11/18 Crushy pmps 72 +12.5 57 +13.2 43

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Michele M

Michele M

Member Since 2013
previous http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=108383&p=1146390#p1146390

looks like we are back to our regularly scheduled program of red and pink #s after yesterday *sigh*

I went ahead and kept the 2 unit dose last night and this morning...I didnt see the point in lowering it when he's at 456
Ill probably give him a skinny 2 units tonight. Hopefully next time he dives it wont be quite so hard to keep him up.

My vet gave me a prescription of regular insulin. Is that something that would help with his extreme bounciness? I definitely need some guidance with using it though!
 
Re: 11/18 Crushy amps 456

CARP grr_red


the only thing I can say is good for you for getting some sleep.
(& I am happy for yesterdays #'s nonetheless)
 
Re: 11/18 Crushy amps 456

I think you did the right thing by holding the dose. Crushy didn't drop below 50 so I'm not sure why you were considering decreasing.

I haven't used R with Gabby. It is not an insulin to be used lightly -- it's very potent and fast acting. Did your vet give you any instructions whatsoever? It can be a useful tool but you MUST know what you're doing. There are several people who have used R that can help you. I understand it's use in principle but not in practice. What I would suggest is that you put something in your subject line about using R so the folks with experience will spot the question.
 
Re: 11/18 Crushy amps 456

thanks Sienne
I was considering decreasing because if you read my condo from yesterday you will see that I had to work very hard to keep him from dropping too low. Since he is in high numbers most of the time indicating he needs more insulin then periodically drops low forcing dose decreases I have been trying to stop those drops with food so I can keep him at higher doses that he needs. Yesterday's drop was difficult to head off with food.
 
Re: 11/18 Crushy amps 456 +4 327 considering using R

I have used R with Jazzy and a little bit with KK. It can be another great tool for handling the bounces, especially since you can monitor a lot and you catch on to things quickly. I can help you learn to use it.

Crushy's dental is tomorrow, right? That makes it not the best time to try something new, but we can work on a plan for when things settle down after the dental. I would go to WalMart and get Novolin R. It's the same thing as Humulin R, but way cheaper.
 
Re: 11/18 Crushy amps 456 +4 327 considering using R

yuck on today's numbers, but at this stage they're the price to pay for those BEE-U-TEE-FUL numbers yesterday!

i think incorporating the use of R to shorten crushy's bounces is a good idea. i've also used R with alex. i don't use R often... only when i need it, but i think it's a wonderful tool to have in your sugar cat toolbox. i agree with libby about waiting until after crushy's dental to discuss a plan of action.

speaking of the dental... it sounds like you're well prepared. one thing i wanted to mention in case no one else has... i'm a big fan of giving a half dose or reduced dose if numbers are high or even skipping the shot if numbers are low at pmps time following a dental. anesthesia can lower glucose in the blood and it can lower BG numbers hours into the next cycle. there's no way to predict ahead of time if it'll happen with crushy. i've seen too many caregivers administer full doses following a dental, kitty drops, and the caregiver has a devil of a time trying to pull the numbers up... tough to do if kitty's mouth is the least bit sore. personally, i'd rather kitty run high for another cycle than have to battle those lows. the plus side is both kitty and caregiver are usually able to get a good night's sleep after the dental. i don't know about you, but i rarely get a good night's sleep the night before a dental. :roll:

let us know how the dental went. sending smooth and happy dental vines...
 
Re: 11/18 Crushy amps 456 +4 327 considering using R

thanks Libby, I appreciate it! Ill pick up some Novolin R in the next couple days

& thanks Jill for the tips on lower BG in the cycle after the dental. I didnt know the BG lowering effect lasted that long! good to know!

Ill let you guys know how the dental goes...
Bleh...not looking forward to tomorrow
 
Re: 11/18 Crushy amps 456 +4 327 considering using R

Michele

Just wishing lots of good dental vetty vines and quick recovery vines for Crushys dental.

I've also, and still do, use R to minimize the bounce. It's worked very well for Gracie. It's important to know Crushys onset, nadir and duration with Lantus. You'll want to be sure the nadirs of the two insulins do not overlap and you only give a small dose until you know how he reacts. The goal is not to pull the numbers down but to keep them from going any higher once the bounce starts.

One thing that a few of us have noticed that use R is that once the R is in and out (approx 4 hours during which you test), you "might" see the BG continue to come lower that cycle or the next. It's as if the R unlocks a door and allows the Lantus to do its job. ECID but I'd be watchful for a couple cycles after you give R to see if Crushy has that response.

Libby is a huge help in learning to use R. She's very good at helping you learn when the best time to give it is.
 
