Kaz AMPS 533/PMPS241

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Claire and Kaz

Claire and Kaz

Member Since 2022
Hi Bron

So Kaz was increased to 2.5 units 4 days ago but his numbers are all over the place. Black first thing and now he's in the blues. Should I stay at the current dose or do you want me to adjust it again?

Claire
 
[USER=10387]@Claire[/USER] said:
Hi Bron

So Kaz was increased to 2.5 units 4 days ago but his numbers are all over the place. Black first thing and now he's in the blues. Should I stay at the current dose or do you want me to adjust it again?

Claire
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I would say he is probably dropping lower overnight and that is why you are seeing the black AMPS. Are you able to get any later tests in during the night cycle if the BG is still dropping?
I would stay with the same dose at the moment, seeing you are starting to get blue BGs.
How are the ketones?
 
Bron and Sheba (GA) said:
I would say he is probably dropping lower overnight and that is why you are seeing the black AMPS. Are you able to get any later tests in during the night cycle if the BG is still dropping?
I would stay with the same dose at the moment, seeing you are starting to get blue BGs.
How are the ketones?
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I try to check Ketones every 2 to three days usually in the evening as they seem to be more accurate when taken then. Today is day 2 he was 0.1 2 days ago.
Its not easy to get up in the middle of the night to check blood as by time set everything up get him ready I'm now wide awake and then I live on 2-3 hours sleep. I was doing this in the beginning and I nearly fell off a 5 story building when I was on site. I need to be fully aware of what I am doing on site or I could kill myself so I really need to get sleep. Since Kaz got sick I am mostly sleep deprived but this would make it worse. If I have to do it now and then I can.
The Libre button is a good option when I need to do this over a few days as I only have to waive it.
I'm going to vet soon (waiting on exact time) as they need to check the Potassium to see if he can come off those tablets so I can get a button put on then if you want me to.
 
I fully understand how hard it is to look after a diabetic kitty on your own and I know how sleep deprived you can get.
I don’t want to put you to the extra expense with a libre. Just make sure he is well fed before you go to sleep.
You are doing a great job with him
 
I may ask for a Libre we'll see I bought two buttons a couple weeks ago. They come in a box of two and I needed one for my trip. I'm worried as his numbers are all over the place and even if it only lasts a couple days I can get a more accurate picture of what's going on. Plus Kaz could do with a break on his poor little ear. He only lets me use one ear and the blood won't come from all spots even with heat when it used to.
I had read that you were not supposed to feed diabetic cats over night? I try to feed him his two big meals before each shot and then 3-4 meals small meals depending on when I get home.

When we do get MeowSpace running (fingers crossed) I can leave him a meal out over night. I can also get a meal ready and cover it and when I go to the loo during the night I can give it to him. My only apprehension with this is that in the morning its the hardest tome to get him to eat. He gets really picky about what he will eat first thing so I worry that if he eats at 3am then he won't eat at 5.30-5.45am when I need him to?
 
Bron and Sheba (GA) said:
He’s looking pretty good with the 2.5 units. I would keep giving that for the next 24 hours and see where he is up to after that.
If he is under 200 at preshot I would stall, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for help. You would need to change the subject line to let someone know you need help…..say..preshot xxx stalling need HELP.
Do you have time to stall in the mornings?
Once you move over to the Lantus forum….which I think you should do soon, you can shoot with a preshot of 150 after gradually moving down a bit each time. The Lantus forum has a lot of experienced users who can help you when I am not around.
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Hi Bron
Just went to the Lantus forum and was reading this is a pretty scary area seems if you don't write everything exactly the right way not going to go well. I am becoming very uneasy as I see Kaz's numbers dropping I fed him high carb food to get the number above 200 which I will be checking in about 20-30 minutes. Seems like on the Lantus site its not an emergency unless your into the lime colored green so now not sure I'll get a response quickly if his numbers are lower than 200.

I am assuming that if I can't get his numbers above 200 I skip a dose. I will try asking on the Lantus area but I am expecting this to happen over the next 24-48 hours as he appears to be trending in this direction.

Wondering if I am supposed to decrease his dose?

Fingers crossed he's above 200 although ultimately he needs to be in green.
 
