1/10 Migoto AMPS 416 - question

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migoto and mom

migoto and mom

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Migoto's pre-food and shot number was 416 this morning. I fed her, gave her +2u and took another reading at +1.5 and her reading was 484! Should I be worried? Or is this because she ate so recently?

yesterday's thread
 
Hi,

I can't give you a lot of advice, since I am very new to this as well, but I can tell you that just by being here you are on your way to getting things under control.

One thing that I have learned is don't increase the dose to quickly. I know it can be stressful seeing the BG numbers too high, but it is important to give Migoto's body a chance to adjust to the dose.

If you look at Sami's spreadsheet you will see that I did that for quite some time and had nothing but bad results. I have only been doing a consistent dose for just over a day, and I am already seeing some better numbers. Plus, I also switched Sami to wet food, which also seems to have made a huge different.
 
It is normal for their BGs to rise at +1 and +2 spot checks! No worries--After all, the cat has just eaten(food spike in bg) .
The BG begins to go Down at +3 and continues to go down to the nadir(mid point)..
So what you are experiencing is very normal--Let me get you the chart on doing a bg curve which expalins it..
You are doing just fine!
 
OK this should explain how we do a bg curve & how bg readings should go--
Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number
Hope this helps you !! :-D
 
Thank you very much!! This helps a lot.

Sorry for all my questions and tendency to panic. It's still less than a week since diagnosis for us.
 
migoto and mom said:
Thank you very much!! This helps a lot.

Sorry for all my questions and tendency to panic. It's still less than a week since diagnosis for us.
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Welcome to Lantus Land and congratulations on learning to Home test! It all does get easier (even the home testing!)

Ask away and remember that with hometesting, you are in control!
 
Just to add on to Ronnie's note with the "typical" curve. One of the facts of life around here is every cat is different (ECID). A nadir isn't always at +6 - it can be anywhere in the cycle and it may differ from cycle to cycle. What you will see over time is where Migoto's curve typically is. On average, Migoto may not show a drop at +1 or +2. But if there is a drop, it may give you valuable data about how the cycle is going to go.

When you have a chance, there is a link in the Tech Forum for how to complete a profile. If you could complete this, it will mean we won't keep having to ask you some basic questions about food, health, etc.
 
migoto and mom said:
Thank you very much!! This helps a lot.

Sorry for all my questions and tendency to panic. It's still less than a week since diagnosis for us.
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Somehow you're supposed to be perfectly educated, calm, and accepting in a week? Shoot...if that were the case, I'd've failed miserably. LOL. Look, you've only been at it a week. Get that spreadsheet up and running, spend some time looking at others' condos/threads and spreadsheets, get a hypo kit ready ('cause you never know when you'll need it), ask all the questions you can think of, and take it one day at a time.

And don't apologize for being new...we all were, once; and a lot of us still are. So hang in there, and just take a breath...you'll be all right.

Best-
Michele
 
Hey for being here a week!!!!! You are doing fantastic--If you dont know something, ASK..We are all here to help you..
I'm the cheeleader here in LL, sooooo GO GO GO you two!! Migoto show us what you can do :RAHCAT
 
You're doing a great job! It can be scary to begin, but you're definitely off to a great start.

I'm a newbie too, I just started shooting Moses last Thursday. And it feels good to get my hands/his paws wet in the routine of it. I'm expecting to take a hard look at the science and numbers eventually, but right now, Moses and I continue to breathe and understand this new process.

I'm glad you're here! These is a great group of cat people :-D
 
Thanks, everyone. Erica - I'm so glad I'm not the only one who is new! You seem to have a better handle on this than I do, but I know what you mean about it feeling good to get some control. I'm still in the stage of being hugely relieved that Migoto's condition is treatable!
 
Migoto's +4 reading was 531...I called the vet to ask about the numbers continuing to go up, and she said that my glucometer might be calibrated incorrectly, or I might be stressing Migoto with the pokes and getting false readings.

