3/16 HANK AMPS 348,+9-130, PMPS+ 12-140,+12.45+143,+1.5-156

viewtopic.php?f=9&t=9252 Yesterday's condo


Now what? His dose was reduced as recommended to .50. I'm not even positive he got that fully due to bubble, etc..
We have done 2 rounds of this. he woke up pink yesterday.
I am not comfortable shooting low. Ya'll don't like us to skip and neither do we....hence the lower dose.

But RIGHT NOW, what do I do? I took a late day test & he was only 10 points lower than now.

Please some quick advice...it's shot time. We are yet over our wonky upside down schedule from this sort of thing since last week.



BTW_ I will be out extended hours into the night tomorrow-Sat ..if that factors. Need to be VERY safe!

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140- WHAT TO DO

I'm not in a position to make dose suggestions, Betty, but I'll try sending a PM to some more experienced people.

How much time do you have?

And again, are you able to monitor Hank tonight? Do you have strips, and a hypo kit, and HC food on hand?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140- WHAT TO DO

Oh my! Even on the reduced dose this morning, he is low at the evening preshot. Wow.

Ok. You can shoot a BCS dose (big chicken sh%#) which would be about 1/2 half of his normal dose. And bless your heart you have barely gotten to figure that one out.

How about a 0.25u dose? I understand about the bubble thing in syringes so lets just say if all the doses have a bubble, then they are relative to each other. Don't worry about it.

Or shoot as little as you can and let us know what you called that dose. Just a token dose essentially.

In my humble opinion, Hank wants to go into remission pretty soon. He just needs a little help with some insulin right now.
If you want to skip tonight I understand that too, then you can shoot in the morning because SURELY he will be higher by then!

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140- WHAT TO DO

I DON't know how to do all that.

I lowered the dose as strongly advised last night after skipping his dose yesterday for a similar number. At numbers higher than this only Saturday I was advised that I didn't have the date to shoot.

I don't understand this...and these urgent moments that continue to arise. he seems fine right now. i don't want to hypo him.

then feed it, and so on. Our shot was due at 10PM. i had planned to do it slightly late, like 5 minutes form now, to allow for us to be a tad late tomorrow eve.



Have to figure this out right now. we don't test far in advance of shot time...it wouldn't seem reflective.

we can not be up all night doing this again...


WHAT DO WE DO NOW????????????

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140- WHAT TO DO

You don't think you can shoot half of what you shot this morning?

Ok. To keep Hank safe in these beginning days, you can skip again. Even though it isn't the normal thing, we don't know what Hank will do tomorrow and the 140 is too low for you.

Start over tomorrow. OK? No shooting tonight again. We will work with you and get this figured out eventually. But like you said, keep him safe. Do no harm.

No shot tonight.

Post at least an hour before his shot time tomorrow for help. OK?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Ok. You can shoot a BCS dose (big chicken sh%#) which would be about 1/2 half of his normal dose. And bless your heart you have barely gotten to figure that one out.


would I do this now, or hedge just a little.

Any other words of wisdom.......... PLEASE.

ya'll this is all so crazy, seriously. It's too much drama, too much. We could not keep this up ling term.

How can there be this much intensity around anything long term.

WE DON'T KNOW WHAT TO DO??


If he get the BCS dose, will we still have to be up worrying, guessing about HC foods, amounts, setting alarms to test, not sleeping, etc???

i want to do right by him, I really, really, do. I just don't knwo what that is form moment to moment.


Chime in............... i can stall a couple more minutes,...but not too much more.
We need to be a little late tomorrow night, and can stay w/ +12 in the AM no problem.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140- WHAT TO DO

Just wanted to say it's nice to finally "meet" Hank. Those red boys certainly can be troublemakers

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Oops, I had a typo there... just half of your morning shot was what I meant for the BCS dose. Not half a half. Sorry.

The hard part is that when you shoot a number that is low to you... you need to test to see how he's doing and if you are not going to be home that is very difficult.

The HC stuff is for when a kitty gets in the 40's and you are pretty far away from that right now. And you'd like to keep it that way until you are more familiar with all of this stuff. That is why I said don't shoot tonight. I hope his number will be yellow or pink tomorrow so you can give a small dose and not have him go too low.

