1/16 Sami - PMPS 157 NEED ADVICE - +14.5 121

Yesterday's Condo

It’s a new day with a new meter. I am not happy about seeing this number this morning, but at least I know it is more accurate that what we have been getting in the past few days on the other meter. I wish we were on to days with all blues, but that might still be a little ways off.

I did increase the dose to 1.5 units this morning under the recommendation of the vet last night. I know we could be seeing some higher numbers today because of the dose change, but I am hoping by tomorrow we will be seeing some better numbers. Keeping our fingers crossed.

Hope everyone has a nice Saturday. Mine will be spent surrounded by my furry friends knitting.

 

Re: 1/16 Sami - AMPS 396 - New Meter

can you add the days from when you started Lantus back to your SS and just make a remark of when you changed meters.

Didn't you just increase to a 1.1 a few days ago? we usually increase in .25u increments, and hold the dose for 6 cycles. I feel that an increase to 1.5u might have been a bit too aggressive

 

Re: 1/16 Sami - AMPS 396 - New Meter

Hi Tina

if u change meters, that info can just be added in ur comments of ur original spreadsheet.
That way all ur data stays together and there's no jumping around from SS to SS.

 

Re: 1/16 Sami - AMPS 396 - New Meter

Just wanted to pop in and see what was going on in this condo. As you've been told, we tend to do a gradual increase or decrease here and try to let it ride for at least 6 cycles to give the new dose wonkiness time to level itself out. Most kitties do tend to bounce slightly when there has been a chance in the dose given. Hope you can start to see some good action out of the dose, but remember, be patient. This does take time.

 

Re: 1/16 Sami - AMPS 396 - New Meter

The numbers are there, they are just on a different tab. If you look to the top you will see the tab with the TrueResults Meter. I just didn't want to look at those numbers any more.

 

Re: 1/16 Sami - AMPS 396 - New Meter

Thank you for your advice, but I will be sticking to the 1.5 units as recommended by my vet.

 

Re: 1/16 Sami - AMPS 396 - New Meter

I agree with Heather about this new increase being a bit too aggressive, particularly for someone new(er) to Lantus. Your vet basically recommended an increased based on one number, and that is something that we don't do here. You need to look at trends in BG, which is why we wait the 6 cycles/3days after each increase before increasing again. You switched meters, I understand, and your new data collection starts with the switch.

Please keep a close eye on the numbers and be sure to get plenty of spot checks. As this dose was not worked up to in the usual fashion, we have no idea what it could do to Sami's BGs.

 

Re: 1/16 Sami - AMPS 396 - New Meter

If you are going to be following your vet's advice and not the protocol mostly followed here in Lantus Land (which you have linked in your signature), you will want to mark that on your spreadsheet for clarification.

 

Re: 1/16 Sami - AMPS 396 - New Meter

Heather did not give you advice. She gave her opinion as being a tried and true experienced diabetic kitty bean. Whose kitty is presently in OTJ countdown. Yes, we follow a tight protocol here. Why are you so defensive. We are a very friendly, helpful, caring group. Many of these individuals have been here for years volunteering the information they have gathered for the benefit of our sugar kitties. You seem to misinterpret, misconstrue, challange or be antogonized by anything posted in you condo. Do you have a purpose for being on this forum? What is your goal. I think at this point we all need to understand what is going on here. I'm sorry if this offends you but it is a question that I think deserves an answer.

 

Re: 1/16 Sami - AMPS 396 - +3 361; +6 284; +9 230

So far Sami seems to be doing well. She is down into the low 200's which I am happy about, but a little nervous depending on where she is at PMPS. I will probably be nervous about giving her 1.5 units if she says at 230 or lower, and maybe even up to 260 before her PM shot. I know others have expressed their concern about the jump in dose and it might come to bit me in the butt, but hopefully it won't. I will wait and see here she is in a few hours and hopefully I will feel comfortable at that dose, because I know how important it is to stick to a consistent dose.

 

Re: 1/16 Sami - AMPS 396 - New Meter; +3 361; +6 284; +9 230

Is your vet that you are relying on so heavily available 24/7 to help you in case your Sami has a hypo??? The people on this board ARE and WILL help you no matter what. Heather and Jill are two of the most experienced peeps on here and I would not toss off their advice so casually. I am worried about Sami and hope you will get middle of the night checks as that is when they sometimes go low (my Morris is a +8 nadir).

