5/15/22 - Kaz -AMPS 277 - Numbers Continue Drop

Started new post as other getting too long

@Bron and Sheba (GA)

https://felinediabetes.com/FDMB/threads/kaz-amps-533-pmps241.262834/page-2#post-2949601

I'm getting worried about how quickly Kaz's numbers are now dropping. My fear is that he will go into the green over the next 24-48 hours and I am now back at work.

Should we be thinking of reducing the dose by .25 to help with this?

Claire

 

Aren’t you off today?
Remember the numbers are lower because you are using the human meter.
I would stay with the same dose for now and see how he goes.
If you can monitor today, I would not give him the 15% carb food but just what you are going to be giving him when you will be away.

 

Yes I am off just worried about tomorrow as I have to leave him.

I will stay away from the high carb even though it scares me to. My original plan was to introduce higher carbs while I was away not really sure what we are doing here yet.

I'll get his normal 2.75 dose ready.

 

Well done sticking with the same dose. Let’s see how he goes over the next 24 hours. I would just feed him the times you are going to feed while you are away, but use the lower carb foods…the ones that are 10% or less.
If you monitor this cycle, you will be able to see if he is dropping too low. Keep posting for us to see. I will be around for about 3 hours then @Bandit's Mom will be around for you to tag.
If he is going to drop too low on this dose, we need to see it while you are testing and feeding the normal low carb food.
The higher carb food just keeps him up artificially. It’s fine to feed the higher carb food if he drops too low but during a normal cycle, we need him to be eating low carb…does that make sense.?

 

It makes sense I’m just so scarred something bad is going to happen when I am not around.
I saw you wanted me to feed at +3 and +6 so will wait for those times. I can also feed him today at +8 but not tomorrow as I don’t get home till 4pm which is +10

 

Ok that sounds like a good plan.

I totally understand this.
I think when you are away all day, it is fine to leave some higher carb food out for him in the feeder.
But when you are at home I would like you to feed him the low carb food so we can see if the dose you are giving him is the safest dose.
If the BG drops too low you will be there to give him some higher carb food.
Remember while you are testing, you are in control

 

Do you have a timed feeder? I would be gone all day and could set up the feeder so Gabby had food available.

 

Yes I have a timed feeder and now a MeowSpace so I know he's the cat getting the food.

 

How many meals can the timed feeder do in the meow space?

I was saying on your other thread that I will try to check up on you during the day since we are in the same time zone.

 

I’m really proud of you for shooting the 2.75 this morning. He is having such lovely blue numbers. With the Meow Space and the timed feeder, you will be able to support his numbers and keep him safe. It will be nerve wracking at first because it’s new, but when you come home and check him and see that he is well, you will gain confidence.

I have another thought. Some people have cameras set up to monitor their pets while they aren’t at home. Have you ever looked into this? Of course, if Kaz likes to go sleep somewhere hidden away all day it may not work. It’s just a thought.

 

Thankyou this is really kind of you. Kaz is currently flat on his back fast asleep. Happy cat right now.

 

Tried camera once before did not work well and my upstairs neighbor had theirs hacked and someone was watching them. This kind of gave me the creeps.

 

So like yesterday his numbers continue to drop but now he is in the green for the people monitor and low blues for animal monitor.

 

I know. That is so creepy… and scary too.

 

This is good. He hit 79 (perfectly safe number) then went back up into the blue. Let’s see where heis later on. Hopefully he will still be in blue, but a higher blue. Greens were scary to me at first.

 

Hi Suzanne

I may check in with you in about 2 1/2 hours as this would be his preshot check in case Bron is not around as I know it will be very early morning for her at that time. If that's ok. All depends on what the number is the last number I got would be to hold the shot. My gut says he's going to be border line again but this time I think hes going to be more on the low side.

Kaz has been more hungry over the past 24/48 hours and then goes straight to sleep after eating but he's fine. I've woken him a couple times and hes very alert when I do it.

