03/28 Skipper: AMPS 452; PMPS 60!!!! What?

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Re: 03/28 Skipper: AMPS 452

Hi guys .. keep in mind morning numbers are often the last to come down .. and you are right, everything you described is improvement .. we have to look at the whole kitty and not just numbers, ok? Have a great day!
 
Re: 03/28 Skipper: AMPS 452

Sending a rescue kitty to help Skipper down!

celi & binks

Cat+Rope+Rescue.jpg
 
Re: 03/28 Skipper: AMPS 452

Thanks!
My husband said he threw up some plant material at lunchtime, so I think he was munching on my plants because he was hungry. I will have to look into the free feeder thing and somehow keep my other cat away from it since she is full-figured. :)
 
Just checked BG before dinner: it was 60. !!!!!!!! I gave him one unit of Lantus. I think he's starved -- he ran to his dish and started chowing. I think I'm going to have to have my husband feed him lunch.
Did I do the right thing with the dosing? I will continue to check him this evening.
 
Hi Beth,

I'm just seeing this.....I would get another test now and let us know what it is, please.

We can talk about dosing later, ok? Right now I want to see what the numbers look like.
 
Breathe.....that's basically the same number as you got at PMPS. Do you have HC food in the house? Please open a can and give Skipper a tsp of just the gravy...not the solid food, ok? Then I want you to test again in 20 minutes and post the number. I'll be waiting for it.

Do you have plenty of test strips in the house and HC food?
 
It's okay. Breathe. The 60 and the 58 are pretty much the same number. How much food did Skipper eat just now, and was it low carb?
 
Thank you for being here, folks.

I gave him half a can of the WEllness Core salmon, herring and whitefish (the only canned food he'll consider eating) and 1.2 cup dry DM. He mostly ate the DM, but ate about 1/4 of the canned food. The other canned food I have in the house is Blue Wilderness Turkey and the food I give my other cat, Blue Longevity Mature. He won't touch either of them. I have plenty of strips and lancets, so I will check him again in 30 minutes. If still low, should I go get some higher carb food, or is the dry DM high enough?
He's acting fine, actually. He was just on my lap purring away.
How low is too low? This is new territory for me.
 
Don't be scared .. you always have to keep in mind you are in complete control of his numbers .. just make sure to breathe :-D and to listen to the advice on the board .. they'll walk you through this and before you know it, you won't be thinking twice about numbers like this!
 
Thank you! :)

I brought his bowl of dry DM upstairs and he is chowing down, so hopefully he's just hungry.

This has been such a nightmare that I can't even imagine the day when his numbers will be 58 and I'll be cheering rather than scared!

Thank you all for being here. I don't know what else I would do.
 
The core is medium carb if I remember correctly. Did you mean 1/2 cup of DM dry?

The reason I suggested 1 tsp of HC gravy (no solid food) is that you don't want him to fill up now, and then not be hungry later if you need to continue feeding to keep his numbers up.

The problem with using dry food is that it works too slowly, and then hangs around too long. Is he eating dry food only? How much did he eat at PMPS?

Please test in 20 minutes.

He is not too low, 58 is a good number. The reason I wanted you to give a little HC food now was to boost him up before the insulin you just gave him kicks in. No need to panic!
 
Yes, thank you. I meant 1/2 cup dry DM. He initially ate about 1/3 of it (at about 5:10 pm) and just ate another third. He ate only about 1/4 of the Core.
I'll test him again in a few minutes and post back.
 
I missed the dry food in your signature....my bad. ohmygod_smile

Don't panic, ok? He will be fine. Just get the test and let's see where he is then. The dry food will boost him, it just doesn't work as quickly as wet does. The core wet will help.
 
Ok, you don't have any gravy food, can you give him a bit more of the core food, just a tsp or two, and add a drop of karo to it?

ETA: I'm not adding karo because he is too low, I'm just trying to boost the carb content a bit. No worries, he's still ok.
 
Do you have any karo syrup or honey at home?

I would try to give Skipper just a little bit of the HC gravy (like Laurie suggested), but since you don't have any, maybe you could add a drop or two of karo to the wet food he is eating. Can you ask your DH to run out and buy some HC food?
 
