5/17 BillieAMPS175 +5 103 +7 85 +8 166 +10 236 PMPS243...

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Deanna & Billie

Deanna & Billie

Member Since 2014
Good morning! Billie had a good night, and I hope you all did too! Here is our thread from yesterday: viewtopic.php?f=9&t=118821

Her AMPS is 175, and I just gave her 0.75 units. She is not liking this routine at all, and already knows when I'm getting our supplies out to test her. She hid from me, but came out when I started preparing her breakfast. Then I got a quick test, let her eat, and gave her insulin. Then she ran from me again.

Have any of you had the problem of your cats avoiding you when you first started testing and shooting? I just went over to try to pet her, and she went under a chair to get away from me.

Also, is it okay to sprinkle a bit of parmesan cheese over wet food if a cat is not eating enough before a shot? I read that trick somewhere and I'm wondering if it's safe to use.
 
Re: 5/17 Billie AMPS 175

Good morning, Deanna! ~O)

Our kitties can definitely get testy with us. I just tried to check Jersey's bg this morning, and she got growly and huffy with me. (Even in remission, it's recommended that you check the bg at least once a week. If they fall out of remission, you want to catch it as soon as possible.) Jersey would sometimes shy away from us, and I couldn't blame her. It seemed like all we were doing was poking and shooting her. I just kept reminding myself that I was doing this so that, in the long run, I could keep her safe. One thing that might help is to take Billie to the testing "spot" and not test her. Just give her lots of love and some treats. It may help if she learns to associate the testing spot with some positive things rather than just the negative things.

Another thought I had - make sure you aren't hitting the main vein on the ear when you poke. You'll get a lot of blood by doing that (and can do it if you absolutely have to), but it will hurt more for Billie. Try to aim for the outside of that main vein. Have you seen the picture of the "sweet spot" for the ear? If not, I'll try to track that down for you.

I haven't used Parmesan, so I'll leave that question for someone who has used it.

Hope you and Billie have a great day!
Shelly
 
Re: 5/17 Billie AMPS 175

Great job with yesterday, today's condo, and linking yesterday's! You are becoming a pro :-D

Some kitties take longer to adjust to the routine of the tests and shots. Lots of love and treats will help. Many of us use the various freeze dried chicken, shrimp, etc treats.

Yes, you can use Parmesan cheese. I use the freeze dried chicken; I buy large bags and then toss it in my food processor to make it into dust and then sprinkle that on the food. I found that too often the pieces are too hard for Gracie. She's a little girl with a tiny mouth and I don't sent her crunching at those big pieces of hard treats. And with the dust...she thinks she's getting more than she is ;-)

You might want to grab some spot checks today. I'd definitely start with a +2 and go from there. I love this blue on her already!!!
 
Re: 5/17 Billie AMPS 175

Billie is looking fantastic - she's having a great start on Lantus. I agree with Marje about getting a +2 - it's a great help in seeing where the rest of the cycle might go. If you're already past the +2, go ahead and get another test now.

from the Tight Regulation Protocol yellow-starred sticky at the top of this forum page:
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
Click to expand...
 
Re: 5/17 Billie AMPS 175

Hi everyone!

I skipped the +2. Billie was hiding from me after a rough AMPS test, and I didn't want to stress her out by grabbing her. I know that may not be the right call and I should learn to suck it up and do it anyway.

I watched her for the first few hours and just did a +5 test. She's at 103 right now. Does that sound good?

Thank you!!

Also, the freeze dried chicken crumbs sound like a great idea and healthier than cheese.
 
Re: 5/17 Billie AMPS 175 +5 103

Yes it does sound good.

One thing I want to caution you about is relying on clinical signs for low numbers. My Gracie has been in the 20s with nary a sign. I prefer for her to not even be in the 40s. Just because a cat in low numbers is not showing clinical signs, it doesn't mean that there might not be effects because low blood sugar means less sugar available to the brain.

It is probably going to make her unhappy until she gets used to the routine. Hopefully, she won't need to do it for long because she is already showing great response. I'm glad you started her at 0.75u.

I'd test her at +7 or so and see if she is on the way up.
 
