10/5 Apollo PMPS 126, +4.5 54, +5 93, +6 96, +7.5 165

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Re: 10/5 Apollo AMPS 192

John - Apollo is doing so great....and you my friend are too. If I had to guess...I bet you're starting to get a hankering for his dance a bit and more comfortable in how to react!

Keep your eyes peeled - he's been amazing thus far on Lantus and doesn't seem to hold a dose for too long!
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85

Apollo's AMPS +3 is 85. Should I do anything at this point or give it more time?
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85

Hi John, that is a pretty good drop in an hour. Marje said she uses the standard of 50 points per hour which we think is a good idea. So I would feed a bit of higher carb food. I'm not sure how high and how much though for Apollo. Looking good!
Liz
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85

NICE! :-D :-D You may want to start experimenting w/ some lower carb foods to control his dips. Sometimes just a little extra LC will be enough to slow things down. This would be a good time to try as he isn't too low yet., maybe just a few % higher than he normally gets.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85

I second what Sienne said with the LC...especially considering it's an 85. For me, I want to be able to steer them just ever so much to keep them safe, but flexible enough to let his body do some of the work and to show you what that dose means to him.

He's been going down the ladder since he started on Lantus. If this dose is still too high for Apollo, not letting the numbers happen (here is where the steering comes in vs. a dive)...means you'll just be revisiting this in no time. You already know you can pull him up if need be.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85

Ok, I just fed him some LC. Basically we want to see how he does on the full dose without artificially propping him up too much unless necessary. That makes sense.

Question 1
Apollo hasn't been eating as much wet food as when we first started the conversion. He has always been a picky eater and used to grazing his whole life. He is eating maybe 1 and a half 3oz cans of food a day. Is that enough? I have been using purebites crushed on top and fortiflora sprinked on top. He does eat, but nothing close to what my other 2 cats are eating. They will eat pretty much anything though. I have given him FF Chicken and Wellness Chicken and Herring, both which he initially liked, but now seems to be eating less and less each day. Any suggestions?

Question 2
The fortiflora says 1 packet a day, so I have been giving half at AM feeding and half at PM feeding. Can I give him more or no? He seems to eat a bit more when I put more fortiflora on it. Or am I just masking an issue with the food and need to try something else?

I am getting more comfortable with everything overall, but the amount of food he is eating is starting to trouble me just a bit.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85

I'm not sure I can fully answer all of your questions but can give you some ideas about a few.

In regards to his appetite. When his blood sugar was so high, he didn't have the ability to use glucose for energy (thus why there was so much left over is his blood). This renders a cat starving all of the time. The extra glucose ends up as waste product in urine, and water follows gluclose....this is why undiagnosed and unregulated diabetic cats lose so much weight, urinate so much and are so thirsty.

The fact that you're seeing him more content in his nutrition, is a confirmation of what you're seeing on the numbers board. The glucose (with the help of insulin), is making it inside of the cell so that it can be used for energy.

You're probably going to have to try different foods, different combinations, etc. One thing to note, is that on the Janet and Binky's chart, calories are listed. Some foods have more punch in their pack, so you can feed lesser amounts still equally out higher calories. There are a lot of picky eaters on this board and I know you're going to get a lot of good tips.

I don't know off hand what Apollo weighs, but there's a general formula you can use to figure out how many calories he should be getting. I just searched for it and couldn't find it, but off hand, you can figure around 30 kcal/day/lb. I'm sure someone will be along to give you the exact formula!
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

Apollo's AMPS +4 is 57. Going to give some HC now.

Jessica & Boo Radley said:
I don't know off hand what Apollo weighs
Click to expand...

He is 12lbs and is 14 years old. He has gotten pretty skinny in backside, but that is mostly from the diabetes I would assume.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

John - I'm SO green with envy... :mrgreen: You and Apollo got this dance going SO well while we're still back here struggling to get out of either the 200's or stop the bouncing. You both give me hope!
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

Another busy day here :mrgreen:

here is a link to a visual that can help you determine appropriate size/weight:
http://www.placervillevet.com/feline body condition.htm

FWIW, BK is 11 poundns and change. He eats 2 3oz cans FF per day. He is around 8 yrs old (former stray). One of our civies, Samantha is approx. 13 yrs old and also eats 2 3oz cans per day, and god knows what else since she is indoor/outdoor and a notorious dumpster diver (only 1 tooth though). She is in good health and wieghs 7 lbs and change (she is a peanut - very petite bone structure). ECID.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

Ok will test shortly. Brb.

