3/19 Prince AMPS-241,+7.5-45,PMPS-191

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Re: 3/19 Prince AMPS 241

Hi Emily, so glad to see that Prince has already cleared those nasty pinks (we won't even mention that other color). I see that in the past Prince has actually gone up after starting yellow. Hopefully Mr Liver will relax a little and Prince can have a really nice run today. It will be interesting to see how he does. Nevertheless, Prince is on his way to a healthier state.

Have a great Wednesday!
 
Re: 3/19 Prince AMPS 241

Wow Prince!! What a way to clear a bounce!!

For a newly diagnosed diabetic to clear a bounce that high so quickly is unusual. From 411 at 10pm to 100 at mid-cycle today is record speed! Hopefully he won't just bounce back up, but if he does, don't be discouraged. Sometimes they clear them quickly...others can take up to 72 hours...but as he spends more time in lower numbers, his liver will get used to living at those numbers again and not freak out quite so much.

If you can, you might want to get some more tests in this afternoon..especially at +11 or +11.5 so when it's PMPS time, you'll have a better idea of where he's been and where he's going.

Keep up the great work Emily!
 
Re: 3/19 Prince AMPS 241

Prince does like to be bouncy....but he does clear them well, too, so hopefully that means his liver will get with the program and bounces will start to settle down soon. I hope you guys are haing a great day!
 
3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45..Please advise

Hi Again,

Prince is dropping lower than ever again. Thankfully I am home all day to monitor, but what happens if you're not?? I am giving him food right now to try to raise the BG.

Should I reduce his dose tonight? I am reading the stickies and seeing that I shouldn't. I have to wait until he is below 50. So, I guess my questions are:

1) What happens if you can't be home all day to keep checking your cat? I was supposed to be out for a while this afternoon but had to cancel when I saw Prince was at 71 at +6. How am I ever going to be able to leave him and not worry about him going hypo?

2) Today I followed the emergency hypo treatment sheet and fed Prince a bit of food when he was at 57. But should I have just tested him and not fed him to see when he would begin rising? What hypo number should you make you panic and start feeding?

So overwhelmed:( I feel like this isn't going that well:( If I should be posting somewhere else and am in the wrong group, feel free to let me know. Not sure where I fit in to all of this.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57..Please advise

I'm at work right now, so I do have to be quick...Prince really is starting to respond to the insulin. Technically, you're not supposed to reduce the dose unless he actually drops below 50. I would suggest re-posting again when you get your +11. I'm going to try and PM some of the folks who are better at interpreting SSs to take a peek at Prince's condo so they can give you more solid guidance.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

update-even though I just fed him, he is down to 45.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

With that 45, he has defnitely earned a .25U reduction.

Did you feed him high carb food? Do you have any karo on hand? If so, a little karo should get his numbers up pretty quickly. But, you still need to monitor, because it will wear off. I'd give him maybe a teaspoon of karo mixed into his food, then retest in half an hour.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

Emily - I'd feed Prince something a little higher carb. Do you have some medium carb or 7-9% low carb food around? Test again 20-30 minutes after he last ate.

And congratulations on the reduction, your new dose is now 2.25U.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

I fed him slightly higher carb food. I have Karo right on my counter, ready to go if needed. Right now he is showing no symptoms, and I'm not letting him out of my sight! Should I try to raise the numbers with more food, or see if he'll raise on his own?

Thank you! I'm so nervous:(
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

It takes roughly 20-30 minutes for food to go from the stomach to the blood stream/blood sugars, so test again 20-30 minutes after he last ate and that number will tell us what to do next.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

update-at +8 he is up to 61. Phew! Thanks, all! Definitely going to reduce to 2.25 tonight and plan to be home tomorrow.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

Great job! Just keep checking to make sure he stays up there. Congrats on the reducie!
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45.Please advise

Great news! I'd still test him every half hour until he's up to 80.

This was also a good experiment to see what to feed Prince if he's low later in the cycle. If cats go low later than a typical nadir, often less carbs are needed to bring them back up. The insulin is easing off at this point. If you'd seen this low before typical nadir, then high carb or karo might be a better idea. But it's all part of what you have to learn about how carb sensitive Prince is. ITake good notes on how much and what carb food you fed Prince today, so that next time you see a low, you have a good idea of what works. I list extra feedings in the notes section of Neko's SS.

