11/18 PMPS 346,+1 348, +2 376,+3 317,..AMPS 379,+3 303,+4 285, +6 269, +7 195,+8 195,+9 231

[Debra and Yoyo]

Please, is someone available that I can reach out to incase I need help with a LOW READING during the night/early morning

DAY/NIGHT 3 of .5 insulin

This morning Yoyo vomited about 10 minutes after eating and having his felimazole pill. Mosltly water and some food came up. Pill did not come up so Yoyo did keep most of his food in him. Refed a little food,careful not to let him vomit again. He seems fine and +1 447 is higher than AMPS.

 

[Rosie & Bailey]

Looks like he kept down enough of his food to cause a bump.
Interesting that this is his lowest amps, yet the food bump is the same as the last few days.

I would just test him for ketones.
Let's see what he does today. I'd love to see a gradual drop into the blues today and a lower PMPS.

You can do this Yoyo!

 

[Debra and Yoyo]

Looks like he kept down enough of his food to cause a bump.
Interesting that this is his lowest amps, yet the food bump is the same as the last few days.

I would just test him for ketones.
Let's see what he does today. I'd love to see a gradual drop into the blues today and a lower PMPS.

You can do this Yoyo!

I'm assuming that his food bump is high because I fed him again around 7:55-8am so I am assuming that reflected in the 8:15am BG level reading.
I keep checking him and he seems to be fine.
I tested him for ketones around 3am this morning when I got up to do his +8. Ketones were NEGATIVE.

Is he out of any danger from the vomiting this morning?

 

[Rosie & Bailey]

Is he out of any danger from the vomiting this morning?

Looks like he didn't vomit all of his breakfast, plus you gave him more. He should be ok. You just need to keep an eye on him. He's high enough that he isn't in any danger. If his BG were to start racing down, you would just feed him. Key thing is that he is not continuing to vomit.

 

[Rosie & Bailey]

His +2 is almost the same as his AMPS. That just means it's an active cycle so make sure to test.
Actually, I would have expected his +2 to be a lot lower if he had not gotten enough food this morning so pretty sure you're good.

 

[Debra and Yoyo]

His +2 is almost the same as his AMPS. That just means it's an active cycle so make sure to test.
Actually, I would have expected his +2 to be a lot lower if he had not gotten enough food this morning so pretty sure you're good.

Ok...makes me feel less stressed out. I think I'm starting to understand how food effects his readings. I probably won't feed him to right after his +4 cause that will be about 3 hrs since he last ate and I'll give small portions more often. Sound right?
Thank you for sending the LC MC HC foods. But I really can't read them. Can you briefly tell me what foods are in what category from the fancy feast list?

 

[Debra and Yoyo]

Just fed after +4 reading, trying not to slow down drop but he was hungry and he ate 1/2 can ff. Will take +5 at around 30 minutes past, so will be +5.5

 

[Wendy&Neko]

Bumping up this thread so it'll get attention instead of yesterdays.

In yesterday's post, you were talking about the high cost of strips. One way around that is to test less. I know the nervousness of giving insulin, so can understand the desire to test a lot. When he's high at preshot, you don't need a +1 test. A +2 test on Lantus is a good one to get for many cats. If it's around the same as the preshot, it'll be a normal Lantus cycle. If it's quite a bit lower, you may need to do more testing. A higher +2 means a quiet cycle where you don't need to test much.

Although people here like data, you don't need to test as much as you have been. If he's lower or dropping really fast, then hourly tests are appropriate. Otherwise, take a big breath, and put away the test kit for a bit. Also, once he's stopped dropping and on the way up, you can wait longer for that next test.

 

[Debra and Yoyo]

Bumping up this thread so it'll get attention instead of yesterdays.

In yesterday's post, you were talking about the high cost of strips. One way around that is to test less. I know the nervousness of giving insulin, so can understand the desire to test a lot. When he's high at preshot, you don't need a +1 test. A +2 test on Lantus is a good one to get for many cats. If it's around the same as the preshot, it'll be a normal Lantus cycle. If it's quite a bit lower, you may need to do more testing. A higher +2 means a quiet cycle where you don't need to test much.

Although people here like data, you don't need to test as much as you have been. If he's lower or dropping really fast, then hourly tests are appropriate. Otherwise, take a big breath, and put away the test kit for a bit. Also, once he's stopped dropping and on the way up, you can wait longer for that next test.

