4/22 Lucian +4/444,+6/367,+9.25/307, PMPS 479,+4/258

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nckitties3

Member Since 2013
Don't understand the amps and not entirely sure he didn't get a fur shot this morning, I think I may have felt a damp spot, but I dunno.
 
Re: 4/22 Lucian AMPS HI

Lucian WTH? What's going on with you and these numbers, buddy? I know Lantus is suppose to be good in cats way past the 28 days for humans but just wondering if you have a bad pen or if it is losing its punch. What is the exp. date on the pen you are using now?

Mel, Maxwell, Autumn & The Fur Gang
 
Re: 4/22 Lucian AMPS HI

nckitties3 said:
Don't understand the amps and not entirely sure he didn't get a fur shot this morning, I think I may have felt a damp spot, but I dunno.


(((hugs))) - its Monday for sure.....
 
Re: 4/22 Lucian AMPS HI,+3/334,

At 334 @+3 I don't think it's the insulin, it's Lucian. Could have been a fluke meter reading, I didn't test again, it's not a surprise for him to be HI. And doesn't look like it was a fur shot this morning, it's damned near impossible for me to tell. I figured he was running high last night, after +4, cause he was waking me every couple hrs to eat. When I got the HI this morning I wasn't shocked, I also got ketone test, which was negative. I think it was 1.5-2 hrs before his test that he ate. I usually make sure it's at least 2 hrs, so as not to be food influenced, but I was half asleep and been up and down all night, It was '6 something' when he had eaten last and 7:50 when I tested him. Could have been as little as an hour prior to the test, but still no reason to jump to 600+ an hr after food.

Checked the pen, it expires 6/2014 and it's been open less than a month.

If he doesn't show me something in the next couple cycles, I'm going to bump him up to try to force the numbers down, can't keep this up again. He's missed 2 shots in the last 10 days and it's been crazy since the first one. It might take a bit higher to get him back down. It took over 3 months to finally start to show improvement and then I screwed it up. I'm not gonna let him suffer with these high numbers for another 3 months. The longest stretch he has had that he didn't show black, was 7 days, until then not more than 2 or 3, that can't be healthy! Even when he has good cycles, he throws a 600+, I don't get it. There's got to be something we're missing with him, disregarding the fur shots, etc, he has always been all over the chart, with the exception of a couple weeks in March, when he was doing better, not great, but better. At least, at this point in his treatment, I know I haven't missed the right dose, he may go up and down in dosing, but we've hit everything from .5-2.5 and there were times I probably should have raised him in .5 increments, but went with .25 to be sure I didn't miss anything. I think he's had 3 missed/fur shots in 4.5 months, could be worse I suppose, but the crazy numbers are getting to both of us. With what it's doing to me mentally, I can only imagine what it's doing to him physically.

Just tested, an hour after eating, up to 444 @+4
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444

Just wanted to eliminate the easiest things first like insulin being out of date...okay we can check that one off the list. What you may have to do if he doesn't come down again is take him up again and force him down and just not give the reduction when it is earned until he can repeat it several times, instead of letting him head for a reduction just steer him into a surf. Yeah it is PITA but we need to figure a way to get him to just stay in that 40-120 range as long as possible even if that means using food to head off the reductions.

Sometimes and this is what I'm starting to try with Autumn is 'front loading' getting all their food for the day into them before onset, so with Autumn that means like today she got her entire 1/2 can in two meals at preshot and +3 since her onset is at +5ish, that way once the insulin kicks in it doesn't have to battle against food spikes from additional feedings throughout the day, now she won't eat again until her preshot tonight and then again at +3 after that...Can't tell you how well it is going to work as we are just starting and I've never done it with any of my others but have seen it done with some others that like to food spike with success.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444

I'd have to leave the house, you have no idea how loud he screams when he wants to eat! Why do you think he wakes me up all night long? When he decides he's hungry, there is no ignoring it, I've tried. After 30 mins I'm ready to stab myself in the neck with a pencil! Lucian is the most vocally annoying cat I have ever had, I swear!

He's been a grazer for 14+ years, I don't see him ever waiting for 6 hrs to eat, unless his BG's are under control.. When his numbers are close to right, he'll go 5 hrs between meals, no problem, but that's only happened a couple times. He so high so often, he's always hungry. I'm sure if he was at least staying under renal threshold, I could stretch out his meals, but not with the way he is. And he never eats more than 1/4 can anymore, the total he's eating each day hasn't changed much, he's just hungry more often when his numbers are high. When I say hasn't changed, I mean in the last 3 months, the 1st month he was eating 2 cans a day and it's dropped to 1-1.25. The first month, he was starving, now he's hungrier more often when he's running high.

