3/14 Ducia AMPS 230, +4 85, +4,5 89, +5.15 104 1U - increased dose @the inexperienced hands

[Tanya and Ducia]

Hello,

Here is the link to the yesterday post:

http://www.felinediabetes.com/FDMB/threads/3-13-ducia-monitoring-jumpy-numbers.174766/#post-1918403

This morning Ducia is starting her 2nd cycle with the increased Lantus dose of 1U.

She is post DKA, fatti liver and recent symptomatic Hypo survivor 8 ½ YO cat girl who is home cared for by very inexperienced caregiver. She has ETube fit in but it is used for medication and water as she eats on herself. In the past Ducia has shown tendency to dramatic drops in the AM cycles as well as big up and downs from hour to hour throughout the day.

I don’t know how to interpret her reactions to insulin and food as yet. I ask that you help me understand her readings better so I can manipulate her BGs by food intake according to the situation at hand.

On 3/12/2017 her AM cycle with the dose of 0.75U was mostly Blue and Yellow. Her PM cycle was entirely Red.

There is an infection currently present for which Ducia takes Clavamox 0.7 x 2 a day. She takes Famotidine for nausea. Stronger anti-nausea med might be available this evening. She had good appetite. I home test her urine for the ketones which so far are either Negative or low Trace. The reference colors are too close to one another.

In past couple of days some increasing/decreasing of doses has been made, as well as shooting earlier on 2 occasions. I have very general understand of the Depot but I believe that my recent moves might have had upset it and warranted some unpredictability of Ducia’s reactions for the next cycles. I have various canned food at home with carbs value from 4% to 21% but I prefer to stay with LC food for her.

Please check her SS which I update hourly and help me orient in the uncharted - for me - waters of the FD.

Here is the last night PM cycle readings:

PMPR 302, +2 281, +3 271, +4 223, +5 219, +6 192, +8 193, +10 255, + 11 283

AMPS 230 which is 53 points lower than PMPS +11. She ate her regular at this time meal of ¼ of 5.5 can 7% meal. The dose is 1U Lantus.

 

[Gill & George]

Nice that Ducia just made it into blue last night.

Looks like she was flattish coming into amps.

Guess you'll be getting a +1/+2 to keep a handle on things, and avoid surprises.

 

[Nan & Amber (GA)]

Glad Ducia is eating well, that is so important. You are really doing an amazing job with her!

How many more days will she be on the antibiotics?

 

[Tanya and Ducia]

Good morning Nan!
Good to see you!

Ducia is on AB thru 03/20.
Our vet might give us Rx for anti nausea later on today. I give the AB one hour after the meal and along with Famotidine it seems to work well (knock, knock on wood). Over night she ate well, took AB without too much lip licking and there was no vomiting.
The fewer meds she takes the better but I like to have the Rx ready.

 

[Tanya and Ducia]

Glad Ducia is eating well, that is so important. You are really doing an amazing job with her!

How many more days will she be on the antibiotics?

Good morning Nan!
Good to see you!

I post the reply wrongly again but here it is now.

Ducia is on AB thru 03/20.
Our vet might give us Rx for anti nausea later on today. I give the AB one hour after the meal and along with Famotidine it seems to work well (knock, knock on wood). Over night she ate well, took AB without too much lip licking and there was no vomiting.
The fewer meds she takes the better but I like to have the Rx ready.

 

[Nan & Amber (GA)]

Hi Tanya--

Was just checking Ducia's spreadsheet and I see you just hit green-- how are you doing?

 

[Tanya and Ducia]

Hi Tanya--

Was just checking Ducia's spreadsheet and I see you just hit green-- how are you doing?

Thank you soo much for watching! We are all right.

Right after the reading I gave Ducia 1/4 can 9% and will retest in 30 min from when she is done with the meal.
Her appetite is great. I hope it will bump the BG up, if not I will add another Tbs 9%.

Questions: The AMPS+4 came 40 min after she was done with a teaspoon of 9%. Does have any effect at all?
If you look at the SS the APMS+3 and AMPS +4 - is it a big drop? The time would be her usual morning diving.

I expect another drop to possible come at around +5.
May switch to twice in an hour testing.

