New Here - It's Official :(

Discussion in 'Feline Health - (The Main Forum)' started by KarensPoe, May 21, 2013.

  1. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Looks like that prior reading was correct. I would give him a rest for a few hours or maybe even wait to see where he is tomorrow morning.
     
  2. KarensPoe

    KarensPoe Member

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    May 21, 2013
    ok I took the food bowl up..there was a bit left...but hes really not interested and to be sure I picked it up
     
  3. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Why take the food away?
     
  4. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Wont that make it go up?
     
  5. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    You are feedin a low carb canned right? What type/brand?

    If his pancreas is working, it will kick in and the blood sugar drops after a meal.

    How do you normally feed ie before diagnosis?

    Wendy
     
  6. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Its the friskies special diet...one tht was recommended...I had fed him 1/2 of the can around 4:15 after I tested this afternoon...about an hour earlier than normal.

    There isnt much left..maybe a couple of tblspns

    I always feed before I dose...within 15 minutes..

    Hes been grazing since about then
     
  7. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    What flavours? Most are ok except the sliced chicken in gravy..

    I would feed him on his normal schedule. If you don't he will get hungry and eat more at the next meal which will also spike his blood. Personally I prefer to give mini meals through the day to try and keep the blood levels more stable..
     
  8. KarensPoe

    KarensPoe Member

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    This is the pate...Friskies Special Diet Turkey & Giblet Dinner, Classic Pate

    He's been eating like mini meals really. I'll put out 1/2 a can...based on how I did it before...but he wont eat it all at once...he eats it over several hours.
     
  9. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok that's perfect.

    Anyway let's see how it goes for now, maybe if he keeps going up on monday you restart the lantus but at only 0.5units or even 0.25.

    Wendy
     
  10. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Thats pretty much what the vet said...if he goes to 350 to dose him, but I'll still test him a few times during the day..just in case

    Thanks
     
  11. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Just did AMBG and came in at 361. Feeding him now...I know I have to dose...vet said if over 350 I should give 1 unit.

    Gave him 1 unit after he finished.
     
  12. BJM

    BJM Well-Known Member

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    Do you have syringes with half unit markings? Those are quite helpful with Lantus when you're getting into low doses.
     
  13. KarensPoe

    KarensPoe Member

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    May 21, 2013
    No, I'd have to eyeball it...its sooo tiny lol but I think I can. Just going to test him throughout the day...and see how its going. Tomorrow vet wants me to do a curve for her
     
  14. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Keep a close eye on him today, I am worried that 1unit is too much.
     
  15. KarensPoe

    KarensPoe Member

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    May 21, 2013
    What should I be watching for? and how often should I test?
     
  16. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    By "watch" I mean "test" ;)

    So I would test at +3 to start and depending where he is ,get more tests in.

    For example at +3, if he is high yellow or pink I would wait 2-3 hours before another test.
    But if he is low yellow, blue or green I would test hourly until you see two readings increasing in a row.

    Trying to see how low he goes. i will be around though and can guide you depending on his readings.

    Wendy
     
  17. KarensPoe

    KarensPoe Member

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    May 21, 2013
    ok +3 is now will be right back.....test is 324
     
  18. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok cool - he is slowly coming down. I would get another test in a couple of hours. Also it might take a few doses of this to see any effect... like last time you didnt see the effect and greens for a couple of cycles because of the way Lantus slowly builds up in the cats system.
     
  19. KarensPoe

    KarensPoe Member

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    May 21, 2013
    So is the possibility of him dropping too fast not a possibility anymore? I'm guessing I'm still in the "regulating" stage since I just started him on Lantus Wed night...so that puts us just past the 3 days...and we even skipped a few doses

    I have to run to the store...will be back in about an hour...his next test is at 11:55 am CST...will update then

    Thanks
     
  20. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    He could but looking at these numbers it seems unlikely.

    So what happens is that when you give Lantus it slowly builds up in the cats system over a few days like in a sort of "Depot".So you dont really see the true impact of a dose immediately. If you skip a dose then you drain the depot a bit. So in order to know how a dose is working you need to give it consistently, every 12 hours, for a few days... unless the cat drops low (under 50) in which case you drop the dose by 1/4unit.

    For example on the 24th morning and night you gave 1 unit. The depot started to build up with each of those doses, so much that the morning of the 25th he was green and you had to skip. And the depot wasnt even properly full to match the 1 unit dose. This tells me that there is a good chance that 1unit is too much.

    We need to find a dose you can give every 12hours to keep the blood in a better range.
     
  21. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I'm starting to understand...will test again in about 15 min and post.

    Test 11:55 am is 227. which is +5...and he's wanting to eat ugh...maybe a tspn or 2?
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    A mini meal would not hurt him.
     
