07/07 Bubbas AMPS 201

[Bubbas and Katrina]

Hello all!


This is my first time posting in this threat. I will be posting daily to get help and advice. Bubbas just started 1 unit of insulin about a week ago so me and him are still very new to this, as you can tell by his spreadsheet, his numbers are kind of up and down. Was told advice to STICK to 1 unit every 12 hours for 2 weeks to let his body build up the insulin. I will be doing a glucose curve this Saturday or Sunday and will be sure to post that in his spreadsheet. Any advice at any time is always appreciated and welcomed!!!

Also, I am using the Alphatrak 2 meter as of right now but want to switch to a human meter. I got the Relion Platinum at Walmart a couple days ago, does anyone recommend another version of the Relion meters? There are many different kinds. Platinum, Blu, Classic, ect.

Thanks!

https://docs.google.com/spreadsheets/d/1hXdnLMelYNLp8xz-P75o4rpNzoh9yRgvJlso8h_xBPg/edit?usp=sharing

 

[Deb and Sylvester]

Hi Katrina,

You did well with the header and asking questions for assistance.

I told you to stick to the 1 unit, because you had jumped to 2 units after only several days of therapy, and that's not how glargine insulin is used. Going to 2 units is the reason you had that very low number and had to skip a dose. Keep reading the material, including the sticky about the "insulin depot", it will explain how the insulin works.

Now that we've got your posting sorted, as I mentioned, every day you start a new thread.

I am tagging some experienced members for eyes on your spreadsheet. Also remember to get at least 1 additional test in during each cycle between doses for SLGS, and if that is your method, please add it to your signature.

@Wendy&Neko
@tiffmaxee

 

[Bubbas and Katrina]

Hi Katrina,

You did well with the header and asking questions for assistance.

I told you to stick to the 1 unit, because you had jumped to 2 units after only several days of therapy, and that's not how glargine insulin is used. Going to 2 units is the reason you had that very low number and had to skip a dose. Keep reading the material, including the sticky about the "insulin depot", it will explain how the insulin works.

Now that we've got your posting sorted, as I mentioned, every day you start a new thread.

I am tagging some experienced members for eyes on your spreadsheet. Also remember to get at least 1 additional test in during each cycle between doses for SLGS, and if that is your method, please add it to your signature.

@Wendy&Neko
@tiffmaxee

Great, thank you so much for your help!!! I cannot do any extra test between 7:00am-4:30pm due to me being at work Monday threw Friday, but during the weekends, I can do as many shots as I need, I'll be doing a curve this Saturday or Sunday. I am still going to read up on SLGS this weekend and more than likely going to do that!

 

[tiffmaxee]

Welcome to LLB. With not being able to test after amps you will want to start with SLGS I think. If you can shoot earlier so you can get a +1 or even better +2 you might consider TR at some point. With SLGS you will hold the 1.0 dose for 7 days unless the bg drops under 90. If that happens a .25 reduction is earned and the 7 day count starts over again. Also with SLGS you will do a curve after 7 days on a dose testing every 2 hours for a cycle or every 3 hours for 18 hours to see the nadir, lowest point in the cycle. Any spot checks you can get are good at any time in the cycle for now. A before bed test is always a good idea when possible as is a +2 whenever available to you. Lantus often onsets, starts working, around +2 so if that test is lower than the preshot there’s a good chance the bg will go lower that cycle. So if heading to bed you can leave out some food. An auto feeder helps many get a restful sleep and feel good about going to work too.

 

[Bubbas and Katrina]

Welcome to LLB. With not being able to test after amps you will want to start with SLGS I think. If you can shoot earlier so you can get a +1 or even better +2 you might consider TR at some point. With SLGS you will hold the 1.0 dose for 7 days unless the bg drops under 90. If that happens a .25 reduction is earned and the 7 day count starts over again. Also with SLGS you will do a curve after 7 days on a dose testing every 2 hours for a cycle or every 3 hours for 18 hours to see the nadir, lowest point in the cycle. Any spot checks you can get are good at any time in the cycle for now. A before bed test is always a good idea when possible as is a +2 whenever available to you. Lantus often onsets, starts working, around +2 so if that test is lower than the preshot there’s a good chance the bg will go lower that cycle. So if heading to bed you can leave out some food. An auto feeder helps many get a restful sleep and feel good about going to work too.

Yes , I think I will start SLGS on Monday since I will more than likely do the curve on Sunday. The Alphatrak 2 test strips are extremely spendy, I just spend $70 on 50 more of them, ( I ran out of them only after having it for a couple weeks) so besides doing the curve on Sunday, I will more than likely be only testing 3 times a day until I can find a good working human (less expensive) glucose monitor and stripes. I have the Relion Platinum which I think works fine? But I will be making my final decision more than likely on Monday or some time next week regarding which human meter I will be using to replace the Alphatrak 2.

