11/17 Lily restart insulin AMPS 166

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Hi Sally,

How are yourself and Lily doing today? Fingers and paws crossed for Lily to do really well on her shiny new insulin! :cat:

Looking at the pattern of Lily's readings over the last few weeks, I think it's going to be tricky for you to get preshot readings above 200 (human meter), so I think perhaps you might need to consider an initial 'no-shoot' number lower than that. In realistic terms, with Lantus treatment you'll be looking to ease Lily down into increasingly better numbers and therefore you'll be looking to give insulin at progressively lower preshot numbers as Lily's Lantus readings accumulate.

I'll check back in with you for the next test result and perhaps we can then have a quick discussion about your dosing decision for this morning. In the meantime, some standard pre-flight checks so that I get a clear understanding of how you're set today. Please can you confirm:

* You have plenty of test strips.

* You have medium and high carb wet food.

* You have some form of dry high carb food or high carb treats (e.g. Temptations).

* You are able to monitor Lily's BG throughout the cycle other than when you're visiting your FIL.

* You think Lily will be able and willing to eat small amounts during the 12-hour cycle should the need arise (talking a teaspoon or two at a time).

I'd also be grateful if you could let me know the times after the dose when you'll be with your FIL (for example: 1st visit AM+1.5-2.5, 2nd visit AM+4-5) so that I'll be able to make better suggestions about any snacks Lily might need for those times.


Mogs
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Morning Mogs, we are doing good. I just retested Lily and she is at 196, probably stressed because we are holed up in the bathroom. LOL, just didn’t want her to get the others food and she has started to run from me at shot time. ☹️ We have plenty of test strips and I have hc and temptation treats. Not sure if I have mc don’t think I do. Yes, Lily is a great little eater so I don’t see a problem with her eating small amps units throughout the day. I spoke with Frankie and he will handle papa all day today so I am here! Thanks for being here Mogs, ok to feed her now?
 
Glad Frankie's helping out today. Starting a new insulin is a bit :nailbiting:.

Sally and Lily said:
probably stressed because we are holed up in the bathroom.
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Aw bless! (((Lily))) :D

Glad the AMPS bumped up a bit for you - less nerve-wracking! :)

It's OK to feed Lily now. As soon as she has a fair bit eaten, it's OK to then give the 0.25IU Lantus. Because its onset is gentler, there's no need to do the 30-minute wait any more.

Because it's Lily's first day, its recommended that you monitor BG closely at least for the first few hours, starting at +1. That OK with you, Sally?


Mogs
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Critter Mom said:
Glad Frankie's helping out today. Starting a new insulin is a bit :nailbiting:.


Aw bless! (((Lily))) :D

Glad the AMPS bumped up a bit for you - less nerve-wracking! :)

It's OK to feed Lily now. As soon as she has a fair bit eaten, it's OK to then give the 0.25IU Lantus. Because its onset is gentler, there's no need to do the 30-minute wait any more.

Because it's Lily's first day, its recommended that you monitor BG closely at least for the first few hours, starting at +1. That OK with you, Sally?


Mogs
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Yes, that is perfect! I will feed and give her .25. This girl is hungry! Thx!
 
Better. If you like you could give her a teaspoon or so of low carb (LC) food. It's not necessary but it'll do no harm to make sure she'll take snacks for you mid-cycle. Now that BG has gone down again, I'd suggest a test at +3.5. That OK with you, Sally?


Mogs
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Critter Mom said:
Better. If you like you could give her a teaspoon or so of low carb (LC) food. It's not necessary but it'll do no harm to make sure she'll take snacks for you mid-cycle. Now that BG has gone down again, I'd suggest a test at +3.5. That OK with you, Sally?


Mogs
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She took a tsp of LC food, I had to fight the others off. LOL. She is 102 at 3.5. Dropped quite a bit.
 
Ah, seems like Lily got a little bump from the 2 tsps. Good to know. Can you give her just 1tsp this time and test at +4.5 please, Sally.

It's typically within the next couple of hours that many kitties reach nadir but we're just feeling our way at the moment.


Mogs
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Nice 'n' steady. That teaspoon was enough to hold her steady.

This time round, don't feed (sorry, Lily!), but test again at +5.0, please.

I'm trying to help you get a feel for whether she will dip in the middle of the cycle in the hope it will help you tonight.


Mogs
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On the rise by the look of things, Sally. As the depot gradually fills with successive doses, you may see her surf for longer in the middle of the cycle.

