3/3 Fortune PMPS 594 +2 HI

Discussion in 'Lantus / Levemir / Biosimilars' started by RachelG, Mar 3, 2021.

  1. RachelG

    RachelG Member

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    Jan 8, 2021
    No sleep last night and it looks like we have momentum today with this low (for him) AMPS. Hopefully we won’t be nervous about healthier numbers soon!

    We fed Fortune a lot last night, so of course breakfast is tough rn. Only a few bites so far. Even last night we could tell he was nauseous :(

    I hope we can get at least 3 oz so I’m not worried about the full shot.
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    I hope Fortune is able to eat for you and the nausea gets better. Sending prayers. :bighug::bighug::bighug:
     
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  3. RachelG

    RachelG Member

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    Jan 8, 2021
    Nausea isn’t improved (still lip smacking, licking before biting, being picky) but when we found the right food he went in! Yay!

    Full 2.75 IU is in Fortune!

    We need to go shopping for more food options, and beg the vet for a script for hill’s A/d since a lot of these foods are low calorie...
     
  4. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Can ask for Royal canine recovery food, it's low carb. My go to is the a/d food. Only way Tripper will take her med and she needs to gain weight. I just ordered the a/d from chewy.
     
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  5. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    Here's some :coffee::coffee::coffee::coffee:

    Surf safely, Fortune and feel better :bighug: I'm sure the vet will approve a/d Rx :bighug:

    Have a good day, Rachel!
     
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  6. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Nausea meds on board now right? Which food did he like?
     
  7. RachelG

    RachelG Member

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    Jan 8, 2021
    Is that a prescription? The IM has not been helpful but hoping the oncologist tomorrow approves an RX. We have bought prescription food on chewy before with a different vet, they have needed to approve it. Good to know there’s options!
    Thanks, Susanne! You too! Goodness knows I need an IV with it today lol


    yup, cerenia, mirtazapine and another dose of ondansetron this morning. May go up to 4mg this afternoon.

    He licked and took some small bites of friskies medley beef something but we got a can of (safe) tuna and he devoured it! He hasn’t had straight non-cat food tuna since he was a kitten. I know it’s not complete for his diet, but for this morning it was fine.

    He has been gravitating towards salmon and tuna, which have always been his favorite. We had been serving him chicken (FF) and before that lamb for years because I always worried about the Mercury, but if that’s what he needs right now, so be it!

    We are resting like potatoes before +2, but depending on what happens I’ll be running out and using the CKD /diabetes list to get some fishy favorites :)
     
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  8. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Yes the Recovery and a/d are rx foods. I just learned the Recovery is lower carb but I don't know what it is. The a/d is the only food I can get Trips thyroid med in her. I give just a little twice a day. I finally just got a case delivered. I use to pick up a few cans at vet but this winter the snow hasn't allowed me to get there when I need to. So bit the bullet and ordered a case.
     
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  9. RachelG

    RachelG Member

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    Jan 8, 2021
    Oh I didn’t even think to see if they sell it at the vet, duh! We will be there tomorrow for his oncology recheck, I will inquire then. Thanks, Paula!

    Fortune’s +2 is higher than his AMPS!! I think that means I can nap?!! But can I nap, physically? That is the question...:blackeye:
     
  10. RachelG

    RachelG Member

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    Jan 8, 2021
    I'm really excited about these blue numbers - and I think Fortune is too! He is bright and energetic today, asking for food all the time. :smuggrin:

    I'm trying to do some pivot tables in excel to decide what to pick up for more MC, HC as well as LC fishy options (since that is what he loves right now), and apparently my brain is still asleep.

    Hope everyone is having a great Wednesday!
     
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  11. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Bright, energetic and hungry! Yeah! Go Fortune.
     
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  12. RachelG

    RachelG Member

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    Jan 8, 2021
    In the sleepless fog, I forgot to mention that tomorrow is his oncology follow up appointment, following chemo last week. Nervous, yet hopeful because the oncologist is terrific and proactive.

    The drop off is at 7:30, but our shoot time is 8:30; last time I asked them to shoot Fortune without an issue, but they shot 1 IU instead of 1.25 (he was on 2.5 IU full dose), so I'm trying to be proactive and think about what to tell them for his dosing. Picking up more food tonight, and hoping he will eat well, but is that too much time variance if he eats around 6am but get his shot between 8-8:30? Should I ask them to feed him more inside?

    Thanks for the thoughts, folks! :bighug:
     
  13. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Only a thought... but can you shoot him at 8:00 p.m. tonight and then 7:30 a.m. (in the car) tomorrow morning when you drop off? 30 minutes for those two should be okay.

