1/7 Ozzy AMPS 284, +3.5 118, +4.5 72, +5.10 58, +5.25 53, +6 71, +6.45 77, +8 100, +10 218, PMPS 312

Yesterday

Good Morning.

Glad to see a PS back into the yellows even if its a high yellow.

Ozzy has been tested, fed, and shot. I am going back to bed. I haven't slept in once since Ozzy was diagnosed. It is cold, gloomy, and raining and my snuggly bed is calling me back.

 

AMPS = 284
+3.5= 118

Hello blue...don't give us any trouble today.

This is definitely Ozzy's largest lantus drop so far. He's at +3.5 right now. From the data I do have, his last nadir's were around +4 but I also know some folks said that once he gets used to lantus, it will spread out more and nadir will be closer to +6. Or maybe not...ECID.

Ozzy did not get his 9am snack because I went immediately back to bed to sleep in after his t/f/s at 7am and didn't program his feeder. He is eating now. In a way, I'm kind of glad I am getting to see how he is reacting without the food being out because I can't always know who is eating what when I get home from work and sometimes there are still small meals in the feeder when I get home.

Anyhooo...here's to a hopefully uneventful day. I am really glad to see blue though!

Thanks @Chris & China for the suggestion to go up a dose.

When should I test again? +5?

 

Maybe test again in an hour. LOVE that low blue.

Btb is an essential coping activity for caregivers here. Glad you got a nap in.

 

I would test earlier, maybe at +4.
I might even give him a little LC snack

 

Yayay!!

What does this mean?

 

He just ate at +3.5, right after I tested him.

 

@Gill & George I can't get over how cute your kitty is...I want to scratch his little noggin right through my screen. Give him a big kiss from me.!!!

 

Yeah , yippeee, yahooo.... I see the blues from Elmo were delivered !!! Btw, on the syringe subject, I just received my order from ADW of ulticare vetRx u100 3/10cc with half markings and love them !!! But I am use to this brand from my vet so that may have a bit to do with it.Also they seem easier for my eyes to discern small markings. So so glad for Ozzy's blue this morning and hope u r feeling better too

 

BTB= Back to Bed

 

Oh Thank You Beth...and Mr. Elmo for sending some blues Ozzy's way!!

Interesting about the syringes. Can you send a picture of one when you have a chance?

I really don't like the relion ones we are using. Coming from vestulin, you know the insulin was kind of cloudy looking so you could see it clearly in the syringe. But lantus is completely clear so sometimes it's heard to see it when you are working with small doses and doses in between the lines. Also wish the end of the plunger or the lines on the barrel were a different color from eachother...that way when you're plunging up to a line, you could see where the black strip on the tip of the plunger is lining up better (because it would be different from the lines on the barrel or vice versa). My other issue is pushing the insulin out when trying to get down to your desired dose....the plunger doesn't move that smoothly (even with trying to prelub it before hand)...so sometimes I over expel insulin and miss my desired dose. It's kind of annoying....

Ok, rant over.

Thanks!!!

 

Oh hahah!!

 

I had to ask too the first time I saw that acronym

 

Oh no, not a rant...not sure if techy enuf to send pic but these are very smooth and I can see markings very easily..if you look on the Lantus Sticky they r or look like the syringe example on the left. I'm just excited about how smooth they move. If we do need to take low dose of Lantus these will make it easier...that and the jewelers loupe I got.Someone ought to listen to your idea of plunger or lines being a different color...that would be SO helpful.

 

AMPS = 284
+3.5= 118
+4.5 = 72

Ohhh...Blue AND green in one cycle!

His next timed snack is in 27 minutes.

I don't want to worry too much about him going in to green....should I be?

We have a whole kit ready on demand if he goes too low...

When should I test again? 30 mins?

 

Should I assume he is going to bounce after this big drop?

Do we continue with the 1.25U at PM shot?

 

From all the data I have so far on lantus (not much), this is the first time he has kept dropping after +4.

 

AMPS = 284
+3.5= 118
+4.5 = 72
+5.10 = 58

Uh oh...I really wasn't expecting him to drop into the 50s today. The 58 was before his 12 pm snack. He is eating now. will test again in 15 mins. Geez...

 

Before I tested him at 12 (+5), he was acting fine...laying in the back bedroom in the sunshine sunning his belly... He still seems to be acting fine. He just ate. Will test again in 15 mins.

