02/13 New here: Rupert AMPS 93

Hi, new here, so bear with me if I don't know all the protocol!

Rupert has had a couple of days with great numbers for most of the day and then spikes PMPS. Friday he was in the 80's/90s most of the day (yay!)..then I guess we hit a bit of rebound over the weekend. Yesterday he was as high as 378 and I started to wonder if the insulin was 'dead' (we've had it a month). Anyway, by evening he started to come down and was at 234 after his shot.

This morning

AMPS 93 (6:30am).

had a hard time sticking his ear today (poor cat, he truly hates me!) will have to check again, will shoot if his numbers are going up. I have to go to work though but will be back at lunchtime to check on him (only 3 hours between when I leave and when I'm back)...

am hoping his low numbers over the past few days followed by the spike (is that 'rebound'??) are a sign that his body is maybe trying to cooperate again? he's been getting 2.25 units BID.

sorry .. too many words here for a first post I guess! great site.

Hi guys and welcome from us! 93 is an awesome morning number! I don't really know rupert's story but just wanted to stop in and say hi .. usually when a kitty has nice numbers and then not so nice numbers, we call it a bounce .. Not sure if you know this or not, but sometimes warming up a rice sock and then heating up the edge of the ear will help with the blood flow .. have you ever shot such a low morning number? If not, and you decide to, I hope you do a few extra spot checks early on, to see how he is doing .. others with much more knowledge will be here soon I'm sure! Have a great day!

Good morning and welcome!!

If you've not had a chance, please read over the starred, sticky notes at the top of the Board. They will familiarize you with how this forum works, our slang, care and use of your insulin, and, most importantly, the dosing protocol that we use.

Here's the link to your post on Health.

It will help us to better understand what's been going on with Rupert if you can put together a spreadsheet. (If you're not in the US there is also a World version of this spreadsheet that will convert the numbers automatically.) It's very hard to make any suggestions or offer any guidance without having the big picture of what's been going on with Rupert.

We generally suggest that unless you can monitor, for someone who is new to this process, to not shoot unless your cat is above 150 at shot time. In addition, if you have shot lower than 150, then ideally, you need to be able to get a +1 and +2 to make sure your cat is safe.

Please let us know how we can lend a hand.

thanx for the welcome! yes,.. I shot a 123 a couple of days ago (it was lower at his regular shot time so didn't do anything, then started to rise so I took the plunge and went for it.. he ate a good breakfast first, I knew I was home all day so could monitor.. he went from amps of 73.... then pre shot was 123 and at +5 he was at 208 with a high of 234 pmps. he had a couple of amazing days after that, and then this 'bounce' this weekend. am going to test him again in a few minutes.. IF I can. he was really pissy about it this morning (poor fella, his ears must be getting sore).

here he is.. big boy!:

Welcome to lantus land!! He is so very handsome.. My Moonie is also a tuxedo cat.
Rupert is doing well so far as we can see but putting up an SS will help us to see where he goes-and advise you.
The Stickys help so much, so please read them all on top of the lantus home page.
Especially the new to lantus sticky.
Rebound occurs when the blood sugar goes low, and the liver panics & responds by spilling glucose back into the bloodstream & raises the numbers...It is only temporary and usually passes within the next day or two, 72 hours maximum..It is very normal, and we learn to live with it here.
It is good that you can come home at +3, to test, as that is when the lantusstarts to take effect.
If you cant get your SS up to work then temporarily post in your daily condo like Tess and Mannie do right in the text here--OK?
Glad you have joined us and know you will have success here--We are a family-Welcome!

thanx again, am working on getting a spreadsheet up, but will post our numbers from the past few weeks when I get to work (ahem!)... have to go feed the horses now. just tested Rupert and he is at 4.6 (I"m in canada)... um.. so thats 83 I think (!!). so I'm withholding his shot. he's had his breakfast, about half an hour ago. I'll feed horses, head to work, try to get SS up and working, or at very least cut and paste mine in here. Thank you SO much for the info.

will test at noon and see what his numbers are doing. I'm afraid I gave him about four 'temptations' to get his ear poke just now. hoping they don't skew his numbers (it was the only thing he'd go for this morning, most of the time he's fine but I've been monitoring him closely all weekend and he's getting sick of me!).

where are you located in Canada?

where are you located in Canada?

There are some better (i.e., low carb) alternatives to Temptations for treats. Freeze dried chicken is very popular with many of the kitties. So are jerky-style treats -- although there have been problems with jerky treats imported from China.

Here's a link to info on LC treats.

Welcome to LantusLand! What beautiful big boy Rupert is!

It was good to skip since his numbers were dropping and you would not be there to monitor.

