? 1/30/18 Bella AMPS 295. Confused

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JanetMR

Member Since 2017
Belka was started back on Lantus . 1 on Saturday evening.1/27/18. She’s had 5 doses.
( held Sunday am dose because her blood sugar was 66. )

She’s on a slightly higher carb diet due to the possibility of ketones.

Her blood glucose levels seem higher than they were off insulin. Except for the lower than normal reading on Sunday. Is this “normal”?

She’s eating fairly well and isn’t her pre diabetes self, but is not lethargic.

I’m assuming I should keep her Lantus dose at .1 and keep checking for ketones in her urine.

Should I keep her on the 6 % carb diet?

Thanks ahead of time!
Janet
 
It could be that the slightly higher carb diet has raised her overall BG level. She could be higher and flat from bouncing and you've captured a fuller picture because you've tested a lot recently. She's shown low levels of ketones before and needs insulin and you've been able to give it. That's progress.

Let's see what the Lantus experts think about dosing.
 
It could be that the slightly higher carb diet has raised her overall BG level. She could be higher and flat from bouncing and you've captured a fuller picture because you've tested a lot recently. She's shown low levels of ketones before and needs insulin and you've been able to give it. That's progress.

Let's see what the Lantus experts think about dosing.

Progress.. excellent. Thanks
It’s hard to tell.
Any suggestions by the experts are appreciated.
 
Progress.. excellent. Thanks
It’s hard to tell.
Any suggestions by the experts are appreciated.
We have to grab onto any tiny thing that's better than it was to keep moving forward. If you don't get feedback from other Lantus folks on dosing my suggestion would be to stick with 0.1 u. A flat run of yellows *can* be a sign of some action ahead. This isn't a rule but something that's frequently observed, hence the heads up.
 
I gave her .1 this morning.
What do you mean by “action”?
If numbers are inflated from bouncing - and I'm not sure Bella's are - it can mean that the bounce is about to break/stop/clear and the BG will fall to levels that are in line with what the dose can produce. You already have a yellow +3 BG only 60 points lower than her AMPS. That doesn't look like a kitty who's ready to dive off the cliff. If she'd been 100+ points lower that might have pointed in that direction.

You forget to put her AM dose on your SS. That's why I asked.
 
The idea is you want to get more food in to her and the slightly higher carb so that you can get more insulin in to her and combat the keytones. There’s probably a little bit of bounce in there, which is to be expected for the most part and is completely normal for many cats. Like Kris said, you are testing more now, so it’s not that she wasn’t having similar numbers (or even higher) without insulin, you just weren’t catching them.

Flat yellow cycles can be indicative of action means you might start seeing some downward movement soon and keep your eye out for it, especially since you’ve said Bella is extra sensitive to low numbers. If you can catch the trend right when it starts, you can bring her up a little bit with food in advance of a drop and try to keep her surfing in slightly higher greens. You can also catch numbers in advance to do something about it so you can shoot insulin consistently. Getting a +10 in both cycles is very useful because it will tell you if she’s going up or down come preshot. Also, if you have a green number at preshot and you are concerned with her going too low or needing to skip the shot, you can bring that number up with food at the +10, so you can (hopefully) shoot a higher number a couple hours later.
 
If numbers are inflated from bouncing - and I'm not sure Bella's are - it can mean that the bounce is about to break/stop/clear and the BG will fall to levels that are in line with what the dose can produce. You already have a yellow +3 BG only 60 points lower than her AMPS. That doesn't look like a kitty who's ready to dive off the cliff. If she'd been 100+ points lower that might have pointed in that direction.

You forget to put her AM dose on your SS. That's why I asked.
Oops
 
The idea is you want to get more food in to her and the slightly higher carb so that you can get more insulin in to her and combat the keytones. There’s probably a little bit of bounce in there, which is to be expected for the most part and is completely normal for many cats. Like Kris said, you are testing more now, so it’s not that she wasn’t having similar numbers (or even higher) without insulin, you just weren’t catching them.

Flat yellow cycles can be indicative of action means you might start seeing some downward movement soon and keep your eye out for it, especially since you’ve said Bella is extra sensitive to low numbers. If you can catch the trend right when it starts, you can bring her up a little bit with food in advance of a drop and try to keep her surfing in slightly higher greens. You can also catch numbers in advance to do something about it so you can shoot insulin consistently. Getting a +10 in both cycles is very useful because it will tell you if she’s going up or down come preshot. Also, if you have a green number at preshot and you are concerned with her going too low or needing to skip the shot, you can bring that number up with food at the +10, so you can (hopefully) shoot a higher number a couple hours later.
Makes sense.
Thanks so much for taking the time to share your expertise.
The challenge with Bella is that she has a poor appetite when her numbers are more
“ normal”. I keep trying new tricks...
 
Makes sense.
Thanks so much for taking the time to share your expertise.
The challenge with Bella is that she has a poor appetite when her numbers are more
“ normal”. I keep trying new tricks...

