5\15 Suzie AMPS 90 - dose advice, am nervous!

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Maria & Suzie

Maria & Suzie

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Morning all,

Suzie gave us a pleasant surprise this morning of 90 AMPS, her first green ever !!!.

I have not yet given her her shot, so am hoping for some quick replies. I know the dose reductions get earned at 50, but she has gone so fast & suddenly from yesterday's AMPS 327, to 235 PMPS last night. Her current dose is 3.75 IU, she's on day 4 of this dose, so I guess it has started to kick in, plus, when I locked her in the bathroom last night, I gave her a rather big portion of soft food, and only very little dry food and I can see she has barely touched the dry.

So, do I give her the 3.75 IU, or do I feed her, wait a little and then give it?

Happy but nervous !!!

Maria & Suzie
 
Re: 5\15 Suzie AMPS 90, +2.5 69 - am nervous!

Just tested her at AMPS +2.5 and her number was 69. She seems fine, I'm very nervous and keep looking at her. Will test again in 2 hours. The difference between her numbers yesterday in the 200s and now suddenly down in the greens has me biting my nails ! nailbite_smile
 
Yes, I shot already. Sorry, a bit flustered so I forgot to say. When I didn't get any re-assuring replies this morning (no wonder with the time difference, and on a Sunday too, I am in Belgium, it's almost 2pm here already, so most members of the board are still having a Sunday sleep in the States of course).

I looked at the Lantus protocol in the morning, fed her and shot the usual dose (perhaps a whisker less) at about 1 hour after the regular shot time in the morning. She free-feeds, and I've been letting her have a little more dry food than I normally would.

I'll be thrilled if she earns a dose-reduction, but nervous at seeing these sort of low numbers and wondering about her little body, she's not experienced numbers this low in who knows how long.

She's here in the living room with me and I keep looking at her, she seems fine, slightly annoyed at how I keep checking on her and disturbing her afternoon nap. I've got Temptations ready if she needs a carby-snack and have the honey jar & Hypo instructions handy too should the worst happen.
 
Wow, those are some nice numbers. Sounds like you prepared in any event, and as long as you are keeping a close watch you guys should be fine. I hope she earns a reduction on this one! Keep updating ok.
 
Maria,

Just wanted to say hi and give you support. I know that nervous feeling. Watching wondering if she is ok. Glad you are hometesting, thats your biggest tool in a situation like this. You will know whats going on with Suzie. Test whenever you feel that it is needed.

Keep us posted and have a good day.
Your right, mine is just starting.

jan and sara
 
I'm trying to resist testing every 15 minutes, just because I'm the one almost hyperventilating ! (and her little ears look like pin cushions as it is!)

As she is 15, it's hard to tell the difference between "lethargic" and "just sleeping on my side like a dead cat because I'm 15 and it's normal for me". She just woke up and I've given her the dry food she was begging for (rather than being hardline with the soft, my nerves have had all I can take !)

How on earth do people survive regular dose reductions, and sitting here, sweating it, wanting the 50 to appear, but also dreading it at the same time??? The "hypo" instructions need to include a section on having a brown paper bag handy for the hyperventilating human! ;-)

Will test when she's done eating and post it.

Thanks for the moral support, it makes all the difference, I am SO GLAD I found this board !!!!

Maria
 
Your doing great Maria. I was glad that I found this board too! It makes all the difference.

Keep up the good work. Suzie will be ok. Especially with you around to keep an eye on her.

jan and sara
 
Her number just now at +5 was 64 !

I'm glad to see a nice slow slope and no sudden plunges and very thrilled at being in the green.

I'm still nervous, but she seems perfectly happy, she had some Gourmet (Fancy Feast), groomed a little, and waddled back to her favourite sleeping spot to continue napping.

Is it my imagination, but is it harder to get a blood drop when the numbers are lower? I've been getting a nice size blood drop, no problem, with the lightest setting of the lancer, but today it's taking 3-4 attempts and going up to a stronger setting on the lancer before I get a blood drop big enough. Fortunately, she's very patient and does not squirm too much when it starts to take too long.

It's my first time skirting around the lower greens, waiting for that 50, does it get easier?
 
OH, it gets way easier. I go to bed on a 64 +5 now. :lol: But - been at it for over a year and have lots of data. Your heart rate hardly even goes up anymore when I hit a 40's. 30's still gets my attention but not the panic feeling like it did in the early days.
 
