8/12 Rufus, +12 74, +13 109, PMPS 424 - Question!

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RuBee

RuBee

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I'm conking my head on the wall at this very moment. AND typing (see? I'm talented.) I don't know where to start, so I guess I'll give the bones and then fill in as required? Rufus has been on a steady diet of 2u Lantus for nearly two years now. It hasn't been working well. Now he seems to be getting better results from a lower dose (1.5u), but I have so little data that I'm not confident with that at all.

I checked what would have been his amps at 7:10 this morning and it came out 78, but then I remembered that I gave his shot a little late last night, so his +12 was actually just taken and came out lower - the 74 that I listed in the subject line.

Shoot? Shoot lower than 1.5? 1.25? He is a confuzzling cat! Please save my head from conking.
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

Hi Bee,

welcome to the Lantus forum.

Will you be home this morning?
I would say Lantus is working for Rufus, however, Lantus likes consistency and patience.

Are you able to re-test that 74? Has it been about 30 minutes since you got that number?
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

Yes, I am home all day. (One thing nice about being disabled with a diabetic cat!) And yes, I could test again (in theory, at least, whether Rufus will allow for it is another thing altogether). It's been a... geesh, the better part of an hour. Time flies when you're speed-reading, I guess.
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

First, welcome to lantus land--Lantus needs to be given on one consistant dose--I saw on your ss that you have adjusted the dose a couple of times--Also, it happens that the bg rises from too much of a dose--It is possible that's what is happening to Rufus.
Have you read the stickys at the top of the page?? It is essential for your stay here to do this.
Today, you will need to monitor his BG as 74 amps could go low--Hope you have HC food or Mc food available in case he drops--Karo syrup. honey, or hi carb snax will work too, but actual food is better

Could you get a +1 and +2 so you can see where he is going??
There is someone here 24/7 so ask questions, & post your numbers today in the subject heading so we can be aware of where Rufus is going.
As far as dosing, we have dosing helpers here to tell you what is advised--
Please update asap! Again, good job testing & good catch on this amps!--Not to worry we are here for you now!
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

ok, re-test

have you fed Rufus yet?
You don't want to feed when you're stalling or you may see a food spike influenced number to shoot.

Now if you fed, we can deal with too.
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

Thank you for the welcome. (Just for clarification - do you want me to amend the subject line of this current thread with his updated numbers?)

And I do have honey sticks and karo on hand, but no HC - or anything other than his usual food, which Rufus ate at about 7:30am. Whoops.

I'm going to try to get a reading right now. *scurry*
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

yes you can edit your main subject line to include current numbers too

Let's see what the new number is.
 
Re: 8/12 Rufus +12 74, +13 109

Ok, we have a 109 - and he was actually angelic through the whole process.

(...actually, this BB software is different from the one I knew. Exactly how do you edit the main thread's subject?) <~ Oops! Never mind, found it.
 
BUMP

ok just so we're clear

74 is +12
109 is +13 you haven't shot yet, so you can remove the AMPS for now ..

go to your first post of this thread and hit "edit" update threat subject line and hit "submit"
 
Re: 8/12 Rufus, +12 74, +13 109

Thanks. (Don't worry - it only takes repeating something sixty times for me to finally get it. j/k) ohmygod_smile
 
Re: 8/12 Rufus, AMPS 74, +1 109

Hi Bee...Welcome!
You go back to your first post and there will be an "edit" box in the upper right corner. We update during the day too with our new BG numbers...and you can always put "Question" in the heading too if you have one!
Glad that you and Rufus are here....what was the original date of his diagnosis? Was he on lantus from the beginning?
 
Re: 8/12 Rufus, AMPS 74 (...sort of. and Hi!)

Welcome to Lantus Land!

A couple of thoughts....
Lantus dosing is based on the nadir -- the lowest point in the cycle. It looks like you've been sliding the dose based on your pre-shot number. If you aren't comfortable with shooting the same dose twice a day, we can lower the dose so you can shoot consistently.

If you shoot early, it's like a dose increase; a late shot is like a dose decrease. If you shot at +14 last night, your shot time this morning is 12 hours from that time. You will need to work the time back to your usual shot time in small increments.

We do not recommend feeding within 2 hours of shot time otherwise, your pre-shot blood glucose level may be influenced by food.

I'm not sure what your pre-shot test is (and whether it's from your usual shot time or 12 hours from your shot last night.)
 