 

Watching over all this....exciting but cautious all at the same time .

 

Hopefully some of the L+L pros will jump in here soon to help steer out of this drop, but in the meantime I've been watching and will jump in with a couple questions: was the snack composed of Ozzy's usual LC, or did you do MC? How much did you feed? +5 is pretty far into the cycle, but on Lantus they can keep dropping for a while so you should be prepared to do a little steering and do the usual (don't feed too much at once, etc.).

 

P.S. Good healing numbers today, though!

 

Jo

On the road and checking in. Please feed him a nice helping if a couple two of LC and retest 30 mins after he eats.​

 

AMPS = 284
+3.5= 118
+4.5 = 72
+5.10 = 58
+5.25 =53

Just gave him some HC Gravy Lovers..He is VERY happy about that. Test again in 15 mins.

 

Oh no Marje- I gave him LC first and then tested and he still went down. But I don't know if it was enough time for the food to kick in and bring BG up. So I just gave him some gravy lovers. I didn't want to take that out yet, but I was concerned he'd keep going down. I should've given him some MC food. We have some of that too.

 

I'd give him 30 mins. It takes time for the food to affect the numbers and if you don't give him time you can overcarb him. Especially later in the cycle.

 

His noon snack was just his regular LC food - about 1oz.
Just gave him some more food 15 mins later- Gravy lovers. about another oz
I'm sure he's going to pop up now. Wish I would've just given him more LC and seen how he handled it. Quick emotional reaction in the heat of the moment.
I have tried not to panic, that happened last time and everything was fine.... should've just stuck to his regular food.

 

30 mins for what? Until I test again? Or in general, 30 mins after steering to test again?

on the regular feline health board, when he went low twice before, they were telling me to feed and test every 15 mins. But that WAS vestulin.

 

But he enjoyed the HC treat so much! How could you say no to that sweet orange face?

It was a pretty dramatic drop for Lantus and he looked determined to be heading to the dreaded light greens, so I'd have done the same in your place before seeing Marje's recommendation.

 

30 mins to test after he eats.

I can explain more tonight when we aren't traveling and when you would want to test every 15 mins.

 

It is hard to say no...especially when he looks up at me with those sweet little sad round eyes!

 

It's ok: it's his first green and it's a learning experi nice. But you basically got him stopped at 53.

 

ok, sounds good Marje. Thank you!! Hope you are enjoying your road trip so far!

 

Wonder if that's a good or bad thing. I kind of was wondering what he would do if I didn't intervene unless it was an ultimate emergency.

I can't be here during the days to steer....

 

Thx. It's a gorgeous day for a road trip.

 

One day at a time. If necessary, you can drop the dose back. In fact, if you are going to start SLGS, he's waned a reduction for dropping below 90.

 

Up you come now Ozzy!!

 

Did I probably blow up a perfectly good cycle by overreacting?? Especially since he was already past the +5 mark. Friggin newbie!!

@Critter Mom Hey Mogs- look what Ozzy is up to today! lol. Always keeping his mama guessing!!

 

Ha! Holding ur hand in cyber land and trying not to hypo hyperventilate.....you are doing awesome and have the wonderful Ladies of Lantus showing the way ...we certainly are in excellent hands here

 

I had a feeling this was going to be an active cycle after that first drop. But I have to admit, I was super excited to see that firsr blue and green!

 

I got one of those but it was to difficult to try and hold it, the syringe and the insulin all at the same time so I got this...

https://smile.amazon.com/gp/product/B003UCODIA/ref=oh_aui_detailpage_o08_s00?ie=UTF8&psc=1

 

Seriously, I wouldn't worry about it-- my guess is that he'll probably be heading skywards from this first green whether or not he got his HC yummies, you've just taken out an insurance policy against the sharks is all.

 

Agreed Beth! Do we sometimes overreact to green numbers I wonder?

Saw some thread here awhile ago...not sure where...think in general chit chat and there was a bit of a debate going on about newbies underdosing their kitties for long periods of time because they were afraid of dealing with green numbers which are actually normal and healthy. Someone said kitties on insulin for awhile that are home tested rarely hypo and kitties own defenses kick in if they go too low. Not sure what to make of all that because there were competing opinions on this matter.

 

Lizzie- how awesome are those!!! Yes! I am buying one!!

 

Ohhhhh....wonder how that would work if you wear glasses????