[USER=10387]@Claire[/USER] said:
Just went to the Lantus forum and was reading this is a pretty scary area seems if you don't write everything exactly the right way not going to go well. I
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Not sure what you mean?

[USER=10387]@Claire[/USER] said:
Seems like on the Lantus site its not an emergency unless your into the lime colored green so now not sure I'll get a response quickly if his numbers are lower than 200.
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You can always get help on the Lantus forum if you change you subject line to reflect your problem. If you put HELP in the subject line you should get a response.


[USER=10387]@Claire[/USER] said:
I am assuming that if I can't get his numbers above 200 I skip a dose. I will try asking on the Lantus area but I am expecting this to happen over the next 24-48 hours as he appears to be trending in this direction.
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If you can’t stall and you need to leave, you can give a token dose such as 1unit and leave some higher carb food out for him.
When does the new feeder arrive.? That should help things.


[USER=10387]@Claire[/USER] said:
Wondering if I am supposed to decrease his dose?
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I would not decrease the dose unless you are giving a one off token dose because of a lower preshot and you can’t stall or monitor the cycle.
 
The new door arrives on Monday per the tracking number but I'm hoping that it will come earlier.

I have stopped all the Tiki right now and am only feeding him foods with carbs (between 3%-9%) to keep the numbers up so I can continue to dose him at the 2.5 level.
If I give him Tiki his numbers will drop again so to keep him safe this was all I could think to do.
Until you tell me otherwise I will keep him at 2.5.

After tomorrow I am home again for three days so I can monitor him a bit closer.

Leaving food out is a problem as Sam will eat it immediately. My other cat has a condition where he forgets he's eaten so he will just eat and eat and eat.

However I have found a way to bypass the security on the MeowSpace so that its open both ways no magnet required to get in. This means that both cats can access it however Kaz is the only one who really understands it. So i was going to leave food in there but I think he may eat it immediately.
Currently trying to teach him what a automatic feeder is. I may leave a meal in the automatic feeder as well and hope he notices it.
 
Bron and Sheba (GA) said:
I would hold the dose of 2.5U for 10 cycles after you first saw the blue BGs as long as there are no ketones.
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Ok thanks

So if above 200 give dose as usual but if below 200 reduce to 1 unit for 1 cycle and then as long as his numbers have increased again go back to the 2.5 and remain there for 10 days in total (5 days in at 2.5 units).

Again thanks for your help. Going to try get some sleep. Have the alarm set for 1 pm to give him a small meal then.
 
[USER=10387]@Claire[/USER] said:
Ok thanks

So if above 200 give dose as usual but if below 200 reduce to 1 unit for 1 cycle and then as long as his numbers have increased again go back to the 2.5 and remain there for 10 days in total (5 days in at 2.5 units).

Again thanks for your help. Going to try get some sleep. Have the alarm set for 1 pm to give him a small meal then.
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Hold the dose at the moment because you are just seeing blue BGs.
If you get a BG preshot under 200 and you have to go to work and can’t stall, then give the token dose and feed some higher carb food before you leave .
If you are staying at home and the preshot is under 200 …you can stall, dont feed and see if the BG is rising…the you can give the normal dose and monitor the cycle as normal.
 
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Bron and Sheba (GA) said:
10 cycles not 10 days.
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If that's the case then I am already on cycle 11.
I tried leaving food out in a timer in the MeowSpace but I will never know which cat eats it (if it gets eaten) as its accessible to both of them right now? One small can of 3% carb food broken into two meals.
Kaz is now overweight which is going to come with its own health issues.
At least tomorrow I can try and test a bit more. I could not get any blood out of one ear it was weird. I had to force him to let me use the other ear but he protested this quite a bit.
 
Suzanne & Darcy said:
I am excited to see some blue on his spreadsheet. This is good!
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I am too but I am the one probably keeping him in the higher bracket now as I have been feeding higher carb food. Scared to let it drop as then I can't dose properly and then have to go to work and leave him and I am scared something bad will happen.

I am not a fan of zoom calls but I wish that this site held once a week/biweekly/monthly meeting on line where you could call in and ask questions from the experts (that's all of you).
I feel like I am picking it up but still don't understand fully where I go from here and I feel I ask too many questions.
Guess I would just like a definitive plan mapped out ahead of me so I can see where I am going instead of day by day.
 
