02/15 Rupert PMPS 534

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Pip & Rupert

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recap of today:
AMPS 59, one hour later 63, after food... then one hour later 59. withheld shot
test at noon (so at about +18 mark was at 324.
PMPS 534.

just gave 2.0

yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=63704
hope I"m doing this right, info wise

so he had a bounce yesterday and I decided to drop his dose from 2.5 to 2 (just seemed like the swings on 2.5 were too much). Just as well I guess, this morning he's at 59!. Totally happy, had a great evening. at +4 last night he was zooming around swatting toys and chasing his sister and generally acting like a goof. Haven't seen him drinking a lot and his appetite seems normal. Obviously I'm going to hold shot and test again in an hour.... he's just had some Merrick Cowboy Cookout and his now 'usual' treat for ear poking (raw steak...damn, these cats eat better than we do!).

thoughts on dose I should shoot this morning once his numbers start up? I' can shoot him as late as 8 and be home +4 to check on him. Am thinking maybe 1.5 or should I have BOS (I"m getting the lingo slowly!) and go the full 2???? a little scarey. advice welcomed.

also.. notice people mentioning automatic feeders... is this for wet food? (everyone off the dry in our house). if so, info appreciated. Very tricky trying to regulate Rupert with four others in the house though!
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

We have never stopped by to say hello and welcome you.

One thing to remember is that when you are stalling to see if they are coming up, it is important not to feed them. Your next couple of hours will be food influenced and you won't know if he is going up from the food or from his cycle. At this point, you have three choices, no shot, a reduced shot, or full shot. Will you be around to test? I would never suggest shooting anything under 100 for new kitties, so I would skip it. Hopefully someone else will come on and weigh in, but those are my thoughts.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

drat. so I already did something wrong? I have let him have a full breakfast (we have new stray moved in and the food bowls were empty this morning so I figured part of the low was possibly due to him not eating much since last night).... doh! am going to test again in about 20 mins.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

No worries! We have all done it. I would definitely skip the shot though and just pick back up this evening with his PMPS. Any number you get now will be food influenced. In the future, keep in mind that you don't want to feed and test every 1/2 hour to see if he is naturally rising.

You might want to print out the link below so you have it handy when Rupert throws you low numbers.
http://felinediabetes.com/FDMB/view...78&hilit=stickie+shooting+low+numbers#p268394
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

I'm not sure what you did with the link to your previous thread, but it doesn't work. You click on the URL button above the text box. That will insert the code, , for a link. Go to your condo from the previous day. Copy the entire link. Then paste that information between the URL brackets.

A couple of things. You might want to read this post on dealing with low pre-shot numbers. Other than when you skip a shot, the one factor to consider is you do NOT feed your cat if you are thinking of either shooting a reduced dose or stalling. If you feed, it's likely that you will see a food spike when you next test vs. having a clearer idea that numbers are rising (or not) on their own. The only exception is if your cat is in the 40s -- then give a bit of food and re-test in 20 - 30 min.

On other thing to keep in mind. If you stall this morning, your PM shot will be 12 hours from whenever you actually shoot. Also, if at all possible, try to not stall AND reduce the dose. Each of these options has an effect on the insulin depot. If you do both, it has double the impact.

Generally, the way we approach a bounce is not to reduce the dose. With Lantus, the criteria for reducing is based on the numbers falling below 50 in a newly diagnosed cat. It's difficult to really know if Rupert bounced or if the higher numbers are largely due to having skipped a shot. Also, dose changes are made in increments of 0.25u. That said, if you feel like you are having to skip shots, then it does make sense to lower the dose so you can shoot consistently twice a day. Since you dropped Rupert's dose from 2.5u to 2.0u, I would hold the dose for 3 days unless there is a drop below 50.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

There's a lot to remember at first. This could very well be from an overfull shed still draining. usually we don't do back to back reductions, remember that shed needs to get balanced. Also you reduced by half a unit, we usually only reduce by .25u or even less, just a drop for some cats. That is a big adjustment for the shed to make

Melissa is right, when we see a low number we stall w/out food unless they are below 50, and then just a smidge of LC.

We generally go one of three ways:
  • - stall without feeding and test again every 15 or 20 minutes, shoot full dose when you see a rise
    - shoot a reduced dose
    - skip the shot and go ahead and feed.

We don't shoot a reduced dose after a stall because stalling the shot acts like a reduction by draining the shed a little. Rupert will be just fine, but at this point it may be a good idea to skip the shot this morning, especially w/ that low a preshot. Don't be upset by high numbers later though, that is to be expected.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

just retested, so at 6:15 he was at 59, at 7:15 after decent breakfast(half an hour ago) , he's at 63.....
thoughts?
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

It takes about 20 minutes for the food to digest and start to show up in the BG, still that is basically the same number. Test again in 30 minutes, but this may very well be a skip day.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

ack, all so confusing! we skipped a shot a couple of days ago and of course his numbers went thru the roof. I"m glad he's come back down again so fast (too fast?) . I"m thinking the idea is to try and keep him in the 'normal' range as steadily as possible. if I skip he's likely to shoot up and we are back to square one? but if I don't skip, he could stay too low and then bounce up again anyway. GAAAAH! guess this is something I'll have to get used to! so confusing though! thanx for the help. I'll retest at 8 and make decision then I guess (with you guys input!). it seems so counter-intuitive to reduce the dose when the numbers go thru the roof but the more I read the more I understand how his body could literally be 'fighting' the forced regulation. Remission more likely if we can slowly 'reset' the system rather than these massive swings.

