8/3 Bear pmps 509

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kldanzi

Member Since 2010
Hello!
First of all, thank you to everyone who has been so helpful to me! It feels so good to know you are supporting me!

I have a few questions that I hope someone can help me with:

#1. I am taking everyone's advice and starting Bear's insulin "over" with 1.0u injections twice a day, 12 hours apart. How many times should I check his BG in the next few days? He's pretty irritated from the 5+ pricks he endured tonight.

#2. I have a vacation planned for Sept. 4 - 12. This seems to be inconveniently smack dab in the middle of adjusting his insulin. How bad would it be to leave him at whatever level we've gotten to while I'm away?

#3. Can I prefill syringes for when I am on vacation so that someone can just come over and give him a shot and feed him? I saw that it is not recommended to do this with Lantis.

#4. Will it be okay for him not to have his BG tested during this time? I know I can get someone to give him his insulin but using the meter is another story.
 
Re: 8/2 Bear PMPS HIGH *Starting Over Question*

Hi good morning

I'm not sure what time it is for you, are you near the AMPS (+12) time?

How is Bear doing this morning? I see u caught a late in the cycle green over nite!

Post when you have your AMPS ok?

We will try to get to your questions thru the day.

First one, at least a couple of spotchecks per cycle would be good. However, if numbers are dropping, you may have to re-test a bit more frequent.
The ears will get use to it, so don't give in if you think you are hurting him and bugging him. It is important to get more numbers sometimes, you'll need them to know he is in a safe range.
Offer some treats (low carb of course) or a little nibble of hi wet food.
 
Re: 8/2 Bear PMPS HIGH *Starting Over Question*

kidanzi & Bear said:
#1. I am taking everyone's advice and starting Bear's insulin "over" with 1.0u injections twice a day, 12 hours apart. How many times should I check his BG in the next few days? He's pretty irritated from the 5+ pricks he endured tonight.
I'm glad you're starting over with the dose. Be aware that there may be a little bit of shed action that will influence today. There is no "recommended" amount of testing. The bare minimum is testing before each shot and at least one additional time during the morning and evening cycles. We strongly encourage a "before bed" test. That said, if you look at Gabby's SS or Luna's, you'll see that both Ronnie and I test a fair amount. In part, how often you test depends on your cat and how quickly you want to accumulate data. Testing frequently also means that you can catch low numbers the way you did last night.

#2. I have a vacation planned for Sept. 4 - 12. This seems to be inconveniently smack dab in the middle of adjusting his insulin. How bad would it be to leave him at whatever level we've gotten to while I'm away?
Usually, when you are away from home and someone else will be administering insulin, we reduce the dose to a safe level. This is under the assumption that there will only be someone around to test at shot time. If you will be leaving Bear in the care of someone who will test as often as you will be testing, then it may be fine to leave the dose where it's at. Again, if you look at Gabby's SS, you see gray blocks where there's no testing and the dose is reduced. It's when I'm out of town.

#3. Can I prefill syringes for when I am on vacation so that someone can just come over and give him a shot and feed him? I saw that it is not recommended to do this with Lantis.
Nope. You can't pre-fill syringes. There is a coating on the inside of the syringe that will degrade the insulin. There is a link to an article about pre-filling in the Lantus care sticky.

#4. Will it be okay for him not to have his BG tested during this time? I know I can get someone to give him his insulin but using the meter is another story.
It's not optimal but it's possible. I have a vet tech who is a feline specialist who cat sits. Gabby will not allow her to test. Gabby starts growling if she even thinks about picking up a lancet. It was touch and go for a while with her even shooting. I'm not thrilled about shooting blind but it's the only alternative and, as I noted above, the dose is reduced in order to keep Gabby safe.
 
Re: 8/2 Bear PMPS HIGH *Starting Over Question*

Just a couple things to mention first.
Keep all your posts and questions in one thread for the day.
Also you can start tomorrow's post with a link to this post. That way people can read back to know the history.
viewtopic.php?f=9&t=21403
viewtopic.php?f=28&t=21404
viewtopic.php?f=9&t=21394

Also, if you can edit your first post in this thread to change the date to read 8/3, people will know it is a current thread for today.

