6/17 Muffin PMPS 198 +2 158 +4 43 advice please

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Julie + Muffin

Member Since 2013
Hi
Muffin had a decent AMPS for her but based on her 14 cycles and nadir I increased .25. Please take a look at her SS and see what you think. Thanks!
 
Muffin's SS indicates you shot the same .75 dose this morning, is that correct? Looks like Muffin started a bounce from the drop on 6/15 AMPS (318) to +3 (190) and had a good nadir of 134 that day for SLGS. Bounces can take 6 cycles to clear...sometimes less, sometimes more :rolleyes: It may be an "active" cycle today so I would get a test in around +2. It's ok to increase during a bounce but doing so when it's breaking could be tricky. If you didn't increase this morning I would see what Muffin does today before doing so. If you did increase to 1u, I think you're fine because you test enough. Hopefully you have High Carb food in the cabinet just in case. Below is the explanation of Bouncing which is found in the The Basics New To the Group Sticky . Keep asking questions. There is a lot to learn and we've all been where you are. You're doing great!

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Muffin's SS indicates you shot the same .75 dose this morning, is that correct? Looks like Muffin started a bounce from the drop on 6/15 AMPS (318) to +3 (190) and had a good nadir of 134 that day for SLGS. Bounces can take 6 cycles to clear...sometimes less, sometimes more :rolleyes: It may be an "active" cycle today so I would get a test in around +2. It's ok to increase during a bounce but doing so when it's breaking could be tricky. If you didn't increase this morning I would see what Muffin does today before doing so. If you did increase to 1u, I think you're fine because you test enough. Hopefully you have High Carb food in the cabinet just in case. Below is the explanation of Bouncing which is found in the The Basics New To the Group Sticky . Keep asking questions. There is a lot to learn and we've all been where you are. You're doing great!

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Sorry...I didn't change her SS to show we shot 1 unit this morning. We will get a +2 for sure and keep a close eye on her today in case she goes too low. Plenty of high carb food on hand because we have one kitty that likes to go low sometimes! She is not diabetic nor really hypo but borderline so she is on high carb all the time. She is on the spreadsheet under a different tab Violet. I was here once before in 2013 with my personal kitty Purrcee, With the constant help of all of the experts here I was able to get him in remission rather quickly. However, I lost Purrcee to throat cancer a little later. Bouncing is still confusing to me so your explanation is very helpful. Thanks so much for your input.
 
How nice of you to take Muffin in. Bouncing is always confusing but part of the course. With Lantus I'm a big fan of getting +2's most of the time. This way if needed a small LC snack to prevent bigger drops may help. It also is a good indicator of how active the cycle is going to be. I'm not on the board every day anymore so I missed your intro etc. Good luck with the increase!
 
Are you using a human meter? Following SLGS or TR? When you can please add those two things to your signature :)

I believe Muffin is clearing a bounce today and may have giving some extra momentum. We usually feed HC below 50. I would give a little LC to encourage surfing and also since it's starting the second 1/2 of the cycle where Muffin might rise on her/his own. Would test again in an hour to make sure Muffin continues to surf.
 
Are you using a human meter? Following SLGS or TR? When you can please add those two things to your signature :)

I believe Muffin is clearing a bounce today and may have giving some extra momentum. We usually feed HC below 50. I would give a little LC to encourage surfing and also since it's starting the second 1/2 of the cycle where Muffin might rise on her/his own. Would test again in an hour to make sure Muffin continues to surf.

Yes using a human meter ReliOn Confirm. Following TR. I will add to signature. We will feed a little LC and hopes she surfs. Thanks!!
 
For reference, here is yesterday's post: http://www.felinediabetes.com/FDMB/threads/6-16-muffin-amps-331-dose-increase-please-advise.179318/ We link to the previous post so people can easily follow the history.

It's not uncommon for kitties to sometimes react strongly to an increase. And when you see a flat yellow cycle before hand, like last night, that can be a heads up to a cycle with action. Paws crossed the LC gets her surfing. According to TR, you would now hold this dose for at least 10 cycles, unless she goes below 50.
 
