10/26 Asia AMPS 407, 217 pt drop in 1 hr, dosecrease?

Status
Not open for further replies.
Stacy & Asia

Stacy & Asia

Member Since 2017
http://www.felinediabetes.com/FDMB/threads/10-25-11-547-pmps-441-1-436-2-557-3-340.185893/

Asia dropped 217 points in an hour last night (+2 to +3), I thought she might keep rapidly coming down for a minute there, but she surfed in the high 300s instead (really bad form, I know). I can say that for the first time since this started, she was decidedly not happy about being in the black (not purring, a little spaced out, just not her typical self) and that wasn't the case before when she went high. Maybe she's trying to acclimate a bit to lower numbers? I'm probably reading too much in to it. Negative keytones still. I can't make much sense of why she does what she does. I still suspect something else is going on, her labs pointed to some increased value that suggests pancreatitis, the first vet didn't mention it to me, I asked the second vet, he thought a sonogram would be useful.

What does feeding the curve mean? Asia eats pretty much all day except <2 hrs pre shot. Does it mean feeding a MC food at a certain time? If so, why?
 
Feeding the curve is done with LC, sometimes MC in kitties that have a pattern of dropping at certain hours of the cycle. I see it mostly done with cats who like to dive consistently at like +2/ +3, etc. I'm not sure Asia has a pattern to determine how you would even go about feeding her curve at this point.

I'd probably take her dose up tonight or tomorrow morning. Either she's wobbling around or started another bounce.
 
Doodles & Karen said:
Feeding the curve is done with LC, sometimes MC in kitties that have a pattern of dropping at certain hours of the cycle. I see it mostly done with cats who like to dive consistently at like +2/ +3, etc. I'm not sure Asia has a pattern to determine how you would even go about feeding her curve at this point.

I'd probably take her dose up tonight or tomorrow morning. Either she's wobbling around or started another bounce.
Click to expand...
I'm not sure she has a pattern to even go about figuring out a dose for her at this point either ;) Her most consistent pattern is to consistently change her pattern! :confused: I'm thinking dose increase tonight as well. I don't like flying solo on a dose increase, but even when I switched it to the day, she decided to react at night anyway (because: cat). :banghead:
 
She got those nice greens 8 cycles ago and she should have cleared that. It looked like she was clearing it the AMPS yesterday but then went up again. Hmmm, could those blues been enough to make her bounce again ? I don't know. With her eating all the time except within 2 hours of test time, I'm not sure if she could be in a pancreatic flare as in appetence is a symptom of it. Maybe putting her on a set eating schedule and testing her at those times could show more accurate numbers . For instance, I feed Bubba 6 times a day and those are the times I test unless a previous test tells me I better test again sooner because of fast dropping or too low of a number.

How is the poop department? Normal and daily?

It does look like she needs more juice. See what others say.
 
Doodles & Karen said:
Put dosecreae in your title with the ? mark prefix. See what others think.
Click to expand...
Just to clarify, what I meant by flying solo was being up all night, when nobody is really on the board for support and she's diving into dangerously low numbers (like I did the other night). Scary, not fun, but that happened when I changed her dose in the day, and it's happened (not as low) the first cycle when I changed it at night. So far there is no rhyme or reason as to when the dose looks like it's taking hold.
 
Bobbie And Bubba said:
She got those nice greens 8 cycles ago and she should have cleared that. It looked like she was clearing it the AMPS yesterday but then went up again. Hmmm, could those blues been enough to make her bounce again ? I don't know. With her eating all the time except within 2 hours of test time, I'm not sure if she could be in a pancreatic flare as in appetence is a symptom of it. Maybe putting her on a set eating schedule and testing her at those times could show more accurate numbers . For instance, I feed Bubba 6 times a day and those are the times I test unless a previous test tells me I better test again sooner because of fast dropping or too low of a number.

How is the poop department? Normal and daily?

It does look like she needs more juice. See what others say.
Click to expand...
I could do that, it's not like she's eating all day and just has this giant bowl of food. Rather, I give her a little bit and when I see the bowl is near empty, I give her more, basically she has on demand access to food. You are saying test her before I refill her food? Or test her after she eats some of it?

