7/25 - Tip - AMPS(410);

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Cindy & Pets

Cindy & Pets

Member Since 2012
7/24 condo

AMPS - 410
+6 - 403
PMPS - 383
+2 - 374
+4 - 348

I seem to be having troubles getting enough data in such a short time. I'm wondering if it might be best I switch to relaxed? ): I mean, I was going to get more +2's, but I fell back asleep because I went to get a +6 last night. I'm at least getting consistent with that.
 
definitely need more data.
kinda looks like your nadir is somewhere around the +4 or 5. But not enough there to be sure.

You can see it had an effect right away.
You might also want to footnote when you give food because that will spike your numbers too.
 
Here soon, not tonight, but tomorrow during the day, I'll pretty much test every hour around where I think the nadir is to pinpoint where I should look for it. Since doesn't it even differ slightly each day? Or when I find the nadir when I do that, will that be where it stays?

By footnote, do you mean on the SS? Or the first post of each condo?
 
As I understand it, all cats are different.

Some have cats who change the rules and some are consistent.
I think that's why we have to do more than 1 curve, separate times.
Because if there is an unknown infection brewing, or a sudden stress, that can have and effect and suddenly you get a spike or drop.

So after you figure it out, always expect it could change. It's very much a "be prepared" scenario.
Diabetic cats are more prone to things like uti's.

and I don't know if our experts have a preference.
I always put it on my ss for the moment until I update just to make others away that I just gave food so the bg is rising for a period.
You can also note it on your condo / post of the day.
If you post a new message on your post, it will bump you up to the top of the list.
 
While she was on humulin N, it was almost always +4, but I'm not so sure that it translates over to Lantus, just with a later time.

I'm wondering, are half-curves just as valid(+2, +4, +6) if half of it is done one day, and the other half done on another day(+6, +8, +10)? Because I'm unsure if I would be able to get up every 2 hours in one night, even if I want to get more night-time data. But I can certainly stay up until her +6 one night, and then another day get up at her +6(12am EST) and finish the curve up if I get to sleep early.

I can try to do both, I mean, I was doing it for a while before on my SS, but it seemed messy. I follow the feeding schedule I have in her profile pretty closely though. But I can still put it up here so that it's easier to get to. Does the amount of food matter as well? As Tip sometimes eats some of Christmas's share of the Special Kitty they get.
 
I think any curve is more beneficial than none. You should get a lot of information by doing it even in a +3, +6, +9.
and at some point check the other spots randomly. You will be on this journey for a while.
You haven't been on the lantus very long and lantus creates a shed and you will starting getting an overlap as the time on it increases
It is slow acting.
You will always want to hold a dose for several days to see how it plays out and then adjust in small increments and then continue the new
dosage for several days ( always at least 3)

I found the special kitty food list.
Which cans are you choosing? There are some there that are way high in carbs.

I have limited my cats choices to ones that are under 5% carbs.
If you are only using the lowest carb choices ( and absolutely no dry food ever) , you can feed them as much as they want.
Hi protein , low carb diets don't make you fat.
And until your cat is regulated and actually improving, she is still starving from the diabetes.

I'm around home a lot so I give Shadow anywhere from a 1/4 of a can to 1/2 (small cans) whenever she asks. the 1/2 can servings come after the shots. I also give her shrimp ( pieces ) as her reward for being poked.
Eating will show up in your numbers for up to 2 hrs afterward. I don't think the amount matters as much as the carbs. Higher carbs affect
the numbers more. That is why you need a couple of cans of high carb in you hypo emergency kit separated from the daily foods.
And why if your numbers get too low, you give them a spoonful of the high carb food to bring them back up - providing they eat it and then
monitoring because that spoonful will wear off.

Were there any signs of drinking more water or peeing more before january when she had to go on prednisone?
I know that steroids can cause cats to become diabetic.
Your cat could have been borderline diabetic before that or maybe it was just the prednisone. Was she eating dry food back then?
 
Sayania said:
I seem to be having troubles getting enough data in such a short time. I'm wondering if it might be best I switch to relaxed? ): I mean, I was going to get more +2's, but I fell back asleep because I went to get a +6 last night. I'm at least getting consistent with that.
Click to expand...

Awwww, I think you are doing GREAT! You are more than welcome to post where ever you like, but I do think you will get more feedback here. Just because you can't test every hour of everyday does not mean you can only post in certain areas of the board. Most people here work and just grab tests when they can. You are testing multiple times/day and trying to get evening tests. You do the best you can do. What more can anyone ask for?! :mrgreen:

What time is your +2 in relation to the time you go to bed?

Most people will test at amps and try to get an "out the door" test before they go to work (or wherever). It can be helpful to get an "in the door test" if you are not giving the evening shot as soon as you get home + pmps. In the evening get a going to bed test (often a +2 - +4 for people). If you can, wake up and get another test. If you cant, then you can't.