I'd suggest doing another test at +6.00. Assuming that Lily's still rising - or at least hasn't dropped again you could then test at +7. Assuming she's in safe numbers then I'd suggest a test at +9 (but feel free to test in between if you would like to).

As usual, lift all food for two hours prior to PMPS (unless Lily were to need food because her numbers were running on the low side - unlikely today).

To help with determining whether it's OK to give insulin tonight, I'd suggest grabbing tests at AM+11.5 and PMPS. It will help you to better gauge whether Lily's BG is rising.

Does this sound OK to you, Sally? Needless to say, if you're not sure of anything or have any questions please post for help.


Mogs
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Critter Mom said:
On the rise by the look of things, Sally. As the depot gradually fills with successive doses, you may see her surf for longer in the middle of the cycle.

I'd suggest doing another test at +6.00. Assuming that Lily's still rising - or at least hasn't dropped again you could then test at +7. Assuming she's in safe numbers then I'd suggest a test at +9 (but feel free to test in between if you would like to).

As usual, lift all food for two hours prior to PMPS (unless Lily were to need food because her numbers were running on the low side - unlikely today).

To help with determining whether it's OK to give insulin tonight, I'd suggest grabbing tests at AM+11.5 and PMPS. It will help you to better gauge whether Lily's BG is rising.

Does this sound OK to you, Sally? Needless to say, if you're not sure of anything or have any questions please post for help.


Mogs
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Sounds like a good plan Mogs. Thanks again for your help! I need to run out to the grocery store so if all looks good at her +7 I will do that. :bighug:
 
When you're out at the grocery store, I recommend you pick up some tins of Fancy Feast Gravy Lovers food for Lily's toolkit. They're used to steer Lantus kitties through mid-cycles if their numbers need a bit of a boost.

Keep safe while you're out and about, Sally. Very nice little blue surf today. :cat:

:bighug:


Mogs
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Critter Mom said:
When you're out at the grocery store, I recommend you pick up some tins of Fancy Feast Gravy Lovers food for Lily's toolkit. They're used to steer Lantus kitties through mid-cycles if their numbers need a bit of a boost.

Keep safe while you're out and about, Sally. Very nice little blue surf today. :cat:

:bighug:


Mogs
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Thanks Mogs, she is 188 at +6.
 
Sally and Lily said:
When you say bounce does that mean up or down?
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We use the term 'bounce' to describe the response of the body to a BG level it perceives as low. This may be a number that genuinely is too low (<50 on a human meter) or it may be a BG level that the body hasn't experienced in a while. In response, the body releases hormones that cause the liver to release extra glucose into the bloodstream and consequently numbers may go up to an unusually high level for a time until the system calms down again. A bounce may clear quickly, but it can take up to 6 cycles for things to settle down again. We'll be able to help you interpret Lily's readings as you go along so you'll learn how to spot them if Lily has any.


Mogs
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Hi Sally,

I've been looking at Lily's spreadsheet and I've seen how low her PMPS is and also that she's still dropping. There's no way I can stay up with you to help you steer numbers (nearly half past two here) and I can't see anyone online who'd be able to assist you. I'd recommend you skip the dose tonight. Lily's responding very well to the Lantus.

If you can manage it, I'd appreciate it if you'd drop a quick post to say you're skipping. (I'm about to lose consciousness here.)


Mogs
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Critter Mom said:
Hi Sally,

I've been looking at Lily's spreadsheet and I've seen how low her PMPS is and also that she's still dropping. There's no way I can stay up with you to help you steer numbers (nearly half past two here) and I can't see anyone online who'd be able to assist you. I'd recommend you skip the dose tonight. Lily's responding very well to the Lantus.

If you can manage it, I'd appreciate it if you'd drop a quick post to say you're skipping. (I'm about to lose consciousness here.)


Mogs
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Yes Mogs, I am skipping tonight’s insulin! Sleep well!:bighug:
 
Thanks so much for confirming the skip, Sally. I really appreciate it.

Some bedtime reading for you:

How to Handle Low Numbers

It covers the principles of how to steer a kitty with higher carb food to navigate them safely through the cycle. At the way Lily's looking to respond to the Lantus, it's a good move to get an idea of what's involved, but you should be able to get help here while learning to 'steer the curve.'

Catch you on the morrow. Wishing a grand evening to you all.

:bighug:


Mogs
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