2/16 Kismet PMPS 132, +2 120, +4 87

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Courtney and Kismet

Courtney and Kismet

Member Since 2012
Yesterday's condo

Happy Caturday, LL!

I had to stall an hour and a quarter this morning because he was 93 at our usual AMPS. I think he managed to elevate his bg by working himself up into a breffi demanding frenzy. You've never heard such a vocal cat! You'd think he was starving! So I shot a skinny .25u (I think that's what you say when it is somewhat reduced?) and gave him his fuds, and now he is napping happily and purring. At some point, I am going to have to get him back on his normal schedule. How do I do that? Do I skip a night, or shoot a smaller dose?

Yesterday 2/15

AMPS 238
+2--- 217
+3--- 113
+5--- 61
+6--- 75
+9--- 90

PMPS 129
+2--- 99
+3.5-73
+4---59 fed tsp LC
+5---74
+12--93

Today 2/16
AMPS 112
+2--- 75
+3--- 56
+3.5- 53
+4--- 48 Fed Tsp LC
+4.3 ASTHMA ATTACK. 2 puffs of albuterol
+4.5--60
+5--- 75
Resting
+9 --Tsp LC
+10---Vomit
+10.5 147

PMPS 132
+2--- 120
+4--- 87
+4.5- Urine Test: Negative Glucose/Negative Ketones
 
Re: 2/16 Kismet AMPS 112 - stall

You can adjust your shot schedule in either 15 minute increments each cycle, or in 30 minute increments each day.
If his numbers are fine high enough, you can shoot your regular dose, as these small increments should not affect his BGs that much.
 
Re: 2/16 Kismet AMPS 112 - stall

You're welcome.

I read your profile. That is so neat, how you all found each other.

You saw my Edit in my last post? I wrote "If his numbers are fine high enough, you can shoot your regular dose"

Good luck, he's doing great, and I see a good future for him.
 
Re: 2/16 Kismet AMPS 112 - stall

Yes, I saw that :D I hope you're right about a good future! And thanks for your note! It was fate, or kismet, that brought us together :mrgreen:
 
Re: 2/16 Kismet AMPS 112, +2 75 Time for reducie?

Nice +2 :mrgreen:

Do you usually feed at +2? If so, I would feed him a bit now, and test again at +3.

GOooooo Kismet !!!!!
 
Re: 2/16 Kismet AMPS 112, +2 75 Time for reducie?

Hey, Courtney! I really don't think you needed to "skinny" the dose this morning. If you stall, you don't want to reduce. The delayed shot acts like a dose reduction so in essence, you doubled the reduction by both stalling and shaving the dose. I also think you could have shot on time if you were going to be around to monitor.

Kismet's numbers haven't dropped into reduction range nor has he been in normal numbers for a week. So, sorry -- no reduction yet. Remember, for a kitty that's back from the Falls, we make it harder to earn a reduction (i.e., numbers need to drop below 40).
 
Re: 2/16 Kismet AMPS 112, +2 75 Time for reducie?

Hi Dyana, I usually don't give him any snacks until after +6. Should I still feed? I was planning on testing at +3 and feeding then if necessary. I am curious to see how low he'll go and if we are ready for a reduction tonight! Kismet loves doing the BG limbo!
 
Re: 2/16 Kismet AMPS 112, +2 75 Time for reducie?

Hi Sienne! Whoops! Well, I've learned something new today :) I think he may have dropped lower last night if I didn't feed, but I wanted to go to sleep lol. I will be patient! I hear it is a virtue ;-)
 
Re: 2/16 Kismet AMPS 112, +2 75 Time for reducie?

Hi Courtney.....reduction or not, those are still wonderful numbers. Nice and healthy.
I have no virtues, I guess....no patience. :lol:
Checks doesn't know that other cats don't get fed all day long. :lol: He's so skinny, i'm always trying to shove food in his mouth.
I read your profile recently too. I love how you and hubby fell in love, over a black cat. A beautiful cat, I might add. :-D

Have a wonderful day. :-D

thanks for visiting our condo, when I was freaking out all day. :smile:
 
Re: 2/16 Kismet AMPS 112, +2 75, +3 56

Hi Barb, thanks for stopping by! Kismet is a foodie, and rarely leaves and fuds behind at breakfast and dinner. He used to a couple of pounds overweight, so he is on a strict diet and rarely gets any snacks. He would eat all day if I'd let him! We have him down to 12 lbs from 18 pre-dx. :lol: He is a young cat, though, only 3, and has always had a very healthy appetite.