Do you think it's a plan?

 

[Nan & Amber (GA)]

Good plan, although I hope you don't need to go to twice an hour testing-- do you hear that, Ducia? Be good and stay in the high greens so your ears can get a break!

40 minutes might be enough to see a little effect of food, and she seemed to level off a little bit between +3 and +4. Hopefully her +4 meal will keep her where she's at now-- 85 is a great number!

I think @Bobbie And Bubba might be around right now, and she has more hands-on experience at looking at spreadsheets and food-steering than I do-- can you take a quick look, Bobbie?

 

[Tanya and Ducia]

Good plan, although I hope you don't need to go to twice an hour testing-- do you hear that, Ducia? Be good and stay in the high greens so your ears can get a break!

40 minutes might be enough to see a little effect of food, and she seemed to level off a little bit between +3 and +4. Hopefully her +4 meal will keep her where she's at now-- 85 is a great number!

I think @Bobbie And Bubba might be around right now, and she has more hands-on experience at looking at spreadsheets and food-steering than I do-- can you take a quick look, Bobbie?

Ok,
30 min after 1/4 ca 9% AMPS is up to 89.
No additional food at the moment.
Will retest in 30min which will be +5.15

How does that sound?

 

[Nan & Amber (GA)]

Great surfing, Ducia!

She's doing fantastic-- these are safe numbers, and she is holding steady. So, it's fine to test at 5:15 if you want to-- all data is good data, and it will give you some more information about how she responds to the LC food-- but not absolutely necessary. She's doing very well right now!

 

[Nan & Amber (GA)]

(if you get a chance, could you edit the subject line to put the new numbers in? That way, people glancing through the forum will know to stop by and see how things are going)

 

[Wendy&Neko]

When a kitty is above 80 and surfing flat like that, it's OK to go to testing every hour. Ducia is looking great today.

 

[Tanya and Ducia]

Great surfing, Ducia!

She's doing fantastic-- these are safe numbers, and she is holding steady. So, it's fine to test at 5:15 if you want to-- all data is good data, and it will give you some more information about how she responds to the LC food-- but not absolutely necessary. She's doing very well right now!

Thank you!
I was thinking that Ducia responded to one teaspoon not as fast as I would like it to be. But now I know her!
I read somewhere that Famotidine that is great help for her nausea after AB may also slow down protein absorption. Have you heard anything about it?

 

[Tanya and Ducia]

(if you get a chance, could you edit the subject line to put the new numbers in? That way, people glancing through the forum will know to stop by and see how things are going)

I've been thing myself how to edit the title of the post - there is an error in.
And of course adding current would help.
But I don't how to do it.

 

[Tanya and Ducia]

When a kitty is above 80 and surfing flat like that, it's OK to go to testing every hour. Ducia is looking great today.

I know you are right.
But...
The ghost of hypo is lurking around, or so my panicky mind tells me...
I will make 30 min check at +5.15 anf if stable or upward than I'll let it rest until +6. This time betweem +5 and +6 her fav for diving.
I will make it up with her ears. I promise.

 

[Nan & Amber (GA)]

I've been thing myself how to edit the title of the post - there is an error in.
And of course adding current would help.
But I don't how to do it.

If you go to the first post of the thread you should have a little box to the right called "thread tools", and you can choose to edit the title there.

I don't know about the effects of famotidine, maybe someone else does?

 

[Wendy&Neko]

Fatomidine (common version is Pepcid) helps reduce the excess acid in the tummy. If kitty has an acid tummy, they can be feeling not well. But that is not what we usually suggest for nausea related to taking antibiotics. In that case, a course of probiotics may help. The antibiotics can kill some of the stomach flora and the probiotics can help restore than balance. I have not heard of fatomidine causing problems with protein absorption, though I have heard it can reduce B12 absorption.

 

[Bobbie And Bubba]

Good plan, although I hope you don't need to go to twice an hour testing-- do you hear that, Ducia? Be good and stay in the high greens so your ears can get a break!

40 minutes might be enough to see a little effect of food, and she seemed to level off a little bit between +3 and +4. Hopefully her +4 meal will keep her where she's at now-- 85 is a great number!