I've tried leaving food out at night, no go on that, they won't eat it after it's been there more than a few minutes. When I say they, I mean none of them, not just Lucian and I get tired of throwing out food. So I never give more than 1/4 can, they won't eat more than that at a meal. Occasionally the feral will eat hers and the others leftovers and puke, so I have to pick up what the others don't finish. Then again, the feral only eats 2-3 times in 18 hrs too. She normally wants to eat every 6-7 hrs. And Patches? I worry about her, she doesn't eat 1/2 can a day, I don't know how she isn't loosing a lot of weight. She might eat 1/8 can 4 times a day, maybe. Been that way since the wet food changeover. She's still my problem child, must be that multicolor thing, like the torti.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444

Okay scratch that idea....Oh can I relate, Myrrdin makes me want to stab myself in the eardrums with an icepick when he is hungry he makes even the Meezers sound like mutes when he revs up the siren.

Okay here is what I'm thinking after looking at his spreadsheet if he doesn't straighten up and fly right here shortly...Take him all the way back up to 2.5u and try to keep him from making a run for the basement and make him surf instead, this might mean giving him a 1/4 can of his regular low carb at preshot, then a snack (1/8 of a can) of possibly MC (11 to 14% carbs) at +3, then his regular stuff again at +6 followed by a snack again at +9 (1/8 can MC) then dinner as usual at pmps.

The high carb stuff might also appeal more to Patches as well so maybe she will eat a little more of that as well.

When I go back and look at his spreadsheet that 2.5u looks like it was where he got the best run of numbers but he wanted to dive a little low so if we can steer that dive into a surf and make him hold those numbers for a longer period of time it will give his pancreas more of a time to rest and reboot. Make him earn is dose reductions by repeating the pattern a couple of times so it isn't just a fluke day, which I think might have been happening, for some reason something was just different on those he dived rather than it truly being the dose needing reduced. When he does earn a reduction treat him more like a long-term diabetic and make him fall below 40 instead of below 50.

Now if you weren't home with him most of the time I wouldn't be recommending this, because it is going to take some real watching and monitoring to know if it is going to work and you are going to have to be ready to intervene if he looks like he is gonna still try to run for the basement even with those MC snacks thrown in.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444

nckitties3 said:
I'd have to leave the house, you have no idea how loud he screams when he wants to eat! Why do you think he wakes me up all night long? When he decides he's hungry, there is no ignoring it, I've tried. After 30 mins I'm ready to stab myself in the neck with a pencil! Lucian is the most vocally annoying cat I have ever had, I swear!

He's been a grazer for 14+ years, I don't see him ever waiting for 6 hrs to eat, unless his BG's are under control.. When his numbers are close to right, he'll go 5 hrs between meals, no problem, but that's only happened a couple times. He so high so often, he's always hungry. I'm sure if he was at least staying under renal threshold, I could stretch out his meals, but not with the way he is. And he never eats more than 1/4 can anymore, the total he's eating each day hasn't changed much, he's just hungry more often when his numbers are high. When I say hasn't changed, I mean in the last 3 months, the 1st month he was eating 2 cans a day and it's dropped to 1-1.25. The first month, he was starving, now he's hungrier more often when he's running high.

I've tried leaving food out at night, no go on that, they won't eat it after it's been there more than a few minutes. When I say they, I mean none of them, not just Lucian and I get tired of throwing out food. So I never give more than 1/4 can, they won't eat more than that at a meal. Occasionally the feral will eat hers and the others leftovers and puke, so I have to pick up what the others don't finish. Then again, the feral only eats 2-3 times in 18 hrs too. She normally wants to eat every 6-7 hrs. And Patches? I worry about her, she doesn't eat 1/2 can a day, I don't know how she isn't loosing a lot of weight. She might eat 1/8 can 4 times a day, maybe. Been that way since the wet food changeover. She's still my problem child, must be that multicolor thing, like the torti.

Have you tried the frozen food thing? It works well for me - although they won't eat "old food" when its newly thawed food soup - that's acceptable. I just freeze it in the catfood dish, but I know a lot of people use an ice cube tray. And as for how much they eat.....I think a lot of it depends on how active they are.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444

I don't know if you've taken this into consideration before- but how carb sensitive is Lucian?

