4/14 Vesta AMPS ???, +2.5 344, PMPS 408, +3 277

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Weather Girl

Weather Girl

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Yesterday's Condo: viewtopic.php?f=9&t=11869

(not sure the lingo or everything, hope the link works)

So no visit to work today, the husband is staying home for a partial day to do some testing. The only problem is he's much less comfortable with the pricking, so his stress level is rubbing off on Vesta and she's not really letting him test :YMSIGH: When he woke up at 2am to do a +6 test after her PM shot, he was unsuccessful and by the time he woke me up to help, Vesta was NOT having it. Same problem this morning- he wasn't able to get an AMPS before giving her insulin, so we just have what number I took at +2.5 for now. Hopefully he'll have something better worked out by the time I get home from work (no bringing kitty in 2 days in a row, there was a tour in the office today, sigh).

Plan for vacation (in T minus 36 hours): Boarding at the Van Nuys Pet Hotel. Husband did a walk through today, and actually got to watch one of them tend to another diabetic cat that's there. The care and fees seem reasonable. Really couldn't find a vet tech this quickly that we'd trust (or Vesta would trust, for that matter). Will definitely look for future trips though. The boarding place will have our vets number and keep at least an AMPS and PMPS chart for us. We're going to leave instructions to call our vet first if her AM/PM PS numbers are below a certain level. Hopefully they'll do a +6 for us also so we can try and track the glucose min.

Any other suggestions? Thanks everyone so much.
 
Re: 4/14 Vesta AMPS ???, +2.5 344

Also, if a moderator can switch my user name that'd be great- wouldn't mind it being "Jamie & Vesta" :razz:
 
Re: 4/14 Vesta AMPS ???, +2.5 344

I would suggest grilling the clinic on their Lantus knowledge. Many vets are used to other types of insulin that don't keep to a tight schedule the way that Lantus needs to be dosed. I would want them to give you a record, including date and time of the shot and the pre-shot test data that is initialed by the person giving the shot, in order to verify that they are doing what they said they will be doing. Will they do any mid-cycle spot checks? Is it a 24/7 facility - in other words, is there someone there to check on Vesta overnight and on the weekends?

I'd also encourage you to bring Vesta's food. Otherwise, I doubt that she will get LC food and it certainly won't be good quality LC food.

I would post a note tomorrow asking for help with "petsitter" (DPS) shot guidelines. You will want to have an amount of insulin that is safe to shoot, especially if there are no spot checks being taken. We will often have a "no shot" number, as well. It may help to have these numbers written down for the people at the pet hotel since there is not guarantee that they will be able to reach your vet immediately if they have a question.

Remember to pack a favorite toy and something that smells like you.
 
Re: 4/14 Vesta AMPS ???, +2.5 344

I plan on making up a spreadsheet with headers: time, pre-shot reading, amount given, initials, and notes. I'm hoping to have a +6 check done in between the 12-hr insulin shots as well. There will be someone there with her 24/7. I'm also going to put together a detailed list of instructions regarding her food (definitely bringing our own) and what to do if they get particular glucose readings. We have our vets # for them to call as a consult, as well as the closest 24-hr emergency clinic in case anything happens. I don't want them making insulin decisions on their own- almost wish I could put one of you as the emergency contact! God knows you are all the true experts here. We're bringing a few of her things as well- her favorite blanket to knead, some small toys, her bed. Maybe a pillowcase we slept on so she can smell us :)

Sienne and Gabby said:
I would post a note tomorrow asking for help with "petsitter" (DPS) shot guidelines. You will want to have an amount of insulin that is safe to shoot, especially if there are no spot checks being taken. We will often have a "no shot" number, as well. It may help to have these numbers written down for the people at the pet hotel since there is not guarantee that they will be able to reach your vet immediately if they have a question.
Click to expand...

Hints? I'll start a thread later in the general forum.
 
Re: 4/14 Vesta AMPS ???, +2.5 344

Hi Jamie
Welcome to Lantus
Sienne gave you excellent advice.
I would also like to add that I would leave a syringe with a piece of tape at the 1u mark
to make sure that they know what 1u looks like. Not to freak you out but you want to be very sure that they don't fill the syringe to the 10u. Mistakes do happen and you want to prevent that.

