8/1 Bob +4.5=44, PMPS=364 Is this a bounce?

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Lkldcatlady

Lkldcatlady

Member Since 2013
7/30 condo

Good morning LL! I'm guessing I wasn't the only one who could not get on the board yesterday as I didn't see many posts dated 7/31. I was traumatized! I was my usual hysterical self running around my apartment like a fool not knowing what to do. I assumed the YA was keeping Bob's BG just as high as his usual dry because he did not clear the bounce in 3 days, it actually went higher on the 4th day. At that point, he was eating it regularly. I tested for ketones and got a .4 and all hell broke lose. I increased Bob's insulin by 1 unit. I figured if my vet could do it, why not? But I know that wasn't the right way to handle things. Then this morning I get a 79. I have no idea if it's because the bounce is over or if Bob did not eat. I gave him .5 this morning because I absolutely cannot miss work and am scared poopless that he will go low and then won't eat the HC wet and I'll have to sit there for 8 hourse giving him syrup and gravy constantly. Somebody please advise how to fix this? My concern at this moment is not getting him into remission. My concern is keeping him at a "decent" number (low 200's and below) for right now if possible, so I can work every day and go to this conference in two weeks and not have a stroke because of being so stressed about.

Anyway, he seems to be eating the YA regularly (so far so good - praying very hard he keeps eating it). The kitties poo and pee stinks sooooooo bad though. Supposedly, this will go away with some time. Yikes. Bob's pee smells like it did before I had him fixed, so you know it's pretty bad. When I first took him in, the little &^%$#^&* sprayed my $200 leather purse. :o :shock: :o He's lucky he's so cute!

I missed visiting with you all yesterday! Hope that never happens again! Everyone have a fabulous day!! I'll have to get caught up on all the news....
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Good Morning, Dara

I'm so sorry, I can't help. I just wanted to say 'Hi'. It's hard to be out of touch for a day, I know. But these things do happen, from time to time.
I hope someone gets on and offers some advice, soon.
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi Dara! I'm sorry this is being so difficult. I totally get it! *hug*

I wish I had some wonderful and perfect advice, but I'm pretty lost in this sugar dance myself. It meant a lot for you to stop by my crisis condo the other day and offer encouraging words. I'm doing the same for you.

You are doing wonderfully. Bob is very lucky to have such a wonderful Bean who cares so much about him! I hope he gets all straightened out soon. :)
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Just as an FYI: When the vet gives insulin to combat ketones, they use a short acting insulin (i.e., Humulin R/Novolin R). This insulin is what's considered a bolus insulin -- it can be given on top of your usual Lantus dose. The basal insulin (Lantus) isn't necessarily bumped up they way you did. Remember -- Lantus is a depot-type of insulin and it takes days for a dose increase to have an effect. The better strategy yesterday might have been to raise the dose by 0.25u AND get fluids into Bob. I also don't believe that a ketone level of 0.4 is indicative of DKA.

For now, I think you need to pick a dose and stick with it. You've been dose hopping over the last few days and it will be easier to get a picture of how a dose is working if you have a consistent dose.
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi Dara,

I am so glad the board is back up. Someone should be offering you some help soon. Unfortunately, our kitties have a schedule of their own, and there is no guarantee what dose will keep Bob at a certain number. Bob's pancreas may be trying to come back to life! which is a good thing, but makes testing necessary.

I hope you are able to figure out what is best for you and Bob! You are doing great!!

Jane
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Sienne and Gabby said:
Just as an FYI: When the vet gives insulin to combat ketones, they use a short acting insulin (i.e., Humulin R/Novolin R). This insulin is what's considered a bolus insulin -- it can be given on top of your usual Lantus dose. The basal insulin (Lantus) isn't necessarily bumped up they way you did. Remember -- Lantus is a depot-type of insulin and it takes days for a dose increase to have an effect. The better strategy yesterday might have been to raise the dose by 0.25u AND get fluids into Bob. I also don't believe that a ketone level of 0.4 is indicative of DKA.

