? 6/2 Maxi AMPS:261; +3.75: 46; +4.5: 46; +5: 53; +5.5: 56; +6: 65

bambinaki

bambinaki

Member Since 2010
Last thread: http://www.felinediabetes.com/FDMB/threads/6-1-maxi-amps-385.230359/#post-2578318

Hello-

I was about to increase Maxi's Lantus this morning to 10.25 since he'd been at 9.75 for 10 cycles. I did not increase it because his AMPS wasn't as high as it had been the last couple of days. So I gave him 9.75 again and also 0.75 of R since he was within his R range for that dose by 11 points.

3 hours and 45 minutes after getting R, Maxi's glucose was 46. Right after that, he ate 1.5 - 2 ounces of his usual Weruva low carb food. 35 minutes later, his glucose was still 46. Right after that, he ate a few pieces of 100% duck freeze dried. 30 minutes later, his glucose was 53. He got a few pieces of Purina DM dry. 30 minutes after that, his glucose was 56. He got a few more pieces of DM dry. 30 minutes after that, his glucose was 65. He got a couple pieces of DM. That's where we are right now. Maxi seems to feel fine. Seeing that 46 was scary, but these green numbers are rally good, right? (I need good news!) Now, how long should I hold at this 9.75 dose?

NB: When I give him R, I usually test him 2 hours after. The post-R test was late today because my other cat is now very sick, I was dealing with that, and time got away from me -- today of all days, when his number dropped so low.

PS: I don't know how much more of this I can take. Maxi just got over a terrible bout of pancreatitis, and now Lorenzo has a liver infection and pancreatitis. His pancreatitis test was off the scale - beyond the maximum high number. If you know Maxi, you know he has his loving brother, Rudi, but Lorenzo hasn't been mentioned yet. FYI, there are no more kitties living with Maxi - I have just these 3 boys: Maxi, Rudi, and Lorenzo (a.k.a. Lolo or Loli). Loli was/is my kitty; Rudi and Maxi were my mom's kitties. My mom got sick, I kept my apartment and Loli stayed there, I stayed with my mom, my mom passed away, I didn't want to disrupt Rudi and Maxi's life any more, so I got rid of my apartment and moved myself and Loli into my mom's house. I now have the mortgage and all other expenses that owning a house entails. I was handling it, but things have piled up - things with the house plus the boys' medical bills. Last summer, Rudi had pancreatitis. Last fall, Loli also had a liver infection but no pancreatitis. The clinic wanted to hospitalize Lolo yesterday, but I said I was out of money, so they gave me Amoxicillan, Denamarin, Cerenia, Tramadol, and fluids, and I brought Lolo home. Between Maxi, Lolo, the flooding problem now at my house, my 70 hour a week job (which has been neglected for the last 3 days and now I'm behind... great!), being in a dire financial situation, and helping the 90 year old lady across the street, I am about to lose it.
Why have all 3 of my boys gotten this sickness? They are indoor only, live in a very clean house, never get into anything they shouldn't consume, and are fed good quality canned food.

Thanks for reading.

Any advice/insights would be appreciated.

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@Wendy&Neko @Marje and Gracie
 

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First, a couple tsp of LC is a good thing right now. It might help him surf along. You'll have to keep testing for two hours after the last high carbs, to make sure he doesn't drop again when it wears off.

A couple comments on feeding. Next time you see an under 50, break out the high carb wet food, or add a drop of karo to a couple tsp of his regular LC. I did high carb food under 50, karo/corn syrup if under 40. You have to figure out what works for Maxi, but you need higher than regular LC if under 50. You don't want him lingering under 50. Your goal with higher carb is to bring him up around 30 points. Again, keep good notes on how much, what carb, and when you feed. I put that info in the Remarks. It'll come in handy next time you see low numbers.

I am glad you didn't increase. I wouldn't have anyway, cause today was the 6th cycle after the last green. That means possible bounce breaking with extra downward momentum. Plus, this dose got him into the 60's, that doesn't leave much room to increase. One other note, if you think you'll be too busy to do the extra monitoring that R requires, just skip R that cycle. A potential bounce breaking cycle is another good one to skip R. If in doubt, ask, or just skip R.

Are any of the three boys related? I've had three cats (unrelated) in a row now get small cell lymphoma. Why? Who knows.
 
Thank you, Wendy.