as I said before. I want patience.... and I want it NOW!!!!!!!!!! tee hee
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

Well, he will probably bounce way up anyway , just from getting to that 59. Combined w/ the skipped shot it was a big bounce, but the bounces are temporary. BTW we do bulk purchases of Patience Pants around here! :lol: :lol:
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

Hi guys .. no dosing advice from me, but I bet that 59 woke you right up :-D We used an auto feeder for mocha, mainly at night when she was locked up with us (civvie eats dry) Its the petsafe 5 compartment feeder. You set the time you want each "bowl" to appear and at that time, the bowls rotate so the one with food is fully exposed. Mocha would be sound asleep and could hear that thing go off .. but I know others on here use different ones .. it's all a matter of preference I guess .. have a great day!
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

:oops: Forgot about the feeder question. Some cats will use them some ignore them. Yes you can use them for wet food, but many cats don't like sticking their heads in the deep recess. Small glass or ceramic bowls can be placed in the compartment, it makes cleanup easier too.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

so, just retested and he's back to 59. so:

he had his last shot (2u) at 6 last night. so at +12 he was 59, then I fed him (okay, I panicked!) and at +13 he was at 63.
at +14 he's at 59

gonna hold the shot. retest at noon.
 
Re: 02/15 Rupert AMPS 59!!!!!! NEED ADVICE

One more generalization, we usually don't stall more than 2 hours. If he is still this low 2 hours after his normal shot time and w/ food on board, skip the shot. You will have ot go to work and it will totally mess up your schedule. Since there is no insulin on board you don't need to worry about hypos either. You can give yourself a break and skip the noon time test. i know it means running home from work.
 
Re: 02/15 Rupert AMPS 59, after food +13 63, +14 59

Yeah, definitely no shot for him this morning.
I can still test at noon. My work is five minutes from home, and I have to come home at lunchtime to feed the horses so it's not a problem!

I shall try not to freak when I see the inevitable leap in numbers!!!!
 
Re: 02/15 Rupert AMPS 59, after food +13/63, +14/59

Rupert has you in the advanced learning class! As you mentioned, he probably will go high because of the missed shot and you are not to worry. Anything you can put on the "Do not worry about this list" is a blessing.

About auto feeders, we use one for Weezer. I freeze portions of wet food in ice cube trays and use those for her mini meals. By the time Mr. Auto Feeder opens, the meal is thawed, but hasn't been sitting there getting progressively warmer and ickier all day. Works well for us.

It's a steep learning curve at the beginning of this dance. But you're doing fine. Just remember to breathe.
 
Re: 02/15 Rupert AMPS 59, after food +13/63, +14/59, +17/324

as expected, he's at 324 at lunchtime. darn. so I should've shot him up anyway. this is quite the learning curve! doh!
 
Re: 02/15 Rupert AMPS 59, after food +13/63, +14/59, +17/324

The good news is you are learning about Rupert's patterns. Now you know that within several hours, Rupert's number spike up -- probably around 3 hours past shot time. If you had shot, for most cats, Lantus onset is at around +2. Knowing that Rupert would be experiencing a rise by +3 (with no insulin) lets you know that there would have been enough time to have shot and between food, the time of onset, and Lantus duration, you would have been fine. (I hope that made sense.)

Pip & Rupert said:
it seems so counter-intuitive to reduce the dose when the numbers go thru the roof but the more I read the more I understand how his body could literally be 'fighting' the forced regulation. Remission more likely if we can slowly 'reset' the system rather than these massive swings.
You don't reduce the dose because numbers are high. When a cat drops into low numbers, the liver may release a stored form of glucose along with counter-regulatory hormones that cause an upward spike in numbers. This is a "bounce." IF the numbers have dropped below 50, that's what would indicate that a dose reduction is warranted -- not the bounce. His body isn't fighting the regulation. The response of the liver is a protective mechanism that safeguards the brain from hypoglycemia. What has happened is that because our cats have become used to spending time in high numbers, their bodies are no longer used to recognizing what "normal" numbers (i.e., 50 - 120) are so their liver panics.

Today, this is another situation whereby you don't know if Rupert's numbers are heading up because he's bouncing or because you skipped his AM shot.
 
Re: 02/15 Rupert AMPS 59, after food +13/63, +14/59, +17/324

on my chart that I keep at home that has a nice little graph, the upside is that his 'highest' highs seem to be steadily getting lower... so the overall trend is good, just these inbetween bits that are fun. will be interesting to see where he goes tonight.
 
Re: 02/15 Rupert AMPS 59, after food +13/63, +14/59, +17/324

when i started people told me these are just opportunities to gather data and to learn more. as sienne pointed out, you learned a lot about how rupert responds to skipped doses now. just file that away in your brain for the future.

there is a lot to learn, so don't get discouraged when you don't somehow just know something. we all have to be told multiple times to have it soak in.

so tonight, i agree with sienne - stay with the same dose from last night - the 2.0 dose, for several days unless you see a test below 50. being consistent will get you the best results.

you're doing great! look at how much you learned just today!

regarding the automatic feeders - there are 2 kinds that i know of. one pops up a lid, one rotates a compartmentalized dish below a cover, exposing one section at a time. someone complained a couple of days ago that the times on their 2 part pop-up-cover dish were preset. if you want suggestions on brands, everyone's got a favorite. just edit the subject line of your post today and ask for "advice on feeders?"

this place is full of women with opinions! some men too! :lol: :lol: :lol: ;-) you'll get lots of ideas!
 
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