2/14 Choco +4 47, +4.5 54, +5 64, +6 70, +10 110, +11 123

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Re: 2/14 Choco +5 69, +6 59, +7 67, +8 75, +9 79, +10 91, +1

I need some help. Please see above post. Also, should I still be shooting 1.5 units with his numbers this low? Thank you.
 
Re: 2/14 Choco+6 59, +7 67, +8 75, +9 79, +10 91, +11 97

to be sure I have things right, you need to move his shot time earlier by 30 minutes by tomorrow morning?

Generally shooting 15 minutes early is not an issue at all, so you can easily move it by 15 minutes tonight and tomorrow morning. An alternative would be to shoot the whole 30 minutes early but reduce the dose (just for tonight).
 
Re: 2/14 Choco +7 67, +8 75, +9 79, +10 91, +11 97, +11.5 10

Okay so if I shoot him at 6:15 that will be 30 minutes early and then tomorrow I will be getting my amps at 6:00am and shooting at 6:15 so that will put me right on schedule. So what should I be shooting at tonight? Did you see I just posted his 11.5 106?
 
Re: 2/14 Choco +7 67, +8 75, +9 79, +10 91, +11 97, +11.5 10

sorry, I'm having trouble posting for some reason. If this morning's shot was at 6:45, I would either shoot 1.5 units at 6:30 (then shoot at 6:15 in the morning) or 1 unit at 6:15 tonight.

There are plusses and minuses either way, so it's your call. EIther way, please plan to monitor tonight. If you need to feed a higher carb food for dinner, then that is fine too.
 
Re: 2/14 Choco +7 67, +8 75, +9 79, +10 91, +11 97, +11.5 10

sorry to be so brief, I was trying to post before my internet hung up on me again. Anyway, this is a nice rise from Choco's nadir earlier, so that's why it's ok to go ahead and shoot. Still, a 15 minute early shot is safer than a 30 minute early shot, thus the recommendation to reduce the dose if you're shooting 30 minutes early. That is normally not something I would recommend (normally shooting full dose works just fine), but Choco's pancreas seems to be healing quickly so I wanted to err on the side of caution.

You want to monitor either way, because I do think there is a chance Choco will earn a dose reduction tonight. Do you still have plenty of high carb food on hand, and lots of test strips?
 
Re: 2/14 Choco +7 67, +8 75, +9 79, +10 91, +11 97, +11.5 10

Okay, I shot 1 unit but it ended up being at 6:20. I do have plenty of test strips although after the past couple of days, my supply has certainly gotten low. :O/ So anyway, plenty of strips and HC food. Should I just keep on the every hour schedule for now?
 
Re: 2/14/11Choco amps 138, +1 158, +2 157, +3 126, +4 85

Libby and Lucy said:
With all respect to Venita, to me there is no sense in NOT giving sufficient insulin. Correcting with higher carb food is exactly how a cat who is one week out of DKA should be handled. They need enough insulin and food to help prevent relapse. If the cat is responding so well to a dose that they need to be given more (or higher carb) food to counteract the insulin, then that is what needs to be done. I have actually been concerned that Choco's dose has been reduced too much since he has been home, so I'm glad he has been able to hold this dose for a few cycles. Maria is doing an excellent job of monitoring and feeding the curve, so it makes sense to continue being aggressive as long as she is home. Additionally, the data she has collected over the past few days is making the picture a lot more clear about what should be recommended for when she goes back to work. She even had the foresight to try not forcing food today to see how he managed his own curve without her prompting. That was a GREAT idea, by the way. :smile:

....

Cats that are only one week removed from a DKA do require more intervention and more aggressive treatment than a regular diabetic cat. My SOP is to apologize to the bean in advance but say "sorry, you do not have the luxury of easing into this the way some peopl do."
Click to expand...

Hi Libby. I certainly hope it didn't sound like I was saying that Maria should not give Choco sufficient insulin. If it did, that was not at all what I intended. Instead, I was trying to say that I think his dose is a touch more than what is sufficient.

But then I got confused when you said that correcting with high carb food is exactly how a cat that is one week out of DKA should be handled. I take from that "correcting" comment that you might mean that for post-DKA cats, a slightly high dose IS sufficient (and not excess) insulin.

Excuse me if I misunderstand, or if I am not explaining this well.

I appreciate your experience with this Libby, but I have looked around and I can find no information that explains special rules for insulin dosages for post-DKA cats. I see nothing in the FAQs, in the Pets with Diabetes wikia, and I can't scare up anything on Google. Is there a source somewhere that you (or anyone else here) can point me to so that I can catch up? Thanks.
 
Re: 2/14 Choco +8 75, +9 79, +10 91, +11 97, +11.5 106, +1 8

Hmmmmm, I'm not used to his numbers going down at +1. This is not a good thing is it?
 