    We'll see what the great minds have to say about it though! :)
     
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  14. RachelG

    RachelG Member

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    Jan 8, 2021
    Oh yeah, we have only done 15 min shift but I don’t see why we can’t do it! We need to move it up for Daylight Savings soon anyway (yay)!
     
  15. RachelG

    RachelG Member

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    Jan 8, 2021
    Oh my goodness, I hope we don’t hit the 300s today! That would be so great!! And a real smile curve - go Fortune!!

    FWIW if I had listened to the vet not to shoot below 250 PS, we wouldn’t be here. Thank you for holding my hand last night @Bron and Sheba (GA) and @Wendy&Neko :bighug: This feel like good (safe) progress!
     
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Yes. I have always been told that 30 minutes in either direction is okay for a cycle when using a depot insulin. I have occasionally been later than that on a night when I was not at home in time to shoot Darcy. Conventional wisdom is that if you shoot much earlier/later than that it counts as a dose increase/reduction, respectively.
     
  17. RachelG

    RachelG Member

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    Jan 8, 2021
    I’m losing it. The appt tomorrow is at 10:30, the chemo appts are the early drop off. So me worrying for naught. Thanks for the help, Suzanne!
     
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  18. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    I know it's totally exhausting for you and DH, but it's so wonderful for Fortune to spend some time in healing green numbers. He was safe the whole time thanks to your guidance. Fortune is a great name for him because he is one LUCKY KITTY to have you! :bighug::bighug::bighug:
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    Ooooh. Good. I like that time a lot better! Now you may want to start planning for daylight savings time! You're tired. So just be careful to know exactly how much insulin you are giving him. DH can check for you! :)
     
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  20. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Beautiful cycle last night. Exhausting, but the lack of sleep is worth it to see Fortune in the lagoon:D.
    Sending lots of vines for a good oncology follow-up tomorrow!
     
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  21. RachelG

    RachelG Member

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    Jan 8, 2021
    Thanks for the support, Katherine, Suzanne, and Lyla. It means so so much. :bighug: It’s so exciting (and scary) to see his numbers come down. Lyla, reading some of your threads definitely helped me feel more prepared!

    We are so FORTUN(E)ATE to have him :p

    He just hit the 300s, but we accidentally fed him a little (~47g) before testing at +11 so who knows if it influenced things. We are shooting in about 49 min, so we have been trying to give him an hour to eat with breaks (cause nausea :(). He at 70g of LC food so far, so I think we are ok to shoot the full dose and keep enticing him.

    I’m just worried the PS number is inaccurate cuz of the food...

    Does this make sense? It may not, and you can tell me. I’ll ask more eloquently tomorrow, hopefully!
     
  22. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    It takes about 30 minutes for food to impact bg numbers. He nadired at +5 and has been rising since. he is in the 300s without food influence @+11. Looking at all of the data in your spreadsheet, imo it looks very safe to shoot on time even if his preshot is around the same as your +11.

    If his preshot number is lower, then you may want to post for help about whether to delay his shot or not.

    Just my opinion.
     
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  23. RachelG

    RachelG Member

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    Jan 8, 2021
    Thanks Lyla! Yeah, if it's significantly lower I will definitely post. He has food in his system that will after the PMPS - do you think that is bad? It used to take Fortune 5-10 min to finish 170g, so we would shoot him once he was halfway through. This is a new world for us where he eats less more often.
     
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  24. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    I don’t think it’s bad, no. The “no food 2 hours before preshot” rule is a hard and fast one generally for newbies especially while they are still collecting data on how food influences the cat’s bg. But Fortune is high enough without food influence where I personally wouldn’t worry about having fed him at +11 today. Don’t make feeding at +11 a habit. Feeding regularly at +10 is fine though if you need to feed him smaller meals more frequently. I have to do this with butters.

    If you are concerned you can shoot an hour later.

    Of course, my advice would be different if Fortune was lower or in a bounce breaking cycle.
     
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  25. RachelG

    RachelG Member

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    Jan 8, 2021
    Yeah, that all makes sense, thanks for walking me through it. So feed at +10, and feed right after checking PMPS. What is your feeding schedule after? We are winging it right now, the more calories the better, but if we should wait until after +2 for example, we can do that...
     
  26. RachelG

    RachelG Member

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    Jan 8, 2021
    Aw crap. PMPS is 594. The food impacted things, and I think the Either the Royal Canin Renal Support E (3% on cat info site) of Hill’s A/D (13% on TanyaCKD.com) is affecting the numbers. :banghead: We were trying to feed whatever he will eat, and those are both stinky, lowish in phos and (I thought) decent carbs. :arghh: He ate a decent amount of them both, too! We swapped in A/D when he stopped showing interest in Renal Support.

    What happens if/when +2 is lower?

