6/1 Poe

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Re: Poe AMPS +4 560

Why the 911?

Has Poe had DKA in the past?
Are you testing for ketones daily?
Do you have urine dip sticks to test for ketones?

High numbers are not as scary as low numbers. With high numbers you might want to test for ketones. With low numbers, you might need to support with more food and testing to steer the numbers and prevent a hypo.

One of our sayings here is 'Better too high for a day, than too low for a minute'.
 
Re: Poe AMPS +4 560

He will come down again. Come on Poe, let's ease on down, now.
 
Re: Poe AMPS +4 560

I spoke the the vet..she had me give him a .5 because we are both thinking that I might not be really "giving" the .1 completely. I will test again in 2 hours. He was seeming kinda lazy, but has perked up wanting to eat now.

I will take off the 911 on this post too. The next challenge is the ketone testing. I have the strips, have read about how to catch the urine...it's just a matter of timing and doing the test properly.

At PMPS test, if he's over 300 I have to dose again at .5. Vet said she will be coming over to the board this weekend to look at his SS.

I am about on the verge of tears...so I apologize if I seem impatient and panicked, truth be told I am. I keep telling myself we are still trying to get the right dose for him and that the number variances should be expected, and that too high for one day is better than too low for a minute...and of course I'm still trying to breathe.
 
Re: Poe AMPS +4 560

I am about on the verge of tears...so I apologize if I seem impatient and panicked, truth be told I am. I keep telling myself we are still trying to get the right dose for him and that the number variances should be expected, and that too high for one day is better than too low for a minute...and of course I'm still trying to breathe.

It is so very, very scary to have a cat with diabetes. You did not seem impatient and panicked to me. You were concerned and did not know if the high numbers were an immediate trip to the vet or not.

I did not know if Poe had DKA before. Has he had DKA? If he has, then it is very important to test for ketones. That is why I was asking you those questions.

I see that your vet increased the dose to 0.5U. You will want to get a +2 today to see which direction Poe seems to be headed. And then a +4-+6 to see how low he drops on that increase.

{{{{{hugs}}}}} for you.

Please, ask for help whenever you need it. You still are very new here and do not know what may be an emergency or not. We are here to support you in this journey.

We have all been where you are now. We understand. This journey with your beloved cat Poe is physically, emotionally and spiritually exhausting. Taking several deep breaths really can help to relieve the stress. I know, it's one of the hardest things to do, calm down when you are so worried about your cat.

Remember to take some time today to refresh and renew yourself. Be well.
 
Re: Poe AMPS +4 560

Thank you...no he's never had a DK or a hypo.

He was a bit sluggish when I was testing him...he did not flinch at all with the poke..usually he gets kinda frisky and will swat a bit...but this time he just sat there.

I got the strips because the vet found traces of ketones when I took him in and got the official diagnosis.

I will be getting the +2 from this dose (although I don't know how to record all this on my spreadsheet now), and every 2 hours after that up until PMPS. She told me that at PMPS, if he is above 300, to go ahead and do another .5 dose.

I am sooo scared sometimes...afraid to leave him alone...afraid to go to sleep at night...afraid I will shoot him with a dose of air instead of insulin..afraid that while half asleep I didn't put enough in or put in too much...

I need to get to the store for the freeze dried chicken treats and the 1/2 unit syringes.
 
Re: Poe AMPS +4 560

KarensPoe said:
Thank you...no he's never had a DK or a hypo.

He was a bit sluggish when I was testing him...he did not flinch at all with the poke..usually he gets kinda frisky and will swat a bit...but this time he just sat there. He may be getting use to being tested. Once you have the treats, you can shake the treat bag to teach him to come running for those 'test and treat' times.

I got the strips because the vet found traces of ketones when I took him in and got the official diagnosis. If he had traces before, you want to keep a close eye on the ketones. It's a safety check, to make sure the ketones don't get too high and cause a problem.

I will be getting the +2 from this dose (although I don't know how to record all this on my spreadsheet now), and every 2 hours after that up until PMPS. She told me that at PMPS, if he is above 300, to go ahead and do another .5 dose. If Poe is lower than 200, delay the shot, delay the food. We want to see a rising number before you feed and shoot. So post here and ask for advice.

I am sooo scared sometimes...afraid to leave him alone...afraid to go to sleep at night...afraid I will shoot him with a dose of air instead of insulin..afraid that while half asleep I didn't put enough in or put in too much...Oh sweetie, you are like all of us here. We were so scared at the beginning of this sugardance, all the same fears you have. As you learn, you will become more confident and know more what to expect. The first couple of weeks are the hardest. It does get easier.

