3/13 Ducia monitoring jumpy numbers

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Tanya and Ducia

Tanya and Ducia

Member Since 2017
Yesterday post:

http://www.felinediabetes.com/FDMB/threads/3-11-update-on-ducia.174711/#post-1917636

Hello,

Yesterday Ducia had reduced dose of 0.5U, almost all Blue numbers in the AM cycle, but spent her PM cycle in high Reds. The reduction was mistake. She is prone to AM dives and I am going to take her PMPS +10 soon.
She might be falling rapidly as she often does. Her PMPS+9 476 immediate re-test 426 was taken by someone else and maybe an error.

She asked for food and got 1 teaspoon 4% at PMPS +9.45. I will take PMPS +10 now and post here.

Can you please help me thru the day with her numbers?

The SS is current.

Thank you!

Her last food was at pre-shot about 1teaspoon LC.
About hour and a half earlier at PMPS+8 she ate her entire reg meal of 1/4 can 4%. @PMPS+9.5 she had 3 teaspoons of 4% because she asked for it and I do give food when she asks unless it is 2 hours before the shot.

We changed her shot time/feeding time twice and if she acts hungry I give a snack to her. It sounds wrong but I cannot decide which one is more important - to stick to the 4 hours interval meals schedule or to not to starve the recovering cat and give snacks whenever she asks. It definately meddles with my grasp on the whole picture.:confused:

Right now @AMPS+1.5 she doesn't show any appetite, is sleeping. Last snack was at pre-shot 1 teaspoon LC.

On the regular food schedule and 12 hours apart shots she ate very well, somewhat over her recommended 5.5 can/200Kcal a day and visible gain some weight, her coat looks shiny again.

Can you please check her SS and advise me about the food. :confused:
 
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Bounces, like the one she went into last night, happen. You'll get her back on track in no time, don't worry. The good news is that ketones are still negative, even with high numbers!
 
Good morning Nan,
I just shoot her 0.75U and watching closely.
It is good that ketones unchanged.
I was told that it takes several cycles on consistently high Bgs for ketones to show up. Do you agree with that?
 
I don't know about "several" cycles-- ketones can develop extremely rapidly. It usually takes more than just high numbers to do it, though. If she's still eating well, that's a good sign, and getting a bit more insulin into her this morning will hopefully help to stop anything from developing.

How is she feeling today?
 
Have you shot at just after +10?
Have you been shooting at +10 the last couple of cycles?? Or am i misunderstanding the SS.


Tanya and Ducia said:
Her PMPS+9 476 immediate re-test 426 w
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Those two nunbers are essentially the same, bear in mind that there can be upto 20% meter variation.

Good news that there are no ketones showing. Taking the dose up is a good idea, since not enough insulin in a cat that is dka prone, maybe asking for trouble, particularly with an infection in the mix, and inappetence. It may be preferable to feed higher carb food to steer her numbers, and keep the insulin dose, rather than reducing or skipping shots.


The reds may be a bounce of the blues yesterday. Or may be a result of the infection.
Nan & Amber said:
I don't know about "several" cycles-- ketones can develop extremely rapidly. It usually takes more than just high numbers to do it, though. If she's still eating well, that's a good sign, and getting a bit more insulin into her this morning will hopefully help to stop anything from developing.

How is she feeling today?
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I agree nan, they can develop in a matter of hours, and fwiw, a kitty doesn't have to be in high numbers to get them.

Not enough insulin, infection, inappetence are all risk factors.
 
Nan & Amber said:
I don't know about "several" cycles-- ketones can develop extremely rapidly. It usually takes more than just high numbers to do it, though. If she's still eating well, that's a good sign, and getting a bit more insulin into her this morning will hopefully help to stop anything from developing.

How is she feeling today?
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She is eating well. The 5mg Famotidine that I am to give every 8 hours help.
She is sleeping now.
AMPS +12.45 she also got8mg Cerenia
 
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Gill & George said:
Have you shot at just after +10?
Have you been shooting at +10 the last couple of cycles?? Or am i misunderstanding the SS.



Those two nunbers are essentially the same, bear in mind that there can be upto 20% meter variation.

Good news that there are no ketones showing. Taking the dose up is a good idea, since not enough insulin in a cat that is dka prone, maybe asking for trouble, particularly with an infection in the mix, and inappetence. It may be preferable to feed higher carb food to steer her numbers, and keep the insulin dose, rather than reducing or skipping shots.


The reds may be a bounce of the blues yesterday. Or may be a result of the infection.

