7/31 Copernicus AMPS=107 ( need advice after last's night 57)

Definitely reduce the dose. Try 13 units next. It's a little hard to say what size the depot thinks it is with the variable dosing from the vet, but 13 should be less than what it currently is. The skip today will help drain the larger depot, so that was well done.

Sorry to hear the poor boy is back in ER. On the upside, sounds like cabergoline is starting to work.

Is the AT your meter of choice going forward? Just wondering if you will try the Libre again. Your spreadsheet is currently set up for human meters, hence the 57 not showing up as a low number. @Marje and Gracie can quickly change it if you are going to stick with the AT.
 
Wendy&Neko said:
Definitely reduce the dose. Try 13 units next. It's a little hard to say what size the depot thinks it is with the variable dosing from the vet, but 13 should be less than what it currently is. The skip today will help drain the larger depot, so that was well done.

Sorry to hear the poor boy is back in ER. On the upside, sounds like cabergoline is starting to work.

Is the AT your meter of choice going forward? Just wondering if you will try the Libre again. Your spreadsheet is currently set up for human meters, hence the 57 not showing up as a low number. @Marje and Gracie can quickly change it if you are going to stick with the AT.
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Yes, Krista, let me know which meter you are going to use. The AT can get very expensive very fast due to the cost of the strips. A ReliOn at Walmart is much cheaper.

However, if you want to stick with the AT, I need to modify his SS. You won’t lose any data. Please just PM me as I’ll need editing rights.
 
Marje and Gracie said:
Yes, Krista, let me know which meter you are going to use. The AT can get very expensive very fast due to the cost of the strips. A ReliOn at Walmart is much cheaper.

However, if you want to stick with the AT, I need to modify his SS. You won’t lose any data. Please just PM me as I’ll need editing rights.
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There is a ReliOn classic, Premier, compact...does it matter??. I have always read human meters weren't accurate and took more blood. But it is my understanding that is what the majority uses. The vets always recommend AT. The AT is very expensive. I have some strips to finish up and then I will work on switching to human.
 
Krista & Copernicus said:
There is a ReliOn classic, Premier, compact...does it matter??. I have always read human meters weren't accurate and took more blood. But it is my understanding that is what the majority uses. The vets always recommend AT. The AT is very expensive. I have some strips to finish up and then I will work on switching to human.
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I think a lot use the Premier but I’d go with what needs the smallest sample and what feels good in your hand. I also found the smallest ones were more amenable to Gracie as there wasn’t some large thing moving towards her head. I don’t k why they quit making the ReliOn Micro but it was perfect. The Compact is about the same size as the Micro but the latter just needed 0.3 microliters of blood where the Premier and the Comoact need 0.5.

The human meters are very accurate. I’ve used both human and AT and I stuck with the human.

How is he feeling today? Did he pass bright red blood clot or dark and tarry looking?
 
Marje and Gracie said:
I think a lot use the Premier but I’d go with what needs the smallest sample and what feels good in your hand. I also found the smallest ones were more amenable to Gracie as there wasn’t some large thing moving towards her head. I don’t k why they quit making the ReliOn Micro but it was perfect. The Compact is about the same size as the Micro but the latter just needed 0.3 microliters of blood where the Premier and the Comoact need 0.5.

The human meters are very accurate. I’ve used both human and AT and I stuck with the human.

How is he feeling today? Did he pass bright red blood clot or dark and tarry looking?
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Two bright red blood clots. :( I'm waiting to pick him up.
 
Not in a mean way, but they make it sound like it's me causing all the stress. They said I test him too much. Ugh. We are in BNBs a lot due to house remodeling. But he's always adapted to change until lately. I wonder if has to do with the acromegaly and HPA axis linked to stress?
 
I came to pick him up and he looked terrible. They forgot to check his BG all day and they also forgot to feed him. They said it was a busy Friday. I am shaking right now. He was drooling and refusing food so I made them take him in the back and check his BG. He hasn't eaten since yesterday. No fluids either.
 