You also don't need to post another thread in general about DPS advice (DPS=dear pet sitter).
Try and get as many checks as you can before you leave, (I don't recall how ling you will be away).
This will give the people here more information to work with in heloing you while you are away.
Then a day before you leave, I know that is soon, you will put in your subject line
DPS dosing advice. That will get the attention of those with experience to help keep Vesta safe
while you are away. Sometimes doses are reduced when there is a DPS involved.
It is better to have higher numbers for a little while than being to low for a short time.
Hope this helps.
 
Re: 4/14 Vesta AMPS ???, +2.5 344, PMPS 408

Thanks Randi for the advice :) We leave tomorrow night, so I'll post tomorrow am for advice.

Talked to the vet this afternoon- solidified the fact that we're getting a new one when we get back. Said our spreadsheet is useless because we did 3-hr tests. But, somehow managed to recommend that we up the dosage to 2 units b.i.d. Opinions?
 
Re: 4/14 Vesta AMPS ???, +2.5 344, PMPS 408

Yeah that vet is nuts.. it's way to early to increase the dose yet.. usually takes like 10-14 cycles (depends on the cat) to settle in to starting a long acting insulin..

REALLY happy you found a 24 hour care place.. that makes me very very very happy!

Oh and you can change your user name yourself in the control panel:

User Control Panel (near the top of the page) -> profile tab -> edit account settings
 
Re: 4/14 Vesta AMPS ???, +2.5 344, PMPS 408

I wouldn't go so far as to say you vet is nuts but did your vet provide any rationale for his opinion about a 3-hour curve (mini-curve)? I know when Gabby was first diagnosed, the specialist completed a 2-hour curve. Perhaps your vet is more familiar with a 2-hour curve or neglected to realize that most mere mortals have to earn a living in order to pay for insulin, strips, and vet bills! Of course, the fact that we do our own curves and don't need to have our cats spend a day at the vet's office for them to do the curve or because we test frequently, things like a fructosamine level aren't necessary means they can't bill us for those services.

If you take a look at the dosing protocol that we use, doses are increased in increments of either 0.25 or 0.5u depending on where the nadir is. To be honest, I would not increase Vesta's dose at this point. Here's why:
  • you are still in the process of building Vesta's shed. Until the shed is 'built,' not all of the insulin you are shooting is fully available for use. This process takes roughly 5 - 7 days.
  • you are still transitioning away from dry food to canned food. Dry food can drive up numbers. I would hold this amount of insulin until the dry is eliminated in case BG numbers drop significantly.
  • you have been at this dose for 4 cycles (2 days). You have barely enough information to know what the nadir is. You have 2 cycles where it's in the 200s and there's not enough information from today (or at least so far) to know what the low point of the cycle is.
  • and if you were to increase, increasing by 1.0u is too much. Making that big of a jump in dose risks missing what may be the ideal dose and dropping numbers very low.

I would encourage you to drop back to 1.0u tomorrow and stick with that dose for the next few days and continue to do the good job you are doing with collecting data.
 
Re: 4/14 Vesta AMPS ???, +2.5 344, PMPS 408

Thank you, Sienne. You're last sentence with the "good job you're doing" comment really helps. I feel like we're barely doing enough!

I can see your point with the building up the storage shed concept. Will talk to the husband about what to do tomorrow am. I'm so nervous about not being able to have any input for 10 whole days on dosage increases, but at the same time I don't want to jump the gun. I guess we'll figure out tomorrow what is better- a slightly higher BG for the period we're gone, or running the risk of shooting really low.

We're going to be like this the whole vacation ---> nailbite_smile nailbite_smile nailbite_smile
 
Sienne is nicer than I am.. regardless of the quality of the advice.. I still think that saying your tests results are no good, but hey lets increase based on them is a sign of being a few beers short of a 6 pack ;).

Hope all goes well with Vesta while you are away.
 
Dawn & Nova said:
Sienne is nicer than I am.. regardless of the quality of the advice.. I still think that saying your tests results are no good, but hey lets increase based on them is a sign of being a few beers short of a 6 pack ;).
Click to expand...

I know, right? A bit hypocritical. We're finding a new vet when we return.
 
Would you feel comfortable giving the petsitter access to you account here or would they be open to starting one? Then they can ask for help and you can check in online. It may prove to be a plus for them boarding FD kitties in the future too.
 
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