 

Well worth the $10. Probably the best $10 I have spent trying to make my life easier with this FD dance.

Oh, and the calipers for constant dosing. I don't even look at the hash marks any more.

 

I wear contacts and have no issues.

 

AMPS = 284
+3.5= 118
+4.5 = 72
+5.10 = 58
+5.25 =53
+6 = 71

He's back up. Ozzy's wild ride!

 

Ha , I just did...for $9 it can't hurt !!! Thanks , Lizzie. These will be good backup in case ....

 

Oh joy, wonder what tonight will bring...
How long does it take to see HC flush out of the BG numbers?

 

Not only have we gone crazy....we are going to look crazy, too!! Haha!

 

Yeahhhhhh......little turkey .....seriously my stomach has been in knots watching this but you snd Ozzy did awesome...not sure where Elmo is headed but we've learning a lot from you and Ozzy as u go ahead of us

 

Group pic would be fun, dressed up in our FDMB garb

 

Yes. We often do overreact at first if the numbers come late in the cycle. You'll learn how to guide his numbers and teach his pancreas to surf them.

It can take up to two hours for HC wear off but you might see a bounce. Also, too much HC can nip the duration in the bud and you get big insulin poop out .

I'm losing my cell service out here in the middle of nowhere but he's likely headed up and you've got other eyes. I'll check in later.

 

I'm not sure how I feel about SLGS vs TR yet. What are the pros and cons for each protocol??

I really don't want to see Ozzy staying flat in yellow for a long time. I also don't want to be afraid of greens. I really want to see greens and blues, but I also want to be careful what I wish for.

Ozzy was on 1U for 6 cycles and was mostly yellow and pink. I also understand we don't have much data during the daytime for those cycles, because I was away at work in the daytime. And maybe he still needs longer to adjust to the build up of lantus in his system overall. He's barely been on it for a week now.

Not sure what to do for tonight's shot yet. Guess we will see what his PMPS is.... I am not sure if this is the best marker though for determining to keep him on 1.25U or go back to 1U, especially since I gave him HC and probably screwed up his cycle.

Oh this is getting even more fun!

 

I don't think I'd ever get use to them...just watching you go through it had my heart pounding for you/Ozzy...not that anything bad would happen but dealing with it , awwwwwwww......u did great !!!!!

 

Are you home to monitor tomorrow or will you be back at work? If home tomorrow, you'll have another shot at getting some good data!

 

Ditto what Marje said.

Just because this is ozzy's first time, and he was close to being below 50, I think checking again in 30min to make sure he is still staying up would be sensible, don't feed anything at this stage.

Does that sound like a plan?

PS
Bfg thanks you for the kisses the cheeky monkey says he'll like a belly rub too.

 

hahahah! Hilarious Beth!

 

Thanks Marje- yes, he's already headed up.

 

Thanks. But I do think I probably overreacted with the HC. Going to take a chill pill next time!

 

Yep, I have tomorrow off too.

I also have every other Friday's off (ya, my work is nice to me!) so I can get a lot more data on 3day weekends. Really wish I would've started the lantus earlier on my vacation when my gut was telling me to switch and we could've been further along in trying to get him regulated and on a good reliable dose.

 

Don't beat yourself up it takes practice, and we still don't know how it's going to turn out.

 

Yes, sounds like a plan!

OOOHHH belly rubs are my absolute favorite. I love the tummy tufts the most! Here's a little cyber belly rub and pat to you cutie pie George!! He looks like he is the absolute sweetest thing ever!!!

 

Oh my gosh....can u hear me belly laughing from here ?!?!?

 

Relax.....we ALL did it!!!

The first time China dropped below 50, I knew to give her some syrup, but wasn't real clear on the "how much" part (yes, we were really new too at one point!).....so I dumped about a cup full into a bowl and let her lap it up (was kind of surprised that she liked it!!!)

Needless to say, she came up fast!!!

Later I learned I was only supposed to give a drop or two

It's all part of the learning curve

 

AMPS = 284
+3.5= 118
+4.5 = 72
+5.10 = 58
+5.25 =53
+6 = 71
+6.45 =77
He is coming up slowly.

 

OH NO! Glad she liked it! Ok, so I'm not the only one who tends to overreact!!

 

Chris, could you please give a summary of what is considered lo,med and hi carb...keep seeing differing opinions on that

 

I think I may have officially crossed over into the crazy cat lady....OH NO!