Btw added a tiny drop of karo to his HC. I know I shouldn't have, but I couldn't help myself I just get so nervous when he is down so low. Especially when he is such a picky eater as it is, it's like my 1 big chance to get him up since it's hit or miss if he is actually willing to eat it.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

Hi guys .. LOVE apollo's numbers! He is doing so well, and you are too .. I know it can be nerve wracking seeing our kitties in the lower number range the first few times, but you are handling it like a pro, well done! Have a great day!
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57, +4.5 77

Apollo's AMPS +4.5 is 77. Yeah I panicked when I probably didn't need to. Oh well learning more each day. :smile:
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57, +4.5 77

I have been intending to tell you - try a can of dog food with gravy. Our cats absolutely LOVE the gravy from either the Alpo's (w/gravy, NOT 'savory juices') or MightyDog, especially the chicken. KT can't have it unless he's getting low. It has more 'smell', Apollo might like it.
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

John & Apollo said:
Ok will test shortly. Brb.

Btw added a tiny drop of karo to his HC. I know I shouldn't have, but I couldn't help myself I just get so nervous when he is down so low. Especially when he is such a picky eater as it is, it's like my 1 big chance to get him up since it's hit or miss if he is actually willing to eat it.
Click to expand...

Ultimately John, you have to be comfortable with what you're doing, and that is MOST important.

I just want you to mull this over....

  • If Apollo could surf in the 50's or 60's (or 70's or 80's or 90's for that matter) all day, it's a very healing and natural place to be. His body is trying to learn how to do that again and you're the teacher helping him by feeding a little here, giving a little insulin there...etc. The more steady he becomes and the more he becomes used to balancing, the better off both of you will be.
    At +4 @ 57....you were in a safe zone - a watch zone, but definitely still safe. He was already beginning to slow down a bit in his numbers, probably due to your feeding. Granted, he was still dropping, so you would want to continue to try to slow it (LC, maybe a hair of MC) without putting it to a screeching halt (karo and too much HC). This is why......

    If he was going to continue to slide down...it would mean he earned another reduction because his body is telling you he's getting too much and he's not able to help you to regulate it. By feeding the karo....we may not know what his body was going to tell you...which means you will be giving the same dose tonight....which means you could be in the same boat.

You should hang up a sign for your self that says "I KNOW HOW TO HANDLE LOW NUMBERS". You've brought him up multiple times brilliantly. If you ever run into a situation where he just won't eat, you can always rub on their gums (buccal absorption is very good), or worse case....rectal absorption works too (too much time in nursing ;-) ;-) ;-) .....). You have very good options if push comes to shove..
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57, +4.5 77

Zener has had trouble eating enough too. One thing that helped was we open a new can of food when he gets his shot (and throw away old stuff - ouch). A new can is always appealing and shot time is when he really needs to eat. Then for later feedings, we add Fortiflora if he's not so keen to eat. Zener is eating 2+ 3 oz cans per day and has just now started maintaining his weight. We have another cat who will not eat anything the same as Zener. She likes Parmesan cheese and another flavor of food.

The other thing that really helped was 1/4 tablet of 10 mg pepcid ac. Apparently Zener's tummy was a little upset. He had some belches that were loud and he would go up to the food bowl, lick a little and walk away. We've dosed him maybe 2 times in the last week and he is eating really well now. Previously we had given him an appetite stimulant (cypro-something) that seemed to work temporarily. Now we are wondering if it was really an upset tummy and we gave him an appetite stimulant. :roll:

Liz
 
Re: 10/5 Apollo AMPS 192, +2 132, +3 85, +4 57

Jessica & Boo Radley said:
I just want you to mull this over....