  23. KarensPoe

    KarensPoe Member

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    May 21, 2013
    ok great..thank you...when should I do the next test?
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Are you willing and around to do a +7? This might give us a better idea of Nadir, since you have a +5 already. Most cats nadir around +5 to +7.
     
  25. KarensPoe

    KarensPoe Member

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    May 21, 2013
    yes...I can do a +7 will post then
     
  26. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Would you be willing to add a location to your user control panel, profile, edit profile, location field? This would give us some better idea of what your time zone is and when the +7 will occur.

    What time will that be by the way? :D
     
  27. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Just did the +7, which is 1:55 pm my local time, Chicago, IL, and it came back at 165
     
  28. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Ok he bounced from the low numbers yesterday. he probably will continue to drop. Keep watching. You may have a low PMPS too

    Wendy
     
  29. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Definition of a bounce:

    When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce".

    Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers.
     
  30. KarensPoe

    KarensPoe Member

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    May 21, 2013
    so can I now do the PMBG test as usual and then feed and dose if necessary?
     
  31. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes, I think a next test at PMPS is the next test you need to do.

    Let's make sure the PMPS is over 200 before you give any insulin, ok? If it is not >200, then please delay feeding, delay giving insulin, test again in 30 minutes and post here for advice. This is called 'stalling'. You can mention that in your post tonight if necessary.
     
  32. KarensPoe

    KarensPoe Member

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    May 21, 2013
    ok PMPS is less than 2 hours...about an hour and 1/2...so I'll post then...

    Thanks
     
  33. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Remember, no food 2 hours before that PMPS.
     
  34. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Its actually going to be longer because I slept in this morning...he didnt get his AM test til 6:45...so it will be the same tonight...in case I have to dose him...so less than 2 hours from now
     
  35. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Tested early..about 30 min...came in at 130
     
  36. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Where are you now? +8?
     
  37. KarensPoe

    KarensPoe Member

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    May 21, 2013
    about +11.5 from AMPS
     
  38. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    ok so he hasnt eaten for 1.5 hours right?

    The issue now is that he isnt likely going to be high enough for you to shoot. This tells me the 1 unit is too much. So likely you will be skipping again. I would like you to start tomorrow with 1/2unit. Which is what we said before... but I know its hard to trust an unknown person on the web compared to your vet ;)

    But whatever you do -whether you trust me or not - dont shoot under 200 you dont know how Poe is going to behave and could be setting him up for a hypo.

    Wendy
     
  39. KarensPoe

    KarensPoe Member

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    May 21, 2013
    its been longer than 2.5 hours since hes eaten...and I wouldn't dose unless he was over 350, so below 200 and not dosing is not an issue.

    My vet wants me to do a curve tomorrow...will that make any difference in the curve? is decreasing it safe? Can I feed him now? or Stall?
     
  40. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Wait till the PMPS just to see what he is doing. Then you can feed him because you arent planning to shoot under 350 anyway.

    Tomorrows curve.. are you planning on 1 unit again?

    The problem with the curve is that the vet isnt seeing the whole picture here. Lantus is supposed to be dosed twice a day and the 1 unit dose is just too high for that. the dose is causing Poe to go low and making you skip....and then because you skip, he is going too high!. The too high is damaging his pancreas and over time will make remission less likely. Somehow you need to communicate that to your vet. The fact the vet supports home testing is a good sign so I am hoping he is open to discussion.

    I want the best chance at remission for Poe and I think he has an a good chance at that (with proper dosing its a 40% chance) so we dont want to mess around here. The window for remission is very short and then you end up with a diabetic cat for life.


    Wendy
     
  41. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I did the PMPS test about 30 min earlier than the time i should have...so that is the number for it..the 130. I put that number in the PMPS column. I can see how his numbers are jumping and how I have to skip a dose...and since tomorrow is a holiday here I have no way to contact my vet. So Ima give him the .50 dose and do the curve...and I'll tell her...I talked to her on Friday...she was the one telling me to not dose below 350.

    we are now at almost 30 min past the test...and I know hes hungry lol its really late for him..and since I'm not dosing, I will be starting tomorrow earlier like I was before.
     
  42. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    ok cool so feed and skip the shot.

    Tomorrow morning lets curve on 0.5IU. Now of course the depot isnt full so Lantus hasnt had a chance to build up in his system to its correct level so he may sit too high for a day or two but at least hopefully you will be able to shoot twice a day!

    Wendy
     
  43. KarensPoe

    KarensPoe Member

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    May 21, 2013
    ok and thank you...I will be up and early tomorrow to start the day and post again with numbers and info.

    :)
     
  44. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Maybe get a +2 or +3 tonite too, more data is always good. lets see where he goes from here.

    I am excited to see how the new dose works tomorrow!! :razz:
     
  45. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Which one is better? +2 or +3? I can do either one
     
  46. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I would do a +2, and only because you dont have one yet for that time. Am trying to see if he continues to drop or goes back up. he probably will drop a little longer and then shoot up to a nice :( pink for tomorrow morning.