Ok?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

CD-

Don't go away. I am going to get a quick test and come right back with the info. i so don't want to have to skip again.

if we did the token dose........and tested in say, 1 1/2 hrs... would it be safe then to go to bed? i am home tomorrow until noon or so...+14.


I will do either.whatever you say. I just need directive.


where are libby and sienne??????????

BRB

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

If you're stalling, post before you want to shoot.

I think CD's suggestion to shoot 0.25u is solid. It's in part for your comfort level and in part, because Hank keeps dropping to numbers that you don't yet have experience with. Most of us routinely will shoot a 140 and not bat an eye. You'll get there.

We're trying to find a dose that is safe for Hank and will let you get a reasonable night's sleep. (I'm the person who posted in another condo that "Sleep is vastly overrated.')

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

will that EVER happen? this is insane...seriously.


don't go away. BRB with test result.

have to HURRY

caveat. WE CANNOT be up all night with this whatever we do. Important things tomorrow. way way behind

let's see what the number is.

don't go away

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140- WHAT TO DO

bettyandhank said:

Have to figure this out right now. we don't test far in advance of shot time...it wouldn't seem reflective.

Click to expand...

Ah, but testing in advance HELPS us see what his trend is. Is he going up, or staying the same, or going down. We NEED to know this in advance. Not just 5 minutes before you want to shoot.

Tomorrow please test an hour before you want to shoot and then from there we can see which way Hank is going by the time you test an hour later at AMPS. Does that make sense to you?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

CD is right. The more lead time there is, the more likely there will be people on the Board to provide some input.

Is there any chance you can move shot times a little earlier? Your PM time is so late that it's no surprise your getting sleep deprived.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

+48 minutes later- 143 . only up 3 pts.

I am a NEWBIE.

I want hank to have insulin in him if he needs it...


want to be safe about it. I clearly don't know this game....


he is eating a couple treats now.

i hope you are right Cd, and maybe this is a sing of remission.

For now, what.

If we shoot, even this token amount, what would the required appropriate follow up steps be.

I will be 50? min late for shot by the time he eats a bit.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Shoot the 0.25 while his head is in the bowl. Do that and give us a few minutes.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

agree, shoot the 0.25. Good job tonight! (and thanks Sienne and CD!)

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

I'm sorry...our posts crossed. Did you say even with this new number of 143, and 50+ min late, to shoot him depsite no date.

a token dose... .25?

is this safe?

will we have to be up tonight with it or can we go to bed in an hour or so?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

ok...don't go away.

I'll be back to visit under less duress.

this makes no sense to me as it seems to contradict what we said only the weeknd


I will trust ......

be right back...n my fingers are coming off trying to type this

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

For tonight, get a test at +1 and +2. Those will be your data collection numbers, so next time shooting blue won't be so scary (because tonight you'll see for yourself what happens after the shot). We'll come back in a few minutes with a more detailed plan for going forward.

nothing should be contradictory. We're trying to find a dose that you can shoot without stalling and stressing. Apparently we haven't found that dose yet, so we're lowering the recommendation again. The goal is to start with a nice easy dose, then work up to Hanks' ideal dose. In the meantime, you'll be gathering data on his responses and increasing your own comfort level with shooting.

To get Hank into remission, you'll have to learn to "shoot low to stay low." You'll have to be shooting full dose on lower numbers, and we're trying to ease you into that. You've shot 170's before and that worked out fine, so shooting 140's tonight is a logical next step. This will work out fine too so next time you'll be able to shoot a little lower.

Next, is there anything we can do to help you get your schedule moved a couple of hours earlier? Nighttime tests are key, especially when you work during the day too. Ideally your shot time would be about 3 hours before bedtime. Is that possible?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Regarding date...
The only way to get data is to give something a try. Yes, there is a calculated risk BUT, you can control Hank's numbers. You haven't done this yet so the entire notion of low numbers is scary. I know you are worried about a hypo. I can only think of one cat who had slight symptoms of hypo. One of the members here when she was very new (so new she'd never given a shot), gave her cat 5 units, not 0.5u. There were no symptoms of a hypo and the entire episode was managed with food and honey and dextrose.

Testing tonight...
Definitely get a +1. A +2 would be very good. Leave food out for grazing over night.
Is there a reason you are testing so late in the day? It may help in terms of people being around in the AM as well as you're being able to get to sleep at a decent hour if your shot times were earlier. It's not essential, but this is just a thought.

