9/24 Kismet PMPS 104, +1 148, +2 149,+3 141,+4 145, +5 125

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Courtney and Kismet

Courtney and Kismet

Member Since 2012
Good morning,

Kismet's AMPS was 68 this morning after not having a shot last night because of low BG#s. Does this mean we are officially OTJ? I am withholding his morning shot, is this the right thing to do? Or should I give a low dose? Here is the link to the thread I started yesterday in the "relaxed" forum.

Thanks,

Courtney and Kismet
 
Re: 9/24 Kismet AMPS 68 - Dose?

I am not an expert by any means, and your numbers look good , but its probably to early to tell if he is OTJ.

This forum prescribes a gradual 1/4 unit decrease - not stopping entirely as that can be too much for the pancreas to handle. They say drop by 1/4unit if his BG goes under 50. Anyway since you skipped the shot, I would do a few measurements through the day to see how he is trending.. Even if he is good today he might not be able to sustain it. Really it might be safer to put him back on 1.75units tonite and watch closely his nadirs. If he drops again under 50, reduce the dose again. The protocol is here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
 
Re: 9/24 Kismet AMPS 68 - Dose?

Hi Wendy,

Thanks for replying. I just tested again and got an 83 (roughly an hour after eating breakfast). Is it still too late to give an injection? I have to leave in an hour to go to work for a few hours, but hubby will be home and can keep an eye on him. He won't test him, though. Would you recommend that I go ahead and give 1u?
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

wait.
That's a low number for a newbie to shoot without guidance.

Didn't you want to keep your shot schedule as well? ( i could be remembering someone else)
I will get some attention for you from someone who can tell you whether or not to shoot.
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

Yep I agree - dont shoot. best now to wait till his pm shot and see where he is. Especially since you wont be home to test him. also the reason his blood may be higher is because you fed him. With low numbers best to wait on feeding and measure to see which way he is going naturally first. Food will mask that.

Also its time to train the hubbie how to test ;)
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

Hi guys .. I think this is the first time I've been in your condo so welcome from us .. those are some great looking numbers especially considering you missed last nights shot .. Best to be cautious since you won't be home to test .. have a great day guys!
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

I flagged Sienne and Marje to come give their input. Sienne is at work .
It may take all day but they will get here.

Just keep posting the test numbers.
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

Hi Wendy, Rhiannon, and Peter,

Ok, no shot this morning. I will be back home in a few hours and will continue to monitor him throughout the day. Hubby tries to help, but is nervous and has difficulty getting blood. It's proven stressful for both of them which is why he opts out. I will have him practice when I get home.

Rhiannon, we spoke a bit last night but I don't recall talking about shot schedule? I'm not sure I understand what you mean. Is that just shooting am and pm shots at same time every day?

Back soon,

Courtney and Kismet
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

yes. I am referring to the every 12 hr shot time.
I try to post in everyone's condo so it's easy for me to forget who works, who doesn't.
Some can not adjust their schedules because of work constraints so they can't stall or let their 12 hr shot times change very much ( not even 15 minutes) so
that's always a factor .
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

Hi Courtney

Sorry I wasn't on yet and I understand you need to get to work. Let me look at Kismet's SS and I'll brb.
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

Welcome to Lantus Land! I'm glad you found us.

Skipping was a wise choice. You don't yet have the data to support shooting this low of a number. It sure looks like the food change is working it's magic. I'm not recalling all of the details from your original posts on Health. Was Kismet sick -- any infection, pancreatitis, etc. -- at the time of diagnosis?
 
Re: 9/24 Kismet AMPS 68, +1 83 - Skipped Dose

Courtney

Back from looking at Kismet's SS. Thanks for getting that up so quickly and sorry I missed you last night. I'm glad you skipped this morning...and last night. That was the safe thing to do.

First...welcome to Lantus Land. We are a close-knit group and, as you have already seen, everyone is very generous with their time and willing to help.

Second...I don't think we're quite at an OTJ trial yet. He might get there quickly but we don't "usually" stop giving insulin at 2u with just a few green cycles under the belt. I'm not saying he won't surprise us but I think
we need to take it a step at a time and see what he does in the next few cycles.

In order to understand why I say that, you have to understand how lantus and levemir work. They are long-duration, depot insulins. Unlike ProZinc where the insulin goes in, the cat uses the insulin, and then the insulin is gone until the next shot, the "L" insulins have a cumulative effect so one shot builds upon the preceding one. When you give a shot of lantus, it forms a precipitate in the subcutaneous fat and then slow releases. This is the depot action. When you start using these insulins, it usually takes about six cycles (every cat is different...ECID) for the shots you are giving to fill the depot and then the cat starts to use the shots you give. When the depot gets overly full, numbers come down like you've seen the last two cycles. This informative post on Lantus and Levemir Insulin Depot will provide more info.

