10/25 MISSY AMPS 339 AlphaTrak

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Maresydotes

Maresydotes

Member Since 2011
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Ok, today is NOT Monday and I am thinking a bit straighter. :oops: Thank you everyone who understood my total brain fart all day! I really don't know what I was thinking. It is a mystery to me.
So, a little recap of my whacked day
:
10/24 155- AMBG
136- AMBG @ +15 mins (and fed :sad: )
Injected 2 units @ +1 1/2 ( massive brain fart on not shooting AMPS)
211- + 2
328- +5
377-PMPS shot 4.5 units
10/25
AMPS 339 shot 4.75
287 + 3

I knew she was going to be higher last night because I shot a reduced dose, late.
I decided to go ahead with thge dose increase from 4.5 to 4.75. Her poor body is probably in shock from what I did yesterday, but I NEED to get her out of those pink numbers. Anyhow, I am taking today very slow, so I don't do a repeat of yesterday.....so I am off and will visit later.
Thank you all for being understanding.
 
Mares,

We're all doing the best we can. I'm sure that everyone of us would do something differently if given a redo. You've got a great heart, the rest is just learning as you go.
 
I don't know if you saw Sandy's post yesterday:
Sandy & Black Kitty said:
For this evening I'm inclined to say stick with the 4.5, remember lantus dosing is based on nadir rather than preshot...let's see what others think as well.

I do think that you need to monitor more closely to determine if this dose is too high,I have a suspicion that Missy has been seeing some low numbers that are being missed. A lot of the pink may be bounces. You need to determine if they are and how long they last..

See how the numbers go the rest of today. If she bounces and her shed gets angry enough from the missed shot and she is very high, you may be able to rest tonight. However I strongly encourage you to get at least a +2 and a +10 or +11 before tomorrow AMPS. This will be valuable data and may let you know if you have to be on your toes tomorrow.
Click to expand...

The bold is mine.

Realistically, when can you test? There is a huge need for PM testing. Given the dose that Missy started out at, it's possible that her dose has been too high all along. No matter if you stick with your current dose and wait for a breakthrough or reduce the dose (essentially starting over), you have got to get at least one test per cycle. There's an indication that Missy is bouncing but without some of the PM tests (e.g., on 10/24 the AMPS resulted in a bounce by PMPS), there's not a way to tell.

Also, when you shot at +1.5 yesterday, was your next shot 12 hours later? How have you adjusted for the late shot?

Just a word about how Lantus works. You really can't used Lantus to hammer down a high number. It's a gentle, long acting insulin. It doesn't work like it's shorter acting cousins that yank down numbers. It's method of action is entirely different.
 
Sienne,
Yes, I did adjust her times to make up for shooting late.
I did see Sandy and Black Kitty's post about sticking with the 4.5 units last night. That is what I gave her on her PM shot.
I really am hard pressed to do PM tests. DH is not really not the hands on. We have discussed it, but I don't honestly think he is going to help me with it unless I absolutely cannot. I can probably do a +1 and +2 with a little effort. Anything else is going to be hard. If I don't get adequate sleep, I am in a brain fog (like yesterday, unfortunately). Sleeping in small doses is ok for a short time, but I can't sustain it. I can try to get some +10 and + 11, but it will be difficult. I can make a point to sleep on the couch once in a while, like I did a while ago, but I don't know if I can even do it once wek. I can TRY.
I do understand that Lantus is slow acting. I guess that is why I was sort of confused yesterday. That was her 5th day on that dose and she had not shown me anything but pink numbers with a very few yellows sprinkled in. I am not trying to be obtuse, but do you really think on a day when I got 8 tests in and the lowest was 289 that she dipped into blue numbers and bounced to pink? If it is slow acting how would I miss the blues when I checked on average every 3 hours? I really have to defer to your knowledge, but I thought by looking at all the pinks in her SS I could not have missed a blue. Maybe at night, I will give you that....will a cat really dip into blue numbers and go back to pink in a couple hours time?
I struggled with the thought of starting over for a while. I discussed it with Jessica and Boo Radley a bit. I mentioned it to my vet, I posted on the board......there was no consensus....I contacted Dr. Lisa about a phone consult to help me make up my mind, but financially, that would be really stretching it with my DH. I am afraid of what all these high numbers are doing to her body. She still drinks and pees more than she should. I know she doesn't feel as well as when she was in remission. I was almost paralyzed about making a decision. I tried to get some decent data before I did anything. I realize what I have isn't as good as it should be, but it is pretty much what I can do.
I will admit, I have kind of backed off her the last few days, testing wise. Her ears are getting sore, even though. Use neosporin. My civvie cat is jealous of the attention she is getting and he is really quite mean. He will do a full body jump on her all teeth and claws out of literally nowhere on her. I spend a big chunk of time trying to keep off of her. I am sure the stress of watching for him isn't helping her.
The other reason I didn't drop down her dose, is that she achieved remission when she was on 3 units, so I thought if she wasn't getting better numbers at 3 units this time, but was getting worse an increase was justified.
What do I expect if I would decrease her dose? I don't want to wreak havoc on her body and she has already been too long too high.
I am so open to ideas and suggestions, but since what I had been hearing was divided, I made the choice to go to 4.5. I hope you understand how confused I am and how badly I want to do the right thing for her. I know she can remit....or at least get under control if she did it once and for months..... I just want to cry because I don't know which way to turn.
So, what is the absolute minimum PM checks I can make and get good data? Do I really not have enough information to make a decision with what I have the past week or two? She doesn't have a clear nadir, as far as I can see. She looks like she is pretty flat, to me. Can I get the info a little at a time....one night +2, one night +6 ,etc.

