12/08, Sam, AMPS 270, +2 333

chuckstables

chuckstables

Member Since 2022
Hey folks,

Looks like sam bounced. Again last night....

Starting to get really tired of this. Do you think we're going too low during the day? His numbers the last few days have been really high during the day.
 
Try not to get discouraged, you are doing a great job! No, this current wave is the bounce starting due to the greens last night. The good news is the last few bounces he has been breaking quickly. Remember what I mentioned on your post in the main forum that not all cycles will look the same.

It takes time and a little patience to get to a more well regulated place, albeit I know how frustrating it can be to get greens one cycle then back to stinky pinkies the next. How do you find Sam is doing / feeling otherwise? Sometimes we get so caught up in the numbers that we forget to see what’s called the “whole cat report”. This bounce shall pass, what goes up inevitably comes down, so hang in there :).

Since he was under 90 last night, I would suggest you reduce to 1.75u. I see you went back to 2u this morning, but I would try 1.75u tonight and going forward, unless of course he drops under 90 again.

here is yesterday for continuity.

https://www.felinediabetes.com/FDMB...236-9-274-pmps-166-1-108.271600/#post-3023080
 
Christie & Maverick said:
Try not to get discouraged, you are doing a great job! No, this current wave is the bounce starting due to the greens last night. The good news is the last few bounces he has been breaking quickly. Remember what I mentioned on your post in the main forum that not all cycles will look the same.

It takes time and a little patience to get to a more well regulated place, albeit I know how frustrating it can be to get greens one cycle then back to stinky pinkies the next. How do you find Sam is doing / feeling otherwise? Sometimes we get so caught up in the numbers that we forget to see what’s called the “whole cat report”. This bounce shall pass, what goes up inevitably comes down, so hang in there :).

Since he was under 90 last night, I would suggest you reduce to 1.75u. I see you went back to 2u this morning, but I would try 1.75u tonight and going forward, unless of course he drops under 90 again.

here is yesterday for continuity.

https://www.felinediabetes.com/FDMB...236-9-274-pmps-166-1-108.271600/#post-3023080
Click to expand...


He’s acting okay, he’s a lot more sedate right now than he was before the dose drop, seems more chill.
 
He’s on 1.5 units at night, 2 in the AM. Vet really doesn’t want me changing it right now. I can reduce further to 1.75 am, 1.5 pm?
 
You should be shooting the same dose in the AM and PM. Due to the depot style nature of Lantus, our dosing methods work best if you shoot the same in the AM and PM. Otherwise you can end up with wonky numbers. I would either do 1.75 units AM and PM or 1.5 units AM and PM.

I thought the latter was what you talked about yesterday. I missed that the vet suggested two different doses.
 
Wendy&Neko said:
You should be shooting the same dose in the AM and PM. Due to the depot style nature of Lantus, our dosing methods work best if you shoot the same in the AM and PM. Otherwise you can end up with wonky numbers. I would either do 1.75 units AM and PM or 1.5 units AM and PM.

I thought the latter was what you talked about yesterday. I missed that the vet suggested two different doses.
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Okay, i’ll try 1.75 units 2x per day then. Do you think his high numbers are from a bounce? I’m just worried i’ve reduced his dose too much. If he still gets low tonight i’ll have to go to 1.5.
 
Finally seems to be dropping, but still very elevated. Vet wants to reduce to 1 unit at night; i don’t think i’ll be doing that. I think the vet at this point is there for any other health problems.
 
I totally agree with Wendy you have to stay with the same dose both for the AM and PM cycle.
Either 1.50 units for both cycle or 1.75 units for both cycles
Anyway you can add to your signature SLGS ,that's the first thing members will look at.
If you can't fit it you can just get rid of where you have 2.25 U 2x daily because the units are always going to change
@chuckstables
 
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chuckstables said:
I agree as well. It’s a shame vets don’t have more experience with this kinda stuff. Will shoot 1.75 tonight, will go down to 1.5 if he’s still low.[/QUOTE:cat:

You might want to re read about SLGS Dosing
I copied this
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
@chuckstables
Click to expand...
 
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chuckstables said:
I agree as well. It’s a shame vets don’t have more experience with this kinda stuff. Will shoot 1.75 tonight, will go down to 1.5 if he’s still low.
Click to expand...
I'm no expert at all when it comes to doses, If you are worried about him going to low maybe you just stay with 1.5 units for both cycles for now , start the 1.5 units tonight . Like Wendy said in your previous post you could try 1.5 units and if it's no good you can always go up
I'm going to tag her just in case I gave you the wrong information
@Wendy&Neko
 
Diane Tyler's Mom said:
Can you add SLGS to your signature please :cat:
You might want to re read about SLGS Dosing
I copied this
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
@chuckstables
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I meant 1.5 tomorrow if he’s still low tomorrow, i know you can only go down by 0.25
 
I’m trying to gauge your usual feeding schedule, sorry if it was mentioned before, but when are you feeding and what amounts at those times? Some vets are more familiar with other types of insulins, which are more in and out and perhaps they don’t always have an understanding of the depot insulins like Lantus, Levemir and other biosimilars. That, and as is noted in the sticky on our dosing methods followed here, given the nature of these insulins, they made sense for caregivers and their cats and that’s what we follow.