Warming his ear w/ the rice sock (1/4 cup of raw rice tied in a sock, 15 to 20 seconds in the microwave)helps to get the blood to flow as Roni said. Also be sure to put pressure on the ear for 15 to 20 seconds after testing, it stops the blood and helps prevent bruising. Most important is to give a treat afterwards. They come to associate testing w/ treats and become much more cooperative! :lol: :lol:

I know the recap in Tess's condo looks like a lot every morning, but I have it in a text document and just change the numbers and any variation in food in the morning. then it's just copy and paste, It's really pretty quick. A SS would be really helpful though, the recap just gives a quick look at the day before.

ok. I think I got the SS thing to work, should be in my sig, but if not:

https://docs.google.com/spreadsheet/pub?key=0AkuJjMzr3feNdE9LTVl0eDhIcnp4X3Z4Q1lQQl95dkE&output=html

here is an image of the chart that I use to track overall trends etc, gives a better visual (for me at least) than just a bunch of numbers on a page:

Your SS is in your sig and looking good. Nice chart! :thumbup On suggestion, since it is in world numbers can you color the background to correspond to colors on the SS? That would give a really easy to grasp quick look.

hm, no clue how to color the numbers on the chart, I'll see what I can do, maybe do another with US numbers.

I'm located on Vancouver island in BC.

Just stopping by to say Hi and welcome!

Whatever you did, the SS looks good and is color coded.

Just to back track a bit. Was Rupert's first shot of Lantus on Feb. 6th?

• First dose Feb 6 at 2.0u
• Increased on PM of Feb. 7 to 2.5u
• Skipped shot PM of Feb.9
• Decreased dose AM of Feb. 10 to 2.0u
• Increased on AM of Feb. 11 to 2.5u

Are you feeding Rupert a low carb, canned food diet? I know in your post on Health you said you switched him from the dry Royal Canin to canned food. I'm going to presume you have found Janet & Binky's list or some of the Canadian members have gotten you information about low carb, canned food that's available in Canada.

I want to encourage you to take a look at the information in the Tight Regulation Protocol sticky. This is the information that we use to guide our dosing strategy on this Board. First, the initial dose is held constant (barring a drop into way low numbers) for 5 - 7 days. Lantus is a depot-type medication and this allows the insulin depot to form. Subsequent to this initial period, doses are evaluated after 3 days (6 cycles). When you skip a shot, that 3 day count starts over just like it would when you increase or decrease a dose.

What I'm trying to tactfully point out is that you are changing Rupert's doses a lot. With Lantus, the dose is changed based on the lowest number in the cycle (i.e., the nadir), not on the pre-shot number. The dose is reduced either if your cat's nadir is less than 50 or if you are consistently getting an unshootable pre-shot number (like you had this morning). When this happens, the dose is reduced by 0.25u. (I also realize that I said something that's contradictory. My guess is that if your starting dose was 2.0u, it may have been too high of a dose. That's why you're currently seeing some lower than expected pre-shot numbers and needing to skip. Once you've been able to calibrate Rupert's dose so you don't need to skip, the dose changes will be based on nadir.)

You'll also notice we change doses in 0.25u increments. If you increase by too large of an amount, you may be over what is a good dose and you have to work to keep numbers from dropping too low. If you decrease by too much, then the reductions doesn't hold. Based on the research that was done in developing this protocol, 0.25u was deemed the appropriate amount for adjusting dose.

I also want to encourage you to get at least one test every night during the PM cycle. As you saw on Feb. 9th, many cats experience lower numbers at night. It's important to test in the evenings for that reason. The other reason to test at night is that if you don't, you are missing half of your data AND you may miss a dose reduction.

I know this is a lot to absorb in the beginning. Please let us know how we can help.

okay. noontime check,
+18 and he's at 223
thinking I should hold off shot till regular time at 6:30/7pm rather than give him shot now and have overlap?? or is this the perfect time to do this? confused.. sigh! he's looking just fine of course.

sorry, that chart is only recent, he's been on lantus since jan 6, started out at 2 units BID. numbers were insanely high 450+ when we started, and stayed that way for several days, then dropped to the 270 range for a bit... the latest trend that I'm plotting is steadily decreasing Highs, with nicely leveling off lows.... I'm hoping this trend continues. his lunchtime number today is good for him on a day when he gets his regular shot. he hasn't had a shot today so this number is really good (IMO).

he is on merrick canned food. NO dry. using raw steak as treats most of the time to get BG readings.
vet recommended increasing dose to 3 units third week in... we did one, he had a low low, so went to 2.0 for two weeks, now he's at what I call 2 and a smidge, not quite 2.5.
on the weekends I'm getting BF readings about once every 2 to 3 hours. tend to do one, +1 and then a +4 o4 +5 and then one at about +8, plus one right before his pm shot. weekdays I do amps, then +4 then pmps.

final report of the day:

PMPS + 4.5 396 down from 505. darn. today started out so well.
fingers crossed tomorrow will be back to the green.