 

Sure. I’ll be around. I’ll set an alarm for myself on my phone too for about two hours from now. I need to check in on a couple of other people as well so no problem at all.

 

Shot time 6:15 pm? Or about that? 6:30?

 

Because of the lower numbers I have been ear pricking at 5.30pm and then feeding at 5.40pm and then insulin at 6.15pm (same process in the morning.) Doing earlier in case I can't give the insulin and need help this gives me 30-45 minutes to get the help we may need.

USUALLY I ear prick at 5.45am/pm then feed at 5.50pm and then insulin at 6.15am/pm (no issue it's usually quick easy process Kaz is extremely good I just show him the needle and he jumps straight onto the bed and waits patiently for the injection.)

 

Looks like he bounced no real idea why this happened as I was expecting much lower numbers and I kept him on the low carb food as instructed? Find this a bit odd.
He's still really hungry think he would eat anything I gave him right now. This was how he was when first diagnosed but as I started giving him the insulin this and the huge thirst seemed to have subsided. Should I be worried that he's suddenly really hungry again? Does this signify something.

 

Yes. He is bouncing from the green.

 

I don’t think it necessarily means anything except that his BG is high right now. My cat was always more hungry in higher numbers and less hungry in lower numbers. What I actually worried about was when he started eating less when he started having lower numbers. I was so used to him being ravenous all the time.

 

Ok thanks. He's getting a bit fat but I'll have to deal with that after my trip. As long as it does not signify something I should be on the look out for.
Thanks for checking in.

 

I see on his spreadsheet that he’s eating 1/2 can of FF several times a day, but probably needs only about a Tablespoon of food to keep his numbers up. But yes, for now you may not want to rock the boat - and you can worry about his weight when you return.

 

Hi Claire , how are things going?. I'm glad Suzannne has been around today.

 

I am sure it’s back to work for you this morning, Claire. I see the AMPS on your spreadsheet for today, but I don’t see anything in the units column. I hope all is well and you’ve got your auto feeder set up in the Meow Space for today. I hope you got some rest last night and will have a good day at work.

 

Hi Claire,

I know you don't know me, but I wanted to offer my insight for whatever it is worth to you. I was a nervous wreck in the beginning (I still am some days), and especially when Kitty's numbers started dropping. I was very nervous when I began shooting blue preshot numbers, and even moreso when I shot my first green number! I've seen some of your threads and I know your job does not provide much flexibility. I found immense comfort in having a camera set up so that I can check in on Kitty throughout the day. In the beginning I was obsessively checking the camera while I was at work (sometimes every 5 minutes it felt like). I set it up to point at her favorite napping spot and I also have her feeder within view. My camera records the previous 24 hours so I can review footage and see that she is eating. They even make some cameras that you can pan around the room if Kaz has a room that he spends most of his time in but not in one particular spot. If privacy is of concern to you, you can always unplug the camera when you are home and just plug it back in when you are leaving.

I know you're very nervous now that Kaz is seeing some lower numbers. Just know that so many of us have felt the same way so your feelings are perfectly valid, normal, and expected. I know it doesn't feel this way now but it does get a bit easier once you get used to the lower numbers.

 

Hi Bron

Kaz's numbers are below the threshold for the shot (200 with AT2 and he's at 192) hes only slightly under but not sure if I should reduce shot to 1 unit.
Going to tag Suzanne for help as I am not sure if you are up yet.
.
@Suzanne & Darcy

 

I thought I input this before I left this morning along with the two meals I left but I must have forgotten? Sorry I'm overly tired but no excuse you can't help me if I don't do this.

 

Did you feed yet? Or are you stalling and retesting in 30 minutes?

 

I am a little uncomfortable with that PMPS.

 

No I have not fed him as I thought I was supposed to stall feeding and test again in 20 minutes which is in about 2 minutes?

