8/28 Charlie PMPS 313 +4 67 +5 49 +6 126 +7 131 | Feline Diabetes Message Board - FDMB

8/28 Charlie PMPS 313 +4 67 +5 49 +6 126 +7 131

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charliesmom

charliesmom

Member since 2012
Yesterday

Spoke to our vet finally today and she analyzed Charlie's spreadsheet. She believes that in hindsight, we should've given her a higher dose sooner rather than starting her at .5 units of lantus. She advised us to increase Charlie's dose significantly from 1.25 to 2 units.

We did so and now are quite scared as her +4 and +4.5 are already quite low.
Should we do anything preventatively to avoid a hypo tonight? Ot is it best to wait and test in 1 hour to see if she goes lower and thus at that time know that this dose is too high?

Please help. Know that advice from the board was to increase to 1.5 units but we followed the vet's advice. She thought a step change was needed. Now I'm scared that step was maybe too big and that we might be up all night.

Please help.
Jill
 
Re: 8/28 Charlie AMPS 378 +4 355 + 7 360 PMPS 313 +5 67 help

With that fast a drop I'd test at least every half hour. Right now I'd give a little extra LC food and test again in 20 minutes to see if the drop has stopped or at even gon up a little. You are close to nadir so that helps. Do you have MC and HC food on hand? Syrup?

This is just why we only adjust doses in .25u increments, we play it safe. Yo also can make sure you don't miss the best dose that way. Too many vets ar unfamiliar w/ the way Lantus carries over and want to treat it like the old fast actin insulins.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63

To be clear, the 67 number came at +4. Tested again 30 mins later and it's at 63.
I made a mistake when I wrote that this figure came in at +5. Not at +5 yet for another 30 minutes so it's even sooner than the theoretical nadir, which Charlie has rarely ever personally experienced.

I've always been told that the increased dose wouldn't play itself out until at least the next cycle. If it starts having this much of an impact within the first 4 hours, is that the sign of a rocky road ahead?

We have LC food and 1 can of HC hills critical care canned food on hand. We also have hills dry diabetic care food (HC) on hand and maple syrup if needed. Plenty of test strips. We're both just exhausted as we haven't slept much lately so all the help and coaching we can get through this tonight will be appreciated in case it doesn't slow down.

Earlier today I thought about increasing only to 1.5
The vet thought that perhaps since we've seen only red and pink numbers over the past weeks, that the doses (even when increased) were having less of an effect and thus we should give her a kick start. She referenced 2 cats she worked with whose owners had accidentally given their cats twice the dose (4 units instead of the 2 they needed) and when they called her to tell her about it after this had happened, she noticed that the regulation and dose reductions came much quicker. So she recommended we try the "kick start" process and we did so. I only spoke to her at 7pm and we had to give the shot at 7pm, so I didn't have any time after work to bounce this idea off the board and we had an appointment at 8.

Thinking that the dose wouldn't have an impact until the next cycle, I thought there was no risk in being away for 2 hours. Thank God nothing happened to my little Charlie.

Still heading down. What shall we do guys?
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 PLEASE HELP

I do think you are probably going to be doing this for a while. I'm watching hard for one of our most experienced folks to jump online.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 PLEASE HELP

don't go w/ the dry, dry food takes too long to kick in and then even longer to clear her system. If she keeps dropping at the next test I'd add a drop or two of the syrup to just a little more LC.

Dose increases CAN take a cycle or severl to take effect. That doesn't mean they always do and the shed is not absolutely consistent int ht amount it releases either. Right now you just need to monitor and feed until you see several rising numbers that haven't been nudged up by food.
 
8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 PLEASE HELP

She is acting real good. Quite alert, up and about, etc.

DROPPING. Gave 3 milliliters of maple syrup with a syringe as she doesn't like maple syrup. So if we put it on her food she will not eat it.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 PLEASE HELP

ECID is different, w/ Tess 2 drops of honey will bring her up about 20 points for about 2 hours. If she starts to drop again then repeat, this will keep her from going too low without bouncing through the roof.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 PLEASE HELP

oops. sorry guys. our wireless just went out (murphy's law) and with the rushing to give syrup + post I guess I didn't see your replies and posted up above.

We gave 3 milliliters of maple syrup with a syringe as she doesn't like maple syrup. So if we put it on her food she will not eat it. At +5 she was at 49. That was ten mins ago. Should we test again in 5 mins or wait a bit?
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 PLEASE HELP

Assume this means our morning shot is lower. Agree to move down again? To 1.75 or 1.5? Or, does it depend on the next test results and how the next hours go.
Boy do I wish I could drink coffee right now.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 PLEASE HELP

Food usually takes about 20 minutes to star showing in BG, so use that as you guide. I don't usually give dose advice, but that 49 earns a decrease anyway. IMHO I's go back to the 1.5 that others advised. It's a lot less stressful to take it in steps than to deal w/ what you are going through.

It could be the maple flavor. We use honey and Tess doesn't notice it. I think it is also a slightly lower glycemic index than syrup too, so not as much of a kick up.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 PLEASE HELP

Keep testing, you can wait half an hour if it is still up go for an hour. At that point the syrup may start to be wearing off.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

I just checked, 1AM there! Can you set an alarm so you can nap?
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

Will do. Just saw her eating. Now she's behind the couch with her tail flapping a bit restlessly. Slightly out of character so I need to keep an eye on this. It's 1am now. Will test at 1:20am (+6)

THANK YOU GUYS for being here at this time.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

breathe!