For now, I think you need to pick a dose and stick with it. You've been dose hopping over the last few days and it will be easier to get a picture of how a dose is working if you have a consistent dose.
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Thanks Sienne - so in looking at his ss and taking into consideration the zero carb food, what dose should I put him on? Should I go back to the 1.25 and stay there? I don't know how low he went last night because I thought the food was making him high. Then again, he may have stopped eating the dang YA. I'm not sure what's going on, but assuming he is eating regularly, do you think the 1.25 is good or should I lower it?
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hey Barb, Liz & Jane - thanks guys for stopping by for my usual drama show! :lol: I really appreciate the support. Trying hard not to be too dramatic, but it's just part of my personality. :roll:

I hope you all have a good day with no drama! :-D
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Keep checking Bob today ( I am sure you are already planning that)
With that added juice yesterday, his depot is fuller and has to drain back down to normal. I think that nice low green today is from that added juice.

If 7/28 was the last time he had the other dry food, then you still have a few more days to watch the YA. The stinkiness should get better in a few more days from what I've observed with others.
I don't think the YA will keep Bob high at all.
Will he drink more water if you add tuna juice or something like that?
You can take a little bit of tuna ( or something else) and put it in the blender with water and make him special ice cubes if he'll lick them.

I'm also curious about his pee smelling worse. Could he have a UTI or something? I never noticed a different smell ... the FD seemed to make the pee less concentrated.
If he did, that would keep his numbers up....regardless of everything else you are doing.
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi guys .. no advice from me either but I can relate to your hysteria .. I'm the same way! And it's even more difficult when the board is down and you feel lost and your mind totally blanks on you .. I hope that Bob eats his fuddies for you!
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hey Dara-
Sounds like you and Bob are really all over the place. Take a deep breath, and keep repeating. :-D I can't really offer any advice but just wanted to let you know you've got support. I like Sienne's advice to just pick a dose (and a food) and stay steady for awhile. Just let his system settle into a routine for a bit.

Hang in there.
Karen

(and no, I wasn't able to login yest either.)
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

rhiannon and shadow said:
Keep checking Bob today ( I am sure you are already planning that)
With that added juice yesterday, his depot is fuller and has to drain back down to normal. I think that nice low green today is from that added juice.

If 7/28 was the last time he had the other dry food, then you still have a few more days to watch the YA. The stinkiness should get better in a few more days from what I've observed with others.
I don't think the YA will keep Bob high at all.
Will he drink more water if you add tuna juice or something like that?
You can take a little bit of tuna ( or something else) and put it in the blender with water and make him special ice cubes if he'll lick them.

I'm also curious about his pee smelling worse. Could he have a UTI or something? I never noticed a different smell ... the FD seemed to make the pee less concentrated.
If he did, that would keep his numbers up....regardless of everything else you are doing.
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Hi Rhiannon! Well, unfortunately I can't check him all day - i can only go home at lunch (around +4.5). He was going up - I checked before I left the house and he was 88. I didnt want to skip completely, so that's why I did the .5.