DH is on the way home with some different food, so I will try feeding him as soon as he gets home. Thank you for your vigilence! My phone is ringing off the hook with other stuff and I'm trying to make dinner, so I have a lot going on. Skipper, meanwhile, stuffed himself in a box that is too small for him and is digesting his dinner.
 
Did you get another test after the 50?

I would ask DH to bring home any of the Fancy Feast Grilled varieties, or any Friskies that says in Gravy.
 
7:15 p.m.: 54

he licked the gravy from the food DH brought home but wouldn't eat any of it. At least it's on the way up and not down.
 
The 50s are good numbers, and not too low. We just have to watch them. Even though you gave a reduced shot tonight, the shed from the last shot is still in his system. Hopefully, Skipper will surf along for a bit in the 50s and 60s, and slowly rise up from the gravy and dry food he ate earlier. I would test again in 30 minutes, okay? And let us know the number.
 
Yes, +2 was 54. I gave him a couple treats I had here (he doesn't like treats either -- he's very picky) but he ate them. They are Zeke's Natural Purrz Salmon (12% protein, 7% fat, 3% fiber, 30% moisture). They do contain grains (barley, tapioca).
 
The gravy has most of the carbs, it's fine if he doesn't eat the food. Even cats who don't like wet food usually like the gravy.

Dyana is giving you good info and advice. You're doing fine! :-D I'm watching, will jump in if you need me.


ETA: Beth, I'll be watching for the next test...Dyana is an early bird and she has to sign off. We tag team and hand off to each other so someone will be around to help when others need to leave. Teamwork! :-D
 
Ok, 8:06 p.m.: 106.
I feel better now.

Thank you, thank you, thank you, for walking me through this. I am more comfortable with the 400s than the under 100s, so this is a whole new world for me. I will get some gravy style food to keep on hand for these times and will discuss with the vet Monday if this is to be expected with Lantus. It seems so weird to me to go from 452 in the am and 60 12 hours later!!!
 
I still catch my breath when Ruby hits double digits. Never fear, you can always find someone here to walk you thru it. They do it with me all the time! :-D
 
Ok, now that he is in a more comfortable range, I would get another test 30 to 45 minutes after the last one. I'm guessing that the dry food is starting to affect his numbers, but you want to make sure he continues to stay up there, because if it's just the gravy, it can wear off and the numbers can come back down. Don't assume that he will continue to rise...you need to keep testing until you see two rising numbers without food influence.

The other thing we need to talk about is dose. I haven't been around a lot lately, so I'm not familiar with your situation, but I'm seeing different doses at AMPS and PMPS. Lantus likes consistent dosing, when you shoot varying doses, the numbers tend to get wonky. You shoot 3u in the morning, the numbers are lower at PMPS, so you shoot less insulin, the shed drains and then the numbers are high again the next morning....this is not a good way to use Lantus.

Since you are feeding dry food, you are following SLGS protocol, right? With the 60 at PMPS, you should reduce the dose. Let me take a look at the SS for a minute, I'll be right back.
 
Thank you so much. I'm going to be taking a class 2 nights a week for three weeks next month, so I'm trying to educate DH on what to do if this happens. I'm making him a cheat sheet of everything, including my login and password for this site, in case he needs it. I will get some of the HC food tomorrow to keep on hand with the Karo syrup. In May I am taking my first trip away from home since Skipper's diagnosis, so I have to make sure DH is ready to handle this alone.
 
Laurie: My vet told me that if his sugar was under 250 to lower the dose by one unit, so that's why I was giving 2. I asked her Monday if there was every a time when I shouldn't give insulin if his BG was low (like tonight, for example), and she said no, he has to have some insulin, even if it's just 1 unit. I was afraid tonight to give him the full 3-unit dose with his BG at 60, so that's why I gave just 1.
This is all new to me, so I'm learning as I go along. We've just been on Lantus 2 weeks today.
 
Good for you, getting your husband on board, that's awesome! My DH is not a medical-type person, I had to work on him for a while just to get him to learn how to test and shoot. He always would text the numbers to me and I would text back and tell him what to do, he never learned how to do everything independently. My DH would never log in on the board, but we do have several husband/wife teams that do that. It's great to have another person to help!

