8/28 Saoirse AMPS 9.4, +4 8.1, +10.5 9.2, PMPS 8.1

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EDIT - STARTS WITH LAST NIGHT'S CONDO (Getting used to posting conventions. )
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Hi all,

Saoirse's PMPS BG is unexpectedly very low this evening. (BG measured on ALPHATRAK.)

Saoirse has pancreatitis alongside the diabetes and had a bout of diarrhoea yesterday which her Pro-Kolin seems to have stopped.

She was high yesterday - possibly due to vet trip. Yesterday evening she stayed flat between PMPS and PM+5, and this morning she went back into mmol double figures for the first time in days. I didn't think that I had mucked up last night's PMS at the time (she did her usual grumble), but her flat levels and this morning's higher number made me think I might have done it wrong.

Tonight she's much lower. When measuring this morning's 0.5 IU dose I could just see the bare edge of the graduation mark on the syringe barely peeping over the plunger and I'm a bit cack-handed at making tiny, tiny adjustments with the syringe and it wasn't significantly over the 0.5 IU so I left it as was.

The only other change is that she didn't eat as much as usual overnight last night or today. Could that be the reason why her numbers are so low today? Or could it be something else? I'd be grateful if someone could look at her numbers and let me know what you think.

I haven't given tonight's dose yet. I'm not able to stay awake to monitor Saoirse. I'm confused. confused_cat

Edited to add:

Saoirse had a dose of famotidine (Pepcid) today for the first time in a few weeks(after the AM+5 test). On one occasion during the period when her insulin treatment was interrupted (numbers too low for Caninsulin) her BG dropped lower after a dose of famotidine. Has anyone else had that happen?

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Update:

BG 7.3 / 131 at 1½ hours after normal dose time (Alphatrak). This was after two mini meals (8g chicken + broth for each).

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Hello.
It looks to me as Saoirse is doing pretty well.... nice blues and greens.
I can understand your worrying if you can't monitor at night.

a lot of us put a little f for fat dose and a little s for a skinny dose.... to let others and yourself know when you tweak the dose a bit.


So have you shot?

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

She seems to be coming up now. If you can change your shot schedule tomorrow to be 12 hours from now, and you can monitor and have plenty of strips and HC just in case, I'd shoot the .5U. We give reductions on the Alphatrak if kitty goes below 68/3.8.

Eta: I noticed you can't monitor, in that case I'd skip tonight, especially if she's not eating well. Lack of food can lower numbers.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Thanks for the replies, Rhiannon and Wendy. I'm struggling a bit at the moment with getting used to the Lantus, especially since Saoirse's pancreatitis got worse after she had to stop Caninsulin treatment for safety reasons at the end of July. (I'm working on getting a profile done for her.)


Thanks for the tip about spreadsheeat/dose annotations. I've been trying to use the "<" and ">" to indicate this in Saoirse's spreadsheet.

Wendy&Neko said:

Lack of food can lower numbers.

Click to expand...

Thanks for confirming this. I've got so much to learn before I can understand what Saoirse's numbers are telling me.

rhiannon and shadow said:

It looks to me as Saoirse is doing pretty well.... nice blues and greens.

Click to expand...

Thanks for the reassurance. I badly need it right now. It was awful seeing her numbers go back up again after her pancreatitis flared up when her insulin therapy was interrupted, especially as she had done the switch to low carb wet food.

rhiannon and shadow said:

I can understand your worrying if you can't monitor at night.

Click to expand...

It's a huge issue for me. I have disabling PTSD and it wreaks utter havoc on sleep. My mind and body need to get completely shattered before I can pass out. Trouble is when I'm that fatigued the alarm clock doesn't wake me. To get the night-time numbers for Saoirse I have to stay awake the whole night or I can't guarantee being awake in time for her morning dose. Low numbers at PMPS really present a tremendous challenge. I live alone so there's no-one to watch over Saoirse while I am asleep. My heart is in my mouth most of the time when I give Saoirse her evening dose and I invariably breathe a huge sigh of relief each morning when I know that she's OK.

rhiannon and shadow said:

So have you shot?