I appreciate you telling me this. I am new at this and have high anxiety. I worry when I start to give insulin and his numbers are say 180 or 225. The unknown for me is tearing me apart inside. Fear is a terrible thing to live with and this is a BIG fear for me. So far his numbers have been high as it is only his 3rd day on insulin. But the "what if" is the part that I am so afraid of. He has dropped over 200 points in about 2-3 hours, most on 1 unit. But what if this happens when his numbers are lower? Any advice is appreciated.

 

[Debra and Yoyo]

I appreciate you telling me this. I am new at this and have high anxiety. I worry when I start to give insulin and his numbers are say 180 or 225. The unknown for me is tearing me apart inside. Fear is a terrible thing to live with and this is a BIG fear for me. So far his numbers have been high as it is only his 3rd day on insulin. But the "what if" is the part that I am so afraid of. He has dropped over 200 points in about 2-3 hours, most on 1 unit. But what if this happens when his numbers are lower? Any advice is appreciated.

I also wanted to ask you or if you can redirect this question.....Why is my title always very light; all other titles are shown in BOLD Letters. Am I doing something wrong?

 

[Wendy&Neko]

Titles for threads you have posted on will be light. Ones with posts you haven’t read will be bolder.

We all understand how nerve wracking this disease can be. It took me a while to reduce my tests. Fortunately for me, I had to cross border shop for test strips so learned to conserve or pay a ton for local strips. I spent a TON of time analyzing the spreadsheet to try to find patterns. Looking at other people’s spreadsheets, especially for newly diagnosed cats, may help.

 

[Debra and Yoyo]

Titles for threads you have posted on will be light. Ones with posts you haven’t read will be bolder.

We all understand how nerve wracking this disease can be. It took me a while to reduce my tests. Fortunately for me, I had to cross border shop for test strips so learned to conserve or pay a ton for local strips. I spent a TON of time analyzing the spreadsheet to try to find patterns. Looking at other people’s spreadsheets, especially for newly diagnosed cats, may help.

Can you please tell me how I can find spreadsheets on other newly diagnosed cats.

 

[Debra and Yoyo]

Can you please tell me how I can find spreadsheets on other newly diagnosed cats.

Sorry I forgot to ask you.....I placed a question mark infront of todays's date and wrote HELP PMPS dosing. Is there any other way to find a kind person to assist me through the night. It just makes me feel more at ease knowing someone is there that I can reach out to especially during the late hours of night and early morning hours.
Or, is there a way to find a kind person if I have an emergency. As you can tell, I am trying to cover my tracks for fear of the unknown.

 

[Rosie & Bailey]

It just makes me feel more at ease knowing someone is there that I can reach out to especially during the late hours of night and early morning hours.

I can check in on you. Not sure how long I can stay up, but I'll do the best I can.

 

[Debra and Yoyo]

Thank you! I put the question mark and help with dosing on my title around 6:30pm and I didn't get any response. I also asked Wendy&Neko how to get a kind person to assist thru the night. I just feel so much better knowing that there is someone there to reach out to. I appreciate any amount of time that you can give me tonight. Yoyo should be fine because his count is high at 346. My worries are when he has low numbers, but I know I am jumping ahead and I need to take one day at a time. Easier said than done Please let me know when you need to leave the site and if you know anyone who can assist incase I need to reach out for assistance.
P.S..... Am I doing this right, I mean the way I ask for help. Should I start earlier asking for help or am I not supposed to be asking for help. Please let me know the rues of the site. Thanks again!

 

[Rosie & Bailey]

You are doing fine. Normally, people just volunteer if they are available. I don't expect you to have a problem since his number is so high, but I do understand the need to have someone there. I felt the same way when I started.

Have you started looking for trends in Yoyo's sheet?
This is what I see:
11/14/2018 AMPS- +2BG = 112 nadir: 110 Dropped into blues by +3 or +4
11/15/2018 AMPS- +2BG = 101 nadir: 127 Dropped into blues by +3 or +4
11/16/2018 AMPS- +2BG = 54 nadir: 156 Dropped into blues by +3 or +4
11/17/2018 AMPS- +2BG = 43 nadir: 217
11/18/2018 AMPS- +2BG = -10 nadir: 195


11/15/2018 PMPS- +2BG = -11 nadir: 189 Dropped into blues by +3 or +4
11/16/2018 PMPS- +2BG =135 nadir: 184 Dropped into blues by +3 or +4
11/17/2018 PMPS- +2BG = 11 nadir: 283

It's not perfecr, but for most of the cycles, Yoyo dropped into blues whenever there was a big difference between the preshot number and +2, just like Wendy said.