I'm in and out of the house most of the time, running my kids around and doing errands and appts, I don't catch her every time she poops, unless I'm here. She seems okay in that department, I have another cat as well, but there are regular poops, dry and crumbly. She scoots when she has issues and that's very infrequent (every few months or so for a day or 3).

Only real health issue she's ever had was tooth reabsorption at age 13. And the two teeth she has left aren't amazing. They bother her on and off and my vet has had to remove tartar caps off of them on a few occasions. They don't seem to be currently bothering her (she paws at her mouth when it's an issue). I wish I had them removed, but there's not much to be done about it now, she's too old for anesthesia and she is the most laid back and tolerant cat...unless you try to go in her mouth, very sensitive and it is absolute torture to her for her mouth to be messed with. She struggled and fear peed on my vet when she had the tartar removed. :(

And the CRF which the most recent vet I spoke with thinks might not even be a thing, so who knows.
 
Also some random questions, I'm trying to take human err out of the equation as much as possible. although I'm pretty sure whatever wrong I'm doing here isn't causing the massive crazy dance that Asia is doing, but you never know:

I've read conflicting advice re: putting the amount of air into the Lantus vial you are taking out. Do that or don't do that?! I have been doing it thus far, but I recently read something that said not to do it. (I have a pen, new and unopened I know you don't do it for that, but I'm using the vial right now)

How do you determine if the insulin is less potent than it should be? My vial was half full and donated to my vet who gave it to me. It's clear, not cloudy. I have no idea when the previous owner opened and began using it, or how well they cared for it, if it was kept in the fridge (I assume so). I've had it since late September.

I had been giving her shots in the flank and belly, I clear a line of fur so I can make sure the needle is going in. Just out of instinct, I had been rubbing the area briskly after the shot to make the ouchies go away or something.:rolleyes: I recently read not to do that. I've also recently read to leave the needle in for a few seconds after injection? Hadn't been doing that, did it this morning.

I'm also sure that each 1.75 dose varies a tad from the last, how can it not when you are eyeballing it? I'm guessing that could affect things as well if even a drop of insulin is a big deal for them. I got calipers and tried to read threads and watch videos how to use them. Couldn't wrap my brain around it yet, especially the part about finding near perfect syringes to test. Mine are currently pretty much the same (BD), the monoject ones I had were horrid and had obvious misprints on the dosing ruler.
 
Toebeans said:
You are saying test her before I refill her food? Or test her after she eats some of it?
Click to expand...
If you could grab a test before she eats again, and try to space out her meals every 3-4 hours, it might give your more accurate info of her BG. It's hard to know where they are if they are grazing.

I hope the teeth aren't an issue as tooth pain and /or infection can make the numbers stay up.
 
Bobbie And Bubba said:
If you could grab a test before she eats again, and try to space out her meals every 3-4 hours, it might give your more accurate info of her BG. It's hard to know where they are if they are grazing.

I hope the teeth aren't an issue as tooth pain and /or infection can make the numbers stay up.
Click to expand...
Okay, gotcha, I can try that.

I know, I hope it's not an issue either, it's hard to say since she's asymptomatic and I can only look at them when she yawns. Since she's not a candidate for cleaning/surgery, one vet suggested pulsing antibiotics to keep infection at bay. It's its own set of problems because convenia (which has more risks than most abx) is it for her as far as antibiotics goes (unless there is some other injectable kind I can admister at home that I don't know about). Pills and compounded liquids are a no fly zone here. Quality of life for her is pretty much zero if she has to be pilled once or more times a day, it really is torture to her if you go in her mouth. And she hates pill pockets, and she is an expert to sniff out food (even tuna juice) that has been tampered with. She also hates fortaflora which I've heard is like kitty crack for most. Needles, however, not bothered. :rolleyes:
 
She's really not been behaving after those greens.

She got to 68......
Looks like she's trending down for her pmps, if she is dropping at pmps, she might be indicating her intention to finally clear the bounce. I would probably hold tonight, if you find pmps dropping.

It's the first time she hit green, it may take her a little longer to come back down of the bounce.
 