Click to expand...

I measured out a dose less than 0.25 IU and I gave it to her at normal PMS time +2. Trouble is I think I may have mucked up the injection because I was so nervous. I'm trying very hard not to miss any doses, especially as her pancreas is inflamed at the moment.

Do things get better when you have more data?

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

You have a lot on your plate.. I was relieved very morning that punkin was alive. If you don't have a timed feeder that would be a huge relief to you. If a cat gets low we give food, so if you provide food every night that's a little bit of insurance. If she will graze you can just leave canned low carb food out for her every night.

Yes. It does get easier as you learn more.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Hi Julie,

Saoirse's always been a natural grazer and the only time she has ever overeaten was when the polyphagia kicked in prior to her diagnosis. Were it not for the pancreatitis flare-up it would have been ideal to leave the low carb out for her to help herself, but since her pancreas acted up I have to feed her tiny meals about once an hour. I bought several timed feeders the week before last so now I can provide Saoirse with eight (count 'em and weep) scheduled feeds. You're right about what a relief they are to have. I don't know what I'd do without them. I sometimes use them during the daytime when I feel the exhaustion might catch me unawares. My only worry is that her appetite will peter out during the night. The cyproheptadine helps with that, but she does have hiccups (left 4 meals untouched last night). In addition to the worry over how she will be at lower numbers on the longer-acting insulin If she doesn't eat enough, there's the worry over her vomiting if she fasts for too long (excess stomach acid).

Whatever about the challenge for me as her person, I hate seeing anything wrong with my girl. I want to do all I can to make her better. That's why I'm so keen to get a handle on the night-time dosing so as not to disrupt her treatment.

Thank you for the reassurance that things will get better as I learn more. Right now I really do feel out of my depth most of the time.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Despite my worries earlier, it appears that the small dose of Lantus I gave Saoirse was injected correctly.

Saoirse's numbers are really tumbling. I don't know what's going on. She has been eating all of her scheduled feeds since early evening along with a little bit extra.

Here are her day's numbers (ALPHATRAK):

AMPS 10.9

DOSE: LANTUS 0.5 (slightly fat dose - not intentional).

AMPS 10.9 / 196
AM+5 7.7 / 139

Appetite slow in early part of AM cycle but picked up in later part. Ate regularly from AM+9 onwards.

PMPS 6.4 / 115 - Normal dose time - withheld dose because of low number - fed 3 mini meals.

Tested at normal PMS +1.5 - 7.3 / 131
Very skinny dose of 0.25 IU Lantus at normal PMS+1.75

Tested at normal PMS +5.25 - 5.7 / 103 <<< +3.5 after actual dose time.

(Saoirse's spreadsheet is colour-coded for Alphatrak.)

Saoirse has only been on Lantus for 1½ weeks so I don't have much data to go on. I don't understand why her numbers are tumbling like this. Is it her pancreas kicking in?

She has eaten on her normal schedule all through the early part of the PM cycle. I've just fed her two extra meals. I'm worried because she might not actually be at nadir yet. Could I be looking at a potential hypo? Help!

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

The number on the AT you are looking for is 68. She is still safe there, but at that point you want to give her 1 teaspoon of gravy from high carb cat food or a couple of drops of karo, honey or maple syrup. Then post here for help. I can't stay with you right now.

Right now give 1-2 teaspoons of regular low carb food to help her stay up.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Thanks so much for replying, Julie. That's 3.8 in mmol/L. She was down that low a couple of times on Caninsulin.

Thanks for the advice on when and what to feed. I have her hypo kit on standby.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

How are you doing? If you haven't retested, you should. There are directions on handling low numbers , less than 68 AT, on the yellow starred sticky at the top of this tight reg forum that'ss called shooting and handling low numbers. Its divided in 3sections and what you want is the one on Handling low numbers.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Hi Julie,

Thanks for checking in on us. I've just retested and Saoirse is back up to 7.4 / 133. That's at delayed dose time +6 (normal time +8 on spreadsheet).