I need to get to the store for the freeze dried chicken treats and the 1/2 unit syringes.
 
Re: Poe AMPS +4 560

I don't think I've visited Poe's condo before...Welcome to Lantus Land. We are all here to help you, from both the "technical" perspective, and the "moral support" perspective, so as scary as this diagnosis is, we are all very familiar with the feeling, and therefore we totally understand what you are going through. Lean on Lantus Land as much as you need, and ask as much as many questions as you need. You're not alone in this!
 
Re: Poe AMPS +4 560

At AMPS, you gave his regular 0.1 dose.
At what + hour did he get the second shot?
 
Re: Poe AMPS +4 560

Karen

I haven't had the chance to welcome you to LL either so welcome. You have joined a group that is family and everyone here will help with moral support, suggestions to help Poe, and anything else you need.

I know the numbers make you anxious; as Amy said, we've all been there.

We don't typically dose Lantus as your vet has done today. While every cat is different (ECID), it usually takes a cycle or more to see the effects of an increase and you might actually see numbers go up first due to New Dose Wonkiness. It happens to some cats, not others. I tell you only so you won't be upset if his BG rises. It's normal...it happens.

I'm not sure if dosing again at PMPS is the best approach here just due to the overlap you might see in the cycles. Others can also provide you with their thoughts and we can see where he is at PMPS.

The best thing for him is to get him on a good, consistent dose that you can shoot as close to every 12 hours as possible. There are times we can't do the latter, and that's ok. But it's a goal :-D
 
Re: Poe AMPS +4 560

Karen:

Please be attentive to monitoring if you give a 2nd shot. It's not something that is typically done with Lantus. Lantus is considered a "basal" insulin -- it's a base and should be dosed consistently twice a day. What your vet suggested is to use Lantus as a "bolus" insulin. This is a strategy that's routinely used with short acting insulin (e.g., Humulin R). With a long-acting insulin like Lantus, if you give a 2nd shot, you end up with 2 nadirs -- one from the first shot and one from the 2nd shot. This gets complicated at your PM shot time because you also have to contend with the overlap between the two shots at different times which means that you now have a lag times between the overlap of the two earlier shots and the PM shot. (It's enough to make your head spin!) In other words, there's a chance that numbers could drop low tonight.

The other issue is that Lantus dosing is not based on the pre-shot numbers. Rather, you make dose adjustments based on the nadir. What that means is that you don't slide the dose amount based on your pre-shot number. Because Lantus is a depot-type drug, when you change the dose, you need to give it time to "settle" in order to evaluate how well a particular dose is working. Again, this is a very different strategy than if you were using a shorter acting insulin. In addition, with the Tight Regulation Protocol, we typically increase the dose by 0.25u when nadirs are below 300. While this may seem like a small amount, you don't want to miss what could be a good dose. Rather, dose changes are done systematically so you don't raise the dose beyond what Poe needs.

I know this is a lot to absorb. We've all panicked when we see high numbers. As I said in your other thread, there can be a number of explanations for a spike in numbers. The one thing I think everyone here can attest to is that Lantus teaches you patience.
 
Re: Poe AMPS +4 560

His AMPS was 318 fed him and gave him the .1 dose
AMPS +2 446
AMPS +4 560
15 min after the 560, I spoke with vet who advised the .5 dose
2 hours after the dose, just now, tested at 292, and gave him some of the PureBites chicken freeze dried treats...have not fed him since breakfast.

I will test again in another 2 hours.

He's wanting to eat I think...although he's much perkier than he seemed earlier. I'm trying to gauge him..his moods...his behavior..at test times...this test he was back to himself, swatting at the lancet playfully again.

So, for a bit I can breathe a bit easier. Thank you all again for walking through this with me...
 
Re: Poe AMPS +4 560

He's probably acting hungry because he could feel his numbers dropping pretty fast. If it's only +6 or +7, you could feed him a little mini meal. We just advise not to feed from +10 until +12.

I'm glad he's feeling better.
 
Re: Poe AMPS +4 560

I gave him a mini meal...he is feeling better...I have supplies needed for a drop although I pray it doesn't happen.

What does ECID mean? (ok found it...every cat is different?) Is nadir a term or an acronym for something else? Nadir is the AM or PM PS +5 - +7, right?

I feel very blessed that I have you all here and a vet on the same page with me.

I would love to get to the point of finding that "perfect" dose for every 12 hours....for a bit, I thought we were almost there, but realize you can't really gauge anything before a 3 day cycle.
 