Re: 5/17 Billie AMPS 175 +5 103

Thank you for that! That's very good to know, yet my vet told me that if she were dropping too low, I would notice obvious signs. Her vet also did not recommend home testing. Hmmm...I am wondering if I should look harder for a vet who specializes in feline diabetes or at least is more familiar with Tight Regulation. When she was first diagnosed, I called a couple other offices to ask if any of their doctors are specialists but was told no. I am also really glad we started with 0.75 instead of the full unit.

I will test again at +7 and see where she is at, and I will make sure to start with a +2 tonight after her PM shot.

I have a question about tomorrow - I have to work and am trying to figure out how I can get home often enough to test Billie. I will be home in the morning to get a +1 and a +2, and I can sneak back to check on her around +6. Do you think that's okay as long as her +1 and +2 look good? Or would it be better to skip the AM shot? I also have to work Monday, Tuesday and Thursday, but have my boyfriend coming over while I'm out.
 
Re: 5/17 Billie AMPS 175 +5 103

I'm not sure where you are located but, here in Tucson, I spoke with several vets.....including two board certified internal medicine specialists and none of them were as expert about FD as the people i found in this group. We live and breathe it 24/7 and they don't. Not all but many vets are not supporters of the TR protocol because they don't have the time to help someone manage tight regulation. Our current vet is awesome but she says she thinks the help we got here as new members far surpassed what she could have done. So i don't use her for dosing advice but she is our number one supporter.

Some cats will show signs of dropping and/or low numbers and some will not. Gracie does not; Elise's Max does not. Maybe in time you can pick that up with Billie but I think home testing is the best way.

Let's see what she does today and tonight before deciding on tomorrow.
 
Re: 5/17 Billie AMPS 175 +5 103

Her +7 is 85. I guess she wasn't down all the way at +5. I can't believe these numbers! Should I check again at +9 to make sure that she's going up?

I don't know if this is relevant, but she has been picking at wet food throughout the day.

Thank you for your help! I agree that FDMB is where the experts are! I am amazed every time I post on here, and so grateful.
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85

I just checked again at +8.25. She's at 166 now. Is that a normal increase? She ate some wet food with parmesan as a treat after our +7 test.
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166

Sorry I misses the +7.....I had to go pick up something for Gracie.

Wonderful curve today! Yes, it's normal for her number to rise. I'd give her a break until +10. The +10/+11 tests are often ignored but let us know going into the next PS whether they are dropping or getting a second dip which is common to Lantus and levemir.

Great job!
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166

Hi, we just did a +10.25 test, and she read 236. That's the highest I've seen on our meter. Does that make sense?
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166 +10.25 236

yes, it's fine. she's not going to get completely regulated immediately.

cats don't always have their nadir at a given time, and even when you *think* that she always nadirs at +6, say, she might nadir earlier or later some days. good catch on the 85! that's a great number.

It's pretty hard to find a vet that knows a lot about managing diabetic cats, especially using TR. Most people don't want to test, but here we've seen a lot of times where a cat can go from 400-40-400 in 12 hours - so we're HUGE advocates for home testing. The older insulins weren't as long-lasting, so dosing was adjusted based upon the number you saw at preshot (assuming you were testing.) the Lantus/Lev insulins are dosed based upon how LOW they take a cat. That's a change in thinking.

I switched to a vet who had 2 diabetic cats herself - and then discovered she didn't even hometest! But she was a wonderful vet otherwise, and i was already on here and learning what i needed to know, so we just stayed with her. I doubt there is anyone better than her in our town.

Most (all?) of us do what Marje described - stick with the vet that you think is overall good and get your day-to-day dosing and management advice here. A vet has to know a lot about many different diseases and conditions, and honestly, i think most don't get much on Feline Diabetes in vet school. Fortunately, getting overall help from the vet and dosing advice here is a system that works for most people and cats.
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166 +10.25 236

Thank you Julie! I do like our vet in general. We have been to a few, and this one really goes out of her way to be thorough and make sure all my questions are answered.

Is it possible that the 236 was a bounce, or would it be too soon for something like that? I'm just surprised, because it is higher than what I have seen at home, and right around what I've seen at the vet with the influence of stress. I added 30-40% to figure out what it would be on the vet's meter, and it's more like 305-330. Of course, it's possible that she did spike from stress. I tested her a lot today, and she was definitely getting stressed out by that.

