2/1 Kitty PMPS 198 - To shoot or no? +1 176

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Julie and Kitty, Feb 1, 2020.

  1. Julie and Kitty

    Julie and Kitty Member

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    Last edited: Feb 1, 2020
  2. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Try waiting 30 minutes from your 198 and test again to see if she is going up on her own (don't feed). I'm not experienced enough to give dosing advice, but if you put the question mark (use the edit title button and the drop down menu to the left of the title) it will catch someone's eye faster. Be sure to keep your spreadsheet up to date with any test numbers you get as well as put your test numbers in your title of this thread.
     
  3. Judy and Freckles

    Judy and Freckles Well-Known Member

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  4. Julie and Kitty

    Julie and Kitty Member

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    Thanks I updated the thread. It's been 45 minutes now since I last tested so I'll wait until +1 and see where it's at.
     
  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Just remember that however long you wait tonight, you will have to delay tomorrow morning. And if you wait too long without feeding, there is a risk Kitty will drop more without food.
     
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  6. Judy and Freckles

    Judy and Freckles Well-Known Member

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    How flexible can you be with your shot time tomorrow? If you wait 2 hours before you give insulin it will take you 4 days to get back to the time you usually shoot at - is that a problem with your schedule?
     
  7. Julie and Kitty

    Julie and Kitty Member

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    Oh okay, well tomorrow I could delay her shot but not during the week due to work. So perhaps it's better to skip it again.
     
  8. Julie and Kitty

    Julie and Kitty Member

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    Ok, I'm thinking it might be better to skip it again.
     
  9. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Did you get another test? Tests don't have to be right on the hour, they can be anytime.
     
  10. Julie and Kitty

    Julie and Kitty Member

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    Just tested at 176! She didn't eat between tests. Also she didn't seem to eat much this evening before her PMPS test. but tends to eat more at night time.
     
  11. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Does Kitty have a history of ketones?
     
  12. Julie and Kitty

    Julie and Kitty Member

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    No, and we have at home test strips so we can check for that. Did one a few days ago and there was no indication of ketones

    I can test next time she goes to pee tonight.
     
  13. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Lantus creates a 'depot' which is like a reserve storage tank. So even though you did not shoot tonight, the depot may still be providing Kitty with some insulin. Looking at your notes on your SS, sounds like Kitty doesn't have much appetite these days?

    Are you hoping to switch her over to wet food?
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    At some point, when you can monitor, you will be able to shoot the blues. Lantus keeps low numbers flat, they don’t dive like they do from higher preshots. Her going down to 174 was probably lack of food.

    Perhaps it is better to lower the dose by 0.25 units, so you can continue to give two shots a day.
     
  15. Julie and Kitty

    Julie and Kitty Member

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    Yes I've been offering wet food, some different types daily and she sniffs and seems interested but hasn't eaten any yet. I've also started mixing some freeze dried chicken morsels into her kibble which she does eat.

    Her food intake has been up and down, she was on a feeding tube until last Saturday since December, and once it was removed she was eating about 100 calories for a couple days and then went up to 150 for a couple of days, then yesterday and today it has gone back down a bit, but she's a small female so probably doesn't need tons of food. 150 i think is good for her.

    She has been acting really good and jumping on things, acting like herself a lot more recently.
     
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  16. Julie and Kitty

    Julie and Kitty Member

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    Yeah I might do that, decrease back down to 1.25
     
  17. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Sorry Julie, I am just seeing the tag. I’m glad Wendy and Judy were around.
     
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  18. Julie and Kitty

    Julie and Kitty Member

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    No worries! Thank you all for the help on this. Is it really bad to be skipping shots?
     
  19. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    It’s better not to skip shots if you can help it but safety first always.
    You are only just now seeing a couple of blue Preshots so you can start thinking about shooting a blue Preshot when you can monitor that cycle. When they are blue Preshots they don’t tend to drop as low during the cycle as higher Preshots do. Normally the lower the Preshot, the flatter the curve.
    If you are unsure post and ask for help.
     
  20. Julie and Kitty

    Julie and Kitty Member

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    By being able to monitor do you mean checking her bg every hour or 2 hours, basically doing a curve?

    And were I to have given her the shot tonight, would I have given a lower dose?
     
