? 5/27 Phoebe Squeak AMPS 282 +3.25 461 Advice Appreciated

J.J. and Phoebe Squeak

J.J. and Phoebe Squeak

Member Since 2019
5/26 Condo
Thank you, whoever is reading this.
Phoebe Squeak had a crazy day yesterday-- all the way from 81-564 (on AT meter) I had been considering a doscrease, but when she hit 81, I thought I'd better not.
Then her PMPS shocked me at 564! As you can see on her SS I retested right away and got 478.
So this morning I opened a new insulin bottle and brought out my back-up emergency meter (new). The new one reads a bit lower than the one I had been using, so I'll go with that one just to keep her safe in case it's more accurate.
But she's still got high numbers and I'm new, so I don't really know if it's a bounce or time for an increase. I'm seeing a new vet tomorrow so I may wait to see what she says but I'd love to know what you folks with experience think.
Does it really take this long to get regulated? We've been at this since March.
Thanks in advance for your words of wisdom and for taking the time.
 
Hey J.J.,
Dang, I looked at all the crazy action yesterday.
I am not confident with words of wisdom for you :-|
I’m going to tag a few peeps for you- don’t be surprised if you don’t get a response... for a while. It is a holiday today as you know.
@tiffmaxee, @Christie & Maverick, @Gill & George and @carfurby, an explanation- some reasoning .J.J would be appreciated :bighug:.
I too look forward to learning...
Thanks again!
 
Tracey&Jones (GA) said:
Did she happen to get into anything? Are there any other issues going on?
Click to expand...
Thanks -- no she didn't get into anything and she has no other health issues. Very confusing. I appreciate you asking, though. The only thing I can think of that was different was that I was slowly switching her from DM to Weruva Mack & Jack which is supposed to have even lower carbs. (Suggested by last vet we saw) Perhaps somehow that food made her BG go high even though it's supposed to have lower carbs? So I stopped the switch and will feed her just the DM (which is what she's been eating since she was diagnosed) till we get this sorted out. Thanks again.
 
Krystina & Nelli said:
Hey J.J.,
Dang, I looked at all the crazy action yesterday.
I am not confident with words of wisdom for you :-|
I’m going to tag a few peeps for you- don’t be surprised if you don’t get a response... for a while. It is a holiday today as you know.
@tiffmaxee, @Christie & Maverick, @Gill & George and @carfurby, an explanation- some reasoning .J.J would be appreciated :bighug:.
I too look forward to learning...
Thanks again!
Click to expand...
Thank you very, very much! I so appreciate you tagging others for me. Let's hope we both learn something. :-)
 
I poked my nose in from work, which means I can't see your SS at the moment, but from what you have described, it appears to be a bounce. 81 on AT2 is getting down there. If Phoebe isn't used to lower numbers, or went very quickly down in a short period of time, then that can cause a bounce, which usually resolves within 6 cycles. Bounces can certainly be frustrating, I know, because Maverick likes his bounces. Once Phoebe gets more used to lower numbers, hopefully she won't bounce as high, and she will resolve the bounce in a shorter period of time. If she did drop quickly down to that 81, you could try and feeding smaller snacks more frequently early in the cycle to help slow her down, which may reduce the bounce that will occur. Here is a post about manipulating the curve with food http://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/#post-1087990 for more info.

ETA: Also, depending on what intervention you used, it can create a high number following. On one particular low number, I gave way too much 21% carb to Mav, and his preshot was into black. Now I know he usually only needs 9% but it depends on how low a number a see, sometimes I use 15%. With more data, you will become more familiar with how carb sensitive Phoebe is, and may choose to use less carbs to give her just a little bump up. Again, since I can't see your SS, not sure what you may have done when you saw the 81.

Hope this helps :)
 
J.J. and Phoebe Squeak said:
no she didn't get into anything
Click to expand...

That is good! Maybe the carbs are a different type? I know I get high off of rice (it is crazy) but a plain old potato...nuthin.

The canned Mack &Jack is zero percent carb in Dr. Lisa's list. The pouch Mack, Jack & Sam is 18% though.

