10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15 72

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phlika29

phlika29

Member Since 2014
Hi everyone

Remi has been on lantus and has been getting good numbers the last few days on 1.25 twice a day. Tonight he has gone into the greens and I could do with some urgent advice.

His nadir is usually between +6/7 and at +5 is is at 67. He last ate his normal food at +4. Do I try to steer him with his normal food now or do I wait and give him high carb food if he goes below 60? I am not sure how much the normal food raises BG.

Come tomorrow morning if he isn't bouncing does he earn a dose reduction?

Here is the thread I started on relaxed lantus (where I normally post)

viewtopic.php?f=32&t=127467
I have the hypo sheet printed out in front of me.

Any help gratefully received.

Sarah
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

Hi Sarah, since you are using a human blood meter, the reduction point we use here for tight regulation is numbers below 50. I'd give Remi a couple of tsp of his regular low carb food. That can help cats "surf" the green. The more time he spends in green, the better for pancreas healing.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

Many thanks Wendyi will give some more of his regular food.

I have another question if give the food and this keeps his blood glucose up how do you know he wouldn't have gone below 50 and earned a reduction? What worries me if this happens when I am back at work I won't be about to check.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

The only thing I'd add to what Wendy suggested is to test at +5.5 or thereabout. When a kitty is dropping, it's sometimes helpful to test every 30 min. so you can know whether or not to intervene with HC food. Right now, try with LC first and retest sooner rather than later.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

Sienne and Gabby said:
The only thing I'd add to what Wendy suggested is to test at +5.5 or thereabout. When a kitty is dropping, it's sometimes helpful to test every 30 min. so you can know whether or not to intervene with HC food. Right now, try with LC first and retest sooner rather than later.
Click to expand...

Cheers. Remi has just finished eating and will retest him in a minute.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

I agree with what Sienne suggested about testing sooner than later. You don't want to wait much longer to test. Hopefully the LC food will help to bring up Remi's #s. Good luck!
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

I just retested at +5.45 and his level has dropped a little more and is now 3.5/ 63. I literally tested it about two minutes after he finished eating. Shall i give him a little more of his lc food?
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

Test him again in about 15 minutes. It could be that the food didn't have much time to go through his system just yet.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

Ok. I just gave him a couple more teaspoons and will retest in 15 mins. Cheers
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

good luck sarah. so glad you have all these experienced people to guide you
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

I usually wait 20-30 minutes after feeding to test. It can take that long for the food to hit the blood stream. And of course ECID, some kitties take longer than others. I wait a shorter amount of time if Neko is really low, but as long as he's above 50 you can wait 30 minutes after food. This will also give you good data on how well the low carb works to bring Remi up. That information, and an automatic feeder can give you some peace of mind on the days you are away.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

tibbs5 said:
good luck sarah. so glad you have all these experienced people to guide you
Click to expand...

Thanks Nadine and the same for you. :smile:
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67

Wendy&Neko said:
I usually wait 20-30 minutes after feeding to test. It can take that long for the food to hit the blood stream. And of course ECID, some kitties take longer than others. I wait a shorter amount of time if Neko is really low, but as long as he's above 50 you can wait 30 minutes after food. This will also give you good data on how well the low carb works to bring Remi up. That information, and an automatic feeder can give you some peace of mind on the days you are away.
Click to expand...

Cheers Wendy. I will retest in about five minutes and then post up. Have just ordered the timed feeder and my partner is off work next week to help test remi.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Right his reading at +6.15 is 72/4.0. So the food raised him about 10 points. He seems happy enough.

Do I need t take any further readings or should I just give him a little more of his normal food. He seems to peak about now.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

I'd test him again at +7, just to be sure. I'd try going without food this time to see if he's holding steady.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Hi - I will only be on her for a few, but but thought I'd add that I'd test again in 30, maybe 60, to make sure the surf is set, sometimes then can drop again. I agree with what Wendy, and the others, posted. Good luck!
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Thanks you two. Will test at +7 and give no food in between
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Could you remove the 911 now? Once you've got the help you needed, we suggest that you remove it. Thanks.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Sorry yes have removed the 911.

His +7 is 4.4 /79 :-D
Thanks everyone for their help and support. Now I have been through it once I will be more confident in steering his numbers with food.

I guess he may bounce tomorrow. But hopefully not too badly.

Many many thanks

Sarah and remi
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

More often than not they typically bounce after an episode like this. Just go about your daily routine and know that this is experience that you've both shared. You both did a wonderful job this evening! :-D
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

great job keeping your cool and handling the numbers, sarah.

If Remi had actually gone below 50, you would've wanted to press the gravy out of the high carb canned food and feed only gravy at first. most of the carbs are in the gravy.

Here are the directions for Handling Low Numbers. That post is divided into 3 parts - first is how to become data-ready to shoot low, meaning to shoot the full dose into normal numbers. That's the path to getting a cat tightly regulated, and hopefully off of insulin. The second part is what to do if you are faced with a low preshot number. The third part is how to handle low numbers (under 50) when you need to bring the cat's blood sugar up into a safe range.

