continued - Thomas's numbers

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Jenn ~ Thomas

Jenn ~ Thomas

Member Since 2023
@Suzanne & Darcy

I have started a new thread since the other is over 50. I think my question was skipped over in the thread.

Thomas was at 95 for his PMPS. What should I do with the insulin. Last time I assumed wrong and you wanted him to have some insulin. He was due at 630 (30 minutes ago)
 
I don't know what to do..... it was under 200 but I thought last time I skipped I should have given a little dose. I am closing in on 1.5 hours late.
 
Look at two nights ago when he was 216…. And you shot .5. And he went pink. I think he could have used a little more insulin. So I think .75 or 1 unit will be safe, based on the data we have gathered.
 
I forgot to mention that there’s very little difference between tonight’s Pmps and the 216 of two nights ago. Meter variance.
 
When he’s had a total skip on the p.m. cycle, his Amps have been higher (red). With the .5 dose we experimented with two nights ago his AMPS was at least only pink. It seemed to help keep him from climbing so high.
 
ok so I gave him .75 I will do a post test in a hour. Tomorrow I should do 7am since I was late tonight? I think my vet said it was ok as long as he got it between 2 hour range, but at this point I don't know how much trust I have in my previous vet.
 
so is the point to give less in the am and more in the pm to kinda even out? and his numbers should be under 200 when he is on a good dose??

How is the kitty doing now? I hope she is better.
 
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Jenn ~ Thomas said:
ok so I gave him .75 I will do a post test in a hour. Tomorrow I should do 7am since I was late tonight? I think my vet said it was ok as long as he got it between 2 hour range, but at this point I don't know how much trust I have in my previous vet.
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I would try to space the doses as close to 12 hours apart as possible. But if you want to work your way back to your normal shot time then shoot 11.5 hours in the morning instead of 12. Then you can do another 30 minutes the next day. I’m not sure exactly how off schedule you will be in the morning.
 
After tomorrow it will have been 7 days on this 1 unit dose, albeit with some skipped shots and some reduced doses, you may want to consider increasing to 1.25 units. Although, if you are planning on switching to glargine insulin, then you may wish to maintain the current dose.

You should read the sticky notes over on the Lantus Levemir forum. It is different. With depot insulins, you “shoot low to stay low.”
 
Jenn ~ Thomas said:
His number was 337 this morning. I gave 1 unit. I will test him again in 3 hours.
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I saw your message about how he seems to be the same in the morning all the time. I hear your frustration and confusion. With the three p.m. skips, he had red AMPS. With the reduced doses in the p.m., he had pink AMPS. one skip in the p.m. he also had a higher pink AMPS .. nearly red. It’s a subtle difference. It is very hard to interpret anything with no mid-cycle tests yesterday. We can’t tell if — before the evening’s blue PMPS he had been lower and then had gone up into blue and then yellow? We can’t tell if he was starting a bounce from a low-ish number that he’s not used to. So it was really hard to tell at PMPS time if it was okay to shoot the full 1 unit. All we had to go on was a single blue number with no context of where he had been before to help us surmise where he might be headed. Don’t know if this is making sense or not.
 
Suzanne & Darcy said:
I saw your message about how he seems to be the same in the morning all the time. I hear your frustration and confusion. With the three p.m. skips, he had red AMPS. With the reduced doses in the p.m., he had pink AMPS. one skip in the p.m. he also had a higher pink AMPS .. nearly red. It’s a subtle difference. It is very hard to interpret anything with no mid-cycle tests yesterday. We can’t tell if — before the evening’s blue PMPS he had been lower and then had gone up into blue and then yellow? We can’t tell if he was starting a bounce from a low-ish number that he’s not used to. So it was really hard to tell at PMPS time if it was okay to shoot the full 1 unit. All we had to go on was a single blue number with no context of where he had been before to help us surmise where he might be headed. Don’t know if this is making sense or not.
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Makes sense?? yes and no lol. He has an appointment this coming Friday so that I can switch the insulin. I can do a test at +3 hours and then I will be back home later this afternoon. What should be concentrated on this week since he will be switching Friday?
 
Jenn ~ Thomas said:
@Suzanne & Darcy @Bron and Sheba (GA) @Ale & Bobo & Minnie (GA)

Hi! Thomas PMPS was 323, what should I shoot?

