3/2 Leonard AMBG-126, PMPS-243, +1-243, +2-196

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steviep

Member Since 2011
Hi there! I'm new so bear with me as I try to get this right!

AMPS: 126
-no shot this am, dosage given by vet yesterday may have been too high so consulting with him today. They said not to dose if he's at this number after his blood test.

Yesterday (his first day so I was pretty panicked-I'm still figuring out what the danger numbers are):

03.01
PMPS: 401
Dose: 2.0 (7pm)
+1 - 454 (after eating 1/2 can of food).
+2 - 149
+3 - 83
+4 - 88
 
Re: 3/2 - Leonard

Welcome to Lantus Land!

I see you made it over from Health. Here's the link to your posts on the Health Board so the folks here have some background.

A housekeeping detail. We include some additional info in our subject lines so if you need help, people will know. The subject lines here include the date, your cat's name, and BG test data. So, for today, your condo (it's what we call a thread) subject line would read:
3/2 Leonard AMBG-126​

Normally, you would have an AMPS (AM Pre-Shot) number. Since you did not shoot this morning, it's not a pre-shot number. Instead, it's an AMBG (AM Blood Glucose) number.

To edit your subject line, go to your first post and click on the "edit" button on the right side above the text box. Make the change in the subject line and then click on "submit." We keep adding info as we get test data. You may have to delete info since the space on the subject line is limited. Also, changing the subject line doesn't effect where on the board your condo is. If you need to bump your condo to the top of the board, you need to add a post. That's important to know if you need help. If you should want input or don't know what to do, ask for help or add a ?? to your subject line and then add a post so your condo moves to the top of the Board.

The numbers from yesterday are good, but understandably scary when you're new to using insulin and feline diabetes. I do suspect you will want to lower the dose. I mentioned in your Health thread that the initial Lantus dose can be based on ideal weight. Do you know what that is for Leonard? What we often find is that if the dose is too high, you end up skipping shots, like you had to do this morning. Since Lantus really likes consistency, lowering the dose will allow you to shoot twice a day (BID). I'd be thinking about a starting dose in the neighborhood of 1.0u but it would be helpful to have Leonard's ideal weight.

The beginning of this process is completely overwhelming so please, ask questions. We're here to help.
 
Re: 3/2 - Leonard

Hi - I just wanted to say welcome aboard. you've found a great place, with very caring people. We are here to help, whatever the need. WELCOME!
 
Re: 3/2 - Leonard

Hi! I just want to say welcome, and we're happy that you're here. :razz:

Hang in there, we are here to help. The first few weeks can be scary until you get an idea how Leonard responds to insulin and food. He made quite a dive yesterday night! You're doing great, though, with the home testing and coming here.
 
Re: 3/2 Leonard AMBG-126

Thanks everybody!

I'm hoping to do a glucose curve this weekend so I can get a better idea of what's going on with Leonard as he did take quite a dive - causing me to panic since the numbers still aren't too familiar to me.

Thanks for the clarification on AMPS / AMBGS. I'm slowly getting a hang of these acronyms.

I'm definitely lowering the dose. Since my vet initially said 0.5 on the phone (even though they changed it last night when he wasn't there), I'm starting with that. I'm not really sure what his ideal weight should be so I'll ask when the vet calls today. I do know he's around 12.6 lbs (5.7 kgs) but he's a big cat so I'll definitely ask.
 
Re: 3/2 Leonard AMBG-126

Based on his current weight (vs. ideal), his initial dose would be 1.25u (actually 1.4 but I'd err on the side of being conservative). I think you could certainly go with 1.0u. and be safe. However, if you are changing over to a low carb, canned food diet (especially since you've recently switched off of dry food), you could start at a lower dose.
 
Re: 3/2 Leonard AMBG-126

I switched his diet last Thursday (right after diagnosis) and his levels went from 720 to 401 between then and yesterday from that alone! (I initially wrote 420 instead of 720 - his initial test with the vet read his BG at 720).

When I informed the vet tech and other vet (not mine) they seemed to still think I should give him an initial dose of 2. I now believe this was very wrong since his levels plummeted so quickly yesterday. I'm definitely planning on sticking with the initial recommendation of 0.5 for the first week at least :).