 

perfect

 

So I retested 20 minutes later and the results are as follows:-

Human Meter 136
AT2 - 204 ---- this is now just above the threshold so I am assuming I can feed him and dose as usual?

Do I change the PMPS number to the higher number in the spreadsheet or make note in the comments section as to what I did.

Does this also mean his numbers are likely to drop this evening?

 

Going to feed him now as his numbers are higher is that correct.

 

I would put the second number in the PMPS .. or jam both of them into the same cell and just color code it.

 

Can you monitor him tonight?

 

This is possible, unless he bounces. He did have that green nadir today.

 

Unless you tell me otherwise I am going to give him his normal 2.75 is this too high???

I can monitor him for the next 5 hours but I have to get at least 4-5 hours sleep I have huge meetings and I am already exhausted from no sleep on Saturday and most Sunday.

 

I don't know what I am supposed to do?

 

Here's the thing. According to the TR rules, you can shoot anything over 50, but usually people work their way down to that number. You're holding the syringe

hold on ... typing

 

So, I am looking at your spreadsheet and he's had nadirs that are green on 2.75 and he's been okay on this 2.75 dose.

 

So give him it? Going to reduce to 1 unit but I will stay at 2.75 but I need to make decision now as I am already past his shot time

 

This preshot is lower though so some consideration needs to be given to that. If you can monitor, then I think you will be able to keep him safe. His nadirs are kind of late (today) so what do you think? You hold the syringe and it's important for you to be comfortable with what you are doing.

 

So you want to give a token dose tonight? Of one unit?

 

I don't know what I am supposed to be doing that's why I am asking Im having a bit of a meltdown right now and the clock just keeps ticking I need you to tell me what I am supposed to do

 

Given him ZERO Insulin as I simply do not know what I am supposed to be doing can someone please help me I don't want to hurt my cat

@Bandit's Mom

 

I'm worried that you will not be able to monitor him tonight as long as may be necessary. If it were my cat, I might consider reducing by .25 units and then monitoring closely. There will still be influence from the other cycle/dose. I don't think I would go as low as one unit. I might even shoot 2 units. It's just that he's so borderline right now... it's kind of a judgment call. Technically, you can shoot the whole dose if he's over 50.. and he may bounce, we don't know (although he has in the past.)

 

I was hoping @Bron and Sheba (GA) was going to be here too.

 

@tiffmaxee what do you think?

 

@Wendy&Neko are you around?

 

Had to do something which I am 100% sure is incorrect but I did not feel like I could withhold the drug this would be no different than withholding drugs to a drug addict which could kill them.

So I have given him 2 units against my better judgement. I am assuming that the 2.75 is too stronger a dose for him based on the last few days and that this amount needs to be reduced but I am also guessing that 2 is way too low.
I do not have a plan as to what In am supposed to now do in the morning as I was expecting someone to tell me what I am supposed to do. Asking me my opinion does not help as I don't know what to do if I did I wouldn't be here for help.

I do know that I don't want to be sitting in my house in floods of tears feeling completely helpless

 

You should probably go ahead and shoot. If you can feed and test him and adjust the number of carbs that you feed him then you are "in control" as Bron said. If he were my cat, I would reduce by .25 units, but that's just what I would do. You have to do what you are comfortable with depending on how long you can stay up or if you can set alarms.

 

I am so sorry that you are in tears. I feel awful about that. The thing is that the TR rules say you can shoot the full dose; however, he is newer to the lower numbers and you are newer to them as well -- so I was trying to take that into consideration as well as factors like the fact that you said you needed to get some sleep tonight.

You haven't done anything wrong at all in shooting 2 units. You can always go back up again. It's just a temporary reduction. You have not hurt Kaz. You are protecting him and gathering data.

 

if it's been 20 minutes, test and see where he's at now.

 

Please make sure to get a +1 and a +2 since you did shoot a "lower than expected" pre-shot number. This will help you see where the cycle is going to go.