 

Re: 1/16 Sami - AMPS 396 - +3 361; +6 284; +9 230

Tina, I see that you haven't noted in your spreadsheet that you're not sticking to the protocol. Can you at least do that so people know, and can help you appropriately, if you need it? And I also noted you didn't address Barbara's question. Can you answer that?

You know what, you're really taking it on the chin. I can imagine you're pretty frustrated right now. I can't speak for anyone else, but I have to say that you've stuck your chin out; dismissing Heather and Jill without even thinking about what they're saying is disturbing to me. And not being willing to do what's right for your cat, but instead rely on a vet who is not a diabetes specialist and who will prescribe things based on one single number instead of looking at the whole picture is worrisome.

I know you're new. I know all this has got to be so confusing. I remember learning diabetes in nursing school, and thinking "well, what????" when it comes to hormones, liver counter regulatory output, renal threshold, cellular needs and sugar releases, timing, and sensors in the body. Feline diabetes is very similar...and I can't imagine how boggled you must feel.

But I can't stress enough - you are on a website which works closely with hundreds, if not thousands, of cats. The collective wisdom here is incredible; vets look at this site to help treat their few diabetic patients. There are vets, vet techs, and people who have adopted only sugar cats, and they are the ones I turn to for help...and to whom I direct my vet when she has questions. Vets are not infallible. If they're not specialists, they probably have seen only a handful of sugar cats in their practice. These folks have seen hundreds of cats, have helped hundreds of owners, and have brought cats into remission countless times. They know what they're doing.

Please use the protocol according to how it's worked. Please listen to, and show respect to, those who are trying to help you. You run a huge risk of hurting your cat if you fool around with insulin without understanding it...and without being prepared to deal with a hypo event should one occur. You've expressed concern about shooting if she's under 230; I don't understand where that number comes from, but I really urge you to stop, look, and listen to those around you who have been there, done that, earned the tee shirt...

Best-
Michele

 

Re: 1/16 Sami - AMPS 396 - New Meter

No I am not offended, not a whole lot can offend me and if I were offended I would just walk away and find another avenue for information. I agree there is a lot of good information here on this board, and I am glad I am here, but I wish there were more people that were comfortable sharing their opinions, experiences and give their advice if they were in my shoes. It just seems like it might be that people feel threatened and don't want to speak up. At least that is what I think based on what has happened to me over the last few days. Sorry you think I am being defensive, I really am not. The last few days on this board have been very aggravating to say the least. Not, you, but another member actually PM me privately to just about scream at me for giving my opinion.

I have given my opinion on other condos and only been bashed for doing so. I welcome everyone's opinion and not just from those who have been here for years, that is what I am here for. And isn't that is what this board is about, sharing experiences.

A lot of what I have written about the "forum police" and being bashed as been sarcastic, because I don't understand why it is okay for some to give opinions but not for others. I just don't get it.

 

Re: 1/16 Sami - AMPS 396 - New Meter; +3 361; +6 284; +9 230

I definitely will get readings in the middle of the night, especially at this dose. I could have made the wrong decision to increase her dose this morning, but I am able to admit when I am wrong if that should happen. As I see it this forum is to get other people input, but in the end I have to decide what I feel is best. And don't think that I am just following my vet's advice without thinking through everything and doing my own research. I have spent more than 3 hours a day for the past week reading up about this protocol and understanding how it works and the research behind it. But the whole issue with the meters really got me frustrated, and I felt the need to take action. Had I known on Thursday where Sami's numbers actually were I might have decided to increase more than 0.1 unit. And maybe now I have overdone it, but that is still yet to be seen.

 

Re: 1/16 Sami - AMPS 396 - New Meter; PMPS 157

Michele and Esse I will get to you questions in a moment, but first I must ask for HELP, and I promise to listen. I can't promise I will do exactly as instructed, but I need some advice.