It's odd, I get such different numbers between here and my vet's office. They told me not to shoot if his levels were 180 or below. Here it seems that it's fine to give him insulin unless it's below 100. Although people here seem way more informed then the vet and vet tech I worked with yesterday.
 
Re: 3/2 Leonard AMBG-126

Hi welcome to LL!
It's odd, I get such different numbers between here and my vet's office. They told me not to shoot if his levels were 180 or below. Here it seems that it's fine to give him insulin unless it's below 100. Although people here seem way more informed then the vet and vet tech I worked with yesterday.

A couple thing going on here. Cats can get very stressed when they got to the vet resulting in a temporary high BG reading, when they get home they calm down and the readings can be much less.

Many of us do shoot at lower BG readings, but we've been doing a lot of testing and we know how our cats react to the insulin. If we shoot low we are there and doing a lot of testing to make sure they don't go too low and we can intervene w/ food to bring them up. You don't have that experience yet and it is better to play it safe.

Also, many vets are afraid to have their clients get down into the normal range of BG for cats (60 to 100) for fear that the cat will go too low. Most owners don't want to go to as much effort for their cats and and so most vets are satisfied to keep cats w/ FD in what they consider a safe range, but that really isn't a healthy range. many of our vets express surprise that we will work so hard to regulate our cats.

There are people here w/ a lot more FD experience than most vets and they can walk you through the process of shooting low numbers once you get to that point, but i repeat, you are not there yet.
 
Re: 3/2 Leonard AMBG-126

I was also sent home with instructions to give 2u and with the phone number for the nearest emergency vet. in case of hypo.
If you look at Tom chart, his insulin needs went way down very quickly due to the change in food. If I had not found this place, well, don't really want to think about it.

I have since changed vets to someone who supports my involvement in Tom's care. Discuss with your vet., some are very supportive and just need to be better informed on the subject.
 
Re: 3/2 Leonard AMBG-126

Yes I'm definitely the type to proceed with extreme caution when it comes to my little guy, so shooting low is not an option right now! It's a bit difficult for me as my schedule is very demanding and I don't have a significant other to monitor Len when I'm not there - so I'm being extra careful with what he is getting and monitoring when I am home. I'm a little worried about the little guy today but I'm sure that's normal. He didn't get a shot this am and I'd rather him be up then crashing when I'm not there to test him until I get to know his needs through a curve. I'm just hoping there aren't any crashes today due to the 2 dose last night at 7pm, but I'm sure he's fine.
 
?? Need advice Re: 3/2 Leonard AMBG-126

So since I didn't give Leonard his insulin dose this morning due to a low number, I expected to come home and test him to find his numbers very high. Nope. Just did a PMPS and it came up as 10.5 (189). I'm not sure whether I should proceed with a .5 dose or just leave it for the night? Any help would be great.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

It's getting past his dose time. I think I'm going to leave it for now and maybe test in a couple hours to see if it goes up substantially.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

how long are you able to stall tonight and still shoot 12 hours after that in the morning? Do you have to be out the door at a particular time tomorrow?

Usually when we stall, we recommend waiting just 15 or maybe 30 minutes before retesting. That will let you know if the number is rising, and if so, how fast it is rising. Don't feed yet, if you're stalling, because if you feed then he'll rise from the food and you won't know for sure if the number would have been rising without the food on board.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

I can stall for about 30 more minutes and then still shoot tomorrow. Unfortunately he did just eat after I pricked his ear as I thought I was going to have to shoot. Lesson learned. I guess I should just hold off tonight and shoot tomorrow after his test?
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

I would see what the number is in 1/2 hour. If he zooms up a lot (which he probably won't, since he hasn't yet today) then it would be good to get some insulin in. 189 is usually a very shootable number, but since yesterday was his first shot and he got this much duration out of it, it does make sense to proceed with caution.

