5/1 Annie PMPS 383, +1-369

So she held yellow through the night :smile:

i hope this means her bounce is over and we can move ahead. this is the lowest preshot number since on the 1u BID but it's still over 200, and i'm going to give her the 1u this morning, but i have to leave for work at + 2.5 i wish i could stay home, but i think she will be fine. Hubby gets home at 6 so she's 3 hours by herself during peak hours.

Anyone have advice? she's still surfing in her same numbers since pm cycle... so im guessing the pm shot should be wearing off soon?

Re: 5/1 Annie AMPS 265 dose advice?

just a side note - I think i still have emotional baggage from when Annie was on Caninsulin - the big scary drop used to stress me out... but i know Lantus doesn't have that, yet i still get a twinge of fear when i see a "low" preshot number

Re: 5/1 Annie AMPS 265 dose advice?

Hi guys .. no advice from me .. not even sure if we've been in annie's condo before, so welcome from us! yay for yellows all night though! I hope others can stop by quickly to answer your question .. have a great day guys!

Re: 5/1 Annie AMPS 265 dose advice?

Hi Star....gotta look at her SS really quick. Brb. Thanks for posting today ...great job!

Re: 5/1 Annie AMPS 265 dose advice?

Peter - i only started posting her condo last night ... and Thank you

Re: 5/1 Annie AMPS 265 dose advice?

Typically lantus has a duration of up to 12 hours although sometimes we see a kitty that has a bit longer duration.

I think you should continue to hold this dose. She is bouncing still although might be trying to clear it. Bounces occur when the liver responds to a lower number than usual (it does not have to be a low number but just lower than what it perceives as normal) and releases counterregulatory hormones and glucagon into the system raising the BG. It's a natural response and it's good...it tells you the liver is doing it's job. We call it "liver training school". Bounces can last up to six cycles so when she goes high after being lower than normal, you do not want to increase the dose. Increases are only done when a bounce has cleared and kitty is still in high numbers. Here's the protocol on increasing the dose:

Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Click to expand...

The tricky part is telling a bounce from high numbers. So it's best to ask before you increase so we can make sure she has cleared the bounce. You are just on the fourth cycle of bounce following those blue numbers on the AM cycle of 4/29. If she was clearing a bounce, she'd drop back down into blue or green. IF, once she clears the bounce, we see she needs more insulin, we'll help you determine how much.

When you get a chance, could you please do a profile for us? I know you are working ....a profile helps us help you as all the important info about Annie is on it and is quickly accessed by us. Here are the instructions (it seems like alot of steps but it goes quickly). If you have any problems, just PM me and I can help you:
Creating a Profile

Re: 5/1 Annie AMPS 265 dose advice?

Thank you so much for your advice and input. I couldn't imagine doing this alone!

I just get worried about leaving the house if her pre shot is lower than usual. but i think she will be fine.

i will work on a profile tonight for Annie

Re: 5/1 Annie AMPS 265 dose advice?

You can leave some food out for her....will she eat while you are gone? If you can leave some low carb food out for her....or even medium carb if you are really worried, then that will help. If she won't eat, are you able to come home and check her or your DH possibly? She's pretty high right now but if she decides to clear her bounce, she could come down more.

You're welcome!

Re: 5/1 Annie AMPS 265 dose advice?

I can put out some food but they eat it like it's going out of style... never any leftovers, i'll see what her number is before i leave for work, i haven't left yet, i leave in a couple hours.

for the profile it's asking me to enter the URL for the link..... i don't know what they mean, haha before that they asked if i need to add a link to my profile, i said yes, but i don't have that link yet?

Re: 5/1 Annie AMPS 265 dose advice?

Yes...just be sure you test her shortly before you go. I have to get off the board now...have an appt but if she's dropping alot more, then ask for help. I'd test about a half hour before you need to go in case you need some
help. If she's clearing a bounce, she might come down faster.

Re: 5/1 Annie AMPS 265 dose advice?

One thing I want to strongly urge you to do is always get a +2 BG. It can tell you whether the cycle has the potential to be an active one or not. The +2 should be about the same as the PS. If its less...considering the 20% possible meter variance, then you should be on the lookout for lower numbers.

Re: 5/1 Annie AMPS 265 dose advice?

Perfect on the profile! She is gorgeous!!!

Re: 5/1 Annie AMPS 265 dose advice?

+2 and she's at 337(18.7mmol)

Re: 5/1 Annie AMPS 265 dose advice?

great job on the profile! love her eye markings - she is a beauty!

when you see a +2 that is a lot higher than the preshot - like this morning's preshot was 265 and the +2 is 337 - that would make me think another bounce is starting. they will lessen but it's common, so just hang in there with the same dose while she gets used to things and settles down.

from her profile:

Just been on prednilosone for a week now, she takes 1/2 of a 5mg tablet once a day. Was prescribed
to her by vet for help relieving her pancreatitis.

Click to expand...

or . . . did you give her the dose of prednisolone this morning? i don't know the action of how that affects BG, but i think that was what carolyn was alluding to yesterday about it possibly increasing BG. if that is for pain, buprenex can be given for pain and it doesn't usually affect blood glucose.

speaking generally, unless there are no other options, diabetics usually want to avoid steroids.

when you've got a chance, would you edit the subject line in the first post of this thread with "prednisolone/ pancreatitis?" or something like that? that will get the attention of people who have experience with those issues and we can learn if that might be affecting her numbers.

Re: 5/1 Annie AMPS 265 dose advice?

