11/01/14 Oz AMPS 249 Now 59 at barely +4

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Ian & Oz

Ian & Oz

Member Since 2014
Hello,
Seeing that Oz's AMPS level was at 249, I thought that this was maybe his new high bounce number, which is lower than it has been. I figured I had some time before testing since he was in the mid 200's, but now at 12:47 pm, he's at 59.
That seems like a Huge drop, is this an indication of anything bad?
I've given him some of his regular food, should I be testing on the half hour or hour right now?
Does he need a reduction in dose yet?

Thank you
Ian
 
Hi Ian.

I would test on the half hour until he stays above 60 or so for a few tests. No, it's not a bad sign. It's perfectly normal.

This is my first time visiting your condo, so forgive me if someone else has already given you this link: Handling Low Numbers. It's handy to have when you're new to this dance, especially if you don't get an answer from the Board right away.

Hopefully some of our more experienced people will be along shortly to give you more guidance.

One thing you'll learn is that your FD kitty will be full of surprises! He is a cat, after all! ;-)
 
Hi Ian,
nope... no reduction until he is below 50..... ( that's why I say 49 is the magic number)

try to give him his normal low carb food.....and check every 30 minutes.

unless you need to leave, then you give him something higher carb to boost his numbers.


hopefully you can hang out, keep checking and maybe get lucky and earn that first reduction. :mrgreen:
 
Hi Ian

Have you retested yet? I see from his SS you have and you've got him stopped. GREAT JOB!!!

This is wonderful actually!! It looks like Oz likes this dose. However, my suggestion to you is that you get a +2 test every single cycle that you can. You'll have a better idea if he's going to do this to you so you aren't shocked at +4 when he does. It would also allow you to start feeding LC as soon as he hits a green number so you can flatten him out sooner. The best approach is to try and keep him above 50 if you are able to so he can spend more time in healing numbers. That doesn't mean to feed him incessantly but to catch the drop as it starts and give him LC food to see if that will stop him before he hits 50 and then will let him surf in safe numbers as he is doing right now. Once you get him stopped and flattened above 50, then you don't feed and see if he will just surf there on his own. The goal is to teach the liver that it's ok to be in normal numbers. More time in normal numbers = more healing for the pancreas = one step closer to regulation.
 
Thank you Marje, Rhiannon & Tricia,
I've been testing him about every 30 mins or close to that. He was dropping about a point between readings but not knowing that was the trend, I gave him a little high carb food at +5 when he was at 57. Just took another reading 45 mins later after the HC food & he's at 68. After every AMPS & PMPS is when he gets fed, he gets fed in between those times also. After seeing the 59 (actually the first test was 52) he was given his regular low carb food, a quarter of a 6 oz can, looking at it from an hourly point of view with food he dropped 2 points from +4 to +5, so i'm guessing the food helped some. I'm not sure, but I'm guessing the food doesn't give him very big spikes, something I have to remember. About earning the reduction, I feel pretty certain that had I not given him food at +4 he would have continued to drop into that 49 range, does that count or do you actually have to see a 49 on his test? I know that the low pre shot is coming & I'm trying to plan for that, should I try & steer with LC food as long as possible before breaking out the HC food when shooting a low number? If the low PMPS happens tonight, am I ok with his regular dose & steering with food. I know I'm repeating myself, I'm sure it's to build my confidence.

Ian
 
If you look at Gracie's SS, you'll see how to stack numbers in one box so we can see all the tests; when I looked at his SS, I didn't see the tests on the half hour. You have to manually color in the box when you stack the BGs. Just click on the box you want to color then go up to the top of the SS in the tool line and click on the "pitcher" and select the color.

We only reduce when we see the number below 50 OR if you are having to fight to keep him up (in other words, you feed, he comes up, he goes back down, you feed, he comes up, he goes back down), then it might be time to reduce. But he responded just fine. If you look at Gracie's SS on 10/21 a.m. cycle, she was relentless. We did end up giving her a reduction the next day even though she didn't actually earn it. Good thing because her depot was full enough that she gave us a 40 a little later on.