 

[Debra and Yoyo]

You are doing fine. Normally, people just volunteer if they are available. I don't expect you to have a problem since his number is so high, but I do understand the need to have someone there. I felt the same way when I started.

Have you started looking for trends in Yoyo's sheet?
This is what I see:
11/14/2018 AMPS- +2BG = 112 nadir: 110 Dropped into blues by +3 or +4
11/15/2018 AMPS- +2BG = 101 nadir: 127 Dropped into blues by +3 or +4
11/16/2018 AMPS- +2BG = 54 nadir: 156 Dropped into blues by +3 or +4
11/17/2018 AMPS- +2BG = 43 nadir: 217
11/18/2018 AMPS- +2BG = -10 nadir: 195


11/15/2018 PMPS- +2BG = -11 nadir: 189 Dropped into blues by +3 or +4
11/16/2018 PMPS- +2BG =135 nadir: 184 Dropped into blues by +3 or +4
11/17/2018 PMPS- +2BG = 11 nadir: 283

It's not perfecr, but for most of the cycles, Yoyo dropped into blues whenever there was a big difference between the preshot number and +2, just like Wendy said.

Thanks for doing that for me.
Is it strange that today at +7 and +8 Yoyo dropped a lot?
I guess that is what is scary to me, that what if his number was low normal at +6 and then he went down that large amount and I wasn't home because I wasn't expecting a big drop. It's like you never know what can happen!

 

[Wendy&Neko]

Your subject says "help PMPS dosing", which to me means you are unsure what dose to give at PMPS. If you are looking for someone to hang out tonight, change the subject to be something like "need support tonight". I am on the west coast in Canada and will be up for probably 5 hours yet. We have some other people in other time zones around the world who might be up even later. Or there might be someone else with a kitty keeping them up late who can help if needed.

Can you please tell me how I can find spreadsheets on other newly diagnosed cats.

The long way is to open up some of the other posts on this board and see when the member joined or the cat was diagnosed. Bailey (of Rosie & Bailey) is one. Others are Tigger, Buddy, Kylee, Gryphon, and River.

Is it strange that today at +7 and +8 Yoyo dropped a lot?

From 269 to 195 is not a lot. It's 27%. Given that manufactures of blood glucose meters are allowed to be out 20%, it's may not be that big a drop. It could be enough to cause a bounce though. You will find that the lower their numbers, the slower the drops.

 

[Debra and Yoyo]

Your subject says "help PMPS dosing", which to me means you are unsure what dose to give at PMPS. If you are looking for someone to hang out tonight, change the subject to be something like "need support tonight". I am on the west coast in Canada and will be up for probably 5 hours yet. We have some other people in other time zones around the world who might be up even later. Or there might be someone else with a kitty keeping them up late who can help if needed.


The long way is to open up some of the other posts on this board and see when the member joined or the cat was diagnosed. Bailey (of Rosie & Bailey) is one. Others are Tigger, Buddy, Kylee, Gryphon, and River.

From 269 to 195 is not a lot. It's 27%. Given that manufactures of blood glucose meters are allowed to be out 20%, it's may not be that big a drop. It could be enough to cause a bounce though. You will find that the lower their numbers, the slower the drops.

Thank you for the information, really appreciate it! Makes me feel a little better knowing that the lower their numbers, the slower the drops.

 

[Debra and Yoyo]

Thanks for doing that for me.
Is it strange that today at +7 and +8 Yoyo dropped a lot?
I guess that is what is scary to me, that what if his number was low normal at +6 and then he went down that large amount and I wasn't home because I wasn't expecting a big drop. It's like you never know what can happen!

You are doing fine. Normally, people just volunteer if they are available. I don't expect you to have a problem since his number is so high, but I do understand the need to have someone there. I felt the same way when I started.