So I will be watching her for symptoms but not doing more pokes until I see the vet again and we calibrate my device in the office to be sure my readings are accurate. :/
 
I have a different spin on the numbers. Right now, Migoto is still building a "shed." I just posted this in Sasha's condo:

Sienne & Gabby said:
At this stage, you are working on building up a blood level of Lantus in Sasha's system. (This is also referred to as a depot or, in these parts, a "shed.") Many long-acting drugs work on this same sort of principle. Part of getting the shed established is giving a consistent amount of insulin since the shed is being built around whatever that amount of insulin is. One way to think about this is you have 1.5 units of insulin in storage. If and when you need to increase a dose of insulin, it will take a day or two to fill the shed. When you need to decrease the dose, it can take a cycle (12 hrs is a cycle) or two to deplete the shed to your new dose. This concept of the storage "shed" is one of the reasons that a consistent dose at AM and PM is important, especially as you're starting out with Lantus. It's also one of the reasons that small changes in dose work better.
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Since some of the insulin you're giving is going to the shed, Migoto doesn't get full benefit of the entire insulin dose. It typically takes around 5 days to get the shed built.

The other point is that not every cat follows the rules about when the nadir is supposed to be. It's one of the reasons that collecting spot check data is so important. We have no idea if this rise at +4 is typical for Migoto or is a reflection of shed issues. As you get more data and see what happens over the next several days, you'll have a better idea of what's going on.

Great job with the profile, btw.

Everything that I wrote about shed holds. However, I just looked at your profile. You are feeding dry Iams Indoor Weight and Hairball formula? This probably explains the spike in numbers and I wouldn't be surprised if Migoto's numbers continue to rise. This food is 40% carbohydrate. We are pretty adamant about feeding canned, low carb food -- less than 10% carb. Not only is the Iams extremely high in carbs, it will stay in Migoto's system for much longer than a canned, high carb food. To be honest, when we are trying to steer numbers in a situation where BG is running a bit low, we use an 18% carb food -- that's what we consider high carb (HC). Please take a look at Lisa Pierson, DVM's site on feline nutrition and Janet & Binky's Food Charts. While there are dry foods that are low carb, the dry stuff is really not a good option for cats -- diabetic or not.
 
Thanks, Sienne. About the profile and the "shed" idea - that makes a lot of sense.

Migoto's eating, drinking, and moving around as usual, so whatever's going on doesn't seem to be bothering her that much, and at least I know her numbers aren't too low.
 
Sienne explained the 'shed' aspect of Lantus/Levemir very well. Please don't jump to conclusions too quickly about Migoto's +4 number. It is early in her treatment and we don't know how she will respond exactly.

As for your meter, test your own blood and see if it seems correct. Not poking between now and when you go to the vet isn't really a good idea. This ear poking seems more stressful on humans than it does for the kitty. Really it doesn't stress them, even though some vets like to suggest that. Ears are stuck up there and are the first things in a cat fight that get scratched, bitten, gouged, and mother nature didn't make the ear very vulnerable and there just are not that many nerves. Feral kitties get their ears tipped (cut) to be identified... Ears are not sensitive.

Without testing, you are at real disadvantage. Testing is your guide, your information, your handle on how things are going for your kitty. Please don't give up on it today. I hope you reconsider. A few higher numbers doesn't necessarily mean your meter is wrong. If that was the case... most of us would have thrown out our meters to get new ones that would show better numbers, hee, hee!

You will find the correct dose for Migoto and that meter will give you the answers you seek.

Good luck, keep testing!
 
Hi Kathy & Migoto.
Never feel worried about asking questions. You will get the hang of it very quickly.
I am starting to feel like an "oldbie" (lol) but really we are only here since Nov.
There are many thing to learn and it takes some time, but it goes by fast.

Testing becomes easier and I know it is hard to beleive but soon Migoto will understand the routine and know when it is test and shot time. Max knows exactly when I will test him and he goes to his chair to wait. I don't know if you are giving treats but the ones I use are the pure snacks chicken, it is only chicken, and he gets some of those when I test him.
Hang in there and you will see it will all come together.
 
Sienne and Gabby said:
...You are feeding dry Iams Indoor Weight and Hairball formula? This probably explains the spike in numbers and I wouldn't be surprised if Migoto's numbers continue to rise. This food is 40% carbohydrate. We are pretty adamant about feeding canned, low carb food -- less than 10% carb. Not only is the Iams extremely high in carbs, it will stay in Migoto's system for much longer than a canned, high carb food. To be honest, when we are trying to steer numbers in a situation where BG is running a bit low, we use an 18% carb food -- that's what we consider high carb (HC). Please take a look at Lisa Pierson, DVM's site on feline nutrition and Janet & Binky's Food Charts. While there are dry foods that are low carb, the dry stuff is really not a good option for cats -- diabetic or not.
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Hi Kathy, Happy Sunday!

