10/6 Asia AMPS 545 +6 349

Status
Not open for further replies.
Stacy & Asia

Stacy & Asia

Member Since 2017
A lot of high numbers. I got Keto-Diastix and she's still negative for ketones, thankfully, urine sugar off the charts. I know it takes awhile for a dosage change to show up in the bg numbers (went from one unit to .75 at the pm 10/4 shot), but I feel bad for her sugar hanging out this high. Is there anything to do or do I just wait and see?

Also, for the spreadsheet, how do I put in info that is outside the 12 hour range? There was one morning she was pretty low (100) and I didn't want to give her insulin at breakfast, so I waited a couple hours until the numbers went up. I logged the amps number and the one after as a +10 and +11 number from the night before, but it really wasn't, it was really a +13 and a +14, and then I skipped the evening dose per vets recommendation.
 
I don't think I've posted in your condo before. What do we call you?

If you want to see an example of what Mandy is referring to, you can take a look at Gabby's SS. Also, if you are noting those +13, etc. numbers, I would enter them in the pre-shot cell. If you end up delaying a shot, remember that a late shot acts like a dose reduction (whereas an early shot acts like a dose increase). You also have to gradually move your shot time back to your original schedule. If order to not have the shift in shot time play havoc with Asia's numbers, you can shift the time by 15 min every shot twice a day or 30 min once a day until you're back to your preferred time. If you skipped the next shot, you're fine to go back to your preferred time immediately.

Have you had a chance to consider which approach to dosing you want to use? If so, could you add the information to your signature line? The dosing strategy makes a difference since the point for reducing the dose differs.

Part of why you're seeing high numbers is that Asia "bounced" as a result of those green and blue numbers. When a kitty isn't used to having her BG fall into ranges lower than what she's used to, the liver and pancreas go into panic mode and dump a stored form of glucose along with counterregulatory hormones into the blood stream. As a result, numbers bounce into a high range. It's one of the body's protective mechanisms so it's normal but rather annoying to those of us who worry about our kitties. It can take around 3 days/6 cycles for the bounce to clear.


 
To add on about bouncing. Asia went from the 400's on PMPS 10/4 to AMPS 175 on 10/5. Bouncing can occur from large drops in a cycle, not just lower numbers. Just hang in there, lets see what she does over the next few cycles. She'll either come back down or may need an increase.
 
Hi there and Welocome to the board.

Here's a link to your previous thread, (we call them condos) http://www.felinediabetes.com/FDMB/threads/10-4-asia-696.184945/ when we start a new daily thread we include a link to the previous days thread, we do this so that it makes it easy to look back through history, it's very useful to folk that are trying to help and give advice, personally I found it useful too as it allowed me to easily look back through history, if I wanted to go back and read over some advice/commments.

The best way to reflect the stall the other day would be to 'stack all the numbers in the amps box' so you would write
100@+12
124@+13
amps 156@+14
To allow the numbers to stack you might have to select the wrap text function.

I think that for the time being you should hold the 0.75u, it looks to me that on the night of october 4th, Asia might have seen some low blue or even green that night, that 175 on the morning of the 5th of october looks like Asia was rising and starting a new bounce, so she may have been lower that in the night of the 4th, we want to wait and see where he lands when this bounce clears (can take up to 6 cycles)

Here's the explanation of what we term a bounce taken from the new to the group sticky

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles


You don't note on your signature which protocol you have decided to follow.

On TR you would continue to hold this dose for at least 8 to 10 cycles,

Here's the extract from the Tight Regulation Guidelines
INCREASING THE DOSE:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

On SLGS you would also hold the dose, you would hold for a week and then assess the dose based on Nadirs, here's a link to SLGS method for further info.

Either approach would see you holding the dose for now (unless she were to drop below 68 again, in which case she would earn a reduction, this is the reduction for TR)

Anything highlighted in blue is a link to more info on the subject, sorry there's a lot to take on board and a huge learning curve in the beginning and it can be overwhelming, hang in there.