I give it to her every morning with her food and that's also when I inject her. But her numbers don't always shoot up like this after her Meds.

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Welcome to LL, Star and Annie. You are getting great advice from Marjorie and Julie. Please don't hesitate to ask questions. We all want the best for Annie. She is a beautiful kitty.

Ella & Rusty

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Thank you, I look forward to working closely with all of you.

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Annie is adorable!!

I'm presuming all of the meds you're giving Annie are for the pancreatitis. And yes, prednisolone can be given to great pancreatitis. I'm including a link to a post on pancreatitis that a vet tech (Jojo) who was, at one time, very active here, put together. Given that p'titis is painful, is there a reason you vet didn't give any pain meds (e.g., buprenorphine)? How is she feeling?

BTW, did the vet run a spec fPL to diagnose the p'titis?

Chances are that the pred may be causing Annie's numbers to be elevated. I wouldn't worry about it, though, since this should be time limited course of treatment. You may need to raise the insulin dose to compensate. It would be helpful if you could note what +time you are giving the pred. We're going to need to try to tease out whether there are bounces or whether this is the pred. It does look like you're right -- Annie isn't getting a big jump in numbers even a couple of hours after the pred and not all cats do. Once Annie has finished the pred, you will need to monitor carefully to make sure she doesn't have a big drop in numbers.

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Hi Star-
I think looking at Annie's ss, it is too early to see any patterns with the steroid.

Here is what I noticed with Latte...
She got her pred in the p.m. the majority of time she was diabetic. Most evenings she stayed higher and flatter than she did in the a.m.'s (when she did not get the pred). Certainly there were bounces thrown in there, and exceptions to any patterns I thought I was seeing. In general, I felt the pred kept her higher for many hours after administering it.

If you look at her ss, in the very beginning we stopped the pred to see what would happen. You will notice she was pretty much low blue and green. I started her on chemo drug, and she continued to stay in a good BG range. I think around 10/26 we restarted the steroid and you can watch as her numbers climb into the higher 100's with some 200's, then came the pinks. All the while we were increasing the insulin dose. If you go to 4/14/2010 when I started giving the steriod 2x/day her lower numbers in the a.m. become increasingly less. You can also notice effects on the BG's after any increase/decrease of the steroid dose.

Much beyond May 2010, I think is irrelevant. She had too many other issues going on to really understand what was what.

Every cat will react differently. Latte's diabetes was caused by the steroid, so she was obviously very sensitive to it. It was the only thing that helped reduce her vomiting and other issues surrounding the IBD/lymphoma. I really think it would be a good idea to talk to the vet asap and ask WHY they prescribed the prednisolone. If it is due to the pancreatitis, ask to switch to buprenex. I just see little reason to give a steroid to a diabetic unless it is a major quality of life issue.

Im not sure if I was much help. I just don't think it is too soon to determine how much of the BG's are related to the steroid and how much is the insulin dose/bouncing/etc.

Get Annie off the pred and the answer will become much clearer! :mrgreen:

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Yes, the vet ran a fPL and it came back at 4.7.
So that's not crazy high it's just over the 3.5 that it should be

She does get her prednisolone at her am feeding which is injection time as well.

I will be talking to the vet tomorrow I'll tell him I want her off the steroids.

Man, what a roller coaster ride, my heart breaks for my poor Annie-bear

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Many of the cats here have a rocky start on their FD path. Gabby was diagnosed with pancreatitis, hepatic lipidosis, and DKA at the time we discovered she was diabetic. She was a very sick kitty. She's done great, though. We've been very lucky -- she had the one bout of pancreatitis.

As long as Annie is feeling better, you should be able to back off of the steroids. The vet may want you to taper them. It's often not a good idea to stop a systemic steroid all at once.

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

How dO I know she's feeling better? She never seemed "sick" before other then her neuropathy.

I do want her off the steroids though

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Is she eating normally? Using the LB as usual? Not vomiting? Grooming regularly? Playing (if she does so)? Those are signs that help us know how our cat is doing.

As I mentioned before, and Sienne reminded you...never stop the pred cold turkey. Follow your vets instructions to ween Annie off.

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Everything is normal. She's going the bathroom normal in the box, no diarrhea anymore, she's been alert and very playful.
She's always been a sleepy lazy cat her whole life except sometimes she chases her sister around at night for all of 3 minutes, which she has been doing, and even playing with her apple(a toy you put catnip in except ours has none in it).

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Oh and no vomiting, she was never one to vomit much. Maybe once a month or 2 months but she does groom herself like normal

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Oh and no vomiting, she was never one to vomit much. Maybe once a month or 2 months but she does groom herself like normal

Re: 5/1 Annie AMPS 265 prednisolone/pancreatitis?

Oh and no vomiting, she was never one to vomit much. Maybe once a month or 2 months but she does groom herself like normal

should i have started a new thread for the pm?

after her nice line of yellows through the night and into her amps(265), i gave her 1u and at +2 she was up to 337, +4 391, +7 337, and pmps 369, gave her 1u and at +1 it's now at 369

at least i can get some sleep tonight

You did perfect...we do just one condo a day and you did it perfectly right!

She's pretty flat. Looks like you can get some sleep. I also think its a good idea to slowly take her off the pred and if she is in pain, use bupe. Sounds, tho, like she's doing well!

yea, and give her poor little ears a chance to heal a bit... she's pretty forgiving though, she still doesn't miss a chance to snuggle

What a sweet girl!

I'd get a before bed test just to be us where she is since she did or get a food spike at +1.