I just got the +3 and we're at 56. Should I feed this to encourage a surf, or retest in 30 and see where he is?
 
Re: 2/16 Kismet AMPS 112, +2 75, +3 56, +3.5 53 Feed LC?

53 @ +3.5. Still holding off on LC. Will test again in 30. He is so hyper right now! I haven't seen him play this hard in months :mrgreen: He is beating up on his poor little duck and doing freak out kitty thundering up and down the stairs, jumping on and off the couch, rolling around, and chirping.
 
Re: 2/16 Kismet AMPS 112, +2 75, +3 56, +3.5 53 Feed LC?

I agree with Sienne, that you could have shot at AMPS this morning if you are around to monitor (as those are the days, when you can be home to monitor and shoot a low number, that maybe you'll see a dose reduction number :mrgreen: ), and that you didn't need to skinny the dose (because of the double reducie affect when you do that).

Eventually, when/if (hopefully when) he gets to the point when he is on an OTJ trial again, we'll probably want you to feed many smaller meals throughout the day, as that is easier on the pancreas to handle. And, we would want you to feed, and test 4 hours later to see if his pancreas is working well, by bringing him down without the use of insulin.

Also, most of us, feed at AMPS, and then give a couple snacks or meals before nadir (+6), and do not feed after nadir, because after nadir is when the affect of the insulin is starting to wain. We want to feed when the insulin is strongest (before nadir) to help flatten out a dip, and stop feeding after nadir when the affects of the insulin are starting to wear off, to try to get as flat as a curve as we can. P.S. don't look at J.D. as an example of a flat curve :-| :roll:

I would feed a small amount at the +3. But, that's how I feed J.D. A PS meal and a couple more meals before nadir.
 
Re: 2/16 Kismet AMPS 112, +2 75, +3 56, +3.5 53, +4 48

Because we both work during the day, Kismet never gets any snacks. Very RARELY will feed at +6, and I would wait until after nadir so his numbers wouldn't be food influenced.

Kismet is a good eater, and gets a can of FF Classics mixed with 1/4 of a 5.5oz can of Merrick's Before Grain Chicken both morning and night. We don't take up his bowl, because he eats everything within 30 minutes.

I guess I can trying making fudcycles to leave out when we're not home and take that off his breakfast. Our vet told us not to free feed or give extra fud because he used to be overweight.

I just got +4 and he is at 48. I did put down a tsp of LC to encourage a surf and will test again in 30.
 
Re: 2/16 Kismet AMPS 112, +2 75, +3 56, +3.5 53, +4 48

Courtney and Kismet said:
I just got +4 and he is at 48. I did put down a tsp of LC to encourage a surf and will test again in 30.
Click to expand...
That's what I would do.

You can break up his total alloted twice a day meals into smaller segments and feed them in divided up mini meals.
Foodsicles and automatic feeders can help you to time the feedings.


Surf nicely, Kismet.
7_3_205.gif
 
Re: 2/16 Kismet AMPS 112, +2 75, +3 56, +3.5 53, +4 48

Hi Courtney, congrats on the reducie!! :mrgreen: :mrgreen: What a beautiful cycle today for Kismet. He is keeping you busy. Go Kismet!
 
Re: 2/16 Kismet AMPS 3.5 53, +4 48, +4.5 60 ASTHMA ATTACK

Thanks, Ann. Not sure if we're ready for a reducie just yet, but we're on the right track :)

Kismet just had a very severe asthma attack @ +4.3. Normally, 1 puff of albuterol (rescue inhaler) will stop it immediately, but he continued to cough so I had to give him an extra puff to get it stop.

I tested him again @ +4.5 and got 60. The stress of the attack plus the food may account for the spike.

Dh and I were just chatting about the asthma... Vetty told us that extreme levels (high or low) can induce asthma. That 48 may have been too low for him. Is there a special protocol for kitties with other dx that might affect their BG? I am scared to let him go too low, now. Any advice is welcome. I am going to put a call into the vet (they are also 24 hr emergency) and see if they have any suggestions.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60

A number below 50 on a newly diagnosed cat earns a dose reduction. You're new dose may be the skinny 0.25 that you shot this morning, or it may be a 0.1 unit. Let's wait to see what others have to say about it.