I agree nan, they can develop in a matter of hours, and fwiw, a kitty doesn't have to be in high numbers to get them.

Not enough insulin, infection, inappetence are all risk factors.
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The unsulin was increased at AMPS.
She gets CLavamox x2 day for infection.
Inapetance I think is a wrong term here. SHe was eating very well, and still does so at her regular every 4 hours schedule. However, last night PMPS +2 after 0.7 of Clavamox she ate only some of her reg meal. About a half of it. Later on, by PMPS+9 she shown appetite and did eat 2 Tbs LC.
Because of shot time change, the ABs and the fact that I forgotten that Famotidine is to be given every 8 hours she missed her scheduled meals, or ate them in portions
 
Gill & George said:
they can develop in a matter of hours, and fwiw, a kitty doesn't have to be in high numbers to get them
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@AMPS+1 Ketones Neg/min Trace. I cannot say Negative completely, the colors on scale for Neg and Trace are too close. Id say it is rather Neg than minimal Trace. Truly, it is my best to assess.
 
Nan & Amber said:
I don't know about "several" cycles-- ketones can develop extremely rapidly. It usually takes more than just high numbers to do it, though. If she's still eating well, that's a good sign, and getting a bit more insulin into her this morning will hopefully help to stop anything from developing.

How is she feeling today?
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Ketones checked @AMPS+1: Negative or minimal Trace. The reference colors are too close.
 
Tanya and Ducia said:
This AM cycle is the 2nd at +10. She was very high.
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OK, let's see how she does with this today, and then get her back on the 12-hr schedule. It's just much easier to manage Lantus on a 12-12 shot schedule-- otherwise, you have overlapping influences of different shot, and the numbers get hard to interpret.
 
Nan & Amber said:
OK, let's see how she does with this today, and then get her back on the 12-hr schedule. It's just much easier to manage Lantus on a 12-12 shot schedule-- otherwise, you have overlapping influences of different shot, and the numbers get hard to interpret.
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That very true - hard to interpret.
The goal is to have her on 12-12. Easier on the food control too.
I hope very much is going to be good today.
 
Ducia's AMPS +2 was BG 343 which is 52 points down from +1 BG 395. Is it considered a big fall?

She was asking for food so I gave 1 Tbs 6% meal +2 ml water. Was it wrong? She would actually eat some more right now but I worry that she wouldn't eat normally at +4. Again, which one is more important?
 
I think feeding her at this time was perfect. It's not a big drop (so far), but she is dropping, so we'd like it to be as gentle as possible. I think having her a little hungry right now is OK, let's see where she goes from here.
 
Thank you!
Her regular feeding is @+$ just 1 hour from now.
She asks for more food but I will hold on on it at least until +3 test.
 
Tanya and Ducia said:
Ketones checked @AMPS+1: Negative or minimal Trace. The reference colors are too close.
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Good news. You can always use a ketone strip on your self and see what it looks like. Hopefully negative. ;)
Tanya and Ducia said:
I wish I knew exactly why Reds.
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Her dose was too low, plus you did a delay yesterday. Remember than Lantus is a depot insulin. It means that what a cycle looks like is largely a part of the depot. The blues you saw yesterday were likely a result of the 0.75 units she had been getting for the days before that. The reds today and pinks last night were partly bounce from the blues, the shot delay and also the fact that you lowered to dose to 0.5 units. The depot also means that we determine the dose based on how low it takes kitty, not the preshot values. The 0.75 units gets her into blues.

Replying to your comment in yesterday's condo, there is nothing wrong with shooting a dropping number, as long as her numbers are still in a safe range. All the dropping numbers tells you is that she is probably breaking a bounce. If she had been dropping quickly into green, I might be more cautious.

With Ducia's numbers as high as they are today, I would just stick with your normal feeding schedule. And you also don't need to test as often. You could probaly take a 3 hour break, and if she's still above 300 at that point, you can stop testing until PMPS.
 
Tanya and Ducia said:
Inapetance I think is a wrong term here
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I wasn't suggesting she had decreased appetite specifically, but rather that decreased appetite (ie not getting enough food), is one of the factors (ingredients) for developing ketones.

Tanya and Ducia said:
This AM cycle is the 2nd at +10. She was very high.
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Though it can in some situations be ok to shoot early, I would try not to make a habit of it, as Nan has already said, with Lantus being a depot insulin, you have to always consider overlap and duration, shooting early, in some situations, can act like a dose increase. Conversely shooting late can act like a dose reduction.