I think it maybe a bounce from that deep dive from 376 to the 81 at +5. You may want to add in some DM with the zero carb food - to up the carb% a little when it looks like she is clearing a bounce. See if you can slow her roll a little and not panic the body too much??? Just an idea to through out there.
 
Christie & Maverick said:
I poked my nose in from work, which means I can't see your SS at the moment, but from what you have described, it appears to be a bounce. 81 on AT2 is getting down there. If Phoebe isn't used to lower numbers, or went very quickly down in a short period of time, then that can cause a bounce, which usually resolves within 6 cycles. Bounces can certainly be frustrating, I know, because Maverick likes his bounces. Once Phoebe gets more used to lower numbers, hopefully she won't bounce as high, and she will resolve the bounce in a shorter period of time. If she did drop quickly down to that 81, you could try and feeding smaller snacks more frequently early in the cycle to help slow her down, which may reduce the bounce that will occur. Here is a post about manipulating the curve with food http://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/#post-1087990 for more info.

ETA: Also, depending on what intervention you used, it can create a high number following. On one particular low number, I gave way too much 21% carb to Mav, and his preshot was into black. Now I know he usually only needs 9% but it depends on how low a number a see, sometimes I use 15%. With more data, you will become more familiar with how carb sensitive Phoebe is, and may choose to use less carbs to give her just a little bump up. Again, since I can't see your SS, not sure what you may have done when you saw the 81.

Hope this helps :)
Click to expand...
Thank you very much for checking in from work! I appreciate the bounce info and the link about manipulating the curve with food. The thing is, I did nothing when she hit 81 at +5, I just tested again in an hour and she was at 93 so I fed lunch as usual at +6. She usually gets fed 4X a day -- AM shot, +6, PM shot & once more before bed -- usually around PM shot +3-ish
I see what you are saying, she went from AMPS 376 to 199 @ +2, so at that point I could have given her a snack to slow things down before she reached 81 at +5. Is that correct?
Also, do you think it's possible that lower carb food -- Mack & Jack canned Weruva (0% carbs on Dr. Lisa's list) -- could somehow raise her BG higher than DM which has more carbs just because that's how Phoebe Squeak's body reacts to it? @Tracey&Jones (GA) and I were wondering about this. Thanks again for your help.
 
Tracey&Jones (GA) said:
That is good! Maybe the carbs are a different type? I know I get high off of rice (it is crazy) but a plain old potato...nuthin.

The canned Mack &Jack is zero percent carb in Dr. Lisa's list. The pouch Mack, Jack & Sam is 18% though.

I think it maybe a bounce from that deep dive from 376 to the 81 at +5. You may want to add in some DM with the zero carb food - to up the carb% a little when it looks like she is clearing a bounce. See if you can slow her roll a little and not panic the body too much??? Just an idea to through out there.
Click to expand...
Good points! I am using the canned so it's supposed to have 0 carbs, but maybe she reacts to it badly? Maybe it's her rice and DM is her potato. :-) And good suggestion to feed her when I see a big drop coming to try to slow things down.
 
J.J. and Phoebe Squeak said:
Does it really take this long to get regulated? We've been at this since March.
Click to expand...

Makes me smile to read your question. I think we all wonder that in the beginning. I've been here about 15 months & just recently Ravan is getting "mostly" regulated!
He still ,unexpectedly, will go up high or too low once in a while, that's why I still test him frequently. If you check his 2018 SS you'll see what I mean. :)

It sounds like your vet is not "Experienced " with Lantus insulin I've seen a lot of vets give the wrong advice when it comes to dosing.
On this forum, some of the people have been dealing with Diabetic cats & Insulin for many years.( the people you're following) They really can give you much better advice on dosing than most vets!

I would tell you to just stick to one meter don't keep switching back & forth it gets too confusing! I've been using a Human meter from the beginning. A Relion Prime from Walmart. The strips are inexpensive $20 for 100.