What time is it there? If you're very tired, then we can try to abort this cycle. By that I mean go ahead and feed her high carb food to try to bump the numbers up quite a bit, hoping that you can sleep sooner. Yes, the syrup and food can wear off but if you get her high enough that you'll have some extra room if she drops when the syrup wears off. I've had to do that before.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

You're doing great. You've bought the numbers into a very safe range. That doesn't mean the roller coaster ride is over but you've got some room to breathe easy. Think about Libby's suggestion. You can short circuit the cycle if you need to or you can continue to test and feed. We're here if you need us. It's early evening for most of us so we're here to help.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

Thank you for the support and encouragement, my friends. Rather than abort completely I will try to keep going for a bit and see how it goes.
This is a way to gather information and I want to be sure she's in the safe zone until I can sleep peacefully. Will post an update shortly after testing in 10 mins or so. If I can get a few cycles in a row trending upwards, you can tell me when I can sleep (or if I really get desperate I will indicate when it's time to abort). Already sort of there but let's take this step by step and I can do mini cat naps (no pun intended) if needed.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

In answer to your question about when it's safe to go to sleep:

Shooting & Handling Low Numbers sticky said:
  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of food with high carb (HC) gravy or HC food only. (If you have a cat with GI issues, using syrup plus LC food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.

DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
Click to expand...
The idea is that you want to make sure the numbers have stabilized without benefit of the HC to prop them up.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 HELP

Hi Jill,

We are sending you many hugs ((JILL&CHARLIE))... You are in good hands, you are doing great, hang in there!! :YMHUG:

Alexa
(Zar)
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126

+6 at 126. Now she's out laying on the arm of the couch here next to me. Seems to be doing OK at the moment. Just drank my water again!
 

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Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126

whew!

This *could* be her bounce starting. I'd like to see another test in an hour, if you can set an alarm. Otherwise, you could try 1/2 hour and if she is quite a bit higher, assume the bounce has started, feed, and go to bed.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126

That was my thought EXACTLY when I saw the jump up. I will test at +6.5 and report back.

In the meantime, as the effect of today's dose may continue to effect things into tomorrow, I"m definitely going to decrease. The question is, as there was no "last good dose" to decrease to, should I decrease to 1.5? Or if the AMPS comes out low, shoot less than 1.5?
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126

Hi Jill, Sending you loads of positive energy to help you and Charlie through this. You are doing great checking her and when she is still up after the syrup effect has passed you will both be able to get some rest. Next update, suggest you put the last dose in your spreadsheet so the wise ones helping you have all the numbers in one place.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126

No dosing advice from me. Just wanted to say you're doing a great job. You and Charlie will be fine.
 
8/28CharliePM313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126 +6.5 119

seriously heavy eye lids.
2am shot came to 119. Slight dip down again.
 
Re: 8/28 Charlie PMPS 313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126

it's pretty much a surf, but she could still wobble downward. You could feed a good sized portion of high carb food and test in 30. That might give you enough wiggle room to get some rest.
 
+7 is 131.

Food is out (LC) and due to all the tuna snacks, Charlie is not in the mood to eat any of it, so unless I HAVE to open the HC can (which Charlie will not eat), I prefer not to. The HC that we have must be force fed and I don't want to wake my partner to do that if not necessary. Should I test again in 30 mins or 1 hour? I will nap and set my alarm.
 
Re: 8/28CharliePM313 +4 67 +4.5 63 +5 49 +5.5 63 +6 126 +6.5

Jill & Charlie said:
In the meantime, as the effect of today's dose may continue to effect things into tomorrow, I"m definitely going to decrease. The question is, as there was no "last good dose" to decrease to, should I decrease to 1.5? Or if the AMPS comes out low, shoot less than 1.5?
Click to expand...
Depending on where Charlie's numbers are at AMPS, I would go back to what Libby recommended last night -- 1.5u. That's providing Charlie's numbers aren't low. If Charlie throws you a lower than expected number, you may want to shoot a reduced dose. If it's really clear in the next hour that Charlie is bouncing, then you'll know what to do. If it's not clear, I'd try to get a +11 or a +11.5 and post. Dyana may be on-line when you post. If not, remember to link this condo and ask Jane to read through today's condo and to lend you a hand figuring out the BCS dose.
 
Thank you for the advice and reminders Sienne.

The tail flapping continues, but she's no longer hiding behind the couch. She's out in the open hanging out with me. Cute.
 

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Charlie is very cute :-D , and reminds me a lot of another FD cat we know out that way, name Carmelita.

Hope you get a bit of some good sleep real soon.
sleeping.gif
 
Charlie is looking good, I stepped out because the cavalry had arrived. :-D :-D I hope they come back w/ a a BCS (Big Chicken Sh** Shot) number for you. What i would look for is that from the +11 to preshot there is a definite rise.

Verrrrrry cute pix! Did you get her into the annual calendar?
 
Jill

Liby, Dyana, and Sienne will be asleep when you come back on so I'm going to step in and be here for you since I'm on west coast time in the US and will be up for your shot time. We've discussed dose for the a.m.

If you wake up before +11, could you please get a spot check and then a +11 number would be great, if possible, so we can plan for the a.m. Shot. I'll be looking for tests, ok? Just post if you get up and do a spot check and also with the +11 test.
 
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