Tanya and Ducia said:
Ducia's AMPS +2 was BG 343 which is 52 points down from +1 BG 395. Is it considered a big fall?
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I'd say she looks flattish downward trend with that number, although it's 50pts lower, its still just over 10% lower than the +1, so within the realms of meter variance.

However, if her +1 was 150 and +2 was 100, we are still looking at a 50pt drop, but that would be considered a fast drop. (33% drop)
 
Wendy&Neko said:
Good news. You can always use a ketone strip on your self and see what it looks like. Hopefully negative. ;)

Her dose was too low, plus you did a delay yesterday. Remember than Lantus is a depot insulin. It means that what a cycle looks like is largely a part of the depot. The blues you saw yesterday were likely a result of the 0.75 units she had been getting for the days before that. The reds today and pinks last night were partly bounce from the blues, the shot delay and also the fact that you lowered to dose to 0.5 units. The depot also means that we determine the dose based on how low it takes kitty, not the preshot values. The 0.75 units gets her into blues.

Replying to your comment in yesterday's condo, there is nothing wrong with shooting a dropping number, as long as her numbers are still in a safe range. All the dropping numbers tells you is that she is probably breaking a bounce. If she had been dropping quickly into green, I might be more cautious.

With Ducia's numbers as high as they are today, I would just stick with your normal feeding schedule. And you also don't need to test as often. You could probaly take a 3 hour break, and if she's still above 300 at that point, you can stop testing until PMPS.
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I will need to reread your post again about delays/overlaps. The dropping numbers are scary to me for now, while I am still learning her reactions and everything else to do with FD. She does big points changes. With experience I hope I'd be more comfortable with it. She just ate her regular on time meal with great appetite. Frequent testing helps to catch low drops in big numbers that she did to me several times. But for nowI'll take some break. I am still so silly that I worry to take a nap, woke up and to find her breathless body next to me. Silly me. :oops: Next test at +6 I think.
 
After looking at Ducia's SS this AM cycle we are trying to make a decision as to increase the PM dose to 1U.
I am very scared by her habitual dives and our inexperience.
She has infection and takes AB that makes her vomit sometimes. It maybe minus.
This PM cycle is going to be her 3rd on high BGs. Bad for post DKA.
But she eats well on her own if on 4 hours schedule and I have stock of food from 6 -7-8% carb to 14-17 FF foods.
Is anyone going to be late on the FDMB? To help to newbies?
The shot is due in 1 hour at 8 Pm Pacific.
 
Because of the depot nature of Lantus, it takes several cycles to build the depot up to the 1.0 unit dose, so you can see what that dose can do. Some cats, not all, will respond well on the first cycle of a new dose. Neko sometimes did. I never try to predict what a cat can do. If you shoot the 1.0 unit, I would be prepared to get a +2 test to see if it'll be an active cycle. Ducia is new enough to insulin that we can't say what she would do yet anyway.
 
Wendy&Neko said:
Because of the depot nature of Lantus, it takes several cycles to build the depot up to the 1.0 unit dose, so you can see what that dose can do. Some cats, not all, will respond well on the first cycle of a new dose. Neko sometimes did. I never try to predict what a cat can do. If you shoot the 1.0 unit, I would be prepared to get a +2 test to see if it'll be an active cycle. Ducia is new enough to insulin that we can't say what she would do yet anyway.
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Thank you Wendy,
I will check in +2 and then depending on what I will get maybe every hour.She dropped in past around +3 to +5. So I am going to keep a check on her.
 
Thank you Tricia,
we did increase the dose and now going to see at +2 how is it going.
She had great appetite at PMPS, and got her med and water.
 
Does anyone knows carbs and total calorie value for 5.5 Friskie Classic Pate Chicken and Tuna Dinner ?
There is no data in Dr.Pierson's 2017 chart.
 
Tanya and Ducia said:
Does anyone knows carbs and total calorie value for 5.5 Friskie Classic Pate Chicken and Tuna Dinner ?
There is no data in Dr.Pierson's 2017 chart.
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On the older chart it is 9%. I would suspect it's probably still about the same.

Looks like Ducia came down a little at +2, but nothing alarming. When would you like to test again?

 
Tricia Cinco(GA) & Harvey said:
On the older chart it is 9%. I would suspect it's probably still about the same.

Looks like Ducia came down a little at +2, but nothing alarming. When would you like to test again?

[/QUOTE
Next test is @+3. Then depending on what it reads like.
I liked the +2 . Seems very smooth compared to her big number drops. Fingers crossed, we will have it nice and smooth.
Thank you for the info on Friskies - I might need exactly the 9% food, especially her fav chicken and tuna tonight.
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