2/17 George AMPS 87 (No shot), +5 142 , PMPS 153 dosing advice please advise

Had a long night last night.
Please advise.
Can I just feed him and skip it today?

Link to my previous post:
https://www.felinediabetes.com/FDMB...pmps-61-1-70-2-64-3-63-4-71-5-71-6-87.243239/

2/16 George PMPS 61, +1 70, +2 64, +3 63, +4 71, +5 71, +6 87

 

Is it AMPS or PMPS?
There's no AMPS in your spreadsheet?

 

I'm sorry. I forgot to enter it in. 87. I do need to work today and can come home and test at lunch. And I get home at 345

 

Always enter it in. First priority after testing and kitty is safe, spreadsheet
It's your very very best friend!

@Bandit's Mom could you take a look?

 

I suggest skip. His depot is very full and despite all that HC, he has not risen much. Skip the shot and go to 1U tonight.

Link to your previous post:
https://www.felinediabetes.com/FDMB...pmps-61-1-70-2-64-3-63-4-71-5-71-6-87.243239/

 

Even though you have skipped, it might be useful to have some tests in this cycle without insulin, to see what his BG does, it might help to have that data when you come to shoot later this evening.

+2 +4+9

 

Thank you both. I can prob get +4 and +9 but I don't think I can get +2.
I am already late to work and I'm all scratched up.

 

thats ok, whatever you can get will help.
Sorry he scratched you.

 

Please post whatever numbers you get here (when you can) and also the PMPS. Thanks

Like I said yesterday, please test before every shot and at least 1 more test mid-cycle. Yesterday's numbers told us that he was getting more insulin than he needed, but without enough data we cannot figure out what his ideal dose is.

 

Welcome to LLB! George is doing so well. I hope you choose to follow TR and post here daily. Looks like he might not need insulin for long and the best chance at going OTJ is with TR.

 

Thank you from the bottom of my heart.
Last night was exhausting!

I can go home for lunch to do a test. a +4 or +5 or +6
and I can do an after work closer to a +8

even though he did NOT get insulin today.

Is there a best time I should go for a mid day test? +6?

 

I would test at +5-6, whichever is easier for you. Unfortunately with so little testing I don’t know when he nadirs.

I suggest to I read two methods and see which will work best for you. Cats do go OTJ on SLGS as well if that’s better for your schedule and comfort level.

 

If he is still pissed and scratchy after all that testing last night, take it easy and get one mid-cycle test between +4 and +6 and then a PMPS?

In general, with testing you are trying to learn how your kitty responds to insulin. You are trying to find out his:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle

With Lantus onset is usually between +1 and +2 and nadirs are usually between +4 and +6. Some cats have early nadirs and some later than +6.
Lantus dosing is based on how low it takes the cat, not on pre-shot values. So that is an important data point.

We say that a +2 test will usually give you an idea of whether it will be an active cycle. If +2 is lower, then the cycle will be active and you want to get another test between +4 and +6.

Not sure if I answered your question!

 

Thank you. How often should I be feeding today? I WAS feeding one 5.5oz can in am and pm and would like to start spreading that out and less food as he had to gain some weight back and is now a pretty healthy weight, but I haven't reduced his food yet.

I do not have an automatic feeder yet. Will probably order one tonight.

I fed him at half a 5.5 oz can at 8am and was going to have my daughter feed him the other half now.

Heather

 

Yes. Spreading out meals is better than 2 large meals in a day.

Sometimes you have to feed a little with every test when he goes low - like you had to last night. In those cycles, we suggest that you not fill the him up too much at PS so that he is hungry enough to eat a spoon of food every hour - if that' necessary to keep him surfing good numbers.

 

Changing his feeding schedule and amounts will probably affect his numbers again differently than what we were seeing? I'm having my daughter feed him now at +4 and I will be there to test at +5 so I am sure the food will affect those numbers. Perhaps I should have went home at +4 when I was feeding him.

Saturday I can do a 12 hour or 18 hour curve. Until then I can go home different days at different times to test at different hours, but with today no insulin this morning I am sure they will be all over the place.

The earliest I could check after his AM Injection would be between +4 and +6. But There could possibly be a day where I could go home twice and work a longer day.
I am usually home weekdays between +7 and +9

My weekday Schedule
AMPS 8AM
Leave just before +1
Home after +7 or +8

Can run home one time a day, on special occasions 2x a day.
Available weekends to do curves.

 

Just to clarify, George is eating only LC canned food, right? Did anyone tell you that we don't feed 2 hours before PS so that the number is not food influenced?

Can you daughter test every day at +2? Or could you move up your shot time by an hour to be able to get a +2 before leaving for work? (I remember your saying that you are a night owl and not an early riser! )

Let's see where he is at PMPS. Just post here after you get it (without feeding) and tag @tiffmaxee or @Gill & George for shooting advice.
I'm in India so I am off to bed in a bit.

 

No! I did not get told that or read that yet. I started doing what my vet told me to do.
FEED - 15 min later - Inject 2 Units

Found this forum, decided 2 units was too much. Lowered to 1.5 while reading and TRYING to get BG levels.