  • If Apollo could surf in the 50's or 60's (or 70's or 80's or 90's for that matter) all day, it's a very healing and natural place to be. His body is trying to learn how to do that again and you're the teacher helping him by feeding a little here, giving a little insulin there...etc. The more steady he becomes and the more he becomes used to balancing, the better off both of you will be.
    At +4 @ 57....you were in a safe zone - a watch zone, but definitely still safe. He was already beginning to slow down a bit in his numbers, probably due to your feeding. Granted, he was still dropping, so you would want to continue to try to slow it (LC, maybe a hair of MC) without putting it to a screeching halt (karo and too much HC). This is why......

    If he was going to continue to slide down...it would mean he earned another reduction because his body is telling you he's getting too much and he's not able to help you to regulate it. By feeding the karo....we may not know what his body was going to tell you...which means you will be giving the same dose tonight....which means you could be in the same boat.

You should hang up a sign for your self that says "I KNOW HOW TO HANDLE LOW NUMBERS". You've brought him up multiple times brilliantly. If you ever run into a situation where he just won't eat, you can always rub on their gums (buccal absorption is very good), or worse case....rectal absorption works too (too much time in nursing ;-) ;-) ;-) .....). You have very good options if push comes to shove..
Click to expand...

Well said Jessica. I know you are completely right.
 
Re: 10/5 Apollo AMPS 192, +3 85, +4 57, +4.5 77, +5.5 89

Apollo's AMPS +5.5 is 89.

Btw when I went looking for Apollo to test I found him playing/wrestling with my other cat. They used to do they all the time, but it's been several months since I have seen him do that. Looks like someone is feeling better. Cool! :-D
 
Re: 10/5 Apollo AMPS 192, +3 85, +4 57, +4.5 77, +5.5 89

One more thing. I am putting together a hard copy of a bunch of stickies from the forum to take to my vet along with a copy of Apollo's spreadsheet to show him how we are doing. I assume everyone has already done this, but if not it really might be helpful to spread the word about alternatives to Humulin N. My vet (still learning) said depending on how Apollo does he has 5 more cats that he treats that he would strongly consider switching to Lantus. So many vets are just not aware of Lantus (and how it works) and I want to do my part to help spread the word. If I could help 1 diabetic cat it's all worth it.

Maybe it's worth putting together a 1 document "packet" in pdf format, that you can hand to your Vet and let them learn? Maybe it has a copy of the veterinary article (to show you're not making this up), copies of most of the stickies just in nice order with a table of contents or something? I'm just thinking out loud here. Easier it is for everyone the better. Knowledge is power.

Thanks again everyone for your support.
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

Apollo's AMPS +7 is 53. Didn't see that one coming. Ok to let it ride or should I feed some LC or HC?
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

Great job today, John!!! Very nice indeed.

Anne said:

Marje said she uses the standard of 50 points per hour which we think is a good idea
Click to expand...

I don't start feeding HC if Gracie drops 50 especially if she is high...I just get extra vigilant on testing and if Gracie is mid to low blue, I might slow her down a bit with some 8% (depending on how low she is) but I don't jump into HC. In fact, I don't even use HC at all. In really really low numbers, the most I use is 13% (MC) gravy. When she gets below 50, I do use a bit of karo because Gracie is a slow responder and tends to keep dropping into the 40s/30s. ECID.

From Dr. Lisa's website, here is a way to calculate calories needed:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70
Click to expand...

"Optimal lean body weight" being what you think your cat should weigh. She says most males should fall into the 11-13 lb range (unless, of course, you have a large breed cat like a Maine Coone). Personally, I found the above to be quite liberal and when I plugged Gracie's optimal lean body weight in there, it was way too many calories for her. Weighing her every few days, she was gaining weight. So I just started cutting it back very very slowly until I got to the number of calories where she did not gain.
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

John I think he still had something to say about that potential reduction!

If your up for it, feed a bit of LC and test again in 20-30! I'm here all afternoon :-D :-D
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

Jessica & Boo Radley said:
John I think he still had something to say about that potential reduction!
Click to expand...

Yeah no kidding! :lol:

I bet if I wouldn't have been quite as aggressive earlier with trying to bring him up he would have hit a reduction number.
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

I completely agree....and am THRILLED that you said that.