I think @Bobbie And Bubba might be around right now, and she has more hands-on experience at looking at spreadsheets and food-steering than I do-- can you take a quick look, Bobbie?

Sorry, I just got the tag but, looks like things are under control. I am glad to see you have increased the dose and are using food to steer. This was the strategy that Jill was talking about to help get rid or the ketones Good job today Tanya!

 

[Tanya and Ducia]

Fatomidine (common version is Pepcid) helps reduce the excess acid in the tummy. If kitty has an acid tummy, they can be feeling not well. But that is not what we usually suggest for nausea related to taking antibiotics. In that case, a course of probiotics may help. The antibiotics can kill some of the stomach flora and the probiotics can help restore than balance. I have not heard of Famotidine causing problems with protein absorption, though I have heard it can reduce B12 absorption.

I don't know if Ducia has acid tummy. She never licked her lips in the way she does now after she started the AB. She also did some vomiting yesterday and the day before and Famotidine seems to help with it all. Does it mean she has acid tummy? I hope its temporary for the AB course duration.
Can you please give me the names of probiotics advisable?

 

[Tanya and Ducia]

Sorry, I just got the tag but, looks like things are under control. I am glad to see you have increased the dose and are using food to steer. This was the strategy that Jill was talking about to help get rid or the ketones Good job today Tanya!

It is VERY exhausting.

 

[Tanya and Ducia]

Ducia +6 is 118.
I think that I should her earls a little and do the next test by her meal time @+8.
I hope it is safe for me to close my eyes for an hour, is it?
There possibly a bouncing PM cycle tonight, in retaliation for the Blues and a Green.
A day will come when I welcome Greens with all my heart like you all do. But given how new I am to all of it I think that Blue is the perfect compromise for now.
Thank you so much for watching over! I am very, very grateful.

 

[Nan & Amber (GA)]

Yes, please do take a break! You need to take care of yourself, too!

 

[Wendy&Neko]

The signs of acid tummy include a foamy vomit. Is Ducia vomiting food or water?

Human grade probiotics can be used. I think a lot of people use the Renew Ultimate brand. This page here has a description of what probiotics to use. You do want to give them 2 hours apart from antibiotics.

 

[Sandy and Black Kitty]

She is post DKA, fatti liver and recent symptomatic Hypo survivor 8 ½ YO cat girl who is home cared for by very inexperienced caregiver. She has ETube fit in but it is used for medication and water as she eats on herself

Hello most of us here started out as very inexperienced caregivers - I certainly was.

There is an infection currently present for which Ducia takes Clavamox 0.7 x 2 a day.

clearing up the infection is important as it is one of the factors that lead to the formation of ketones. It's good she has the etube since another contributor to the formation of ketones is not consuming enough calories. Kitties recovering from DKA should consume approximately 1.5 x the calories normally required to maintain ideal body weight The final ingredient contributing to the formation of ketones is not enough insulin.

Ducia also needs to stay well hydrated.

I home test her urine for the ketones which so far are either Negative or low Trace. The reference colors are too close to one another.

great job testing for ketones several times a day. Ketones can develop quickly- my Black Kitty went from trace to large in 24 hours once. I found that viewing the strip in the natural light of a window made. It easier to distinguish negative from trace.

In past couple of days some increasing/decreasing of doses has been made

frequent dose changes can result in the Depot always seeking equilibrium. Lantus works best when doses are consistent.

You are in a period of intensive care right now., which is indeed exhausting. Thankfully it is temporary. Hang in there and hang in here. It will get better.

 

[Sandi & Chase in AZ]

The signs of acid tummy include a foamy vomit. Is Ducia vomiting food or water?

Human grade probiotics can be used. I think a lot of people use the Renew Ultimate brand. This page here has a description of what probiotics to use. You do want to give them 2 hours apart from antibiotics.

So then Chase isn't the only one who vomits here, or there... but ALWAYS with a huge hair in it. LOL. ewwwwww.

 

[Tanya and Ducia]

A new thread was opened here:

http://www.felinediabetes.com/FDMB/...ed-help-interpreting-bgs.174849/#post-1919363