Now, to answer your questions:

1. It's up to you how frequently you test and Bear WILL get used to it and bleed better and you will not need to test near as often later. Once you know when his nadir is - around +5 or so - and when he starts to register his latest shot - around +3 or so - you will have a good idea how he is doing. If you wanted, maybe tests every 3 hrs would be good and give you an idea how he's doing.
+3 can give you an idea if he is already starting to come down.
+6 can give you an idea of how low he is going in a cycle.
+9 can let you know if he's still dropping or on the way up again.

2. vacation in a month? Nice! Don't worry about dose until you get a week or so from your departure. For all you know, Bear could become a diet controlled kitty by then! Now how nice would THAT be!! Seriously, it is impossible to know what dose to give in a month because you have still not found his perfect dose. All we have found is that he has been getting waay too much.
Let's take it a day at a time, watch him closely for his improvement and adjust his dose as needed. Then in the last week of August, you will have a much better idea what needs doing.

3. NO. Do not prefill the syringes for shots days ahead. There are plenty of other options, such as show the person how to fill syringe and give shots before you leave. Or others get a vet tech or someone knowledgeable to come in to test and give the shots. Others will have more suggestions for you on this question.

4. Again, it is best to wait to see how Bear is doing. I am not sure I understand how people would be OK to give shots but not ok with a poke on an ear tip; I think I would be ok to poke the ear but needles would have made me uneasy. I bet if you have a person in mind, you can show them how ... after all, look at you!
I suppose no testing is done, you were not testing before and at a high dose, so I am sure at a reduced dose in your absence may be ok in certain circumstances.
In this area, many others will have more decent info for you.
 
Re: 8/2 Bear PMPS HIGH *Starting Over Question*

Looking for an update for this morning's AMPS!

Post when you can - inquiring minds wanna know! :razz:
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

Hi everyone.... First of all, Bear is okay, sorry for freaking out! Apparently I stayed up waaaay too late last night reading this stuff and totally fell back asleep after my alarm so I didn't get to test this morning because I was late for work!! BF gave him 3.0u this morning and I just got home so I'll be testing in a second... let you know!!
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

3.0u at 8:30AM.
+8 HIGH
(Did I post this right?)
Ugh. We're back to "HIGH".
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

yup it's posted right...I'm a little concerned where the HI is coming from without the preshot AMPS number.

Out of all the testing - we really really encourage preshot numbers, we have no idea where Bear went after last nite's +8 that you caught.

But let's see what others say ok? It'll work out, just hang in there.

Can I ask why not the 1u this morning?

Were you able to pick up a box ketones strips? If you can soon ok?
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

Boyfriend is a little stubborn and got scared to back him all the way down to 1.0u and I was flying out the door.... He did it after I left. I just taught him to prick the ear and use the meter so hopefully that won't happen again.

I need to get a shower before I can go out in public to get the ketones strips so that is my next task today. (I'm a cook and I sweat all morning.) Too bad I just missed a perfect opportunity- Bear peed on the floor.
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

Getting DBF and spouses on board to test really helps! I hope you are successful with him taking this on, plus it would be a huge relief for you.
Trust me - I know!

Oh-oh - on peeing on the floor, does Bear do that often?
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

Peeing on floor often, yes. Mostly if we leave clothes or blankets on the floor. We have to keep every single door in the house shut at all times.
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

Ronnie is being very nice. I'm going to be the police. It is imperative that you get pre-shot tests. You have no idea if Bear was at a 75 at AMPS and frankly, you do not yet have the data to shoot a low number. You cannot assume anything until you have enough test data to be able to make an educated guess as to how Bear is responding.

If you want to shoot 3 units, that's your call. I do think it's quite possible that Bear is chronically rebounding (high numbers that are triggered by bounces from low numbers). The only way to get him to a dose that makes sense is to start over low. And, you have to get mid-cycle spot checks in order to see what's happening. The "high" reading is a result of the 69 last night.
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

I am guessing that Bear went quite low and then his shot caused him to bounce HIGH because of it.

Take a rubber ball and bounce it as hard as you can onto the floor .... what happens? That ball just FLIES HIGH. That's what likely happened with Bear. What you want to happen is to take that ball and toss it lightly so that the bounces are more like a roll, like a skimming a rock along a water's surface, with little fluctuation of numbers.