ETA: Could you update the subject line of your first post with the new data so we know Prince is now OK. Thanks!
 
Re: 3/19 Prince AMPS-241,+7.5-45, +8.5-71

You did great! Congrats on the dose reduction.

Given that Prince likes to create some excitement, you might want to consider testing routinely at +2 or +3. If you look at the "ideal" Lantus curve in the New to the Group sticky, you'll see that at +1, you're likely to see numbers rise due to both an increase from food but also because the insulin from previous shot has run its course. The typical +2 is at about the same as your pre-shot value. If the +2 is considerably lower than your pre-shot, it may be an active cycle where you need to keep an eye on Prince's numbers.

You were concerned about not being around if numbers drop. Often these early tests give you the warning you need so you can steer the cycle.
 
Re: 3/19 Prince AMPS-241,+7.5-45, +8.5-71-Advice on pm testi

After Prince's BG antics today, I am now super paranoid about him going hypoglycemic (as if I hadn't been worried before). He gets his dose reduction (2.25U instead of 2.5U) tonight. I am planning on getting up multiple times tonight to test him, but I was wondering if you all-knowing cat diabetes experts could recommend specific times, like +2, +6, etc.
Thank you!
 
Re: 3/19 Prince AMPS-241,+7.5-45, +8.5-71-Advice on pm testi

i'm not sure any of us are "all-knowing!" :lol:

he might bounce from being low - many cats do.

i'd get a +2 - it helps to compare it to the preshot number and that can tell you some about what the cycle is going to do. if it's going up, a bounce might be starting. if it's about the same as the preshot number, that tells you a "normal active" Lantus cycle is beginning. the normal active cycle looks like a curve, typically, and bottoms out sometime a few hours later and then rises. i think that curve is on the "new to the group" sticky.

if it's lower than the preshot, that's your "pay attention" flag.

you asked earlier about how people cope with being gone - we find ways to have food for our kitties be available. some cats graze and you can leave food out when you go. if you have a scarf-er, which punkin was, there is no leaving food out and thinking it will still be there in 5 more minutes, much less hours.

A couple of options - some people have a neighbor or friend who can feed. some people mix cat food with water and freeze "catsicles" - either small ones in ice cube trays or larger ones in muffin tins. As they thaw, the cat (that's not a scarfer) will eat them. some do what i did - buy a timed feeder so that you can be certain food will be available at certain times.

i bought http://www.amazon.com/PetSafe-5-Meal-Electronic-Pet-Feeder/dp/B000GEWHNS?tag=felinediabetesfdmb-20. It was great for us. I could set it to open 4 times. When i went back to work about 9 months after punkin was diagnosed, i set it to open (always) at +3 for a second breakfast. then, deciding by the preshot, if i thought he needed to be fed more often than that, i'd set it to open more times. His nadir was about +5.5, so I'd have it open at +3, +3.5, +4, +4.5 if i was worried he was going low. my husband and i each worked 3.5 miles away from home, and i got off at +6, so sometimes one of us ran home to check him at break or lunch times. it was a little crazy, but it worked.

the only criticism i know of with that particular feeder is that sometimes the base doesn't rotate fully and so the food compartment isn't completely open. we found that putting the food tray into the base, filling it, then rotating it (press a button) one compartment let us be certain that it was all the way seated in the base. if it was seated fully, it always rotated and opened.

as far as tonight goes, i'd decide when to test based upon the previous test. look at the speed of the drop from one test to the next and figure out if that speed continued (which it doesn't always in some cats) where would the cat go in the next hour or so. None of us can sustain testing all night, but people do learn to "sleep-test" where you wake up just long enough to get a test.
 
Re: 3/19 Prince AMPS-241,+6-71,+7-57, +7.5-45..Please advise

Whoa!!! What a great day Prince had. I checked your condo earlier but it was way before all the excitement. Emily, you did a great job (again) keeping Prince safe. Not only that, you managed to keep him in healing green numbers for four hours (at least). That's awesome! Additionally, Prince earned an honest reduction. I love when that happens because then you don't have to second guess your next (dosing) move. Prince let you know loud and clear what your next move should be.

Way to go on having the stickies on dosing and treating hypos handy. Knowledge is the best line of defense for avoiding a crisis. Some of the most beneficial knowledge we can have as caregivers to our sugar babies is that obtained from the data gathered through testing and keeping detailed notes on what exactly we fed and how our kitties responded. That will make managing Prince's FD a lot better.