Bron and Sheba (GA) said:
I think you can go up to 2.75 units Claire. Will be interested to see the blood results. Get a copy of them if you can.
What is the date of your vacation?.
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I fly on the 16th of June and return on the 5th July.

Besides adjusting the shot for my trip I also need to adjust the time of the shots to coincide with when this lady will be visiting. Right now I give him his shot at 6.15am and 6.15pm but I need to adjust this to either 8am/8pm or 8.30am/8.30pm.
(forget which time she said but think it's the later). This means adjusting everything by 2 hours. I think I read I can adjust by 30 mins each day but obviously wanted to check that this is the case as I need to figure out when I need to start making this adjustment.

I will adjust Kaz's evening dose to 2.75.

I'll also send email now asking for the blood results which I was supposed to get yesterday as they keep telling me the Potassium is important.

Thanks

Clair
 
Good luck with the increase, Claire. His spreadsheet definitely looks like he needs that increase. I am happy that you saw some yellow on 5/8 though.
 
Bron and Sheba (GA) said:
I think you can go up to 2.75 units Claire. Will be interested to see the blood results. Get a copy of them if you can.
What is the date of your vacation?.
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Hi Bron

Dr Brum sent me an email which I find a bit bizarre.


No need for potassium tabs. The blood glucose was great at 180-

So if I gave him a pre ear prick at 6am and the reading was 425 for BG. Then as soon as I got back from the hospital it was 218 (around 10am) does it make sense that his BG dropped that low after 3 hours and he had food.
Seems a bit odd. I would have expected pink numbers not blue. What does this now mean for Kaz's cycle. I personally did not see blue but if the test results say he was in the blue then do I hold for another 8-10 cycles or do I still adjust to the 2.75.

Full results are below which I don't fully understand will start looking things up but everything appears in the acceptable range except BG and BUN?


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Is that all the bloodwork that they did on that day? The BUN is marginally elevated but many factors can influence BUN. Could he have been a little dehydrated on that day? Without a urinalysis to go along with this chem screen, it’s hard to interpret the BUN. A urine specific gravity reading would be helpful.
 
There’s not a whole lot of difference between 187 and 218. If you got those readings yourself on your own meter, I would say that they were within the +/- twenty percent meter variance.
 
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It’s probable that he is bouncing again from the 187/218 on that day

It’s excellent that his potassium is back up, by the way! I hope it will stay that way. Will you take him back for a recheck before your trip to make sure it’s still okay? I am sure if you notice anything unusual like lethargy, you will take him back anyway.
 
[USER=10387]@Claire[/USER] said:
Then as soon as I got back from the hospital it was 218 (around 10am) does it make sense that his BG dropped that low after 3 hours and he had food.
Seems a bit odd. I would have expected pink numbers not blue. What does this now mean for Kaz's cycle. I personally did not see blue but if the test results say he was in the blue then do I hold for another 8-10 cycles or do I still adjust to the 2.75.
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You would expect the BG to drop as he had had an insulin dose 4 hours earlier and as Suzanne said with the meter variance there is not a lot of difference.
Yes I would still do the increase tomorrow.
 
The libre you are going to put on when you go away, is going to give human meter BG numbers, so it might be an idea for you to buy a ReliOn premier meter now, which is only $9 at Walmart and 100 test strips are $17.88, so that when you put on the libre when you go away, the BG numbers will be similar. At the moment because you are using an alphatrak meter, they are higher. What do you think?
 
Bron and Sheba (GA) said:
The libre you are going to put on when you go away, is going to give human meter BG numbers, so it might be an idea for you to buy a ReliOn premier meter now, which is only $9 at Walmart and 100 test strips are $17.88, so that when you put on the libre when you go away, the BG numbers will be similar. At the moment because you are using an alphatrak meter, they are higher. What do you think?
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I already own this blood meter (think its this one I got it at CVS or its really similar it was cheap) I bought it when the first Alpha Track broke as I needed a device to use in between.
I was using the other as it was specifically for animals and the people one seems to give lower readings and the fact that the Alpha has him in black so much and the other device simply said HI so I had no idea what the actual reading was and it worried me.?

