? 6/22 Post DKA, Ketone Mod Millie PMPS 131 AMPS 445:Dosing Feedback Increase??

[Sylvia & Millie]

Morning! Millie looks much better this morning, still no new ketone readings (frustrating!!!).

This is where I get nervous. I know we need to increase her insulin but Millie's evening PMPS was 131 and I'm always afraid of her going too low. I know it's high this morning but she is also on all kinds of HC treats & food to encourage to eat after her two days of MODERATE ketone readings. Don't know why it frightens me so much every time we change insulin doses. I was thinking of increasing from 2U to 2.25.



http://www.felinediabetes.com/FDMB/...-153-still-increase-dose.179565/#post-1987042

 

[Cherryl & Mouzer]

Morning! Millie looks much better this morning, still no new ketone readings (frustrating!!!).

This is where I get nervous. I know we need to increase her insulin but Millie's evening PMPS was 131 and I'm always afraid of her going too low. I know it's high this morning but she is also on all kinds of HC treats & food to encourage to eat after her two days of MODERATE ketone readings. Don't know why it frightens me so much every time we change insulin doses. I was thinking of increasing from 2U to 2.25.



http://www.felinediabetes.com/FDMB/...-153-still-increase-dose.179565/#post-1987042

No matter how long I might be at this with Mouzer, I think any increase would be spooky for me. I wish you and your baby the best!!!

 

[Mandy & Rex (GA)]

@Gill & George your thoughts??

 

[Sylvia & Millie]

No matter how long I might be at this with Mouzer, I think any increase would be spooky for me. I wish you and your baby the best!!!

It helps to hear that.

@Gill & George your thoughts??

I think my fear stems from what I originally learned regarding the dangers of too much insulin. I have to step out for a couple of hours today (during her +2,+3) and I worry that I won't be here as well. I do know she needs the increase, guess part of it is illogical as well; just the responsibility of all of this. It helps to know others experience that, too.

 

[Mandy & Rex (GA)]

Have you fed yet? If not, check again at the half hour mark since the first test and see if it is going up.

 

[Sylvia & Millie]

Have you fed yet? If not, check again at the half hour mark since the first test and see if it is going up.

She was really hungry this morning so I fed her right after we tested her.

 

[Mandy & Rex (GA)]

It looks like Gill left.

I would go ahead and shoot. Whatever you are more comfortable, do that .. 2u or 2.25u. She needs insulin in her. Then you can get more advice for PMPS.

 

[Sylvia & Millie]

It looks like Gill left.

I would go ahead and shoot. Whatever you are more comfortable, do that .. 2u or 2.25u. She needs insulin in her. Then you can get more advice for PMPS.

 

[Mandy & Rex (GA)]

It looks like Gill left.

I would go ahead and shoot. Whatever you are more comfortable, do that .. 2u or 2.25u. She needs insulin in her. Then you can get more advice for PMPS.

Get another test and update your spreadsheet to show that you stalled and shot late.

 

[Sylvia & Millie]

Get another test and update your spreadsheet to show that you stalled and shot late.

I didn't shoot late, we test early because my husband leaves for works. Her shot is due in 45 minutes.

 

[Mandy & Rex (GA)]

I didn't shoot late, we test early because my husband leaves for works. Her shot is due in 45 minutes.

Oh, that's good to know! Can you check at that time to see where Millie is at? AMPS is taken at the time insulin is given so I thought you were stalling.

 

[Sylvia & Millie]

Oh, that's good to know! Can you check at that time to see where Millie is at? AMPS is taken at the time insulin is given so I thought you were stalling.

She also just had a very HC meal. I am thinking of going ahead and doing the 2.25, especially after what I was told the last few days.

 

[Mandy & Rex (GA)]

She also just had a very HC meal. I am thinking of going ahead and doing the 2.25, especially after what I was told the last few days.

Good luck! There will be eyes on your posts. Do a test before you head out and then again when you get back.

 

[Sylvia & Millie]

Good luck! There will be eyes on your posts. Do a test before you head out and then again when you get back.

I will try to teat her by myself, not always able to do as Millie is tough for one person to test.

 

[Kris & Teasel]

I will try to teat her by myself, not always able to do as Millie is tough for one person to test.