On weekends, or days off you can try to do more tests at different times, or a curve.

Try not to beat yourself up. You are doing great. As Sienne suggested yesterday (I think), Tip probably needs more insulin.
 
Well, I didn't think I was getting much of the even numbers, so I wanted to get more of that.

The cans I got this time was....
Super Supper Dinner
Classic Tuna Dinner
Mixed Grill Dinner
Classic Cod, Sole, & Shrimp entree
Ocean Whitefish & Tune Entree
Ocean Whitefish & Tuna Dinner
Meaty Turkey & Giblets Dinner.
All of it is pate.

And alright, I know that if she wants more, I do give it to her. But most of the time she walks away from the bowl after about 6 ounces.

There was just weight loss, but that was happening before she was put on the prednisone, we had assumed it was arthritis due to age and the weight loss was from not wanting to get up. She was eating dry food back then, and until I had gotten Christmas off of the dry food, Tip had been sneaking some bites from her bowl. Other than that, there were no other symptoms.
 
carolynandlatte said:
Sayania said:
I seem to be having troubles getting enough data in such a short time. I'm wondering if it might be best I switch to relaxed? ): I mean, I was going to get more +2's, but I fell back asleep because I went to get a +6 last night. I'm at least getting consistent with that.
Click to expand...

Awwww, I think you are doing GREAT! You are more than welcome to post where ever you like, but I do think you will get more feedback here. Just because you can't test every hour of everyday does not mean you can only post in certain areas of the board. Most people here work and just grab tests when they can. You are testing multiple times/day and trying to get evening tests. You do the best you can do. What more can anyone ask for?! :mrgreen:

What time is your +2 in relation to the time you go to bed?

Most people will test at amps and try to get an "out the door" test before they go to work (or wherever). It can be helpful to get an "in the door test" if you are not giving the evening shot as soon as you get home + pmps. In the evening get a going to bed test (often a +2 - +4 for people). If you can, wake up and get another test. If you cant, then you can't.

On weekends, or days off you can try to do more tests at different times, or a curve.

Try not to beat yourself up. You are doing great. As Sienne suggested yesterday (I think), Tip probably needs more insulin.
Click to expand...
Thanks, that does mean a lot to hear that. :) I was getting discouraged and feeling like I wasn't doing enough. Guess I shouldn't be so hard on myself.

Right now my sleep schedule is all off, but ideal is the +2 is 2 hours before I go to sleep. I'm trying to line up more with my schedule during school. I wake up right when her AMPS test is, where I test, feed, then shoot, and lately, it's been 'go back to sleep' after that, but I'm going to have to break that habit soon.
 
I hadn't caught you had a condo so I just went back and read some of it.

Its 5 more days until the 30th.
I agree with the others that I would raise the dose a little. I think you would see a positive response to it but if you didn't, that would
point even stronger to possible infection/bacteria.
Take a baby step. try 1.25 if you are going to be around enough. You've been on the 1 unit for a while.

Your vet may have picked that date because he's off on a vacation this week.
You may also have a vet that thinks after a 1 unit dosage, the next increase is 2 units. So many of them don't seem to thing about smaller
increments.
 
I can try 1.25 tonight.

It was probably vacation, but I'm not sure. We had discussed the switch over phone, and then she said she wanted to see me back in 7 days to see if she needed and up in dose. The only times Tip had change 1 unit was when I had to go to the other vet I usually deal with. Who, well, doesn't seem to know as much as the one I prefer to go to. I'm thinking that's an experience difference, the one I like has been there twice as long as the other vet. But I'm not positive, when it came to scheduling, I talked with the receptionist, which is when I also scheduled their yearly.
 
On a different note...
I am wondering if anyone has suggest you test Tip for ketones on a daily basis? With the high, flat BG's and possible infection you would want to stay on top of it.
 
I have not been checking on a daily basis. But on the 20th she tested negative for ketones. I can start testing for that daily.
 
Tip was at 383 for her PMPS. I'm wondering, should I go ahead with the 1.25? Or stick with 1 until tomorrow morning, when I can keep track of her more?
 
If it were my decision, I would shoot 1.25.
I would be wanting out of the red numbers and you're kind of dancing back and forth.
I don't think the small increase is going to drop you a significant amount, but I think it will go down.

I hope you can see the half mark on your syringe because it's hard to get measure without a line to go by.



If it were my cat, I'd probably actually move to 1.5, but make sure I'm around too. I don't think the small increment is going
to suddenly plunge you into a low low number.
 
Alright. I had actually already given her her shot about 5 minutes ago, at 1U, I should've posted earlier, but had an internet outage an hour and a half ago because the hone is down. Don't know how that means they had to shut the internet down to fix the phone, but they did. Is it possible to dose her the extra .25? Or should I just leave it?
 
