10/5 Kitty Rabbit PMPS 342, +2 (344)

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Christine & KR

Christine & KR

Member Since 2012
Hi, all! Last night Kitty Rabbit got her first shot of Lantus from me (she'd had one Humulin N shot from the vet a week and a half earlier). I did not test at all after the first shot figuring I needed to give the insulin some time to work before I started poking Miss Grumpy in the ear more than I normally do.

This morning her AMPS is 193. I've read in numerous places NOT to shoot (at least as a newbie) below 200. I'm waiting 15 minutes to test again and see what's happening. If she's over 200 in 15 minutes (or at least climbing in that direction) do I shoot a reduced dose? I was directed to do 1u BID. If her number's over 200 should I go with .5u?

Thanks,

Christine

(Edited to correct subject line to correctly reflect shot)
(Edited again to add +4.5. Any help will be appreciated!)
(Edited again to update bg history for the day and add the date)
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Welcome to Lantus Land! ~O) ~O)

Sorry I don't have dose advice (still too new to Lantus). Just wanted to welcome you and Kitty Rabbit. cat_pet_icon
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Are you going to be home today? Do you have lots of test strips, low carb food, and high carb food if needed?
You can shoot a 193 if you will be around to monitor her.
 
Re: Kitty Rabbit PMPS 380, AMPS 193

FYI: When you put AMPS in your Subject Line that means you shot the insulin, so I would change that to +12 193, for now, until you give the insulin. Did you give the insulin?

You can, I think give her 0.50 units, and make that your regular dose to start with, and see how she does with that dose. Can you get some mid-cycle tests in today?
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Dyana,

I'm going to be home and I have all the supplies. However, I'm watching the time, knowing what shot schedule we need to be on for me to make it to work on time, and we're at the end of my shot window. I can shoot, but it's going to make the next couple days difficult.

If I shoot, how much? Full dose or half?

At this point I'm thinking not shooting and going with a half dose tonight is the better option. Your thoughts?

Christine
 
Re: Kitty Rabbit PMPS 380, AMPS 193

I think we cross posted. So see my post above.
I think you can start with 0.50 this morning, and see how she does with this dose. Get some mid-cycle tests, and maybe go with 0.50 for the evening too, and your new regular dose. Let's just see how she does today.
Those are my thoughts.
 
Re: Kitty Rabbit PMPS 380, +12 (193)

You're right; we cross-posted.

I went with .5u. This poor cat is going to be the most bg-tested animal in history today!

The shot was almost 10 minutes past the end of my normal, make-it-to-work-on-time shoot window. I seem to recall reading that, from this point on, I need to back up the shots 15 minutes each time to get back to the start of my shoot window. Is that correct?

Christine
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Yes that is correct. You can move the shot by 30 minutes once a day, or 15 minutes twice a day, to not have much effect on the cycle. How much do you have to move the shot time?

I base my shot time on the latest time I get home from work for the PM shot, that way I have as much time as I can get (a whole 1 hour and 30 minutes) on the morning side to test and feed after shooting the morning insulin.
 
Re: Kitty Rabbit PMPS 380, +12 (193)

I need to move the shot time back about 40 minutes. I'm off the next couple days (thank goodness I did that!) so I should have plenty of wiggle room to make the changes.

I've based my shot times on my mornings as they're less flexible than my evenings. I'm now thinking I may need to renegotiate my start time at work so I have enough time in the morning to deal with unexpected issues like today's.

I think I finally fixed the subject of the very first post. I thought changing the subject line in my post would do it but that didn't work. Hopefully I've got it now.

Thanks for your help this morning,

Christine (and KItty Rabbit)
 
Re: Kitty Rabbit PMPS 380, +12 (193)

I'm sorry to confuse you. Now that you gave the shot, you can change the +12 back to AMPS.

When people are stalling after shot time, they will make their Subject Line something like
Kitty Rabbit PMPS 200, +12 120, +12.5 155,
And then once they've shot the insulin, they change the Subject Line to the actual test number when they gave the shot
Kitty Rabbit PMPS 200, AMPS 199
those are just some examples.

Gotta go to work..

Have a Great Day!

I would start with a +2 test.
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Thanks, Dyana. I did a +1 (186) before I saw your last note. Looks like KR's not going to have a fun day as I'll now do a +2, too. Mom's really going to be a vampire today...

Christine
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Welcome to Lantus Land!!

I'm glad Dyana was around when you needed a hand. On the Health board, they advise to not shoot below 200 if you are new to insulin. We are a bit more liberal and suggest 150 as a lower, "ask for help," number. Since you are an early riser, there is information in the Shooting & Handling Low Numbers sticky at the top of the Board on your options for a low pre-shot number. I'd encourage you to read all of the starred, sticky notes. There's a huge amount of information there about how to maximize your use of Lantus.

I would strongly encourage you to get at least one test per cycle in addition to your pre-shot test. Lantus dosing is based on the nadir, not on the pre-shot numbers so those spot checks are important!