When you say you opened a new "bottle" of insulin do you mean a new pen? Do you use a syringe to draw the insulin? I use a pen to the last drop of insulin One usually lasts me over 3 months.

You say you switched from DM ? What does DM refer to? I hope you're not feeding any dry food?

If you want to help Phoebe it would be good if you read the Yellow sticky notes so you understand how the insulin works.The more you know the easier it will be.

Best of Luck with Phoebe :) Cute photo of her!

images
 
I think you need to document in your comments what food and at what time she is getting it. It may help explain the numbers. Then it may help know when to mix in a bit of DM to the Mack & Jack and see what works to slow that drop a bit.

I think what affected the numbers was the deep dive triggering a big bounce more than the food. You started the switch and upped the dose roughly the same time, all good things but more than her body to incorporate at once.
 
JoyBee&Ravan said:
Makes me smile to read your question. I think we all wonder that in the beginning. I've been here about 15 months & just recently Ravan is getting "mostly" regulated! Wow!
He still ,unexpectedly, will go up high or too low once in a while, that's why I still test him frequently. If you check his 2018 SS you'll see what I mean. :)
Thanks, I will.

It sounds like your vet is not "Experienced " with Lantus insulin I've seen a lot of vets give the wrong advice when it comes to dosing.
On this forum, some of the people have been dealing with Diabetic cats & Insulin for many years.( the people you're following) They really can give you much better advice on dosing than most vets!
I'm sure you are right. We are meeting a new vet tomorrow, so fingers and paws crossed that she's the right one.

I would tell you to just stick to one meter don't keep switching back & forth it gets too confusing! I've been using a Human meter from the beginning. A Relion Prime from Walmart. The strips are inexpensive $20 for 100.
Thanks.

When you say you opened a new "bottle" of insulin do you mean a new pen? Do you use a syringe to draw the insulin? I use a pen to the last drop of insulin One usually lasts me over 3 months.
We have been using a small bottle I guess it's called a vial, and we use a syringe to draw the insulin out. Our vet told us we could use it for 3 months so we had a new one standing by to start on June 7th and we just opened it early in case the insulin had gone bad somehow and was causing the problems.

You say you switched from DM ? What does DM refer to? I hope you're not feeding any dry food?
Oh gosh, no dry food! DM is the RX food made by Purina for diabetic cats.

If you want to help Phoebe it would be good if you read the Yellow sticky notes so you understand how the insulin works.The more you know the easier it will be.
Thanks.

Best of Luck with Phoebe :) Cute photo of her! She is a cutie! Glad you like her photo. And I really appreciate your help.

images
Click to expand...
 
Ah, ok thanks for clarifying, if I understand correctly you fed zero% carb at +6? One of the things I thought about mentioning as well is that sometimes feeding after nadir can put the breaks on the insulin's duration, but in your case if it was zero% carb, I can't necessarily see that affecting the duration. Perhaps it depends on how much you fed. I spoke with a neighbour of mine a while back whose daughter is diabetic, and I recall her mentioning that even proteins can at some point be converted to glucose, especially when the the body thinks the BSL are too low. Not sure if that works the same in cats as humans, but food for thought anyway.

I'm wondering if it may be possible that she hit her nadir around +4 and was coming up a bit by +5. Nadirs aren't always exactly at +6, they can and do move around. The thing with bouncing is when the cat's body dumps sugar back into the bloodstream, it's impossible to know how much of those counter-regulatory hormones are released back. Even if you didn't intervene with higher carbs, or affect the duration that cycle, the numbers can indeed be that high because of her liver panicking.

J.J. and Phoebe Squeak said:
I see what you are saying, she went from AMPS 376 to 199 @ +2, so at that point I could have given her a snack to slow things down before she reached 81 at +5. Is that correct?
Click to expand...

