7/30Michael amps 355 New to TR from Health

[Paula]

Paula & Kitty Michael Bouncing Again Help!
Postby Paula » Wed Jul 30, 2014 5:25 am

Good morning all,
For 6 cycles (I think) M has been in the yellows until this am. BG 355. I have been giving .5u bid. This am I tried for the .75 u but I couldn't see. I couldn't tell if it was .5 or 1u so I went with the 1u. I hope I didn't mess things up.
Please look at the SS. The last 2 days I have only been able to test amps & pmps due to appts.
Btw does anyone know if tapazole affects Bg #'s? Michael started tap this am 1/2tab sid. We (the vet & I) hope it doesn't upset his tummy as he needs this for the hyperT. All of this is so complicated. It seems I am guessing at everything. All I want is to keep M safe and he seems to keep bouncing. It really scares me and is a lot of stress!
Chris, Kpassa, and everyone that replied to my previous posts, I hope you read my thank you replys.
All of a sudden I didn't hear from anyone. Again I'm not really sure how to use the message board.
Paula

 

[julie & punkin (ga)]

hi paula! welcome to you and Michael!

Chris and Kpassa are regulars here, so they will see your post. no worries!

There are several kitties here with hyper-t. you're in good company. You'll just adjust the insulin to work around any meds that he has to have.

Great job getting a spreadsheet set up and getting going. I haven't read all your previous posts, but have looked through his spreadsheet and your comments. those really help, by the way. it's good to make observations about how he feels and if he's not eating, etc., in the spreadsheet.

it looks like 1u has gotten him in the 50's in the recent past after you changed him to low carb canned food. that's great - normal numbers are 50-120, and with tight regulation, our goal is to keep cats in that range. their pancreas can heal and hopefully, the cat will go off of insulin and become diet-controlled. that's the goal - some cats don't go off, but keeping their blood sugar controlled keeps their other organs as healthy as possible.

I'd stick with the 1.0u for now - Lantus does best when you're consistent with dose as much as you can be. With TR, we shoot numbers over 50ish, but for new people, we suggest if you get a number at preshot less than 150, post and ask for help in the subject line. You'll want to edit the subject line of the first post in the thread (we call them condos, for kitty condos) so it shows in the main page and say something like "stalling, help please". While you're waiting for an answer, don't feed michael. you're going to wait about 20 minutes and retest him, and if he's rising then you'll shoot and feed.

There's a ton of information here. Read through the stickies and don't worry about memorizing info yet. The 2 things I'd flag for you are the post on taking care of your insulin - there's a video there on how to draw up your dose so you don't contaminate the Lantus. you want it to last as long as possible. Also, on the Tight Regulation Protocol sticky, there is a PDF about 5 paragraphs down that's called "Management of Diabetic Cats Using Long-Lasting Insulins." You have to download it. They specifically mention hyper t kitties in it, and i think it's worth you trying to just muddle through it as best as you can to get the gist of it.

It's also important to print out the sticky on "Shooting and Handling Low Numbers." That post is broken into 3 parts - once in a while the board goes down, and you want to have the part on handling low numbers (less than 50) on hand just in case you can't access the board.

I'll stop there so I don't overload you. Glad to have you and Michael here. Ask as many questions as you have - use the ? post icon so you don't get missed - and people will teach you what you need to know to help Michael become as healthy as possible.

 

[Dyana]

I'm glad to see you posting over here, Paula.

Do you have the syringes with the 1/2 unit markings?

It looks to me like the 0.75 dose would be the one to try.

You are doing a good job with Micheal. I am proud of you.

 

[julie & punkin (ga)]

oh - one more thought. you said you were having trouble telling how much the dose was this morning. Some syringes are easier to read than others. If you've got the Relions from Walmart, they have a fat barrel, which means the dose markings are closer together and it's harder to make slight tweaks to the dose. I'm guessing you might have those since you're having trouble with it.

Many of us use the Terumos from ADW. They have fairly accurate markings, the barrel is thinner than many brands which means it's easier to see differences in doses, and they are very inexpensive. If you want to go to American Diabetes Wholesale (where that link takes you to the terumos) you can register first at http://www.mrrebates.com and then you'll get a rebate on everything you buy through ADW. I used to get $30 checks for punkin's supplies, so it can really add up.

