12/2 Mikey DOSE REDUCTION AMPS 497 +11/378 PMPS 341 +2/389

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Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given

Hi guys .. wow what a day you had yesterday! Nice job handling it .. Im not surprised that mikey is this high .. a drop to 38 yesterday could definitely cause such a high bounce .. I wonder what mikey has in store today! Have a great weekend!
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given

Jenn
You did good
Go back and look at yesterday and what marje and I said about "bounce".
That's all this is.
Good morning!
Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

ok. so far I have been prepared for handling LOW numbers. His BG at +1 is 568! What do you do for HIGH numbers?

pS- he is starving!
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Did you feed him at AMPS?
Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

fed him 1/4 can at AMPS and 1/8 just now
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Just keep doing what you are doing & shoot through the bounce--A bounce can last for 72 hours, so monitor him as you normally would... Mikey, despite the bouncing is doing well!
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Are there any "signs' to look for when he is so HIGH? I know all the things to look for and have handy for a HYPO/too low. Is there danger is being too high? If so how do you get him to come down?
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Jenn,
Do you check for ketones? Might want to do that today.
The only thing that's going to lower the BG is insulin, and Mikey isn't getting any more of that until 11:30 tonight. It's nowhere near as much of a problem to be high for a day or two than it is to be low for a minute.
This isn't a really big issue, just something that "happens" as the diabetes starts to get more under control.

Do a board search for the word "bounce". You'll get like 10,000 hits. Happens every day to some sugarkitty or other.
Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

I'll test for ketones as soon as i can. I know i tested on 11/29 he was negative. I've been giving him food w/ water to make sure he's "drinking"

The drastic numbers just scare me.
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

I understand the "drastic numbers" thing.
Yesterday's numbers, those fit the "drastic" label, since it was your first really really low number.
Today? Not so drastic.
Ketones are more likely to show up in a kitty with higher numbers for a long period of time, not just from one cycle of highs. But good idea to check them anyway.
Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Also my fiance will be here on Sunday to shoot Mikey (he know how nervous I was so he took the day off of work)
I shot MIkey at 11:15am before knowing this so I don't need to get him to 12. What time should I shoot tonight? 11:15 and then work back to 11 tomorrow morning?
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Other than checking for ketones,
my reaction to high numbers is to cover my eyes and just wait for the next shot of insulin :sad:

Hang in there!!!

celi
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

If you wanted to shoot at 11 tonight, that would be fine, especially if his numbers stay this high. Either way would work, it's up to you.
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 1.25u given +1/568

Jen

That plan you have will work well. Stick with 11:15 tonight, and go back to 11:00 tomorrow morning. That way you aren't making two adjustments in twelve hours in opposite directions. Good plan!

And your fiance doing that for you? Yep, I think you found the right guy! He's a keeper. :smile:

Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431

Ok. I will shoot at 11:15 tonight and then 11am tomorrw, 11pm tomorrow night

BG @ +3 431 going down but still in the red :sad:
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431

That's still okay, Jenn
Look at the "pattern" rather than the numbers. This is sort of the way Mikey rolls. He climbs a bit after breakfast, and then he dips around +3. He does that fairly often. So he's doing his normal Mikey thing. Just using different colors today. :smile:

Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431 +4/389

KETONES NEGATIVE!!!

BG 389 @ 4pm. Do I have to test him so frequently the rest of the night?
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431 +4/389

Jenn:

Sorry I have not been online all day....still dealing with Mom issues.

I don't want to disagree with Carl but I do ;-) and I agree with Anne. You can shoot at 11 tonight. It's ok that you shot at 11:15 this morning and 11 tonight. Just get back on your regular schedule tonight, k?

I know these high numbers are scary. It's ok....just keep checking him for ketones once a day while his numbers are high...he's already coming back down...GOOD BOY!

It's important that you feed him his regular LC food even when his numbers are high. He has to have food.

Which brings me to last night.......great job....I'm so thankful to Carl for staying up with you; if I had thought Mikey was dangerously low or Carl was not totally capable, I would not have gone to bed; you both did AWESOME!
I only have a couple points to make:

1. it's really important before you post back to the person who is helping you, that you scroll back through and make sure you have read all comments. Sometimes when things are happening so quickly, we cross post and you
miss important suggestions. One of those was me telling you to feed him LC food after you got him up from the 38.

2. if he's hungry still, you can feed him LC food but don't overfeed....keep it small helpings in case he comes back down
Click to expand...

I think that got lost in all the excitement and that further confusing it was the information on getting two rising, non-food influenced numbers. When you give him the HC and he comes up, you can continue to feed him small amounts of LC. You need to see him coming up safely and just make sure you have two rising numbers ....but what I should have added instead of "non food influenced" was "non HC/karo influenced". I did say it takes about two hours for the karo/HC to wear off and so once you are past that time and he's still coming up, you are good with two rising numbers even if you have been giving him LC.

As you saw last night, he did come back down before he went up again and it was about at the two hour point from the HC/karo.