Re: 2/14 Choco +8 75, +9 79, +10 91, +11 97, +11.5 106, +1 8

I popped open a Fancy Feast/Gravy Lover can and he licked some of the juice and spit out the meat. Really??? What is wrong with this cat??? I made him eat the pieces he spit out. Will be doing a +2 at 8:00.
 
Re: 2/14 Choco +8 75, +9 79, +10 91, +11 97, +11.5 106, +1 8

Don't worry about Choco spitting out the solids!! (I'm giggling!) It's the gravy that contains the carbs! Some cats don't like chunky stuff.

With a "perfect" curve (whatever that is!), the +1 usually reflects a food spike and is higher than your pre-shot test. The +2 would be about the same as your pre-shot number. When you see that your +1 and/or +2 is lower, it's likely to mean that you're going to have an active cycle. This is the reason that Libby was suggesting that you monitor closely and that Choco might be angling for a dose reduction. Sometimes those early tests are very revealing.
 
Re: 2/14 Choco +9 79, +10 91, +11 97, +11.5 106, +1 88, +2 5

I gave him about a teaspoon of FF Gravy Lovers. Should I wait a whole hour to check or since he is dropping so low should I check maybe in a half hour. I'm all kind of confused about what is going on right now. @-)
 
Re: 2/14 Choco +9 79, +10 91, +11 97, +11.5 106, +1 88, +2 5

I would get a test at +2.5.

Let me suggest you change your subject line. Start with your PMPS for tonight, and then your +1 and +2. We don't need the AM numbers at this point.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49

I would add a drop or two of Karo into a small amount of LC and drizzle a bit of gravy on top. (It's Gabby's birthday so Choco should enjoy the treat!!)
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49

LOL, Lucy and Jazzy want to know how they can get in on that treat! I think Lucy would gladly go back on insulin again if she ever figured out that it would earn her HC gravy sometimes.

I think most of the gravy lovers' line are not quite as high carb as the "grilled" varieties, so adding a couple of drops of karo to 2 tsp of gravy should help.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49

Libby -- I agree. I think the Gravy Lovers is somewhere in the neighborhood of 15 - 17%. A little Karo will bump things up since there's some momentum behind these numbers.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49

This FF is marinated morsels. I gave him a bite of LC rolled it in some gravy and put two drops of Karo. Is this going to be able to be fixed and HOPEFULLY not happen in the morning? Getting a lil' worried (ok maybe more than a lil'). :?
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

Looks like Gabby's birthday mush helped. Choco sends Gabby a big head bump. ;-)
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

good, you slowed the drop. Now let's see if he'll come up a little higher. How about some more gravy? A couple tsp of gravy (without the food part, since he doesn't like it anyway!). You can add a bit of karo too, to bring up the carb content a little more.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

I'll have to go open a can of 9 lives for that. The gravy lover has gravy but it's hard to get out without the meat. Would it be a good idea to get that gravy you can poor on their food. I don't know if cats have it but I know they have it in the dog section. Since he won't be getting this untll +3.25, should I still test at +3.5 or wait until +3.75?
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

I would do the test at least 15-20 minutes after the gravy, so it has time to kick in.

You don't HAVE to avoid the chunks, I just figured that most of the carbs are in the gravy, so that gets him more carbs without making him as full.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

Wow, if I only had to feed him gravy, things would be SO much easier. He sucked that down like a champ. Choco just showed me (as if I needed showing) how much he doesn't care a thing about wet food. I popped open a can and my other cats came running while he just kept his little (not really little) butt laying on the bed not even lifting his head to see what I had. Geeesh....
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

I don't have advice, but it looks like Choco earned his reduction on this cycle!

Libby, I totally understand where you're coming from. I think what is hard with Maria's situation is that she will not be able to get any spot checks during that AM cycle. She basically has to shoot, leave for work, and then won't get home until right at PMPS time. The DKA allows little margin of error on one end, but her schedule allows little margin of error on the other. I don't envy the position she's in at all, and when I said I would probably reduce, I was just being honest with what I would be feeling if, as a newbie, I was facing her challenges. I'm not doubting the validity of what you're saying at all.... The newbie fears are just all too fresh in my memory.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

Okay, I have a newbie question. When it's mentioned that Choco may have earned a reduction after tonight, what exactly does that mean? I mean I get what reduction is but we reduced tonight and he dropped like crazy (at least to me he did). Just trying to understand.
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

Below if from the protocol regarding dose reductions.

Reducing the dose...

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42, +3.5 42

There are a couple of ways to extract gravy. Do this over a bowl: Open the can. Put the lid back inside the can. Turn the can over while pressing on the lid. The pressure of the lid will push the solids down and the gravy will drip out.

Or, you can put a colander over a bowl and dump out a couple of cans of gravy-type food. Hopefully, the stuff will drip out.

Earning dose reductions is what this is all about. It is the process by which a kitty goes into remission or becomes tightly regulated.
 