Here are some pictures of the micro doses: http://steverapaport.com/jock/SyringeFineGradations/
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60

Hi Dyana, thanks for responding. Kismet is not a new diagnosis. He is back from the Falls since going OTJ last October. I am going to check Kis @+5 and give him a break. The testing doesn't appear to be stressing him out, but I want to let him relax and have some quiet time.

Edit: With this 75 @+5 I am going to give him a break and won't test again until PMPS. I'll give an update after I speak with the vet (waiting for call back.)
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60

Courtney and Kismet said:
Hi Dyana, thanks for responding. Kismet is not a new diagnosis. He is back from the Falls since going OTJ last October. I am going to check Kis @+5 and give him a break. The testing doesn't appear to be stressing him out, but I want to let him relax and have some quiet time.

Edit: With this 75 @+5 I am going to give him a break and won't test again until PMPS. I'll give an update after I speak with the vet (waiting for call back.)
Click to expand...
Oh, Sorry.. I read it earlier and just went back and re-read Sienne's post ohmygod_smile
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

Courtney --

Aside from dropping into lower numbers, the other way to reduce the dose is a week in normal (50 - 120) numbers. That may be the preferred strategy for Kismet. I've not heard anyone comment that high or low numbers can trigger an asthma attack. I wonder, though, given how active Kismet was earlier, if that may have had more to do with the asthma attack than his numbers. Regardless, you have an alternative strategy to help get Kismet back to the Falls and you won't have to worry about using food to prop up his numbers from going too low if you keep him in good numbers for a week.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

Sienne, you bring up a really good point. Looking back on my notes from the last couple of days, he has been playing/running around more than usual so that may have something to do with it. I'd hate to have to stop him from playing.

I just spoke to the vet, who reiterated that high and low bgs can cause stress which might trigger asthma, and vice versa. Asthma might trigger higher bg readings. ohmygod_smile She said, however, that 48 doesn't seem like a very low number that would cause an attack and pointed out that he hovered primarily in the 50s during OTJ, and we were asthma free the whole time. She told me I could try a dose reduction tonight or tomorrow, depending on his numbers. She said if he is higher that 150, to stick with the 0.25. This sounds reasonable to me. I guess it all depends on where he is at tonight.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

What a lovely day, for Kismet. :mrgreen:
I didn't know certain things triggered asthma attacks. I thought it was a weather thing.
The only other kitty I remember that has it is Tarragon (Melissa). I don't remember what triggers his. She hasn't mentioned it recently, thank goodness.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

Barb, you're right... for most cats, asthma is simply allergic bronchitis, but in Kismet, we're not sure what causes it. Our vet has told us that in some asthmatics, stress is the trigger. So, high or low bg numbers (or oscillating between them) can cause stress on the body which might trigger asthma symptoms.

He was dx with asthma and diabetes within a week of each other last September. We treated both conditions simultaneously. When he went into diabetic remission, he also went into asthmatic remission. Flash forward to a few days ago. He started wheezing a bit, so I had a feeling I should check his bg, and that was when I discovered it was elevated. Two days later, he had a full blown asthma attack for the first time since OTJ, and now he's back on insulin. While we don't really know what the connection is between the two conditions (which one occurs first and triggers the other), we are fairly confident that in Kismet, there is most definitely a correlation.

We are working diligently to regulate both conditions. Hopefully, if we can get one under control, the other condition will stabilize, too.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

Oh, and another thing to mention about stress triggering asthma: The first (and last) time Kismet had a proper bath in the bath tub, he had his first ever asthma attack. I didn't know what it was at the time and thought he was just hyperventilating.

This is a video of what Kismet's asthma attacks look like: I took this video to show the vet last September before we got the diagnosis. Kismet asthma attack
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

Hi Courtney, how is Kismet doing now after the asthma attack? I hope he's staying quiet and no more ashtma attacks. I also was thinking of Tarragon (Melissa). She may be on tomorrow and you can talk with her. Sending some healing vines to Kismet.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +4.5 60, +5

Wow Courtney, you have to keep Kismet calm, and quiet, and no extremes in bg numbers?
I would have thought that was a hairball in the viseo, also. Poor baby.
 
Re: 2/16 Kismet AMPS +4 48, +4.3 ASTHMA ATTACK, +10 VOMIT

Barb, that's exactly what I thought it was, but he was having them upwards of 5xs a day and never producing anything. So I took that video for the vet to see, and that helped her make the diagnosis. The primary difference is that they crouch when it's asthma and stretch the neck to try to open the airway. The coughing brings up a lot of fluids, and they usually swallow it back down. When it comes up, it is foamy and mucusy.