I'll go ahead with another test and her PM shot in a half hour.
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166 +10.25 236

yes, it's definitely possible it's the beginning of a bounce. we'll be able to tell by what she does in the next few hours. if she keeps going up, that'll tell us it's a bounce, especially if her BGs go significantly higher. If it is a bounce, you just hold the dose through the bounce and wait to see what numbers show up when it clears.
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166 +10.25 236

Hi Deanna! It's my first time stopping into your condo. Billie is looking great! And awesome job catching that 85!

I don't think a lot of vets suggest home testing because they figure it's too much for the caregiver, and the CG won't do it. But you see how Billie's numbers dropped today. We had some trouble finding a good vet, and even the one we see now had concerns about TR and our dose, but once she saw how often I test and Cobb's spreadsheet she said we did better than she would have ever expected. So if you like your vet otherwise, you can stay with them and make your own dosing decisions.

You're in a great place! We're glad you and Billie found us!

~Suzanne
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166 +10.25 236

Hi Deanna and Billie and welcome to Lantus Land,

You are doing a fine job. It takes a while for cats to settle in to a dose, and every time you change your dose you have to reckon on a period of adjustment. I would not worry at all about bounces and such. Just try to be consistent and see what happens over the course of several days and weeks. Billie's numbers today look very good. With regard to your work schedule, you just have to do what you can and not be too concerned about having to skip tests. Everyone has to skip tests. Just make sure that Billie has enough food on those days when you can't be home. Many of us use automatic feeders. It is good that Billie likes to eat a little at a time all through the day. Rusty is a "grazer", too, and I think that this way of eating helps to even out curves. (But ECID, as you have undoubtedly been told--Every Cat Is Different).

The best vet is one who leaves you alone when it comes to managing your kitty's feline diabetes!!

Welcome!

Ella & Rusty
 
Re: 5/17 Billie AMPS 175 +5 103 +7 85 +8.25 166 +10.25 236

Thank you all!! It's nice to hear from so many great people!

I just did a PMPS test and gave Billie her shot. She is at 243 right now. I will do a +2 and see where she is at. If she is bouncing, what should I be concerned about? From what I understand, a bounce happens when levels get lower than what the body is used to, and the liver reacts by producing glucose. So we'd be worried about her numbers getting too high rather than too low? Correct me if I'm wrong!

Also, this is my schedule tomorrow - I will be home until +2, then can stop back to check on Billie around +6, and I'll be home for the night by +10. It will only be her third day on insulin. Is it safer to skip a dose since I won't be able to monitor her as vigilantly, or is it safe to give the dose and check on her at those times? Let me know what is safest.

Thank you!! Also, I love the automatic feeder suggestion and plan on getting one for days when I won't be around for longer periods of time.
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

I think tomorrow morning, if you're faced with a number that you are uncertain about, it would be better to skip the shot. if it's over 150 or so, you *probably* are ok shooting. You'll want to get the +2 and if she's lower than the preshot, leave plenty of food out and available to her.

If you're in doubt, however, just skip. Everyone has messed up a shot here and there, and if you do, we never re-shoot. Like sometimes the cat will move when you're shooting and some/all of the insulin might end up outside of the body. if that happens, we call it a "furshot" and just let it go. just in case some got in, we don't try to give more.

The "How to Handle Low Numbers" sticky has specific guidelines on what to do if you're faced with a low preshot number. I'm just thinking in your case, we don't really have enough data to predict how she'd respond with any certainty, so this time, i'd probably skip.

What's your regular work schedule? Is there anyone else available to test her?

This is the feeder we used and were really happy with: http://www.amazon.com/PetSafe-5-Meal-Automatic-Pet-Feeder/dp/B000GEWHNS/?tag=felinediabetesfdmb-20 I bought it at our local PetCo.
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

That makes sense. Thank you! If she has a high number or it looks like she is bouncing, should I still shoot, or is there still a danger of her going too low even if she is bouncing? If there is no immediate danger to skipping a shot, I might skip.

My work schedule is made for the rest of the month, but from June on, I'm going to work my hours out so that I can be home more often. For the days in May that I am supposed to work long hours, my boyfriend has offered to stop in and check on her, since he works different hours than me, so that's great. Tomorrow is really the only day that I don't have a comfortable plan.
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

Looks like Billie's liver did not like that 85 but that's ok! It will be interesting to see how long it takes her to clear her bounces.