Actually, the pee started with the YA and it's all the cats! I think it's just the extra protein. Jennifer at YA said at first kitties will overeat it (especially if you are feeding other food), but eventually, they will eat only about 3.5 TBS a day. but while they are overeating, alot of the protein is not absorbed and comes out in the poop. I'm going to call her and ask about the pee today to make sure. They are all drinking pretty well now that they are on the dry food again. I'm thinking about buying a fountain too...Also, Bob has a vet appt at 6:30 for a little checkup and to get some fluids (just in case!)!
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi Peter & Karen - thanks for stopping by!!! yes, I'm usually hyserical, but I'm working on that. I just don't know which dose to pick and stay with. He's been so all over the place with the food and going down so fast, I'm not sure what to do. Ugh. Well, we will see how he does today and maybe that will help me decide. I have a bag of orijen dry ready to go, but I'm praying I won't have to break it open. :roll: Thanks again for the encouragement!
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hmmm..... That explanation from YA doesn't make sense to me. Kitties that eat a raw diet do not have stinky poop or pee. There can be a period of adjustment but largely, Gabby's poop was smellier on Fancy Feast than on raw or Wellness.
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Is YA considered raw? I did not know that, but I'm going to call and ask a few questions. I'll let you know what she says. If you have a minutes, could you look at Bob's ss and tell me what dose you think I should keep him on for now?
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hey Sienne - just got off the phone with Jennifer from YA. their food is not raw. She said you may be thinking of a raw mix-in that they sell. Anyway, she said the smells are totally normal right now as they are overeating the food. She said there are alot of minerals, vitamins and proteins that are not being digested and it's coming out in the pee and poop. I guess it's like what happens when we take vitamins and pee out half of it! She said a few weeks most animals will eat very little of the food because it is so nutrient dense, they don't need alot. 1 cup has 600 calories - yikes! I hope somebody tells Hector because he likes his fuds and it's obvious by his big booty.
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hey Dara! Glad you talked to Jennifer - isn't she GREAT! I was very impressed with them! BTW, it wouldn't hurt to ask for the seasoning packet just in case you need to keep him "interested" and he goes into one of his "finicky" moods. They will send it to you - it adds more "smell" to the dry and entices them more.

Hang in there - from one high stung mummy to another! Still like my idea of an ear chip though ---- wouldn't that help us!

B
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi Dara,
Oh my you are having a time!! I sure do wish our sugar babies would just pick a # and settle in....But NOOOOOOO, they like to keep us jumping nailbite_smile :roll:
I know when I started I was all over the place with the doses too, because I didn't understand how the Lantus worked. Once I got Hoot settled in to the same food and dose, it was much better! I hope you can get Bob settled down a bit and he keeps eating the YA for you. Hang in there :YMHUG:
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi Dara,

Sorry I can't offer advice re. dosing, but I see Sienne already responded there.

Dara said:
I tested for ketones and got a .4 and all hell broke lose.
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Re. ketones, I don't know if you were using a blood meter to test, but it sounds like you were. I have a Nova Max Plus meter for measuring ketones in the blood & that meter says .1 to .6 is considered normal. These results would measure as "normal" on the urine ketone dipstik. If you are measuring with a blood ketone meter, let us know which one it is. Also, there should be a brochure with the meter that tells you the "normal", "warning" & "high risk" categories.

I know how scary it is when your cat is bouncing around the way Bob is. I freak out with Tigger all the time! I would be nervous increasing Tigger's dose by a whole unit without the counsel of other more experienced members, though (but I'm a BIG BCS), & I don't always trust my vet to have the best more current info re. feline diabetes. Maybe your vet is more experienced! I can certainly understand, given your history with Bob, your fear about going to work while Bob's going lower!

Just remember "Rome wasn't built in a day", Bob didn't get this overnight & it won't always go smoothly. You're doing the best that you can & all that you can, & that's ALOT! Maybe Deb will give you another pair of patience pants!

Sending you calming vines & Bob leveling vines! :YMHUG:
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Hi Dara,
Good luck with getting Bob settled into a dose that you can give consistently. Lantus really likes consistency.
I've missed something, somewhere: what is YA? I assume it's some kind of dry food and that your cats are dry-food addicts. Have you tried to transition them to wet food?

Have a good day and try not to stress out. :smile: Just settle in on a dose and follow the protocol.

Ella & Rusty
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Ella,
YA is "Young Again" dry. It is marketed as having "zero carbs", but there's been lots of discussion as to whether that is accurate or not. At worst, it would be considered low carb. But also supposed to be very "caloric dense", so daily intake has to be watched.

Dara, just because it is dry, Bob might need more water than he would on canned food. Also, if you see any indication of ketones, extra water can help flush those out.

I agree with Sienne and others - you just need to pick a dose going forward and try to stick with it for 3 days or more. Give the depot a chance to settle to a certain level.