In any event, if you are wondering what might be up for tonight, let’s see where you are at around +11. It’s a good spot check, since it can give you an idea of whether you are coming upward by preshot which indicates the cycle is waning, or whether perhaps you are getting a bounce clearing cycle like yesterday through to preshot. If you can get a +11 and PMPS post those and we’ll see if you need to do anything different.
 
Christie & Maverick said:
I’m trying to gauge your usual feeding schedule, sorry if it was mentioned before, but when are you feeding and what amounts at those times? Some vets are more familiar with other types of insulins, which are more in and out and perhaps they don’t always have an understanding of the depot insulins like Lantus, Levemir and other biosimilars. That, and as is noted in the sticky on our dosing methods followed here, given the nature of these insulins, they made sense for caregivers and their cats and that’s what we follow.

In any event, if you are wondering what might be up for tonight, let’s see where you are at around +11. It’s a good spot check, since it can give you an idea of whether you are coming upward by preshot which indicates the cycle is waning, or whether perhaps you are getting a bounce clearing cycle like yesterday through to preshot. If you can get a +11 and PMPS post those and we’ll see if you need to do anything different.
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His feeding schedule has been totally messed up due to the bounces. I try to feed him in the morning around shot time, evening around shot time, with some wet food as a snack in between main meals. But everytime he bounces he wakes me up at 5-6 am begging for food, have to feed him to go back to bed.

He finally seems to be dropping.
 
Yikes you’re a night owl ;). I liked having a bit of a buffer especially in my pm cycle where I could still test before bed and had the opportunity to give snacks around +2 and +4 with Lantus. Are your shot times pretty much necessary as is, or could you adjust to shoot a little earlier? No worries if not. I’m just pondering whether a small adjustment to feeding and shot times can help with that issue of him waking you up.

The other thing that worked wonders for me was an automatic pet feeder, I’d set it to open so the cats can get a midnight snack and not wake me up. Maverick still wakes me up with his poking me if I don’t have my arm available for him to nestle in, but I’ll take that over getting up to feed him any day.
 
Christie & Maverick said:
Yikes you’re a night owl ;). I liked having a bit of a buffer especially in my pm cycle where I could still test before bed and had the opportunity to give snacks around +2 and +4 with Lantus. Are your shot times pretty much necessary as is, or could you adjust to shoot a little earlier? No worries if not. I’m just pondering whether a small adjustment to feeding and shot times can help with that issue of him waking you up.

The other thing that worked wonders for me was an automatic pet feeder, I’d set it to open so the cats can get a midnight snack and not wake me up. Maverick still wakes me up with his poking me if I don’t have my arm available for him to nestle in, but I’ll take that over getting up to feed him any day.
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Can you get an automatic pet feeder for wet food?
 
Oh ya absolutely! I use the Petsafe 5 auto feeder. I like that because it is electronic timer, turns at a set time to open to next available slot. Some people in hotter climates use ice packs underneath to keep things cold but I’ve never needed to. I have done snacks from cans that were kept in the fridge. Honestly, between that and my headlamp to see blood drops from tests easier, best money I ever spent.

ETA: it was also primarily for when I was away during the day at work and wanted to be sure food was available at certain times during the day.
 
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Christie & Maverick said:
Oh ya absolutely! I use the Petsafe 5 auto feeder. I like that because it is electronic timer, turns at a set time to open to next available slot. Some people in hotter climates use ice packs underneath to keep things cold but I’ve never needed to. I have done snacks from cans that were kept in the fridge. Honestly, between that and my headlamp to see blood drops from tests easier, best money I ever spent.

ETA: it was also primarily for when I was away during the day at work and wanted to be sure food was available at certain times during the day.
Click to expand...

Given that in my area right now I'm freezing that would work great. Got an AC anyway; whenever it gets above 22 or so outside I just turn it on lol. I am so intolerant to heat.

This just all sucks honestly. I took sam about 18 months ago because I love him. I moved out of my parents place (at the age of 27; goo meeee), and a month later my parents told me I had to take sam as all he'd do is sit outside my old bedroom door crying and being depressed. The stress of this is affecting my work performance (as I found out today; because I took 3 minutes extra on a 5 minute break to test sam, and because I sound distracted all the time because of how stressed I am). I'm just kinda at the end of my rope and struggling. I'm trying hard to help him, and he's trying hard to help me (he's started sitting on my couch next to me, which is really nice).

Sorry for the rant. It's just been a crappy day. Nobody apart from you guys seem to understand how much I love him and the lengths I'd go to to make sure he is okay.

One more question; he seems to enjoy looking out my patio door to see the cars go by. Do you think birds would come to a bird feeder if it's placed on a patio? I want him to have something else to look at while I'm gone to work.
 
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