So when we are looking at low numbers, we have to consider that they are affected by the higher dose....in Kismet's case, 2u. So we know that 2u is too much for him. Normally, we would decrease the dose by .25u but I think even 1.75u might be too much for him.

I think the best course of action for now is for you to test him as soon as you get home and post his number. We'd also like to see a number about an hour before you normally shoot which would be +35 since it will have been that long since you last shot. If he's still running in green, we might step the dose way back to 1u or we may choose to have you not shoot for six cycles to drain his depot and see what he does on his own. So it will be important to see what he does today. He is slowly coming up and I do stress slowly....normally when cats get in those low numbers, they bounce back up. Paws crossed!

In the meantime, if you could let us know....was he on dry food or did the vet have any indication what caused his diabetes? Steroids? Illness? Bad teeth?

Thank you! And just post later with his updated numbers. Be sure you put in the subject line "Need dose advice" so we'll see it.

ETA: I just read the Health condo.....so he was on dry food AND steroids!! Good move to get him off both. Let's hope a little bit of insulin plus the diet change and taking away the steroids will get him into remission quickly.
 
Re: 9/24 Kismet AMPS 68, 83, 73 - Skipped Dose

HI Sienne and Marje, Thanks for your help! I've been told that both of you are the resident experts here and I really appreciate your warm welcome and all of your guidance as I learn more about DM.

Yes, Kismet's DM was an accidental diagnosis... he was being treated for "asthma" with prednisolone, theophylline, and flovent. When he was diagnosed with DM, his BG was at 480 and vet prescribed 3u bid and Hills Rx DRY. Fortunately I found this board and a new vet and we switched him to DM canned and stopped steroidal treatments. He has albuterol as a rescue inhaler.

I just got home (lunch break) and he is as 73!!! I thought he'd be much higher but it seems that he is going down. He is about 10 points lower than he was an hour after breakfast. I will continue to test and will check back here for advice when it gets closer to dose time.

Rhiannon, thanks for clarifying "shot schedule." Yes, we are on one. He get's fed at 9 am and 9 pm EST. My husband and I both teach night classes so that's why so late. Sometimes we do 10 and 10, but only if we are home late for some reason. We work at the same university and usually carpool.

Marje, thanks for explaining Lantus and the science behind the depots. I am hoping he is one of those rare ones who is a transient diabetic (the specialist suspects he may be) but I realize we are not in the clear yet. I will resume regularly scheduled testing and update here when I can.

Thank you all SO MUCH! I would be lost without your help and my baby would be in serious trouble! Loving these green numbers today :D

Edit: Just tested again and we've gone up 30 in an hour? +4 is 102 from +3 at 72. :/
 
Re: 9/24 Kismet AMPS 68, 83, 72, 102, 104 - Skipped AM Dose

Woohoo! Gotta love those numbers! :-D What time zone are you in? Everyone is in a different one so that's why we usually talk about + hours after the shot.

Could you modify your subject line of the original post at the very top to include the hours of the BG test? Something like this:
9/24 Kismet AMBG 68,+1 83,+4 72,+5 102,+8 104 - Skipped

The AMBG is AM Blood Glucose which means that you didn't give a shot, rather than AMPS = AM Pre-Shot. Then everyone can tell what's happened with Kismet throughout the cycle. Great job! Tell DH (Dear Husband) that I am the queasiest, least medically inclined person you will ever meet and I learned to test Zener. It gets easier with practice. :-D
Liz
 
Re: 9/24 Kismet AMBG 68,+1 83, +4 72, +5 102, +8 104

Hi Liz, thanks for the tip! I've changed the subject line to reflect the numbers. We are about 2 hours away from dinner time (end of 12 hour cycle). I will be coming back here with that number and advice on what to shoot and if to shoot so I will need someone's advice urgently. I am EST and will be feeding him dinner at 9pm so I will check in right before then with his PMBG number.

Hubby still isn't keen on the idea. He can't even figure out how to load the meter :roll: He tried to do it earlier and kept trying to insert them backwards. My meter has a short testing window once the strip has been inserted and he has prematurely inserted them and we've lost at least ten strips already. *sigh*
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +5-102, +8-104

Relion Prime.

111 @ +10.5 and 112 @ +11. I'm feeding him dinner in an hour. I will test him again PMBG. I'm afraid to shoot tonight with these numbers. I wouldn't shoot anything over 1u. I will be back in an hour with that number and for advice.