Also, I posted earlier about this week. Thomas has an appointment with new vet so that I can switch to Lantus generic. What do I need to do/watch to prepare for him to switch Friday?
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I gave him .75 dose. I am already working back from being late yesterday and tomorrow I have to leave at normal time to take my son to school and go to work. Hopefully this is a ok dose.
 
ok well I have been dealing with my family being sick since Friday and now I am feeling lousy. I am going to bed now. I will check tomorrow to see if there were any responses.
 
I am sorry if I cannot test him all the time. I own and operate my own business, have a 8 year old, have Lupus and with that I am no spring chicken. I am 53. I am exhausted all the time. I am doing my best with Thomas. I love him to pieces. I know he is happier now than going to the vet but he still has a way to go. He is still peeing on the tile floor everyday so I know he isn't at his best.
 
Jenn ~ Thomas said:
I gave him .75 dose. I am already working back from being late yesterday and tomorrow I have to leave at normal time to take my son to school and go to work. Hopefully this is a ok dose.
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The problem is that we have no idea if the .75 dose was a good idea or not because there were no tests after the dose was given. It sounds like you have had your hands full with sick family and now you may be sick?
 
Jenn ~ Thomas said:
I am sorry if I cannot test him all the time. I own and operate my own business, have a 8 year old, have Lupus and with that I am no spring chicken. I am 53. I am exhausted all the time. I am doing my best with Thomas. I love him to pieces. I know he is happier now than going to the vet but he still has a way to go. He is still peeing on the tile floor everyday so I know he isn't at his best.
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There’s no blame attached here to any of the questions or comments. Sometimes it’s hard to tell that from just reading typed text where you can’t hear the inflection or tone of a person’s voice. :bighug: It’s just that nobody can tell what is going on on the days where there are just the preshot tests. So if he has a similar preshot test again and you are wondering what to shoot, we have no idea. Soon he will be on Lantus and you will not change doses based on a low preshot (unless it is really low). I don’t understand why you shot .75 when he had the pink preshot two nights ago when he was 323. But maybe you were feeling ill and knew you could not test? Please don’t think I am criticizing you. I’m just trying to help to the best of my ability for you and Thomas.
 
Suzanne & Darcy said:
There’s no blame attached here to any of the questions or comments. Sometimes it’s hard to tell that from just reading typed text where you can’t hear the inflection or tone of a person’s voice. :bighug: It’s just that nobody can tell what is going on on the days where there are just the preshot tests. So if he has a similar preshot test again and you are wondering what to shoot, we have no idea. Soon he will be on Lantus and you will not change doses based on a low preshot (unless it is really low). I don’t understand why you shot .75 when he had the pink preshot two nights ago when he was 323. But maybe you were feeling ill and knew you could not test? Please don’t think I am criticizing you. I’m just trying to help to the best of my ability for you and Thomas.
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Hi, oh no I didn't feel as though you or anyone else was criticizing me. No one was telling me what to shoot so I had no idea what was correct. I looked at it like.... his numbers were not under 200, so that meant he needed something. The numbers looked ok since giving him 1 am and .75 pm so I just kept going with that.

Yes I went to sleep early. I have not got the sickness that put everyone down for the weekend. but my body needs rest to be able to function at my job as well as to keeping myself healthy enough to get through each day.
 
Jenn ~ Thomas said:
his numbers were not under 200, so that meant he needed something. The numbers looked ok since giving him 1 am and .75 pm so I just kept going with that.
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We can’t tell if the numbers are okay without any tests. The pink preshot tests in the morning are either due to too little insulin given in the p.m. — or due to him dropping too low (or lower than he is used to.). We have no clue.

I have a question. How long before the morning shot do you get up? Would it ever be possible to get a PM +10 test? I guess that would be too early?

Have you ever considered getting a Freestyle Libre continuous glucose monitor put on him? There are so just many 24 hour periods where we have only AMPS and PMPS tests. A Libre is something that could help you.
 
I am usually in bed by 9pm. I get up at 550 and do Thomas AMPS, feed all the animals, get my sons breakfast/lunch ready. Get myself ready, give Thomas his insulin at 630, gather up all my work stuff and out the door at 650. If I get up earlier I would have to go to bed earlier and that isn't possible.

the Freestyle Libre?? isn't that what sticks to the back of a humans arm? how would that go on a cat? I will have to look into that. I was really hoping that the food was the culprit of his diabetes.

yesterday and this morning is the longest there has been no urine on the tile floor in the kitchen for a year! He must be feeling better somehow....
 