Here's a link to tips for new members, written by Tricia, it will help you get the most from the board.
Here is a link that explains some of the slang terms we use, we sometimes forget folk are new and don't understand our funny language:oops:.
Another link that I have found extremely useful is this one written by Julie, it links to useful threads, and info throughout the board.
Where can I find....?

BTW I love her avatar, I just want to smoooch those cheeks.


 
Sienne and Gabby (GA) said:
I don't think I've posted in your condo before. What do we call you?
Click to expand...


Im Stacy, hello! :)

Sienne and Gabby (GA) said:
If you want to see an example of what Mandy is referring to, you can take a look at Gabby's SS. Also, if you are noting those +13, etc. numbers, I would enter them in the pre-shot cell. If you end up delaying a shot, remember that a late shot acts like a dose reduction (whereas an early shot acts like a dose increase). You also have to gradually move your shot time back to your original schedule. If order to not have the shift in shot time play havoc with Asia's numbers, you can shift the time by 15 min every shot twice a day or 30 min once a day until you're back to your preferred time. If you skipped the next shot, you're fine to go back to your preferred time immediately.
Click to expand...

Okay, that makes sense. I will adjust how I recorded those numbers. So how very exact do the shot times need to be? I'm never 10am/10pm exactly because I'm waiting for her to eat a little before I give the insulin, so there can be a 15-30 minute variance, is that awful? I'm not sure how to fix that if so, she has her own way of doing things and is sometimes going to eat the moment the food is placed in front of her, but sometimes she's waiting for the temp to change, the stars to align, who knows what. Vet and acupuncturist stressed if she doesn't eat, don't give the shot. She is eating, she's just not the type of cat that wolfs down her food the second it's there, she's a grazer, so I wait until I know she's had a little before giving insulin (thus shot times are not exactly on the dot).

Sienne and Gabby (GA) said:
Have you had a chance to consider which approach to dosing you want to use? If so, could you add the information to your signature line? The dosing strategy makes a difference since the point for reducing the dose differs.
Click to expand...

TR

Sienne and Gabby (GA) said:
Part of why you're seeing high numbers is that Asia "bounced" as a result of those green and blue numbers. When a kitty isn't used to having her BG fall into ranges lower than what she's used to, the liver and pancreas go into panic mode and dump a stored form of glucose along with counterregulatory hormones into the blood stream. As a result, numbers bounce into a high range. It's one of the body's protective mechanisms so it's normal but rather annoying to those of us who worry about our kitties. It can take around 3 days/6 cycles for the bounce to clear.
Click to expand...

So it's not as if the insulin isn't working when her numbers rise after the shot instead of falling, her body just hasn't adjusted yet?
 
Hello Stacy

Toebeans said:
but sometimes she's waiting for the temp to change, the stars to align, who knows what.
Click to expand...
LOL
upto 30min is usually OK, I was never very precise with the timings either, but I would note on the ss what time I shot, just so I could keep track.

I used to shoot George when he had his head in the bowl, most times he never even looked up:rolleyes:

Glad to here you are doing TR, and thanks for adding it to the ss.

Toebeans said:
So it's not as if the insulin isn't working when her numbers rise after the shot instead of falling, her body just hasn't adjusted yet?
Click to expand...
It's not so much that the insulin isn't working, but rather her body is producing other hormones to counteract the insulin, because the liver panicked when she got to lower numbers than she's been used to of late, that resulted in the liver dumping glucose into the blood stream, and hey presto, the BG levels rocket. Mostly we take note of the bounces, but ignore the high numbers it yields, we look to the lows to make decisions on dose.
In a bounce cycle the numbers will be flat and high and it will appear than the insulin is not working at all, they can bobble about a bit but you won't see any clear nadir/curve.

In an active cycle, you will see the numbers drop initially at onset, continue to fall through to nadir, then rise up again toward the end of the cycle, giving you a curve.
 
Gill & George said:
Hi there and Welocome to the board.