I agree that you should try the 2.25 u. Do your best to get test just before you leave but the HC breakfast will likely be affecting her BG. If you're only gone an hour or two she should be OK. As scary as it is, you have to learn to handle lower BG numbers for Millie's sake. DKA is scarier.

 

[Gill & George]

@Gill & George your thoughts??

Sorry Mandy was on the board briefly earlier then had to get on with lunch, I was still logged in so it probably looked like I was still about.

I'm glad Millie is feeling/acting a bit better, hopefully once you get that blood ketone meter getting a reading will be much more easy.

I know we need to increase her insulin but Millie's evening PMPS was 131 and I'm always afraid of her going too low

Did you get any BG readings last night in the pm cycle? Nothing is showing on the ss.
I really think, that you need to get into the habit of getting a before bed test, this is doubly important when you are shooting a lower than usual PMPS. By monitoring you can keep her safe and avoid her going too low.

So that 445 on the SS was taken an hour before shot time?? If that's the case it needs to go in the +11 box. Please confirm if that test was before you gave insulin or not.

 

[Sylvia & Millie]

Sorry Mandy was on the board briefly earlier then had to get on with lunch, I was still logged in so it probably looked like I was still about.

I'm glad Millie is feeling/acting a bit better, hopefully once you get that blood ketone meter getting a reading will be much more easy.


Did you get any BG readings last night in the pm cycle? Nothing is showing on the ss.
I really think, that you need to get into the habit of getting a before bed test, this is doubly important when you are shooting a lower than usual PMPS. By monitoring you can keep her safe and avoid her going too low.

So that 445 on the SS was taken an hour before shot time?? If that's the case it needs to go in the +11 box. Please confirm if that test was before you gave insulin or not.

Yes, the test was before the insulin and about an hour ahead. It's our pre-shot test. Do I then use the same number at +11 and pre-shot slot?
No readings last night. I was up the whole night before, I'm not feeling well and needed to sleep last night.

 

[Gill & George]

Do I then use the same number at +11 and pre-shot slot?

If it's an hour ahead, it's 11 hours since you last gave insulin so that is your +11. If you have shot and haven't got a test right at amps then leave that square blank.

Really you should be getting a test at pre shot (within about 10min of giving him his shot), though I appreciate why you are doing it the way you do, and today with his number being so high it probably doesn't matter.

What I would do is test(give George his Freeze dried pokie treat), put Georges food down (unless I was stalling due to a low number in which case he wouldn't get food) and shoot the insulin while he was busy wolfing his breakfast down, this was all within 5min, some cat's don't like being bothered when they are eating so with those you would wait till he finished eating and shoot.

You want to be giving some food at the time you shoot, so that she has some food in her for when she onsets. (usually on lantus this is around the +2 mark, If you test/feed at +11, shoot at +12, by the time the insulin onsets the food she got at +11 will have likely worked it's way out of her system, so with no food about you might find she experiences sharper than normal drops at onset.

No readings last night. I was up the whole night before, I'm not feeling well and needed to sleep last night.

I know you had a rough night yesterday, and must be beyond exhausted, been there bought the Tshirt, so I wasn't suggesting that you should have been up all night, but (again sorry to nag) when you shoot a number that's lower than you have ever shot before, it really is advisable to get at the very least a +2 (in most cases a +1 and +2 would be better), if you had found her to be dropping drastically at that point, and needed to hit the sack, you could have attempted to abort the cycle by assist feeding HC food. I just want you to be aware that in a situation like last night more monitoring is required in order to ensure Millies safety.

That's all water under the bridge though, she's looking brighter this morning and that's what's important. I do wonder with that high number you got at +11 is a bounce from the blues or whether she did drop lower last night?? We'll never know.

Have you shot the 2.25u this morning?

 

[Jill & Alex (GA)]

I do wonder with that high number you got at +11 is a bounce from the blues or whether she did drop lower last night?? We'll never know.

I wonder the same.

Have you shot the 2.25u this morning?

The increased dose will probably be fine today since the numbers are so high. Are you able to test Millie by yourself if you had to or is it a two person job?