Re: 11/18 Crushy pmps 72 what the what??

thanks Marje and Jane



ok I just got my first green pre shot number
What bizarro world is this??

need to re-read that shooting and handling low pre shot #s.....
 
Re: 11/18 Crushy pmps 72 what the what??

Michele....I'm still up. Do you need some help?

I'd be sure and get a +1 and +2.
 
Re: 11/18 Crushy pmps 72 what the what??

Whoa, 72? Way to clear the bounce, Crushy . . . surf safely!
I sympathize with the unpredictability :shock: I am usually saying "what the what??" at least once a day with Papaya's numbers!
Have a good evening, Michele!
 
Re: 11/18 Crushy pmps 72 what the what??

nice!

Question, do you have any instructions about picking up food tonight? Some vets say to pick up food at midnight before a dental. If so, that will need to affect your decision.
 
Re: 11/18 Crushy pmps 72 what the what??

thanks guys!
geez never a dull moment Crushy!

the vet said dont feed after 1:30 am (its 10:25 here now...his usual shot time is 10:20)

I think I can feed a little later then that though because when I first talked to them they said dont feed after 5:30 am...then I told him his feeding schedule and they said ok dont feed after 1:30 am. They moved him up an hour in the schedule after that so Im thinking wiggle room Id be ok if I fed up to 3:30 am or so....probably not a huge meal at 3:30 though
 
Re: 11/18 Crushy pmps 72 what the what??

no I dont know the exact time. Just that he is the first or one of the first ones scheduled. I drop him off between 7:30 and 8:00 am
 
Re: 11/18 Crushy pmps 72 what the what??

Ok. while I am emailing with you THIS is going on. :o

What the what is right!! Of all times for Crushy to break through.
thank goodness Libby is here.
Michele is using the vet who did Hank's dental last month and he was fine with us feeding until midnite. We had scheduled the first appt of the day and agreed 6-8 hours with no food was fine. I am not sure that is their standard protocol but I asked about it specifically. (the forms said 9Pm- but we discussed alternative schools of thought) I am not sure what time your appt is?? Did he instruct you otherwise?
No matter what be sure to let them know. And again thank goodness for all the extra eyes...we need them tonight. Good damn lord Mr. Drama returns!
not exactly on queue. :roll:

I had come to wish you good dental vetty vines for tomorrow but will have to resume that momentarily. Let's see what is happening with THIS!! :mrgreen: first.
JEEZ!

good thing you have your relaxation on!!!!!!!!
 
Re: 11/18 Crushy pmps 72 what the what??

We had scheduled the first appt of the and agreed 6-8 hours with no food was fine.
Click to expand...
that's what libby and i were just discussing. no food 8 hours prior sounds about right.
 
Re: 11/18 Crushy pmps 72 what the what??

IF you end up having to feed a little later, and they do have wiggle room, then I think it is likely they can shift your order if it helps ie: if you were first make you second..if you need the time to accommodate anything that has to happen for this.

I think 6 hours with no food is minimum. You just won't know how late they can push their last surgery.
 
Re: 11/18 Crushy pmps 72 +12.5 57

he just tested 57 at +12.5

I did feed him 3 small pieces of chicken as his ear poke treat when I got the 72...I was going through the motions and not thinking. But his #s went down??
crazy!!
 
Re: 11/18 Crushy pmps 72 +12.5 57

UNBELIEVABLE! :shock:
Thank goodness for Jill and Libby!!!!!!!!!
I have no idea. It's like he has master planned this the whole time and we were the only ones that didn't know.

You ok?

Don't worry, they will work with you tomorrow..you just have to make them aware what was has gone on. You want to be sure it's safe with the anesthesia. You have a diabetic cat with a mind of his own.
 
Re: 11/18 Crushy pmps 72 +12.5 57

Im ok....
Im kind of hoping this is a breakthrough of some kind but...I dont know

I wonder if this is one of his dips....sort of late (or early)

I think your right Betty about them working with me tomorrow. They are really nice that way....

haha Betty...yes the bounce broke! yay!
 
Re: 11/18 Crushy pmps 72 +12.5 57

libby's typing options before it gets any later.
i type with onlytwo fingers... she knows how to type! :lol:
 
Re: 11/18 Crushy pmps 72 +12.5 57

it's so inconvenient when they decide to clear a bounce right at shot time. There's usually some extra momentum behind the drop when a bounce is clearing.

Normally this would be a GREAT thing and we would work with you to shoot the full dose. With the dental looming tomorrow, the choices are different.

1. Shoot, feed, steer the cycle as needed. Obviously if he still needs to be fed after your cutoff time, then you would have to keep feeding. That might mean having to cancel or reschedule the dental, depending on what time it is. Crushy doesn't always get a food spike, so you might be feeding quite a bit in the first couple of hours. He does usually bounce before the end of the cycle, though, so if/when the bounce starts you can stop feeding.