 

Staying level, you're 1hr since the HC now, so not out of the woods yet.

I think I would check him again in 45min to an hour just to confirm he's staying up of his own accord.

 

ok, sounds like a plan.

 

Low is under 10%
Medium is 11-16'ish
High is 16+

But as with everything in this dance, ECID....so what works for one cat doesn't always work for another

I use FF Chicken Florentine (12%) for China's MC and FF Grilled Chicken Gravy Lovers for HC (18%)

 

These are Ozzy's favorites, too.

He especially loves the Florentine!

 

When you are up at 4:30 am to t/f/s after 3 1/2-4 hrs of sleep because of a 3rd or 4th late night doing what just happened (low #'s) you won't care how you look, only that you can see to get the dose accurate. Trust me. .

 

I trust you!!

 

Some of the very basic differences are:

TR...dose adjustments can be made as often as every 3 days (6 cycles)...this is most effective because if they're staying in numbers we don't like, we can increase more often
SLGS...dose adjustments are made once a week....this can be hard on the caretaker IF the cat is "stuck" in high numbers very long

TR...reductions in dose are given if they drop below 50 on a human meter, 68 on a pet meter
SLGS...reductions are given if they drop below 90 on either meter

TR...You'll want to get the 2 PS tests and at least one other test....preferably at least 2 other tests.....One somewhere between +4 and +7 on the AM cycle and a "before bed" test on the PM cycle...if you can only get 1, the "before bed" test is most important since most cats go lower at night
SLGS...You still must get the 2 PS tests in, and then do a curve once a week (testing every 2 hours for 12 hours or every 3 hours for 18 hours)

 

This is very helpful info. Thanks Chris.

So I think I am interested in TR but will this work for me with my schedule? I definitely cannot get a +4 and +7 test in daily on the AM cycle, but can every weekend and then also on my 2 Fridays off (so 10 days/mo). I can get some PM tests in....+2, +4 no problem. I might occasionally be able to get in a +5 or +6 on a weeknight. Weekends are always open. I saw a sticky on TR for those that work and I think most people were doing a +1 in the AM before heading out he door and then 2 tests at nighttime (in addition to the 2 PS). What do you think?

 

AMPS = 284
+3.5= 118
+4.5 = 72
+5.10 = 58
+5.25 =53
+6 = 71
+6.45 =77
+8= 100

Curious where he is going to be at PMPS. Think he will bounce up into the 200s in just 4 hours? What if he is only in the 100s at PMPS? We should decrease his dose then, right?

Ozzy has NEVER had blues/greens this long in any one cycle. Even though it got a little concerning there for a moment, I am so thrilled to see him in normal healthy healing numbers for this many hours of the day. So exciting!!!!!

 

Thank u, Chris

 

I am doing a sort of modified TR due to work. You are going to have to figure out what will work for you and, more importantly, what will keep Ozzy safe.

Here is my daily schedule during the work week:
3:35 wake up/test +11 from PM cycle.
Shower/get ready for work
4:15am downstairs get auto feeder set up for a.m cycle, get shot ready
4:20am-4:25am test, feed
4:30am shoot
Update SS, post daily thread
Finish getting ready for work
Relax and have a quiet cup of coffee
6:00am +1.5 test
Update SS, update thread
6:05am-6:10a say a prayer, give Gizmo a kiss and leave for work

PM
3:50pm leave work
4:15pm get auto feeder set up for p.m. cycle, get shot ready
4:20pm-4:25pm test, feed
4:30pm shoot
Update SS, thread
Get hourly tests unless obvious he is not going low
Nadir is +5-+6 (that is 9:30pm-10:30pm) final test

 

Lizzie, that is an impressive schedule, especially your ability to wake up at 330am!!! Holy moly! I wish I was an early bird like that. It's nice to see you get some 'me time' in the ams before work, too.
What do you mean by you get hourly tests unless obvious he is not going low? How many tests do you do in the evening cycle? What time do you go to bed if you are waking up at 330a? How many hours of sleep are you getting? Seems like very few if you're up testing at 1130p and up at 330a. You're a machine Lizzy!

 

It is a very tight schedule with absolutely no wiggle room. So far, so good.

Yes, sometimes I am up until 10:30-11pm. Other times I am in bed and asleep by 7-8pm. If need be, hubby will grab a test or two if I have gone to bed.