I just tested Sami for her PMPS and she is 157. I don't know if this is bad, but I am concerned about giving her 1.5 units. I know now that I probably should have stuck with the 1.1 dose I was giving as of last night, but I didn't and now I need to deal with it. I just gave Sami her dinner and can recheck in 30 minute. I can stall her test up to 2 hours if necessary, but only if that is the best option.

Thank you in advance for your advice and suggestions.

 

Re: 1/16 Sami - AMPS 396 - New Meter; PMPS 157

157 is not a dangerous number. Take a breath. In, out, again. She's eaten, yes? So just have the patience of Job and test again in about 45 minutes.

157 is all right. It really is.

Someone will be along to help you with the shot for tonight, but I just wanted to hop in and say 157 is just fine. And yes, it's scary the first time it happens, but it's also just fine.

Hang in there...

Best-
Michele

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

157 is not a bad number. Here though, when we get a number we are uncomfortable with we DO NO FEED. We retest in 15 minutes and see if the number is going up or down. The next test will reflect a food spike.

 

Re: 1/16 Sami - AMPS 396 - New Meter

Yes, sharing experience is wonderful, but you are still pretty wet behind the ears and are giving advice that you truly do not have the experience to be giving. I commend you for wanting to help, but often it is best to step back if you are not 100% certain of what you are posting. There is much that goes into giving dosing advice - knowing the ins and outs of the protocol being used and having seen it used in many cats, knowing how to read a spreadsheet properly, knowing the nuances of the particular cat you are helping and the bean that is caring for the cat.... Giving opinions based on less than two months worth of Lantus use can be detrimental to the person you are trying to help. I'm sure you don't want that.

Please do take the time to read Suggestions for Advice Givers as well as all of the starred stickies at the top of Lantus Land. Focus on learning the basics of the insulin you are using and Sami's regulation. By doing so, you will gather enough information over time to add value to a conversation with facts and data.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Please update your ss, all right?

Am I right in thinking she was at 230 at 8, and now at 12 she is 157? And that she should be having her shot now, but that you're stalling it to make sure you're not shooting a dropping number?

There are a few options you have. One, shoot nothing (not the best idea around). Two, shoot a smaller dose, and three, shoot the full dose.

I agree with those upthread who thought this might be too aggressive, and would suggest to not shoot 1.5 units. You really don't have the data yet to shoot the lower numbers. Tilly protocol says that if you don't have the data, you can shoot a 'token' dose, but I wouldn't know how much that is. And skipping the shot is not a good idea if it can be helped.

So someone will come along and help...in the mean time, go brew a pot of coffee...it might be a long night. You do have plenty of test strips and some HC around, right? I don't believe 157 is a dangerous number at all, but it's always best to be prepared.

Best-
Michele

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Please test again in 30 minutes - DO NOT FEED YET. Please post the next number and we can help you decide what to shoot.

 

Re: 1/16 Sami - AMPS 396 - +3 361; +6 284; +9 230

Please don't think that I am dismissing Heather, Jill or anyone else without thinking about what they are saying. Believe me I do think about it, but with some of the things posted it seems that there is no leeway, it is hard and fast with no variation.

I try to show respect to everyone who is trying to help, but when someone comes off as being authorative a know-it all it turns me off. I understand that there are some people who have been here for years, and they have a lot of experience with this, but for me that doesn't make them more knowledgeable then the next person, only having more experience. As I have seen from so many spreadsheets that almost every cat is different and reacts differently to the insulin, so all I can to is listen to the opinions that everyone gives, and do what I feel is best. And hope that if I make the wrong decision I don't get yelled at. Understand that this is all very new to me and with all the information overload it is very difficult to decide what to do.

I see now that perhaps I should have stuck with the protocol and not increased under the advice of my vet. But like many people sometimes I need to make a mistake to see my error and now that I do I will do my best to stick with the protocol. I should have learned this when I first arrived on this board, because after two weeks of numbers all over the place (even with a meter that was reading low) Sami's numbers were stabilizing once I started to follow the advice given on this board, but I didn't and now I am learning yet another lesson.

I am sorry if any one felt like I was being rude or unappreciative, but when you get yelled at sometime you can come off defensive even if you don't mean to be.

I hope everyone can understand where I am coming from; everyone of use has been a newbie and trying to understand everything and do everything possible to make their kitty feel better.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Too late, I had already fed her before I posted. I will try to remember that for next time.

