1/24 Kit AMPS 353, +11 337, PMPS 299

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Re: 1/24 Kit AMPS 353

Good Morning, LIL and Kitten ~

"Last day of classes....whoooo hoooooo!!!!" -- Yay! How long do you have off, LIL? My husband is taking a sabbatical now. So nice to have him home to test Butters' bgs :-D .

Some more cool blues for Kitten at PMPS and into the evening. No sleep for the weary, huh? Quite a few kitties go low in the evening the way Kitten is doing, but the two diabetic cats we've had typically haven't done that. Why don't I ask Gayle, a very experienced member, to come take a look at Kitten's spreadsheet? She's good at seeing patterns and how they relate to dosing needs. Blues and greens are both good colors for Kitten, LIL, when they come steadily and can be managed. Let's see what Gayle thinks about the 1.75U dose versus going back down to 1.50. Since you're going to be home now, LIL, you'll be able to watch for those lower evening numbers...something you've been doing all along.

Have a great last day,
Eva
 
Re: 1/24 Kit AMPS 353

Hi Lil,
I looked at Kit's ss, and I keep thinking late nadir. I could be wrong, but that's how it looks from the few days with test numbers. Then again, going with frequent dose changes, by oops or otherwise, causes disruptions the shed. That's likely the reason your test numbers look all wonky.

For sure it looks like the 1.75u brought numbers down from 419 to 111 by +9, so it could be a bit on the high side for dose. And seeing blues in the pm and then higher 300s in the morn makes me wonder if Kit is going much lower at night since lots of cats do, or if Kit is just revving up for the day. You can confirm it easy enough by just getting back on track.

I don't know how frequently you feed but feeding smaller meals more often is one method to even out odd curves.
I think you could try to go wit the 1.5u dose and see if the curve levels off. You may see a higher curve of 200s with higher ps numbers, but you can decide on an increase later if needed. When I see a red amps and then a blue pmps, I think that's not quite right, and may need to decrease. The blues look real nice but you want to make sure it's not getting too nice while you sleep and then high again in the morn.

Contour's a fantastic meter, and I use for both mine.

It's up to you but maybe you can try 4-6 cycles at 1.5u and let the dust settle. Then, when you have a more level curve, you can decide if you want to move up by .25u to the 1.75u. If you see fast drops in BG, then maybe the 1.75u was too much.

I don't know about the others, but I like to err on the safe side, and you want to get Kit's numbers to stay under 240 to minimize organ damage.

Last, the numbers are not the whole cat... watch Kit for signs. If Kit's feeling fine and all the 5 p's are in place, then you are not doing too shabby at all.
 
Re: 1/24 Kit AMPS 353

Hi Eva and Gayle...Thanks sooo much for your inputs!

I was thinking about how his numbers are also all over the place. I also thought late nadir, but then it seems like the evening is flipped, so I've been really confused about the whole thing. I part of me hates that I freaked out and decreased that when I saw the first blue... I too agree that red amps and then blue pmps is definitely showing that something is not quite right - so I am really thanking you for advice to go back and hold that for a while. Plus I'm getting so nervous every evening b/c its such a drastic change that I'm not sure where he'll be going with it.


I'm thinking that maybe going back down to the 1.5U could a good idea at least until the end of the weekend...I'll be able to do a lot more mid-day testing. With exams for the next week, I'll be home at noon, (+5) so I'll be able to get a handful of data for those midday numbers by the end of the week and then go from there. Hopefully that sounds like a good idea? Or should i keep this and get more midday tests? Kit is way more active and doing a lot better than before...


Thanks again for the advice and suggestions....it's super appreciated!

PS. Eva: I wish I was off completely. The kids start exams tomorrow until next mon, so i have to be there to administer it to my classes. Tuesday is a reserve day in case another day we get a snowstorm, so if all goes well, day off for me! The good thing is that I go in, watch them for 2 hours, and then get to come home and mark for the rest of the evening. I dont mind the marking since I'll be at home in comfy clothes :)
 
Re: 1/24 Kit AMPS 353, +11 335

So I didn't manage to get my usual +8 today (I think I was walking around aimlessly for a bit when I got home out of sleepiness...other than that, I truly, honestly dont know why...usually i come home, test, feed, then get on with my afternoon...today, I was in la-la land it seems). But I decided to get in a +11 for curiosity. Partly because on more than one occasion, my +8 was higher than my pmps, so i wanted to see what a +11 would give me in comparison. And it was a purple..

Maybe it's Kit's special way of saying, "I think you need some sleep...let me fix these pm numbers so you can relax a bit tonight" lol. Or maybe it will be the opposite and he'll have some quick drop after his shot. I guess we'll see this evening!

Im starting to feel like a walking zombie.

I'm actually looking forward tmr to getting a few more numbers to fill in the picture. I feel like with only one test mid-cycle, i'm not sure where things are. These next couple days can actually help piece together some data.
 
Good Morning, LIL and Kitten ~

"I think I was walking around aimlessly for a bit when I got home out of sleepiness" -- Hey, LIL, been there, done that :-D . You're really starting to gather some good test data on Kitten to give you a better idea of how he's responding to different doses of Lantus. I think you're doing a great job!

You know, those higher flatter curve days can be frustrating but also give you a breather, too, after worrying about lower numbers. And curves like that are fairly typical in the early months of Lantus treatment. You'll have a day or night in Kitten's case with lower numbers than he's used to, like those blues he's been getting, and then higher rebound or bounce numbers the next day. Bounce can take up to 72 hours to clear...ECID (Every Cat Is Different).

