? 4/6 Hugo AMPS 98!? +1 = 133 +3 = 164 +6 = 244 Broke the bounce, now what!?

We gave hime the 2 units and we're going to monitor him. I'm boiling him some chicken now to get him to eat more.
 
Since you've already shot, all you can do at this point is monitor. I'd get a +1, def. a +2. Do you have plenty of supplies eg: test strips, medium/high carb food and karo/honey/maple syrup?
 
If it was me, I'd get that +1 to see what direction Hugo is going. It's best to know early if you need to intervene or steer the cycle with higher carb food or karo/etc. I mention karo just in case Hugo decides he's not hungry and won't eat when you need him to. I've had to employ this technique with my kitty Moey. He recently has begun to refuse Medium/High carb food.
If you don't mind removing the 911 prefix and replacing with a ?. 911 is reserved for emergencies such as hypoglycemic events.
 
Hey there! Sorry I wasn't around earlier (work).

Looks like you are well prepared for the day. I know it's scary to hit these numbers at first, but let's just see where he goes from here. There's a good chance he is already on his way up from that low, and you'll be able to relax, but we'll just have to see!

How long now until the +1?
 
While we're waiting, here's the rundown for the next time this happens. What you can do is a "stall":

1) don't shoot (yet)
2) don't feed, and
3) test again in 30mins

That will give you more information before shooting as to whether he's on his way up or down (it also gives you more time to roust up some helpers on the board ;) ). We don't feed when we stall because we want that second number to be free of any food influence.

We have a saying on this board, "shoot low to stay low"; it's counterintuitive, but a lot of times when you shoot a low number they don't drop much, just stay at a safe and healthy level. It's what Lantus is really good at. Hugo is still new to this, so it will probably be a while before he gets to the point where you are doing this regularly, it's just something to think about for the future.
 
+1 was 133. I wouldn't be as nervous if he had eaten all his food, but he ate only about half and I've been trying to get him to eat more ever since. I'm supposed to be working. There's also some freak thunderstorm happening as well. It's literally a perfect storm.
 
Elle D said:
There's also some freak thunderstorm happening as well. It's literally a perfect storm.
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Ack! A dark and stormy morning, eh?

Good news on the 133-- there might be a little food bump in there, but as you say he didn't eat much, and it's great that at least he's headed in the right direction!

Keep trying to tempt him with goodies. I'd test again at +2 or +3 at latest. The insulin from this shot won't start working until around then, we're just trying to get an early heads up if he has some downward momentum going at that time, so we can intervene with carbs. But, again, that 133 is an excellent sign that it might end up being a calm day after all (well, other than the freak thunderstorm!).
 
Elle D said:
Would a little dry food be too much? Or should I keep trying to give him low carb or chicken for the moment?
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Well, for now I'd stick with the low carb and chicken, since he did at least eat half his breakfast. He might even have been less hungry because he was in lower numbers, so it might be a self-fixing problem! Given the history of ketones and HL, though, we don't want to let a poor appetite go too long, so keep the dry food at the ready. Maybe later today you'll want to resort to that, I just don't think we're quite there yet.
 
Elle D said:
He wouldn't be more hungry in low numbers? He's still drinking a lot.
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It varies by cat, and by where they are in the disease. It's true that many cats get more hungry when they get into or close to the hypoglycemic range, but Hugo didn't get that low (that we know of) this morning. On the other side, uncontrolled diabetes and high numbers can make a cat ravenous (glucose isn't able to get into the cells, so they are effectively starving), so dropping numbers can alleviate that. And then, even more simply, just the yo-yoing from the really high numbers he's been in to where he was this morning could make him feel kind of "off", even though the numbers he was in at the time were healthy and normal. The fact that he did manage to eat some of his breakfast is encouraging that it's nothing more serious than this kind of thing, and will soon pass.
 
He came in this morning yelling for food, which he hasn't been doing since the ketones started, which is why I was really surprised that he only ate half. I hope you are correct and it is because he is feeling better by being in a normal range.
 
Could you please update your subject line, to include the +1 133. Those of us scanning the board take a quick look at the subject lines to see if anyone is in trouble.

First of all - congratulations on shooting that green. :D You don't have to stall when you get a nice high green like that, unless you want to know if he's rising or falling. Might be important if you have to go out of the house. Otherwise, you just get a +1 and a +2 to start. Second, it's not important that he eat all of his food at once. You do have a couple hours until onset. We do have a number of kitties here who are grazers.
Elle D said:
because he is feeling better by being in a normal range.
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That's the most important bit of all! :joyful:
 
+6 244?????????

I am deeply confused. I gave him some chicken, and he ate a little bit of his food, but not THAT much. Why would it shoot up like that???

He was doing so well. What's going on??? He couldn't be bouncing again, right?
 
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So how much longer should I stay on the 2 units? Shouldn't it have cleared by now? Ugh, my heart hurts. He can't stay in those high numbers.
 