 

Sorry, I missed that you had shot. 2 unit is OK for tonight, it will give you the chance to gather some data. I would test again at +2. Normally we determine if a dose is too much insulin based on how low it takes the cat. He got down to 79 yesterday on this dose. That is a safe number and you have room for him to safely go lower. If you are following TR for dosing, he has not earned a dose reduction. When you shoot lower numbers, you typically end up with flatter cycles. If they drop 200 points starting close to 300 like he did today, he won't drop 200 points from low 100's, maybe more like 50 ish points.

 

Suzanne I joined this site and have stayed here as I truly believe that you all care and want to help. I stopped listening to my vet a long time ago and I am fully relying on the help of this site. Is that fair on all of you probably not but my trust is in all of you not my vet and definitely not myself as I am still clueless. So far its been a matter of simply increasing doses to get the BG down I am not prepared to deal with situations like this especially as its the first time its happened.
When Kaz was first diagnosed I was in tears most of the time as I thought I was going to kill him by not being able to care for him properly but over the past 6-7 weeks I have found that much of my anxiety has gone as I have always had someone on this site tell me what I should be doing. This site has been a life saver for me. This is the help I need right now I need for someone to tell me what dose to give and if it needs to be reduced to tell me what to reduce it to as I don't have this decision making knowledge yet. It is ultimately my decision to follow your advice and I would only ever hold myself accountable.
Please know that I am truly thankful for all of your help and the help of other.

 

Sorry I was not around today. I know this is all confusing and scary at first. I think it will help you when you see that you can control the bg with high carb food and honey or karo if necessary. Remember on a human meter 50-100 is normal. Some cats that are diet controlled regularly go down under 40 bg 3-4 hours after they eat. It might be helpful to look at other peoples’ spreadsheets and what happens when the bg is under 100. Cats often have a flat all green cycle when regulated. This will get easier. I remember so well crying when I first started dealing with fd. I had cats with much worse diseases such as lymphoma and ckd but this was so confusing. Now I’ll here helping others long after I lost Max too quickly to CHF.

 

Hi Claire, I’m sorry I wasn’t around for you earlier……a bit early in the morning for me.
But you have had lots of support which is great. I know how much Kaz means to you and how you worry about hurting him….but you are doing a really really good job managing him. I know a lot of your anxiety is coming from the fact you have to go away in a June for 3 weeks. So all these different BG numbers are giving us really good data for when you are away.
Remember any number over 50 on the human meter is safe. And shooting lower numbers usually gives you a flatter cycle than when you shoot a higher number. And when you are home testing you are in control.

Is Kaz eating all his food that you leave in the Meow feeder when you go to work?

 

Thanks appreciate the kind words

 

Hi Bron
Things not going so well for us for the past 24 hours. Kaz is feeling fine. I think my problem is that I have no control, and I don't know what to do. Going up with the dose when he simply had high BG wasn't that scary it's no different to me regulating my own medicine and I had someone telling me exactly what to do and when to do it. But now the numbers are coming down and I'm told not to shoot if the numbers are below 200 which they were today. I waited 20 minutes tested again and the # was 202 but by now I was so panicked I did not know what to do. Seems like people want me to make my own mind up as to what I should do but I don't know that's why I am here. I thought if I posted and asked for help someone was going to tell me exactly what I should do as I don't feel that I can make those decisions yet.

I've already said that I thought the 2.75 was too higher dose as the numbers were so low but I was incorrect and told to continue with the dose as is.

I know that these numbers are going to be under 200 again within the next couple days and I need a set plan on what I am supposed to do For EG

150-200 - then reduce shot to 2 units if you can't stall and have to leave. If you can stall wait 20 minutes test again if still in same range then give 2 units
100-150 - reduce to 1 unit
under 100 - no insulin

Not saying that the above ranges are correct I just need some sort of protocol to follow if I can't get any help to tell me exactly what dose to give. This way at least I have a set backup plan.

 

He is going down. Are you feeding?