Your profile notes that you'd found blood in Kitty's litterbox, etc. Has that problem been dealt with and what was the diagnosis? Did your cat have a UTI?

Please let us know how we can help. People here are very generous with their time and information.
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Sienne,

The blood in the litterbox (and everywhere the poor cat sat during that night) was from a UTI. KR received a shot of an antibiotic from the vet the next day on the presumption that's what was causing the problem; when test results came back two days later the diagnosis was confirmed and it was determined no other antibiotic was necessary (I haven't seen signs any blood since then, either). That's also how we found the FD. The vet was shocked at the glucose levels in KR's urine. She told me KR appeared just too healthy for her to even think to test for diabetes.

I've read through all those stickies at least once, but reading something and experiencing it turned out to be two completely different things. I'm very grateful so many people are willing to offer their time and advice to those of us just starting this dance.

Christine (and grumpy KR who's NOT liking getting poked so often today)
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Do you give treats to KR after testing, whether you get blood or not? It made all the difference for Poopy. He not only comes to me for tests, he purrs during the whole routine as he knows he gets a special treat afterward. :smile:
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Hi guys .. Just wanted to welcome you guys to lantus land! That's a beautiful (although nerve wracking) number to wake up to the first time! You handled it great and I hope that kitty rabbit gives you a nice long ride with these blues! Have a great weekend guys!
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Thanks, Christine.

It would be useful to know what antibiotic your vet used. My guess is that your vet gave Convenia. It's not an antibiotic that most of us like our vets to use because it lasts 2 weeks. The reason we're not enthusiastic is that if your cat has an adverse reaction to the drug, once it's in you can't get it out. Unlike an antibiotic that you give once or twice a day, you can stop giving the pill. With a long-acting drug, your options are limited. That said, your cat is fine which is a good thing.

One thing to look out for is that it may have been the UTI that caused the high BG numbers. Your cat may have been prone to diabetes but it took an infection to raise BG levels. If this is the case, as the UTI is clearing, numbers may come down and can come down rapidly. I don't know if this is the case but it is something to be aware of so you don't get caught by surprise.
 
Re: Kitty Rabbit PMPS 380, AMPS 193

Sienne,

According to my copy of the vet records, KR recieved .28u Convenia. Oh, great.

You can see in the subject line what I just got as a test result. KR's not showing any symptoms of hypo (being grouchy about testing doesn't count; that's normal!) and she just happily chowed on a teaspoon of her favorite HC wet food. She's not eating like she's starving to death. I've got both the "how to shoot low" and "hypo prevention" posts in front of me. I really didn't see this day going like this...

Yes, KR gets LC treats (freeze-dried chicken liver) whether or not a test goes well. I don't know how much longer that will last, though. She appears to be associating the treats with the negative part of the testing (Mom pricking her four times to get a decent blood drop) rather than the positive part (lots of cuddling and petting).

Christine
 
Re: Kitty Rabbit PMPS 380, AMPS 193, +4.5 (44)

Good catch on the numbers. Please re-test at +5. I'm at work and can't hang around. Please keep testing and feeding every 30 min. until you see KR's numbers are stabilized above 50 and then test every hour until you have 2 tests that are in an above 50 range without benefit of food. Once numbers are above 50, you can use low carb rather than high carb food to steer the numbers.

You might want to start thinking about routinely getting a +2 test. It can let you know where the numbers are heading. Also, with KR dropping into the 40s, your dose this evening is reduced to 0.25. It looks like this:
025unit-1.jpg

You might want to practice drawing up the dose using water or some other liquid.

Like I said previously, there's a reasonable chance that KR's numbers went into the diabetic range due to the UTI. As the UTI is clearing, the need for insulin is rapidly diminishing.
 
Re: Kitty Rabbit PMPS 380, AMPS 193, +4.5 (44)

Yay! Congratulations on the reduction!!
Paws crossed that K.R. doesn't really want to be here and will exit stage left as quickly as she can.
But Welcome , no matter how long it takes.
 
Re: Kitty Rabbit PMPS 380, AMPS 193, +4.5 (44)

I think this reduction is going to make the rest of my hair grey... :))

OK, here we are at +6, and she's at 62. Obviously she's not stable yet (from 44 to 74 w/food to 62). I just fed her about 1/4 can LC FF and will test again. I'm planning to test at 30 minutes after she finished eating, but if I should test earlier (or later), someone please let me know.

Christine
 
Re: Kitty Rabbit PMPS 380, AMPS 193, +4.5 (44)

+7 was 64 (I ended up testing on the hour; I've woken her so many times to test today I just couldn't do it again at the 30 minute point). I gave her 1/4 can LC FF that she doesn't get very often and she literally licked the plate clean. I'll test again at +8. I know +7.5 is going to be inflated because of the food; if I really need to know how high she's up someone let me know as I'd rather give both of us a break from all the pokes in the ear if I can safely do so.

I'm a little overwhelmed right now when thinking about how tonight's going to go (and there's still 5 hours yet...). What are the parameters for deciding between .25u and not shooting at all? If I shoot should I plan on testing every two hours?