I can switch to the human one while I travel which I will do towards the end of the week I don't think I have many test strips left so need to go buy some more.
 
Suzanne & Darcy said:
Is that all the bloodwork that they did on that day? The BUN is marginally elevated but many factors can influence BUN. Could he have been a little dehydrated on that day? Without a urinalysis to go along with this chem screen, it’s hard to interpret the BUN. A urine specific gravity reading would be helpful.
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I would think that the BUN number is elevated in part due to the Prazosin he takes I think it can elevate kidney. Not really good drug to keep a cat on but sadly he blocks as soon as you take him off. I was going to do an experiment of weening him off due to the diabetes as diabetic cats drink a lot more and this actually might help with his condition. With all this cat has had to suffer over the past couple months I was waiting and now don't want to do it till after I get back from the UK.
 
[USER=10387]@Claire[/USER] said:
I would think that the BUN number is elevated in part due to the Prazosin he takes I think it can elevate kidney. Not really good drug to keep a cat on but sadly he blocks as soon as you take him off. I was going to do an experiment of weening him off due to the diabetes as diabetic cats drink a lot more and this actually might help with his condition. With all this cat has had to suffer over the past couple months I was waiting and now don't want to do it till after I get back from the UK.
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Sorry the only reason they did bloodwork was to see if he could come off the Potassium but based on the results from the prior two dates it would appear that this is all they test for. Is there something specific your looking for? I can always add it to my list and then next time they draw blood ask them to test for it?
 
[USER=10387]@Claire[/USER] said:
Sorry the only reason they did bloodwork was to see if he could come off the Potassium but based on the results from the prior two dates it would appear that this is all they test for. Is there something specific your looking for? I can always add it to my list and then next time they draw blood ask them to test for it?
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I was just thinking that they should have gone ahead and done a CBC along with the chem panel and a urinalysis. But that's for a full checkup. They were only checking for potassium -- so it makes sense they just looked at electrolytes.

I know that Prazosin can lower BP, so it can then, in theory, reduce GFR in the kidneys, which could elevate BUN. Does he have a history of having an elevated BUN? I am wondering if he only started having an elevated BUN after he started the Prazosin.
 
Suzanne & Darcy said:
I would have thought that when he was diagnosed on March 5 they would have done both panels of blood work and a urinalysis.
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To be very honest I am not sure as they never did bloodwork till he got the masses on his liver and kidneys a couple years ago(once every 5 years the doctor would say why don't we check but more rabbis and distemper and a yearly check). Till then he went to a small vet but after Kaz got sick I moved him to Angel under Dr. Brums care as I trusted him plus I wanted Kaz somewhere he could be helped quickly if something was wrong. Dr Brums attitude is to let a cat be a cat and once a year he will do blood work on Kaz but don't think they are full screens. Technically he is due for his annual in August but as he's in and out not sure if this will be kept?
Kaz also goes to cardiology once a year to have his heart looked at. This is more of a precautionary thing than anything else and is linked to the masses.
 
Suzanne & Darcy said:
I would have thought that when he was diagnosed on March 5 they would have done both panels of blood work and a urinalysis.
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I think they may have done the tests your talking about when he was hospitalized with DKA as i got an itemized invoice and remember these being on there. They never shared these results with me.
 
Bron and Sheba (GA) said:
The libre you are going to put on when you go away, is going to give human meter BG numbers, so it might be an idea for you to buy a ReliOn premier meter now, which is only $9 at Walmart and 100 test strips are $17.88, so that when you put on the libre when you go away, the BG numbers will be similar. At the moment because you are using an alphatrak meter, they are higher. What do you think?
Click to expand...

Hi Bron

I am going to try to start using the people monitor this weekend (going to have to try and run both so I can understand it)
I have not asked about upping the dose again as Kaz's numbers are all over the place and as he's getting blues and now today greens (may be getting these while I'm at work) I assumed you wanted me to hold at the dose I was at.

When should I ask you about the plan to put in place while I am gone? I need to try and make sure I have enough time to educate Laurie. I'm hoping she will want to come around a couple times and watch me give the insulin and then try herself in front of me.

MeowSpace is now fully functioning and Kaz gets an additional 2 meals during the day when I'm at work. Also means I can now leave the house a bit more.