2. Skip. You'll be able to keep the dental appointment. Numbers will be high but can be dealt with.

3. Shoot a reduced dose of 1 unit. This might be a good compromise - get some insulin in. You'll still have to monitor, but it should be easier to stay ahead of the numbers.

Normally stalling would be a good option, but since we are sort of up against the clock tonight (for the food cutoff) that's not a very good choice for tonight.

What are you feeling is the best option?
 
Re: 11/18 Crushy pmps 72 +12.5 57

Can I ask one more question for the consideration pile?....

Michele has been simultaneously trying to keep Crushy on a diet. So she was cutting down on his cals. While steering the other day, I noticed she was giving teensie amounts of food each time. I believe she asked you about this at some point so there may have been an answer that I missed, but if she is feeding MC (or HC) to steer...is she having more trouble getting numbers up because the amounts are so small? Would it matter or help to feed same % but perhaps slightly more of it so not having to work so hard at it? Not saying to dump a whole can or anything, but as you have her managing the curve to fend off a reduction, is there an amount she should be trying to feed at each turn?

And I thought of it again tonight because it might mean being able to not have to drag it out so long if there were an issue with him dropping.
By the time I have typed this probably 5 other things have happened in the condo. i will send any way because if not pertinent for tonight maybe it will be for another time. And again forgive me if this was already answered and I just may have missed it.

Thanks for all the wonderful help and support. Very exciting kitty tonight!!
As the Crushy turns!! :lol:


and PS: are you saying if NOT for the dental you would have recommended shooting the full 2U on a 57?
 
Re: 11/18 Crushy pmps 72 +12.5 57

I want to take advantage of this opportunity

I want to proceed as if he doesnt have a dental appt tomorrow. If we cant do the dental because of late feeding and I have to pay a fee for rescheduling then thats ok. This is just a routine cleaning to rule out any potential problems. Its not something that HAS to be done tomorrow. (Im going to be bringing one of my other cats to them soon for some dental too so they are going to get some more business from us in the future.)

So......stall?

He just tested at 54
 
Re: 11/18 Crushy pmps 72 +12.5 57

When I saw the "PMPS 72", I thought you had already shot ;-)

To answer Betty's question! I have found that if numbers are coming down fast or are low, it's better to feed a larger amount. As an example, we normally feed Gracie about .25 oz in her normal mini meals. But if she's coming down fast or low, we might feed anywhere from .35-.5 oz depending on the situation.

In order to keep her from eating too many calories over her norm, we might cut back a little in each minimeal in the next cycle.
 
Re: 11/18 Crushy pmps 72 +12.5 57

the drop has stopped. What # are you comfortable shooting? Most likely he will rise after you feed (and if he doesn't, you know what to do).
 
Re: 11/18 Crushy pmps 72 +12.5 57

BTW Michele..it may not be one OR the other. Who's to say that Crushy won't bounce and be more than high enough to do whatever by then.
At this point irrespective of the dental..you have a dropping number...that is a whole other quandary.

I suspect you may be able to do all the above with some schedule re-arranging.

Can we clarify with Libby, that do you feel this is an opportunity for which the timing is crucial?

Between this potential breakthrough, plus the dental (if that was having any impact), plus anesthesia (which lowers the BG) in combination may really shake things up.
I will back away and let the wise ones chime in...just food for thought.
 
Re: 11/18 Crushy pmps 72 +12.5 57

Michele even if you had to feed til say 3:30-4AM you could still have a mid-morning dental. (IF it made sense still)
 
Re: 11/18 Crushy pmps 72 +12.5 57

he just tested at 43
So the drop is not over after all
I guess I need to feed huh?

(your right Betty the dental still might happen...we'll see!)
 
yeah, this tends to happen when they are dropping and their meal is late. I would give just a tsp or two of low carb to see if that puts on the brakes. It shouldn't take much, this late in the cycle.
 
also, I don't want you to think that this is the only opportunity you'll have to shoot low. If you miss tonight, it will come around again. It always does. I know you have worked very hard for this breakthrough, though, and I completely understand wanting to take advantage. I remember getting so excited when Lucy gave me a low preshot!
 
Unbelievable!!!

(and exciting)

..except the timing.

good thing you went to relaxation class before this ;-)


I will need valium soon if something doesn't give... @-)

shoot even without the food factor he may be too LOW for anesthesia. who KNOWS what's gonna happen??

they already think I am nuts...now me and all my friends are..we are nutty beans with nutty cats
 
darn I fed him some MC before I read that Libby ohmygod_smile

I'll feel comfortable shooting as soon as I see rise I think

I wonder what the odds are he goes straight into a bounce and the dental goes as planned.....

so If I see a rise then shoot 2 units? or did he earn a #@%! reduction?
 