Will this really screw up her number? I know she will probably go up because she ate, but what can I do now?

 

Re: 1/16 Sami - AMPS 396 - New Meter; PMPS 157

Thanks Michele, I realize 157 isn't a dangerous number, but my concern is with giving Sami 1.5 units tonight and having her drop too low overnight. I will test her again in about 15 minutes and let you know where she is.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Opps, I didn't know that before, so I will remember that for next time. There isn't much I can do about it now.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Alright then, let's move on and focus on Sami.
Re-test like it was suggested.
Post ur number, and we go from there....u will prob have to monitor tonight whatever ur comfortable with to shoot.

Plus this will give u good data for ur SS.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Sorry about not updating the ss right away, but yes, She was at 230 at +9 and 157 at +12, and I am stalling to see what I should do. I would rather not skip the dose, but as you can see I am not data ready to shoot 1.5 units at this lower number. I don't know if I should drop back down to 1.1 units or maybe even lower for this dose and then resume the 1.1 units in the morning.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Please test again at +12.5 and post. Nothing we can do about the food now, but in the future we do not feed within 2 hours of a shot (past +10) in order to get a PS number that has no food influence. When stalling a shot, we do not feed until the shot has been given.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

I do try to take up the food 2 hours before the PM testing, but didn't do that today, there wasn't much food left in the dishes from the afternoon snack, but I have found that they prefer fresh food, so it is still possible that she didn't eat within 2 hours of her PM test.

I just tested her again at +12.75 and she is at 156, and she did eat dinner. It is hard to determine exactly how much she at because I have five cats and she tends to go from bowl to bowl testing all the food, even though it is all the same.

 

Re: 1/16 Sami - AMPS 396 - +3 361; +6 284; +9 230

It is hard to decide what to do. Even with my background, it's hard to decide what to do. There is so much to understand. I've been new...still am, frankly, and I totally "get it".

Believe it or not, I'm a lot like you. I have the absolute worst time learning something by reading it. I am left with "kay, fine. Erm, what??" But if I do it on the floor, with a real live, sick patient, then it all makes sense to me. Once I've done it 20 times, and then go read the book, it makes complete sense. So yeah, we're a lot alike. The difference is that I'm 44, and have learned that there are a whole lot of people who've already done this, and are willing to help me...if I can shut up and listen, and take direction. I've learned, at 44, that I don't need to invent the wheel yet again...just take what I've been taught, and go with it. It's a lot easier that way, believe me.

And I will also say that experience does indeed make someone far more knowledgable. It's one thing to learn it from a book, and a far different thing to do it in practice...time and again, over and over. Experience makes people far more educated than just a book...which is why neurosurgeons don't start out that way...they can read a book, sure, but they're not cutting into my brain unless they've done it on others - and the others have survived. LOL. They have years of experience behind them before they're neurosurgeons...that experience is what counts, not the book knowledge.

Let me see if I can recap what's happened in your head. You got the dx, and got very scared. You read everything you could find. You talked to your vet, who you see as an experienced, knowledgable person. The vet said "X", and that became the rules to live by. Then...you came here, where we say 'well, X isn't exactly right. We need A, B, C...and btw, we also need 1, 2, 3. And after that's done, we want you to do X1,B3,C2, A1.'. And that's scary now, too, because there are things happening which you weren't told about, and which show you that maybe your vet is not the end-all of what's right. And you feel like you're spinning around, and have no idea what you're supposed to do...and all you want is someone to tell you "if you do this, all will be well" so you can just do that and get back to lovin' on Sami instead of being scared all the time.

How close am I? LOL, I say all that because that's exactly what I went through. Truth is, no one can say 'do X and all will be well'. That is the issue with chronic illness. We do this one day, that the next, and are still left scratching our heads when yet another variable shows up and says "BOO".

I totally get it, Tina. I really do. What you need to do now is get very open, and willing to listen to those who can get you through this and into some sort of regularity and control over this. You really need to just take a big breath, put the ego aside, and say 'yeah, I'm scared. These folks can help, but it may be a day by day thing for a while, and until I know what I'm doing, I need to just trust them.' It's all right to be scared, and to feel out of control. It's where we all started. And not one of us have forgotten it.

