7/28 Charms PMPS 107,+2 110,+3 98,+4 102, +5 105

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Sam and Charms

Member Since 2013
Yesterday's Condo

Hi - These are crazy numbers for Charms! He hardly has had any yellows and this morning he has gotten a blue and a green. I need some help, instructions, what to do when. I have read all the stickies and have stuff printed out, but I just need some reassurance that I am doing the right things. Should I test him sooner, how often. Charms is acting fine, nothing is different today except for these new numbers. - Sam
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87 HELP!!

Yahoo for green. Way to go Charms!! :mrgreen: :mrgreen:
I'd test within an hour of getting that +5. You are doing great so far Sam. Thank goodness this happened on a weekend. :-D
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87 HELP!!

I would re-test at +5.5 and give Charms some LC food to help slow things down.

You're not jumping up and down about green?
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87 HELP!!

If you give Charms LC food, get yet another test 30 minutes after that. It takes 30 minutes for the effects of the food to hit the blood stream. Due to Charms higher dose, there is a possibility of acromegaly. Acrocats have a working pancreas, which food can sometimes stimulate, which could in turn drive the numbers down further. Note that I said "sometimes" - it doesn't always happen with Neko but it's a possibility I have to be aware of.

Do you have HC or high carb food with gravy around? You don't need it yet, but just making sure in case Charms goes below 50 today. With Neko, I can't use LC food and have to use HC at low numbers. You can also add a drop or two of karo or syrup to regular LC to make HC.
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87, +6 82 HELP!!

Thank You Sienne and Wendy for the support and help. Charms thanks you too! I was too scared to be happy about the green! When Charms first got diagnosed I would hyperventilate everytime I gave him a shot! I try to read as many other posts as I can , but I get panicky just reading about really low numbers in other cats. I am always afraid I will harm him while I am trying to help him, It is a strange phobia I have. Plus right after I posted the numbers our power went out here! That was enough to give me an anxiety attack! It s back on , so I just posted the +6 test and got the 82, so it looks like things are slowing down, thank goodness. I gave him a little LC food like you said Sienne.

What to do next?
I am sure you guys are laughing at me , in a supporting way, because I know I should be so happy! - Sam
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87, +6 82 HELP!!

Awww...no laughing we promise!! Not even a giggle, chortle or snicker!! We've all been there!! You're doing great and so is Charms!!

That first green freaks everyone out...the next time, it won't scare you quite so bad, and the time after that, you'll start to take it in stride...the more you know about Charms, how the insulin works, how sensitive to carbs Charms is, the more prepared you'll be for "next time"!

You're doing fine!
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87, +6 82 HELP!!

I'd test 30 minutes after you gave him that LC food and then post the new number. If we are lucky, he'll surf in the 80's for a while. BTW, I love 80's surfs! Nice and green and not too low. If he's still in the 80's after your next test, you can move to hourly testing.

And no way we are laughing. You are doing great!! First green after months of no green, I tossed way too much high carb food at Neko at our first low number. She was freaking at the lower numbers too (and starving). And it happened at night with hardly any one around. Charms has great timing doing it on a Sunday. :-D

As long as you have higher carb food and/or karo around, you are in control of lower numbers. Good idea to read condos of other cats going low and you should print off a copy of the Handling Low Numbers sticky in case the power goes out again or you lose internet at the wrong time.
 
Re: 7/28 Charms AMPS 211, +2 184, +4 112,+5 87, +6 82 HELP!!

Wendy and Chris are right. It takes a while to get used to seeing greens and feeling comfortable steering the numbers with food. Take a look at some of the 911 posts and then how after a few times, the same person who was hyperventilating and panicking is now handling low numbers like a pro. I think we have all had that same concern -- that in an effort to do the right thing we are hurting our cats. Understand that if you were hurting Charms, there would be any number of us who, in no uncertain terms, would tell you that you were screwing up. You're not screwing up.
 
