6/16: Sammy - AMPS 274; +5 283; +9 248; PMPS 255; +2 223; Vomiting

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Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

@Jill & Alex (GA), @Wendy&Neko, and @julie & punkin (ga) I do trust you all more than you think and thank you for all your suggestions last night.

Even with the reduced dosing last night Sammy pretty much held his own in the 200 range for most of the night, but I think that had a lot to do with the fluids. I wasn't until AMPS this morning that he wasn't able to hang in there. So far today he did come down a bit by +3, but by +5 he is already higher than he was this morning.

I did go ahead and increase to .5 unit this morning, mostly because when I did the .25 unit last night I didn't think it was going to be enough, but I really wanted to drain the depot a bit and I wanted to see how he would do on that small of a dose.

Now he is having one of those bad appetite days. I gave him a famotidine, but he vomited a few minutes afterwards.

At this rate I am expecting him to be over 300 by PMPS tonight, and that just isn't good. And as much as I would I would like to increase more slowly to make sure that we don't over step the optimal dose, I am thinking that it might be best to go back to the 1.10 unite (1.28mm) dose we were doing yesterday morning.

I know all of you will recommend going back up again, so I don't really even need to ask, but I am going to anyway. I would also like to know if you also think that the surf last night was mostly due in part to the fluids or if think there is something more to the numbers last night. Usually when he has fluids his numbers come down, but they don't usually stay down for more than 6 hours or so.
 
I think it was a smart move to go back to the 1.1u and see if it can get him in green. I'd hold it there for 6 cycles before adjusting it, unless he earns a reduction.

Because Lantus is a depot insulin, we know a higher dose can continue to "give" for as many as 6 cycles after a reduction. So yesterday morning's 1.1u dose would've still been "helping" with last night's pm cycle after you shot the 0.25u, and it would likely still be having some influence with today's cycle.
 
As Julie said, the depot can carry on through for a few cycles, so I think that was at play last night. Paws crossed you've avoided the pink mountain with the quick return to a higher dose. One thing to be aware of for the the next couple of cycles, since there has been some jumping around in dose, you could get some wonky numbers. Don't try to over analyze the odd numbers if you get them. It could be some NDW at play too.

Sending vines for Sammy, I hope his tummy settles down.
 
Thanks @julie & punkin (ga) and @Wendy&Neko, Sammy was down at +9 so I am going to wait to see what PMPS is. Yes, I hear you on the depot, and since my main concern is that he was getting to much insulin, I might hold the .5 unit dose again tonight if he is around 250 or lower. I would like to drain that depot just a little bit more before I jump back up.

If he is higher and closer to 300 then I will probably increase at the very least to .75 unit. I know the goal is to get him back into the normal numbers as quickly as possible, but again, I am very nervous that he was increased too quickly and was getting too much insulin.

Also, he is still having tummy issues, we are currently enjoying the back yard and of course he is eating grass and then puking. I hope the grass will help settle his stomach and allow him to eat tonight. I also hope that all the vomiting doesn't cause his numbers to go up, because I know that can happen also. And, I will try not to analyze the numbers too much.
 
Sammy wasn't eating at PMPS, so I decided to stick with the .5 unit dose. He ate a bit about 20 minutes after the shot, but then vomited. He just ate a bit more so I will be monitoring him closely to make sure he holds it down.
 
Sammy is having a lot of trouble keeping food down tonight. I am not sure if he ate something earlier that just didn't agree with him.

When he ate a bit an hour ago (+1.5) he ended up vomiting a little after +2. At +2.25, I gave him some different food, Fancy Feast Liver and Chicken and he ate the small amount that I gave him. I also gave him ¼ tablet of Famotidine. Hopefully he will keep this down.
 
I'm sorry to hear Sammy is vomiting. Sometimes kitties who have been used to lower numbers appear to become nauseous when their BG numbers run higher than what they're used to. If you haven't, please start testing Sammy's urine for ketones as soon as possible. The recipe for ketones is an inadequate supply of insulin + inappetence + certain other systemic stresses. Please post immediately if Sammy starts throwing ketones, ok?

I hope he feels better soon...
 
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