 

I’m glad Kaz is fine. You actually do have a lot of control when you are testing the BG. I think the issue is you are frightened of the lower numbers …..which we all are at first. And this is why I wanted you to swap to the human meter now and not just see the lower numbers on the day you were leaving for the trip. But the lower numbers are the normal numbers that we need to get Kaz into. The higher numbers he’s been in are too high and are not doing him any good. And compounding all this is the fact you have to go away for 3 weeks soon and I think that is affecting how you are coping with it all.
Now this is all very understandable, and we all get it, but we need to help you and Kaz get used to some lower numbers.

Yes initially you were told not to shoot under 200 as all the preshots were all much higher than that. Then the BGs started to lower and you got a preshot of 177 and you shot the full dose which was great! And we saw that Kaz did well in that cycle and didn’t drop too low.
So 177 is your new no shoot number when you stall dont feed and test 20 minutes later. If you post and tag someone, we will help you decide what to do. If you are going to be home I would shoot the full dose even if it’s a bit lower as you will be there to monitor.
That way we can see how Kaz manages when you shoot lower numbers.
If you have to leave the house and you get a lower preshot, I think it is fine if you short a lower dose for now. Once you come back home from the trip we can get down to getting him into even lower numbers.

Lets see how Kaz goes with the 2 units and the preshot of 136. So far he is doing well. Put in the remarks column what you give him to eat and when, so know what you are feeding.

 

Going to try and get at least 3 hours of sleep. I left food in timer.
Just want to clarify I can not monitor him tomorrow I have monthly meetings in the early morning that run back to back I can not miss these as I run the meetings.
So on the human meter if it’s 177 which is low I give him the full 2.75 and he will be safe.
I gave him 2 units tonight and his numbers continue to drop and I am feeding him.
Have alarm set for 2.30am so going to see how he is then.
Thanks

 

I’ve been checking Kaz’s spreadsheet every hour this evening. I am happy he is safe. Good job keeping him there.

 

His bg is coming down verily slowly and he’s safe. It’s a typical lantus cycle and what you want to see. He should reach nadir or pass it when you test next.

 

Claire, I hope you are managing to get some sleep.
I am always around at your am shots and always keep an eye out for you amd look at Kaz,s SS.
It is around 7.30pm my time when you do the am dose. So you can always post and I will see it.

 

Hi Claire, waiting to see what the AMPS is this morning.

 

HI Claire, I can see you have taken the preshot and it is 278.
I think you would be fine to give the full dose of 2.75 units.
What I would do, for your peace of mind, is to put some higher carb food (maybe a couple of teaspoons of the 15%) into the feeder for the +4 snack as you will be away all day. And the usual carb food for the other snacks.
How does that sound?

 

Lets see how Kaz goes with the 2 units and the preshot of 136. So far he is doing well. Put in the remarks column what you give him to eat and when, so know what you are feeding.[/QUOTE]


Considering he only got 2 units yesterday his preshot number is actually very good. Feeding him now and will give the 2.75 (I have to leave for work within 5-10 minutes of his insulin shot) in about half hour unless I hear otherwise.
I believe that his number this even on 2.75 will be low again but I will do as you say.

I see that you said new number is 177 (assuming this is human meter) and if below and tag and ask for help but if I am unable to get help or someone is asking me to decide on what I should do then what do I give him as I need help as I simply do not know what the safe amount would be.

Thanks

 

Been giving food at +3 and +6 per an earlier post from you do you want me to chenge the feeding times. Think you had said +3 and +6 was when the insulin was at its strongest. Feeding now

 

Sorry..stay with the times you have +3 and +6 and put the higher carb food into the +6

If you leave some of the higher carb food in the feeder for him, that will help the BGs if they drop at all. he is looking great by the way.

 

Thanks I will do that.

 

Have a great day and let us know how Kaz goes. You and he are a great team!

 

Have a good day, Claire. Be safe.