Re: 7/28 Charms AMPS 211, +4 112,+5 87, +6 82 ,+7 88,+8 98

Thank You Sienne , Wendy, and Chris! Could never ,ever, do this without all of your help and support. You guys are more reliable than the vets office and more helpful too! Ok I am still seriously recovering from all the greens , is Charms actually "surfing" greens after all those horrible days of RED, RED, RED! How could this happen so quickly. I put the new numbers up ( had to run out to the barn to let the horses out and clean stalls, but I kept running in checking on Charms, might have tracked a little manure in!) He is acting fine with this sudden drop, I am the one having heart palipitations!

Now my two big questions are , he is currently at 8.5u . Do I give him all of that insulin tonight, and then how often do I test him? What would make me give him a different amount tonight? Plus I have been raising him by .5 every 4 cycles, his next increase would be tomorrow morning, because of the greens do I hold the dose at 8.5 in the morning?

I have another question - I was running out of those One touch ultra test strips, had a stockpile from my Dad, so I went out last week and bought one of those Relion Micro meters, did not think I would be testing so much so I had not tried it yet, At +8, I tested with both meters One Touch gave me 98, the new Relion micro gave me 89. Should I just start using the new meter? or use both for a while?

Also, I do not have any of those gravy cans, but will get some today. I have 10% cans. I do have honey. I also have the cat treats Charms loves, I think that is how he got diabetes in the first place! He "charmed" everyone into giving them to him. I think he might have gone green today in hopes of getting some.

Thank you all again, this is an incredible place ! - Sam
 
Re: 7/28 Charms AMPS 211, +4 112,+5 87, +6 82 ,+7 88,+8 98

I'm still too inexperienced to even try to advise on doses that high, but one thing I did notice was that you're increasing in .5 units. We usually only increase .25 at a time and hold it for at least 3-5 days (6-10 cycles) before increasing any more.

Decreases are "earned"...if Charms went below 50, he'd "earn" a reduction. It's possible the 8.5 is a little too much, and since you skipped the 8.25, it may have made a difference, but again, I'm too unfamiliar with those kinds of dosages to guess.

I know I'm happy to help, even with just hand holding if I don't have any useful advice, as are all the wonderful people on this message board! We all want the best for our own cats, as well as each others!

Congrats on the surf too!! Go Charms!!


Oh yeah..meters can differ by about 20%..even from the same meter, so the numbers you're getting are well within that, so pick the meter you like best (or can afford to buy strips for) and stick with it :)
 
Re: 7/28 Charms AMPS 211, +4 112,+5 87, +6 82 ,+7 88,+8 98

Hi Chris, because Charms had been on two other insulins at high doses , before Lantus, and his numbers were still really high and flat, Sienne had me fast tracking him. That is why I was increasing every 4 cycles at the .5. I would never attempt to do this alone, and my Vet has no experience with Lantus, so I welcome all the advice, knowledge, and experience of everyone here, and the hand holding is a necessity! Thank You so much! I think I am more stressed about this whole diabetes thing than Charms! - Sam
 
Re: 7/28 Charms AMPS 211,+5 87, +6 82 ,+7 88,+8 98,+10 120

I think we're all more worried than our cats are...there's a lot to be said for being a "dumb animal" (although our cats have us trained well, don't they? :lol:

From what I've read here, it seems most vets have little experience with Lantus...or diabetes in general. The first vet I took China too demanded I change her to Science Diet M/D (dry) and said "If I can get her into the 300's, I'll be happy with that. Insulin is a big hassle, and keeping her in the 300's will slow down the complications she'll eventually have"...What an idiot! I was really happy I'd spent the night researching and knew better than to take his advice! I also have a diabetic adult son, and knew 300's was in no way considered "controlled". I didn't want to PUT OFF the complications...I'm hoping to AVOID them!!

Vet 2 told me that I shouldn't trust anything I read on the internet, and that dry/wet were equally fine....On to vet #3

Vet 3 agreed she needed to be on insulin, but had never used Lantus (he'd only used Pro-Zinc, but was willing to let me try, especially since Lantus is available at most pharmacies here, Pro-Zinc has to be special ordered)...He still said she'd need to be on at least 4 units once/day before I should expect to see any results. He's been shocked to hear her numbers at 1u twice/day and LESS...at least he's willing to admit he doesn't know everything, so he's a keeper! (I'm also running out of vets in the area....LOL)

Good to know Sienne is advising you...She's great!!
 