Here's a link to your previous thread, (we call them condos) http://www.felinediabetes.com/FDMB/threads/10-4-asia-696.184945/ when we start a new daily thread we include a link to the previous days thread, we do this so that it makes it easy to look back through history, it's very useful to folk that are trying to help and give advice, personally I found it useful too as it allowed me to easily look back through history, if I wanted to go back and read over some advice/commments.
Click to expand...

Thanks, I will get the hang of this, I promise. Lots of info, trying to understand it all. Wishing my brain had a USB import function. Just feeling a little guilty that Asia gets the short stick while I'm on the learning curve

Gill & George said:
BTW I love her avatar, I just want to smoooch those cheeks
Click to expand...

Thank you! Her smushy face has melted many hearts :p
 
Thanks, Stacy. Not that I dislike Toebeans, but I figured it wasn't actually your name! And thanks for adding TR to your signature line.

Numbers typically rise after a shot. There are a couple of reasons why. First, Lantus duration is around 12 hrs, give or take. So, the previous shot is wearing off. Second, you're feeding your cat. Even if you're feeding zero carb food, there will still be a rise in numbers due to the influence of food. And last, Lantus takes roughly 2 hours to start working. Because this is a long-acting, depot type of insulin, it has a gentle onset and doesn't slam numbers into the ground they way shorter acting insulin does. If you look in the New to the Group sticky, there's a breakdown of what numbers ideally look like throughout the cycle. What I've just described isn't the same as a bounce. There's the normal rise and fall of numbers throughout the cycle versus a cat's body responding to lower than usual numbers or a fast drop in numbers. The latter is when a bounce occurs.

Because Lantus doesn't kick in immediately upon injection, most of us test, feed, and shoot within a very narrow window (10 min or so). In fact, I tended to give Gabby her shot when her face was in her food. (There was very little that distracted her from a meal.) You do have a 15 - 30 min window within which you can safely shoot and not have to worry about adjusting your shot times, though.
 
Toebeans said:
So it's not as if the insulin isn't working when her numbers rise after the shot instead of falling, her body just hasn't adjusted yet?
Click to expand...
Correct =] especially if she experienced a steep drop the cycle before. Some kitties bounce more than others. Over time youll see patterns in Asia's spreadsheet (or not... every cat is different).
 
Sienne and Gabby (GA) said:
Because Lantus doesn't kick in immediately upon injection, most of us test, feed, and shoot within a very narrow window (10 min or so). In fact, I tended to give Gabby her shot when her face was in her food. (There was very little that distracted her from a meal.) You do have a 15 - 30 min window within which you can safely shoot and not have to worry about adjusting your shot times, though.
Click to expand...

I can't give her a shot while she is eating, she is such a senior cat, I have to do things as much on her time as I can. She has arthritis and will squat down (and stop eating) if you try to pet down her spine, or grab a pinch of skin for a shot, so she needs to be laying down for shots, for glucose monitoring, etc. I can't imagine it only taking 10 minutes. It's test on my bed, give her food, let her do her thing at the food bowl and grab her when she's given it a rest to take her back to my bed for insulin shot. Hurry is not her geriatric vocabulary, it just takes a little more time, but her comfort is my priority. It's good to know I have a little window for this, so far she isn't bothered with all the poking and prodding, but I'm still trying to be as respectful as possible and make this a positive (as possible) experience for her.
 
I was surprised to see her age. What a grand lady!

Do you have her bowl raised? Sometimes, that makes it easier on those achy joints. I'm also presuming you've tried Cosequin or the prescription version (Adequan)?

Treats are also a big help. Many of us use freeze dried chicken (aka "kitty crack") as a treat. If Asia likes it, if you crumble it up on top of food, it's a great enticement for a picky eater.

Since you're feeding raw, have you looked into Darwin's? They have a raw formulation that's low in phosphorus. Given that Asia was diagnosed with CRF, a low phos food will help to slow down the progression of kidney disease. Raising her bowl may also help with any stomach acid that can be a factor with CRF, too.
 
Sienne and Gabby (GA) said:
I was surprised to see her age. What a grand lady!