Toebeans said:
because convenia (which has more risks than most abx) is it for her as far as antibiotics goes (unless there is some other injectable kind I can admister at home that I don't know about).
Click to expand...
Convenia is not a mouth infection appropriate AB rather it is more for skin infections. I don't have enough knowledge to know about any other injectable ABs that are appropriate to target mouth infections. Maybe someone will weigh in.

Bubba is very hard to pill also.He is another one that will not eat or drink tuna juice that has a bitter AB in it. Recently he had tapeworms and I had to get 2 large pills down him. I had to split them and put them into the largest gel cap.( 4 of them :eek:) I shoved them down his throat and had tuna juice next to him for him to take a lap or two and then kept shoving the gel caps down and letting him drink the tuna juice until I had all 4 down him. It worked like a charm.

Do you have any gel caps?
 
Toebeans said:
Also some random questions, I'm trying to take human err out of the equation as much as possible. although I'm pretty sure whatever wrong I'm doing here isn't causing the massive crazy dance that Asia is doing, but you never know:

I've read conflicting advice re: putting the amount of air into the Lantus vial you are taking out. Do that or don't do that?! I have been doing it thus far, but I recently read something that said not to do it. (I have a pen, new and unopened I know you don't do it for that, but I'm using the vial right now)

How do you determine if the insulin is less potent than it should be? My vial was half full and donated to my vet who gave it to me. It's clear, not cloudy. I have no idea when the previous owner opened and began using it, or how well they cared for it, if it was kept in the fridge (I assume so). I've had it since late September.

I had been giving her shots in the flank and belly, I clear a line of fur so I can make sure the needle is going in. Just out of instinct, I had been rubbing the area briskly after the shot to make the ouchies go away or something.:rolleyes: I recently read not to do that. I've also recently read to leave the needle in for a few seconds after injection? Hadn't been doing that, did it this morning.

I'm also sure that each 1.75 dose varies a tad from the last, how can it not when you are eyeballing it? I'm guessing that could affect things as well if even a drop of insulin is a big deal for them. I got calipers and tried to read threads and watch videos how to use them. Couldn't wrap my brain around it yet, especially the part about finding near perfect syringes to test. Mine are currently pretty much the same (BD), the monoject ones I had were horrid and had obvious misprints on the dosing ruler.
Click to expand...
Gosh, it would help if you knew when the vial was first opened. Usually they are good for about 6 months. Being clear and not cloudy is a good sign but, if you could possibly find out when it was opened would be optimum.

As far as injection technique, yeah don't rub because you don't want to rub any liquid out of the site. Rather smell the site so you will know if you gave a FS or not. Have you looked at this thread on using a vial? It might give you some insight. I have always used Lantus pens so I am not adept to guide you so this video will be helpful.
http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/

As far as shot site, the above link if you scroll down past the syringe handling video, gives a chart for alternate sites. I always shoot below each shoulder and alternate each shot. I have shot the scruff ( supposedly not a good absorption site ) but, I did a few times when he was racing down the dosing ladder and I wanted to slow him down. I am not sure if it helped slow him or not.

I like Gill's advice as she looks like she is trending down. Let's see what her PMPS is.
 
Bobbie And Bubba said:
Convenia is not a mouth infection appropriate AB rather it is more for skin infections. I don't have enough knowledge to know about any other injectable ABs that are appropriate to target mouth infections. Maybe someone will weigh in.

Bubba is very hard to pill also.He is another one that will not eat or drink tuna juice that has a bitter AB in it. Recently he had tapeworms and I had to get 2 large pills down him. I had to split them and put them into the largest gel cap.( 4 of them :eek:) I shoved them down his throat and had tuna juice next to him for him to take a lap or two and then kept shoving the gel caps down and letting him drink the tuna juice until I had all 4 down him. It worked like a charm.