His body has likely been used to having high numbers so long that when you give insulin and lower his BG, his body says WHOA this is wrong! and he bounces back to his 'comfort zone'. He will need to learn what the right numbers are and that will take some time.

I know how it feels to go all the way back to 1u, especially when you are seeing high numbers, but it's very important to start things right. You want to be feeding low carb and stick to the new dose of 1u at 830am/830pm, and try to get as many tests as you can. Remember the more you test, the more you know what is happening to Bear. Once you have an idea what is happening, you can adjust his dose.

If you test him every 2hrs for example, and you see that his numbers are staying high and flat, maybe in 300s or 400s, then he may need more than 1u.
On the other hand, if you do the same tests, but see him test very low around+5 or so, maybe around 100 or lower, and he rises way up to a HI at the next pre-shot, you know that you may need to give Bear less insulin.

It's very important to do some testing to find out just what is happening with Bear after the dose you give. if you look at his spreadsheet now, can you tell which of the two scenarios happened today? Nope. And that's why we test. I guess you could say that Bear's spreadsheet is similar to a scratch and win lottery card LOL.

No need to worry now about no pre-shot test this morn, or the dose at 3.0 instead of 1.0; you can get some tests now, and also before the pm shot, and you can lower to the 1.0 tonite if you like.

When you want to post a test number, you can also make a change to your first post again to edit and change the starting over question to be something like "+10 300"

Good luck tonite and be sure to post the result you get when you test with the ketostix.
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

Better the 3.0 than the full 7.0. It's very good that you'll be testing. I'm relieved to hear that Bear is ok. What State/Time zone are you in? (I may have missed that.)
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

We live in the US, Pennsylvania. Oh man, Eastern Standard Time I think? I got the tests and now that I want him to pee he is just staring at me!! Of course!
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

kldanzi said:
We live in the US, Pennsylvania. Oh man, Eastern Standard Time I think? I got the tests and now that I want him to pee he is just staring at me!! Of course!
Me, too. : )
 
Re: 8/3 Bear PMPS HIGH *Starting Over Question*

One thing to remember is that while we would all like instant consistent results...diabetes doesn't work that way. Bear's body has gotten 'used' to the high numbers- so when he drops down so much his body panics and 'bounces' him back up. If I remember correctly from my reading it can take up to 72 hours for things to normalize again.

SO... start with the 1 unit- give it 5-7 days with testing and see where it takes you. It could very easily be too low for him, but look at the numbers you started with...another week isn't going to make that big of a difference in the grand scheme of things. It is better to start low and work your way up than have to big of a dose and hypo or bounce sky high constantly.

I know it is a lot to take in- it took me awhile to get my routine going but now waking up and checking BG is just as important as brushing my teeth and putting on my shoes before I run out the door to work. ;-) You'll get the hang of it all soon!
 
Haha, I didn't even manage to get my shoes on before I ran out the door today!

Just wanted to say that I did the ketones test and it came up neg! Hooray!
 
yea for Neg Ketones!

I know you got a lot of information to digest and you are probably a little loopy from all the reading and stuff. No one expects you to "get it" overnight. It took me a while to understand it. You are getting really really good advise and I hope that you feel comfortable with following it.

I'll let others guide you since they know more than I do, but I will be checking in on you guys.

Oh, btw...I'm from Pittsburgh, PA...what part of PA are you in?
 
Hi Kidanzi, You are on the right track now, so stick with your new testing/dosing strategy for the next 7 days, as you have been advised to do, and then we'll take it from there. Don't panic when you see those high numbers. Just follow directions. Lantus likes consistency. It takes time for it to work well. So be patient. Everyone here wants you to have a healthy cat. Hang in there!

Ella & Stu

p.s. Stu wants Bear to know that he went through exactly the same dosing fiasco (dose way too high) and that now he feels really good because he is following the protocol.
 
Sounds about right, dinner will have pushed his blood sugar up. You should start seeing the numbers lower in the next hour or two.
 
hi there,

glad to hear you got a ketones check, and great to hear it came back negative.

Just wondering how today is going with the 1u re-start.

Open a new thread when you get a chance to check in ok?
 
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