2/6 - Sami - PMPS 429; +1 402; +2 266; +3 287

Status
Not open for further replies.
Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

Well, it was quite an interesting night. I had thought I was doing myself a favor by waiting until +3 to test before heading off to bed for a few hours. As it turned out Sami decided this was the precise moment to decide to go GREEN. I ended up having to stay up 2.5 hours to make sure she was safe before going to bed. Don't get me wrong, I was very happy to see the green, it was just a little scary that it came on so quickly after a PMPS of 317, plus it was still very early in the cycle.

Sami seems to be on a bit of a bounce this morning. At least I hope it is a bounce and the the effect of the different food I feed her last night to bring up her sugar. I am hoping that she doesn't go much higher than her AMPS of 238. We will see how the day goes.

I am off to take a quick nap before I have to leave for work.
 
I am hoping that she has stabilized in her climb after the lower numbers last night. I am wondering if I should give her 50 ml fluids again tonight or hold off to see how she is reacting to this dose? I just seems that when she gets fluids she dips way day, but then spikes back up again. As it was observed last night when I have given her fluids at +8.5 AMPS she doesn't drop as fast or as low during the evening cycle. I am wondering if this is a better option, but the problem is I don't have the ability to give fluids at +8.5 AMPS during the week. Maybe I will try doing 50 ml every day, maybe that will be a little more stable for her.
 
She had a nice run of green last night though!! It's really great to see that the 2u dose is getting her into better numbers....now you just have to wait out the bounce!

@Amy&TrixieCat is one I can think of right off hand who gives fluids routinely and although she's currently OTJ, she might be able to give you some clues on the timing of the fluids in regards to the insulin
 
I spoke with the DOC today and she thinks it is entirely possible that Sami went too low this morning between AMPS and +2.5, and that is why she is still rising up. She thinks I should reduce the dose to 1.75 units. She thinks that I will continue to see higher numbers not because she isn't getting enough insulin, but because she is getting too much. It is entirely possible that Sami would have dipped below 50 last night if I had not intervened with HC and MC food.

Sami had a nice slide from PM on 2/3 to PM on 2/4 and then her numbers rose again.

We also talked about reducing Sami's fluids to 50 ml and giving the daily rather than 100 ml every other day. I also want to try giving them later in the cycle rather than at +1, but unless I get up in the middle of the night to do fluids I just don't know if that is going to be feasible.

DOC thinks that if Sami is around 400 tonight I should reduce the dose. I am inclined to keep her dose at 2 units tonight if she is close to 400 and then see how she does tonight and see where she is tomorrow. As I have always stated I want to give Sami the best possible chance of making it back to remission and I think if I waver on the dose that might prevent this.

Any advice on this would be greatly appreciated.
 
Nice streak of green!!

FWIW, I don't think you should reduce her dose. It's possible she may have dipped below 50 if you didn't intervene, but you did and she didn't. By doing that, you helped her pancreas stay in nice, healing numbers for a long stretch. You steered the cycle, which is awesome.

Today looks like a classic bounce to me. Her body panicked at the 62, but that doesn't necessarily mean the dose is too high. I think the 2 units is what brought her down into those healing numbers. Reducing, IMHO, might throw that off track.
 
Sami is bouncing from last night's greens, it can take 6 cycles to clear a bounce. It's been weeks since Sami saw greens so her pancreas/liver are complaining. Good plan to stick to 2.0U as we know she can see greens there and that's what's needed to get her back on track. I really doubt she went lower this morning as Lantus doesn't onset until around 2 hours after the shot time.

Trying half the amount of fluids also sounds like a good thing to try.
 
@Suzanne & Cobb(GA) and @Wendy&Neko

Thanks for the advice. I will stick with the 2 units tonight, but I think I will keep the fluids at +1 but with the reduction. I figure if change everything all at once, I won't know what worked and what is coincidence.

It is the weekend so I will be able to monitor her a bit more closely. I think Sami is rather tired today. She isn't getting as many cat naps at the office as she is use to at home. There are too many noises that startle her. It might take another week or so before she gets more accustom to the environment at the office.
 
I am planning on trying to get test every hour to see where she is, at least up to +4. I don't think she will drop to low, but I would like to see how fast she is dropping.

I gave her fluids at +.5 PMPS, and it might have been slightly shy of 50 ml.
 
Even with only 50 ml of fluid she still took a nose dive within an hour and a half of fluids. I am still going to monitor her to see how low she goes. As long as she stabilizes by +4 or +5 I will try to get a few hours of sleep and then set the alarm to check every 2 hours. I will also leave out food.
 
I am half tempted to back off to 1 unit and give her fluids twice a day and see how that goes. I am still in the camp that this whole sugar episode was cause primarily by STRESS over the past few months.
 
Way to clear a bounce Sami :)

I'm not knowledgeable about giving fluids and the effect with insulin but I'm thinking its not a good idea to drop her dose like that. Wait and see what Amy has to say
 
Good luck with trying the different amounts of fluids!

I agree with everyone else...I'd stick with the 2 units and just try to keep her in those healing numbers as long as possible in between the bounces.....since Sami is a long term diabetic, we don't usually reduce unless they go under 50 three times or you have a hard time keeping her above 50 even with high carb intervention

With her being back from remission, it's important to be even more aggressive than we'd normally be if she was a "first timer". Even if stress is what caused her to drop out of remission, the "cure" is still the same
 
@Chris & China You call Sami a Long Term Diabetic, but she was only on insulin for a few month 5 years ago, and then only randomly throughout the 5 years. Can you explain why you are considering her a long term diabetic? I am just trying to understand.
 
Even though Sami went into remission 5 years ago, we'd consider her a diet controlled diabetic when she went into remission. Once a diabetic, always a diabetic. Long term means diabetic more than one year, on insulin or off.
 
Tina

While you hold the syringe, and I know the fluids throws a different issue into the whole dosing thing, I also would not reduce her dose until she earns a reduction. I would try to give her 50 mls of fluids every day and give them as early as you can when you get home. I'd also be sure I always get at least a +2 test at night. If we see she's already down alot by +2 every night after fluids, then also start getting a +1. Then you can manage the numbers on the way down with LC food and slow them down.

I also do not think she had time to go low between AMPS and +2.5. She's bouncing hard because she dropped so fast last night and she got into numbers she hasn't been at for a while. I think your vet is thinking she has Somogyi and the "fix" for that is lowering the dose. But there are no studies or data to show that Somogyi actually exists, especially in cats. Most vets do not see enough SSs to understand what rebound, or bouncing, is.
 
Status
Not open for further replies.
Back
Top