LC Friskies pate was started not to long before he actually got tested for diabetes. He was loosing weight and on dry kibble mostly, but he loved cans so I switched and upped it for weight purposes (only know realizing all the reasons canned is better than dry) I was giving him 1 can AM and 1 can PM.

I could see about switching times for shots. My two older children are not home every day either and go back and forth between my house and their dads every other week.
George is usually so hungry in the mornings and that is how I was able to test him because he was so focused on food, but now he knows and eats less and gets more irritated.
I did like later time because I am more guaranteed to be home at 8pm vs 6 or 7pm.

Thank you for all your help! I'm glad I didn't keep you up last night. I will tag the names for shooting advice tonight.

I need to learn more about how food influences the numbers.

 

Good news? +5 is 142

No AM shot
Feed 8am
Feed 12pm
+5 142

Plan to feed again at 4 then again at 8.
8pm is PSPM
Will post PSPM numbers and wait for advice.

I'm feeling confident to test again at +8

Should I give food during the night? I will need to recalculate how many calories a day he should be having and then decide how many meals to divide it up into and the proper spacings for the meals.

 

Looks like he’s going up so you should be able to shoot tonight. However, please post the PMPS number and ask for dosing advice. If under 175 stall, don’t feed, and wait for an answer. If at least 175 you can feed and then post for dosing advice. How long after PMPS before you go to bed? What’s the latest you can test at night? I will check back at your PMPS.

 

I usually go to bed between +2 and +4 but I only got like 3-4 hours of sleep last night. I was hoping to be in bed by just after the +2 mark.
I can wake up and do a test, but I would prefer not too tonight.

 

You won’t need to test that much every night and even less once we see his patterns. As Bhooma said, the +2 for many is a good indicator for many how the cycle will go. With Max, he would onset between +2-3. So unless he was low at preshot I didn’t test until around +2.5. It also helps to have an auto feeder that once you go to bed you can set if you go off so you won’t need to stay up or set an alarm as much.

 

I am getting ready to do the PMPS

I did fill the needle with 1 unit this morning and it has sat out room temperature. I know depending on his numbers anyway, but is the lantus sitting out since 8am ok to be used tonight or tomorrow or should I throw it away and get new?

 

It’s not to to prefill them. We all forget sometimes and leave a vial or pen out overnight and that’s not a concern. It’s likely fine. Ive never done that before. I wouldn’t use it tomorrow but probably fine tonight.

 

PMPS 153
Ate some food at 5-530.
I was feeding him 2x daily 8 and 8.
Now I'm breaking it up.
Should I give one unit?

@tiffmaxee @Gill & George

Thank you in advance

 

I would shoot something . Get a +1 and feed a little and a +2. But if you can’t stay up and are too tired skip.

 

So give him the 1U from this morning, and test at +1 and +2?
feed after the +1?

 

No. It depends. Can you stay awake if he drops? If you can’t give a token .25. You didn’t sleep last night. You can also
skip and start over in the morning.

 

I can stay awake until +2 maybe +3. I don't think I can do a +5 or +6, I would be worried I would sleep through the alarm.
I can do .25 or skip? I am surprised his numbers are still so low.

 

Skip. Get some needed sleep. Get a +2 just to see if he’s headed up. His numbers are fine. He was getting too much insulin for sure.

 

Elise, suggestions for the AM dose since you won't be around. Assuming George is below 200? 1U? Less?

 

I think if under after skipping 2 doses that 1.0 will be too much. I want to look at the ss and read the previous posts.

 

Tell me when you can test tomorrow please.

 

I think I would go with .5 if he’s under 200.

 

I can test at 8am CST or any time between 630AM and 830AM CST.

Ultimately, I would like to stay closer to 8 and 8. or between 7 and 8

THANK YOU THANK YOU!

IF he is under 200, .5

I can test earlier tomorrow so that that we can get a +2 before I go to work and I can come home to test for a +6

Then I can work on getting him closer to a later time afterwards...

 

The +2 would be two hours after insulin.

 

Great, if you can get a +2 every day before heading to work, nothing like it!
Catch up on some much needed sleep tonight.

We shall look out for a new thread tomorrow with the AMPS!

 

THANK YOU THANK YOU! See you in the morning!

 

My goal is to test tomorrow at 6-630 AM so that I can do a +2 before I leave, and I can run home for a +6 at lunch if needed.
His last feeding for tonight will probably be around midnight. I need to feed him less as his weight is increasing.

Hopefully someone will be up then! Ha ha. If he is under 200, I will give .5U
Do ya'll let the insulin get room temp or do you shoot it in cold?

If he is over 200?

Goals +2, +6 and after work would be a +10

 

Excellent if you can work your schedule around his tests!

Actually, with little to no data on George, we are almost throwing darts. We can start at 1U and work our way down - might require aggressive testing like last night, or we can be more conservative and work our way up. Hence the 0.5U as suggested by Elise.

Why don't we take a call once we have an idea of his AMPS? If you can get a test before bed tonight - whenever that is, it would be great!

I shoot insulin cold. But some folks warm the syringe (not the pen/vial), with their hands before shooting. Does George react to the insulin? Does it sting?