I just wanna weigh in here with what Sienne mentioned about the dry food. Dr Lisa's site is full of information about the effects of dry food in a kitty, and yes - diabetic or not - it's true.
I hope you will take a look thru her site, it really would be so beneficial for Migoto to be transitioned away from dry food. Please remember it needs to be a slow transition, it is very important you're aware of this. Everything is explained in Dr Lisa's website.

While using insulin, it will take so much longer to get his numbers stabilized. And yes, dry food will always give you that high BG spike.
I know it seems so much safer to not be in the low numbers, but the reality is, feeding dry food while treating with insulin will just be an endless circle of high numbers.
There are precautions to take, things to learn in advance to prepare u for those low numbers. One of the best thing to have in your hypo tool kit will be several cans of high carb 18% wet food, ones with gravy content too.

I'm so glad to see you here in Lantus Land, learning and asking questions. Migoto is a very lucky little feline to have you as his mom. cat_pet_icon
 
Thank you, Ronnie!

Sienne suggested I print out Janet & Binky's chart and take it in to my vet, and I am going to do that. I really want to switch Migoto to better food...but do it as safely as possible.

Thanks so much for your kind words. I keep worrying about failing Migoto, but hopefully that won't happen! I know that it takes time to see changes.
 
There is no way in the world you could fail Migoto!! Not only are you clearly dedicated to your kitty, we wouldn't let you. You have found a wonderful community of people who are just as caring about each other's cats as you are about yours. If you page back through some of the excitement that's gone on here in the last few days (condos that have lots of posts), there were members who stayed up all night with a cat and companion who were in a difficult situation. There is a tremendous amount of expertise and dedication here. The beginning of this process is scary and the learning curve is huge. We've all felt overwhelmed and like we're going to make some horrible mistake. Even if you make a mistake, there are people here who will help you to sort out what the best and safest course of action is. Everyone here knows that people are doing their best.
 
migoto and mom said:
Migoto's +4 reading was 531...I called the vet to ask about the numbers continuing to go up, and she said that my glucometer might be calibrated incorrectly, or I might be stressing Migoto with the pokes and getting false readings.

So I will be watching her for symptoms but not doing more pokes until I see the vet again and we calibrate my device in the office to be sure my readings are accurate. :/
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Or maybe the dose might be too high. I am still new so I can't be sure, maybe some of the veterns can help with that, but I can tell you that before coming to this board I was dosing Sami based on BG at the time of shot, I didn't know any better, and my vet gave me the go ahead. BAD IDEA. Plus, it seems that the more insulin I gave Sami the higher her number went. Under the recommendation of others on this board, I reduced the dose back to 1 unit, and in just a few doses of 1 unit I am finding that Sami is doing much better than she was on 2 or more units. She is still a little high pre-shot, but she seems to be consistently dropping so I will be sticking with 1 unit until I see otherwise.

I know the vet recommending you increase to 2 units, but you didn't have any home testing data to go on. Based on what others have told me in this group, it might be wise to back off to one unit for a few days to see if she doesn't start to stablize.

You can also test your meter with a control liquid, sometimes it comes with the meter, mine did.

Hope to see some lower numbers in Migoto's near future.
 
She's 413 at +11.

At least she's out of the 500s...but still.

I don't know whether to dose her or not this evening. She hasn't been eating much all day (post-breakfast - she did have one snack though), but I've left her food dish out. She's eating now, but it's an hour before her usual dinner/insulin time. If she doesn't eat again at 6:30 I think I should hold the dose? Does anyone have recommendations?

Tina - that is really interesting that you were getting higher BG #s on a higher dose. I mean, I am so sorry you had to go through that, but that seems to be what might be happening with Migoto.

Sienne - thank you so much. That makes me feel a lot better. I know I'm trying, but there are so many things I don't know.
 
Yes - she's been very sleepy today. I mean, she will walk around a bit but very quiet and subdued and seems very tired.

She's used her litterbox, though not as much as she has been lately (which was a lot). She's still drinking regualrly and peeing a lot but that seems to have cut down.

But very very tired.
 
migoto and mom said:
She's 413 at +11.

At least she's out of the 500s...but still.

