fav for some years and Id discontinued it earlier maybe now she wouldn't have all these problems

 

Thank you. We haven't seen a dull moment here lately.

 

Hindsight is always 20/20 vision. We can all say the same.

 

Quick break in the meeting -- glad to hear that the vomiting was just temporary!

If you haven't already, I'd give a little LC snack after the 96 at +5, just because it was a big drop from 306 at +3.

 

LOL

 

She ate her reg meal right after. I am going to test her in 5 min it's her +6

 

Ducia just shown @+6 BG 65 twice, I retested immediately.

 

Offer her a few teaspoons of LC and retest in 30. It's still a safe number and it's later in the cycle so this could be her nadir. But , let's not assume that she won't go any lower and play it safe with a little food.

 

We normally start one thread per day. This one is getting too long. If you want eyes on today's action, I would start a new post.

 

I just peeked at your SS glad to see her holding.

 

Wendy,
I just did. Here is the new link:

http://www.felinediabetes.com/FDMB/...s-333-2-402-3-306-5-96-6-65-6-5-75.174515/ETA

 

Thank you. I posted New Thread as this one is too long.

http://www.felinediabetes.com/FDMB/threads/3-8-ducia-amps-333-2-402-3-306-5-96-6-65-6-5-75.174515/