Tell you what. Do me a huge favor, and go grab Sami. Shove your face in her belly, and breathe in her love. Rub your face along hers. Scritch her chin. Rub her happy spot, and tell her you love her, and that things will come right. Take 5 minutes and do this with her, all right? Just take 5 minutes and reconnect with your cat...and then relax and know you're in some of the best hands around and they can get you through this if you let them.

Best-
Michele

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

We still want to wait for a true rise before you shoot. Please test again at +13.5 and post.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

do you have your new number yet?

There are a few ways to handle a lower than normal preshot, in order of preference and depending on your ability to monitor.

1) don't feed, test again in 15-30 minutes and repeat until you're comfortable that Sami is rising or surfing, then shoot full dose.

2) shoot a BCS (Big Chicken Sh*t) dose.

3) skip.

The first option has the least impact on the shed for the next few cycles, plus will give you good data, including showing you whether Sami needs a dose reduction (by going low). Because you have already fed, we'll need to wait for a significant enough rise (or a long enough time) to be sure any rise we see is not just a food spike.

The second and third options will effect Sami's shed for longer, but they are options if you can't monitor or if Sami doesn't rise to a number you are comfortable shooting.

Once you shoot your lowest ever preshot, you should get a +1 and +2 (at least) to collect data and find out which way Sami is going with this cycle. Of course, those numbers might show that more tests are needed, or they might show that Sami is going to Rebound City and you can back off testing.

eta: sorry, I see that you posted your number while I was typing, see you at +13.5

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Libby - Sami was 156 at +12.75. Waiting now for the +13.5.

 

Re: 1/16 Sami - AMPS 396 - +3 361; +6 284; +9 230

You are very close, only I really don't take the vet's recommendations as gospel either, that is why I am here and I have shared some of the information I have gotten here with her. She doesn't always understand what is happening here, but there are some things that I feel strongly about and want her to know about.

I am still very scared with all of this, and just want to make sure I do the right thing for my cat.

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

Yes, I will test again in another 30 minutes and repost.

 

Re: 1/16 Sami - AMPS 396 - +3 361; +6 284; +9 230

Of course you're scared. This is scary. And of course you want to do right by Sami...

So, take a breath, know we're in your corner, and that the protocol works (and yes, I've been known to question it, too...LOL), and that there are people here who have experienced many times what you're dealing with for the first time. And like I've said before, hang tight...you're gonna be fine, and so is Sami.

Best-
Michele

 

Re: 1/16 Sami - AMPS 396 - PMPS 157 NEED ADVICE

She is still dropping, at +13.5 she is at 142.

Now I also looked at the food that was put out and of the 2 cans that were put out there is really only about 1/2 can to 3/4 a can gone. I can't be sure how many of the cats ate food, but I amy pretty sure that Sami ate at least a 1/4 can herself.

Now what should I do?

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

I would test again at +14 and we can figure out what you should shoot then. We usually want to get something in the shed by +14 as that's when the insulin really starts wearing off.

Do you have HC canned food and lots of test strips in the house and can monitor after you shoot tonight?

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

I do have lots of test strips, and I can monitor after I shoot. I have some HC dry food, and what I think is HC canned food on hand.

Here are the canned foods I have on hand, but I couldn't find them on the list so I don't know what the carb count is.

FF Grilled Seafood Feast in Gravy
FF Grilled Salmon Feast in Gravy
FF Grilled Tuna Feast in Gravy

I will test again in about 15 to 20 minutes.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Yes, those are HC, good that you have those on hand.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Those flavors aren't on the J&B charts, but as long as they are grilled or sliced with gravy then they will do the trick - those are all about 16% to 18% carbs. We don't use dry food unless the kitty will not eat anything else. It takes too long to hit the BGs and lasts far too long in the system. Can take days to clear.

I'll be here when you get the +14.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

I could sent my husband out really quick to pick up some other food that is higher in carbs, would you recommend that if we can get to the store before it closes, or do you think we will be okay with the ones we have.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Those are fine. Many of us use the grilled or sliced FF. Not all are on the old list. It's okay - they will work well if needed as long as grilled or sliced. :smile:

ETA: Don't feed now - just want to know that you have it on hand in case Sami drops lower tonight.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Okay, I am going to go test Sami again and will be back in a minute to let you know where she is.