You are keeping score about this in your head, I’m sure. When their numbers are higher, they can’t make proper use of their food so their body is telling them to eat more (which doesn’t help, but the brain tells them it should). She could feel crummy in normal numbers not being used to them which would contribute to her not wanting to eat as much, and also, the alarm in her brain that says “food, food, food” might just be quieter because she is able to make use of the food she is getting when she is below renal threshold. You’re doing great, keep trying new tricks, as long as she is eating, you can fine tune things when she gets used to the insulin and being in normal numbers.
 
You are keeping score about this in your head, I’m sure. When their numbers are higher, they can’t make proper use of their food so their body is telling them to eat more (which doesn’t help, but the brain tells them it should). She could feel crummy in normal numbers not being used to them which would contribute to her not wanting to eat as much, and also, the alarm in her brain that says “food, food, food” might just be quieter because she is able to make use of the food she is getting when she is below renal threshold. You’re doing great, keep trying new tricks, as long as she is eating, you can fine tune things when she gets used to the insulin and being in normal numbers.

I’m trying to get a perspective on how she’s doing while trying not to have expectations.
Easier said than done.
Thanks again.
 
Should I keep her on the 6 % carb diet?
yes. It’s fantasic that you have 4 consecutive cycles of .01u. I don’t think that would have been possible without extra carbs.

What’s the latest ketone reading?
If it’s ‘trace’ or above I think an increase to .25u is a good idea.

She’s eating fairly well and isn’t her pre diabetes self, but is not lethargic.
all Ps in place?
 
yes. It’s fantasic that you have 4 consecutive cycles of .01u. I don’t think that would have been possible without extra carbs.

What’s the latest ketone reading?
If it’s ‘trace’ or above I think an increase to .25u is a good idea.

all Ps in place?
I haven’t been able to catch her peeing as of yet this morning. ( trying to get ready for a family birthday party that I’m hosting. ) ahh!
She’s acting good..alert/active and appropriately hungry. ( for now)
I’m hoping to check her blood glucose as often as is humanly possible.
 
BG + 9: 331
Urine ketones negative !!

Great for ketones.. her blood sugar ????
Just when I think we are onto something.....
Patience, patience... I know.
Well Done!
Negative is great however that’s just one test. Fingers crossed for a trend. Let’s see if you can get a total of 6 consecutive .01 shots under your belt and maintain negative ketones.

How much does Bella weigh? Has her weight changed up or down since before dx?

Being new to FD and arriving here with the ketone wolves at the door unfortunately makes for an initiation by fire. It is an intensive care situation and does require a shot by shot approach. I strongly recommend you post a new condo daily. That way you are under the radar each day and it’s easier for folks stay up to date.

eta-does that 331 belong st AM+9?
 
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Well Done!
Negative is great however that’s just one test. Fingers crossed for a trend. Let’s see if you can get a total of 6 consecutive .01 shots under your belt and maintain negative ketones.

How much does Bella weigh? Has her weight changed up or down since before dx?

Being new to FD and arriving here with the ketone wolves at the door unfortunately makes for an initiation by fire. It is an intensive care situation and does require a shot by shot approach. I strongly recommend you post a new condo daily. That way you are under the radar each day and it’s easier for folks stay up to date.
I’ll do my best.
Bella weighed in at 10 lbs 13 ounces last Friday. She was about 11 lbs 3 ounces when diagnosed. She was almost 13 pounds before all this started. So she’s lost weight.

Is a condo the same thing as a thread?
I am still learning the site. It’s confusing.

Thanks for the support.

I feel sometimes like I am standing all alone in a big open field with a syringe in one hand and my Bella in the other....
 
Is a condo the same thing as a thread?
I am still learning the site. It’s confusing.
Yes. We call our daily thread our ‘condo’
Thanks for the support.
You are welcome.
I feel sometimes like I am standing all alone in a big open field with a syringe in one hand and my Bella in the other....
just look over your shoulder-we have got your back. Just a click away.
 
Yes. We call our daily thread our ‘condo’
You are welcome.
just look over your shoulder-we have got your back. Just a click away.

Now I’m really confused.
Bella’s BG was 408 this evening ( PMPS). The highest reading that I’ve ever home tested.
She was 331 three hours ago ( + 3)
Should I be concerned??
Remain on current plans? I did give .1 unit
Worried :nailbiting:
 
Well the higher carb food these past 3 days has tipped the scale to where .1u did not send Bella’s BGs into the cellar, allowing you to string 5 consecutive .1u doses.

It looks like she has been eating well and is getting plenty of calories. The next step is to try .25u, continue to feed as you have been these past few days, and see if it will bring BGs into a lower range and maintain negative ketones.

What do you think?
 
Well the higher carb food these past 3 days has tipped the scale to where .1u did not send Bella’s BGs into the cellar, allowing you to string 5 consecutive .1u doses.

It looks like she has been eating well and is getting plenty of calories. The next step is to try .25u, continue to feed as you have been these past few days, and see if it will bring BGs into a lower range and maintain negative ketones.

What do you think?
Sounds like a plan. I will start with the morning dose.
Thanks for responding.
 
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