Re: Poe AMPS +4 560

The nadir is the lowest point in a cycle, and can change, so it's not always the same time every cycle.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

His AMPS +8 at 267

Next test is the PMPS and I will post result before I do anything else.

Thank you
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

When you post at your PMPS, also go back to the very first post and make sure the question mark radio button is clicked on. That way, people will know you are waiting for an answer.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

I just did his PMPS he is at 283

I am not sure how to dose him. Vet had said above 300 to do .5, but I think that's too much.

Will not feed or shoot until I hear from you

Thank You
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Karen...hang on a minute, ok?

I want to look at his SS and see where we are with the second shot.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Karen

He's past both nadirs and so I would expect he might continue up. On the other hand, this is unchartered territory with him. You might not see the effects of both shots until this cycle or next. And we often see flat yellow cycles leading to lower numbers. But ECID...sorry to use that term again.

Dyana mentioned to me that she wondered if it might be a good idea to skip tonight to avoid the overlaps and allow you to get back on schedule tomorrow morning.

Do you have a feeling one way or the other on what you'd like to do? If you felt you wanted to shoot, I'd give less insulin and monitor him very closely.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

I have skipped before...am comfortable with that..test him tonight before I got to bed which will be around 6 or so hours from now, start fresh in the morning. I am not sure if a .5 or a .25 would be a better dose in the morning though as I'm sure he will need it then
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

It's one of those things where the skipping has contributed to his numbers being wonky and normally I would not want you to skip. But with that overlap and flat yellow....he could go up or down. You could be up testing. If you skip, his numbers will likely go up.

If you decide to skip, I'd give him .25u tomorrow and let's try to get consistent on the dosing. Give him six cycles (unless he earns a reduction) and then let's reassess.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

ok, so I skip....test him throughout the night or at say 2 and 6? and then test him in the morning at usual time, and only do a .25 dose regardless of what he tests at?
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

There has been so many different doses given over the last week, 1 U, skip, 0.25U, 0.1U, that extra 0.5U your vet said to give today at +4. I think you will be seeing a lot of variability in the numbers for several days. The depot hasn't really had time to fill before the dose has been changed once again.

With, the addition of that extra dose today, I think you are better off skipping this evening and picking things back up at your normal shot time tomorrow morning.

I would like to see a 0.25 dose given tomorrow morning and held for a least 6 cycles. A couple more cycles may be a good idea to hold that 0.25U dose and let things settle down, especially after that extra dose this am. I was thinking about this last night, and I was going to suggest that 0.25U dose after seeing the results of the 6th cycle at the 0.1U. That 0.1U dose does not seem to be enough.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Yes a +2 and before bed is fine or if you want to get up and test at +6, that's fine. It would be really helpful to have a +10/+11 so we can see if he's dropping or not into AMPS.

If he's above 150, you should be able to shoot the .25u since you are draining the depot some tonight. But be vigilant....get a +1 and +2 because he had that extra insulin today.

If he's below 150, post and ask for help, ok?
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

I was thinking that the .1 might not be enough either, plus my inexperience at measuring and shooting does not help. I tried to get the 1/2 syringes at walmart again, but they said my vet did not allow refills without authorization and they would have to fax, etc, and I didn't have time to wait for them.

I'm comfortable and agree with you, Deb, about going to the .25 and staying there consistent...and I promise to work harder on my patience, as I'm learning that these variances happen.

The +6 will actually be the before bed, and I can set my alarm for a +10.

Then I will test at AMPS, and not do anything if he is below 150 until I hear from someone here. I have this all right, right?
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Karen,

Then I will test at AMPS, and not do anything if he is below 150 until I hear from someone here. I have this all right, right?
Yes you have this correct. No food, no insulin, post here.

Please let me know when your morning shot and test time is. I'm a bit lazier about getting onto the board in the AM on the weekends but tell me when you will be doing your AMPS ( in your local time would be good) and I will be sure to log on and look for your post.

On the + 10, I'd rather see you get a +11 instead. That way, we can see if the AMPS test, one hour later is a rising or falling number. This will help us to make a decision on your shot in the morning in case the number is < 150. OK?


ETA: What is your favorite color?
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Morning test/feed/shot is 5:30 am. I test at 5:30 (central time), then feed him and shoot him based on a normal cycle.

The +11 would be then at 4:30 am (central time)

Oh..hmm my favorite color? Purple
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Ok here are several pairs of patience pants for you to borrow in your favorite color, purple. Wear them well. ;-)

Ok, I'll be here for your AMPS time tomorrow.
 

