8/26 Leo AMPS 513 +2 440 +5 343 +7 370 +10 443

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Lisa & Leo

Lisa & Leo

Member Since 2012
I'm back online after a long cry. I got up in the night to take a couple values and got so depressed at seeing 500's. But I did read the encouragement of several of you that my decision not to shoot had much merit - thank you for that. I didn't feel so guilty after reading your notes.

In retrospect, I could have shot. And wish I did ... but I simply didn't have enough data to do so. Next time I will consider a stall or BCS with more confidence.

Yesterday's Condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=77828

Summary from yesterday's PMPS:
PMPS 75
no shot
+1 74
+2 72
+6 460
+10 529
AMPS 513
Shot 2.0u

I will test at +2 and +5 or +6 ... I understand now that the earlier and later readings are as important as the nadir. HOWEVER - I will take all your advice and guidance.

Also, yesterday it was recommended that I reconsider giving a full can of FF with his injection. So I gave 1/2 can, and also 2 meatsicles (about 2/3 of a can total) which melt about half way after 2 hours. I think that would put food closer to being available during his nadir - please confirm if this is logical. I am reviewing automatic timer feeders and request recommendations.

Thank you - Lisa
 
Re: 8/26 AMPS 513

(((Lisa))) Dear Lady Lisa! Please don't be so upset. We ALL understand and back up your choice. Let's not dwell on it, let's move on instead and make sure Leo keeps making progress. Ok? We're all here for you. You did GREAT!! (Did you check your PMs?) Shooting with too little data is not a good idea. You wanted to - and DID - keep your baby safe. That is what counts.

Your feeding plan sounds fine to me.

One request: Could you add Leo's name to your subject line, please?

Update us when you have the next BG. Try not to be too discouraged. Soon you'll be an old hand at this. Take heart!

Post ANY other questions or concerns and we'll be here to help.

Hugs!
Jane
 
Re: 8/26 AMPS 513

Good Morning, Lisa (hugs).
You are learning a lot.

Did you go back to your regular shot time this morning?

I feed 1/4 can of FF at PS time and 1/4 can about 1 hour after that. I leave out two 1/2 cans of frozen FF in two separate bowls, and I set a timed feeder to give J.D. some food at about 2 hours before his nadir and at about his nadir. J.D. is on Levemir, so his nadir time isn't until +7.5, or so. I use this PetSafe 2 Meal Feeder. I have two cats, so I leave out enough for both to eat. Normally, it is not all eaten when I return home from work at PMPS, but I am gone for at least 10 hours. Sometimes, it's all eaten. On those times I wonder.

Leo, come on down, nice and easy, today, please.
 
Re: 8/26 AMPS 513

Having food available up to nadir can help to slow dropping numbers IF your cat is prone to dives. Granted, Leo took a dive yesterday -- we just don't know if he took bungee jumping lessons from Gabby as of yet.

At this point, I wouldn't spend much time beating yourself up. Learn from the data. Shooting lower numbers is an acquired skill and the first time is always a nailbiter. It's why I didn't want to twist your arm too much. You need to weigh all of the factors when making a decision whether to shoot and some of those factors include your schedule, fatigue, and comfort level.

Oh.... And can you put Leo's name in your subject line?
 
Re: 8/26 Leo AMPS 513 +2 440

Jane, Dyana, Sienne - thank you for your encouragement. In the big picture, last night was a learning experience and yes, not a tragedy. It just felt like it because I was so invested in getting things right and keeping his BG down. They are already getting better.

+2 440

So a question on this value - I've seen him drop at +2 before. Does the insulin start to work this quickly? Is this what I am seeing? He ate all his 1/2 can FF but there was no spike, so could that mean he's not a food-spiker?

