1/5 Gobbles AMPS 419 - Emergency?

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Wendy&Tiggy said:
At 6 weeks old, the lantus should be fine as long as you have been treating it gently, no shaking the bottle, it doesn't have particles or cloudiness, and you keep it in the fridge mostly. If so, it can last for up to six months.

I am hoping you aren't getting your syringes from the vet, cheaper to use the American diabetes wholesale or Walmart links provided on this site.

Testing your glucometer against his is a good idea, more for his sake than yours, because then he knows where you really are with the numbers when you show him your spreadsheet.

By Monday you will have data with your new meter for a few days, and probably a recommendation on a dose change at that point from the experts here, so you will have info to tell him!

You are doing a PMPS and PMPS +2 tonite yes?
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PMPS is 342 and yes, I am planning on getting a +2 tonight but won't post it tonight because I have to shut down my laptop here shortly and basically just am setting a timer to make sure I'm up in 2 hours....will post when I get up...lol...I got the syringes from the pharmacy when I originally had his lantus filled...I don't remember how much they cost as I basically picked a CC when they rang me up. I do remember the cost of the lantus -- $136.00 -- I called around and that was the cheapest I could find out of 8 drugstores (with the highest being $164.00) 342 worries me (I should be worried, right?) but I made sure it was NOT a furshot tonight!
 
hi there!

I wanted to chime in on dosing. We would really need for you to get some evening spot checks before suggesting a dose change. Most likely Gobbles can handle more insulin, but without knowing for sure whether he is dropping at night, I wouldn't be comfortable suggesting an increase. Also, if you had a fur shot last night, we usually suggest waiting a few cycles after that so we can be sure he isn't going to drop again when his insulin depot refills.

Can you get some PM tests? At the very least, most of us get a test right before we go to bed, which for most of us works out to about +3 or +4. Then we can talk more about dosing.

I have another question - for the last few days your spreadsheet says the dose was 1.00f. So on 1/3 you increased his dose just a little bit, then possibly missed all or part of his shot on 1/4, is that right? If so, then I would definitely wait a day or two before thinking about increasing his dose anyway. While you're waiting, work on getting some evening tests so we can have a more full picture of what is going on.

Did he get a shot on 1/2 PM? Spreadsheet is blank there.

Sorry for the questions, but your answers will really help. Those of us who study spreadsheets a lot have "trained" our eyes to see certain patterns. Missing the PM data makes me feel blind. :smile:
 
Good news on no ketones.

His insulin depot could be low from the fur shot, so it could take a day or two to build up again and so bring him back down into better levels . So we need to wait to see what happens first before recommending a dose change.
 
You will need to handle your vet carefully. Our vet has come to realize that she cannot offer dosing advice like we can get here and doesn't try. I think most vets just shoot from the hip with dosing advice because they really don't know. I would probably just nod in agreement with whatever he/she says (they wont remember anyway) and then do what I think is best at shot time, i.e., what is recommended here. :-D
Liz, Zener's other mom
 
I want to also chime in with what Libby said (and she has some of the best SS reading eyes in LL). The higher numbers you see during the day could be because he's going lower at night. He might not be going very low, but lower than what his liver deems is safe.

Forgive me if I am reiterating anything you've been told, but when they are dx with diabetes, the BG has probably been fairly high for a bit. The liver adjusts to those numbers as the "new normal". When you start giving lantus and the depot fills and numbers start to come down, the liver gets a little panicky and releases counterregulatory hormones to bring the BG back up. We call this a bounce and we suggest you ignore those numbers.

It can take up to 72 hours for the bounce to clear so we can see the actual nadirs. So, if your vet looks at the SS and sees he is 300 at +4 on a bounce day, he might want to increase the dose. But we don't base dosing decisions off one cycle or one number. We are looking at several cycles and we wait for the bounce to clear to see where he really is.

Thus Libby's great suggestion for you to get a before bed test.....that let's us know which we he is headed. And if you are up by +10 or +11, grab one then because we can see if he's on his way up or down by shot time.

I would not raise his dose without knowing what he's doing at night. You don't want to take a chance of overdosing him.
 
Anne & Zener said:
You will need to handle your vet carefully. Our vet has come to realize that she cannot offer dosing advice like we can get here and doesn't try. I think most vets just shoot from the hip with dosing advice because they really don't know. I would probably just nod in agreement with whatever he/she says (they wont remember anyway) and then do what I think is best at shot time, i.e., what is recommended here. :-D
Liz, Zener's other mom
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Good advice! I've been told three times by my vet now to "just test him every few days as +4 and we will increase to 2. U if it is over 300". I didn't realize that he "won't remember anyway" as some doctors do! He did tell me that the Lantus keeps 2 months or more and to gently roll it before giving the shot; should I be doing that? I looked just yesterday and did not see any "floaties" in it...
 
