1/22 Latte PMPS-240, +2.5-382!!! Insight, please

I was wondering if some folks could take a look at her ss and see if they can figure out any reasoning for such random high and sometimes low amps. Also, suggestions as to what I could do to even things out a bit or get them a little more consistent?

She seems fine this a.m.....eating okay, up and about, bright eyed.
Heading off to work soon...

See you all later! Everyone have a GREAT day!

viewtopic.php?f=9&t=3424&p=33626#p33626
yesterday

 

Re: 1/22 Latte AMPS- 294 Insight, please

My best guess is that Latte is not yet tightly regulated so you see the bouncing around. Like many of our kitties, Latte may not yet have graduated from LTS.

 

Re: 1/22 Latte AMPS- 294 Insight, please

I know I'm WAY behind the times, but... if that 'pred' on your spreadsheet is prednasone, that is likely to have a big effect on BGs. Is that an on-going treatment, or something that is related to treatment for a condition that is likely to go away?

 

Re: 1/22 Latte AMPS- 294 Insight, please

I know you already factor your pred into your considerations, and probably your fluids as well, which I have read have an impact on the BG's. Her unsteady food intake probably has an effect. Look at how much frequent mini meals affected Ronnie's Luna. Feeding dry can confuse the picture, as it can affect numbers many hours after feeding (and you are very good about noting your feeding comments on your SS). Vomiting might have an impact. And pain, too, if she is occasionally feeling uncomfortable, might raise BG. Transient dehydration. The moon. These are all things that are not possible for you to control, but can give an idea of why your numbers might not make sense. I know that Bear's numbers are affected by my work schedule. Who knows what goes on inside these kitty minds and bodies. Maybe an IBD kitty has better food absorption through the gut on one day, and not so good on another. Yesterday Bear was all in blues. Today he is all in yellows. I have no idea why.

 

Re: 1/22 Latte AMPS- 294

There are so many possible reason...as Linda and everyone pointed out...
sigh. We try to search for answers and sometimes we just cannot come up with
just one thing.....it's each and every little variable that all adds up....
You are doing a great job Carolyn!!!
Hope you have a good day..... :YMHUG:

 

Re: 1/22 Latte AMPS- 294, +9.75- 212 Insight, please

Thanks for the replies!
First, I want to make it clear that I KNOW we have (or "I") have been very difficult when it comes to dosing advice. One day I think she needs an increase, 6hrs later I think not, 3 days later Im concerned if she is safe on her current dose...then she suddenly gives me perfect for a week. If I'm making you all crazy, dont worry - Im making myself crazier! :? I do recognize that she has many factors contributing to her numbers, all which can change at the snap of a finger. Im pretty good at making anything more complicated than it needs to be. Maybe it should be more straight forward for us and I should keep raising her dose till she drops too low, then decrease, raise again if necessary, etc? Am I making this too complicated? Is she your standard protocol kitty and Im just a worry wart and a chicken?

Her regular vet, and even specialist have her written off as a cat who cant have any control with BG's because of the pred. DOnt get me wrong, I think they really appreciate our efforts. But I dont think they believe it will make any difference. Are they right? Is this just pointless for me to keep trying for the right dose? The right dose would give us something like what we saw, probably a few days ago...mostly blue, with a touch of yellow and green. Some days maybe a little more green, somedays a little more yellow. But the high yellows and bordering on pink is nearly as unsafe for her as mid greens. The high yellows (RT) because of uti's. The mid greens because of potential vomiting, especially if Im not home.

I dont want my request for insight to come accross as whining, or being freaked out, scared, stressed, etc. I just seriously want to learn and hear from other people as to what they would do in this situation. Maybe its been said and I didnt want to hear it? I apologize if thats the case...might just be a slow learner (or absorber of knowledge)


Answers/Questions-

Sienne (or anyone else): When in LTS, if that is what she is still being a part of, do you raise and lower doses, or do you just sit on what you think is best until things even out? How long do you wait for things to even out? It seems as soon as we are more even, everything suddenly changes.

Greg: She is on prednisolone and she will be on it the remainder of her life, from what I can tell.