  21. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    By monitoring I mean getting a +1 or +2 to start with to see how the early part of the cycle is going. If the +2 is the same or lower than the Preshot then the cycle will probably be an active cycle.
    Then you would keep testing depending on how much the BG is dropping. Sometimes you have to test the whole cycle and sometimes only until nadir..
    Once you are in the position of having to monitor the cycle the first time because of a lower than normal Preshot, someone will help you decide when the next test is.

    I think with a Preshot of 198 you could have given the full dose if you were able to monitor the cycle and had plenty of test strips and high carb food and your kitty will eat.
    ETA. Just rereading your thread and I see Kitty had a feeding tube in until this week... and eating is not great yet... so I think it was fine that you skipped.

    Wendy has suggested you reduce the dose by 0.25 units so you can shoot both cycles so I would follow her good advice.

    As you gather more data you can lower the Preshot number further when Kitty is eating better.
     
    Last edited: Feb 2, 2020
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  22. Julie and Kitty

    Julie and Kitty Member

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    Yes, that's right about the feeding tube, here is her full story: http://www.felinediabetes.com/FDMB/threads/new-here-update-on-kitty.224044/

    Today she had her "regular" high AMPS so I gave 1.25 u of insulin and will see where she's at this evening. I do have some high carb treats she will eat but only a handful at a time.
     
  23. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Oh my goodness what a story. Poor Kitty and poor you for being treated badly by those ERVets. I just don’t understand how they can send a cat home without investigating fully. Hopefully the 1.25 units will allow you to shoot both cycles and her appetite improves. Sending her best wishes
     
  24. Julie and Kitty

    Julie and Kitty Member

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    Thank you, it was quite an ordeal but I think we've made it through! :cat: I've learned there are a lot of clueless vets out there and that you really have to be an advocate for your own cat's health. Same with yourself and human doctors!
     
  25. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Absolutely you have to be an advocate for your pets. Being clued up helps a lot. You are doing a great job looking after Kitty.
     
  26. Julie and Kitty

    Julie and Kitty Member

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    I got a 12.4 (223) for her PMPS tonight, should I go ahead with the full dose or reduce? I won't be able to monitor too late tonight as I have to wake up early for work tomorrow. A little nervous giving a full dose
     
  27. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    You have given a full dose with 230 before.
    How long can you monitor for?
    Would you be able to get up with the alarm later if necessary?
    How is her appetite?
    Do you have test strips and high carb food?
    Ultimately it is up to you if you decide to give the full dose or reduced dose. You will still have to monitor if you give a reduced dose.
    I have to go out now but will try and look back in shortly
     
  28. Julie and Kitty

    Julie and Kitty Member

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    I can monitor until about 11pm so +3 and could potentially get up in the middle of the night. She's been eating well today, a mix of her high carb kibble with low carb freeze dried chicken.
    I do have lots of test strips. I think I will go ahead with the 1.25 dose tonight and check before bed time.
     
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  29. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Ok. I would get a +1 and a +2 so you can see what is happening. I’ll watch out for updates.
     
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  30. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I see +1 243. A bit of a food bump. Expected and normal.
     
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  31. Julie and Kitty

    Julie and Kitty Member

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    +2 at 234. I think she's good :)
     
  32. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Get another test before you go to bed and if it’s about the same you should be ok. I’d leave some food out for her to eat overnight though.
     
  33. Julie and Kitty

    Julie and Kitty Member

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    Ok, will do :) thanks so much for your help!
     
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  34. Julie and Kitty

    Julie and Kitty Member

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    167 at +3, going to sleep now
     
  35. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Might be an idea to get up and check a +6
     
  36. Julie and Kitty

    Julie and Kitty Member

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    Sorry didn't see this until this morning! I didn't get a +6 but her AMPS was 313 and I gave the 1.25 u. She was pretty active during the night and ate quite a bit.

    I'll stick with this dose for now and I can do a curve on Friday, or is that too soon?

    I wonder if the low carb food is also affecting the BG range, i've been mixing more of the freeze dried chicken with her kibble lately.
     
  37. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Yes the more low carb food you can swap over to, the more likely you are to see lower numbers.
    If you see a drop like last night from +2 of 234 to +3 of 167 that is telling you it is an active cycle and I would test again later to see how low it’s dropped for safety and also for good data. .
    It won’t hurt to do a curve on Friday but you will need to wait a week to increase... if it’s needed.
     
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  38. Julie and Kitty

    Julie and Kitty Member

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    Ok, will see what happens tonight!
     
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