I haven't had a chance to read your previous threads yet. Has Leonard ever had ketones, that you know of?
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

The vet didn't mention any in the urine sample but he did have some trouble with his back legs (walking on his hocks) which is why we went to the vet. However, that's gone away since his diet change to high protein and no dry food last Thursday.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

I just tested again - 13.5 (243). It was a bit of a struggle to get the blood and then it bled a lot! Eek, always scary to see. He did eat half a can of Merricks about an hour ago but I'm going to give him a .5 dose.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

He really is testing me! I'm worried about giving him anything at all because his post-eating numbers are higher but nothing like they were before so I get nervous!
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

That's a good rise. I would say go ahead and shoot but others with more experience will advise.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

I think the 0.5u is fine. Plan on getting a +1 and a +2.

Did anyone mention methyl-B12 for the neuropathy? (That's why Leonard is walking on his hocks.)
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

I've given him 0.5. I'll plan to get +1 and +2. He's starting to hate me right now, hopefully the ear pricks get easier :) He bled so much from the last one, it was a bit scary!

This is very stressful, hopefully I'll get used to this because right now I'm constantly on guard! Thanks for all of the reassurance. I'm not sure what I would do without this forum right now.

Edited to add: I read about the treatment for neuropathy but it seems to be clearing up on it's own so I'm waiting a bit to see how he does. He's actually not walking on his hocks as much at all these days.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

nice shooting. :smile: Try to get another test before bed tonight. That will make you feel better because you'll know where he is going. Of course if you want to test again before that, that's great too! The more data you can get, the more comfortable you'll become because you'll start to see his patterns.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

The testing gets easier -- I promise. Just remember to give Leonard treats every time you test. Treats, lots of affection and praise will make this go easier and help him to associate testing with a reward. Also, you need to be confident. If you are scared, you will communicate it to Leonard.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

I took a reading and it was a bit of a big, long struggle this time. The reading ended up being the same: 13.5. Hopefully I injected the insulin correctly. I wonder if his BG spiked because I was stressing the poor guy out trying to get blood. I use the warm sock and I had a really hard time getting blood this time around - a lot of meaningless poking!
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

If you need to poke more than once, try to poke near the spot you last poked. Hopefully, 2 small drops form one big enough for the strip!

More housekeeping: Please use US #s when you refer to BG test data. Lots of people don't have a calculator handy! You want to keep your subject line updated with Leonard's test info. So for now, it would look like:
3/2 Leonard AMBG-126, PMPS-243, +1-243​

Here's what this tells me, so far. In an ideal curve, your +1 is higher than your pre-shot value. That's because it will often reflect a food spike. Leonard's +1 is the same as his PMPS. The +2 is usually close to the pre-shot test. If Leonard's +2 is lower than his PMPS, it is possible that it will be an active cycle.
 
Re: ??? Need Advice 3/2 Leonard AMBG-126

Just wanted to welcome you to LL! You'll get the hang of it and so will Leonard!!! You've gotten great advice today; just ask questions!
 
Re: 3/2 Leonard AMBG-126, PMPS-243, +1-243

Thanks so much for the welcome! Everyone has been really great! It really doesn't help right now that I'm in the middle of the busiest 2 weeks at work and rushing home to stress over my boy. I'm sure I'll find a rhythm but right now it's feeling like I'll never see friends or go out again! Ahhhh!
 
Re: 3/2 Leonard AMBG-126, PMPS-243, +1-243

There is a world spreadsheet that does the conversion for you. Its a template and found when you search for FMDB templates. You enter the canadian numbers on the "world" tab, and it automatically converts it and posts it to the US tab. This way when you publish your spreadsheet others will be able to read the US numbers automatically for advising you also.

When you poke the ear - make sure not to poke the vein. You want to poke the very edge of the ear. Poke on the furry side. If you put a flashlight up to the ear you will see the vein - you don't want to hit this with the lancet.
 
The vet technician I was with yesterday told me to poke the vein! Ahhhh. This was bad advice? No wonder the poor guy is bleeding so much. Not good.

+2 was 196. I'm going to leave the little guy alone for the night and poke him in the am.
 
You don't want to poke the vein, you want to poke between the vein and the edge of the ear.

I would try to get one more test tonight...as Sienne said, if the +2 is lower than the PS test, you might see an active cycle. Can you try to get a +3 or even better, a +4? That will give you a better idea of where Leonard is heading.
 
Unfortunately he wouldn't let me get another test in but I got one when I woke up this morning. Currently creating a new condo but his AMBG was 160 so no shot this morning.
 
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