I think 1.25u is as good a place to start as any, but I think it might be "low". It's hard to tell on the SS because there have been lots of adjustments lately. To me it looks like the numbers you saw on 1.25u were still being affected by prior higher doses, so you weren't seeing what 1.25u will actually do for Bob.

Maybe try 1.25u for three days and then reevaluate?
 
Re: 8/1 Bob AMPS=79 Got a train wreck over here????

Thanks everyone for the support and advice. I went home at lunch and Bob was 44. Ugh. Gave him high carb tuna food and he was 88 when I left. My mom went back an hour later and gave him more with a little syrup in it. So I'm praying he stays up until I get home. Still trying to determine if Bob did not eat at all or if this YA is as good as I hear about keeping blood sugar low.

The owner of the company called me because I sent an email mentioning Bob might be starting to snub the food already. Gave me some advice on kitties and eating and then told me there have been hundreds of diabetic kitties who have gone into remission on their food. I hope that's true and he's not just saying that - it's obvious how well the wet would have done for Bob had he been willing to eat it. IF we are stuck with dry, I hope it can at least be easy on his pancreas.

so, please say a prayer for Bobby - that his bg stays up until I get home.
 
Re: 8/1 Bob AMPS=79, +4.5=44

Bob! Listen to you Mum & keep your BG where it will be good for everyone!!! Keeping paws crossed......

Ann & Tess said:
I read an article comparing the NovaMax ketone meter and the Precision Xtra ketone meter. The Nova Max was quite inaccurate in the low levels. Usually Precision strips are more expensive, but I've seen them on eBay for less than you can get the NovaMax strips. If Bob is prone to ketones it may be worth getting the other meter.
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I read that same article,too, but settled on the Nova Max Plus because I could get it @ ADW for $24 including meter + 12 strips. Good deal. I ordered 20 more strips, & had 3 error readings on 1 roll. Bad deal. Tigger showed a high of .7 then 1.1(several times) at a period when he'd had some 400 days. I totally freaked, & when I read his urine later the same day it read normal. Tigger acted normal the whole time, but I know some cats do that & then tank. Even at 1.1, he was at a warning level & not at an DKA level until 1.5, tho', but those numbers can change quickly. I do believe the blood meters are more sensitive. Tigger's other ketone readings have been in the normal range, but I'm always nervous using the NovaMax now. I can't say if it's inaccurate or just more sensitive than the urine stix. If I had to do it over again, I'd get the Precision meter, & thanks, Ann, I'll check the prices on the strips on EBAY. Never too late!
 
Re: 8/1 Bob AMPS=79, +4.5=44

Yes - thanks Ann & Suzanne for bringing that to my attention. I'll definitely buy a Precision meter. Althought I'll have quite a collection of meters at home that I don't use - Alphatrak, Relion Confirm, and now the Novamax. Maybe I could donate them to a shelter or something.

For some reason, I thought .8 was the "start getting hysterical" number. Although I started at .4 :-D I'll have to re-read the manual. Bob spent the 1st two months on insulin being in high 300's - 600 and didn't develop ketones so hopefully, he's not predisposed to something like that, although I always want to be careful.
 
Re: 8/1 Bob AMPS=79, +4.5=44

I found a great quote "Drama is life with the dull bits cut out". I think Bob wins the drama award today.

I agree with the others on picking a dose and sticking to it for a few days. Something under 2.25 maybe?

no_drama_award-r598c04e4aa2545c7999a78c199c8cacb_8bozu_8byvr_324.jpg

Hey, Bob, could you do without drama for a couple of days please?
 
Re: 8/1 Bob AMPS=79, +4.5=44

Nosing my way in here....
I hope bob brings himself up and cuts out the drama too! :) And I had NO IDEA you could test ketones through blood! I am going to pick up a prescision meter right away too!!! I have had no luck getting them through urine, and it's stressed me out quite a bit thinking we may just never know Nadia's ketone levels.
 