Thanks Claire
 
[USER=10387]@Claire[/USER] said:
Hi Bron

I am going to try to start using the people monitor this weekend (going to have to try and run both so I can understand it)
I have not asked about upping the dose again as Kaz's numbers are all over the place and as he's getting blues and now today greens (may be getting these while I'm at work) I assumed you wanted me to hold at the dose I was at.

When should I ask you about the plan to put in place while I am gone? I need to try and make sure I have enough time to educate Laurie. I'm hoping she will want to come around a couple times and watch me give the insulin and then try herself in front of me.

MeowSpace is now fully functioning and Kaz gets an additional 2 meals during the day when I'm at work. Also means I can now leave the house a bit more.

Thanks Claire
Click to expand...



Sorry one other thing he's currently at 98. I gave him some higher carb food to bring the numbers up slightly. As long as he's 150 or above I give him the full dose. If below 150 give him only 1 unit. What is the number when I should be holding the insulin please.
 
Still unable to tag anyone tried putting the @then persons name but nothing happens. Guessing not doing it in the right place. Tried looking on this website for instructions but can not find. Sorry such IT idiot but I wanted to make sure I could get hold of the other members you had mentioned in case of emergency.
 
it sounds like you are on the right track, using the @ sign then as you type the persons name like bron, a little box appears with multiple choices and you click on the one you want

it looks like this:

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Sorry nobody was around but he answered the question for you!

See what Bron thinks about a no shoot number. Technically with TR it is 68 on alphatrak, but you work your way down to that slowly. Since he is post DKA and fairly unregulated we really don't want to skip if we can avoid it.

@Bron and Sheba (GA)
 
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[USER=10387]@Claire[/USER] said:
am going to try to start using the people monitor this weekend (going to have to try and run both so I can understand it)
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Do you mean you are going to start using a human glucose meter? If so you will need to note it in the SS so we know which one you are using. If you are going to swap over to the human meter fully, I will ask @Bandit's Mom to change the SS for you. You will find it confusing if you are going to test with both meters. The Human meter runs a bit lower than the pet meter.


[USER=10387]@Claire[/USER] said:
have not asked about upping the dose again as Kaz's numbers are all over the place and as he's getting blues and now today greens (may be getting these while I'm at work) I assumed you wanted me to hold at the dose I was at.
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Now that you are seeing green BG you need to stay with the same dose (2.75 units) for now.

[USER=10387]@Claire[/USER] said:
When should I ask you about the plan to put in place while I am gone? I need to try and make sure I have enough time to educate Laurie. I'm hoping she will want to come around a couple times and watch me give the insulin and then try herself in front of me.
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We won’t be able to tell you the dose until just before you leave as we will need to be able to see how low the dose it taking Taz each cycle.
You can start to tell Laurie when and what to feed Kaz. I would write it down in dot form so it is easy for her to see. and I take it she will fill the auto feeder up each cycle? I would write on the top of all the cans the carb % and tell Laurie what to do if the BG is lower etc and when to feed what %.
Make sure you have the hypo kit set up for her with instructions on what to do if she finds Kaz is having a hypo or is in very low numbers.
And are you still going to have a libre freestyle fitted before you go?
We will tell you the no shoot number and the dose probably the day before. I know it isn’t long before but that is the best way of doing it.
How does that sound?

[USER=10387]@Claire[/USER] said:
MeowSpace is now fully functioning and Kaz gets an additional 2 meals during the day when I'm at work. Also means I can now leave the house a bit more.
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That is really good news

FrostD said:
See what Bron thinks about a no shoot number. Technically with TR it is 68 on alphatrak, but you work your way down to that slowly. Since he is post DKA and fairly unregulated we really don't want to skip if we can avoid it.
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If you are using the alphatrak meter 68 is the BG where you have to take action to bring the BG up higher with high carb food or honey/Karo. If it is the human meter the BG take action number is 50.
As Kaz has not had any preshot numbers under 225, I would start off with 200 then lower it down to 150 over a period of time (and assuming you will be around to monitor the cycle. If you get a number under the preshot you have set, you can either stall and test again in 20 minutes if that is possible and see if the BG is rising or you can give a lower dose. If this happens post and hopefully someone will answer.
We need you to practise tagging someone. So hit the @ then start typing in the username of the person you want to tag. A box like Kyle posted will look up. You need to click on the person you want to tag. Try it now and see if it works.
 