Dose and options...
Stick with a dose of 0.25u. If the numbers are high, that's OK. We need to get some stability in the dose. We will re-evaluate the dose in 3 days.
If you stick with shooting 0.25u, you should be able to comfortably shoot anything above 120.
If you have an AMPS or PMPS below 120 you have 3 options:

• Stall. When you stall, you do NOT feed and you re-test in 15 min. You may have to do this several times. The goal is to see if numbers are either staying flat or rising. You do not want to shoot a dropping number.
• Shoot a reduced (BCS) dose. You don't want to stall and shoot a BCS dose since this will have a double impact on the shed.
• Skip the shot.

Each of these options has an effect on the shed.

Does this make sense?

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Jeez.

Done. a .25 or BCs or token. who knows. I have no idea how anyone could clearly know at those micro-doses. I could never discern a .1, .2, ..
the plunger corcle takes all the space between the 1/2 & -0-.

Anyway, he has a little something, and at a ridiculously uncomfortable number for me.
I hope the reward outweighs the risk.

So what is it with Hankie and his unpredictability. This really has been an insane, exhausting, all consuming process.

I will be out for the first time since this all began, starting tomorrow. I leave around noon or early afternoon, returning anywhere from 9:30Pm -midnight depending on the day. This is NOT a time I can report and hour early. I'll be racing home to get him taken care of as it is. I SO hope there are folks on the board. Please be looking for us. As I am gathering and you are seeing, Hankie is not terribly predictable. Whatever we were doing supposedly to make it easier for the bean, escaped him.
I am going to be concerned about him being gone for these extended stretches. He looked really good today, in the blues apparently most of the day.



Does CD have a point, ......might this be a sign of remission coming?
We are yet one cycle in on this lowered dose. it hasn't really had a chance to settle. And he was pink just yesterday.
Can anyone offer insight. Ya'll are so much more familiar. Can you see any trends or patterns or messages coming out of all this?

We are so lost.....just going by the seat of our pants. i can say on my own i NEVER would have shot that, ever.
it seems like giving medicine erroneously. i don't want to hurt him.

So, now there is a new threshold. 143. But it was a token.
If he was not going to do well on it, would he show signs of that early enough before we go to bed that I would know?

Having HC & Karo, which everyone always asks about on the board, isn't the same as knowing what to do with it, when, how much, and so on.

CD, your kind words meant alot, so thanks, and I did learn form some of your explanations.

You are in essence giving the insulin in anticipation of future rising BG. The concern I have, is that the rise seems to be an uncertainty. or if it does, WHEN.
So far w/ hank, it seems like the days are all so different form each other. it's erratic.

i just need some peace for us. we have to get things to a more constant even place. Next week we can try for an hour ahead.

Thanks for helping me tonight folks. let us know if I need to do anything.

Bring on the wisdom.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Libby, Sienne

Ok, crossed posts again. Just getting back up here. Let me read through and will BRB with reply.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

CD, I think maybe I confused Betty with talk of a hypo kit. Betty, it's not as bad as it sounds! It's just a supply of things like high-carb food and some Karo syrup. But more about that another time -- maybe tomorrow -- if you're skipping tonight's dose.

Betty, don't worry! It will not always be like this. It gets better -- fast.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Good job shooting the micro dose. I know what you mean about how hard it is to tell. I used a magnifying glass. I would draw up more insulin than needed and while looking through the magnifier, I would gently TWIST the plunger to get to a tiny dose. When I just pushed, I'd had less control and would accidentally shoot it all out in the sink. Oops. So twisting the plunger to get the micro dose really helped.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Ya'll wanted me to do the .50 for 3 days before any adjustments. we did only one cycle. My understanding was that you cannot make a dosing decision on a single event. I understand the .25 tonight and the why's. However, i thought that was to address the low tonight and consider it a BCS token option.

Can I clarify that you are suggesting lowering him to that for a 'permanent' dose? Ie: in the morning, tomorrow night?

I need to re-itterate: Unlike every other day since diagnosis, I am about to be away for long periods over the next several days. Not only can I not move our time up right now, I will perhaps be a little late. We were planning to slide 15 minute increments over the next couple days to allow for that.
Due to tonight's delayed shoot, that may not be necessary as we can stick w/ 12/12 from THIS time, then slide back after the weekend incrementally.