Ann, he was doing ok for awhile and laid low. He started asking for food around +9, so I put down a tsp of LC. He perked up and cuddled for a bit and then played some more with his duck (not too hard.)

I just found a small puddle of vomit at the bottom of the stairs and him trying to bury it (good helper, he is) so it looks like that snack came up. He's acting okay otherwise; just a little sleepy. I am going to watch him closely for the next few hours.

Just got the 10.5 --- 147. Hard to tell if this is a bounce or vomit #. The vomit was splattered on the floor, it looks like it was projectile as he was coming down the stairs. He made no sounds that I am aware of.
 
Re: 2/16 Kismet AMPS+4.3 ASTHMA ATTACK, +10 VOMIT, +10.5 147

Whether there's a relationship between asthma and diabetes or whether activity is a factor as well, like I said earlier, you have options. There's no pressing need to have Kismet's number drop into lower ranges. A week in nicely normal numbers will result in a lowered dose.

What I'd suggest is keeping really good notes on Kismet's behavior, especially if he has an asthma attack.
 
Re: 2/16 Kismet +10 VOMIT, +10.5 147 Dose ?

The vet recommended shooting 0.25 if he is over 150, and reducing to .1 if under. He's been surfing green all day, until vomiting and spiking to 147. I wanted to get some feedback from you guys here. I will be doing PMPS test in 25 minutes.

Edit: Sienne, didn't see your post until after I posted. I agree with you 100%. I want to what's best for Kismet, of course!
 
Re: 2/16 Kismet +10 VOMIT, +10.5 147 Dose ?

My concern with what your vet is suggesting is that you're basing your dose on the pre-shot numbers. Lantus dosing is based on the nadir. In addition, if you keep changing the dose from what could be cycle to cycle, you're going to wind up with wonky numbers. I'd pick a dose and stick with it. If you want to reduce, then hold the dose for 3 days to see how Kismet is responding unless it's clearly a failed reduction. If that's the case, then increase back up.
 
Re: 2/16 Kismet +10 VOMIT, +10.5 147 Dose ?

I talked to her today after he dropped to 48 and had the asthma attack -- so she was bearing this number in mind when she made the rec.

My concern is that he dipped low today with essentially a double reduction. Do you think I could try a skinny 0.25 again? (And stick with that for 3 days_
 
Re: 2/16 Kismet +10 VOMIT, +10.5 147 Dose ?

Just stopping in to say I hope Kismet is feeling better this evening!!! I don't know if you were aware that Melissa's Tarragon also has asthma - maybe you two can share info!!
 
Re: 2/16 Kismet +10 VOMIT, +10.5 147 Dose ?

you can try skinny 0.25u if you want. Then hold that dose for a few days, unless he drops too low. Your goal should be to keep him in numbers under about 120 all the time, if possible. Those are the numbers where his pancreas will have the easiest time healing. Good luck!
 
Re: 2/16 Kismet +10 VOMIT, +10.5 147 Dose ?

I agree with Libby. I think you can shoot the skinny 0.25u. If it looks like it's too much, you can always drop the dose.
 
Re: 2/16 Kismet PMPS 132

Libby and Sienne, thanks for advising. I went ahead and shot the skinny .25u. Hopefully he'll surf tonight and let me catch up on my work and sleep!

Amy, thanks for stopping by! I will def get in touch with Melissa, thanks :)
 
Re: 2/16 Kismet PMPS 132, +2 120

Good luck with the new dose and I hope he is feeling ok.

That's great you got the video so the vet could see what Kismet is like during an attack.

He's such a lucky guy to have you!
 
(((Marje))) That is so sweet of you! But I am truly the lucky one. He's such a good boy... truly the best cat I ever had. Well, my Elvira (Voorie),my childhood bff of 14 yrs who had advanced kidney failure, was also very special. I gave her sub-q fluids and prednisone for a year, and in the end, it wasn't even the Kidneys that got her. The steroids enlarged her heart and the fluids got into her lungs, so I did the humane thing by her. Wow, that was 6 years ago already. I still miss her every day. My Sweet Elvira But Kis is the light of my life... I'd do anything for him! But I think everyone here is cuckoo about their kitties, or we wouldn't be here, I guess ;-)

Thanks for your kind words and for stopping by our condo. I hope you and Miss G have a great night!
 
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