6/22 Boo AMPS 201, +5 374, +10 370, PMPS 334

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Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262

Thank you, Libby. I was really wanting to skip the +4 because she is hiding from me (she thinks) and resting comfortably. I will wait until +5.

BJ, that is fascinating. Thank you so much for taking time to type it out. I really do appreciate it. I will print and save for reference. Oh, and I do have the WalMart Relion. Good thing I bought the larger box of strips and lancets! I would not have been pretty beating the streets last night in the state I was in. :shock:

xoxoxo
Carla
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262

Hi Carla!!

A big LL HUG to you!! My better half, Mike, posted on your condo last night. He was so concerned for your Boo. She is a beautiful girl.

You did have a very scary night but the good thing is now you know how to handle low numbers!! Looks like Boo might be going up either from the accumulation of carbs from the dry food or she could possibly be "bouncing". Unfortunately, we don't know which is driving the car today!!

I'm sure someone has explained that when the liver senses low numbers that is not used to the body having, it releases counterregulatory hormones and glycogen to offset those low numbers. That, in turn, causes the BGs to rise. There are several "bouncy" kitties in LL.

BJM gave you great advice in taking care of you today and especially breathing. I know it is difficult when you are in stressful situation (like not knowing what to shoot) and you get different answers from our members.

We're a learning forum....we try to give you the tools and education so you can get comfy with the protocol and make decisions you and Boo can live with; you can always get input from others in LL and we do highly encourage your questions. Usually, beans are able to have some time to learn this before their baby gives them a low number but Boo had other plans for you.

Safety of the kitty is a number one priority here. What makes it a wonderful place is people make suggestions and you, as the bean, holder of the syringe, and the one who knows your kitty, makes the decision. While it may seem like you are getting "advice", I like to think of it as suggestions or ideas for you to consider. No one will ever be upset if you don't do what they suggest (unless of course you are putting your kitty in danger which you wouldn't do)....that's not how it works here. Like today, you considered the different suggestions of giving 2u or skipping and considering your own situation, decided to stay home and give 1u. Great job!! Everyone supports you and your decision...you are already learning the process!

There is a core group of extremely experienced people who you will come to know; I think most of us leave the dosing suggestions to them because they are able to see things on spreadsheets that we cannot. But there are also lots of other experienced folks to give you ideas, answer your questions, help you with low numbers and preshots, and give you moral and emotional support. Please take advantage of that as well as reading the stickys.

There have been times when Mike and I just wanted someone to tell us what to do because, considering the options, we weren't sure. We've come to realize it is not their responsibility to tell us...only to educate us on what the acceptable, safe possibilities are and then we need to make the decision. We've learned so much. And you will, too. Soon you will be helping other newbies through low numbers, etc.

You did a great job last night and we hope you stick with us. This group handles more FD kitties in probably six months than most vets handle their entire careers. The number of cats they have gotten off the juice is remarkable. And there is usually someone here 24/7....the west coasters are up late, the east coasters are up early and we usually have some overlap. But that is where the stickys come in just in case we don't.

So welcome!!!! Hope you get some rest today....you and Boo earned it.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262

Marje, thank you for taking time to post that. Truly. Please thank your husband for chiming in last night in my hour (12 hours) of need. All of you made me feel way less alone in dealing with this.

It's almost time for my +5. Boo has been hiding from me for 2 hours.... gotta go see if I can coax her out of her super secret hiding place (behind the entertainment center). :lol:

Thanks again.
Carla
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262

When you have a moment to pop out to a pharmacy, pick up some Neosporin ointment (not cream) with pain relief - it'll help the blood bead up and reduce discomfort from pricking.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262

Carla: You're welcome. And in the future, I'll keep my posts shorter. :lol: :lol: :lol: :lol:

Have a great day!
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

+5 374.... don't like that number, but much prefer it to 34.
nailbite_smile

I am glad I'm seeing this though because I never would have understood the bounce without the numbers. I would have just come home after work and noticed that her numbers were high... I'm sure I would have just assumed they climbed steadily from her AMPS #.

I'm glad I have been able to see her eat and drink today and use the litter box. I am much more at ease giving her a shot tonight since she didn't tank today. Trying also to remember that much of today (and tomorrow) will be wonky.