You are doing great!! You are In Control!! Food is the way we control their numbers when they go low...I know these low numbers are heart stopping in the beginning, but you will feel better about it as you go.
What a wonderful cycle this is--Your cat is surfing the 60's, and considering 60-120 is a normal BG, she is doing just fine--
There are plenty of members to help you here, so not to worry! Good going today :mrgreen:
 
Yea it get's easier. Perhaps it's your being nervous that makes getting blood harder. I know when I was anxious about getting a reading (either high or low) I had trouble coordinating everything (pounding heart, sweaty hands, wide eyes...) I hope you do creep up on that 50 and earn a decrease and I hope Suzie turns out to be a "flat cat" with no big bounces after a low. You will notice however with Lantus that shooting lower numbers does not frequently lead to a plummet in the numbers. We say "shoot low to stay low" it seems the big drop doesn't happen when insulin is given and they are already in the lower numbers, whereas it is not uncommon for them to start at 400's and drop several 100 in 5 hours.

* Totally sillyness here: I was kind of thinking that when the BG is high it should be harder to get blood....shouldn't the blood be thick and and sticky like honey with all that sugar in it? ohmygod_smile
 
Been there - Kasha's hit the 40s a few times and she acts like it's no big deal. But the day she hit 34, I about lost my mind. I had to "call a friend" for moral support while I spoon-fed her high carb gravy. Kasha, of course, showed no symptoms other than being sleepy and irritated at me for constantly checking on her. She's almost 18, so I know what you mean about trying to tell the difference between lethargy as a problem and normal sleepy (irritable) older cat behavior.

But after today, you'll realize that monitoring her at home gives you a lot more control over what happens. Imagine if you didn't know her numbers were low - you might have lower blood pressure, but you wouldn't know to keep an eye on her. And she's not plunging dramatically (like Kasha does sometimes), so that's nice too.

I haven't noticed any changes in getting blood drops when she's in the low numbers - except when my hands are shaking! Usually it's only when her ears are cold that I notice it's hard to get a good drop (which makes total sense, of course).

See - now you have an idea how she reacts to the 60s (and maybe lower). This may make you more comfortable the next time it happens.

Good luck - take a deep breath :smile:
 
We refer to what you did this morning as BOS (balls of steel). Pretty impressive. And yes, as Joyce said, it does get easier. In fact, in no time you will be annoyed that Suzie tested with a 52 vs. a 46 and missed the reduction. Green will become your friend! We've all be through this and it is one of the strengths of the Board -- you don't go through the first time or several alone.

Also, don't be surprised if you see a bounce this evening. Suzie's numbers may shoot up. Her body may have forgotten what low (i.e., normal) numbers are like. When this happens, the liver panics and dumps stored glucose and counter-regulatory hormones into the bloodstream.

I wouldn't keep testing Suzie every 15 min. (Hopefully, you've stopped already). You can test every hour since she appears to be surfing. One of the principles of using Lantus is to "shoot low to stay low." Most of the time, if you shoot low, you will see a drop but not the way you see a drop from high numbers. I would suggest you go back and re-read the sticky on becoming data ready to shoot low numbers.
 
I'll take the BOS comment as a compliment !!! I wasn't half nervous - Sunday morning and all of you sleeping tightly in your beds with the time difference. But having read some other posts over the past weeks, and re-reading the protocol, I gathered my courage and went for it. Thank heavens for home glucose meters !!! How anyone can attempt any of this without one, I don't know!!!! (nor without all this help I am getting from all of you on the board)

Was just kidding about the testing every 15 minutes. ;-) I felt like it, but I've applied the BOS principle too and have told myself to do it every 2 hours if she's over 60, every hour if she's over 50 and only do it very frequently if it goes under 50. Unfortunately I'm not doing a good job of getting blood on the first try today, so her ears are a little punctured, but she's not complaining.

Thanks for the tip re. the bounce, I was sort of suspecting that her body may freak out a little at the sudden low numbers. (if hers doesn't, mine certainly will !) Secretly, I don't think I could cope with a very low PMPS again this evening - I give her evening shot at 10pm, so it'd really mean total lack of sleep if she is very low and I need to test her often. My husband goes on a 3-day business trip tomorrow, so I'll be alone with it, but think I can manage to work from the home office a lot so I can still watch her. Well, I'll deal with whatever numbers she throws at me.

She's now sitting here looking at me, clearly expecting some food.

So, basically, if she does not hit 50 today, I need to brace myself, gather up more BOS and still shoot 3.75 IU this evening?
 
Yes. BOS is a compliment!

Maris & Suzie said:
So, basically, if she does not hit 50 today, I need to brace myself, gather up more BOS and still shoot 3.75 IU this evening?
Click to expand...
That's right. Unless her numbers are still low and if they are lower than the 90 you shot this morning, please post for input before you shoot, you continue to shoot your regular dose. It does look like Suzie may be wanting a decrease so you are wise to be prepared.