Re: 8/12 Rufus, +12 74, +13 109

To answer questions, Rufus was diagnosed in November of 1997 and was put on PZI first. (Hence my clinging to my sliding scale.) I'm finally understanding the dosing idea (in baby steps, unfortunately) but it's still pretty alien to me. Is my usual Test, Feed, Shoot OK or should I be using a different routine? And should I be waiting longer for potential food spike to wear off?

(And there he sits in my mother's favorite chair bathing while I worry about him. Pfft. Cat.)

Edit:
Crap. We went through too many strips the other night (he likes to shake his head when I touch it to his ear). I've got three left until this afternoon when the mail comes.
 
Re: 8/12 Rufus, +12 74, +13 109

Test, feed, shoot all under 15 minutes.

Sometimes it takes little longer, and you can actually bring that down to all under 5 minutes.

But if you do get a lower than usual preshot number, you want to hold off on food, and re-test.

Are you comfortable shooting a lower dose?
Would you like to re-test Rufus and see where he is at before you do that?

Just remember, you what ever dose you shoot, you want to keep it consistent and give it time to settle.
The more data you collect, will really help in the feedback too.
 
Re: 8/12 Rufus, +12 74, +13 109

Edit:
Crap. We went through too many strips the other night (he likes to shake his head when I touch it to his ear). I've got three left until this afternoon when the mail comes.
Click to expand...



hang on Bee, this could change things
 
Re: 8/12 Rufus, +12 74, +13 109

Our mail is really inconsistent around here - sometimes it comes at 2pm, sometimes it comes at 4:30pm, so with only three strips left for testing until who-knows-when, I don't know how I feel about shooting low.
 
Re: 8/12 Rufus, +12 74, +13 109

At the top of the lantus page there are 'stickies" that are starred. Try to read all about the protocol and all the things you might find helpful They are loaded with important information for you! Come back and ask as many questions as you might have. We are all here to help so don't be shy! It's a lot of reading and learning in the beginning but it does get easier! You might be familiar with he information, but just review it for now in that case, okay?

What kind of meter are you using? Contour? We used that at first too but had the same problem with waiting for the strips to arrive in the mail. Ugh. I switched to the Reli-On micro from Walmart and have been very happy with it. The test strips are $20 for 50 so that made more sense to me....
Hope you mail comes soon!
 
Re: 8/12 Rufus, +12 74, +13 109

Cant you run out & get a small amount of strips??
I am thinking they are creating a new dose for you, as need to keep Rufus safe now--Maybe a BCS dose(big chicken s**t dose) just to keep his shed going--I'm not a dosing helper, but I'm sure we are tryin g to find right dose for him.
That's the trouble with the mail order strips--THE MAIL--snail mail!!!
Just keep cool, one of us will be back to you--real soon!
 
Re: 8/12 Rufus, +12 74, +13 109

Bee

when is your usual shot times? Is it 7am/7pm?

And now it's been how many hours since that?
 
Re: 8/12 Rufus, +12 74, +13 109

I'm using the Contour USB (and I heard from one member that the original Contour gave unreasonably low numbers for their cat and that it was persona-non-grata in their house. I have a reliOn coming for comparison by Monday at the latest.)

- I'd run out but I don't drive and my mother (whom I live with) is at work. Trapped. =\ If push comes to shove I'll call her and see what she can do.
 
Re: 8/12 Rufus, +12 74, +13 109

Rufus usually has a 7/7 schedule or as close to it as we can fit. - should I see if I can test again? We're at +2 from last night's late dose... and he's napping.
 
Re: 8/12 Rufus, +12 74, +13 109

If you don't have strips and can't get out to get more, I'd skip the shot. It is not ideal but I also don't want to ignore safety issues. If strips don't make an appearance today, can you get out to pick up more or can someone lend a hand with a shopping trip? (FWIW, I always have a back up stash of strips. ) It's your choice, though, whether you skip.

Since you'll be skipping, you can adjust your shot time so you are back on your schedule. I have a couple of other questions. How did your vet arrive at Rufus' dose? There is a formula that can be used to determine initial dose:
initial dose = ideal weight in kilograms x 0.25​

Usually, the dose is somewhere in the neighborhood of 1.0u. Given that you've been getting some low pre-shot numbers and have adjusted your dose, I'd like to suggest that we lower Rufus' dose so you can shoot the same amount of Lantus twice a day. I'm going to touch base with a few other people (once my e-mail decides to work -- my e-mail server is down) and see what we think about the PM dose.