Re: 7/28 Charms AMPS 211, +4 112,+5 87, +6 82 ,+7 88,+8 98

Sam, I'll try to answer a few of your questions. First, you can stop at 8.5 units for a little while. We had you increasing by .5 and faster than most so we could get Charms out of the reds and pinks. Done that!! :-D There is a chance that Charms will bounce after seeing that lovely green today. The protocol says that if you are seeing nadirs under 200, to hold for 6-10 cycles. With the green, I'd definitely hold at least 6 and hold longer if he bounces until the bounce is over. Bounces can last up to 72 hours. And yes, stick to 8.5 units tonight. He gets a deduction if he goes under 50.

How could Charms change so quickly? You got to a dose that overcame what looks like some kind of resistance. Hard to say what it is at this point without tests but it's great to see that breakthrough. It may or may not mean you are done with increases, time will tell. The protocol does say .25 unit increases, but after 5 units, it's OK to move to .5 unit increases. As a percent of the overall dose, a .5 increase at 8.5 units isn't as significant. However, this is where you'll have to experiment. Sometimes a .25 unit increase is all that's needed. All part of ECID (each cat is different). If I was seeing greens on our way up the dose ladder, I tended to .25 unit increases.

The Relion meter strips are cheaper. If they are easier to get for you, make the change but stick to one meter from now on. Playing meter games can drive you crazy. The meters aren't all that far apart. Meter manufacturers are allowed 20% variation and you saw 10% difference. You can get some of the FF Gravy Lovers at Walmart when you are getting more strips. I find there is a little more gravy in them. Now that you are seeing green, it's good to make sure you have a decent supply of strips at all time and that gravy/karo.

Great day for Charms! :mrgreen: :mrgreen: I promise it will become easier for you too. :-D :-D
 
Re: 7/28 Charms AMPS 211,+5 87, +6 82 ,+7 88,+8 98,+10 120

Thank you , Wendy. I will give him the 8.5 tonight. I usually only test once after, the PMPS. I give him insulin at 5:00am amd 5:00pm, so the +3 or +4 I do in the PM is my "before bed test" ! I try to head to bed early because I get up early. I really could use more sleep! What should I do tonight ? I am not used to these low numbers, I know they are the goal but they honestly scare me! Should I try to do more testing tonight? I am one of those people who stresses over details , so if you can , let me know what numbers would make me test more and when I would test. Thank You - Sam
Also - I love to read about your rowing! I am like my cats , I hate to get my feet wet, but it sounds like a lot of fun! You are very ambitious!
 
Re: 7/28 Charms AMPS 211,+5 87, +6 82 ,+7 88,+8 98,+10 120

Do your normal +3/4 or before bed test and post if it's lower than his PS. Around here, we recommend a +2 test because if that is the same or lower than your PS, you are going to have to test more. Neko usually has a later onset, so I find the +3 gives me similar information.
 
Re: 7/28 Charms AMPS 211,+6 82,+7 88,+10 120,PMPS 107,+2 110

Hi, I just updated with Charms new numbers. Great numbers! But I am still very nervous. How often do I need to test this evening? -Sam
 
Re: 7/28 Charms AMPS 211,+6 82,+7 88,+10 120,PMPS 107,+2 110

Sam

What an awesome day for Charms!! I'm so excited for you all :mrgreen: :mrgreen: :mrgreen:

Lantus is known for it's second dip at the end of the cycle and looks like Charms got the benefit of it. However, his +2 is similar to his PS. Since he is at a high dose and we don't have data, I'd suggest you get a +3 and see which way he's headed. He might have decided he wants to spend more time in green today.

On the meter change, if you haven't done it, please just be sure and mark it clearly on your SS so we know you changed meters. Those two numbers are actually pretty close :-D
 
Re: 7/28 Charms AMPS 211,+6 82,+7 88,PMPS 107,+2 110,+3 98

Yes you called it Marge, Charms just got another green! When should I test again? When will it be safe to go to bed? I am one of those early to bed early to rise people! - Sam
 
Re: 7/28 Charms AMPS 211,+6 82,+7 88,PMPS 107,+2 110,+3 98

He's coming down pretty slow. We usually like to see a rising number (not influenced by alot of food) before you quit testing.