 

[Wendy&Neko]

Hello and welcome to the LLB forum. For people wanting a little background, here is Katrina's first post on Feline Heath.

No need to delay starting SLGS, you won't really be doing much different than you are now. Just stick with the 1 unit dose, unless he goes under 90, in which case you'll need to reduce the dose by 0.25 units. It's possible the 1 unit dose might even be too much insulin. More data, and that curve, will help us figure that out.

Is there any chance you can get a test 2 hours after your PM shot time? The +1 doesn't tell us as much, other than how much of a numbers boost he gets from dinner. The Lantus onset (when it start working) in many cats is around +2, so that +2 test can give you a clue what is happening to his numbers at night. We change the Lantus dose based on how low it takes the cat, so getting a view into the night time numbers - when many cats go lower, is really helpful. That and the curve give us the data we need to decide if and how to change the dose.

 

[Bubbas and Katrina]

Hello and welcome to the LLB forum. For people wanting a little background, here is Katrina's first post on Feline Heath.

No need to delay starting SLGS, you won't really be doing much different than you are now. Just stick with the 1 unit dose, unless he goes under 90, in which case you'll need to reduce the dose by 0.25 units. It's possible the 1 unit dose might even be too much insulin. More data, and that curve, will help us figure that out.

Is there any chance you can get a test 2 hours after your PM shot time? The +1 doesn't tell us as much, other than how much of a numbers boost he gets from dinner. The Lantus onset (when it start working) in many cats is around +2, so that +2 test can give you a clue what is happening to his numbers at night. We change the Lantus dose based on how low it takes the cat, so getting a view into the night time numbers - when many cats go lower, is really helpful. That and the curve give us the data we need to decide if and how to change the dose.

Ok great, yeah I felt like I was doing the SLGS process kind of anyways already. And so on any given AMPS or PMPS if his reading is under 90, reduce it to 0.75 units? I think I get kind of confused on that part, I've been suggest by multiple people to stick to 1 unit every 12 hours, so its basically stick to 1 unit every 12 hours UNLESS his number goes below 90? correct? I think my syringes only do full and half doses, so I am not sure on how to get like 0.25 or 0.75 or anything like that. And I will make sure to do the curve and post the numbers as the day goes on Sunday.

And yes, I can most definitely do a test 2 hours after his PM shot at 6:30ish pm every day. Once I get some more suggestions/advice on a good Relion human meter I will stick with that human meter starting next week because as of right now, I am solely using the Alphatrak 2 since I just spent $70 on more of them, so I am trying to utilize those until I completely switch to a Relion one. lol

 

[Wendy&Neko]

And so on any given AMPS or PMPS if his reading is under 90, reduce it to 0.75 units?

Correction, if you see any reading at any time below 90, reduce the dose. The lowest numbers tend to be around 6 hours after the shot, plus or minus a couple hours. Hence the need to periodically do curves or spot checks on weekends when you can. So stick with 1 unit for now, unless the meter shows a number under 90.

None of us have syringes that do anything smaller than half units. We eyeball it. In the Sticky Note on Syringe Info there are some pictures of those in between doses.

 

[Bubbas and Katrina]

Correction, if you see any reading at any time below 90, reduce the dose. The lowest numbers tend to be around 6 hours after the shot, plus or minus a couple hours. Hence the need to periodically do curves or spot checks on weekends when you can. So stick with 1 unit for now, unless the meter shows a number under 90.

None of us have syringes that do anything smaller than half units. We eyeball it. In the Sticky Note on Syringe Info there are some pictures of those in between doses.

That makes sense! Just to be absolutely sure, you mean go down to 0.75 units if his reading is under 90 right before his PM shot and food correct? Like don't switch to 0.75 units that day if his number in the middle of the day is under 90, but than goes up to like 130 or something before his PM shot? Does my question make sense? lol

 

[Marje and Gracie]

That makes sense! Just to be absolutely sure, you mean go down to 0.75 units if his reading is under 90 right before his PM shot and food correct? Like don't switch to 0.75 units that day if his number in the middle of the day is under 90, but then goes up to like 130 or something before his PM shot? Does my question make sense? lol

I’m really happy to see you and Bubba here, Katrina. Great job in your first condo!

Any time during a cycle that his BG goes below 90, you will reduce the dose by 0.25u at the very next shot even if his PS BG has climbed significantly.