Cindy:

To be honest, all we really ask for on this Board is that you test at pre-shot times and at least once per cycle. From that perspective, you're doing great. If you are able to get a +2 and a +4 at night, that would be wonderful. Those numbers will guide you as to where Tip's cycle is going and if you need to set an alarm and grab another test.

This is what I posted last night:
Sienne said:
What would you think about raising Tip's dose tomorrow? I'd think about increasing to 1.5u. HOWEVER, you do need to get PM cycle tests if you are going to increase. Many cats have lower numbers at night and if you don't get any tests during the evening cycle, you're missing half of your data.
Click to expand...

I would encourage you to raise Tip's dose. Typically, we ask caregivers to wait 5 - 7 days before increasing the initial dose. Because Tip has been on insulin previously, I'm suggesting that we move a bit more quickly since you know how to test AND because I don't like seeing Tip in such high numbers. In addition, your initial dose of Lantus was probably much less than what Tip needs based on what her SS looked like while on N. Based on the Tight Regulation Protocol, I think it makes sense to raise Tips dose to 1.5u:
"General" Guidelines:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
You will want to keep monitoring Tip's numbers they way you have been -- including PM spot checks.

I just want to point out an erroneous statement:
Rhiannon & Shadow said:
If it were my cat, I'd probably actually move to 1.5, but make sure I'm around too. I don't think the small increment is going
to suddenly plunge you into a low low number.
Click to expand...
This is inaccurate. At one point, someone made the observation that a dose of 0.1u could not drop numbers below 40. It can. There is no way to predict how sensitive a cat will be to any dose of insulin -- no matter how big or how small. There are a myriad of factors that can effect the response to dose. I've been here for 3 years and while there are times when I'm dead on accurate in my predictions, there are just as many times when my crystal ball fails. The best way to keep your cat safe and to understand her response to insulin is to get data. And in that regard, you're doing a terrific job.
 
I can actually get a +2 and +4 tonight, her +2 was 374, and I'll update the top of the post and SS in a sec, finishing up dinner.

I think now I'm alright with upping Tips dose. So should I go 1.25 tomorrow morning, 1.5 tomorrow evening? Or just jump up to 1.5?

And another question, I've been giving her the Lantus right after she starts eating, so that I test her, I give her food right after, and then after she's shown she'll eat enough, I give her the Lantus, but should I instead wait until after she's done eating? Which way will make it most effective?
 
Just increase to 1.5u. If you go stepwise, you need to let each new dose settle. Given that Tip's nadir has been over 300, I'd really like to see you get those numbers down and it's within the parameters of the protocol to increase to 1.5u.

How you're testing, feeding, and shooting is exactly what I do with Gabby. You're thinking along the lines of N vs. Lantus. With N, your onset is very quick. You must have food on board before you shoot or you risk a very steep drop in numbers. With Lantus, onset isn't for 1 - 2 hours (depending on your cat). You have more time for Tip to eat. If you look at the progression of typical numbers with Lantus in the New to the Group sticky, you'll see your +1 typically shows a food spike and your +2 is around the same as your pre-shot number. There isn't the steep drop like with N.

FWIW, you can also spread out Tip's food. Many of us give "mini-meals." You don't need to feed all at once.
 
Alright, I can increase to 1.5u tomorrow morning.

Oh good, I'm still unsure of what all I should be changing when going from humulin n to lantus. And you let the insulin warm up a little before drawing it up, right? Or is it to be left cold? I've heard that if given cold, it can sting and hurt. So I've been leaving it out while I test and put the food down.

I do try to let her have 1 snack between meals, not as big as her morning or night ones. I was debating between switching it to where it's more evenly spread out in the 4 meals though. I also let her snack on chicken, since I've heard that it can sometimes help with their teeth. Correct any of this if it's wrong, please. But it's cooked chicken, she refuses to eat raw.
 
When people comment about Lantus stinging, it's usually in high dose cats. You know not to shake or roll Lantus, right? (Humulin is a suspension -- you need to get the particulates back into the liquid. Lantus is a solution and doesn't need to be mixed.) I do the same thing but it's probably not more than 2 min. between when I draw up the insulin then test, put Gabby's food down, and give her a shot. Her head's in the food bowl when she gets her shot.

Usually when people recommend feeding chicken for a cat's teeth, they are recommending either gizzards or chicken necks. Frankly, I think brushing my cat's teeth is easier. (Neither of them will go near a chicken gizzard or heart -- cooked or raw.)

As far as meals, some people will let their cat's graze. Gabby will eat everything in the bowl, no matter how much or how little. It makes more sense for me to spread out her food. I also spread out her meals because she's prone to dive early in the cycle.
 
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