Christine
 
Re: Kitty Rabbit PMPS 380, AMPS 193, +4.5 (44)

The short answer to your question is: We don't know yet, since you don't have enough data on Kitty Rabbit on Lantus. If you want to give her (and you) a break and also let the 1 unit you shot last night work through her system, maybe skipping tonight is a good idea. BUT, let's see where her +11-ish is before considering that option.

Back to check on you later :cool:

MJ
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

Hi Christine, No dosing advice, just want to welcome you to Lantus land! Are you having difficulty getting a usable blood drop? Several people have posted here about that and gotten lots of good suggestions, here is a posting from last month that may help. Practice measuring that small dose (many measuring" threads here too) and have a great day!
Leslie
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

Thanks, everyone. I think we just did our fastest blood test ever...although I must've hit the vein for the amount of blood I got. Hey, at least it only took one poke.

The better news: +8 is 101. She ate a little under an hour ago. Is it safe for me to skip the test at +9? KR's been amazingly cooperative (although grumpy) all day and I'd like to ensure it stays that way. If it's not safe to wait until +10 for the next test, we'll both get over it.

Christine


Leslie,

As for getting a blood drop, it's strange. I think I'm getting the same general area every time, but it doesn't always work. The test we just did I was a bit below where I normally go. Maybe I've actually been too high all this time? I did notice I wasn't always going deep enough, so now I make sure not to just prick the surface. Her ears are definitely warm to the touch before I start. I'd say I just need more practice, but I'd think today covers the "practice" requirement!
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

Might be the start of a bounce from the 44. Hopefully she won't rebound back into pink.
I think it's safe to get a +10 instead of +9.

MJ
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

202 at +10. I'll test again at +11.5ish...then probably ask for advice again on whether or not I shoot tonight. :)

I don't know that it makes a difference, but other than waking her for tests KR followed her normal daily routine and slept in her favorite chair all day.

Christine
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

Hope KR does not bounce too high. Based on her numbers so far, I expect the wise ones here will advise you to shoot and do appropriate follow up testing.
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

She bounced up just about to where we started 24 hours ago: 342. I shot .25u and will test every 2 hours unless someone tells me to test more often.

Should I either change the subject line of this post or start a new thread?

Christine
 
Re: Kitty Rabbit +4.5 (44), +5 (74), +6 (62), +7 (64)

You should change the Subject Line. We try to keep to one thread a day per kitty, to keep everything together in one place, otherwise you might have people replying to both posts and information can get lost.

Congratulations on the dose reduction to 0.25 ! :mrgreen: You're doing a great job!
 
Re: Kitty Rabbit PMPS 342, +2 (344)

OK, all you experienced people out there, what the heck is going on??? Kitty Rabbit received .25u two hours ago and I sure didn't expect the bg reading I just got. Is this a result of the 44 we had about 10 hours ago? If so, when does she drop again (or does she)?

Should I plan on testing every two hours all night?

Help!

Christine
 
Re: Kitty Rabbit PMPS 342, +2 (344)

Just re-read a lot of the material I'd printed earlier today...and found my answer about the PMPS and +2 numbers.

Still not sure how often I should test tonight. Every two hours, or can we do less than that?

Thank you for your help today,

Christine
 
I would not test every 2 hours. I'd get a test before you're planning on going to bed. If KR is still in the pink zone, go to sleep. If numbers are rapidly dropping, I'd suggest feeding some low carb and setting an alarm for an hour or two. I don't think that's going to happen but it's hard to know.

Your cat bounced! The low numbers triggered KR's pancreas to pump out glucagon which in turn causes the liver to release a stored form of glucose. In addition, counterregulatory hormones are released. All of this results in BG numbers spiking upward. It can take up to 72 hours for the bounce to clear. The good news is that you should be able to sleep!
 
Sienne,

Thank you for the response. You just saved a grumpy cat from becoming a truly angry cat. :) And I get to go back to sleep and stay there!!

Last question for this day: from earlier reactions about reductions, I'm guessing that .25u BID has become KR's regular dose. Is that correct? If that's the case, I'm also guessing I can spread out the testing a bit (say, every three hours). Am I on the right track?

Thanks again, and have a great weekend,

Christine
 
Once you change a dose, you hold that dose for 3 days. So yes, the 0.25u dose is KR's new dose.

The exception is the initial dose of Lantus which is generally held for 5 - 7 days. However, in some cases, like KR, the suggested initial dose may be too high and the cat lets us know that it's too much insulin. Even once the dose is established, our cats may have other plans in mind. You ay increase a dose and your cat's numbers drop telling you it's too much insulin. You may reduce the dose and it becomes very clear that the reduction has failed and you need to increase. I don't mean to inundate you in too much info but it would be misleading to just give you a yes or no answer.

I would definitely get a +2 or a +3 tomorrow morning. Testing every 3 hours would be great while KR is getting used to Lantus.
 
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