I think you did fine today. You could have tried LC instead of HC but it's a learning curve and it's good to experiment and see what he needs when and what he responds to.

I don't like to anticipate scenarios and solutions just because when we get to that point, there might be something better to do. Let me think about some examples for you and I'll BBL.
 
Hi there :cool:

Looks like Oz is working the juice :mrgreen: You are doing great!

Now would be a good time to start sprinkling the ss with some PM+10s and 11s. You will be glad you did.
The data will come in extremely handy in the near future. It will give you confidence that you are making the best shooting decisions when Oz throws you a lower than usual AMPS which one day, perhaps very soon, he will.
those tests will give you a feel for whether he is on the way up or down, which can make all the difference in keeping Oz on the path to regulation.
 
Thank you Marje,
For now all of the extra testing info is on the right side in the comments box.
I did put several numbers in one of the boxes on the 28th, but when I look at it, the numbers are partially hidden, so I didn't think it would be completely visible & haven't done it again. Is there a better way or something I'm not doing when stacking multiple numbers in a box so that they don't appear partially hidden?

Ian
 
Hi Ian!

Here is your condo (thread) from yesterday 10/31. If I were you, I'd bookmark that one - you may want to go back to it when you're trying to decide what to do with a lower preshot number. There was a lot of good information in it that you will likely want to reread at some point.

Looking good today - you've done everything just fine. If you've got a bounce that's only peaked at 250 - that's pretty great. Some bounces will go over 600 if a cat's liver is really in big-reaction mode. It says that Oz is settling down and accepting normal numbers as normal. He's done with any effects from the skipped shot and back to action today.

To help with that issue on the ss, you can do 2 things. You can widen the vertical columns by hovering your mouse over the vertical line at the top of the ss. I can't remember if it's between the alphabet letters or between the +7 +8 numbers. You'll get that icon that's like a capital I when you're in the right spot, then you can left click on it and drag the vertical line slightly to the right to widen the cell. You don't have to widen every cell in his ss, just the ones that you need wider.

A second solution is to reduce the size of the font within the cell. To do that, go to the 10 that's to the left of the B that bolds things. Click on the little down arrow to the right of the 10 and then choose 6 or 8. You might want to play with it and see what works best for you.

There are pros and cons to each of these. If you reduce the size of the font, it can get too small to read. Most people do that, though, just because even at 6 you can usually still see the #s well enough. It'll allow you to fit in the "12=xxx" width and have the whole thing seen. If you widen the cells too much then your spreadsheet can get really wide. You might want to widen the vertical columns slightly and then reduce to 8 pitch, so a little of both.

If you have test numbers stacked in a cell, you'll have to manually change the color. There is a little icon that looks like a beaker pouring out, 4 icons to the right of the B bold icon. click on that and you'll see a section that says "custom colors" - i think those are the ones that were used in your ss. You can use anything you want that gets near the original color the cell would be. Some people like to color tests that are less than 50 is a lighter green to make them stand out - that's just your choice.

In any case, he's looking great.
 
Is there a better way or something I'm not doing when stacking multiple numbers in a box so that they don't appear partially hidden?
Click to expand...

You did it correctly on the 28th but the font just needs to be smaller. So click on the box, then click on the number to the left of the "B" for "bold". The numbers are the font size. Just select 7 or 8 and you should be able to see all the numbers in the box.

Sandy has a great point...the +10/+11 test will show you if he's coming up, still going down, etc. I will very often get a +10 for Gracie so I know where she's been when I get ready to shoot at the next PS.

Remind me what time you shoot.....if it's earlier than 6 my time, I'll be around to look for you and help but I'm thinking you shoot around 9 which is 7 my time and I'll be out again for a while tonight. But if I'm not around, hopefully someone will be. However, a few example scenarios (Julie left some on your condo from yesterday).

Let's say he continues to come up without food the remainder of the cycle but then dips back down into the 70s at shot time. I'd recommend you go ahead and shoot the regular dose on time, feed LC, test at +1 and +2 to start. If he's still coming down, feed a couple more tsps LC or as we say, "lather rise repeat" until he stops. Could he come lower? yes, he could but you will be testing and you can give him some HC to bring him up if he's getting around 50 and you are getting nailbite_smile nailbite_smile But you are going to be testing and you are starting to get an idea of how he responds to food. You did a GREAT job today. Have confidence.