Poor baby is probably famished. While we are doing a play by play analysis he is HOooNGRY!

Oh my Marje, yes he did earn a reduction. Whoops!

So aside from the dental, what number would you have recommended she shoot ..and what amount?
 
Re: 11/18 Crushy pmps 72 +12.5 57

while we're stalling...

and PS: are you saying if NOT for the dental you would have recommended shooting the full 2U on a 57?
Click to expand...
in this case, if the dental were not in the picture i would have suggested shooting a full dose on the 72 @ +12 "if" michele had all her hypo supplies and was prepared to monitor all night long if necessary.

as far as steering the curve with food goes...
i feed different amounts in order to steer the curve depending on the drop and where alex is in the cycle. they're labeled as snacks and the mini-meal portions are marked with asterisks on her spreadsheet. for alex a snack is 1/16 of a can of food. a mini-meal portion is 1/8 of a can. alex is also very carb sensitive so *usually* all i need is LC, but ECID. eventually a caregiver gets a feel for how much food it takes to pull numbers up to steer the curve depending on where you are in the cycle.

for those new to low numbers i usually suggest feeding a teaspoon or two (depending on where kitty is in the cycle). it's a starting point which can be tweaked as the caregiver gains knowledge and experience with their cat.
 
See above...he did earn a reduction.

If he didn't have the dental tomorrow (and I know that is flexible), I think Libby made an important point earlier when he was flat between 57 and 54. That would have been the time to shoot because you could feed and numbers would start up. If you wait too long, you can see this happening....he keeps dropping and you take the chance that he won't come up enough in a couple hours to shoot. Then you have to skip.
 
honestly, at this point I would probably skip so you can get to bed at some point. It's almost midnight, right? And you have to get him there in 8 hours, and he's too low to shoot. If you feed now, monitor until he turns upward, and go to bed, everything will be fine. The numbers will probably be kind of wonky for the next couple of days anyway thanks to the dental, even if you did shoot tonight.
 
or did he earn a #@%! reduction?
Click to expand...


....I think he did. But the timing is not so bad, as he will be running low from anesthesia anyway.
thus requiring a reduced amount. actually pretty serendepitous.

I bet he was about to bite your leg for some grub. glad he got at least a teaspoon. what a good boy.
 
no dental, I would have shot the 72. But that doesn't matter, because that's not the situation we have in front of us right now.

Reduction? I don't know, I think the 43 was more due to the bounce clearing and not feeding. Again, I would probably see how things settle out after the dental before worrying about that. He is going to have an empty depot to refill.
 
Libby and Lucy said:
no dental, I would have shot the 72. But that doesn't matter, because that's not the situation we have in front of us right now.

Reduction? I don't know, I think the 43 was more due to the bounce clearing and not feeding. Again, I would probably see how things settle out after the dental before worrying about that. He is going to have an empty depot to refill.
Click to expand...

due consideration has to be given to the low being because of the bounce clearing and not being fed. a reduction was not earned in the normal sense.
let's see how this all pans out after the dust settles. no decisions have to be made tonight...
 
ok Im going to skip the shot and head to bed

he just tested at 50 (about 25 minutes after he ate) so he is heading up but not at warp speed. He still needs some more food tonight though and Ill probably test him for the next couple hours to make sure he is either surfing or rising.

thank you so much everyone for talking me through this!!!
I learned a lot!
you guys are awesome!
 
Libby and Lucy said:
honestly, at this point I would probably skip so you can get to bed at some point. It's almost midnight, right? And you have to get him there in 8 hours, and he's too low to shoot. If you feed now, monitor until he turns upward, and go to bed, everything will be fine. The numbers will probably be kind of wonky for the next couple of days anyway thanks to the dental, even if you did shoot tonight.
Click to expand...
fwiw, i agree with libby, michele.
i know you've been working hard for this break, but i guarantee it will come around again. it always does!
and who knows? this dental might make all the difference in the world. crushy may end up requiring less insulin just from having clean toofies!


oops... i was typing when you posted.
 
Very exciting night.

Bucket Loads of positive Dental Vetty Vines for Mr. Drama!!!!


And Hugs to you friend. Sure hope you get some sleep.

Will check on you in the morning and be watching during the day.

Don't worry...there are more opportunities and low PS in the waiting...

You could not have predicted or done any more than you are already doing.

I remain so impressed!!

'nite...
:YMHUG: :YMHUG: :YMHUG:



ETA: Amen to what Jill said!
 
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