Wendy&Neko said:
Next time you see an under 50, break out the high carb wet food
Click to expand...

The first (or second) time he got a green number, I got scared and gave him high carb and was advised to take it easy on the food, so I had that in mind today -- didn't realize it was different for under 50. I have now written it in big letters on my guide notes.

Wendy&Neko said:
I am glad you didn't increase. I wouldn't have anyway, cause today was the 6th cycle after the last green.
Click to expand...

I (mis) understood that I should increase after a total of 10 cycles at the dose that produced a green, not 10 cycles after the green.
So, I will not think about increasing until 10 more cycles after this one.

Wendy&Neko said:
if you think you'll be too busy to do the extra monitoring that R requires, just skip R that cycle.
Click to expand...

I sincerely thought I would test at +2 as usual, but Lolo's situation made time get away from me. I will try not to let that ever happen again.

Just wanting you to know that there was some thought behind my actions, even if it was incorrect thought.

Wendy&Neko said:
A potential bounce breaking cycle is another good one to skip R.
Click to expand...

I will have to figure out how to know a potential bounce breaking cycle when I see one.

I'm thinking I should not give R unless he reaches well into the 1.5 unit (300-349) or higher range,at least for the time being. Do you think that's a good idea?

There is a lot of evidence that suggests that Maxi and Rudi are brothers. Lolo is not related.

Thanks again!
 
Good plan to ease off the R a bit. He seems to be dropping more than 100 points from it and I am debating whether the R scale should be lowered a bit.
 
I wanted to get that out there quickly so you can give him some R. This is another reason to throw away the dry food. Those carbs tend to stay longer in the system. High carb wet wears off after a couple hours. But the main reason for the bounce is the under 50 and length of time in green. It's not surprising given he's not familiar with these numbers yet.

I also have another technique you can try tonight. We call it "shooting through the bounce". What it entails is shooting his old higher dose (9.75 units) one more time tonight, then going to his new reduced dose tomorrow morning. This can help take the edge off the bounce too.
 
@Wendy&Neko Please pardon my language but ****! It wasn't +7. It was 7:30pm, which is +10. (I had it right on the spreadsheet.) I'm sorry!
 
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So, @Wendy&Neko I guess I should wait until PMPS, right? Please let me know what to do about R at PMPS. And I should stay at 9.75 Lantus tonight, right?

And also please let me know what the next doses should be tomorrow and onward.
Starting tomorrow morning reduce by 0.25 to a dose of 9.0 and hold that dose for 6 cycles?

Many thanks.
 
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I think you can give R now if you want. It's just you won't be giving any other R until PM +6 if you want to. Yes 9.75 units tonight, down to 9.25 units tomorrow morning. He's earned a dose reduction by going below 50.
 
Wendy&Neko said:
I think you can give R now if you want.
Click to expand...

Well, a workman came to look at the flooding problem and now it's PMPS time.

Wendy&Neko said:
down to 9.25 units tomorrow morning
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OK, so I stupidly said above to "reduce by 0.25 to a dose of 9.0." If I reduce by 0.25, the new dose would be 9.5, not 9.0, of course.

So, Wendy, you're saying to decrease by 0.5 (from 9.75 to 9.25) and not 0.25 (from 9.75 to 9.5)? I read in the TR Guidelines about reducing by 0.25. I just want to make sure...

Thank you, and I apologize for all my mistakes. I've heard that stress increases mistakes, and now I'm living it. I've just read what I've written in this particular reply over and over, and I can't see any mistakes. I hope...
 
Reduce by 0.5 units. Over a total of 5 units dose, we make changes by 0.5 units for now. Think of it as the reduction being a percent of the total dose. Over 10 units it changes again. Later, you may find he's sensitive to smaller changes but stick 0.5 units reductions now.
 
Wendy&Neko said:
Reduce by 0.5 units. Over a total of 5 units dose, we make changes by 0.5 units for now. Think of it as the reduction being a percent of the total dose. Over 10 units it changes again. Later, you may find he's sensitive to smaller changes but stick 0.5 units reductions now.
Click to expand...


OK, I will start with 9.25 tomorrow morning.

Thank you very much.
 
Maxi's PMPS was 479, way into the 1.75 u r range, but I was afraid and gave only 1.5 u R.
@Wendy&Neko , have you decided on whether to change the R scale?
 
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