Jenn ~ Thomas said:
I am usually in bed by 9pm. I get up at 550 and do Thomas AMPS, feed all the animals, get my sons breakfast/lunch ready. Get myself ready, give Thomas his insulin at 630, gather up all my work stuff and out the door at 650. If I get up earlier I would have to go to bed earlier and that isn't possible.

the Freestyle Libre?? isn't that what sticks to the back of a humans arm? how would that go on a cat? I will have to look into that. I was really hoping that the food was the culprit of his diabetes.

yesterday and this morning is the longest there has been no urine on the tile floor in the kitchen for a year! He must be feeling better somehow....
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Yes. The freestyle libre meter is something that people with diabetic cats can use for glucose monitoring. Usually a small patch of fur is shaved and the meter is applied to the cat. Many cats tolerated it well. Some people put a little shirt on their kitty to cover the spot so the cat won’t mess with it. When you switch to Lantus, you will not need to wait any more — to feed him and then wait 30 minutes before shooting. You will just test feed and shoot the insulin all at the same time and there’s no need to wait. Many people will purchase and apply the Libre sensors themselves to save money — there’s even a Facebook group for it, I believe. But vets can do it as well.
 
I will read up on the Lantus tonight. it is still no food for 2 hours prior to testing correct? So I will be able to determine how much insulin to give depending on the AMPS/PMPS? No bouncing as you say?.........

I just did a +5 test and it was 272.
 
Jenn ~ Thomas said:
I will read up on the Lantus tonight. it is still no food for 2 hours prior to testing correct? So I will be able to determine how much insulin to give depending on the AMPS/PMPS? No bouncing as you say?.........

I just did a +5 test and it was 272.
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Also, didn’t get a chance to reply to these questions. Yes, at this point in Thomas’s FD journey, you would still withhold food for two hours prior to the AMPS or PMPS tests.
 
Also, yes cats can still bounce on Lantus or any of the depot insulins. And the dose with Lantus, generics or other depot insulins are NOT based on the preshot numbers. They are similar to what is really supposed to be going on with ProZinc and even Vetsulin — doses are based on the NADIR. With the single cycle insulins like Vetsulin, the dose is still based on the nadir- or it is supposed to be — but we do have to give a little more consideration to the preshot numbers, especially with Vetsulin which hits hard and fast and doesn’t last long normally.
When you switch, you will need to know how low the dose is taking Thomas, when and what is his nadir.
 
Suzanne & Darcy said:
Also, yes cats can still bounce on Lantus or any of the depot insulins. And the dose with Lantus, generics or other depot insulins are NOT based on the preshot numbers. They are similar to what is really supposed to be going on with ProZinc and even Vetsulin — doses are based on the NADIR. With the single cycle insulins like Vetsulin, the dose is still based on the nadir- or it is supposed to be — but we do have to give a little more consideration to the preshot numbers, especially with Vetsulin which hits hard and fast and doesn’t last long normally.
When you switch, you will need to know how low the dose is taking Thomas, when and what is his nadir.
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what is nadir? I am getting ready to read about the Lantus. Just want to be prepared as much as I can
 
Jenn ~ Thomas said:
what is nadir? I am getting ready to read about the Lantus. Just want to be prepared as much as I can
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Nadir means the lowest point in the cycle. Doses are based upon the “nadir” which is how low a dose is taking the cat.

We haven’t had much of this type of information on Thomas, making it very difficult to know how to dose him with vetsulin. I don’t think any “curves” have been done on Thomas, where you would pick a day and test BG every 2 hours for an entire cycle. With Lantus, you absolutely need to know what Thomas’ nadir is. If you can only get a spot check during mid-cycle now and again, then you will need to do one of those curves on a weekend day (or another day where you’re able to test every 2 hours during the cycle.). If you find that you can fill in the blanks of his spreadsheet by testing one day at, say, +4 and another at +6 and grab tests to fill in some other hours, then a full curve may not be necessary.
 
Jenn ~ Thomas said:
Its more like 10.5 but I woke up to go potty so I figured I could get in a test and still go back to sleep for a hour
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Good. That reminds me of one of our members who said she used to drink a whole bunch of water before she went to bed so that she would be sure to wake up and test her cat!

He is way too high in these pinks. I’m really really happy that he’s not being peeing on the floor, and it is possible that he’s feeling a little bit better due to the insulin. He probably was in red and even black numbers when he was undiagnosed. These high numbers are not good for him though and are very hard on his kidneys. I can’t wait to see him in blues and greens! He is going to get there after you start the new insulin. It’s a process, bit he will get there. Lantus will have great duration and so you should not see many of these cycles where he is high at the beginning and end of each cycle (unless he’s beginning a bounce.). He is going to feel even better! I’m pretty excited about it.
 
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