Have you started looking for trends in Yoyo's sheet?
This is what I see:
11/14/2018 AMPS- +2BG = 112 nadir: 110 Dropped into blues by +3 or +4
11/15/2018 AMPS- +2BG = 101 nadir: 127 Dropped into blues by +3 or +4
11/16/2018 AMPS- +2BG = 54 nadir: 156 Dropped into blues by +3 or +4
11/17/2018 AMPS- +2BG = 43 nadir: 217
11/18/2018 AMPS- +2BG = -10 nadir: 195


11/15/2018 PMPS- +2BG = -11 nadir: 189 Dropped into blues by +3 or +4
11/16/2018 PMPS- +2BG =135 nadir: 184 Dropped into blues by +3 or +4
11/17/2018 PMPS- +2BG = 11 nadir: 283

It's not perfecr, but for most of the cycles, Yoyo dropped into blues whenever there was a big difference between the preshot number and +2, just like Wendy said.

Is it strange that his +2 376 is higher than PMPS 346?

 

[Wendy&Neko]

Is it strange that his +2 376 is higher than PMPS 346?

Not at all. That's also only 30 points apart, less than 10%.

 

[Rosie & Bailey]

Thanks @Wendy&Neko
I am trying to help Debra as much as I can, but I am not adept at finding trends in Spreadsheets.

What I showed Debra is the extent of my "expertise"
Oh, and that we want our kitties to drop slowly because fast drops can contribute to bouncing.
So, as much as we would like to see Yoyo in lower numbers, it's best if he gets there gradually. He may still bounce in the beginning, but maybe not as erratically.

Please correct me if I'm wrong.

 

[Wendy&Neko]

@Rosie & Bailey Always good to have a second set of eyes on a spreadsheet.

 

[Rosie & Bailey]

@Wendy&Neko Should Debra continue to hold the dose the full 7 days? Looks like .5 may be too low for Yoyo?

 

[Paigeworthy]

Can you please tell me how I can find spreadsheets on other newly diagnosed cats.

Hi Debra! You are welcome to look at my spreadsheet; River was diagnosed 3 weeks ago and has been bouncing around all over the place. She is on 2 units Lantus 2x/day now after starting at just 1. The sheet is linked in my signature.

 

[Chris & China (GA)]

If she's doing SLGS, she'd need to hold the dose but I truly don't know why she doesn't do TR.

She's testing more than enough for TR and it would give her a better chance at remission with Yoyo.

@Debra and Yoyo ….I'd just like to add my voice to the chorus of "you really don't need to test as much".

If you can get a +2, that's usually going to give you a pretty good idea of what the cycle is going to be like later on and if you need to plan on getting more tests or if you can take a "pokey break"

It's almost like having a crystal ball when it comes to predicting what the rest of the cycle is like!

 

[Wendy&Neko]

Should Debra continue to hold the dose the full 7 days? Looks like .5 may be too low for Yoyo?

The depot takes 5-7 days to build at the beginning. Even with TR you hold 5-7 days to start, unless the numbers are a lot higher, and with SLGS you definitely hold 7 days. Today is just day 5. I would hold the dose a couple days yet.

 

[Debra and Yoyo]

The depot takes 5-7 days to build at the beginning. Even with TR you hold 5-7 days to start, unless the numbers are a lot higher, and with SLGS you definitely hold 7 days. Today is just day 5. I would hold the dose a couple days yet.

The first two days I started with 1 unit. The third day I started with .5 units. Isn't today Day 3? Please explain. Thank you!

 

[Paigeworthy]

The first two days I started with 1 unit. The third day I started with .5 units. Isn't today Day 3? Please explain. Thank you!

Hey Debra — I think @Wendy&Neko is saying that you should keep the same dose for seven days before beginning to make changes, regardless of whether you are trying Tight Regulation or Start Low Go Slow. This is day five of Yoyo being on insulin.

 

[Chris & China (GA)]

Isn't today Day 3? Please explain.

No...today's day 5 since you started on Lantus....it takes 5-7 days for the "depot" so you'll know how well the dose is really doing.

Very simply put, when you start Lantus, a little goes into the bloodstream and the rest of each shot goes "into the depot" and then is slowly released back into the bloodstream throughout the cycle. It's kind of like a timed-release.

It takes 5-7 days before the depot is "full" and you know for sure that it's releasing an amount that's in relation to the dose you're giving.

Once you know the depot is full, how often you increase the dose is based on which dosing method you want to use. SLGS or TR.