When kitties go really low their bodies are not used to it so they "bounce" high. I don't fully understand what happens but they run high #'s because of the low the cycle before (or couple of cycles before)

Look at the 2016 tab on Gizmo's SS at 12/23 & 12/24, see those low greens mid cycles? Now look at his #'s on few cycles more - it was high.

That is an example of a bounce (a very short one).

You will start to see patterns. The more you test the more patterns will be revealed.

 

Here is a good explanation of bounces
http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

Thanks, I did check out Gizmo's SS. I notice you have a ton of data all throughout the am and pm cycles. Do you drop in sometimes during the day to test him or Hubby tests him?? Wow that 25 on 11/20 looked scary!! You did an amazing job steering him up!!!! I think I'd freak over a 25!
Looks like you have experimented with doses a lot, too. Was Gizmo dx in October this past year?

 

Thanks for posting this. Easy to understand.

 

No, I had a ton of vacation to use up before the end of the year.

I would need to ck that. That doesn't sound right. Sometimes #'s get messed up, but yes, the first couple of times you feel like throwing up. Lol. Then, after you have been through it and know how they will react to the food, it is still stressful but not nearly what it is like that very first time.

Not experimenting once I was on track with the protocol.

Yes Gizmo was dx in October. Best guess is because of pancreatitis, steroids given, extremely HC special diet and potassium gel that contained sugar - all at the same time.

 

I might have mis read that number...I think I'm starting to need glasses. Starting to get hard to read all this tiny print.

 

Re:11/20 I remember that now. Yep, that was a gut rencher. First time I ever shot a green PS.

Here is the exciting thread

http://www.felinediabetes.com/FDMB/...mps-139-1-160-2-166-3-202-4-205-8-247.168426/

 

Lizzie and Jo....had to chime in here to say u two r AMAZING !!! DH and I r semi retired and home most of the time so I never have to do the scheduling and shuffling the two of you have to do with your work schedule. I am in awe, seriously in awe. You r two wonderful kitty mommas with sweet, helpful DH( mine is too, bless his heart)...and I am in awe of what u r doing cos u love ur fur babies

 

AND, btw, today I about threw up for you ......you know all will be well, you know what to do but it's the between when they drop and when they go up that turns ur hair grey !!! Mercy !!!

 

Actually it is the waiting the 30 min to test again that is the thing that drives my anxiety.

 

They're awesome! I just started using them last night

You did well, you kept Ozzy out of the danger zone. I think it will get easier as you learn how much and how fast he responds to LC, MC, and HC food in this situation... though I haven't seen green yet with Chino, so I won't pretend to speak from experience.

 

AMPS = 284
+3.5= 118
+4.5 = 72
+5.10 = 58
+5.25 =53
+6 = 71
+6.45 =77
+8= 100
+10=218

Looks like the ride on the fun bus is over this cycle for Ozzy. But he really has never been in green/blues for so long in one cycle so I am happy about that.

He is eating a snack now. Will test him again preshot, feed dinner, and shoot.

Depending on his PS number, may need some dosing help. If he stays high, I may continue on with the 1.25U dose. Is that advisable? He did get into the low 50s on 1.25 today but not lower. Then again, we will not know how low he would have gone if I did not intervene.

 

Thanks for your comment Adrian. Just looked at Chino's SS to see what you guys are going through. I was whining about not being able to get my kitty out of yellow and here you are dealing consistently with red, pinks, and BLACKS! Omgosh! That would stress me beyond belief. I really am praying for you and Chino that he gets into some healthier numbers here soon. Going to be watching your threads and keeping an eye on Chino's journey from now on. Good luck!!!

 

Since you're home and able to test, I'd go with the 1.25 again....we never assume that "if we didn't intervene, they would have earned a reduction"....if the dose is too high, they'll earn it

 

Oh amen, Lizzie, amen !! Gut wrencher for sure

 

Thanks Chris...Got about a little over an hour to go to T/F/S.....it's like waiting for the end of a movie to come so you know what's going to finally happen....

I wonder if he is going to go a lot higher and be in the pinks again PS, or if he'll get that lantus double dip.

Even though today was a crazy unpredictable cycle, I think I am happy with Ozzy's results on the 1.25U. I mean he's NEVER had blues and greens for so long in one cycle. That has to be doing some good for his little pancreas! If we can keep him like that for the next few cycles (and more obviously), I can finally STOP worrying about those darned evil ketones!!