I see that Prince is at 191. That's a great number to shoot. I'm glad to see that you're planning on taking more tests tonight. A +1 and +2 tonight will be very telling. I'll be popping in to see how Prince is doing.
 
Re: 3/19 Prince AMPS-241,+7.5-45, +8.5-71-Advice on pm testi

Thank you guys! I'll keep you updated! I'm definitely going to get a +1 and +2, still trying to decide what other times to set on my alarm.
 
Re: 3/19 Prince AMPS-241,+7.5-45, +8.5-71-Advice on pm testi

Updates will be great especially if you start seeing dropping numbers. Like I said before it gets eyes on Princes condo in case you need help later. When you get a chance would you update your original post's subject line to reflect Prince's PS#?
 
Re: 3/19 Prince AMPS-241,+7.5-45, +8.5-71-Advice on pm testi

Thanks, MrZ! Is a PS# a post-shot number or the PMPS? I shot at 8pm, so I was going to test again at 9m (+1) next. Do you mean post that or the PMPS number? Also, do you have any recommendations on when to test in the night? Besides +1 and +2, I was thinking +6, and then depending on how that looks, maybe +8?
 
Re: 3/19 Prince AMPS-241,+7.5-45,PMPS-191,-Advice on pm test

The PMPS is the PM- Pre Shot....as the AMPS is the AM Pre-shot

Any tests after that are "+ tests"...+1,+2,+2.5...however much time since the Pre-shot test

We suggest after a day like today, you get a +1 and +2...and then if the +2 is about the same, or higher than the PMPS, you're probably good for the rest of the night because Prince is bouncing, but there's no such thing as too much data, so if you want to get a +6, that'd be great too!

We can't really tell you when to plan on getting later tests, because we want to see the +1 and +2 first

Edited to add...Looks like the +1 was 275...so Prince is "bouncing" due to the lower numbers he went to today. Bounces just happen, and mean his liver is working fine, but they're frustrating. All you can do is hold the same dose for the next 72 hours and wait for the bounce to clear...UNLESS he clears this bounce as quickly as he did the last one, but there's no way to know that in advance.

Right off hand, I'd say you're fine to get some much deserved rest tonight, and if you want to set an alarm for another test, anywhere from +5 to +8 would be useful data to have
 
Re: 3/19 Prince AMPS-241,+7.5-45,PMPS-191,-Advice on pm test

Let's see where he is at +2 to decide when might be a good time to test. PS means Pre-shot which could be AM or PM based on when taken. Sorry, I could have been clearer and written PMPS.
 
Re: 3/19 Prince AMPS-241,+7.5-45,PMPS-191,-Advice on pm test

here ya go - this is the "typical" lantus cycle that one can expect if the +2 is about the same as the preshot. although - cats haven't read the manual, so sometimes they do what they do. Some cats nadir is as early as +2.5 or +3, and some cats can be as late as +10ish or so. Once you are a little farther into the process, the nadir will become a little more obvious to us and we can help you figure out when Prince's typical nadir is.

but this is a guideline.

Example of an ACTIVE Lantus cycle for most, but not all Lantus kitties:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
Click to expand...
 
He's bouncing! Grrr. 275@+1, 375@ +2. Going to get a test at +6 and I'll check back in the morning! Thanks, all!
 
Hi Emily

You've had a couple very exciting days with Prince!! You did a great job :-D There is a lot to absorb and remember and since the learning curve is so steep, we are here to help you.

Prince might be a kitty who likes to clear his bounces so he gives you a dropping number at preshot. It's probably a good idea to understand the difference between a dropping number and a second dip because Lantus likes second dips!

A dropping number is when the BG starts higher, usually earlier in the day, and then keeps coming down so the lowest number in the cycle is at the next PS. Eventually, you can learn to shoot a dropping number above 50, to take advantage of carryover and overlap. But for now, it's probably a good idea to post when you get a dropping number like you did yesterday.

Remember that if you stall, don't feed. The other thing I saw from yesterday is that if you stall, you should usually shoot the current dose if you are going to be home. Since stalling acts like a dose reduction, there is no need to shoot a BCS :-D

A second dip is when the BG comes down to a nadir, goes back up after nadir, but then comes back down at the end of the cycle but not lower than the nadir. Second dips are usually safe to shoot on time with the full dose.

Lots to learn but you are doing super!
 
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