The other point is....if you get really nervous during the 20 minute wait....you can always test sooner ;-) ;-)
 
Re: 10/5 Apollo AMPS 192, +3 85, +4 57, +4.5 77, +5.5 89

You are doing really well, this is a great surf.

On the Fortiflora, as an inducement to eat we just add a tiny sprinkle, but more won't hurt. The one packet a day is for when it is being used to balance the bowels. It is a probiotic that replaces the good gut bacteria. It also has "animal digest" which is what they spray on dry food to trick animals into thinking it is something they would actually want to eat. We just use it for flavor and smell enhancement.

Max's House has a great article on feline nutrition. About halfway down the page there is a chart (sorry but it doesn't copy and paste into this format well) on how much to feed. 30 kcal /lb is on the upper end for a very active cat. Older more sedentary cats should have around 20 kcal. If Apollo is 12 pounds ideal weight he should eat about 240 kcal a day, if he is under weight he may need a little more, overweight a little less. Wellness has 35 to 40 calories an ounce depending on the flavor and FF is usually around 32.

15 kcal per day is the minimum to prevent hepatic lipidosis according to DR. Lisa. She also gives a formula of (13.6 X optimal lean body weight in pounds) + 70 but this is for calculating where to start on a weight loss program.

Confused yet? @-) @-) :roll: i bet you didn't think you needed math ofr feeding your cat!
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

Wow- looks liike you've got a lot going on here with Apollo! Head spinning yet? Good looking numbers though! Keep it up!!! :lol:
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

John, something else to use as a tool as you're waiting this out:

Think about how much you fed him at the +4, specifically considering how much food it took to create that big bump up. Your job becomes figuring out the right tweak to the extra carbs....not too much, but just enough to bump him to a good number (too much doesn't allow his body to work at all in the same way too little doesn't cover what his body can't do)...that old teaching him thing again ;-) ;-) .

It takes times to figure out, but you can say for certain, that the amount you gave him at +4 bumped him up quickly and at a good hit. You know you have that in your pocket if you ever need it. Now, tweak to figure out the in-betweens....that's how you'll gain confidence and control...knowledge is power ;-)
 
Re: 10/5 Apollo AMPS 192, +4 57, +4.5 77, +5.5 89, +7 53

John, the idea about a PDF packet is fantastic!!! I totally Second...
 
Re: 10/5 Apollo AMPS 192, +4.5 77, +5.5 89, +7 53, +7.5 48

Apollo's AMPS +7.5 is 48. Just fed him some LC. He wasn't too pleased with being woken up again. :smile:

Anything else at this point? He just earned another reduction, right? Wasn't sure since he just had one last night.
 
Re: 10/5 Apollo AMPS 192, +4.5 77, +5.5 89, +7 53, +7.5 48

Read my last little bit about the balance - we probably cross posted.

You're now at a number that you want to raise just a bit. LC may has been allowing a slow drop, which is good. Now that you want a slow raise....we need to add just a bit of extra juice. This is where you can start experimenting to figure out the right amount for him!

Think about the amount of HC you gave him mixed with Karo. Try just the HC amount to see what kind of action that gets. You'll then have some pretty good reaction numbers for today (a fixed HC amount both with and without karo)!

Good question regarding the reduction.....I just asked this this morning and am going to go in and copy and paste the answer so you have too!
  • Is there a limit to the number of reductions you can take in a 24 hour period....specifically, can you take two if you drop below the reduction number on both cycles, or do you assume the second cycle was left over shed action....allowing for only one reduction per day?

    Answer
    Postby Sienne and Gabby » Wed Oct 05, 2011 9:44 am
    Generally, only one reduction since back-to-back reductions seldom hold. Usually, the second drop is as you noted -- it's due to a shed that hasn't caught up to the reduced dose.

    There are exceptions. We just ran into this with Stella yesterday. There are times when a cat has hit a breakthrough dose and may need to come down the dose ladder quickly.
    Click to expand...

So I would take the reduction...he did not drop last night, which would have been the left over shed action if you were gong to see it. OH YEAHHHH APOLLO!!!
 