On SLGS, you hold the dose for 7 days, which can be hard on the caregiver if it's not getting kitty where you want them.

On TR, you can increase as often as every 3 days, so if the dose isn't getting them where you want them, you can increase more often until it's getting them down into lower blue and green numbers....then you'd slow down a little in how often you increase (depending on experience and data on your spreadsheet)

 

[Rosie & Bailey]

OK, so even though numbers are creeping up she keeps the dose because she is just starting the Lantus.
She started on 1 unit, then switched to .5 units. This morning's dose would be cycle 8 on .5 unit. So does that mean she has 6 more cycles on this dose, and then she can reassess?
Is this because even though numbers are creeping up, this might still be the right dose for her and the depot just isn't filled up yet?
If she changes now, she could be prematurely jumping to a dose that is too much for her kitty, but wouldn't know it right away?

I've never been able to read the SS so now that I am trying help Yoyo, I don't want to mess her up. Needed to bring in the big guns.

Thanks so much for all your help to all of us here!

 

[Debra and Yoyo]

OK, so even though numbers are creeping up she keeps the dose because she is just starting the Lantus.
She started on 1 unit, then switched to .5 units. This morning's dose would be cycle 8 on .5 unit. So does that mean she has 6 more cycles on this dose, and then she can reassess?
Is this because even though numbers are creeping up, this might still be the right dose for her and the depot just isn't filled up yet?
If she changes now, she could be prematurely jumping to a dose that is too much for her kitty, but wouldn't know it right away?

I've never been able to read the SS so now that I am trying help Yoyo, I don't want to mess her up. Needed to bring in the big guns.

Thanks so much for all your help to all of us here!

Good morning,
I know that they are saying the dose has to be consistant. The consisant dose of .5 unit started on 11/16/18. This morning will be the 7th cycle of .5 units and the beginning of day 4 on .5 units.
Slight delay on my end as Yoyo ate fast and his entire breakfast came back up. Do I retest again before refeeding?

 

[Rosie & Bailey]

Do I retest again before refeeding?

I don't think so. Purpose of the number is just to see if it is safe to shoot, and he's high enough that it is not an issue. Hope he keeps it down this time.

This morning will be the 7th cycle of .5 units and the beginning of day 4 on .5 units.

SO it looks like you have 7 more cycles on this dose before changing. Hopefully, his numbers start creeping down now that he is on the second half of the cycle and the depot is starting to fill.

 

[Debra and Yoyo]

I don't think so. Purpose of the number is just to see if it is safe to shoot, and he's high enough that it is not an issue. Hope he keeps it down this time.


SO it looks like you have 7 more cycles on this dose before changing. Hopefully, his numbers start creeping down now that he is on the second half of the cycle and the depot is starting to fill.

Refed about 1/4 can ff, didn't want to over feed him. Is a 1/4 of a can enough food? Usually feed around 1/2 can. Gave insulin 8:20am

 

[Debra and Yoyo]

Refed about 1/4 can ff, didn't want to over feed him. Is a 1/4 of a can enough food? Usually feed around 1/2 can. Gave insulin 8:20am

This morning as you may see in Yo's Spreadsheet I have two readings.....first reading at AMPS was 237 but small sample of blood and low reading so I redid it and 2nd reading within seconds was 271 AMPS. Is this normal? I usually do the test on very little blood but this time I just redid it because the number of 237 was low to me. Any thoughts on this?

 

[Rosie & Bailey]

Is a 1/4 of a can enough food?

1/4 can was probably enough at the time, but hopefully you gave him the other half so that he gets all of his food. You said he is underweight right now, right?

Yeah, there is a 20% variation in numbers so its possible one is 20% too high, the other 20% too low. That's why the focus is more on trends rather than individual numbers. Glad he's coming down today.

 

[Debra and Yoyo]

1/4 can was probably enough at the time, but hopefully you gave him the other half so that he gets all of his food. You said he is underweight right now, right?

Yeah, there is a 20% variation in numbers so its possible one is 20% too high, the other 20% too low. That's why the focus is more on trends rather than individual numbers. Glad he's coming down today.

I offered him the rest of his food and he didn't want it. Will try again. He was very thirsty this morning. Neve saw that before. That is why he vomited from drinking too much water. Will try my best to check for ketones, have to catch him in the litter box to get catch. His #'s seem to be staying high today!