If you get a number that worries you tomorrow morning, Julie is correct that you can skip. Right now, it doesn't appear that Billie is going to be a diver (unlike some other little brown princess kitty I know named Gracie) :lol: :lol:

Dyana and Sienne are usually on early in the morning as well as other experienced members. You can post and get help if you need it. Just be sure you make an eye-catching subject line like "NEED HELP PLS" :-D

See you at +2.
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

Thanks! I'll see where she is at in the morning and go from there. I just did a +2 and it was 230, so that's good because it's similar to the pre-shot, right?
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

Thanks! I'll see where she is at in the morning and go from there. I just did a +2 and it was 230, so that's good because it's similar to the pre-shot, right?

Sorry for the double post. For some reason, this site is taking a really long time to load/not loading, and I guess I clicked submit a couple times.
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

One more update for tonight - I just tested at +3.5, and she's at 269. From what I know about bouncing, it sounds like that might be what's going on. If her numbers are still up there in the morning, should I definitely shoot even though I won't be able to monitor her constantly? I will be home until +2, back for a quick check at +6, and then back for the night at +10. I'm not sure if hypo is as much of a concern when there is bouncing going on, so any guidance on that would be much appreciated! I hope everyone has had a good night.
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8.25 166 +10.25 236 PMP

Hi Deanna and extra sweet Billie! Welcome to the Lantus Land family! (the board has been a little wonky lately, so sometimes you'll get double, triple or even more posts)

Yes, the +2 being very similar to the pre-shot can be a good hint that they aren't going to dive down really low later, but of course, every cat is different!

To add to what you've already learned, what I've told a lot of people when they first start out is this (on getting them used to testing)

Decide where you want Billie's "testing spot" to be..someplace convenient for you and all the supplies. On a table, a counter, a certain rug on the floor, wherever. As many times a day as you can, take Billie there and just fool with her ears. Most cats don't care that we're poking them because the edges of the ears have few pain receptors, but they hate having their ears fooled with! Even if you only get a second or two of "ear rubs" in, give her a treat. Something low carb of course! The more they associate that "testing spot" with the yummy food, the less they care about why they're there! Usually, within a week or two, even the most stubborn cat is willingly going to their spot to get their treat, and not paying any attention to what you're doing!

On bouncing...I've been told that the higher numbers on bounces don't do the same amount of damage that high numbers from the diabetes do, and there's not a darn thing we can do but wait until the bounce is over anyway, so we really don't do anything about them but notice they're happening. We are careful not to increase the dose if they might be bouncing though, because when they start to "clear the bounce", they can do it fast, and if they're coming down fast from a bounce AND we've increased the dose, we can send them too low again, and just set them up to bounce again! They can take up to 72 hours to clear a bounce, so all we can do is hang on for the ride!

Most cats also will go looking for food when they're blood glucose goes lower, so since Billie's went down into numbers he probably hasn't seen in awhile, that would explain why he seemed to be hungry today! If you think Billie might be going lower when you can't be home to check, it's always a good idea to leave some food down so if her BG starts to drop, she can get a snack! That's why a lot of us use timed feeders, or you can make "food-sicles" by adding water to food and putting it into ice cube trays to freeze. Most cats won't eat what they can't smell, and frozen food doesn't have much of a smell, but a few hours later, when it's had time to thaw, it'll smell like food and they'll have it handy...and it's fresher than leaving food out all day. Adding water to their food to make it a little more "soupy" can help keep it from drying out too!

Keep asking questions! The people here are wonderful about sharing their time and knowledge!
 
Re: 5/17 BillieAMPS175 +5 103 +7 85 +8 166 +10 236 PMPS243..

On bouncing...I've been told that the higher numbers on bounces don't do the same amount of damage that high numbers from the diabetes do
Click to expand...

I can see where Chris is coming from. High numbers from a bounce are over in roughly six cycles and so the long-term and cumulative effects of persistent hyperglycemia don't occur. But any number over the renal threshold causes sugar to be dumped into the urine and the kidneys can't distinguish between numbers over the renal threshold caused by persistent high numbers vs high numbers from a bounce.
 
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