From what I've learned about Lantus, LIL, often if you see longer, more extended duration than normal with a dose, it can mean too much insulin. But in Kitten's case, as Gayle's mentioned, he could just have late nadirs and be a cat that tends to go lower at night. I'm leaning toward a bit too much insulin and that it might be better for you to go back to the 1.50U dose for a while to see how Kitten responds. Let's see what Kitten does this morning though, LIL. Depending on his numbers, what I would do is hold the 1.75U dose for today, giving him 6 cycles/shots at that dose, and then reduce to 1.50U tomorrow morning. However, if he's gone low again overnight, then reduce to 1.50U today. Maybe Gayle will stop in to give some input on this, too, LIL.

Hope you have a lovely day today, LIL.

Eva
 
Thanks Eva....I actually fell asleep yesterday super early - my eyes didn't want to stay open anymore. But I'm home now and going to monitor today and see what happens and then reduce tomorrow after the 6 cycles. Moreso it's cuz I want to see what the odd midday numbers would be...then go from there :) I agree with the bringing it back so we can get a better curve rather than this S shape that I've been getting.

This morning Kit was being a little pain...he just didn't want us to go near him with the meter, so he kept flinching and pulling back and everything. Finally we managed but it read LO, so my husband had a heart attack almost. Luckily, it was just yesterday that I read that that can happen if blood sips in too slowly (which I noticed that it did at the time), so I managed to calm him down, send him away and do a test on my own to get a more normal number...

Day 1 exam done and marked! i was on a roll today...now have to report cards and I'm finished for one class (two more to go...). Cannot believe how many students leave exams blank, even after I gave them the short answer questions! How much more do some ppl want? I guess they'd like me to write it for them too...frustrating. Overall, good average, good kids...gonna miss (some of) them.

Time for lunch!
 
Good Afternoon, LIL ~

That AM +5 of 139 would be a decent nadir (low point)...if that is Kitten's nadir. Will be interesting, LIL, to see if the curve heads upward or keeps going down now. If Kitten's numbers continue to go down lower into the blues, I think I'd be inclined to reduce his PM dose to 1.50U. What do you think about that?

"gonna miss (some of) them" -- Same thing my teacher hubby says, LIL :-D .

Hope you've had a good lunch.

Eva

P.S. "Finally we managed but it read LO, so my husband had a heart attack almost." -- LIL, I do know how he felt. Anytime we get a startling, heart-attack-provoking, wonky meter reading, we always retest as you did.
 
Good afternoon!

Teachers are all the same eh? What was your husband teaching?

The +5 was actually 5.5, but i tested now at +7 and its pretty much the same (131). Yeah if it keeps going down then I guess it would be best to go back down to 1.50. I think I'm personally a bit confused though...no other reason other than I'm not sure how things actually are working inside of Kit (I know my textbook stuff, but not real-life things). So it's best to go back to 1.5 so that we can establish a better curve so that eventually if we have to come back to 1.75 then it would show a better curve rather than this S shaped thing we have going on now? If numbers are not going too low (i.e. staying in the blues), why is it better to decrease? I understand it is too much of a jump from AMPS to these blues, but is that not something that would level itself more with time? or is it because we dont want him to be dropping too much at night when there isn't a curve to help me figure out where he's going? or is it dangerous to drop that much in general? Sorry for the million questions!!!

Hope you have a lovely day too, and thanks for always checking in on us. I hope Butters is doing well too!!! :)
 
Hi, LIL ~

Those blues you're getting for Kitten are very good numbers. "If numbers are not going too low (i.e. staying in the blues), why is it better to decrease?" -- LIL, I think you've asked an excellent question. And I don't know that decreasing is necessarily the way to go with Kitten's dosing. The concern I have is that the 1.75U dose over the next several days might starting driving the PM numbers down even lower into the greens (or even the AM numbers with that AM +5.5 of 139). And greens can be great numbers for Kitten, too, as long as they stay above 50. As long as you're able to monitor to see how low that 1.75U dose is taking Kitten in both the AM and PM, then sticking with that dose might be the way to go for a while longer. You'll have filled the Lantus depot/shed for the 1.75U dose with your PM dose by holding that dose for 6 consecutive cycles/shots, and then you might start seeing even more action with that dose.

LIL, I know I haven't exactly answered your question because, to me, this is a call you need to make based on your comfort level with the 1.75U dose. As I understand it, you'll be around more to test Kitten over the next few days. Is that right?

My husband teaches business information technology courses and economics.

Bye for now,
Eva
 
Eva, you've 100% been a huge help! You've answered every question I've always had! :) I totally know that it's all comfort levels, etc, and that ECID and stuff, but I love to have as much info as I can and then kinda know what to look out for. I am home to watch him for the next few days, so I may actually just keep a vigilant eye on him and see how things go...if i start seeing green then i'll move earlier kinda thing. One day at a time I guess!

Thanks again for your constant help. I apologize if I ask so many questions.... :)
 
Lil,

If there is one thing I have learned here...There is no such thing as too many questions...we may not always have all the answers but not a single one of us minds the questions. :-D And the only stupid question is the one that goes unasked.

Mel, Maxwell, Musette & The Fur Gang
 
Hi, LIL and Kitten ~

Looks like a higher day today after that nice string of blue numbers yesterday, although Kitten could go lower this PM since he seems to clear a bounce pretty quickly. And again, a higher bounce day after his lower blues is fairly typical, LIL, and something you have to wait out. You'll start beginning to see a pattern for Kitten. Are you still comfortable with the 1.75U dose, LIL?

Hope you have a good afternoon.

Eva
 
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