Example 2: the carbs you gave him earlier wear off and he starts back down so by PMPS, he's at 60. The best thing to do, because he wouldn't have been dropping very much very fast, is to shoot the normal dose on time, feed his normal LC helping, test/feed as necessary at +1 and +2. You can even get a +.5 to start with if you are really nervous. He may very well come back down on you but it's Saturday night and no time like the present to learn to deal with those lower numbers. ;-) Can you stall? Yes you can but what I've often seen happen is the number continues to drop to the point where you are forced to skip. Whereas if you shoot the 60 and feed, you have a better chance of getting the numbers to start coming up a bit before he onsets. Does that make sense?

When Gracie was on lantus, she loved to drop all cycle and give me a 50 something at PMPS. I learned early to shoot, feed to bring the numbers up before onset. Sometimes with her, I'd give her a little something right before +10 to slow the drop into PMPS because if I didn't, I knew she'd be around 50 at PMPS and then keep dropping even if I fed her. ECID. That's normally not necessary to do but with her, I had to. I think I've only skipped two shots from low numbers in +4 years. The first was just what I described above....she was 81 @ PMPS, I stalled, she dropped and kept dropping until she was 49 and I couldn't shoot. I should have shot the 81 because I had dealt with low numbers and could have handled it. The second time, she was in the 40s at PMPS and after two hours and a little food, was still in the 40s so I had to skip.

Example 3: he's below 50 at PMPS. Stall, don't feed, test every 20-30 mins, when he's on the rise reduce the dose to 2u, and shoot. Why reduce the dose? Because if he goes below 50, he earns a reduction.

Please feel free to let me know what questions you have.
 
Hi Marje,
I'd give her a little something right before +10 to slow the drop into PMPS because if I didn't, I knew she'd be around 50 at PMPS and then keep dropping even if I fed her.
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My initial worry, not being experienced, is how quickly he's dropping now & it's such a big drop.
I know you & others have said the lower they are, the less they have to drop when shooting, I just wonder/worry if he's at say 65 pre shot for the first time, since he's not regulated will he plummet towards 30.
I always give him food right after each shot & he gets a "full" meal which is half of a 3 oz can, he may eat a little more from someone elses bowl, but I try & keep that from happening. Is that amount of food enough to stop a big fast drop, to slow it down?
How much food is needed to steer low pre shot numbers into a safe area?
Oh yeah, his shot time is 9 pm my time, so 7 your time.

Ian
 
no, not being regulated doesn't mean he'll plummet. Chances are very good that if you shoot a 65, he'll hang out fairly flat for the next 12 hours.

however, at the moment, since he's come up to 112, you probably aren't going to be faced with it tonight. you never know, of course.

as far as steering him with food goes, it's a very individual thing. start with a teaspoon or two of his regular low carb food. see what happens with that and change things from there. often we suggest giving 1-2 teaspoons of regular food when a cat gets into green numbers - that can help them "surf" and stay in green numbers for a while.

I'm around tonight and can look for you. I think we're 3 hrs different, so your 9pm is my 6pm on the west coast. I'll keep an eye out for you, ian. I don't think it will be tonight, though.
 
Ian

I think you are in TX, right? So your 9pm is still Julie's 7pm until tomorrow so I'll drop her an email and let her know. I definitely will not be here at 7pm tonight but should be home before 11pm your time so if he is going low, I can hang out with you, too.

The one thing I want to be sure you understand is that we can't know what will happen if you shoot a 65. Our "hope" is that he would typically stay flat. That's what lantus "can" do. However, when the depot gets full, some cats can and will drop lower. So while we hope that they will not, we understand that they might...depending on the cat and depending on how they respond to food. It is scary for all of us when they do. Gracie has done it to me more times than I can possibly remember and even though I know I have karo and food and she's a good eater, it still makes my heart stop for a moment.