What can I do to help her poor ears? You can see places ( I poke her on the hairless side) where I have poked and they
are reddish and kind of a bump. I alternate ears every time, but poking her 8 times a day is 4 in each ear, there isn't that much room!
ok...so sorry for going on and on. I am just trying to illustrate my dilemma. I am so stressed right now I have been breaking out in hives. Anything you can help me with is greatly appreciated.
 
Mares --

All we really think is needed on a regular basis is a test before you go to bed -- the infamous "before bed test." There will be times that you will need to test more but that's if Missy is giving you low numbers. We're not trying to jeopardize your health. I don't know where in the cycle you call it a night. A +2 may give you a hint as to where the cycle is going. If you are able to adjust shot times so you can get a test later in the cycle, that would be great. It will also give you a buffer if you need to stall. Be aware that if your +2 is considerably lower than your pre-shot, it may indicate an active cycle and some additional tests would be needed.

As for whether numbers can change dramatically in the space of a few hours, you betcha! Gabby has gone from a pre-shot in the 400s to a drop into the 40s and back into the 400s by the next pre-shot. And she's not the only kitty that's done this. Look at 8/12 on her SS for #s in the 30s and a bounce to a high pink. The other consideration with a bounce is that it can take 72 hours for it to clear. So, while you may have seen a pink and yellow cycle, it may have been you were seeing the continuing effect of some bounciness. You don't want to increase the dose during a bounce because it may put your cat over what would be a good dose.

As for your civvie, I'd suggest giving treats as often as you give them to Missy. Gizmo expects a treat every time Gabby is tested. He also gets special time that's his alone.

It's not necessary to drop the dose. There's no absolute correct decision here. It's possible that numbers will get better but it's possible that numbers will stay where they are. Either way, you'll have to test.
 
oh mares, i'm feeling for you!

you can get tests at different times during the night and they will show a pattern. it doesn't have to be all in one night.

from what you've said before i think you sleep about 12 hours a night, is that right? i think that's what sienne's asking you. if you're sleeping 12 hours a night then you are getting pre-bed tests. other than sleeping on the couch, can you occasionally set an alarm to get up 4 or 6 hours into her cycle to test? not every night, perhaps once a week.

you can only do what you can do - you can't jeopardize your own health to take care of her - where would missy be if you have a health crisis? MS is nothing to fool around with - you absolutely must take care of yourself first or it may progress on you. you have to come first in this.

the bumps on her ears - do you apply pressure with a tissue for a few seconds after the test? i noticed with punkin that it makes a difference in the formation of bruises or bumps post-test. try applying pressure a little longer than you have been and seeing if that helps.

i've had hives many times in my life - that tells me how bad things are going for you. they are a nightmare. and there's little to be done about them except for me, taking drugs that knock me out completely.

remind yourself of the famous Lantus Land Quote - it's a marathon, not a sprint. you have to take care of yourself.
 
Hi guys .. I don't have much advice as far as how the dosing should be handled but I can certainly sympathize with you .. I think all of us can .. we've all been there, been totally exhausted, frustrated and beyond emotional .. I have no shame in admitting there were several days mocha's numbers brought me to tears, simply because I didn't understand them AT ALL .. But I always had to tell myself the next day was a new day and things would be better .. and if it wasn't? Well .. that's what they make chocolate bars for :lol: Hang in there guys .. :YMHUG:
 
just thinking more about your situation - do you have a timed feeder? what's missy's food situation - when are you feeding her and is she eating at night?
 
Thank you so much for the moral support!

PeterDevonMocha, I can so understand crying over numbers!! I have Halloween candy, maybe I need to break it out for myself!
Julie,
Do timed feeders work with wet food? I don't have one. She gets her big meal at AMPS, with a few small tastes through the day. Then another big (relatively speaking...I have to watch her weight) meal before the PM shot. Usually she has something left I the bowl before I go to bed to snack on during the night. It is hard, because up to now, she ate her EVO and Phoenix had his food and they didn't cross feed. But he decided to go over to the EVO :roll: , so now I have to watch intake levels much more closely. If I leave food out at night, I can't be sure Missy is the one who is eating it, anymore.
How long do you hold Punkin's ear after the pokey? I do it for a few seconds, but she isn't a big fan of it. I am thinkig of going to a finer lancet. I think I am using 28 gauge right now.

