4/16 Kasha AMPS 217

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kryskat

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Ok - so I've been giving her what I consider .75 units of Lantus twice a day (it's consistent, at least, if not accurate) - I haven't been messing with her dose, just giving it time to settle (I'm finally learning). Her numbers seem to be more stable, but not as low as I'd like, of course. At what point can I consider slightly raising her dose?

The added complication is that I'm going out of town on the 25th for a week and won't be home to monitor, so I need a stable dosage that her caretakers can give her while I'm gone.

Other added complications are 2 other cats at home with health issues. My one boy has a tumor on his foot that we are keeping bandaged at all times because it bleeds. And worse, his brother has lost a bunch of weight in the last 2 mos and the vet isn't sure why. All of his tests so far are ok, but he's obviously not ok. Wondering if this additional stress in the house will adversely affect Kasha's numbers, but so far she seems blissfully unaware (or just doesn't care because the boys are icky to her anyway).
 
Morning, I was just looking at Kasha's SS. This is the 6th dose at your .75 units - but it looked like you were doing a fair amount of dose hopping before this (sorry, haven't been following your condo before this so I don't know any of the circumstances associated with that). I am thinking it might be nice to let this dose settle out for a few more days - get some consistancy going.

When you go away who will be shooting Kasha? Will they also be testing her? If not - is there anyway you can teach them to test so you aren't shooting blind? Are they familiar with shooting?

Most of the time we reduce the dose when you have petsitters (DPS). The cats may not eat as well, may be stressed with someone else in the house and may have lower - or higher - numbers. But since lower numbers are possible and the cat usually isn't being tested midcycle the lower dose of the insulin is usually safer. It also is helpful to select a dose that will be easy for the DPS to measure consistantly. For instance as you stand today - lowering the dose to a .5 would be an easy dose for them to measure. Many of us leave a syringe with colorer water in it with the example of how much we want shot. My cat, even with a lower dose and a petsitter that stays here and has been staying here for several years when we travel had a 29 one morning for her amps! If your petsitter can get ahold of you while you are gone with the numbers it would be helpful - or have some other back up plan in place - like knowing how to post for emergencies here.

Usually a day or so before you leave put the question of DPS DOSE ?? in your subject line. When you are closer to leaving it will be easier to help with a dose suggestion. Libby/Lucy (and others ) have been very helpful to me when I have traveled.
 
Hi...I don't think I have posted in your condo yet.
I would have to agree with Joyce. There may be room for an increase but since there was a lot of blue yesterday I think I would wait a couple more cycles to see what happens.

As far as pet-sitter dosing.....a lot can happen in a week so that is a good question to ask as it gets a little closer to the date you are leaving. Joyce gave some very good points as how to prepare for the pet-sitter.
 
I have 2 vet techs from my vet's office coming by to give the insulin and take care of the kitties while I'm gone. I don't know if I can convince them to test - my vet says I'm only the 2nd person she's ever had to test bg, so it's not something they consider necessary. She (vet) was excited at first that I was doing it, but then I think she decided I'm too high maintenance - LOL. Basically, I would still be shooting 2 units, twice a day if it were up to her, even though Kasha's numbers started to get really low at times and I ended up reducing the dosage on my own after calling her several times about it. I was dose hopping partially because she had told me that if the preshot values were under 200 to reduce the dose and I was experimenting a little - but only when I would be there to monitor. At times I panicked and reduced the dose because I couldn't be there to know what the nadir was.

We're going to the vet Tues. night for a checkup - not sure why, but figured might as well before I go away for a week.

I may have my parents or a friend check in and do some random tests - hopefully near the nadir - they won't give shots but may be convinced to poke her ears. She's a feisty girl and people who've known her as a younger cat are a little afraid of her.
 
It would be very good if you could convince the vet techs to test. As I said - Tuscany threw a curve ball one morning while I was away - a 29! Imagine if my DPS would have shot that without testing....

Even though they are vet techs - I would still leave a syringe filled with the color water to mark the level /dose that you want. There have been reports on here (can't tell you who) about cats at vets that are dosed wrong. It never hurts to leave a reminder.