I am thinking of going ahead and doing the 2.25, especially after what I was told the last few days

The only way to know if her insulin needs to be increased is to know

• how low the current dose is taking her, and
• if she continues to throw ketones

Going forward, you'll want to base your decisions after gathering this information. If you have any questions or end up with a preshot number lower than usual, please post for help. We may be able to offer suggestions or advice to help keep ketones at bay while keeping Millie safe.


I hope you were able to get some sleep last night. Taking care of kitties can be exhausting.

 

[Sylvia & Millie]

If it's an hour ahead, it's 11 hours since you last gave insulin so that is your +11. If you have shot and haven't got a test right at amps then leave that square blank.

Really you should be getting a test at pre shot (within about 10min of giving him his shot), though I appreciate why you are doing it the way you do, and today with his number being so high it probably doesn't matter.

What I would do is test(give George his Freeze dried pokie treat), put Georges food down (unless I was stalling due to a low number in which case he wouldn't get food) and shoot the insulin while he was busy wolfing his breakfast down, this was all within 5min, some cat's don't like being bothered when they are eating so with those you would wait till he finished eating and shoot.

You want to be giving some food at the time you shoot, so that she has some food in her for when she onsets. (usually on lantus this is around the +2 mark, If you test/feed at +11, shoot at +12, by the time the insulin onsets the food she got at +11 will have likely worked it's way out of her system, so with no food about you might find she experiences sharper than normal drops at onset.


I know you had a rough night yesterday, and must be beyond exhausted, been there bought the Tshirt, so I wasn't suggesting that you should have been up all night, but (again sorry to nag) when you shoot a number that's lower than you have ever shot before, it really is advisable to get at the very least a +2 (in most cases a +1 and +2 would be better), if you had found her to be dropping drastically at that point, and needed to hit the sack, you could have attempted to abort the cycle by assist feeding HC food. I just want you to be aware that in a situation like last night more monitoring is required in order to ensure Millies safety.

That's all water under the bridge though, she's looking brighter this morning and that's what's important. I do wonder with that high number you got at +11 is a bounce from the blues or whether she did drop lower last night?? We'll never know.

Have you shot the 2.25u this morning?

Yes, I gave her the increase.

 

[Sylvia & Millie]

I wonder the same.

The increased dose will probably be fine today since the numbers are so high. Are you able to test Millie by yourself if you had to or is it a two person job?


The only way to know if her insulin needs to be increased is to know

• how low the current dose is taking her, and
• if she continues to throw ketones

Going forward, you'll want to base your decisions after gathering this information. If you have any questions or end up with a preshot number lower than usual, please post for help. We may be able to offer suggestions or advice to help keep ketones at bay while keeping Millie safe.


I hope you were able to get some sleep last night. Taking care of kitties can be exhausting.

Testing Millie is usually a two person job, thus the reason we test before my husband leaves for work which is Millie's +11. I want to be sure to have some idea in case I can't do it alone. Today she let me do a +4 without much fuss.

I picked up the blood ketone monitor, tried to use it but my tech challenged self could not figure it out.

Millie is eating and drinking really well. I picked up MC high calorie food to try to put weight back on her. She could stand to gain 3-4 pounds.

 

[Mandy & Rex (GA)]

What was the +4 reading? I don't see it on the SS.

I hope sooner than later Millie gets better about you testing her alone.

 

[Sylvia & Millie]

What was the +4 reading? I don't see it on the SS.

I hope sooner than later Millie gets better about you testing her alone.

Millie's +4 was 181.

Thank you!

 

[Kris & Teasel]

Millie's +4 was 181.

Thank you!

 

[Mandy & Rex (GA)]

You may want to feed her a little to slow that drop. Otherwise she looks great!

 

[Jill & Alex (GA)]

Testing Millie is usually a two person job, thus the reason we test before my husband leaves for work which is Millie's +11. I want to be sure to have some idea in case I can't do it alone. Today she let me do a +4 without much fuss.

Good! I hope testing will get easier as time goes on.

Millie's +4 was 181.

Has she dropped any lower since then?

 

[Sylvia & Millie]

Good! I hope testing will get easier as time goes on.

Has she dropped any lower since then?

No, she didn't drop anymore.