2. because he had never been into the 30s and we weren't sure how he would respond to HC gravy being that low, I had you give him just a bit of karo. He REALLY responded. So, I would suggest that you write in your notes for next time, just try to give him the HC gravy without the karo and then retest in 20 mins and see if that alone will bring him up. Not all cats need the karo...some do just fine with just the gravy and he looks like he might be one of them. If you do give him the gravy and he doesn't come up alot, you can give him just a little more and retest in 20 minutes ...it might take a couple times of gravy to see his numbers rise without the karo.

Again, you all did great. I'm sure you are exhausted today. I'm glad Marc is going to be available on SUnday. Please be sure he knows how to post so if he has any problems, he can get hold of us :-D

Do you have any questions from yesterday....anything that would help you for next time?

ETA: Because I did not know how high he would go, I did not advise you to "shoot through the bounce". That's the next lesson ...I'll post more on that in a bit. I have to run out really quick but will be back soon.
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431 +4/389

So, I would suggest that you write in your notes for next time, just try to give him the HC gravy without the karo and then retest in 20 mins and see if that alone will bring him up. Not all cats need the karo...some do just fine with just the gravy and he looks like he might be one of them. If you do give him the gravy and he doesn't come up alot, you can give him just a little more and retest in 20 minutes ...it might take a couple times of gravy to see his numbers rise without the karo.
Click to expand...

Jenn
Perhaps that should read "if there is a next time". There is no need to automatically assume that there will be a next time. It isn't guaranteed, and it hopefully will never happen again. Marje is right for detailing the "what to do" information, just in case. A kitty doesn't "need" to become hypoglycemic in order to get better or go into remission some day. Bob went below 50 (on my meter anyway) two times. 44 and 42. He displayed no hypo symptoms, ever. He never needed any karo, or HC food to bring him up. Just a spoonful of LC and a pat on the head. He went OTJ after 10 weeks. No, he didn't drink Lantus. He drank PZI.
Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431 +4/389

I don't want to disagree with Carl but I do and I agree with Anne. You can shoot at 11 tonight. It's ok that you shot at 11:15 this morning and 11 tonight. Just get back on your regular schedule tonight, k?
Click to expand...

Marje,
We'll have to agree to disagree. :smile:
Here's my logic: Shooting early tonight is in effect a dose increase
Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
Click to expand...
He just had a dose decrease this morning, and given that it was 15 minutes late, was a greater "decrease" in effect.
So that's two time adjustments and effective dose adjustments in one day. ETA - actually it's two adjustments in a 12 hour period.
Also, if you're going to effectively give him a "dose increase" with an early shot, wouldn't it be better to do that in the morning when Jen is already going to be awake rather than at night and have another night like last night?

Early warning, I can't pull another all nighter tonite, and I'm pretty sure Jenn probably isn't really into the idea either.

Carl
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431 +4/389

Carl

With lantus, if you shoot within the 15 min timeframe, it isn't considered to be a dose increase or decrease. It's the "allowable" time that keeps it from being either.

ETA: If he DID come down like last night...it's my turn to stay up with her. You were very wonderful to do it last night...my turn tonight. But, I don't see that happening because he's bouncing and because
she reduced his dose to 1.25u.
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +1/568 +3/431 +4/389

FWIW, 15 min. early or late shouldn't make a difference. If it's more comfortable to shoot at 11:15 tonight, that's fine. However, given the high numbers today, shooting a bit early is just fine.

You did great last night. This is, indeed, a bounce. Unfortunately, the only solution to a bounce is time. It can take up to 72 hours for a bounce to clear. No matter how tempting it is, do not increase Mikey's dose. Just wait this out.
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +5/389 +7/421 +11/37

BG 378 @ +11 (1o:07pm)

As much as I hate seeing the "higher" numbers I understand that it happens (bounce as I am learning)
Thank you all again SO much for all the help you have been giving me. I can image how hard it is for you all when a new bean comes to LL. Lots of re-posting. It has been the most difficult foster I have had but I know that it is worth every second. The alternative was him being euthanized. My only regret is that I don't have the space to have helped more diabetic cats at one time.

I am hoping, as Marje noted, he will be ok for tonight. I really need some sleep. As it is with the 15 we don't get much sleep to begin with.

Since it seems ok to shoot at 11pm I will. He is starving. I got home later than I thought I would. Another think I have to get used to is leaving the timer w/ the food when we leave, just in case we run late. Learn something new every day ;-)
 
Re: 12/2 Mikey DOSE REDUCTION AMPS 497 +5/389 +7/421 +11/37

Hi Jenn:

You know we are happy to help out and answer your questions. I am in awe that you are fostering him and doing such a great job. It is not easy and you are handling it with real grace!

It's not hard with newbies coming to LL...we were all newbies so we understand and there were people there to lead us through every step. One day you will be helping others....

That's wonderful you say that you don't have space to help more than one FD cat a time but.....yikes...you really wouldn't sleep!!!

I'd give him his insulin and I think you have two options tonight depending on how soon you want to get to bed:
1. get a +2 and if it's way up there near the PMPS, call it a night OR if you are still up
2. just get a +3 because he will probably onset by then and you can just see if he's going to stay flat or come down some.

Your choice for when you need to be in bed.
 
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