I don't know whether to dose her or not this evening. She hasn't been eating much all day (post-breakfast - she did have one snack though), but I've left her food dish out. She's eating now, but it's an hour before her usual dinner/insulin time. If she doesn't eat again at 6:30 I think I should hold the dose? Does anyone have recommendations?

Tina - that is really interesting that you were getting higher BG #s on a higher dose. I mean, I am so sorry you had to go through that, but that seems to be what might be happening with Migoto.

Sienne - thank you so much. That makes me feel a lot better. I know I'm trying, but there are so many things I don't know.
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Sami was the same way, she wouldn't eat when I tried to give her food. I had to learn to let her be and let her eat on her own. The only time that I really got nervous was when she got too low and I had to force some food down her.

Again, please remember that I am still a newbie myself, but I would suggest that you go ahead and give her her evening dose even though she hasn't been eating today. But, I might suggest that you reduce it to one unit rather than the two. Again the reason I say this is because you don't have a lot of data to judge how Migoto will do on 1 or 2 units. As you can see from Sami's spreadsheet she wasn't doing well on 2 units but now that I have reduced her to 1 unit she is doing better. Still high, but better. Just my opinion.
 
migoto and mom said:
I don't know whether to dose her or not this evening. She hasn't been eating much all day (post-breakfast - she did have one snack though), but I've left her food dish out. She's eating now, but it's an hour before her usual dinner/insulin time. If she doesn't eat again at 6:30 I think I should hold the dose? Does anyone have recommendations?
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Yes, 413 is a number that definitely needs insulin. Lantus isn't an insulin that needs food on board right that minute to shoot, if she is eating now she is fine. (FYI, though, we do usually pick up food about 2 hours before shot time just so we can get a "true" BG reading at shot time - a reading not influenced by food. But, if you've been worried about her eating, I would have done the same thing in letting her eat if she wants to).

Sienne - thank you so much. That makes me feel a lot better. I know I'm trying, but there are so many things I don't know.
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I can't speak for Sienne, but I can say that the reason I am here is because this place helped me learn to help my kitty, and now I want to pay it forward. We want to try to support you while you learn, because feline diabetes IS a very steep learning curve and it's overwhelming to think you have to learn everything at once. :smile:
 
Okay, it sounds like the consensus is to give her her shot at 6:30, but drop it back to 1u.

My vet told me not to give insulin if she hadn't been eating - but I don't know whether that meant AT ALL or right at the usual time.

Before today she's taken her meals very promptly.

Edit: she did eat a bit at 6:30! So I gave her 1u and she seems fine - washing herself (normal post-dinner Migoto activity).

I am going to ask my vet about trying a diet change plus 1u instead of no diet change plus 2u. Hope it works.

YOU PEOPLE ARE A MIRACLE. :) Thank you from a nervous newbie.
 
migoto and mom said:
Okay, it sounds like the consensus is to give her her shot at 6:30, but drop it back to 1u.

My vet told me not to give insulin if she hadn't been eating - but I don't know whether that meant AT ALL or right at the usual time.

Before today she's taken her meals very promptly.

Edit: she did eat a bit at 6:30! So I gave her 1u and she seems fine - washing herself (normal post-dinner Migoto activity).

I am going to ask my vet about trying a diet change plus 1u instead of no diet change plus 2u. Hope it works.

YOU PEOPLE ARE A MIRACLE. :) Thank you from a nervous newbie.
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I think you will be happy that you did give her a dose; otherwise you might be stressed out all night. And Migoto might not be eating purely for the fact that she doesn't feel good and if she gets another dose of insulin you might be pleasantly surprised and she will start eating again on her own once she gets a little lower. I can tell you from my experience that Sami eat very little when she was in the 400 and 500's. Since her diagnoses she has lost 2 lbs, so now I am feeding her whenever she wants food, even though she really doesn't need to gain those 2 lbs back. She is currently 12 lbs, and a good healthy weight.

Hope to see some lower numbers for Migoto tomorrow morning.
 
good job, glad you shot. :smile:

Just to clarify, your PMPS is being done 12 hours after AMPS, right? Your numbers are in the +11 column on the spreadsheet, that's the only reason I'm asking. Just want to be sure I'm not missing something.

Now that you have chosen a dose, remember that 1 unit is Migoto's dose until it is time to increase according to the protocol. Don't be tempted to increase the dose if you see high numbers. Great start!
 
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