I'm in a bit of a state because I'm so shattered I'm about to pass out (no hyperbole here). I want to stay awake but my body is refusing. My stomach's in knots that I can't stay awake. I'm going to set an alarm to wake me in an hour but I strongly doubt it will work. This is frightening. I wish I was stronger. I feel I'm failing my girl. I wish I had more data on how she responds to Lantus. If it was Caninsulin I'd know that she was OK on this number and at this point in the cycle.

The only thing I can think to do is leave extra food out alongside the timed feeders and let her help herself. Would that be the best thing to do?

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Hi there

Are you two alright?

With a 115 at +6 and food left out you can relax.

it looks like the change to Lantus is agreeing with her ;-)
Going down the dosing ladder, which Saoirse may be doing, often can be a frightening and emotional time.

You are plenty strong and are not failing your girl.
Try and get some rest. It's all good

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

Hi Julie and Sandy,

Sorry for taking so long to update this thread. Last night was tough.

As I suspected, the alarm didn't wake me. Saoirse wasn't in her usual spot when I awoke this morning and it put the heart crossways in me, but thankfully she was fine. Her digestive system's nagging at her today after the exra food, but the most important thing is she's hear to tell the tale.

Last night was really frightening: I could not will myself to stay awake. I felt like I was abandoning my precious girl. Thank you both for help getting through it and for your encouragement. It means so much. I get panicky as it is, but I would be utterly demented by now if it wasn't for the wonderful people here at FDMB.

Re: 8/27 Saoirse AMPS 10.9/196, PMPS 6.4/115 - Tonight's Dos

I'm sorry i couldn't stay with you last night - i had company that arrived as I was responding to your 911.

yay for the timed feeder - that's great you have 2 of them! hahahaha i thought about getting a second one at one point, but mostly we were ok without them.

With 8 compartments available, that means you can think ahead to when she might go low (midcycle) and put higher carb food in there if you anticipate needing it.

Just a housekeeping note - we do start a new thread (condo) each day so that they don't get too long and information doesn't get missed. Otherwise they get too cumbersome. Starting a new one each day instead of bumping up old ones also keeps everyone on the front page who has posted that day. I'm not reprimanding you or anything, just letting you know for tomorrow.

For today, I think I'd update your subject line from the first post and just put in today's info, then use this condo today and start a new one tomorrow.

My foster daughter has PTSD - it's difficult to manage. We'll help you help Saoirse as best as we can! There are other members who have medical conditions as well that make them unable to test at night. Getting tests during the day and whatever you can in the night cycle, even a +1, 2 or +10, +11, all helps us see what might be happening at night.

I'm glad you've got the feeders to help. Saoirse is doing very well on a tiny dose - so that's very good news.

Re: 8/28 Saoirse AMPS 9.4/169, +4 8.1/146, +10.5 9.2

No worries about last night, Julie. You very quickly gave me the steer I needed and it helped us enormously.

That's a great idea about adjusting the carb content of different meals during the night. I hope I can get Saoirse onto a complete food soon. I'm very worried about her having to subsist on just chicken & broth but it's all her system can tolerate at the moment. Even the extra portions she had last night were enough to cause her significant discomfort for most of the day today. :sad:

For right or wrong, I've given Saoirse only 0.25 IU this evening. I'm just keeping everything crossed that she has no surprises for me at +3. nailbite_smile I know it's not ideal in terms of keeping her 'topped up' properly, but I have to put her safety first and if I can catch up on some sleep tonight then we'll be able to get back on track tomorrow.

I'm very sorry to hear that your foster daughter has PTSD. It's an awful affliction. Even after 8 years I can't believe how badly it affects one's life and functioning. Please send her my best.

Again thank you for helping me and my beloved girl. I appreciate it so much.