I think you have two choices: you could test at +4 and see how serious he really is or you can take a nap and test at +5.

IMHO, he has a really big depot at 8.5u and I'd be concerned about not seeing a rising number before I called it a night. Many of us sleep/test. I know that is hard to do when working....I did it for a year and was a zombie.
 
Re: 7/28 Charms AMPS 211,+6 82,+7 88,PMPS 107,+2 110,+3 98

Just popping in to say .. Finally some good numbers yay!!!!

Keep up the good work guys...
 
Re: 7/28 Charms AMPS 211,+7 88,PMPS 107,+2 110,+3 98,+4 102

Got a very slight increase at +4. When do you think I should test again, or is it safe to stop testing on this cycle yet?
 
Re: 7/28 Charms AMPS 211,+6 82,+7 88,PMPS 107,+2 110,+3 98

I want to provide some info for others who may be following Charms incredible numbers today.

I did suggest fast-tracking Charms. One way to fast-track is to increase the dose every 2 cycle (vs. every 3 cycles). Charms dose was also increased by 0.5u (vs. 0.25u) because he was in consistently high numbers.

We tend to follow a modified version of the TR protocol. The German Lantus board has their own modification. The procedure that I suggested that Sam follow for Charms was consistent with the German board's approach.
Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.
Click to expand...

I agree with Wendy. I think there's a good chance that Charms has (had?) insulin resistance. The only way to know this for sure is to test for insulin auto-antibodies. IAA is a temporary situation. Once the resistance is broken, the dose will come down. However, it's important to stay ahead of the antibodies at this time until they are thorough "squished."

I realize you've been spared frequent testing up until today. (Un)fortunately, that's going to have to change. If the IAA has broken, Charms could rapidly come down the dose ladder. That means you'll need to be attentive to where his numbers are going. I'd suggest that you routinely get a +2 test. This will give you some sense of whether numbers are dropping since the +2 and pre-shot are about the same in a "typical" Lantus cycle.
 
Re: 7/28 Charms AMPS 211,+7 88,PMPS 107,+2 110,+3 98,+4 102

Oh Sam!!!! I am so frigging happy to finally see those greens for Charms. I thought for the last few days you might be getting close to a breakthrough dose for him. Absolutely unbelievably fantastic news!! Whooo Hoooo!!! Go Charms Go! Big yard dance in the pouring rain in the dark! Too excited to do a dance inside for you and Charms, there simply isn't enough room to do those leaps!

Who cares if you tracked a little manure into the house to run back and check on Charms. You should be so thrilled.

Now you are on to the next phase. You will need to do more testing but there are plenty of people to support you here in these next steps in the sugardance you are doing with Charms. He is leading this dance and not always telling the steps as he goes along.

:-D :-D :-D :-D :-D :-D :-D :-D :-D :-D
 
Re: 7/28 Charms AMPS 211,+7 88,PMPS 107,+2 110,+3 98,+4 102

The 98 and 102 are almost the same number, within meter variance. Paws crossed he's surfing there. I'd get a test at +5 and hope for a higher number before calling it a night.
 
Wendy- Just got the +5 , 105. What do you think?

Deb - I knew you would be thrilled!!! Charms would do that dance with you if he were there, I on the other hand am still recovering from the shock!

Sienne- Thank you for explaining the protocol you used for Charms to everyone. I know we could never have gotten this far without you, lets hope for my nerves sake that Charms cooperates on the way down!
 
This is where it's hard. You don't have much data on Charms in low numbers - it's such a novelty. I know on Neko that once she starts surfing, she doesn't go down much after that, it at all. I also found her cycles looked a bit different when we finally started seeing low numbers. It looks like +6 is when Charms typically likes to nadir. You'd probably be safe after that, or you could compromise with a +5.5 which should be close enough. When did he last eat?

BTW - could you update the SS?
 
Charms is free feeding on the Young Again Zero carb, so he eats smaller portions more often. He is not running around all ravenous anymore, begging like the dogs ! When I test him he does eat a tiny amount of 10% can, just so I can get the BG. I just did the 5.5 test and he is 120 so I think I will get some sleep. Hope it is safe. - Sam
 
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