Actually, I wasn't kidding about testing every 15 - 20 min. With numbers in the 40s, you want to feed and re-test in 15 -20 min. and repeat the process until you see numbers in comfortable surf territory (i.e., 50s or above). You want to get 2 consecutive tests where numbers are surfing or rising and then I back off testing to every 30 min. until I see a solid surf. You can feed either LC, MC or HC depending on how carb sensitive Suzie is and you probably won't know that until you try one or the other out. You might try MC (you can use a small amount of LC (a teaspoon or so) with some HC gravy on top to make MC food. See how Suzie's numbers respond. (We refer to this as, "lather, rinse, repeat.")

Keep in mind that using food to guide the curve depends on when in the cycle a drop occurs (i.e., early vs. at or after nadir) and how much momentum there is. If a drop is early and from high to low numbers, there is a lot of momentum and you may need to pull out the HC big guns. If the drop is like what Suzie experienced today, there was minimal momentum and you have a lovely surf.

You are handling this like a pro!! (Hopefully, your heart rate is back to normal.)
 
Just tested her at +7, it's 75, so she is swinging back up again. Doesn't look like we'll see that 50 today, but that doesn't matter, I can't believe she's been in greens all day !

Thank you everyone for the support, I'll keep posting and hope to get advice for her pm shot.
 
Oh, I forgot something - I managed to test her urine today, not that I was expecting ketones, but she presented me with an opportunity to test and I haven't tested in a while, so I thought I'd take the chance.

No sign of blood - yay ! no ketones - yay ! Glucose - for the first time it remained pale yellow, yay x2, but.... the one for protein turned green, and I haven't seen that before... what could that be? She does have bad kidneys, could the protein be appearing because she is drinking less these days? Is it a concern that protein is making a showing in her urine? Can't be all too bad, because she is sitting here at my feet grooming, but thought I'd mention it in case anyone knows what it means & if it matters...
 
Ah I'm assuming you are using Clinistix or combur 10. I have some of those here too (I have have to test my own sometimes). I have chronic kidney disease and always have high protien, but there are other things that can alter the results of the dipstick. the protein feild is highly sensitive to interferring chemicals, blood, Ph value, specific gravity, and contamination with other fluids (vaginal secretions, feces, or bacteria present in the urine) in addition if Suzie has recently lost weight or is underweight and has been recently been ill then the kidneys will often excrete some protien.

Since you know she has kidney issues anyway the protien is probably related to some extent to that. Proteinurea, or albuminurea (which these sticks are sensitive to) is very common in kidney disease and usually the the first and most sensitive sign (positive long before serious damage) Blood testing done by the vet to check creatinine and other kidney parameters will determine the extent of kidney function decrease.
 
Her +9 reading was 115.

So no reduction today I guess, but we are very happy with our first greens. I'll post her PMPS reading later, but it's looking like staying on the 3.75 IU dose, yes?

As for the protein reading in her urine, it's one of those "mention it to the vet next time I talk to her things" rather than urgent then. She was diagnosed with CRF 2.5 years ago, but, looking back, frankly, in that time, I am not sure how much of her issues have been CRF or diabetes, since the vet we used to use simply missed the diabetes, and I didn't know enough to know any difference. Since she is drinking less now, and eating different things, everything could be finding a new balance. Time for a new thorough blood check for Suzie I think, also now that she has gained some weight and gained some strength (about only 2 weeks ago, everyone was convinced she was dying...)

I need to talk to our new vet soon anyway, since I have to plan ahead for my vacation in July and with Suzie's new diabetes need, I have no family members in the area who can handle it, so I have to leave her in a "cat hotel" run by an ex-vet tech, which means she needs vaccinations, one for FLV and the other for cat-flu, and of course she has to be strong enough. (any thoughts on giving these vaccinations to an elderly & diabetic cat?).

Thanks for everyone's support today !

Maria & Suzie (now proud owner of her first green numbers !) :mrgreen:
 
nice shooting this morning! What a perfect cycle for Suzie, may she have many more just like this one. :mrgreen: As Sienne said, she will probably bounce from this, but the good thing is that once they get here, they can get here again. Hopefully this is a breakthrough for Suzie.
 
PMPS is 203. Guess we'll stick to the 3.75 IU dose for tonight then?

It's still the lowest PMPS we've seen, there is a clear downward trend, and we saw greens today, so we are happy.

Will ask DH to test her before he goes to bed, which tends to be late. I think he has to get up unusually early tomorrow, so he can do an extra test then too.

Thanks for all the help & encouragement today !

Maria & Suzie (she who did her first greens today) :mrgreen:
 
Same dose it is then !

Yes, great day, but I'm exhausted. I didn't know that sitting and staring at my cat could be so tiring !!!

My blood pressure still hasn't come down from seeing that 64 for the first time !

Thanks again everyone for everything ! Without this Board I would probably have passed out at some point when I saw those lows !

It's nearing bed-time here, hope all your kitties give good numbers today!

Maria & Suzie cat_pet_icon
 
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