Some cats never get into the 30s and they go into remission with having ever "kissed" a lower number. But, if he does ever throw a lower number like a 30-something at you, first....retest. Take just a few minutes to grab your backup meter and test again. Then give him some HC food/gravy and a drop or so of karo. Then post. Breathe. Give him 20 minutes after you get the HC/karo in him and then retest to be sure he's coming up. Ok? You are in control.
 
Well I guess it was time for the big bounce from this mornings new low numbers.
We'll see how it goes tonight, wondering if he'll recover normally or quickly.
What do you do about daylight savings time?

Ian
 
ah, I see his pmps on the ss - 295. Don't worry, he'll come down before too long.

You need to adjust his shot time. I'll find the post Angela did on changing times and bump it up.

Marje was right in what she said about shooting low. Once you've done it, then you have something to predict for the next time. Most cats don't drop drastically if they're shot low unless they were dropping before, but cats are all different. That's why you choose to shoot low the first time when you can monitor.
 
Thank you Marje & Julie, just reading your recent posts.
It seems when shooting low, you just have to decide when to jump & use the knowledge available to help him, everyones on their own ride. From what you've said though, there are some usual things that happen & we all just have to hope for those situations.
Thank you for all of your help ladies!!

Ian
 
on option for the time change is to just shoot on time in the morning. That will make tonight be a 13 hour cycle, and it's not likely to make too much of a difference with Oz in a bounce right now anyway.
 
not sure if you looked at the spreadsheets that I linked in the post I gave you a few days ago about shooting low.

I'd suggest you look at those - Peyton's, Zack's, and Davidson - scan down the left column of amps BGs and look for green ones. When they shoot a green preshot, look across that row and see what happens to the blood sugar in the next 12 hours.

Most of the time, after shooting green a couple of times in consecutive days, there is an overall change in the spreadsheet. Notice how the spreadsheets before that point typically have a rainbow of colors, and after that point you'll see blues and greens. I'm generalizing - i don't have their ss open. In a cat that's not newly diagnosed (less than 1 year), or has a concurrent issue like pancreatitis or hyperthyroid, or like my cat, acromegaly, that isn't necessarily the outcome. You might get green cycles for a while but sometimes it will look like the pancreas held it together for a while then got fatigued and couldn't keep up the pace.

But in most of the newly diagnosed cats that don't have some other issue as well, it can signal a huge change in the progress of their diabetes.
 
ian said:
How much food is needed to steer low pre shot numbers into a safe area?
Click to expand...
A preshot number should not be food influenced. In other words no food within the 2 hours prior to shot time. keep in mind that with Lantus, you are shooting at a number 3 or so hours down the road, when onset takes place. The PS reading helps you know what kind of duration he is getting as well as which direction BGs are going. So you test, feed him his regular meal, then shoot - all within a few minutes of each other. After that a +1 or +2 will reveal if you need to do any steering with food.
:cool:
 
I thought I'd give you ChrisFarley's ss too: https://docs.google.com/spreadsheet...bTk3S29rU18wWFUwd2kxNmJ2V2c&usp=sharing#gid=0 The other ss I gave you are all people who aren't currently posting. Melanie is a current poster, so you could ask her questions if you wanted to.

On his ss, notice about 9/20 when Melanie first starts shooting blue pmps. He's got lots of green nadirs and the time he's spending in green mid-cycle is lengthening.

the next transistion is about 10/2 when he begins getting blue amps tests.

starting 10/15, all of his blood sugar tests except one are under 120.

on 10/27 she reduced his dose because he'd spent 2 weeks in normal numbers (except one test) at the same dose.

on 10/28 he went to 42, so she reduced his dose again.

now Melanie is counting the 14 cycles at the same dose to see if she can reduce his dose again, or perhaps he'll go below 50 before then and that will bring about the next reduction.
 
Just checking in and I'm glad you will get a break tonight. It's always easier to deal with your first lower numbers during the day :-D

Looks like Julie has given you some good info on changing shot times tomorrow.

Have a great night.mmif he does start back down, just post...I'll be around.
 
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