Onward!

P.S. Having a friend bring over some Neosporin ointment. I've stuck Boo so many times now that I'm not getting a clear little punch hole... It sort of drifts over to the
series of punch holes to each side and makes the blood run rather than bubble. I really hope to give her a break from the sticking soon.

xo
Carla
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

you're doing great, carla! talk about baptism by fire!
i read you're near memphis. i'm close to nashville. there are several of us from the volunteer state!

today's numbers are simply a reaction to last night's low numbers. it's clear boo is bouncing. i'd take a break and not test her til +10 or +11. that way you'll know where her number is coming from when you get her preshot test tonight.
take a nap if you can. i bet you're tired!
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

A wipe down with a cold washcloth may remove any stray blood and feel good, too, like mom cat cleaning and grooming her.

A bit of play activity or a petting and massage session with Boo might be good - help her deal with her stress. :smile:
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Aw, Jill.. I shouldda guessed you were a Tennessee girl! :-D I am in Memphis proper. Funny little town, but it's home.

BJ, I will absolutely wipe her down when she comes out of hiding. Great idea. And I'm sure a cool rag would be a comforting change from the warm sock I've been using right before I test her. I welcome the chance to stop sticking her for a while. She's been so good about it... I have to tell you, I'm completely surprised. I thought she would fight me like crazy. She definitely feels it... she jumps and sometimes yelps a little, but I have a feeling that will get better on days when I haven't checked her every half hour! I think the key was a change in MY nature, not hers. I got to a point last night where it was kind of all or nothing... I didn't have the option NOT to check her, so it had to be done. We both seemed to accept it. Though I have never literally sweat like that in my life. And I'm a singer/actress... i peform all the time and deal with adrenaline, etc. I have NEVER sweat bullets like that.

If I had not had you guys and the sweet peeps on the HEALTH Forum, I don't know what I would have done. I can't even imagine how terrifying it would have been to have to try to figure out what to do with those numbers by myself. I hope someday I can help someone else out in the same way.

Nap time!
Carla
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

I hope someday I can help someone else out in the same way.
Click to expand...

Don't worry about that...you will someday!!! :lol: :lol: It happens all too often.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Being a rather OCD (obsessive-compulsive) type, I graphed it so you could get a visual idea of what today looks like.
 

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Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Good afternoon! So glad that you survived your first low number event!! You did such a great job last night, and I'm happy to see you've decided to join us over here in Lantus Land!

You've not only had to try to learn information quickly, but put it into practice much sooner than most!! Please know that you won't have all this committed to memory overnight! I'd suggest printing out all of the stickies and putting them into a small binder or presentation folder and keeping it with your hypo kit. On the cover or first page, I would put the phone number of your vet and the nearest 24 hr. emergency clinic, and if you aren't familliar with the emergency clinic's directions, also include their address and directions. I found having those resources at my fingertips was very helpful... I could sit and read/re-read a particular point I was unsure about, and when I was panicked or unsure (and there were PLENTY of those moments!!), I had something on paper that I could calmly read and process. It was especially helpful when I needed to make a decision and folks weren't around to make suggestions... I wasn't trying to remember "now, which sticky did I see that in???" but rather could just flip through pages until I found what I needed.

So, welcome again! :-D :-D :-D
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

BJM said:
Being a rather OCD (obsessive-compulsive) type, I graphed it so you could get a visual idea of what today looks like.
Click to expand...

BJ, that helps so much... thank you!!!! I will have to get on the graphs/charts when I'm at my office tomorrow.

General Questions:
After I take the next test for Boo around 6:30 (+10), is there someone I can ask about PM dosing? I'm sure my vet will weigh in, but I wondered if i needed to start a new thread here for dosage help?

Also, I kind of got schooled on what to do with numbers that are way too low last night.... what do you do when a number is way too high? Give another shot even if it hasn't been 12 hours?

Just trying to cover all the bases should an emergency arise.