While you're using whatever syringes you have, you can stack 2 pairs of reading glasses on your nose to be able to see better. I'm a quilter and have a friend that does that - and as stupid as it looks, it really does work. All craft stores also sell magnifying lenses, either to wear or clip to a cupboard door, that will help you see better. Anne/Liz/Zener's people bought optic lenses that look like jeweler's magnifying glasses. All of these will make it easier for you to see your dose.

 

[julie & punkin (ga)]

looks like dyana and i gave you conflicting dose advice! what's most important is that you be able to draw the dose accurately and consistently. Choose what you can do that with and stick with it for a few cycles, getting at least one mid-cycle check in the am and pm cycles so you know how low the dose is taking him.

 

[Ella & Rusty & Stu(GA)]

Hi Paula & Michael and welcome to Lantus Land,

I agree with Julie and Dyana that the dose should be consistent. Lantus does best when it is dosed every 12 hours and any changes in dose determined by the protocol, which you can read in the "Stickies" (informational topics) at the top of the Lantus forum.

I am a bit confused about your Tapazole question. You say in your signature that Michael was diagnosed with Hyper T in 2012. But you have only recently started him on Tapazole? Was he on a different medication for 2 years? My previous diabetic kitty, Stu, also had Hyper-T. His blood-glucose numbers were all over the place, but he also had other health issues that were addressed too late. As I understand it, Tapazole (methimazole) is often begun at too high a dose, rather than starting at a lower dose and working up. (Stu's vet started him too high.) Perhaps that is having an effect on Michael's blood glucose? Do you know the Yahoo Hyper-T forum? You may be able to find some answers there:
https://groups.yahoo.com/neo/groups/feline-hyperT/info?yguid=354124632
Also, some of the people here on the Lantus forum have Hyper-T cats and may be able to help you. My experience with Stu's Hyper-T was that it speeded up everything in his body, so that he often had low, or dropping, bg numbers often to be followed by bounces as his liver tried to compensate. Anyway, you should discuss the size of the Tapazole dose with your vet.

Good luck with it all. You will get lots of good advice and support here in Lantus Land.

Ella & Rusty

 

[MollynSkooter]

{{{{Paula}}}}}

So glad you decided to join us in the TR group!!! You are super lucky as you have some of the most awesome people to get advice and support from.

I suck at advice on what to do, but awesome at being supportive


WELCOME TO LANTUS LAND!!!!!

 

[Chris & China (GA)]

Welcome to TR Paula and extra sweet Michael!

Those doses "in between the lines" are awful, but what's important is that you keep them as consistent as possible. Just in case you haven't seen these already, here's a thread on Dosing with calipers which can make your dosing much more precise, or here's another post that includes some Pictures of micro-doses down towards the bottom of the page. (there's lots of other good information on that page too!)

What you can do is take one of your old syringes and draw up something colored (like tea, coffee, water with food dye) and decide where .75 is for you...then when you draw up your insulin, compare the two until you get a better feel for it.

1 unit has brought Micheal down from the 300's to double digits (65 and 53) twice before, so it's important that if you continue with the 1 unit, you try to get those tests in..especially at night. It's still entirely possible Michael is bouncing from lows he's hitting overnight, but there's just no way to know yet.

We just want to keep him safe...that's our number one concern, so please don't think I haven't heard you when you've said it's been hard to get those tests in lately. If at all possible, we really need to see at least that "before bed" test.

Hopefully he won't need to be on insulin long and can be one that's able to go OTJ quickly! That's what we all hope for when we have a new member! We love all our members, but getting their kitties OTJ is the best! (even if it means we don't see as much of them!)

 

[Sienne and Gabby (GA)]

Hi, Paula and welcome to Lantus Land!

The folks here have provided some good information. One additional suggestion, though, is that with TR, you want to get at least one test each cycle in addition to your pre-shot test. I'd encourage you to get a "before bed" test every night. Even though the PMPS numbers may look high, you never know if the numbers will drop. Our kitties are full of surprises. If, in fact, Michael is bouncing, having a spot check will help you to know if your hunch is correct.

The other consideration with the numbers yesterday is New Dose Wonkiness. Sometimes, when you increase the dose, you see a temporary increase in numbers despite the additional insulin. No one really knows why this happens, but it does!