 

Kaz's numbers are dropping again. I have given some higher carb food like you suggested I did before leaving for work this morning. I am also leaving some low carb food in timer and will try to get up in the middle of the night to test him although I am finding this harder and harder to do as I am so sleep deprived.

I know you won't be around at 6.30am my time so I have to make a decision for tomorrow or the next day as its only a matter of time before he's too low to give a shot to.
I know 177 is my new human meter number for the 2.75 but is there another number for a lower shot and high carb food so he's safe while I am at work? (should I reduce to 2 units again if number is between 125-177? Then if lower than 125 do I go to 1 unit?)

 

Remember you can always tag bandits mom, tiffmaxee or Suzanne & Darcy if you get stuck in the mornings.
If you can, I would get a +11 in the pm cycle so that you have an idea of what is going to happen at +12 (AMPS) when you suddenly have to make a decision.
I think I would leave the 10% carb food out for him in all the snacks while you are at work, so that he has some carbs there if he drops lower while you are at work.
As far as dose goes. ….if you get a preshot lower than 177 at night or when you are home during the day, I think you should shoot the full dose as you will be around to monitor and we will be able to see how he goes with that dose and the lower preshot.

If you have to go to work and you get a lower than 177 preshot, you could give a lower dose, say 2 units but still leave the 10% carb food for all the snacks in the feeder.
If it is under 120, post and I would tag one of the people I mentioned above and ask for advice. They are all very experienced members. If you get the +11 BG it will give you time to do this if necessary.

I know you are anxious about the green BGs but you can see that he has been quite safe when he has been in them. You will get used to them more as he has more of them. And it’s great he is starting to come down into the normal numbers for a cat. He will feel much better.
I know you don’t feel you can shoot a full dose at a low number yet, but a lot of people, me included, shoot/shot any number over 50 with the full dose and the cycle seems to stay flat. I am not suggesting you do that yet, but it is something to keep in the back of your mind.

Have a look at Hendricks SS. He had DKA and is now almost exclusively in green BGs
https://docs.google.com/spreadsheet...Y3bj6tt4NeAjfhJvVQb55bsyopXQHILbxlVKF/pubhtml

 

Actually I am around at your AMPS but not at your PMPS. Not sure where my head was earlier ........So I can help you with the AMPS.
Post as early as you can so you are not rushed. I'll watch out for you at my time 7.30 pm

 

His numbers are high this morning so am continuing with his normal morning feed he always gets the Tike here. I am not sure about the higher carb food as his numbers are high this morning.

Thanks for the above this is helpful. I physically could not get up during the night I tried and was actually quite unwell which I know is due to lack of sleep. I will try and do better this evening.

 

Good morning, Claire. That pink this morning looks like one of Kaz’s bounces (from that 70). I’m sorry you are not sleeping enough and feel unwell. I actually worry about you since you told us that you have to be on job sites. Hopefully, Kaz will drift slowly back down to a little lower number by the time you get home.

 

Good morning Claire. I think Kaz is most likely bouncing too. I would just put in the normal food into the feeder.
Hope you have a good day.

 

Morning exhausted but this is how it has to be right now. I actually worry more about my drive as I get really tired driving these days but hopefully I can do a bit catch up this weekend.

Bron - you had said to leave high carb food out for both snacks today but his numbers are high this morning so wanted to check before I did this. I know my interpretation of high carbs and this sites interpretation is slightly different.

High carb to me is 9-10% and then anything above this is really high so can you just clarify if you want me to leave 15% which is really high for both meals. I shoot in about 15 minutes this is usually when I do food prep but I'll wait to do this last.

Have to leave in about 20 minutes though as my first meeting is at 7.30am this morning.

 

You must have been posting at same time so will leave the normal 2-4% carb food.

 

Anything 10% or less is considered acceptable as low carb. Then there is mid carb and high carb.

 

Started a new thread

Thanks

https://felinediabetes.com/FDMB/thr...77-numbers-continue-drop.263306/#post-2950733