Yes exactly, the snack maybe could have been a little higher LC, and then maybe even another snack again at +3 or +4 (with a test at +3). You may already have a fair idea, but I thought I'd mention as well that it sometimes takes a bit of time to figure out how your cat responds to insulin. Most cats usually onset around +2, so when you see such a drastic drop by +2, it usually means you are in for an active cycle, and that would possibly warrant a test earlier than +5 if you are able, or have some higher LC mini-meals available for her if you need to leave and can't monitor. Just a few things to watch out for in the future. Of course, when you get a good idea of how your cat responses to insulin (onset/nadir/duration) and how carb sensitive she is then you can adjust things to suit your cat.

Sorry, now I think I am just rambling, but feel free to continue to ask questions.
 
Christie & Maverick said:
Ah, ok thanks for clarifying, if I understand correctly you fed zero% carb at +6? One of the things I thought about mentioning as well is that sometimes feeding after nadir can put the breaks on the insulin's duration, but in your case if it was zero% carb, I can't necessarily see that affecting the duration. Perhaps it depends on how much you fed. I spoke with a neighbour of mine a while back whose daughter is diabetic, and I recall her mentioning that even proteins can at some point be converted to glucose, especially when the the body thinks the BSL are too low. Not sure if that works the same in cats as humans, but food for thought anyway.

I'm wondering if it may be possible that she hit her nadir around +4 and was coming up a bit by +5. Nadirs aren't always exactly at +6, they can and do move around. The thing with bouncing is when the cat's body dumps sugar back into the bloodstream, it's impossible to know how much of those counter-regulatory hormones are released back. Even if you didn't intervene with higher carbs, or affect the duration that cycle, the numbers can indeed be that high because of her liver panicking.



Yes exactly, the snack maybe could have been a little higher LC, and then maybe even another snack again at +3 or +4 (with a test at +3). You may already have a fair idea, but I thought I'd mention as well that it sometimes takes a bit of time to figure out how your cat responds to insulin. Most cats usually onset around +2, so when you see such a drastic drop by +2, it usually means you are in for an active cycle, and that would possibly warrant a test earlier than +5 if you are able, or have some higher LC mini-meals available for her if you need to leave and can't monitor. Just a few things to watch out for in the future. Of course, when you get a good idea of how your cat responses to insulin (onset/nadir/duration) and how carb sensitive she is then you can adjust things to suit your cat.

Sorry, now I think I am just rambling, but feel free to continue to ask questions.
Click to expand...
Thank you so much for all the info. I can't tell you how much Phoebe Squeak and I appreciate your help!
 
J.J. and Phoebe Squeak said:
Does it really take this long to get regulated? We've been at this since March.
Click to expand...
It's different for each cat. You can't really put a time on it.

We have been using a small bottle I guess it's called a vial, and we use a syringe to draw the insulin out. Our vet told us we could use it for 3 months so we had a new one standing by to start on June 7th and we just opened it early in case the insulin had gone bad somehow and was causing the problems.
Most vets give this short time for a vial because that is what the manufacturer recommends for people use. If you store your vial in the refrigerator, and take care of it, it can last a lot longer than 3 months. When Furball was first diagnosed, I bought a vial and used it til the last drop.

I suspect the PMPS last night was a bounce from the drop to 81 yesterday. Maybe the bouncing is continuing today.

On the zero carb food, some cats get lower numbers on zero carb food because they need a little bit of carbs to keep from dropping too low.
 
carfurby said:
It's different for each cat. You can't really put a time on it.

We have been using a small bottle I guess it's called a vial, and we use a syringe to draw the insulin out. Our vet told us we could use it for 3 months so we had a new one standing by to start on June 7th and we just opened it early in case the insulin had gone bad somehow and was causing the problems.
Most vets give this short time for a vial because that is what the manufacturer recommends for people use. If you store your vial in the refrigerator, and take care of it, it can last a lot longer than 3 months. When Furball was first diagnosed, I bought a vial and used it til the last drop.

I suspect the PMPS last night was a bounce from the drop to 81 yesterday. Maybe the bouncing is continuing today.

On the zero carb food, some cats get lower numbers on zero carb food because they need a little bit of carbs to keep from dropping too low.
Click to expand...
Thanks very much. I appreciate you taking the time to give me advice.
 
You must log in or register to reply here.
Back
Top