We do not get up early in the morning, so the AMPS would be an issue moved up much. In my former life before this diagnosis, I used to get up and walk
straight out of bed, back in an hour. I then tend to them. That is when they are used to eating, etc.. That also works for us in the eve, as long as his numbers are in line and the 'shoot' is obvious. it's all this erraticness and urgent need for advisement and dosing and typing, that prolongs and makes us late.

this whole thing has literally consumed us. I am so behind EVERWHERE else. other things are not getting tended to and falling apart. We have been in crisis mode with this going on 3 weeks. I have got to figure out how to make this more sane & manageable soon. We are just being stretched too much and not enough time to do everything. It has become a whole other world.

As far as tonight, a +2 means 1AM. A) will I be awake? b) what do I do if the number is ___X. This is the part we are missing. We don't know what to do 'if', 'then', when' What if the number is wonky? When am I supposed to be scared, what do I do? Who will be on the board.?

At this rate, we may be up at 1AM. But none of the other 15 chores I had to do tonight got done. They were the ones put off form the day before, and the day before that, and so on. Everything is in chaos around here. I haven't seen my car keys or phone case since before rushing him to vet #2 when his weight was dropping.

Do I look for numbers going up, then it is ok to go to sleep?
If I can only test at +1, is that enough? (midnite)
If numbers are going down instead of up, do I worry? Do we do anything? what?

Am i understanding that we are to abandon the .50 dose we just began yesterday -vs- the 3 days we were told to hold it before changing?
Are you suggesting now a .25 dose tomorrow again????

I can check back here at night when i come in, but will have limited time. My goal would be to do whatever can keep him mild and kopasetic, and even. and not rock any boats, over the next several days while I am out of the house so much.

Thanks for all the good advice.

perhaps we can move our time up maybe 30 minutes next week, something like that.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

IMHO, I think it's too early too tell if Hank will slip right into remission. CD has been around here longer than I have so maybe she's seeing something that I don't see yet. I'm also very cautious about suggesting that a cat will fast track into remission. When Gabby and I first got here, one of the experienced people who was guiding me, kept saying that Gabby will race down the dose scale given all of the early blues and greens. We're still here. It was very disappointing and I felt like I was doing something wrong. What I had to wrap my brain around is that it had nothing to do with me and everything to do with Gabby. Our cats are leading us in this dance. At this point, I think we need to see how Hank does when the dose is consistent and it settles.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Can I clarify that you are suggesting lowering him to that for a 'permanent' dose? Ie: in the morning, tomorrow night?

Click to expand...

Yes. New dose is permanent until Hank's numbers tell us he needs a change.

it's all this erraticness and urgent need for advisement and dosing and typing, that prolongs and makes us late.

Click to expand...

If you can test a little earlier before each shot time, then people would have a chance to help you before it gets so hectic. Just do your best and we will too.
Things will get less crazy as you get used to the testing shooting thing. Really. (I used to cry when I tested my kitty in the beginning, so believe me, I understand.)

Test tonight at +1

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

I am going to test right now, it will be +1.5. I'm afraid we will zonk out after that.

I don't know how I feel about this potential .25. We just dropped in 1/2 to .5 only yesterday. Isn't there a delayed settling in affect that may not yet have shown?

I will post in the am as well, we are late now, so closer to 10:30.

back in a sec w/ this test result

TNX!

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

Some of this is trial and error. I know that it's frustrating. We're also trying to be sensitive to your situation -- late shots, company coming, the newness and resultant panic and feeling overwhelmed. We've all been there and really do understand. Just as importantly, we want to find a dose that you are comfortable shooting twice a day and that is safe.

Like CD and Libby suggested, 0.25u is the new dose. Shoot this amount in the AM and PM. Hold this dose for 3 days unless you get a test and the number is less than 50. I don't think you will see that low of a number. In the off chance that you do see low numbers:

• If you have numbers in the 50 - 70 range, feed a teaspoon or two of LC food. This should help to keep Hank surfing in this range which is good for pancreatic healing.
• If numbers are in the 40 - 50 range, feed a teaspoon or two of MC (drizzle some HC gravy over LC food). The idea is to bump up numbers into the 50 or higher range.
• less than 40 feed a teaspoon or two of HC for the same purpose as above.
• With numbers below 50, re-test in 15 min. and feed if numbers aren't rising. Repeat this until numbers are bumped up. (We call this lather, rinse, repeat.)Once you get two rising or stable, above 50 numbers, test in 30 min. to make sure numbers don't drop again. If numbers stay up after 2 tests, you're good to go.