Sienne,
I do always give Phoenix treats when I am testing her. He is right there with us. He is my behavioral problem child as Missy is my health problem child :lol: . He has always been rough with her, but somewhere along the line they had a falling out and she prefers to avoid him. The totally unexpected, unprovoked attacks (she can be dead asleep on the
couch) had been happening before FD. It is just worse now. A lot of it is frustration....he doesn't to it well. I tried
Feliway, I try to give him 'special' attention... He is just an a*s. (but a sweet one, to us)
I certainly didn't realize they could drop so fast and pop back up so fast.
Well, I certainly have lots to mull over....I haven't really been posting the last couple days. Had stuff to do and I just needed to take it slow and get some perspective. I was totally immersed in her and FD (and trying to figure out where Phoenix was getting out of our fence! Lots of coyotes around here. I don't want him out of the yard!)
Thanks so very much!
 
i hold his ear for probably 5 seconds after a poke.

timed feeders do work with canned food. you can mix a can of cat food with water and then freeze it in muffin tins. people call them "pucks." you can also just put canned food in the feeder and it will be ok for 12 hours.

could you tell us what time you get up, what time her shots are, and what time you go to bed? maybe that would help with ideas.
 
Julie,
My DH is on second shift so I do her testing and shots at 10:30am and 10:30pm. (which is when I get up and go to bed, basically) I do sometimes stay up after her shoot, so I can get numbers on those days, but do +1 and + 2 tell you much? That is why I haven't tested , in the past, on those days. (besides her poor little ears). I figured between shooting and eating, I would not be getting much usable info at those times. I can do the alarm thing or sleep on the couch to get +10s and +11s. I can see those times being pretty useful. I just know I can't do it every day.
That is why I was so whacked Monday. I was worried about her being lethargic, had lots of running around to do...I get scattered. I try to have my AMs all set up and ready so I can do the testing, feed shoot on ' autopilot' because they don't let me have coffee first. ;-) The lower number threw me for a loop, because 1. It was totally unexpected 2. I wasn't fully conscious :smile:
The reason for the feeder is to give them food during the night, correct? I am around during the day, for the most part, so no need for it then. That is to stave off a hypo incident, right? Again, though, I have no guarantees as to who will eat it, although Phoenix tends to come upstairs when DH does.
I am not sure I am getting 5 seconds on the ear. I will pay attention. Do you use the neosporin before or after the poke?
I will be back in a bit, but I have to go tail my brat boy and see if I can figure out how he is getting out of the yard. It
has been 3 times already in the past 4 hours. At least he comes to the front and asks to come in, but he just has no need to roam when he has 1/2 to play in that is safe and fairly 'wild'. Here is a link to a couple second video of him bringing me a leaf. He does it all the time....weird little boy. You can see a few of the other leaf presents he has brought us in the grass. They are Big Leaf Maple leaves and sometimes all you can see is a leaf and a cat body trotting up to the deck :-)
Thanks for all the effort into my girl!

http://www.youtube.com/watch?v=TxrJj5Ol ... ata_player
 
all of those tests are valuable - the +2 tells you what direction the cat's BG is headed. in an ideal world with a perfect lantus curve, the +2 would be the same as the preshot. if it's significantly less, that tells you that missy may be dropping quickly. if she's dropping and bouncing, the +2 test might tell. can you get the +2 for a few nights in a row? if she's got a significant drop, she has to be monitored to make sure she doesn't go hypoglycemic. Sienne's Gabby isn't the only cat that drops fast - Marjorie's Gracie, Michelle's Mannie and Ann's Tess all do that some of the time, so it's not like it's rare.

same thing with the +10 in the morning - that would give you a number that when you get to the preshot that lets you know if the preshot number is a rising number or falling number. it makes a difference. those +2s and +10's don't have to be on the same days.

are you ever able to sleep on the couch, set a cell phone alarm so you can test and then go right back to sleep, or is that a bit of Hell for you?

so it sounds like missy is regularly going 12 hours without food at night - is that right? that's too long for any diabetic cat. can you freeze some watered down cat food and give it to missy every night until you get a feeder? if you don't think she would get it, i'd separate the cats at night so she for certain gets the food. for tonight until you get some frozen, just separate the cats and leave her food out.

i think you have to put aside worries about her ears. the worry about her dose is more important. cats always get their ears torn up when they are in fights, and it's far more important that you test and keep her safe from hypoglycemia than it is that her ears be untouched. there's no science about the neosporin - i actually slather it on some nights when i'm done for the day - maybe you're not using enough. the numbing seems to last for a while though. it doesn't work to put it on right before a test because it goos up the strip. either put it on after the test or at the end of the day.

sandy, sienne, jill, libby & laurie are all the people who really understand Lantus and how it works best. You want to follow their advice to a T. :-D

ps, your brat boy made me laugh hiding behind his leaf like that! he thinks he's a dog!
 
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