Well wasn't really expecting her to go so low. We have HC food on hand. Should we start with 1 tsp at a time?
 
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A couple of taps of high carb, preferably the gravy. Then test again in 30 minutes. If not above 50, repeat HC, wait and test. I cannot stay up with you, but the directions are in the Stcky Note on Handling Low Numbers.

Muffin has earned a 0.25 unit reduction back to 0.75 units tomorrow morning.
 
I just had a look at your SS and see that Muffin is surfing in the 40s. Have you given her some HC? How much? Does she seem to feel okay?

BTW, I'm just an hour or so west of you!

 
I see from your SS that Muffin has come up to 85 at +5.5. This is good. Now you need two tests without food that aren't dropping to be really safe.

Regarding your SS, you can put more than one reading in a cell. To do that, type both readings, like this: In the +4 box, type "43" then space, then "46@+4.5". Then, with the cell highlighted, go up to the taskbar and choose the icon that looks like a sideways u-turn arrow. This is the wrap text feature. You will get several more icons - choose the same symbol again and your numbers will fit in the cell. You can look at one of my spreadsheets to see how it should look. You will have to manually color the cell. To do that, highlight the cell and click on the icon that looks like a paint can.

Now that the crisis has passed, can you please remove the 911 from your subject line? Thanks.
 
I see from your SS that Muffin has come up to 85 at +5.5. This is good. Now you need two tests without food that aren't dropping to be really safe.

Regarding your SS, you can put more than one reading in a cell. To do that, type both readings, like this: In the +4 box, type "43" then space, then "46@+4.5". Then, with the cell highlighted, go up to the taskbar and choose the icon that looks like a sideways u-turn arrow. This is the wrap text feature. You will get several more icons - choose the same symbol again and your numbers will fit in the cell. You can look at one of my spreadsheets to see how it should look. You will have to manually color the cell. To do that, highlight the cell and click on the icon that looks like a paint can.

Now that the crisis has passed, can you please remove the 911 from your subject line? Thanks.

Taken from with-in the thread about hypos:
SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness


TREATMENT

During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.

LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry food. the high carbs will help to increase his/her bgs quickly, but remember the effects of dry food usually takes longer to clear kitty's system once the crisis has passed. Feeding a high carb canned food is preferable to feeding a high carb dry food because the effects will clear kitty's system faster. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizing is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer.
I can stay if you need more help. Please post and let us know how it's going.
I can stay if you need more help. Please post and let us know how it's going.

Hi Tricia. thanks so much for staying. Dawn is at the sanctuary and she is doing the testing so that's why we haven't responded. I think we are on the right track as Muffin is coming up. Going to be a long night.
 
A couple of taps of high carb, preferably the gravy. Then test again in 30 minutes. If not above 50, repeat HC, wait and test. I cannot stay up with you, but the directions are in the Stcky Note on Handling Low Numbers.

Muffin has earned a 0.25 unit reduction back to 0.75 units tomorrow morning.

Thanks Wendy. We will definitely reduce.
 
Hi Julie,
I'm by no means an expert and I use alphatrak to test.

If it was me and the spreadsheet gave a lime green, I know a lime green means pay attention, so I would syringe ff gravy lovers gravy 3 mls in the mouth. (If I saw no signs of hypo) Wait and watch kitty and more gravy if looking wonky and test in 20 min. *depending on cat's behavior* if cat shows signs of a hypo, medical treatment may be needed**

Others my have different advise for you.

I don't know what number is low on a human meter, so I'm looking at color on your sheet.

Information is only offered as a what I would do, as there are not a lot of people on the board right now. I'll copy info from hypo sticky.

You have eyes on, it the cat fits the hypo scenario, possibly syrup in the gums and retest. * or medical attention*

Food will raise the bg at a slower pace because it must digest, and it may keep the Bg number higher for a bit longer than gravy or syrup.

Best wishes to you and your kitty.

.- you have eyes on, you know what scenario best fits what you see for the treatment section pulled from the thread.
Thanks Apple. Appreciate your input!
 
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