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Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Karen....sometimes little things get lost in condos although I k ow Deb put it in her response. Just want to be sure you see this:

If you get 150 or below in the morning, don't feed. Post first. Then someone will help you.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

:lol: I'm sure I'll wear those very often in the next few days.

I feel like I've been on a roller coaster for the past 2 weeks...trying to understand and learn...changing doses...numbers too high...numbers too low.

Once I get a steady regular dose going, I'm sure I'll have a better understanding of this all works together. I'd be happy if we could keep him at a .25 for 3 days. I'll monitor and test as much as necessary. The only issue I run into is during the week where I'm gone about 7-8 hours

Thanks again..next post will be in about an hour for his PMPS +2
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Karen....sometimes little things get lost in condos although I k ow Deb put it in her response. Just want to be sure you see this:

If you get 150 or below in the morning, don't feed. Post first. Then someone will help you.

Yes...I've written it down.

Thanks again
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Well....we knew he could go way up. Do you want to give him some insulin?

If you do, you will have to shoot 12 hours from when you shoot tonight.

If you decide not to shoot, I'd probably not get another test until +10/+11.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

I'm concerned that if I start shooting this late, I will run into trouble during the week, the mornings specifically, because I have to be at work early.

I know he will go up...is there anyway to project if it will get dangerous? I am planning on doing the +11
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Hyperglycemia is only dangerous if extended. We want to get him going on a consistent dose to get the numbers down so he doesn't become insulin resistant. You are ok for tonight. I'd put the meter away and save some strips.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

OK I feel comfortable with that.

My goal is to get him consistent with hopes of remission...not resistance. On a personal note, is it normal to be on this emotional roller coaster too? I'm a mess...and I know that's not good for him either...

He's happy now...resting after dinner and then some treats (freeze dried chicken) after his test.

I'm wired for sound I think :roll:
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

On a personal note, is it normal to be on this emotional roller coaster too? I'm a mess...and I know that's not good for him either...
Absolutely! You are a devoted mamma bean and only want the best care for your beloved cat. There is so much to learn, new routines to develop, not knowing if you are doing the right thing.

We are here to provide emotional and spiritual support as well as dosing information and testing times.

I equate this sugardance to a crash course, college graduate master's degree level, in managing feline diabetes. You will get the hang of things. It takes time. You will soon know more details on treating feline diabetes than most vets.

Remember to take some time and do something special for you. Sometimes, we get so wrapped up in caring for our extra sweet kitties, that we forget to take care of ourselves. Go read a book, watch a favorite movie on your vcr, take a walk to a favorite place, have a piece of chocolate or a glass of wine to help you relax, look at the stars.

Just keep telling yourself you can do this. We are here to help, in any way we can. OK?
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

I'm glad you decided to skip and start over again at 0.25 tomorrow. Thats what I would have suggested you do. I was afraid you were going to follow the vet's instructions and have a whole jumble of overlapping shots going on. I think what you did is the smartest.

I get to sleep in a little bit before work tomorrow, but 6:00am EST is J.D.'s shot time, so I'll check on you at that time.

Try to get some good sleep while you can.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Although I know I'm not alone, especially when I come to this message board, I guess because it's just Poe and me, I feel kind of alone. This has made me realize how dependent he is on me even though he is a cat :lol:
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

He is, but you are doing great! Remember to take time for yourself too and try not to worry. When you have a question or start to panic.. Come here and someone will advise. And remember to spend quality time with Poe doing whatever he enjoys.. Stroking, playing , whatever..

Wendy
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

It is just J.D. and I, but we are not alone with this message board.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

PMPS +11 is 296

Im going to lay back down for an hour until his AMPS. Will check back then

Thanks
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Poe is certainly high enough this morning to shoot and feed. You are fine to go ahead and give him the insulin.

Remember, we were starting over at the 0.25U this morning.

Will try to have you keep giving that same dose for the next 6 cycles. Then reevaluate.

ETA: Remember, if you go back to your first post and edit the subject line with the list of BG numbers. So like this:

6/2 Poe +11 296 AMPS 335 +2 xxx +6 xxx

You do not have to say AMPS (or PMPS if it is evening) with each number listed. If you have a single AMPS, we know the additional + times are number of hours since that AMPS.

ETA2: corrected amount to shoot. Typo 0.2U should have been 0.25U.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

ok I like that idea. .2 it is. Will feed him now. What AMPS + test should I get today?
 
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