Linda: I felt a little less alone after reading your condo this a.m. (sorry I have not had a chance to officially comment yet). How do you make decisions on increasing or decreasing? Your point about her possibly experiencing more aches and pains on some days as a contributor is very logical.

Pat: I cant tell you how much I appreciate your daily visits and sense of humor. Reading about shadow and raja always gives me a boost of confidence and a little bit of a lighter heart! But I have to ask this....WHY??!?!??! WHY PAT?!?!? Why cant we figure this out?!?!?! :lol: (sorry - couldnt resist)

Thanks again for any further insight.
Im going to keep my request in the subject body because I really would like to continue getting feedback and ideas.

 

Re: 1/22 Latte AMPS- 294 Insight, please

yeah, can't add much but based on my own boomerang kitty i'd say it has to do with inconsistent eating and prednisolone, neither of which you can do a ton about, BUT we are able to skinny up and fatten our doses very very slightly to take care of things like inappetance so that's what i'd suggest to you.

 

Re: 1/22 Latte AMPS- 294 Insight, please

Sorry I can't offer you any advice but it appears as though you've gotten some great advice. We do tend to stress ourselves to the breaking point over every little thing we think is wrong with our sugar kitties. Just wanted to let you know that you are definitely not alone with that. Sending many hugs your way.

 

Re: 1/22 Latte AMPS- 294 Insight, please

How do I make decisions about dose increases and decreases?

Well, I do ask for input from LL. If he is spending too much time in yellow, then I would want to add some fat on to his .5U. If I am getting numbers that I don't feel comfortable shooting, or where I have to BCS too often, I would take a drop off. If he never dips his toes into green, I might be tempted to add a drop. I don't see a problem with keeping a dose that works most of the time, and just skipping a shot if required, because he usually recovers pretty quickly after the next shot. I don't want him to dip too low, to the point where I have to give HC, because the HC flares up his IBD. It is tempting to try and emulate what I see in so many condos here - you see people shooting low numbers and going for the green. I have to remember that it's not desirable for Bear to try for those kinds of numbers, and that this Bear is different.

I DO NOT think it is pointless for you to keep trying for the right dose. I have been doing this for over two years, and it is still a quest. I don't think it's a bad thing to be a worry wart and a chicken (since I am both of those things). You are juggling very complex issues. I tend more to the conservative side myself, but that's my inner chicken speaking.

 

Re: 1/22 Latte AMPS- 294 Insight, please

Despite there being research supporting the use of a particular protocol that works for most cats, the cats that are accepting into a clinical trial have to meet certain criteria. Latte would not be accepted into this kind of study due to all of her complicated medical history. That being the case, let the protocol be a guideline but a flexible guideline. The approach that Linda takes with Bear makes a great deal of sense and may also make sense for Latte. It would seem that finding a "base" dose that you can move a little up or a little down from will give you flexibility for what Latte's needs are. In general, I think this is what happens once a kitty is tightly regulated. I can't imagine that you would shoot exactly the same dose every day and the BG levels would be identical. Things like illness, exercise, or stress would effect numbers and they'd need to be adjusted to take those changes into account. In Latte's case, doses may need to be tinkered with to accommodate pred levels, whether or not she's eating and if she's eating dry or wet, the addition or discontinuation of other medications, etc. You know your cat. You're doing a wonderful job.

 

Re: 1/22 Latte AMPS- 294, PMPS- 240 Insight, please

Thank you! This has been a very thought provoking and insightful discussion so far (for me).

Question on the tweaking (fattening/skiny) doses...when is that considered dose hopping? What kind of frequency are you doing this? Can or might this need to happen in a few days time depending on numbers/symptoms?

I dont know if I fattened the dose or not tonight. I tried. I tinkered with the syringes - how I would want a bit more fat, how I would want the 1.75 to look, how it usually looks right now, etc. Ive been putting the bottom part of the plunger at the top of the 1.5 line. Tonight I aimed to put it on top of the line, with virtually no light/space between plunger and line (there really is a difference, right? :lol: ). Yes,I know each of us do our own measurement and it needs to be consistent. Im just trying to explain it to see if this is how you might fatten an already fat dose, without moving up too much. The difficulty in doses like this is consistency.