Also, please remember to PM me if you switch to a human meter so I can fix the SS. Thank you.

 

[Bubbas and Katrina]

I’m really happy to see you and Bubba here, Katrina. Great job in your first condo!

Any time during a cycle that his BG goes below 90, you will reduce the dose by 0.25u at the very next shot even if his PS BG has climbed significantly.

Also, please remember to PM me if you switch to a human meter so I can fix the SS. Thank you.

Great! So any time at all during the day if its 90 or below, give 0.75 units, and if it ends up going back up the next day or whenever right before the next shot, I can go back to up 1 unit? Sorry I just wanna make sure I am getting everything correct.

And yes I will forsure!

 

[tiffmaxee]

Great! So any time at all during the day if its 90 or below, give 0.75 units, and if it ends up going back up the next day or whenever right before the next shot, I can go back to up 1 unit? Sorry I just wanna make sure I am getting everything correct.

And yes I will forsure!

No. If the BG drops under 90 at any time that becomes her new dose for the next 7 days regardless of how high the BG goes. If there is another drop under 90 before 7 days you reduce to .50.

 

[Bubbas and Katrina]

No. If the BG drops under 90 at any time that becomes her new dose for the next 7 days regardless of how high the BG goes. If there is another drop under 90 before 7 days you reduce to .50.

Ok I think I am getting it now

 

[Marje and Gracie]

Great! So any time at all during the day if its 90 or below, give 0.75 units, and if it ends up going back up the next day or whenever right before the next shot, I can go back to up 1 unit? Sorry I just wanna make sure I am getting everything correct.

And yes I will forsure!

As Elise said, once you reduce a dose…and also increase the dose, you will hold the new dose for a full week, unless he drops below 90 at any time at which point you will reduce the dose at the next shot, hold the dose again, and then do a curve. In other words, you are going to hold doses for a week and then reassess unless he earns the reduction by dropping below 90. Does that help?

 

[Bubbas and Katrina]

As Elise said, once you reduce a dose…and also increase the dose, you will hold the new dose for a full week, unless he drops below 90 at any time at which point you will reduce the dose at the next shot, hold the dose again, and then do a curve. In other words, you are going to hold doses for a week and then reassess unless he earns the reduction by dropping below 90. Does that help?

Yes that does! I am sure along the way I will have questions but overall everything makes sense!

 

[Marje and Gracie]

Yes that does! I am sure along the way I will have questions but overall everything makes sense!

It’s all about questions and learning!!

 

[Bubbas and Katrina]

Haha sure is!!!

 

[Bubbas and Katrina]

It’s all about questions and learning!!

Here is my concern. So before I gave bubbas some food, his blood sugar was 410 ( about an hour in a half ago) pretty high. It’s been an hour since insulin and it’s 490!!!! This is starting to get concerning. I understanding everyone is saying stay at 1 unit for a full week, and I get it, but bubbas is only going up. When his blood sugar gets high (never like this) he starts to not poop, only pee, barely eats and only drinks, he starts to get lethargic, drops weight super fast, and it honestly scares me. I’m genuinely starting to think 1.5 units every 12 hours might be the sweet spot. 2 is clearly too much, but I don’t think 1 is enough. I also understand that I’ve only been giving him insulin for 1 week and 2 days, but I’m mostly given him 1 unit every 12 hours, and it’s not working. I was told to hold a dose because it can take two weeks for a cats insulin to really stick in the body, but I can’t put my cat threw super high readings like this. I am basically starving my cat when his blood sugar is this high. I’m afraid if he has even a couple for days of such high readings, it will be bad. He can’t just stop pooping, he can’t keep losing weight super fast (it’s been about a pound or so every week in a half when his blood sugar isn’t in a good spot). I just don’t think 1 unit is doing it guys. I’m really trying to listen to everyone’s advice, I seriously am, but as his mama I’m having a gut feeling to start at 1.5 units. There has been a huge mood and everything difference from yesterday when his numbers were lower, to today when they are high.