Re: 2/14 Choco +1 88, +2 58 +2.5 49 +3 42, +3.5 42, +4 47

I'm sorry Barbara, I didn't see your message until just now. I had to give my foster baby fluids and she was not liking that. I did not give him anything between his +3.5 and +4 test so looks like he is going up on his own and I'm sure his birthday treat helped a little.
 
Re: 2/14 Choco +1 88, +2 58 +2.5 49 +3 42, +3.5 42, +4 47

That's quite alright. I'm eating brownies for you to keep your strength up. LOL Choco is something else with these numbers. What a good sugarbaby.
 
Re: 2/14 Choco +1 88, +2 58 +2.5 49 +3 42, +3.5 42, +4 47

I wish I understood what y'all are talking about but I do agree, he is a good baby. :O) Mmmmmm, brownies. :smile:
 
Re: 2/14 Choco pmps 106, +1 88, +2 58 +2.5 49 +3 42

marleesan71 said:
Okay, I have a newbie question. When it's mentioned that Choco may have earned a reduction after tonight, what exactly does that mean? I mean I get what reduction is but we reduced tonight and he dropped like crazy (at least to me he did). Just trying to understand.
Click to expand...

Hopefully someone can come along behind me and explain this better than I am about to. :-D

Lantus has what we in Lantus Land affectionately call a "storage shed" or insulin depot. This insulin has a cumulative effect, so each 12 hour cycle is affected by what happened in several cycles leading up to it. The reason this is relevant is that even though you reduced the dose to 1 unit tonight, that 1 unit shot was carrying effects from the 1.5 unit shots from the past few days. Almost always, the effects of a dose reduction are not seen in the first cycle when you reduce the dose, but are more visible 2-3 cycles later. This makes it as confusing as heck to understand what is going on with your cat's numbers until you have been here a while!

So, while you did reduce to 1 unit tonight, really this cycle was really carrying the action of this morning's 1.5 unit cycle. Therefore, while Choco did earn a reduction, he really earned a reduction off of the 1.5 and not the 1 unit. That would make his new dose 1.25 units BID.

Incidentally, that is why I suggested that you lower the dose and shoot early tonight rather than tomorrow, when you have to leave (I know it probably would have made more sense to you to reduce the dose when you won't be home rather than when you will!). I knew there could be leftover action from the 1.5 tonight, but by tomorrow there should be less of that action remaining and you should see more effect from tonight's reduced shot.

Please post your number in the morning if you have any questions about shooting. There will be people watching for you and they can help. This would be my suggestion for your plan as of now, but cats have a way of changing our plans for us without warning. ;-)
 
Re: 2/14 Choco +2.5 49 +3 42, +3.5 42, +4 47, +4.5 54, +5 64

It did make sense in my foggy tired brain but it will make a lot more sense tomorrow when I'm more awake. So just to confirm, I will be shooting 1.25 in the morning? Can I go to bed now? :smile:
 
Re: 2/14 Choco +2.5 49 +3 42, +3.5 42, +4 47, +4.5 54, +5 64

I would plan on 1.25 in the morning, but don't hesitate to post if you need help. Would your sister (or anybody) be able to come over tomorrow to be sure Choco eats during the day?

You can go to bed if you'll leave food out for Choco. Good job tonight (again). You have a great attitude. I know this is hard, but now that you are going back to work you will be grateful for all the data you have collected the past few days.
 
Re: 2/14 Choco +2.5 49 +3 42, +3.5 42, +4 47, +4.5 54, +5 64

Unfortunately, my sister will not be available tomorrow and I don't have anybody else. Should I leave a couple different choices out including some HC? I will definitely post in the morning but really should ask you now, what number would be too low to shoot him in the morning and what would a good number be to shoot him? Just so I can have an idea. I am going to try and get a +6 reading since it's so close. Thank you Libby and everybody for your help and support. It has been a bit hard but Choco is my child and I will do everything I can possibly do for him. Night everybody.
 
Re: 2/14 Choco +2.5 49 +3 42, +3.5 42, +4 47, +4.5 54, +5 64

I think he should be shootable as long as he is around 100 or higher, but you really do have great judgment so use it if you need to. :mrgreen: I think a buffet would be a nice idea, and I have been known to feed high carb food when I'm leaving for the day if I'm not sure I trust the numbers. The cats don't mind the yummy fuds and any effects on their numbers seems to be short lived so it doesn't do any permanent harm.

Don't worry too much. We're not this intense all the time (well, some of us might be!) but in this case being aggressive is the way to go. It has been great to get all these numbers, so now we have a good idea of what Choco's patterns are. He's doing great, and you're learning fast, and soon you will probably find that you don't have to work nearly as hard. It gets much, much easier.
 
Re: 2/14 Choco +3 42, +3.5 42, +4 47, +4.5 54, +5 64, +6 70

I'm all about easier. :-D Goodnight and we'll talk to you all tomorrow!
 
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