Thanks for your help.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

She is at 141 at +14.

+12 = 157
+12.75 = 156
+13.5 = 142
+14 = 141

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Okay, so she's not dropping any more. How do you feel about dropping back to the fat 1u/1.1u that you were giving before, and getting a +1 test? Sound okay with you?

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Out of curiousity I just tested her with the TrueResults meter that we had been using before this morning and she read 101 on that meter. The lowest that she has ever been on that meter when I shot 1 unit was 185, so I am not really comfortable shooting 1 unit at this reading.

I really don't want to skip the dose all together, but I am so nervous. She has never been this low and I just don't know.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

It's okay. We've all been there before. What would you feel comfortable shooting? 0.5u? 0.75u? Want to get something in the shed if possible. As long as you have HC and can monitor, then you can control numbers, but you do need to feel comfortable with what you decide to do.

You do know that the True Results meter reads lower and is not as accurate. I would put it deep in a closet and never touch it again. ;-)

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

I'm sorry but enough of that meter. ditch it. We went through all this. It is not valid and you don't change meters at a time like this. Okay?

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Hi Tina,

I've skimmed through this thread before posting and would like to share my thoughts:

1) If you received "nasty PM's", please do everyone on this board the favor of copying/pasting it publicly for all to see.

I say this because while the PM function is available and a useful function, it is NOT intended to be a way for one person to privately bash another and get away with it. The only way to stop this behavior is to publicly expose the PM offender.

So, please POST the offending PM for all to see and let's get this person to defend themselves publicly and not just be a private basher. This nonsense must stop.

2) My first meter was the true track/true result thing - personally I found it to be totally inaccurate when compared to a name brand meter. I couldn't figure out why the numbers read so much lower than the name brand. A very wise person from this board told me to toss the meter and use the name brand and stop trying to figure it out. I did and never looked back. If you look at my SS, you can see what I mean by wacky numbers.

3) I understand the fear, frustration and uncertainty of who do I trust and believe - I think most of understand that. Many of us have all kinds of vet stories we can share and how the vet's advice was wrong, incorrect and dangerous.

Now, I'm not saying your vet is any of these things, but given the BG's you are looking at, you may want to reconsider changing the dose - so quickly and by that huge an amount.

If you do not want to follow the protocol, that is your option, may I suggest that rather than go from 1.10 to 1.5 directly, that you instead try a 1.25 or something that is in-between the two.

I am not an expert when it comes to dosing, I understand my cat and some of the basics regarding protocol. I also know that the advice given by the experts here is invaluable. If it wasn't for them, Maui would not be OTJ today.

Hope this is helpful to you.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

As I was the offending party-"the Forum Police" who PM'd you yesterday when you gave 2 members incorrect information, I hardly think that what I said to you was screaming-
I wish I was able to show that PM as all I kept saying is that you cannot give advice unless you have experienced it.-And you answered me in a very mean way!

Tina, it is unfortunate that it has come to this- I am Truly sorry your cat is having a hard time right now
I never told you not to have an opinion, but I did say you cannot give advice when you have no experience here.
This is a difficult journey and has many twists & turns in the road..
I had a difficult start here and had a Vet who almost killed my cat..and had I not come here, she might have been dead! I had lurked here for a month before I even came on the board.

This board saved my cat's life and Mine many times Over!!
This is our Family here, laugh together, cry together, and try to find ways to manage this devastating illness..
Our cats are well because of this..
I hope for your cat's sake that Sami will be well too!!
It takes a long time for many of us to get to that place where our cats are stable, but it's all worth it when that cat comes & lays by your side..and purrs.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Yes, I do realize the TrueResults meter reads lower and isn't as accurate, but since my data history is with that meter it gives me a little more information to work with in making a decision.

Would feel more comfortable with .5 or .75 units, but I don't want to screw up her system, or make her go too low.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

I only wanted to get a reading with that meter since that is what I have data from. I don't plan on using it in the future, but I felt I needed more information in order to decided with dose to give.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

if you're comfortable with 0.5 or 0.75, then I would shoot that. Remember that tomorrow morning's shot will be due 12 hours from now, not at your regular time (if Sami is high enough in the morning, you can shoot 1/2 hour early to start working back toward your schedule.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

It doesn't really give you more information, as we base dosing on trends and you are now using a new device for that. Stick with one or you will drive yourself crazy and not be able to figure out what to do.