 

[Marje and Gracie]

Here is my concern. So before I gave bubbas some food, his blood sugar was 410 ( about an hour in a half ago) pretty high. It’s been an hour since insulin and it’s 490!!!! This is starting to get concerning. I understanding everyone is saying stay at 1 unit for a full week, and I get it, but bubbas is only going up. When his blood sugar gets high (never like this) he starts to not poop, only pee, barely eats and only drinks, he starts to get lethargic, drops weight super fast, and it honestly scares me. I’m genuinely starting to think 1.5 units every 12 hours might be the sweet spot. 2 is clearly too much, but I don’t think 1 is enough. I also understand that I’ve only been giving him insulin for 1 week and 2 days, but I’m mostly given him 1 unit every 12 hours, and it’s not working. I was told to hold a dose because it can take two weeks for a cats insulin to really stick in the body, but I can’t put my cat threw super high readings like this. I am basically starving my cat when his blood sugar is this high. I’m afraid if he has even a couple for days of such high readings, it will be bad. He can’t just stop pooping, he can’t keep losing weight super fast (it’s been about a pound or so every week in a half when his blood sugar isn’t in a good spot). I just don’t think 1 unit is doing it guys. I’m really trying to listen to everyone’s advice, I seriously am, but as his mama I’m having a gut feeling to start at 1.5 units. There has been a huge mood and everything difference from yesterday when his numbers were lower, to today when they are high.

He was just in the 90s last night so he’s bouncing. It’s the body’s natural response to lower numbers they aren’t used to. The liver releases counterregulatory hormones and glucagon and the BG shoots up. It can take up to six cycles to clear it. In fact, he was clearing a bounce yesterday a.m. cycle and that’s why he was so low at PMPS last night.

I’m certain those high numbers make him feel bad. Please be sure you are testing ketones every day.

I know you are working but please try to get as many tests as you can so, at night, that would be the PS, +2 , and before bed. If you are up by +11 in the morning, grab a test.

You don’t need to hold this dose two weeks; if you decided on SLGS, it’s one week. If you are doing TR, that can be faster but seeing green last night, we wouldn’t recommend you raise.

 

[Bubbas and Katrina]

He was just in the 90s last night so he’s bouncing. It’s the body’s natural response to lower numbers they aren’t used to. The liver releases counterregulatory hormones and glucagon and the BG shoots up. It can take up to six cycles to clear it. In fact, he was clearing a bounce yesterday a.m. cycle and that’s why he was so low at PMPS last night.

I’m certain those high numbers make him feel bad. Please be sure you are testing ketones every day.

I know you are working but please try to get as many tests as you can so, at night, that would be the PS, +2 , and before bed. If you are up by +11 in the morning, grab a test.

You don’t need to hold this dose two weeks; if you decided on SLGS, it’s one week. If you are doing TR, that can be faster but seeing green last night, we wouldn’t recommend you raise.

That makes me feel a little bit better, thank you! I didn’t know what bouncing was so it sounds like that’s what’s going on. I JUST tested his urine and it’s negative, no ketones. I will go ahead and test him again in about 5 mins, then again in about an hour or so. I decided I’m going to do the curve tomorrow so the numbers will be on his SS tomorrow as I go. I will keep the advice and stick to 1 unit for right now until further advice.
I gave him 2 a couple mornings ago because his blood sugar dropped , so I decided to give him 2 units that’s one time but it seems as though I messed everything up by doing that. When I see high numbers like that, it makes me panic pretty bad. But now that I know about the bouncing thing, it makes me feel better, so thank you!

So after 7 full days of being on 1 unit, if his numbers are still high, that’s when I could increase his dose?

 

[Marje and Gracie]

That makes me feel a little bit better, thank you! I didn’t know what bouncing was so it sounds like that’s what’s going on. I JUST tested his urine and it’s negative, no ketones. I will go ahead and test him again in about 5 mins, then again in about an hour or so. I decided I’m going to do the curve tomorrow so the numbers will be on his SS tomorrow as I go. I will keep the advice and stick to 1 unit for right now until further advice.
I gave him 2 a couple mornings ago because his blood sugar dropped , so I decided to give him 2 units that’s one time but it seems as though I messed everything up by doing that. When I see high numbers like that, it makes me panic pretty bad. But now that I know about the bouncing thing, it makes me feel better, so thank you!

So after 7 full days of being on 1 unit, if his numbers are still high, that’s when I could increase his dose?

I know it’s hard to not panic with high numbers when he doesn’t feel well. I’m glad his ketones are negative. Please keep checking every day.

Just remember we don’t dose-hop with Lantus. If he drops below 90, reduce the dose at the next shot. Other than reductions, yes, hold the dose a week run a curve, and then post for dosing advice. Sound good?

 

[Bubbas and Katrina]

I know it’s hard to not panic with high numbers when he doesn’t feel well. I’m glad his ketones are negative. Please keep checking every day.

Just remember we don’t dose-hop with Lantus. If he drops below 90, reduce the dose at the next shot. Other than reductions, yes, hold the dose a week run a curve, and then post for dosing advice. Sound good?

Yes I will check as much as I can! And yes sounds good! Just tested his blood sugar and it was 419. Might do one before I go to bed soon.