Re: 8/1 Bob AMPS=79, +4.5=44

Wendy&Neko said:
I found a great quote "Drama is life with the dull bits cut out". I think Bob wins the drama award today.

I agree with the others on picking a dose and sticking to it for a few days. Something under 2.25 maybe?
Click to expand...

Thanks Wendy - great quote! :-D I'm scared now to go that high. What if he is actually eating and the .5 I gave him was too high (he went to 44 at lunch today)? I know the depot is still full from prior days, right? So, the depot fills differently, like when I was giving 4.25 it would fill to a larger point than if I were giving 1 unit for a week straight. Is that correct? If so, should I get it full with a smaller dose so we can see what is actually happening or do you think his numbers will go up? so confusing...

Liz4Paws said:
Nosing my way in here....
I hope bob brings himself up and cuts out the drama too! :) And I had NO IDEA you could test ketones through blood! I am going to pick up a prescision meter right away too!!! I have had no luck getting them through urine, and it's stressed me out quite a bit thinking we may just never know Nadia's ketone levels.
Click to expand...

Hey again LIz! I think someone said you can only buy that meter on-line, but I'm not sure. I just saw it on Amazon for $15.00 of course, the strips were crazy expensive. Maybe ebay?
 
Re: 8/1 Bob AMPS=79, +4.5=44

I'm pretty sure that 44 today was from the 2.5 units he got for two cycles. He's showed you that's too high before. That leaves a choice of 1.25, 1.5, 1.75, or 2 units.

You should pick one of those and let the depot fill (6 cycles) so we can see what it's doing. That's where those patience come in handy. Carl suggested going back to 1.25. The .5 unit today will have helped to drain that higher 2.5 depot a bit.
 
Re: 8/1 Bob AMPS=79, +4.5=44

Thanks Wendy. I'm going for 1 unit! I can always raise it later if I need to. I will try really hard to stick with this. I just get scared at the low numbers.

Is this high PMPS due to a bounce? Usually, Bob's bounces show up the next morning. Not sure I've ever seen it this fast. He has been eating and drinking tonight.
 
Usually, Bob's bounces show up the next morning. Not sure I've ever seen it this fast.
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That's a good observation, and I'd agree with it. I think that it might be a "size of dose" thing on this particular cycle. When you were seeing the pattern you noticed, the doses were higher. Perhaps the insulin, at those doses, was just lasting "longer" and the low dose this morning didn't do all that much. Yes, he dropped down into the 40's off of it, but he started the cycle low as well.

That said, there don't seem to be any "rules" on bounces. Sometimes they show up quick, sometimes a cycle or even two after a low. This particular bounce, to me, looks like something I would expect. If the immediately reaction is for the liver to dump "sugar" to boost the BG up quick, I'd expect it to show up really quick. There is the release of glucogon, and also "counter-regulatory hormones". I think it is the hormones that stick around the longest, and show up as "bounces later"?

Good that you picked a definite dose going forward. Give it a few cycles to see what Bob thinks about it.
 
Thanks Carl! Just loving this "no rules" thing. Dangit! Can't quite get a grasp on this thing....

I was very sorry to hear about Mullet. Worse feeling ever I know - I always go through a "no more animals" phase after something like that, but thankfully, I always come to my senses and find more kitties to take care of. He was a very lucky kitty to have you. My thoughts and prayers are with you and Bob.
 
Thanks Rhiannon! I'll check it out. I have some strips that came with the meter but I didn't plan on using them.
 
Just stopping in to say "hi!" Wow...I'm exhausted reading your condo...you and Bob are very active!!! I would guess that PMPS is a bounce, but I'm sure others will weigh in.

FYI...did anyone mention to you that there is a LantusLand on Facebook? Generally, any sort of advice needs to be given here, on FDMB, so that everyone is in the loop as to what is going on with Bob. But if there is a board outage and you really need help, you can check in on FaceBook. It's a closed group, so you need to join.

Have a great evening!!!
 
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