Latte is doing alright. She had a burst of energy when I got home and ate a fair amount of kibble while I was at work. She used to, just a month ago eat 1/3 c of kibble practically everyday while on the pred. Its now taking her more than 2 days to finish that amount. So, it has slowed down A LOT. I have been spoon feeding babyfood after her pm shot the last three nights and she seems to enjoy it. It's actually quite peaceful to watch her lick at a spoon, like what she is eating, and not open 5 cans of food only to have her turn her nose up to all of them and then have me get stressed because she is not eating. She is getting maybe 1/4-3/4 jar of babyfood between shot and +2 or +3. I offer wet before bed, which she may lick at for a moment...but then turns to the kibble as I lay down.

Her tummy has been gurgling again, so Im a bit on edge.
She has been crying at the waterbowl and drinking a lot the last hour or so. Thought she was dropping....instead she was rising. This PMPS is NOT good for a pred cycle. *sigh*

Ive been messed up timing wise with the additional med, so have 'forgotten' lactulose a few times this week. Its also quite a juggle to get everything in, and am now 2 days late on the b12. I will get that in her tomorrow a.m. I think I need to go back to my check list and mark things off every morning/night.

Looking forward to a weekend of maybe getting some stuff done! :mrgreen:

 

Re: 1/22 Latte AMPS- 294, PMPS- 240 Insight, please

I have dose hopped. I know it's not right. I would rather dose hop down, however, than shoot too much. A lot of it is just having a feeling that something is right or not right. For me, it is being conservative. Your numbers run higher than mine, though, so I would try and get more input from others as to whether this would be advisable for Latte.

Consistent measuring is difficult for sure. I am in love with my .5U dose. I honestly would have trouble making a big distinction between a fat 1.75 and a skinny 2.0. Like you said, pick a benchmark, make a note of it, and try to be consistent.

 

Another Question...

Ok, Im sorry to keep coming back!
And Im certain I will get a smacked with a noodle for this, rolling eyes, or... :?:

*If* I put a little more fat into the fat one day, can I put a teeny bit more fat in it the next day if I decide maybe it should have been more? :lol:

Sorry - okay, not really funny! :roll: But seriously, she reacts to increases pretty quickly. If she is still high in the morning might adding a little light between the plunger and line be acceptable or would that be a possible back to back increase? Did I ruin my desire to increase slightly tonight by not doing enough with no ability to correct for many days?
(you know she is going to go low now that I have even suggested this as a possibility)

Sienne-- In case you come back, I want you to know that your last response was incredibly helpful. After rereading it a few times and sitting back to think it through, I suddenly felt this huge weight come off my shoulders. The black and white is not a fitting protocol for Latte. She is not typical and therefore may need a little bit of creativity. It's what my heart has been telling me all along, but my brain kept thinking was wrong. Thank you!

 

This is unbelievable. NOW...yes NOW Im a little bit NOT happy! angry(2)_cat

Im going to have a drink...or three!

She is medicated, a jar of babyfood in her, will offer some wet in a few hrs and then go to bed early.

No more testing tonight...cant watch this train wreck.

Increasing to 1.75 in a.m., unless I hear loud cries of NOOOOOO!
I will be home to monitor through Monday pm. If anything changes (vomiting, etc) I will just have to decrease a drop or whatever.

PS- Ive taken Shadow's number off speed dial for the night. Sorry, Pat! They are apparently in it together - again! ;-)

 

((((Carolyn)))) most of your questions are over my head, but I look forward to learning the answers. You might just have to experiment a little to see what works for Latte. I do think you can keep looking for the right dose, and I do think you can eventually get Latte regulated to whatever level you want her to be in. It might take her longer to get there because of the meds and the dry food, and her range might not be as tight as some, but I think you should be able to get it pretty tight. My guess is that the dry food is playing more of a role in the inconsistency than you think, and I know you can't remove the dry food from the picture so it's something you'll have to keep in mind.

I do think you have room to increase the dose tomorrow.