Do you have any gel caps?
Click to expand...
That stinks it's not good for teeth. She has only had it for UTIs, which I suppose it is good for. Asia is the most tolerant and friendly people loving cat in the universe and you can do just about anything to her except go in her mouth, it's always been a sore spot for her and I could pill her before her tooth reabsorption issues, but not since. She gets suddenly 10 times stronger than you think she could possibly be at 8 pounds and some change, she flails and tries to get away, and fear pees herself, even with liquid, same thing, foaming at the mouth, she acts like you're trying to kill her, then she goes and hides for hours. She's not a scaredy cat one bit, it's just straight up traumatic for her to have that done. What quality of life would she have if we did that rodeo twice a day and she became afraid of me? Assuming I could even get the pill down in the first place, which I haven't successfully done in almost a decade. Even the pros have trouble and need more than one person to pill her. It's very sad. She's had her anal glands expressed before and she certainly doesn't like it and grumbles a lot, but it's nothing near what going in her mouth is like. My other cat will let you play with her teeth. It's just a thing with Asia, and I have to accept it.
 
Bobbie And Bubba said:
Gosh, it would help if you knew when the vial was first opened.
As far as injection technique, yeah don't rub because you don't want to rub any liquid out of the site. Rather smell the site so you will know if you gave a FS or not. Have you looked at this thread on using a vial? It might give you some insight.
http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/
Click to expand...

They don't know when it was opened, but it's a moot point because I got the good for 28 days directive, I have a pen sitting in the fridge waiting for deployment. Lantus smells like bandaids. All I smell are bandaids from the time I take it out of the fridge until the time I put it back. Yuck.
  • Never shake or roll your vial, cartridge, or pen.
Wait, WHAT? I was told to roll the vial gently 10 times or so to mix the insulin, don't do this? :confused:

p.s. Thanks to all of you for helping me navigate this. I feel like the annoying too many questions person. :facepalm: I so appreciate your patience and guidance, I'm not sure where Asia would be right now if I hadn't found this board. :cat:
 
You do not have to roll or shake Lantus. ProZinc is an insulin that you roll gently but, NOT Lantus.

I too am so grateful to have found this forum. We help each other :bighug:
 
Toebeans said:
Does it ruin the insulin? since I've been doing that twice a day for about a month, is it bad?
Click to expand...
I don't know if it ruins it or not or if it's just not necessary. I hope some others will weigh in with the answer to that question. I don't believe the video I linked says that it will wreck it but, I didn't take in the vial video as much as I paid attention to the pen video tutorial.
 
Here are the notes from the sticky: I recommend watching the video - it's very, very helpful! :-)

PROPER HANDLING OF LANTUS and LEVEMIR:
  • Lantus and Levemir should be visually inspected prior to administration. Use only if the insulin appears clear and colorless.
  • Never shake or roll your vial, cartridge, or pen.
  • In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
  • Do NOT use Lantus or Levemir if it has been frozen.
  • Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
  • If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon.

I did EVERYTHING wrong with my first cartridge of insulin, including leaving it out of the fridge too long, etc. :-) Live and learn!
 
Girlie's mom said:
Here are the notes from the sticky: I recommend watching the video - it's very, very helpful! :)

PROPER HANDLING OF LANTUS and LEVEMIR:
  • Lantus and Levemir should be visually inspected prior to administration. Use only if the insulin appears clear and colorless.
  • Never shake or roll your vial, cartridge, or pen.
  • In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
  • Do NOT use Lantus or Levemir if it has been frozen.
  • Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
  • If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon.
I did EVERYTHING wrong with my first cartridge of insulin, including leaving it out of the fridge too long, etc. :) Live and learn!
Click to expand...
Girlie's mom said:
Here are the notes from the sticky: I recommend watching the video - it's very, very helpful! :)

PROPER HANDLING OF LANTUS and LEVEMIR:
  • Lantus and Levemir should be visually inspected prior to administration. Use only if the insulin appears clear and colorless.
  • Never shake or roll your vial, cartridge, or pen.
  • In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
  • Do NOT use Lantus or Levemir if it has been frozen.
  • Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
  • If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon.
I did EVERYTHING wrong with my first cartridge of insulin, including leaving it out of the fridge too long, etc. :) Live and learn!
Click to expand...
Now you know. I did a lot of things wrong in the beginning and learned as I went along thanks to this board.
 
Status
Not open for further replies.
Back
Top