Krista & Copernicus said:
I came to pick him up and he looked terrible. They forgot to check his BG all day and they also forgot to feed him. They said it was a busy Friday. I am shaking right now. He was drooling and refusing food so I made them take him in the back and check his BG. He hasn't eaten since yesterday. No fluids either.
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Oh I’m so sorry 😢
Just terrible how they treat your poor baby 😭😭😭😭
 
You skipped, he's bouncing from numbers he hasn't seen for ages, and he's super stressed. The numbers will come down. By the way, one advantage of a human meter is that it doesn't read as high in those higher numbers.

I hope he'll eat at home. Neko always looked really sad in those high numbers.
 
Since you skipped this morning’s shot, you can shoot any time BUT that will be your new shot time. The next shot will be due 12 hours after that. You’d need to slowly work back to 8 am and 8 pm.
 
JL and Chip said:
Since you skipped this morning’s shot, you can shoot any time BUT that will be your new shot time. The next shot will be due 12 hours after that. You’d need to slowly work back to 8 am and 8 pm.
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Wendy said reduce dose when he was low but now he's so high so I don't know what dose.
 
Wendy&Neko said:
Definitely reduce the dose. Try 13 units next. It's a little hard to say what size the depot thinks it is with the variable dosing from the vet, but 13 should be less than what it currently is. The skip today will help drain the larger depot, so that was well done.

Sorry to hear the poor boy is back in ER. On the upside, sounds like cabergoline is starting to work.

Is the AT your meter of choice going forward? Just wondering if you will try the Libre again. Your spreadsheet is currently set up for human meters, hence the 57 not showing up as a low number. @Marje and Gracie can quickly change it if you are going to stick with the AT.
Click to expand...
Since they forgot to feed him all day and he's at 700 now , thoughts on dose? He's not eating.
 
13 units dose. He is high but we determine dose on how low they go on a dose. 14 units was too much insulin. Lantus isn't good at shooting down higher numbers.

Have you given him any anti nausea meds? Or fluids? I'm worried about shooting the full 13 if he eats nothing. But with some ketones (not critical yet), he does need insulin.
 
Wendy&Neko said:
13 units dose. He is high but we determine dose on how low they go on a dose. 14 units was too much insulin. Lantus isn't good at shooting down higher numbers.

Have you given him any anti nausea meds? Or fluids? I'm worried about shooting the full 13 if he eats nothing. But with some ketones (not critical yet), he does need insulin.
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I gave him zofran and I did transdermal Cerenia but I wish I did the oral. It has better efficacy. I waited an hour and still nothing. Should I do fluids? I also have hydra care
 
Wendy&Neko said:
13 units dose. He is high but we determine dose on how low they go on a dose. 14 units was too much insulin. Lantus isn't good at shooting down higher numbers.

Have you given him any anti nausea meds? Or fluids? I'm worried about shooting the full 13 if he eats nothing. But with some ketones (not critical yet), he does need insulin.
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I haven't done fluids yet. I want to. But I wasn't sure if they would dilute the insulin.
 
Did he eat anything? I'm surprised he'd vomit due to bupe. It's a rare side effect. Lots of acros take bupe for pain.

Please update the spreadsheet. It's not unusual after a skip that it takes a while for the numbers to come down, especially in combo with a bounce.
 
He kept rising to 750 and wouldn't eat and we didnt like the tremors and drooling and vomiting so my husband took him back to the vet. He is a sensitive cat. Even though other cats can have an opioid for pain, this seems like a drug reaction to me. He's had reactions to things before but not this bad. They said he dropped into the 50s for them at 4am (they gave IM insulin). I will try to get all the readings and put in the spreadsheet.
 
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Wendy&Neko said:
Did he eat anything? I'm surprised he'd vomit due to bupe. It's a rare side effect. Lots of acros take bupe for pain.

Please update the spreadsheet. It's not unusual after a skip that it takes a while for the numbers to come down, especially in combo with a
Wendy&Neko said:
Did he eat anything? I'm surprised he'd vomit due to bupe. It's a rare side effect. Lots of acros take bupe for pain.

