6/7 Meadow AMPS 391... Another question

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Meadow

Meadow

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AMPS this morning at 6am of 391. Looking at her SS, I'm thinking she has cleared the bounce from yesterday? Or maybe not....I think she should be a bit lower at the +5 mark, don't you??

Was at the vet this morning with Nicky and spoke about Meadow's numbers. He suggested we go back to the 1 unit mark and begin again to work our way up. He says if we can get her consistently at 250, he'll be happy. He says we have to look at her clinical symptoms as well as the numbers and go according to that too. Says he'd rather have a "slightly diabetic" cat than one whose numbers are too low. I love my vet and he has always done wonders with my cats, but I'm not sure he's really up on diabetes. What's are your thoughts, everyone?
 
I tend to agree with your vet. Meadow still drops so drastically after her rebound "clears".

I saw your question last night about what it means to clear the rebound, but I didn't have a chance to respond. I was hoping that someone else would have come along but I see everyone is quite busy. There are new kitties here every day. :mrgreen:

When the "bounce is clearing" is when the BG's are on the rise....(as they do during the rebound/bounce)......and you start to see the BG's drop as they normally do in reaction to the Lantus. Some kitties can see a green number in the AMPS and by the time PMPS comes around they are already in the red numbers. Some take one 12 hour cycle or two for the BG's to rise and then start to come down. Once the BG's start to come down to where they normally are we can say that the "bounce has cleared".

My concern with Meadow is that she is in a constant bounce cycle. Her current dose seems to bring her BG's <100 and then she reacts with a rebound/bounce cycle for the next 24 hours or so.

By decreasing her dose we hope to see that her drops no longer go below 100. This will prevent her from bouncing as high as she does and keep her BG's in a safe enough range that you will not have to keep skipping shots.

My recommendation, if you start over at 1unit, is.......if you start to see Meadow's BG's rise and stay steady high (>350) please test for ketones. It is important when you decrease a dose drastically. However, going from 1.75u bid to 1u bid is not that big of a difference (in general terms). BUT EVERY CAT IS DIFFERENT! So please make sure you have some ketostix at home to test her urine if her BG's rise and stay high. You can purchase those over the counter at most any drugstore, Target, Walmart etc.

Good luck with the dosecrease (that is what we call it when we increase or decrease a dose). :mrgreen:
 
actually I think the reason Meadow is going high is because she isn't getting all of her shots. Each skipped shot affects the shed, and it can take a couple of days for the shed to refill. There could be some bouncing off of lower numbers there too, I would be surprised if there wasn't any. Normally the way to deal with the bounces is to ignore them. We call it "Liver Training School" - basically we train the liver to accept the lower numbers by exposing it to those numbers over and over again, until eventually the liver says "oooooh, ok, those numbers aren't going to kill me!" and stops overreacting. For some cats liver training school is quick, for others it takes a while.

What a reduced dose CAN do is bring the range up just enough so you won't get those numbers you can't shoot at PS time. We already reduced to 1.75 for that reason, so if that hasn't brought the range up enough you could try 1.5. As Paige said, do test for ketones. At some point we'll probably need to raise the dose again, but at least that will hopefully get her into a range where you can shoot every 12 hours. Once you get the shooting schedule straightened out, I think you'll be surprised at how the numbers fall into place.
 
BTW - I didn't see your ss updated for tonights dose. Did you start over at 1u?

Also, just a little housekeeping....every day in your new condo we ask that you link the condo from the day before. This way it is easy to click on the link to see what was going on the day before, in case anyone has any question....

Yesterdays Condo: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=16521
 
I've been beaten to the post... :lol: All I have left to say is hello!

And maybe also, that typically, and I am not insinuating that this is the case, but typically vets are more used to faster acting insulin such as vetsulin. Lantus doesn't work the same way... I suggest, if you haven't done it yet, that you print the protocol and take it to your vet with you next time you go.

You're doing well.
 
Thanks for the reply. Paige. I think I understand this bounce and clearing it a little better now.
After speaking with the vet again later in the day, we decided to decrease her dose to 1.25u. So that's what she got tonight. I have been testing her urine regularly with the Ketostix and one time I got a "trace" reading..or what looked to be trace anyway...and all the other times she is normal.
I also ordered the syringes from Hocks with the 1/2 unit markings. It crossed my mind that maybe I am getting a tad too much insulin in the syringe because you sort of have to judge the increments on the syringes I have. So tonight she got just a smidge over the 1u mark and hopefully that is 1.25.


paige said:
I tend to agree with your vet. Meadow still drops so drastically after her rebound "clears".

I saw your question last night about what it means to clear the rebound, but I didn't have a chance to respond. I was hoping that someone else would have come along but I see everyone is quite busy. There are new kitties here every day. :mrgreen:

When the "bounce is clearing" is when the BG's are on the rise....(as they do during the rebound/bounce)......and you start to see the BG's drop as they normally do in reaction to the Lantus. Some kitties can see a green number in the AMPS and by the time PMPS comes around they are already in the red numbers. Some take one 12 hour cycle or two for the BG's to rise and then start to come down. Once the BG's start to come down to where they normally are we can say that the "bounce has cleared".

My concern with Meadow is that she is in a constant bounce cycle. Her current dose seems to bring her BG's <100 and then she reacts with a rebound/bounce cycle for the next 24 hours or so.

By decreasing her dose we hope to see that her drops no longer go below 100. This will prevent her from bouncing as high as she does and keep her BG's in a safe enough range that you will not have to keep skipping shots.

My recommendation, if you start over at 1unit, is.......if you start to see Meadow's BG's rise and stay steady high (>350) please test for ketones. It is important when you decrease a dose drastically. However, going from 1.75u bid to 1u bid is not that big of a difference (in general terms). BUT EVERY CAT IS DIFFERENT! So please make sure you have some ketostix at home to test her urine if her BG's rise and stay high. You can purchase those over the counter at most any drugstore, Target, Walmart etc.

Good luck with the dosecrease (that is what we call it when we increase or decrease a dose). :mrgreen:
Click to expand...
 
Thanks a bunch, Libby. What you said makes complete sense. The only difference between what you suggested and what the vet and I agreed on was to go to 1.25 u and this point. And as I told Paige, I am monitoring Ketones as well. I like the "liver training school" concept. ;)
 
Hi Helene, thanks for the reply and encouragment. I think you are right about the vets knowing the fast acting stuff better. We started out with Humulin N, which he said he gives to all his diabetic patients. I did bring him the printouts of all the info here about Lantus and he appreciated it. He didn't even know how to write the script for the cartridges! I guess even vets can learn something new every day. ;)
 
Sorry Paige...didn't get to go back online until now to update for tonights BG's. I am only going to do 4 a day for a little while because her poor ears look a bit sore to me and she is shaking her ears now when I test. She didn't do that before all the poking this weekend. I think she needs a break.

We are starting again at 1.25 rather than going all the way down to 1u.
Will alsao try to remember to post the link to the previous days condo. I wasn't aware you needed that, but it does make sense to do it. Thanks much for all your help.

paige said:
BTW - I didn't see your ss updated for tonights dose. Did you start over at 1u?

Also, just a little housekeeping....every day in your new condo we ask that you link the condo from the day before. This way it is easy to click on the link to see what was going on the day before, in case anyone has any question....

Yesterdays Condo: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=16521
Click to expand...
 
Hey Dottie,
You can think of the links to the previous condo as a chapter in a book.

Open a book in the middle and you don't have a clue what's going on, but if you can go back one condo, then another and another, you can find out happened in the past few days. It's very handy.
 
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