Re: 10/5 Apollo AMPS 192, +4.5 77, +5.5 89, +7 53, +7.5 48

Ok just gave him some HC (no karo). He wasn't too amused with me waking him up yet again. :smile:

Will test again shortly.
 
Re: 10/5 Apollo AMPS 192, +4.5 77, +5.5 89, +7 53, +7.5 48

I'm just glad his low numbers are happening during the day time. :smile:
 
Re: 10/5 Apollo AMPS 192, +5.5 89, +7 53, +7.5 48, +8 71

That's a respectable number, still a big increase. Log in the amount you fed so that in the future, you can use it for reference if you want to move a little or a lot.

You can probably keep him surfing now with LC and just a drop or two of HC gravy on top!

Great job John!
 
Re: 10/5 Apollo AMPS 192, +7 53, +7.5 48, +8 71, +10 75

Apollo's AMPS +10 is 75. Didn't feed him anything since +7.5 48.
 
Re: 10/5 Apollo AMPS 192, +7 53, +7.5 48, +8 71, +10 75

He's surfing away.....and knowing that you're now only 2 hours away from your PMPS....feeding at this would be unadvised!

Speaking of PMPS....how are you feeling? We still don't know where he'll fall, but this was a late cycle for him, so just want you to look this over now, so it's fresh in your mind come shot time and you can make the best decision based on you, your schedule and the amount of juice left in your reserve!

DEALING WITH LOW PRESHOT NUMBERS

****The following guidelines apply to those following the Tight Regulation protocol for Lantus and Levemir****

You just tested your cat’s preshot number, and there is a much lower than usual number staring back at you. What do you do?

There is no one-size-fits all answer, but there are some general guidelines. As with everything else, each cat is different (ECID) and each caregiver is different too.

The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if the cat is less than 50 then usually the best option is to wait until they are above 50 to shoot. While you’re waiting, the shed is draining, so you want to get the insulin in as soon as it makes sense to shoot.

If it is your first time shooting green, then we will likely suggest that you stall the first time, even if the number is 80-100. That will let you collect data on what your cat will do when you stall. One thing you can do if you are having a low cycle is to get a +10 and +11. Those will give you a good idea of how quickly the cat’s numbers are rising (or not) when preshot time arrives.

Beyond the general guidelines, there are other factors we consider when we are helping someone with a low preshot.

If the low preshot is not part of that cat’s normal pattern or there is reason to think something might be wrong, we will be more conservative.
If the cat is not a food spiker or tends to have an early onset/early nadir then they may not want to shoot as low. If the cat has a late nadir, then they will HAVE to learn to shoot low.
We will also be more conservative in some cases because of the person – if you are not able to monitor then you want to be more careful, or if you are not sure that you can get back to the board to keep us updated throughout the cycle. Trust me, if you shoot low, we will be watching for your updates and we will worry if we don’t see them.
We have to be a lot more careful with the cats who eat only dry food, because they don’t have access to the tools the rest of us use to keep our cats safe.
Also, when it comes to very low preshots, there is an unwritten rule that whoever helps that person shoot low should expect to sit with them through any low parts of the cycle. There have been times when I knew a cat’s number was likely shootable, but I also knew that I could not be around to help if the shot resulted in low numbers later in the cycle. For safety’s sake, if I could not find someone else who would be available to support for the next several hours, I would most likely suggest that the shot be reduced or skipped. I will not encourage someone to shoot low and then abandon them.
There are a lot of other scenarios, and you always want to keep your cat in mind.
Click to expand...
 
Re: 10/5 Apollo AMPS 192, +7 53, +7.5 48, +8 71, +10 75

That's almost a PERFECT cycle - little high AMPS but the rest of it is just SO nice....

Wonderful job Beans!!!
 
Re: 10/5 Apollo PMPS 126

Apollo's PMPS 126. I'm torn as to what to do for tonight. I'm leaning towards skipping tonight. Here is my dilemma. Tomorrow AM I am going to have to skip his shot as I have a multi-hour appointment in the late morning, so no one will be here to check on him.
 
Re: 10/5 Apollo PMPS 126

I guess I could also stall for a few hours (give him time to rise) then give him his reduced dose tonight and skip tomorrow AM. Then back on normal dose time for tomorrow PM dose?
 
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