Please update the spreadsheet. It's not unusual after a skip that it takes a while for the numbers to come down, especially in combo with a bounce.
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Wendy&Neko said:
Did he eat anything? I'm surprised he'd vomit due to bupe. It's a rare side effect. Lots of acros take bupe for pain.

Please update the spreadsheet. It's not unusual after a skip that it takes a while for the numbers to come down, especially in combo with a bounce.
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He dropped into the 50s again last night after going up to 750. This seems to be true Somogyi effect. That was on 13 units. But he was also administered IM insulin last night. Now that that was done I don't really know what the 13 units alone would have done but I imagine I still need to decrease
 
Krista & Copernicus said:
13. He wasn't eating and continued to rise to 750. He got a cernia injection, and ondansetron and IM insulin. He dropped to the 50s again at 4am. So I think I need to decrease more. But these highs are the highest he's ever had. Somogyi?
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An intramuscular insulin injection? Interesting. Did they say what type of insulin? Like Wendy said, Lantus isn’t great at pulling down high numbers quickly so I’m not surprised BG continued to rise initially. I think the 50 was more a result of the extra insulin they gave, especially if given IM, rather than the 13u.

Drooling and lip smacking can mean nausea, which doesn’t surprise me under the circumstances (the clinic forgot to feed him yesterday, BG is high, etc.). I’d be surprised if the bupe caused an adverse reaction unless maybe it was too a high dose. But with all of the variables, it’s hard to know anything for certain.

The Somogyi thing has pretty much been debunked.
 
JL and Chip said:
An intramuscular insulin injection? Interesting. Did they say what type of insulin? Like Wendy said, Lantus isn’t great at pulling down high numbers quickly so I’m not surprised BG continued to rise initially. I think the 50 was more a result of the extra insulin they gave, especially if given IM, rather than the 13u.

Drooling and lip smacking can mean nausea, which doesn’t surprise me under the circumstances (the clinic forgot to feed him yesterday, BG is high, etc.). I’d be surprised if the bupe caused an adverse reaction unless maybe it was too a high dose. But with all of the variables, it’s hard to know anything for certain.

The Somogyi thing has pretty much been debunked.
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He had a head tremor and still has it slightly. My husband said he was shaking. He was stumbling, not just a little drool, he was soaking wet with drool and urine for that matter. He's had a focal seizure before a couple years ago. He also lost all the hair on one side of his body before. He definitely has drug and chemical sensitivities. Whether Somogyi effect is real or not (since all his vets seem to tell me it is), I don't want him swinging from 50 to 700. So we keep tweaking the dose I guess.
 
Wendy&Neko said:
nope, sounds like they gave too much IM insulin, it will be very fast acting IM too.
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I will have to ask when he had the IM. The fast acting usually only last a few hours. His drop was at 4am. I suggested that it was the IM, but I was met with pushback. She said they do this all the time. So of the dozen vets I've seen not a single one knows how to manage diabetes here? He also never ate for me. Just licked some churu. So I couldn't get oral cernia in him. The transdermal did nothing. I wanted the injectable and it worked great. He's eating again. But now I'm getting lectures about managing his insulin on my own and they are messing with his dosing again. But I wasn't going to let Copernicus puke and drool and twitch all night. I don't want him to swing from 50 to 709. So now I guess I won't know if 13 alone was too much bc thy did fast acting.
 
Find out how much insulin they gave and what kind. 13 by itself was fine, but he didn't need any more than that.

Krista & Copernicus said:
His drop was at 4am
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I have no clue how that relates to + hours on the spreadsheet. I see two big drops, from 750 to 400, then from 400 to 53. Did they take the 400 and the 53 measurements? What +hour was the IM injection.

Unfortunately, fast drops cause bounces - which mean high numbers.
 
How is Copernicus today? What was his PMPS? Did the ketones drop back down?

I’ve been checking his spreadsheet to try to follow along. Hope you both had a better day. I can sympathize with all of the confusing and conflicting info.
 
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