Do you have her bowl raised? Sometimes, that makes it easier on those achy joints. I'm also presuming you've tried Cosequin or the prescription version (Adequan)?

Treats are also a big help. Many of us use freeze dried chicken (aka "kitty crack") as a treat. If Asia likes it, if you crumble it up on top of food, it's a great enticement for a picky eater.

Since you're feeding raw, have you looked into Darwin's? They have a raw formulation that's low in phosphorus. Given that Asia was diagnosed with CRF, a low phos food will help to slow down the progression of kidney disease. Raising her bowl may also help with any stomach acid that can be a factor with CRF, too.
Click to expand...

Her bowl is raised. I have not tried or heard of Cosequin or Adequan? I know there are prescriptions for arthritis that are contradictory to CRF. I had heard green lipped muscles are a good thing to try and you have to be careful where you get them from (I.e. reputable source vs Amazon), recommendations welcome if anyone knows a reputable place to order. I asked one vet about it, he wasn't knowledgeable. She is currently getting acupuncture once a week for her arthritis and it certainly has helped quite a bit, but it's no miracle cure. Asia is impossible to pill. The vet can do it, but it involves torturing her and stressing her out, so it's not something I see the positive outweighs the negative as far as trying to pill her on a daily basis goes, once or twice a day torture (even for her own good) is not good quality of life IMO. Same goes for liquid preparations, she struggles and drools and freaks out and then hides and is sad (and she's not a hiding or sad kind of cat), it's terrible.

She is the most friendly unbothered cat I've ever met, you can touch her anywhere, she loves belly rubs, she never bites or hisses or scratches, she loves all the people she ever meets, but she's always been sensitive with her nose and mouth area (she doesn't lash out, but she does try to get away and will struggle immesensly to get away if you insist of looking in or putting something in her mouth). She has a pretty flat face, so I think that's part of it, she probably can't breath so awesome if someone is touching her nose/mouth. She also had teeth issues some years ago and has been extra sensitive about her mouth since then. So I can't pill her, and in addition to that, she is an extremely picky eater. I tried to mix some probiotics into her food once, she would rather starve than eat that. She won't touch pill pockets or really any cat treats I've ever tried, except one. She does LOVE the freeze dried chicken treats, so I give them infrequently and sparingly, less they lose their appeal. I was giving her tiny pieces of them at shot/glucose check times, but she's really not bothered by pricks and injections, she doesn't even flinch. She eats her food just fine, has a good appetite, she just takes her time.

I have not heard of Darwin's, I will check it out. Back when we started raw, it was called BARF and many people made their own, commercially prepared brands were slim. We have been happy with Stella & Chewys for some years and she's sooo picky about food changes, but I will look in to it for sure.
 
Toebeans said:
I had heard green lipped muscles are a good thing to try and you have to be careful where you get them from (I.e. reputable source vs Amazon), recommendations welcome if anyone knows a reputable place to order.
Click to expand...
Hare Today which also provides raw for kitties has a Green Lipped Muscle Powder. I considered it for Doodles but never ordered it since his wet food Ziwi Peak had it in the ingredients https://hare-today.com/category/nutritional_supplements
 
Cosequin is the kitty version of glucosamine and chondroitin which humans take for arthritis. You open the capsule and mix it into food. Adequan is an injection that Asia would need to get at the vet's office unless the vet is willing to give you a vial to dose at home. The prescription medications that are contraindicated with CRF are nonsteroidal anti-inflammatories (NSAIDs). They are contraindicated most of the time for cats. In fact, meloxicam (Metacam) carries an FDA black box warning due to its causing acute renal failure in cats.

I'm assuming you're aware that most pills can be compounded into either liquids or transdermal gels. It may cost a little more but there are very reputable compounding pharmacies that will do this.

My vet recommends Darwin's. If you want the renal diet, you'll need an Rx from your vet. The other option, since Asia seems to be picky, is a phosphorus binder. If you're familiar with Tanya's site, she provides a great deal of information on CRF including information on phos binders.

 
Status
Not open for further replies.
Back
Top