Sneakers would go from pink to black on a +1% carb change in food. To stop her rolling i fed all of the food in 1%- with FF that gave her 4 or 5 choices so she was happy. We did that one % for two weeks and she finally stopped swinging like a pendulum on steroids.

Something to consider if you haven't already.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367

I don't know how carb sensitive he is, it's so hard to get him to eat and I can't afford FF. His food is anywhere from 1-8 carbs, occasionally a 9. I tried keeping him real low in the beginning, was under 5 for the first couple months with no improvement and constant battle. That's why I added the 6,7,8, 9 to his menu.

Mel, if I steer him, how will he ever get to 40? OK, I'm dense, need to explain that one. If I am intentionally keeping him from dropping below 50, then he'll never earn a reduction. Is MC considered over 10 and under 15? I dunno. I was considering taking him back to 2.0, I'd be afraid I couldn't control the 2.5 since he's been on a much lower dose and I certainly have no $$ for a hypo vet visit. Maybe 2.0 for a few days and see how he reacts before I consider trying 2.5? I'm sure I messed up when I reduced him twice in 2 days, rather than riding it out, because of him dropping to 50 or less. I think I should have only reduced him .25 and rode it out for a few days and let him adjust instead of reducing again the following day when he dropped. He was on 1.5 when that started, which is why I don't understand why 1.5 isn't working now. So I though I'd give him another 3 cycles on 1.5 then bump to 2.0 if he isn't coming down by then.

I've never tried freezing the food, since I'm home and have the 3 of them, all with different tastes, what a pita huh? As luck would have it, I'd freeze the one Lucian doesn't want at that minute and he'd wake me up to b*tch about it. Either way, he'll wake me up, I'm sure. When we lived in the country and they could go out, he'd wake me to go out in the middle of the night, one advantage to a litter box.

Oh and he hasn't eaten in 3 hrs, he's asleep.

Edit - spoke too soon, woke at +6.75 and ate.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367

Okay let me see if I can explain how he will eventually get to 40 even if you steer him with food...when the dose becomes truly too high..i.e. his pancreas decides to sputter and kick in even a little bit, he will drop on you to below 40 ...that is where HC food and Karo come into play. Then he will have earned a reduction because his own body is producing its own insulin or at least some of his own insulin to counter act the sugar produced from food.

You won't be so much steering him to keep him from a reduction as you will be keeping him from making those fast runs to the blues and greens...the ones where he starts in the day in the 300s and is down to the green by +6, sort of like how a parashoot works on a drag racer. When you find you are having to feed him up to keep him above 40 more days than you are just letting him surf then it is time for a reduction...Not sure if I'm explaining it well.

Yes MC is foods that are higher than 10% but less than 15% carbs.

If you don't think you can control him on 2.5 then lets try it at 2u and see where he settles down on that, as you know we can always add more but we can't get it back out once shot.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367

OK, I think I can handle starting at 2.0 and then go up if needed, that's what I was considering anyway, didn't want to risk not being able to handle him. I'll have to get MC food, all I have is the HC for emergencies. Back to the food list.

Thinks are so crazy right now, it's hard for me to concentrate.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367,9.25/307

Lord such strange numbers.


Edit - Could he have gotten a fur shot last night and I didn't notice? It is so hard for me to tell most of the time. For those of you that don't know, I have medical issues that cause hand tremors and numb hands and fingers, so tests and shots are difficult for me. I'm really wondering, cause he was coming down slow and nice for the last to day since the missed shot.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367,9.25/307

nckitties3 said:
Lord such strange numbers.


Edit - Could he have gotten a fur shot last night and I didn't notice? It is so hard for me to tell most of the time. For those of you that don't know, I have medical issues that cause hand tremors and numb hands and fingers, so tests and shots are difficult for me. I'm really wondering, cause he was coming down slow and nice for the last to day since the missed shot.


Anything is possible, but I think that missed shot just changed his tendency to read in the black from the evenings to the mornings. One thing you might want try is to get an occasional +11 test. I know there might be food in it, but I'm curious as to whether he rises as fast as he drops for you. If he's generally in good shape at +11 then you know he really isn't in such a bad place - its just that Lantus isn't staying around quite as long as it needs to.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367,+9.25/307

I've considered that too, since there are some cats whose meds last a little longer than 12 hrs, couldn't there also be some that last less than 12 hrs? Makes sense to me, but what do you do about it? The other way around, you lower the dose, what to do, give his shots every 11 hrs? I'm completely lost on that one. Not to mention it would be a crazy schedule to try to keep up with.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367,+9.25/307

Well usually in those cases ...because that is exactly what I ran into with Musette...Lantus worked for her, but it didn't stay around long enough. You either split dose (crazy schedule and really doesn't work well with depot insulins) or you switch to Levemir. Which has a later onset, a longer hang time and a later nadir.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: 4/22 Lucian +4/444,+6/367,+9.25/307, PMPS 479

You know I can't change the insulin, how do I split the dose, if I have to try that at a later date.
 