Thanks!!!!!!!!!!!
Carla
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Christie!!! So THAT'S who gave me that advice!!! :lol: :lol: :lol: I printed out the protocol, what to do in the case of hypo, all that stuff and put it in a binder at your suggestion!! Great advice!!
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Patty & Champ said:
Christie!!! So THAT'S who gave me that advice!!! :lol: :lol: :lol: I printed out the protocol, what to do in the case of hypo, all that stuff and put it in a binder at your suggestion!! Great advice!!
Click to expand...

Thank you, Christie. I just saw your post. I will for sure print those out tomorrow from my office!
xoxo
Carla
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

cmcd65 said:
General Questions:
After I take the next test for Boo around 6:30 (+10), is there someone I can ask about PM dosing? I'm sure my vet will weigh in, but I wondered if i needed to start a new thread here for dosage help?

Also, I kind of got schooled on what to do with numbers that are way too low last night.... what do you do when a number is way too high? Give another shot even if it hasn't been 12 hours?

Just trying to cover all the bases should an emergency arise.

Thanks!!!!!!!!!!!
Carla
Click to expand...

Hi Carla,

No you won't need to start a new thread. Most of us just edit the Title line for Date, Name, and PMPS.

Definitely post that +10 number and I suspect your dose will remain at 1u for a few days until the 'bounce' clears. That is the dreaded 72 hours post hypo time that requires a good strong dose of patience.

There is nothing we do with high numbers unless they are charted on the spreadsheet and we see some consistency. A few hours of high numbers generally won't provoke a dose change. Lantus works best with consistency of dose and consistency of dose times.

So I would encourage you to get your spreadsheet set-up as soon as possible!

You did really good yesterday. You can be proud of yourself and Boo.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Blue said:
Hi Carla,

No you won't need to start a new thread. Most of us just edit the Title line for Date, Name, and PMPS.

Definitely post that +10 number and I suspect your dose will remain at 1u for a few days until the 'bounce' clears. That is the dreaded 72 hours post hypo time that requires a good strong dose of patience.

There is nothing we do with high numbers unless they are charted on the spreadsheet and we see some consistency. A few hours of high numbers generally won't provoke a dose change. Lantus works best with consistency of dose and consistency of dose times.

So I would encourage you to get your spreadsheet set-up as soon as possible!

You did really good yesterday. You can be proud of yourself and Boo.
Click to expand...

Blue, thanks so much. Exactly what I needed to hear. And I promise I will get on that worksheet tomorrow. A dear friend of mine (a person, not a cat) died several years back after slipping into a diabetic coma. I just didn't know if cats did that too if their numbers spiked too high. Still reading. :smile:

Thanks again.
Carla (and Boo)
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

I just got home and thought I would check on you. It's nice that Boo is giving you a bit of a testing break this afternoon. Definitely post your +10 when you get it. Someone will be here.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

A small caveat on bouncing: if your cat has ever had ketones, you need to have either the urine testing strips (ex ketodiastix), or the meter that can do both blood and ketone testing (uses different strips for each) and test for ketones when the glucose is over approximately 400-500.

A trace level of ketones showing up suggest a vet visit may be in order.
A high level of ketones is "go to the vet, go now" situation - its really not something you manage at home when those are high.

Cats do vary in their reactivity to a sustained high glucose level; you just have to wait out the bouncing swings for the next 3 days of stable dosing and monitor what and when you can.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

BJM said:
and test for ketones when the glucose is over approximately 400-500.
Click to expand...

good points about ketones, and I will add that some cats can develop ketones even when they are much lower (even 100s). It doesn't happen often, but it can happen. It's a good idea to test for ketones frequently no matter the number range.
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

Libby's right -- particularly in a cat that's prone to ketones, they can develop in the absence of high numbers, especially if there's an infection brewing. I tend to think testing for ketones even if your cat is generally in a good number range is an ounce of prevention. Both Lucy (Libby's cat) and Gabby have survived diabetic ketoacidosis (DKA). It's not something I would wish on anyone.

I'm glad to see your day was far less eventful than your evening. You've been doing a great job -- even if it was, as Jill said, a baptism by fire. It really does get easier. Promise!
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

To test for ketones you can do this at home with keto-stix from the pharmacy. You don't need a prescription for them, but you may need some litter box stealth to catch the urine on the strip.