Also, what is Rufus' ideal weight? From your profile, it doesn't sound like there's been a problem with ketones -- that's correct?
 
Re: 8/12 Rufus, +12 74, +13 109

I don't really know anybody in the neighborhood who doesn't work - or anyone who doesn't work for that matter, but I know if it's bad my mother will pull whatever strings she has.

I like the idea of lowering the dose, actually, and I want to get back on track as well. I will talk to his vet (whenever I can - staffing shortages don't make for great communication) and keep her on point with the readings. As for how she got that dosage in the first place - pfft. I have no idea. We started him on 1u and he was switched to 2u quite a while ago. After a recent Fructosamine (last Wed.) she wanted him increased to AM3u and PM2u. Needless to say I feel kind of weird about her after that.

As for Rufus' ideal weight - he's half Norwegian Forest Cat, and 15.4 lbs. now. Nobody has complained to us that he's overweight, but he does have a little fluff to him. Whether that's just "him" or fat, I don't know. He certainly takes after his NFC side more than his mother's.

Ketones - he hasn't been tested in a while. I have a lot of supplies I need to get restocked. He was "passable" for so long when we weren't testing, I think we committed the ultimate sick-cat sin - becoming complacent.
 
Re: 8/12 Rufus, +12 74, +13 109

When you have a moment, please update the spreadsheet with the new numbers.
You can squeeze in extra numbers in the cells by expanding them, or enter the info in the comments section.

You can also add any relevant info (ex: why you skipped this morning, low on strips)
This will help others too when they check your spreadsheet.

This info you just gave us is also something you can add to his Profile.
That way we don't keep asking the same thing.

I have one additional question: what is his feeding schedule like?

And lastly, take time out to read the stickies here in the Lantus forum.
Ask lots of questions, it's going to be ok. You'll get back on track in no time.
:mrgreen:
 
Re: 8/12 Rufus, +12 74, +13 109

Rufus' feeding schedule? To give you an indication - I nearly got eaten today because I tried to test him past 7am. He'll put up with it before then, but once it's food time - it's food time. I'd like to start feeding him spread out through the day, but I don't know how to go about portioning it. 1 can in the AM, 1/2 can at midday, 1 can at PM, 1/2 can before (my) bedtime? Or just two cans in four even portions? Yikes, that sounds like it could result in stitches.
 
Re: 8/12 Rufus, +12 74, +13 109

Thanks for the info. I somehow missed that Rufus was diagnosed in 2007. The initial dose info doesn't really apply at this point.

We're thinking about 1.5u for tonight. How does that sound?

One of the differences you'll notice in the Tight Regulation sticky (and in the links to the formal versions of the protocol), is that we increase doses in 0.25u (or a max of 0.5u) increments. In that way, an ideal dose isn't overlooked. (Do you have syringes that are marked in 1/2 unit increments? You'll need them unless you're better at approximating doses than I am.) It also minimizes the chance that you'll have a problem with hypoglycemia. You may see low numbers but remember that a dose decrease is earned with a drop below 40 for a longer term diabetic cat. We also do not shoot different amounts at AM and PM. I suspect your vet is more familiar with some of the shorter acting types of insulin which are more forgiving on their dosing regimens than Lantus. At some point, you may want to pass along some of the research articles that are in the links.

If you don't have high carb canned food at home, I'd encourage you to pick some up. Janet & Binky's list has canned foods on both the new and old lists broken out by carb content. You'll want a supply of food of at least 16% carb and that has "gravy." Many of us use Fancy Feast. The grilled or marinated styles have gravy. There's a new style, "gravy lovers" that's not on the list and it does have a higher proportion of gravy.

My civie is a Norwegian Forest Cat. He's a character. He's still a kitten (about 18 mos old) and weighs over 13 lbs. They are big kitties! And, as you noted, fluffy. If you click on the link in my signature, there are photos of Gizmo and Gabby -- Gizmo was about 8 mos. old in those photos.
 
Re: 8/12 Rufus, +12 74, +13 109

:lol: funny!

You'll get lots of suggestions on this.

As an example, for us, Luna eats one can (5.5oz) he gets that one can spread out for the day.
Main meals breakfast and dinner he gets a bit more...then small snacks mid morning and mid afternoon, mid evening and bedtime.