Sami is going to bounce off these numbers at some point. She is not used to them right now, and even though they are still above the normal range, her body views them as abnormal. That is part of the process.

Lower numbers are nothing to be afraid of if you have the right tools (HC canned and test strips). You can control them and you will see that. Please look at Sasha's spreadsheet. She is continuously in the 50 to 80 range and is happy as a clam. She has been as low as 22 before without any problems. We do not aim for that, but low numbers sometimes do happy and you feed them HC and all is fine. I've been at this for 2 years and I wouldn't be advising you of anything that I thought would be harmful to Sami, I promise.

The beginning is scary, and the first low numbers can be scary, but there is nothing to fear right now. Just need to get insulin in her and take it one step at a time.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Okay, I think I will test her one more time in a few minutes before I shoot. that will be +14.5. And as long as she is still steady or rising I will go ahead and shoot a fat .5 or .75, I guess I will decide when I actually do it.

Now my question is how do I mark my spreadsheet with this information so I have the data for the future?

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Ditto what Libby said - 0.5u or 0.75u is just fine for tonight if it is more comfortable for you. Please do just get a +1 test in after you shoot and we can see what other tests you need from there.

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

Okay, I am really confused now.

Sami is now at 121 at +14.5. Do I still go ahead and shot a .5 and keep testing? And if so how often should I test?

 

Re: 1/16 Sami - PMPS 157 NEED ADVICE - +13.5 142

You can put all of the tests in a line in the blank note line on the right hand side of the SS. Something like this:

+12 157, +12.75 156, +13.5 142, +14 141

Then put the actual PMPS number that you shoot (which will be +14.5) in the PMPS box and add a +14.5 beneath the number.

Does that make sense?

 

Since you are so far off schedule now and the number is dropping, why don't you go ahead and skip tonight and start over in the AM with the 1.1u dose? Okay plan for you?

 

That sounds fine, but I really don't want to screw her up again. Even if I wait another 30 minutes I could still adjust to a time that I can shoot for Monday morning. Should I let it go another 30 minutes and test again? Or should I just call it a night and let it go? Either way, I could still test her again in another hour or so to make sure she is surfing or rising.

 

Plus, I am going to feed her again (since I don't think she ate enough at dinner) so she might start rising with a snack.

 

It's not a problem to skip tonight. Her shed is a bit overfilled from the increase today, and skipping will let it drain out. I don't normally advise to skip if it can be helped, but this is a special situation.

If your schedule is flexible, then you can certainly dose later tonight if you want, but we do try and stick as close to 12/12 as possible. As Libby said, that would put your next shot time at 12 hours past when you shoot tonight.

 

Okay, at this point I will test again in another 10-15 minutes and see where she is. If she is on the rise I will go ahead and shoot .5 and then feed her again. If she is surfing or lower I will skip, and go ahead and feed her.

If I skip should I just check and dose at the normal time of 6:00 am tomorrow?

 

Sounds like a good plan. If you do skip tonight you can shoot at whatever time is best for you in the AM, as long as you can stick to it 12/12 and can get some before bed tests in the future with whatever time you choose.

 

You're in for a rebound, no matter what you do. How bad it is depends on what action you take right now.

I think Cassandra had a great suggestion: skip the shot, and keep an eye on Sami until you see a consistent, 3x rise. She seems to still be dropping, at a point where the insulin should've been depleted. That tells me that 1.5 is too much for her, and it would be best to let her find the bottom by herself and not add any more insulin into her system at the moment. If you do add insulin, you're setting up for a hypo event.

Of course it's your choice, but if it were me, and my cat, and Cassandra suggested it, I'd be skipping the shot, be prepared for low numbers, and pick everything up tomorrow morning at the regular shot time with 1 unit.