Re: 4/22 Lucian AMPS HI,+3/334,+4/444,+6/367,+9.25/307

nckitties3 said:
I've considered that too, since there are some cats whose meds last a little longer than 12 hrs, couldn't there also be some that last less than 12 hrs? Makes sense to me, but what do you do about it? The other way around, you lower the dose, what to do, give his shots every 11 hrs? I'm completely lost on that one. Not to mention it would be a crazy schedule to try to keep up with.


When I test at 11 (which works well for me when I can't hold off feeding them...if Jez is higher than I like, I'll shoot at 11.5 and call it 12....ECID but Jez isn't 12 hour consistent....her morning numbers are generally higher than her evening ones.....so it actually seems to work out fine if I shoot the morning a bit early and perhaps the evening a bit late.

So some of what you see on her spreadsheet is actually AMPS at 11.5 and PMPS at 12.5....but I bet you can't really see any difference between those and the 12/12 days.

And like I said - if you find that Lucian is actually looking pretty good at +11 but then rising really fast - its not nearly as much of an issue as if he was going high early and staying there for 3 hours preshot.
 
Re: 4/22 Lucian +4/444,+6/367,+9.25/307, PMPS 479

Okay here is how I did it with Musette before I finally was able to switch her to Levemir. (Warning this is NOT an accepted protocol with Lantus in general). But first I ran two curves on her...First day I tested amps, +2, +4, +6, +8, +10, pmps..the next day tested amps, +1,+3, +5, +7, +9, +11, pmps so I knew exactly where her onset and nadir was. Then I took her total dose and divided it in two. I gave 1/2 her normal dose at her normal time, then waited for its onset and gave the second half of the dose so basically the second dose was hitting onset as the first half was hitting nadir and she was starting to rise off it, that way the second half of the dose was starting to work and helped extend her surf causing her to nadir on it later in the cycle...

It is much trickier to do with a depot insulin than it is to do with an In & Out insulin and requires a lot of testing to keep them safe while doing it....it is definitely a custom dosing protocol and not something to be done without the ability to monitor closely or for someone just starting out caring for a sugarcat. In other words we would have to custom design it to fit Lucian and Lucian only. The goal is to try to balance the overlapping cycles and nadirs so he doesn't take off like a rocket at the end of the cycle, which it did do for Musette although I only used it for her as a stop gap until I could get her vet to agree to a script for Levemir and switched her over.

So for those that may be reading this....Split dosing is a custom protocol and is only used with experience care givers that have a cat that is not responding to the tried and true Lantus protocol...this is definitely an "Off Label" use of Lantus.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: 4/22 Lucian +4/444,+6/367,+9.25/307, PMPS 479

MommaOfMuse said:
Okay here is how I did it with Musette before I finally was able to switch her to Levemir. (Warning this is NOT an accepted protocol with Lantus in general). But first I ran two curves on her...First day I tested amps, +2, +4, +6, +8, +10, pmps..the next day tested amps, +1,+3, +5, +7, +9, +11, pmps so I knew exactly where her onset and nadir was. Then I took her total dose and divided it in two. I gave 1/2 her normal dose at her normal time, then waited for its onset and gave the second half of the dose so basically the second dose was hitting onset as the first half was hitting nadir and she was starting to rise off it, that way the second half of the dose was starting to work and helped extend her surf causing her to nadir on it later in the cycle...


So for those that may be reading this....Split dosing is a custom protocol and is only used with experience care givers that have a cat that is not responding to the tried and true Lantus protocol...this is definitely an "Off Label" use of Lantus.

Mel, Maxwell, Autumn & The Fur Gang


What a creative way to manage a difficult diabetic....it makes sense. And I like knowing that people do a bit of experimenting on the side ;).
 
Finally a number I can live with.

Thanks Mel for the info and if the time comes, you know I'll have to ask again, my memory is a half inch long.

Good night, it's been an exhausting day.
 
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