Some folks decrease the amount of litter in the box to barely enough to scratch around in.

Another option that a vet gave me was to simply empty the litter box and place beads in the box. That way if I missed the stream...I'd have a puddle to check as the beads don't absorb the urine. Again, it doesn't need to be full, but enough to scratch around in.

Thank goodness I've always been able to catch Atlas at the box!
 
Re: 6/22 Boo AMPS201,+1 202 +2 176 +3 262 +5 374 +10 370

Ok..... First things first. :razz: +10 370... which, ONCE AGAIN, suprised me! So glad it didn't go higher.

Boo has not been eating a lot this afternoon... been sleeping mostly.

My vet suggests 2 units tonight at 8:30

Opinions??

Carla (and Boo)
 
Re: 6/22 Boo AMPS 201, +1 202, +2 176, +3 262, +5 374

it's up to you what dose to give, but 1 or 2 units sounds good to me. Do get some ketone strips to test his urine if you are reducing his dose, and if you see anything other than Negative on a ketone test strip post or call the vet for advice.

I would look at it almost like starting over. Now that you know how to test at home, you can take control of your dosing decisions. Get a preshot test before every shot, and get other tests whenever you can. Use those numbers to guide your dosing decisions. We can help, if you want.

Getting a variety of tests will give you a better picture of what is going on over a period of time, rather than just a snapshot at the vet's office. Knowledge is power!
 
Re: 6/22 Boo AMPS 201, +5 374, +10 370

Funny how things happen. I accidentally picked up Ketone strips when I bought my BG strips. So I have them. I'll just have to catch her in the box.

Carla
 
PMPS 334.... She's been right around that number for close to 7 hours, give or take.

Doc suggested 2 units. I gave her a little shy of that.

Fingers Crossed.

Thanks!!
Carla
 
cool... you have the ketone strips!
when i see alex on her way to the litterbox i grab a long-handled soup ladle and slide it in behind her to collect urine. works like a charm!
good luck with the new dose!
 
Re: 6/22 Boo PMPS 334, +5 328

Jill, what a great idea with the ladel. Boo has long hair so I was wondering how on earth I was going to get up under there! :o

Her numbers have been high during her bounce after her hypo night and she's been going #1 on Piddle Pads instead of the box... always a sure sign that her BG is high. I'm hoping she evens out soon.

If my vet tells me to raise her morning dose an entire unit, should I suggest increasing by 1/2 units instead? I don't want to increase too quickly (again), but I don't want to leave her numbers high for too long either.

Suggestions?

THANKS!!!!!
Carla
 
carla, i'll be honest with you. i think you should stick with 2u twice per day (unless boo drops below 50 signaling the need for a reduction) and collect as much data as you have time for. lantus is a depot insulin... meaning the action of the insulin is cumulative. one dose can effect up to the next 3 days worth of numbers. too many vets don't get that. they think they should use lantus like the insulins they're more familiar with such as Humulin R, Humulin N, and PZI. this is not the case!

obviously, all decisions are yours to make. all i can do is make suggestions based on understanding how to use the long-acting insulins such as lantus and levemir.
 
Thank you, Jill. I will be able to do a AMPS reading this morning, one aournd +4, and then not again till +8 when I get home from work. I know her numbers were at least alternately high over night because she used 2 piddle pads while I was asleep. I will get a test in this morning before her shot and post it.

Thank you so much for help. I'm SURE my doc will say to increase to 3 today and I'm just really scared to do that.

Thanks again.
Carla
 
Hi Carla
When you get the chance can you please start a new condo for today so we can keep up with each day's developments? Thanks so very much.I know you are busy between Boo and work.

One thing I always relay to newbies who are worried about having the dosing discussion with their vet is that the vet works for you and Boo is your kitty....younger are her number one advocate. Some vets say "me or the internet". But I think it is very important to take the protocol, give them time to read it, take your SS and discuss. Many of us have vets who then leave the day to day management to us. I wish you luck with that but regardless what your vet says you still hold the syringe.
 
Jill, I very well may have done it incorrectly, but I *think* I did start a new condo today.... Please tell me if you don't see it below on the thread.

Thanks!
Carla
 
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