FrostD said:
Sorry nobody was around but he answered the question for you!

See what Bron thinks about a no shoot number. Technically with TR it is 68 on alphatrak, but you work your way down to that slowly. Since he is post DKA and fairly unregulated we really don't want to skip if we can avoid it.

@Bron and Sheba (GA)
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Sorry probably another stupid question but on the SS and I was going to ask this as soon as I switched to the human meter are those numbers at the top designed for a human vs a cat?
I thought these were cat readings and was going to ask for the equivalent of a human but if these are indeed human readings then Kaz's numbers have actually been a lot worse than I realized.

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Bron and Sheba (GA) said:
Do you mean you are going to start using a human glucose meter? If so you will need to note it in the SS so we know which one you are using. If you are going to swap over to the human meter fully, I will ask @Bandit's Mom to change the SS for you. You will find it confusing if you are going to test with both meters. The Human meter runs a bit lower than the pet meter.



Now that you are seeing green BG you need to stay with the same dose (2.75 units) for now.


We won’t be able to tell you the dose until just before you leave as we will need to be able to see how low the dose it taking Taz each cycle.
You can start to tell Laurie when and what to feed Kaz. I would write it down in dot form so it is easy for her to see. and I take it she will fill the auto feeder up each cycle? I would write on the top of all the cans the carb % and tell Laurie what to do if the BG is lower etc and when to feed what %.
Make sure you have the hypo kit set up for her with instructions on what to do if she finds Kaz is having a hypo or is in very low numbers.
And are you still going to have a libre freestyle fitted before you go?
We will tell you the no shoot number and the dose probably the day before. I know it isn’t long before but that is the best way of doing it.
How does that sound?


That is really good news


If you are using the alphatrak meter 68 is the BG where you have to take action to bring the BG up higher with high carb food or honey/Karo. If it is the human meter the BG take action number is 50.
As Kaz has not had any preshot numbers under 225, I would start off with 200 then lower it down to 150 over a period of time (and assuming you will be around to monitor the cycle. If you get a number under the preshot you have set, you can either stall and test again in 20 minutes if that is possible and see if the BG is rising or you can give a lower dose. If this happens post and hopefully someone will answer.
We need you to practise tagging someone. So hit the @ then start typing in the username of the person you want to tag. A box like Kyle posted will look up. You need to click on the person you want to tag. Try it now and see if it works.
Click to expand...


@Bandit's Mom (testing this works)

Hi Bron - yes I switched to the human meter this morning per your recommendation. I inserted a line on the SS showing this and then also recorded the Alpha number in the comment section.

I tried tagging Bandit's Mom more to see if I could get it to work than anything else. Also interested in those coloured bands above. I always thought they related to cats but is there a different color band for cats as these two meter read differently. A 68 on a human meter would appear to be really low on a human meter based on the readings I am getting now?

EG Pre Shot AT2=548 Human Meter=441 (100 points in difference) Just worried as if I get a 200 on the human then that would technically be a 100 and blue and then I am not supposed to be giving insulin as below the threshold number of 150? Just want to make sure I don't hurt Kaz accidently.

Yes the MeowSpace is the best thing I have ever bought for Kaz and is a life saver. He will not leave the front door as soon as the cat feeder goes in as he thinks his brother can get in even though I keep telling him otherwise but he's a pro at getting in and out and I even left him a small meal last night as his numbers were low.

Think this is last answer. I cut out small squares about 3 weeks ago and stuck carb % on all food and one can (marked one) is never used its left out so I can quickly see what % I am giving each time. Quite frankly it makes it easier for me although at this point I know what most of the usual food is. Plus I printed the food chart and have that on the kitchen counter too with all foods in stock highlighted for easy view.

Thanks for your reply
 
As Kaz has not had any preshot numbers under 225, I would start off with 200 then lower it down to 150 over a period of time

Sorry I don't understand this please. I know I am keeping the insulin at 2.75 per your answer above but not sure what this means. Written down in my book about the 68 vs 50 numbers for taking action.
Thanks Claire
 
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