Food is the best way to steer numbers. Leave food out overnight. As long as Hank will eat if his numbers are dropping, he'll be fine. I give Gabby lots of snacks. They help to keep her surfing or to slow down drops.

I know your schedule is going to be hectic over the next week. If you can test and give as much advance notice as possible if you need help, it will make it easier to get you the info that you want if there's more time. People are on and off the Board. Tonight I was logged in and dozed off. If we can migrate your times a little earlier after company is gone, that may help the night time sleep issues but let's not worry about that now. (Fair warning, if Hank does go into remission, there will be late nights!) I wish I could promise that Hank will allow you to stick to a perfect 12/12 schedule. Until you have the data and are comfortable shooting low, the options I listed out in my previous post apply. The most frequently used option is stalling and it does play havoc with schedules. You will get progressively more comfortable with shooting low numbers. If you read condos, you will see people make that transition from being afraid of low pre-shot numbers to becoming confident. It just takes time and patience.

Keep in mind that numbers do curve down over the course of the Lantus cycle. This is normal. It's not until you are closer to regulation that you will start seeing very flat cycles.

Please keep in mind that Hank is in change. You can try to move heaven and earth to keep him "mild and copacetic, and even. and not rock any boats" but, it's all up to Hank's pancreas. These guys read your condo and then shake things up -- or not. It depends on their mood and probably how many treats you gave him vs. how many he thinks he deserves.

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140,+13-143

Sienne-

I will better read your post. Just saw you back here. Hank is at 153. BUt he had eaten after the shot, then was eating a few bites as i grabbed to test him.

The .25 freaks me out. I really understood that was for tonight inly to address the circumstance (aka BCS)


Confusion also based on reading back over yesterday's posts and what was said regarding the changes having residual effect.,.needs 3 days time to settle before addressing any potential changes, etc.. It could be tomorrow before the .5 kicks in.

i will be gone so much, I don't want him to feel sick or miserable. No pinks! i want him to feel good.

i will post his number in the morning, I don't suspect you will be here.


I'll do the best i can tomorrow night. I bet I am not home before 10-10:30. i will race to test, post and clarify then.

thanks so much again for all the good advice & support.




b&H

Re: 3/16 HANK AMPS 348, +9.15-130, PM+11:55-140-** NEED EYES!!!

I don't know how I feel about this potential .25. We just dropped in 1/2 to .5 only yesterday. Isn't there a delayed settling in affect that may not yet have shown?

Click to expand...

That phrase, settling, is used when beginning insulin and when increasing a dose.

• Essentially when a cat gets its first dosage - that is an increase from not having insulin. The 'shed' needs to be built and the cat's BG numbers might not improve much for a few cycles until the insulin fills up the shed. Then ideally the kitty would respond with lower numbers.

• If numbers don't improve after about 6 to 10 cycles, an increase is needed. Increases need to settle in because the new dose is higher and shed needs to fill up a little more at that point too.

If the dose is too high, the shed is overfilled, and cat goes lower than you want. So we try to always start on a low dose and go slow (let it settle) before increasing the dose.

If a kitty needs his dose lowered - there is no 'settling' time. You lower it.

Some kitties like Hank have to start with a lower dose than others. Finding this initial dose has been a little problematic for Hank. But I hope the .25u is the one he can start on with more consistency and work up from there as needed.

Also, your advice & numbers and info, regarding feeding were great pointers.

What if he won't eat?

Mostly he will, but there are times he simply will not eat. he''d not interested,not interested, period.

Betty & Hank said:

What if he won't eat?

Mostly he will, but there are times he simply will not eat. he''d not interested,not interested, period.

Click to expand...

My guess is that what you mean is that there are times when he won't eat at that moment. He will eat eventually. First, the current dose of Lantus doesn't start working instantaneously. You have some time if you've given a shot and Hank walks away from his bowl. If the issue is will he eat if his numbers are low, right now, we don't know. Most kitties will eat if their numbers are low. They also really, really, like the HC gravy. Cats are pros at self-preservation. Even a finicky eater will eat something if BG is dropping - it's instinctive. In part, you'll help Hank to understand that food helps him feel better so he'll catch on quickly.