Ok, I looked at the SS...it looks like you are in the process of transitioning to wet food, right? The lower numbers you are seeing at night are almost certainly due to the decrease in dry food during the day. He got no dry food during the AM cycle today from what I see on the SS, only wet core....even though the core is a little high, it's lower than dry food, and you are seeing the effect of less carbs in the PMPS and early PM cycle numbers because the dry food takes a little while to get into his system. Does that make sense?

How is he doing with the core? Does he like it? Will he eat it willingly, or are you still having to coax him with some crumbled up dry on top?
 
Suggest you get your dosing advice here (Laurie is great for that ;-) ) rather than from your vet they seem to have no idea of how Lantus works. Changing the dose based on PS is not the way to go with this type of insulin, because of the shed effect the change in dose is not usually felt until the following cycle anyway, leading to more wonky numbers. Also DO NOT SHOOT UNDER 50 EVER - and it might be that there is a lower threshold than that using SLGS I'm not sure (someone else will know) but since 90 is the number you're looking for for a reduction and 50 is the number we're looking for with TR...
 
millerb said:
Laurie: My vet told me that if his sugar was under 250 to lower the dose by one unit, so that's why I was giving 2. I asked her Monday if there was every a time when I shouldn't give insulin if his BG was low (like tonight, for example), and she said no, he has to have some insulin, even if it's just 1 unit. I was afraid tonight to give him the full 3-unit dose with his BG at 60, so that's why I gave just 1.
This is all new to me, so I'm learning as I go along. We've just been on Lantus 2 weeks today.
Click to expand...

Thanks for that info, it helps. I can understand the vet telling you to reduce the dose below 250, and even though that isn't exactly the way we suggest people do things, it's not a bad thing to do in your situation. If you are concerned about giving the full dose on a lower PS number, it's ok to shoot a BCS (big chicken sh-t) dose. With dry food in the mix, it's best to be cautious, so 250 is not a bad number to use until you get him transitioned to wet food. Once you get him transitioned, you will be able to shoot lower PS numbers with the full dose, but for now, you did fine reducing. I'm glad you reduced the dose to 1u tonight, that was good instincts on your part. :-D The important thing to remember is that if you shoot a low number like you did tonight, even if you reduce the dose, you need to test often early in the cycle and feed as necessary to keep him from dropping too low until his numbers stabilize at a safe level.

As Serryn said, please don't shoot below 50....normal BG is between 50-120, shooting a number below 50 is quite risky...you have very little margin for safety. If you ever are in doubt about whether to shoot or not, please just stall, don't feed, and post on the board for help.

You won't learn everything in one night, and I'm probably dumping too much info on you all at once....I don't want to overwhelm you.

I think you should reduce the dose, how would you feel about trying 2.0u BID? We usually reduce by 0.25u, the reason I am suggesting a larger decrease is because you are transitioning from dry to wet food, and you have not been able to shoot the same dose AM and PM. I'm hoping that if you reduce by that much, you will be able to shoot the same dose BID. What do you think?
 
9:08 p.m. (+4) 187

He's finally gotten to where he'll eat the Core without much coaxing. I literally have tried every canned food available in my major metro area that doesn't have beef or liver (which he vomits immediately), or chicken (my other cat is allergic to chicken). This is the only one he'll eat semi-willingly and keep down. I realize it's not low carb, but he also has CKD, so I can't go too high in protein because of that. Right now his kidney levels are in the normal range, and I want to keep them there.

My vet told me Monday to let him have the dry food b/c he needs the extra calories. He needs to gain back another 1.5 lbs to be back to normal (he was 8 lbs at his lowest in January when he had DKA, but his normal weight is 11-11.5). Here's our background: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=64383. She wants him to eat whenever he wants to get some calories. I want him to gain weight, too, but not at the expense of high BG.

THANK YOU AGAIN to everyone who helped me. I so appreciate it. Now it's time for bed!
 
Maybe I should have thought twice before I sent that Rescue Kitten to Skipper :-D
Perhaps a less vigorous kitten next time :lol:

celi
 
That's a good number, Beth. Good job tonight! I hope the info I gave you is helpful, and that I didn't overwhelm you!

I understand balancing the issues...if core is what he needs, then that's what you need to do. There are other caregivers who have similar issues with food, we can work around that. No worries!

Good night! :-D
 
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