Just observing a couple of things on his spreadsheet that indicate progress.
......He's now 3 days without any pink.
......His pmps tests have dropped from higher numbers into blue numbers.
......You saw green in both cycles today.

I think you want to mentally gear up for the opportunity he's going to give you to shoot low. Read the link I posted above, especially the first 2 parts. Also, here is another post from a recent conversation about Shooting Low. Looks to me like Remi is going to give you that opportunity, so be prepared so you can take it.

sleep well!
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Morning :-D thanks for everyone's help last night.

This morning remi hasn't gone too high and is still in the blues so not sure if you would say its a bounce or not.

AMPS 130 (fed 20g thrive)
+2 121 (fed 20g thrive)
+4 106 (fed 20g thrive)
+5 113 (likely to be affected by the food an hour before)

I have family down and so won't be able to get as many readings this afternoon but the cycle to me looks nice and flat.

Julie thanks for the comments and advice. I will make sure I go over the shooting low notes a few more times and will print out the conversation you linked. I want to be ready and think I will be able to handle giving it to him low since I survived last nights experience with the help of you all. My main concern is that during the day if no one is home even when food has been left down remi will just not get out from under the duvet to go get it. I guess if his blood glucose gets low enough he will seek out food, at least I hope he will. He is pretty much deaf and won't hear the automated food thing open either. If it comes to it I will just find a way of checking in on him myself and giving him food.

I am really pleased that he is levelling out in the blues. Going on the last few days does it look like he is on the right dose? My other question is because I fed him last night he didn't drop lower than the 50 and hence didn't earn a reduction-but if I hadn't fed him he might have done. So how do I know he isn't on too high a dose. Or should I look at it differently-even with food he went below fifty and hence earns the reduction. Thinking about it I guess I might have answered my own question :lol:

Thanks everyone

Sarah
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

I use food to keep Gabby surfing in good numbers and prevent her from "earning" a dose reduction. That's a different way to think about things!!

If you're concerned about Remi not eating if you're not around to let her know that her bowl is full, you could leave food in the same room where she's hanging out. I'm not sure if that will help or not. Frankly, I'm never sure if Gabby gets up to eat when I'm gone either. (She likes her beauty sleep!) The bowls are empty but Gizmo is not shy about eating.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Since he is deaf, you might look for something that vibrates on a timer, rather than making a sound per se.
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

If he really needed a reduction, giving him a bite of low carb food wouldn't have prevented it.

He doesn't look like he's bouncing. I see normal curves in each cycle right now. That 252 early this morning may have been the last-gasp-protest of his liver before it's accepted the normal blood sugar range as normal.

Now you have another "red flag" that his pancreas is healing. His amps just came down almost into normal numbers.

The typical process of cat that's becoming regulated (and hopefully on their way OTJ) is that the nadirs come down into normal numbers first. Then the pmps comes down. Last is the amps - it's influenced by Dawn Phenomenon.

You're also seeing his cycles flatten out into more of a line this morning than a curve. That's Lantus at its best.

You're going to be faced soon with deciding what to do when you go to work and have to leave him. I'm not sure what to suggest, but i would say you don't want to shoot low and then leave him until you have confidence in how his body will respond by having that data gathered while you are home and testing. If there is any way you can get a +2 before you go to work, that would give you an idea of what he might do. Think about any friends you can call on to check him while you're at work, or figure out how you can come home and check his blood sugar. Consider if you may be able to leave him some higher carb food if you're worried.

I can't solve it for you but want to raise the issue for you to try to figure out what you can do. It looks like in spite of working, you get lots of tests in. He looks great! All of this time spent in healing numbers (50-120) is good for his body!
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

Thanks julie

With the aid of the changing clocks I have just made it so remi is injected at 6am and pm. This should make it easier to get more tests in both before work and in the evening. So I will try to get some +1 and +2 for the next few days to build up more data and then perhaps drop to +1 before work. He was a little tonight but still in the blue levels.

10/26
AMPS: 130
+2: 121
+4: 106
+5: 113

PMPS: 191
+1: 180
+2: 162
+4 137

I am lucky in that my partner has mastered taking remi blood glucose too and he works different hours than I do. He is usually at home until the afternoon and so can keep am eye on remi. I would have to direct him if he went low but that's okay. My is only up the road and has always been good at helping with remi but she has not as of yet taken a blood glucose reading but I guess she could learn too :-D

I had never heard of the dawn phenomenon. Hormones have always been an area of study that I found most confusing, so complicated. I did a degree with the Open university and you can actually do a course online just on diabetes.

So I am hoping that this week if we hold this dose we will begin to see even lower numbers and he spends even longer in the normal range and if not I guess I might have to increase the dose slightly.

Many thanks

Sarah
 
Re: 10/25-remi urgent PMPS 157, +2 106, +4 76, +5 67, +6.15

sounds like a great plan, sarah! between you, your mom and your partner you've got a whole team to help Remi stay safe.
 
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