Spreading out the meals can help.
Just remember no food in the 2 hours before shot time.
 
Re: 8/12 Rufus, +12 74, +13 109

I think I will start feeding him at even intervals. He acts like he's so hungry he could eat the can when I feed him every time.

1.5u sounds great. A nod in the direction of the 2u but optimistic about going downward. I like that. As for the syringes - we just got a new bundle and Mom asked for 1/2u markings and... lo and behold, she got them, even though the pharmacist looked at her like she was bonkers. (I just checked and was surprised to find them.)

Will be going to the grocery store very soon and will pick up some Fancy Feast for the emergency kit, as well as more ketostix from the drug store, and some backup strips too. I have a feeling (with the cats' instinct to shake their heads and wiggle) we might wind up going through more strips than even Moms and Dads who are testing young children. It would be interesting to know how many of those pricey little suckers my furball has made me throw away. :lol:

And OH my goodness, Gizmo is a beautiful baby - and looks very similar to Rufus, lol. Ru' has a bit more white on his nose, but he's got those "elephant" paws, too (talking about both the size and the white "toes"). If I had my way I'd get another NFC or mix, but they're not all that easy to find in this area.

Thank you all so much for your help (and patience.) I'll update numbers as the day progresses. Hopefully the mail will come early and I'll be able to go back to testing regularly, but I still think I'll be buying larger bottles (or more than one) from now on. For now, I'll just keep an eye on him and let him mock me with his carefree birdwatching/sunbathing while I fret and stew. :lol:
 
Re: 8/12 Rufus, +12 74, +13 109

I order my syringes through Hocks. You don't need a prescription for them. Their GNP brand are inexpensive and there's minimal problems with bubbles. They also ship quickly. Their prices on strips are competitive, as well. (If you use the link at the top of the page, FDMB gets a commission.)

You will go through lots of strips. When numbers are running low, you can end up testing every 15 to 30 min. until numbers start to stabilize. We should all own stock in these companies!!

Gizmo's paws look like catcher's mitts! And, he's still growing! I know Gizmo's breeder fairly well. She may know of someone in your area who also breeds. This is their webpage. The website isn't that great. Their Facebook page has better pictures.
 
Re: 8/12 Rufus, +12 74, +13 109

Welcome to Lantus Land, Bee! Don't worry, the folks here will get you and Rufus on track before you know it. :smile:

You're in the right place!
 
Re: 8/12 Rufus, +12 74, +13 109

Thanks for the rec! I'll look into that. I have to be careful, though. What I want isn't always what's best for everyone (*cough*Rufus*cough*) else. He's kind of territorial - was always trying to "overthrow" our older cat before Sam got his wings. Poor guy spent his last years on earth being tackled and nipped in the rear.

Gizmo will be a glorious sight to behold when he's grown up - mane and all. It makes me wonder about "designer pets" - it's pretty clear from the forest cat that Mother Nature never makes a mistake when she goes to the drawing board.

I will look into Hocks. I've been ordering on American Diabetes Wholesale since I first started buying syringes outside the pharmacy (stopped when we switched to the Lantus) and I've liked them, but I like the 8% to FDMB, too - a little bit like 'returning the favor'.

And thank you, to both Laurie and Mr. Tinkles. :) If it can be done it will be done. I'm stubborn enough for that. I just don't want to put Rufus in a position that isn't right for him; it's not fair to do to someone whose voice isn't understood by everyone (and doesn't have thumbs...)
 
Ok, we're back! Rufus is high - should I shoot, wait, test, feed or just feed and shoot and test? That sounds kind of careless... gah. Not sure what to do.
 
Hi again. :)

He has been just dandy all day. Unfortunately I wasn't able to get another test in during the day because I sat down on the couch and fell asleep - apparently it's not good for Mom to miss her meds either! :lol: When I woke up he was actually battling a squirrel through the window at one of his favorite perches. Priceless. Squirrel thought it was hilarious.

By then it was so far into the evening it wouldn't have been a good idea to test - if I don't give him time to "forgive" me it turns ugly!

Ok! Food time!(And thank you!)
 
Oh, we give treats alright. But if we don't finish up fast enough he takes them. He keeps coming for them, thankfully. Kitty Krack, I believe it was called. I need to get something like the liv-a-littles, though. Definitely a better solution than too many bonito flakes. We were told they had high ash content.
 
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