Best-
Michele

 

Just to clarify, this isn't necessarily always what happens with a dropping PS. Oftentimes there is a double dip with Lantus/Lev - meaning the insulin will give a true nadir and then drops again around PS time. It is fine to shoot that with experience and no low numbers may ever come from it. However, given the unwarranted increase and the immediate drop following the increase, it does appear that the shed is too full right now. Shooting would still be fine as long as monitoring was done, and it is possible that the cycle would have to be controlled by food, but it is very difficult to predict that as we do not know when the bounce from these numbers will begin.

Because of carryover and overlap, there will always still be insulin still working past shot time with Lantus and Levemir.

 

Okay, I skipped the dose. At +15 she was 120, somewhat steady from +14.5, but still dropping notheless. I did just feed her again, so more than likely she will start to rise again. I will prepare myself for a higher number in the morning.

My next question is, should I continue to test her for the next few hours to make sure she does start to rise or do you think it is okay to give her a break on the testing since I didn't give her a shot. If I should continue to test how often, every 30 minute or every hour?

 

Clarification noted, Cassandra, and I *knew* that already. I just forgot to put that in my post. LOL.

Tina, I think you should be testing a bit this evening, and posting numbers. She may get kinda low, and it will be a bit scary for you, but remember to look at the patient, and do what is suggested here on the boards. You'll get through, and yes, she may go quite high tomorrow (take a look at my ss for good examples of rebounds that go skyhigh...).

BTW, what did you feed her?

Best-
Michele

 

You can stop testing for now. Maybe grab one in a few hours if you want just for data.

Just post again in the AM if you need help with the shot - one of us should be around. I would go back to the fat 1u/1.1u dose that you were on prior to this last increase today.

 

Really? On a dropping number? Cool, I just learned something. Tina, this is why newbies shouldn't give advice. LOLOLing at me...

Best-
Michele

 

It was LC canned food. I put out a few differnt things because what I put out earlier didn't go over well with anyone. Here is what I put out:

Turkey & Giblets Feast
Tender Beef & Liver Feast
Flaked Tuna with Egg Bits

Sami ate a little out of all these bowls, and remember I have 5 cats. Two of which got some of the dry HC prescription food in the other room, where Sami had no access.

 

This is really just surfing, not a true drop. It was not a massive OD and there is little chance of any danger as the insulin continues to wear off. Not a problem taking a break from testing for now. :smile:

 

Aha! Thanks for the concept...now, to remember that when Esse goes low.

And Tina, I have 9 cats. It is very, very hard to know who ate what, especially since some won't eat when the others are around (my two shy girls).

Best-
Michele

 

looks like quite a lot going on here... on many levels! ;-)
nice job testing, tina. you've collected a lot of useful information today. happy to hear you'll be taking the dose down a little...

 

Okay, will do. I will try to test her one more time before I go to bed, just to get the data, but only if she is up and about too. I don't want to have to wake her up or disturb her if she is already in bed, which is highly likely because it is already past our normal bedtime.

My guess is that she will be back in the 200's, or higher, tomorrow morning and I will feel very comfortable shooting the 1.1 unit in this range, but if some sort of miracle happes and she says in the low 100's I will be back her tomorrow morning for more advice.

Thanks for all the help. It is very reasuring that someone is always here to lend a helping hand.

 

Absolutely, at this moment the plan is to go back to 1.1 unit tomorrow morning. I think I have learned my lesson, although I can be very hard headed at times, so don't be surprized if I screw up again.

 

Yeah, what is up with that. Crystal the smallest of all my cats likes to eat when no one else is around. And for that matter Sami use to sneak back into the kitchen after everyone was in bed to sneak more food. I think she still does this, but not as much because there is no dry food left out for the midnight snack, just wet food and after awhile they don't have any interest in it.

I am thinking about getting a timed feeder though because I have two little piglets who will wake me up at 3:00 am if they are hungry and there isn't fresh food. It was okay when enough dry food was left out overnight, but now they finish up the wet or are not interested in what is left by 3:00 am. Bummer for me because they won't let up until I get up and feed them. Hubby usually gets to sleep right through their antics.

 

we ALL screw up... multiple times!

whenever you're prepared to see sami in green, there's room to take the dose up to 1.25 unit.
eventually the goal should be to keep sami in normal numbers overall. with the long acting insulins, we use overlap and carryover to our advantage to achieve that goal...