    Wendy
     
  47. KarensPoe

    KarensPoe Member

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    May 21, 2013
    PMBG +2 is at 127...he didnt eat much dinner but is eating now again..this is really tough. I thought for sure he'd be hungry right after the PMBG...
     
  48. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    The lantus is hanging around a bit longer than the 12 hours. It can stay for 15-18 hours before it wears off entirely and he starts to go up. Also his pancreas may be working a little.
     
  49. KarensPoe

    KarensPoe Member

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    May 21, 2013
    His appetite fluctuation is making it hard too. I'm afraid to dose him when I need to if he dont eat enough.

    But he's playful and happy...and I'm looking forward to see how he does on 1/2 the original dose.
     
  50. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
    For his appetite, are you worried he's not eating enough throughout the day/night? If so, then yes, you want to see him eat with his shot time to make sure he doesn't drop too fast. But, if he's eating enough, with Lantus it's more important to eat around nadir/+5-7 hours after shot time than it is to eat at actual shot time.

    For me, once I figured out how much on average Michelangelo needed to eat each day, I no longer worried about him eating at shot time. Both of my boys (8 months and 1 year and a month old) eat about 2 cans of Friskies one day and 5 cans the next and other variations. It all equals out to about 4 cans a day over the span of a week. So as long as I see him consuming "enough," I'm not too worried if his appetite fluctuates from day to day.
     
  51. KarensPoe

    KarensPoe Member

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    May 21, 2013
    I just did his AMPS...its 87. I did it twice...the first one came at 79 which I thought for sure was wrong...so I got a new strip and did again...and its 87..he kinda jerked when I poked him the second time and so it bled kinda heavy, if that matters. Being half asleep does not help.

    He finished his dinner sometime during the night...but I know I can't dose him. I'm going to feed him...does the amount matter?

    I'm not worried that he's not getting enough...he finishes what I give him...I guess I was just used to him eating everything in sight at one time and now he just takes his time and eats over the span of hours.

    I just fed him about 1/4 can of the Friskies Special Diet. Don't think I'll be doing the curve today.
     
  52. Simon'sMommy

    Simon'sMommy Well-Known Member

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    May 10, 2013
    Hi. I am really new, but that is a nice AMPS number and it seems like your kitty's pancreas is starting to work on its own a bit. I know you are not giving Poe a shot with that low a number, but getting another test in to see if he is rising is probably a good idea since it is under 100 and he has not had insulin in a good while.

    As for feeding and the amount, I don't think that matters as long as he eats. I am sure that someone with more experience will be around soon, but in the mean time, I would retest since it has been an hour since you posted the under 100 BG number. Can you retest and post the number?
     
  53. KarensPoe

    KarensPoe Member

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    May 21, 2013
    AMPS +1 is 98
     
  54. Simon'sMommy

    Simon'sMommy Well-Known Member

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    May 10, 2013
    Seems good that his number is coming up a bit yet is still in a somewhat normal area without insulin. If this keeps up, your baby may be going into remission on his own. I am too new to say anything about that, but if he has not had any insulin in that many hours and he ate something and it is till under 100 in green territory, he is making some insulin on his own or he had enough in him from your previous shot to last a long time.

    I am not familiar with any insulin except ProZinc which does not build up like Lantus and Levemir, so I don't really know how that works. Just want you to know that someone is here with you in case you need me. I will try to help the best I can.

    Is Poe eating this morning? You should probably get another test in another hour or so to see if his BG is rising or falling again. Someone else will be here by then to guide you I anticipate. If you just need to talk though, I am here!
     
  55. Simon'sMommy

    Simon'sMommy Well-Known Member

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    May 10, 2013
    Also, can I suggest that you start a brand new thread with the 911 symbol in the corner? That way, when a more experienced member comes on, they will know that someone needs them. They might not see it if they have to come to page 4. Just post what you wrote about the AMPS (copy and paste if you want to) and then his +1 reading and what he had to eat. Ok? Can you do that?
     
  56. KarensPoe

    KarensPoe Member

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    May 21, 2013
    hi :)

    Thanks for your support...he eats kinda slow...although he's probably eaten half the amount I've given him in the last hour or so. No shot for him this morning...I'm running low on strips and it's only 6:44 am here and I will need to get to the store...so I think I'll do another in 2 hours instead of one, unless I'm told its necessary. His poor ears...although he never complains..

    I am so happy that his numbers are this good. He hasn't even been on the insulin for a week yet, and I've skipped quite a few doses already.

    Thank you again for being here with me...I'm still trying to absorb all this although I'm getting a better understanding with every test.
     
  57. KarensPoe

    KarensPoe Member

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    May 21, 2013
    Started a new thread

    Thanks again
     

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