Dyana - yes, we went back to our normal shoot time. The 4-day commitment to work him backwards could have been a challenge if I'd shot. Thanks for your feeding schedule - I will check out the feeder link you provided. I read some reviews last night and didn't find one right away with good reviews. I'll keep looking. Leo will try his best to come down nicely :-)
 
Re: 8/26 Leo AMPS 513 +2 440

Hi Lisa

I'm having some internet issues tonight, but let's see if I can get a few thoughts in anyway. First, a quote from the New to the Group Sticky:

Learn how YOUR kitty is responding to insulin:
Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir - the lowest point in the cycle
Duration - the length of time insulin continues to lower blood glucose
How to do a Curve - a simple explanation

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

A typical Levemir curve will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.
Video: Levemir: Mode of Action


A full understanding of the following concepts will go a long way in helping you regulate your kitty's blood glucose when using Lantus or Levemir:
Carryover - insulin effects lasting past the insulin's official duration
Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
Insulin Depot - (aka "storage shed" in Lantus Land) "spare tank" of insulin, which has yet to be used by the body
LANTUS & LEVEMIR: WHAT IS THE INSULIN DEPOT?

I encourage you strongly to re-read the info here (sorry the links didn't translate into th quote, just go directly to the sticky and you'll see them there). The questions you're asking have to do with the issues of regular "duration", "onset", "overlap", and the function of the "shed". I know those are a lot of terms, but I don't want to quote all those definitions here and overburden the post. Please re-read, follow the links in the sticky, and re-assess. What you're seeing is a fairly standard interplay between the *last* shot wearing off and the *new* shot taking hold. As for the food spikes, it will take a bit more time to see how carb-sensitive Leo is. Not all cats respond within 2 hours - Leo may be a cat that take 3 or 4 hours to respond to an LC-feeding. Nothing to worry about, just something to keep in mind when you collect data so that you can learn your cat's food-personality (along with his Lantus-personality), as it were.

I'm sorry to be rushed, I hope this all makes sense. I can't stay on longer because of the wretched internet... I'll try to check back in later. If you get stuck with answers you need, add "Questions" to your subject line, add the "?" symbol to it, or PM someone, ok?
I'll try to stop in again later.
You're doing fine!!
Hugs
Jane
 
Re: 8/26 Leo AMPS 513 +2 440

Good morning, Lisa:-)
It looks like Leo's liver decided that a big ole bounce was the proper response to all those pretty green numbers yesterday, so a shot last night probably would not have changed its mind:-)
We don't especially like seeing the high numbers when they happen, but knowing they were logical or expected makes them easier to deal with.
Hope you and Leo have a great day,
Carl
 
Re: 8/26 Leo AMPS 513 +2 440 +5 343

Jane - thanks for the pointers. I'll continue to study his SS to learn how he is responding to the insulin and food.

Carl - so the high numbers were not totally due to the lack of a shot? You're saying that his liver dumped glucagon in addition to the insulin and shed wearing off? That would be good to know that these high numbers have (possibly) two separate causes. Thanks for making this point.

Summary
AMPS 513 - 1/2 FF, 1 meatsicles
+2 440
+5 343 - 1/4 FF (all previous food eaten)
 
Re: 8/26 Leo AMPS 513 +2 440

Lisa,
Yes I definitely think most of the high numbers was due to bouncing. He did the same thing from the greens three nights ago, even with insulin given. With the depot present, even though you skipped, there was still some insulin in his system. It may have drained the shed some, but skipping didn't cause the high numbers all by itself.
Carl
 
Carl - makes sense. His curve today is overall high, but not unlike some of his earlier high cycles. Hopefully he won't break 500 on is PMPS, but we'll see.

AMPS 513
+2 440
+5 343
+7 370
+10 443
 
SS looks like it wasn't terrible, Jane,

PmPs 429
+5 323
Carl
 
Thanks for summarizing Carl -

Here's the rest of his PM

PMPS 429
+5 323
+10 353

I am happy to see he didn't spike by +10 - I fed 3 frozen meatsicles at PS instead of two. If he's following his trends, his AMPS may fall a tad, which would be wonderful!
 
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