On TR, you are supposed to stick with a dose for at least six cycles to evaluate it (more once you start getting into green numbers for the first time; not sure whether or not this counts as he's had greens before but your dosing was inconsistent then). Anyway, this being cycle #6 on the 2.0U, I'd get feedback from the experts on whether or not to increase, but for what it's worth I'd be inclined to hold steady for a bit longer. The fact that he came down to green numbers on an AlphaTrak is a great sign that this dose is doing something for him.

It may still need to be tweaked upward (again, see what the experts think!), but not because of the bouncing he's doing now. Think of the bouncing as kind of an overlay on his "real" numbers at a particular dose. In a way, the bounce numbers are irrelevant to your decisions. The hard part there, of course, is figuring out how to "see" the numbers that the bouncing is obscuring. The green-blue territory he was in this morning might have been a peek at them...
 
Elle D said:
Shouldn't it have cleared by now?
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Here's the really bad news I should have mentioned above: bounces can take up to six cycles to clear :confused: :confused: :confused:. That, along with letting the depot settle, is the reason for the minimum wait time for evaluating a dose.
 
Nan & Amber (GA) said:
Here's the really bad news I should have mentioned above: bounces can take up to six cycles to clear :confused: :confused: :confused:. That, along with letting the depot settle, is the reason for the minimum wait time for evaluating a dose.
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So does this mean I have another 3 days of cycles? Also, who are the experts I should be consulting? The mods?
 
Hi Elle, sorry I wasn’t around earlier. I’m just waking up in Australia.
Congratulations shooting a green:D
Looks like Hugo’s body has taken fright at the 98 he got this morning.....his body isn’t used to these normal numbers any more and has sent out an sos....”help save me”and he’s dumped those regulatory hormones and stored glucose into his system to “save himself”. Once his body gets used to normal numbers again he will most likely stop bouncing. There is nothing you can do about a bounce but wait it out......this is where you put on your patience pants.;)
I would stay with the 2 units for now. We can see it is getting him down to greens.
You are making progress. I know it is hard to see those higher numbers, but it is not because he needs more insulin, it is because of the bounce.
Keep testing for ketones every cycle if you can...that’s very important.
And keep up encouraging him to eat as much as possible.
 
Elle D said:
So does this mean I have another 3 days of cycles? Also, who are the experts I should be consulting? The mods?
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Not necessarily-- he may not bounce that whole time, for one thing.

We don't have official dose experts or dose advisors on the board, but there is definitely a range of experience and comfort levels in giving advice. Hugo's case is more complex than I am comfortable with when it comes to dose changes, but, though I wouldn't want to name names and put anyone on the spot :D, you've had some of the heavy hitters of the board in your threads generously offering advice on dose, I'm sure they will keep doing so.
 
Bron and Sheba (GA) said:
Hi Elle, sorry I wasn’t around earlier. I’m just waking up in Australia.
Congratulations shooting a green:D
Looks like Hugo’s body has taken fright at the 98 he got this morning.....his body isn’t used to these normal numbers any more and has sent out an sos....”help save me”and he’s dumped those regulatory hormones and stored glucose into his system to “save himself”. Once his body gets used to normal numbers again he will most likely stop bouncing. There is nothing you can do about a bounce but wait it out......this is where you put on your patience pants.;)
I would stay with the 2 units for now. We can see it is getting him down to greens.
You are making progress. I know it is hard to see those higher numbers, but it is not because he needs more insulin, it is because of the bounce.
Keep testing for ketones every cycle if you can...that’s very important.
And keep up encouraging him to eat as much as possible.
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Ok. I wasn't able to get a urine or blood check this morning for ketones and it's really freaking me out. We just can't seem to get his ears to bleed very much right now. I suspect it's the off brand lancets we got as emergency replacements. They seem to enjoy stabbing without drawing any blood, even when we went up 2 settings on the damn things. He's acting ok. He's sleeping on the bed, which he wasn't doing when he wasn't feeling good. I don't think he's 100% yet. I'm just hoping these high numbers don't set anything back off again. I will keep a closer eye on him this evening.

Also, thank you again for your guidance. I apologize, I didn't know you were in Australia! My grandmother was actually from there, Mooroopna - near Melbourne. She told us a lot of stories about it when we were kids, and I've always wanted to go there and meet the rest of my family there.
 
Nan & Amber (GA) said:
Not necessarily-- he may not bounce that whole time, for one thing.

We don't have official dose experts or dose advisors on the board, but there is definitely a range of experience and comfort levels in giving advice. Hugo's case is more complex than I am comfortable with when it comes to dose changes, but, though I wouldn't want to name names and put anyone on the spot :D, you've had some of the heavy hitters of the board in your threads generously offering advice on dose, I'm sure they will keep doing so.
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Thank you so much for staying with me through this. You've really helped keep me calm. I was actually able to get a little work done and eat something! I appreciate all your help so much.
 