Libby and Lucy said:
hi there!

I wanted to chime in on dosing. We would really need for you to get some evening spot checks before suggesting a dose change. Most likely Gobbles can handle more insulin, but without knowing for sure whether he is dropping at night, I wouldn't be comfortable suggesting an increase. Also, if you had a fur shot last night, we usually suggest waiting a few cycles after that so we can be sure he isn't going to drop again when his insulin depot refills.

Can you get some PM tests? At the very least, most of us get a test right before we go to bed, which for most of us works out to about +3 or +4. Then we can talk more about dosing.

I have another question - for the last few days your spreadsheet says the dose was 1.00f. So on 1/3 you increased his dose just a little bit, then possibly missed all or part of his shot on 1/4, is that right? If so, then I would definitely wait a day or two before thinking about increasing his dose anyway. While you're waiting, work on getting some evening tests so we can have a more full picture of what is going on.

Did he get a shot on 1/2 PM? Spreadsheet is blank there.

Sorry for the questions, but your answers will really help. Those of us who study spreadsheets a lot have "trained" our eyes to see certain patterns. Missing the PM data makes me feel blind. :smile:
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Actually, I increased his shot PM 1/2. I did give him a 1.00f shot on 1/2 PM; just forgot to type it in. I appreciate all of the answers. I've updated his SS; can you take a look? Sorry I could not get a PM +3 or +4 but I did get a PM +2. I have slowly moving his shot time up because I have to go to Cleveland tonight and pick my daughter up from the airport (ETA 7:58); if the plane lands on time it would be at least 10:00 p.m. before I get home. Last night his PM shot was at 9:45 so this morning I will do his shot at 10:00; then hope I am home by 10:15 p.m.
 
Wendy&Tiggy said:
Good news on no ketones.

His insulin depot could be low from the fur shot, so it could take a day or two to build up again and so bring him back down into better levels . So we need to wait to see what happens first before recommending a dose change.
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Sounds like a plan!
 
Marje and Gracie said:
I want to also chime in with what Libby said (and she has some of the best SS reading eyes in LL). The higher numbers you see during the day could be because he's going lower at night. He might not be going very low, but lower than what his liver deems is safe.

Forgive me if I am reiterating anything you've been told, but when they are dx with diabetes, the BG has probably been fairly high for a bit. The liver adjusts to those numbers as the "new normal". When you start giving lantus and the depot fills and numbers start to come down, the liver gets a little panicky and releases counterregulatory hormones to bring the BG back up. We call this a bounce and we suggest you ignore those numbers.

It can take up to 72 hours for the bounce to clear so we can see the actual nadirs. So, if your vet looks at the SS and sees he is 300 at +4 on a bounce day, he might want to increase the dose. But we don't base dosing decisions off one cycle or one number. We are looking at several cycles and we wait for the bounce to clear to see where he really is.

Thus Libby's great suggestion for you to get a before bed test.....that let's us know which we he is headed. And if you are up by +10 or +11, grab one then because we can see if he's on his way up or down by shot time.

I would not raise his dose without knowing what he's doing at night. You don't want to take a chance of overdosing him.
Click to expand...
I am not at all sure about the fur shot ; and hope the numbers are from that; say, for example, the shot was definitely given, and the numbers that are presently on his SS were the same as if he DID get a shot; what may that point to?
 
TheBowHuntress said:
Libby and Lucy said:
hi there!

I wanted to chime in on dosing. We would really need for you to get some evening spot checks before suggesting a dose change. Most likely Gobbles can handle more insulin, but without knowing for sure whether he is dropping at night, I wouldn't be comfortable suggesting an increase. Also, if you had a fur shot last night, we usually suggest waiting a few cycles after that so we can be sure he isn't going to drop again when his insulin depot refills.

Can you get some PM tests? At the very least, most of us get a test right before we go to bed, which for most of us works out to about +3 or +4. Then we can talk more about dosing.

I have another question - for the last few days your spreadsheet says the dose was 1.00f. So on 1/3 you increased his dose just a little bit, then possibly missed all or part of his shot on 1/4, is that right? If so, then I would definitely wait a day or two before thinking about increasing his dose anyway. While you're waiting, work on getting some evening tests so we can have a more full picture of what is going on.

Did he get a shot on 1/2 PM? Spreadsheet is blank there.