    SN, DH is asking if it’s bad he accidentally pushed a few bubbles into the Lantus pen? Do we need to swap it out?

    It’s been a day, lol. Thanks for the help!!
     
  27. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    When to feed is a bit of trial and error. Most people feed most if not all food before nadir. That probably won’t work for fortune right now while you’re trying to plump him up.

    I feed butters 4 - 5 times per cycle, roughly every 3 hours. She needs to have small frequent meals.
     
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  28. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Fortune kitty! Come down from the moon please.
    One step at a time, Rachel:bighug:Shoot. Get a +2. Let’s see where he is at then. At least you know he responds well to carbs:joyful:
    He doesn’t have a history of steep dives and is unlikely to do so tonight.
    And just feed him as you normally would (just no food after +10 if you can help it)
     
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  29. RachelG

    RachelG Member

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    Jan 8, 2021
    IT's the small things! lol Oh maybe it's a bounce? Maybe? Possibly? lol Either way, we got to shoot the full dose with confidence! :rolleyes:

    I agree with you, I'm not sure we can get everything in before his nadir, exactly like you said Lyla - we want him to eat as much as he can! I also want to balance that with getting his BGs as nice as we can to help him feel well, and knowing that feeding him frequently isn't always doable. Like today, I had to run out to get food and it didn't happen til 5:30, whereas ideally he could have has a couple of meals throughout.

    I feel like this is the first time his nadir has been so obvious! Usually he is lower closer to the end of the cycle. I'm calling it progress!

    Maybe he heard me complaining about no sleep and was like, "ok I'll give you a break from poking me, while making you worry." :p
     
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  30. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Lol WTG:woot:
    Most likely a bounce. Bounces can take 4-6 cycles to clear.
    Butters often nadirs late in the cycle...often right at pmps/+12.
    I recommend you start recording how much food you’re feeding, %carbs and at what hour in the cycle you fed . Look at my ss for an example. This will help you collect better data on how food influences his BGs.
     
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  31. RachelG

    RachelG Member

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    Jan 8, 2021
    Either a bounce, or perhaps new dose wonkiness? Or both? Ooof. Time will tell...

    I'll check it out! Now that we are, ahem, "experimenting" based on what he can tolerate because of the nausea, I'm trying to log the food, the %carb, phos, protein, and the calories. It's a bit much and I haven't entered everything from the past few days, but it's a WIP. And I'm so tired...but the idea is to get an idea if he is eating enough calories to maintain/gain weight, plus things like carbs (for FD), protein, and phos (for CKD).
     
  32. RachelG

    RachelG Member

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    Jan 8, 2021
    Omigosh Lyla I just saw your tab labeled "Active BGs & Food," and I'm in awe!! :woot:
     
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  33. Liz & Minnie

    Liz & Minnie Well-Known Member

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    Feb 4, 2021
    Lyla...this is amazing. I am copying...oh wait, I think the appropriate business-lingo is "leveraging". Especially now I have to break up with my IM vet.
     
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  34. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    That PMPS is Fortune's way of telling you that you can get to bed earlier tonight. It's a bounce. Look what happened the cycle or two after he last went green. :rolleyes:
    Have you seen this version of the cat food list before?
     
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  35. RachelG

    RachelG Member

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    Jan 8, 2021
    He is such a good boy, letting us go to bed earlier! We barely functioned today.

    Also was hoping it was a bounce because that means it wasn’t (only) the food.

    I have seen it! I downloaded it to excel and have been playing with it to find moderate protein, low(er) phos and various carb (we didn’t have much MC or any HC before, and last night showed us we needed it! Just karo). I have been isolating it to get to a few options so we could grab a variety for Fortune to try, while trying to keep it as safe and healthy as possible.

    Still need to order a phos binder - it’s in my Amazon cart!
     
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  36. RachelG

    RachelG Member

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    Jan 8, 2021
    Very mixed feeling about these numbers. On the one hand - SLEEP!

    On the other, I was so excited to start seeing a nice healing cycle for Fortune. I knew it was likely from the 3 IU yesterday morning. :rolleyes:

    Here’s hoping he clears it safely, and we can see what this new dose can do.

    Have a good night, all! :bighug:
     
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  37. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sleep tight. Let's see what 2.75 units can do when the depot is full. One cycle isn't usually enough to see what a dose can do.
     
  38. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Jun 4, 2020
    I feel your pain, Rachel! I'm getting ready to post my abysmal evening numbers. Love to Fortune!!
     
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  39. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    The bounce will clear. Right now it’s important he eat so if he needs AD or fish flavors so be it. For some cats they will eat AD when they won’t eat other foods. Rial Canin has more calories but my cats didn’t love it. It’s worth a try. Maybe you can get an RX for them tomorrow. Vetty vines. :bighug:
     
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