Elle D said:
Ok. I wasn't able to get a urine or blood check this morning for ketones and it's really freaking me out. We just can't seem to get his ears to bleed very much right now. I suspect it's the off brand lancets we got as emergency replacements. They seem to enjoy stabbing without drawing any blood, even when we went up 2 settings on the damn things. He's acting ok. He's sleeping on the bed, which he wasn't doing when he wasn't feeling good. I don't think he's 100% yet. I'm just hoping these high numbers don't set anything back off again. I will keep a closer eye on him this evening.

Also, thank you again for your guidance. I apologize, I didn't know you were in Australia! My grandmother was actually from there, Mooroopna - near Melbourne. She told us a lot of stories about it when we were kids, and I've always wanted to go there and meet the rest of my family there.
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How lovely to have an Australian grandmother!
Don’t apologise......if you tag me I will see it when I get up. And others will respond in the meantime.
Are you able to get some better lancets? I know it’s hard getting anything much at the moment with all the restrictions.
Are you warming the ear and milking it before trying to test?

Getting a urine ketone test is fine if that is all you can do. It’s important that we know what the ketones are doing every day at this point.
The high numbers are from the bounce, not from not enough insulin....there’s a big difference.
You have made big progress. Huge is eating better, his numbers are responding to the consistent dose of insulin and ketones have decreased.
 
Bron and Sheba (GA) said:
How lovely to have an Australian grandmother!
Don’t apologise......if you tag me I will see it when I get up. And others will respond in the meantime.
Are you able to get some better lancets? I know it’s hard getting anything much at the moment with all the restrictions.
Are you warming the ear and milking it before trying to test?

Getting a urine ketone test is fine if that is all you can do. It’s important that we know what the ketones are doing every day at this point.
The high numbers are from the bounce, not from not enough insulin....there’s a big difference.
You have made big progress. Huge is eating better, his numbers are responding to the consistent dose of insulin and ketones have decreased.
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I'm trying. I just reordered some from Amazon that I ordered more than 2 weeks ago that never arrived. I have a few for a different lancet that we tried that seem a bit better, so we might use that one until we run out.
 
Another quick question. Since he's bouncing, is it worth it to get a +9 or should I just wait for the PMPS to get a read?
 
I'm a big believer in saving your test strips for when you need them. I always asked myself the question, what would I do differently with that information? Sometimes data is good to fill in a picture, sometimes it just tells you what you know already. Hugo is bouncing, yet again. :rolleyes:

As for how long you stay on this dose, typically we'd say 5 days for doses that show some green, but that will change if ketones show up.
 
Wendy&Neko said:
I'm a big believer in saving your test strips for when you need them. I always asked myself the question, what would I do differently with that information? Sometimes data is good to fill in a picture, sometimes it just tells you what you know already. Hugo is bouncing, yet again. :rolleyes:

As for how long you stay on this dose, typically we'd say 5 days for doses that show some green, but that will change if ketones show up.
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So is that 2 additional days? Or 5 more days from now?

And yeah, that's kind of how I felt too about the strips. Especially these Alphatrak ones.
 
5 days total, so two additional days.

I cross border shopped for cheaper test strips - so I worked on learning Neko's patterns so I could test strategically.
 
PMPS 416. He still isn't eating as much as he usually does. I'm sick to my stomach. I need to get a ketone test.
 
Bron and Sheba (GA) said:
Remember the high preshot is part of a bounce..
Come on Hugo....visit the LB for your mama.
Have you tried sprinkling some Parmesan cheese on top of his food?
Did you get this link?
http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/.
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The parmesan thing seems to have helped. He ate more. I also gave him some more chicken. I'm now praying that my insulin shot skills haven't failed me and given me a fur shot. I feel like I don't even know anymore. We're watching the litterbox religiously.
 
Elle D said:
The parmesan thing seems to have helped. He ate more. I also gave him some more chicken. I'm now praying that my insulin shot skills haven't failed me and given me a fur shot. I feel like I don't even know anymore. We're watching the litterbox religiously.
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You would smell a fur shot if you gave one. It has a distinctive smell, you can’t miss it.
You are doing a really great job looking after Hugo.
The high BGs are hard to see but they are not happening because he’s not getting enough insulin..they are because his body dumped the hormones and glucose into his system.
I know how hard it is to see our kitties sick but Hugo is doing much better...
He’s eating better than he was.
His BG came down to green (yay!) even though he is now up on the trampoline....
You have had a couple of negative ketone tests.
So you can see Hugo is making progress in the right direction......
We need to just make sure the ketones stay negative.......
 
I could smell insulin on my fingers after I massaged the area, though that doesn't necessarily mean with him that I gave a fur shot. I seem to frequently be able to smell it even when the shot was successful. Even so, it always makes me alarmed that I didn't do it right. Now is not a time for mistakes.
 
Elle D said:
I could smell insulin on my fingers after I massaged the area, though that doesn't necessarily mean with him that I gave a fur shot. I seem to frequently be able to smell it even when the shot was successful. Even so, it always makes me alarmed that I didn't do it right. Now is not a time for mistakes.
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Don’t massage the area after giving the insulin. Also don’t role or shake the lantus bottle before use.
If you are concerned about fur shots you can clip the hair in a couple of spots so you can see the needle go in.
 
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