It would also be great if friend/family member would come test. I have a neighbor, a friend, a co-worker and my sister who all know how to test and shoot. (Unfortunately my sister lives 2000 miles away - but does visit 6 times a year or so)
 
Yeah - it would be a great thing to have a friend/family member/etc. who would test and shoot. That would certainly help me with the fact that I'm stressing myself to death about all of this. Unfortunately, no one is willing. This has added to my stress. I do have one friend that would be willing, but her schedule (kids, work, etc.) would not allow her to shoot at any normal time. But she will come over to test on her days off - which might give me some nadir or close-to-nadir readings. I also convinced my parents to learn to test, but they refuse to shoot. Not to mention that schedules aren't their forte since retirement, if you know what I mean.

If I convince the vet techs to test - what guidelines should I give them? If the pre-shot value is lower than normal, do they reduce the dose or just skip it? One is coming to do mornings, and one will do the evening shot.
 
The guidelines for what the vet techs shoot gets a little grey zone - perhaps libby or jill may have better thoughts on that - it partially depends on what type of numbers you have been getting.
Remember it is usually recommended that you reduce dose for pet sitters - that helps to avoid the lower numbers.

Take a look at Tuscany spread sheet. Right now - with as good as her numbers have been - If I was going away I would reduce her dose to 1.75. I would tell the DPS that if the preshot value was (and this is my cat only at this time - just for example) <120 that I would like her to delay the shot - without feeding - for 15-30 minutes. Retest and if rising number to shoot her. If not rising - if she could again delay - if the schedule allowed - I would delay again for 15-30 minutes. If the DPS couldn't delay - number wasn't coming up but not tanking I would have told her to either drop dose down to token dose (like in my case down to 1 unit). 3rd case would be skipping shot entirely but that is not my preferance for my cat. Also, if I have lower numbers to start with - I will have the DPS give a 8-9 % carb food instead of my usual 2-4 % foods. I also know that my cat does well feeding herself (usually). You can see on my SS notes where DPS is shooting. If you are looking - if I am only gone for a weekend or overnight I often have the DPS keep my same dose, especially if she is off on the weekend and can mid cycle check.

I travel alot for fun -usually gone 5-6 weeks a year. We do go overseas alot and at those times I have no contact with pet sitter (yes, can drive me nuts - especially the one phone call I made home from Africa last October just happened to have been the day after the 29 AMPS- see end october 2009). When I am in the country I have the dps text me or call (pain in the butt when it is 4:30 am on west coast and the dps is texting with the EST numbers). You do the best you can.

It is easier now cause the DPS has done this quite often for me. The DPS knows how to put out a 911 on this site and usually someone is around. It will be helpful if your parents will get some midcycles - if there are significant lows then obviously instructions will have to be left for the techs about reducing dose.

It is very stressful the first few times you go away (ok, all of them - but not as bad). It is very hard releasing the control to someone else that doesn't know your cat like you do. I do understand that. In the beginning of Tuscany's insulin journey - all I could think about was some upcoming trip. I think I drove some people here nuts trying to figure it all out ahead of time - as in months/weeks ahead of time. I even -gasp and horrors now - started the cat on insulin and left the country like a week or so later with my dps shooting but not testing. (my rational at that time was that hundreds of cats are on insulin and not hometested... ) I wouldn't even think of that with all I know now.
 
Ordinarily, you can increase dose after 6 cycles. However, when you've a beautiful string of blues, we encourage you to hold the dose for 5 days/10 cycles.

Joyce has a great DPS. Gabby has, historically, not let anyone but me test. She took a pretty good swipe at my former DPS (who I adored but moved) who is a feline veterinary nurse. A friend of hers who's a vet tech has taken over when I travel. Like Joyce, I lower the dose for my DPS. I think it will make sense if you post a little closer to your day of departure so we can help you come up with guidelines for dose and shooting.
 
Ok - thanks, I appreciate so much not having to guess and make all these decisions on my own! I'll check back in closer to my date of departure (next week). Of course, tonight she had a lower PMPS than she's had in awhile. Hoping to get back into the greens :) So much easier when I'm home to keep an eye on her!
 
Nice blue to start the evening cycle with.

One housekeeping item... When you have a chance, there is a template for a Profile in the Tech forum. Could you complete that and add it to your signature? It will cover most of the basics -- date of diagnosis, any medical problems, what you're feeding, etc.
 
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