Sorry for the questions, but your answers will really help. Those of us who study spreadsheets a lot have "trained" our eyes to see certain patterns. Missing the PM data makes me feel blind. :smile:
Click to expand...
Actually, I increased his shot PM 1/2. I did give him a 1.00f shot on 1/2 PM; just forgot to type it in. I appreciate all of the answers. I've updated his SS; can you take a look? Sorry I could not get a PM +3 or +4 but I did get a PM +2. I have slowly been moving his shot time up the last few days because I have to go to Cleveland tonight and pick my daughter up from the airport (ETA 7:58); if the plane lands on time it would be at least 10:00 p.m. before I get home. Last night his PM shot was at 9:45 so this morning I will do his shot at 10:00; then hope I am home by 10:15 p.m.
Click to expand...
 
What is going on in his body when his BG is high (say, for example, constant numbers between 200-400)? For more than a day? Potential damage? (His urine output has always been excessive since before his DX since he drinks more water than usual)
 
There's a difference with regard to the effect of high numbers for a few days vs. a few weeks. The longer term effects of uncontrolled diabetes are hard on the kidneys, in particular. It's why you'll see us mention "renal threshold" on occasion. Ideally, you want your cat to be well-regulated and in normal numbers or as close to the 50 - 120 range as much of the time as possible. If your cat doesn't agree with that plan, keeping the numbers below the low 200 range will be below renal threshold (at least for most cats).
 
Sienne and Gabby said:
There's a difference with regard to the effect of high numbers for a few days vs. a few weeks. The longer term effects of uncontrolled diabetes are hard on the kidneys, in particular. It's why you'll see us mention "renal threshold" on occasion. Ideally, you want your cat to be well-regulated and in normal numbers or as close to the 50 - 120 range as much of the time as possible. If your cat doesn't agree with that plan, keeping the numbers below the low 200 range will be below renal threshold (at least for most cats).
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If you look at his SS, I assume he's basically been over the renal threshold since he was diagnosed?
 
Not really. The numbers have fluctuated. I wouldn't get all twisted up with what was. You can't do anything about that and all of our cats were diabetic before we knew that was the case. All you can do is go forward and do what you can to keep Gobbles in healthier numbers.
 
Sienne and Gabby said:
Not really. The numbers have fluctuated. I wouldn't get all twisted up with what was. You can't do anything about that and all of our cats were diabetic before we knew that was the case. All you can do is go forward and do what you can to keep Gobbles in healthier numbers.
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One other symptom: His hair was somewhat shabby and looking a little thin when he was dx. His hair is thinning on top of spine near tail base, flanks and behind ears. I was "told" by someone that thinning hair is not a symptom of diabetes....any thoughts on that?
 
Changes in coat, they way you're describing it (i.e., hair loss), isn't a symptom I've heard others describe. What may be a possibiity is that given the weight loss that often happens with FD, there's the possibility of some kind of nutritional imbalance that would effect Gobbles' coat. If your vet can't sort out what the cause is, maybe consultation at a vet school (dermatology, endocrinology?) might be a thought.
 
Sienne and Gabby said:
Changes in coat, they way you're describing it (i.e., hair loss), isn't a symptom I've heard others describe. What may be a possibiity is that given the weight loss that often happens with FD, there's the possibility of some kind of nutritional imbalance that would effect Gobbles' coat. If your vet can't sort out what the cause is, maybe consultation at a vet school (dermatology, endocrinology?) might be a thought.
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He has had a lot of dander, in fact, I brushed him this a.m. and there are a LOT of little white flakes (but not due to fleas as he has no fleas and was treated a few weeks ago (advantage flea) for his monthly flea treatments.
 
Cat dander is common with diabetes. As he becomes regulated it will get better. Tiggy gets it too.

High BG levels do damage the organs over time but it takes a while and hopefully we can get him controlled soon. Plus he has been getting occasional breaks from high numbers if you look at his SS.

Keep testing, it is interesting his BG has increased yesterday, let's hope it comes down again soon .. He isn't usually this high even if you consider meter differences so I wonder if he is bouncing off of a green from the 4th.
 
Wendy&Tiggy said:
Cat dander is common with diabetes. As he becomes regulated it will get better. Tiggy gets it too.

High BG levels do damage the organs over time but it takes a while and hopefully we can get him controlled soon. Plus he has been getting occasional breaks from high numbers if you look at his SS.

Keep testing, it is interesting his BG has increased yesterday, let's hope it comes down again soon .. He isn't usually this high even if you consider meter differences so I wonder if he is bouncing off of a green from the 4th.
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AMPS = 359
 
Ok good - he is coming down a bit... could still be after effects of a furshot too and the depot could be building.

Remember now to create a new topic (we call them "condos") ie 1/6 Gobbles AMPS... and do the quick update on how gobbles is doing today plus a link to yesterdays condo (this one!)
 
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