Any suggestions/guidance is appreciated!
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG-104, Advi

Hi everyone, I need advice on whether or not to shoot Kismet tonight and if I yes, what dose do I give? PMBG is 104 after a day of all greens and low blues.
He didn't get his PM shot last night or his AM shot today. He had been getting 2u but he dipped VERY low last night and I held off. His last insulin shot was yesterday morning at 9am.
We are now +36 since last shot.

To recap:

Yesterday 9/23
AMPS--117
+10----49
PMBG--47
PM+1---56
PM+3---54

Today 9/24
AMBG 68
+1----83
+4----72
+5----102
+8----104
+10---111
+11---112
PMBG-104

I tested PMBG 10 minutes early so I could get someone's advice before feeding.

Thanks!

Courtney and Kismet
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Send a pm to sienne and see what she thinks. Worst case you skip again till you hear back.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

I already pm'd Sienne.

This is a voluntary help site so sometimes people are doing other things , dinner, work, etc....
There can be times where you may be waiting a while for answers.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Thanks Rhiannon, I realize how busy everyone is and moreover how generous you all are with your time! Sorry for being so needy lol. I don't feel comfortable making these decisions by myself yet. Thanks for your patience :)
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Geez.... I wanted to eat dinner!

Actually, Marje and I were chatting. The good news is we both were of a single mind. How about dropping Kismet's dose to 1.0u?

My thinking is that there's a good chance that Kismet's a steroid-induced diabetic (with a fish allergy, if I recall correctly!!). I'm thinking that it makes sense to drop the dose so you can shoot twice a day.

I don't know that you're going to be at the 1.0u for long. If you're not comfortable with the 1.0u, you can essentially start over at a 0.5u dose and we can see where Kismet goes with it. It's easier on the nerves to raise the dose than chase them downward.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Thanks for answering Sienne, I'm sorry to bother you and interrupting your dinner.

I think I am going to start at .5. I want to be able to sleep tonight without fear he is going to go hypo. If he's really high tomorrow, maybe I will shoot 1u.
I won't ask for advice anymore. Thanks.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

You didn't interrupt!

Regardless of Kismet's numbers tomorrow, stick with the 0.5u dose. You don't want to keep shifting doses. Lantus really likes consistency. If you keep shifting around the dose, you usually get wonky numbers. You need to hold on to a dose to allow the depot to stabilize. Unless Kismet's numbers drop again, I'd stick with this dose for at least 3 days. Remember, dosing is based on the nadir, not on the pre-shot value.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Hi Courtney,

I am pretty new to all this as well. I just wanted to comment on your statement that you lost about 10 test strips because you didn't test quickly enough. I have the same meter as you do, and if you don't get the drop of blood on the strip before the meter turns off, just remove the test strip and reinsert it. As long as you didn't put any blood on it, the strip is still good and the meter will turn back on. Hope that helps!

Good luck! You have a lot of great people here to help you. They have been invaluable for me!
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Great idea to go with the 0.5u. I think that's a good choice. Sienne really was kidding - please do not hesitate to ask questions, even multiple times when you don't understand something. We all want to help Kismet and you and DH with this. And we all know how difficult it is. You might want to consider a different meter if this one shuts off so quickly. Also, you can change your username in the User Control panel somewhere.
Liz
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

I won't ask for advice anymore.
Click to expand...

I've been here for about 15 months. I've seen hundreds of people ask for advice. One or two only asked once. The rest come back for more. A lot of them stick around long enough and join those who have been answering questions for years.

I have never seen a question go unanswered, and I've never seen anyone go for more than an hour or two without their questions answered.

Don't ever stop asking for advice, help, hand-holding, whatever.

The people here sort of like it when people ask questions. ;-)

Carl
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Is the Prime like the Micro? Can you stick the strip into the opening, but just don't push it all the way in until you're ready? WIth the Micro, I could push it almost all the way in, poke Bob's ear, then push the strip the rest of the way in and wait for the beep. If you're worried about Kismet being impatient and not holding still while until the meter is ready, you can catch the drop of blood on your fingernail, let Kismet go, and then get the drop off your nail.

Carl
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Hi Courtney!

I'm sorry Sienne and I were both occupied.....I had to take Gracie to the vet and when I got home, we hadn't eaten all day so we ran out for a bite. But, as Sienne said, we
were talking about it while we both had dinner :lol:

If you shot the .5u, could you please post his PMPS? Then I'd like to ask you to get a +1 to start with and probably a +2 if you can. Because he still might be working on depot,
I think it is best to just snag a couple tests before you go to bed for the night.

And I agree 150% with Sienne....stick with the .5u until we see what he's going to do. We don't dose on PS....we dose on nadir with some consideration given to PS so it's important
that even if he is 300 at PS, you stick with the .5u, ok? I don't think he will be but just want to cover that base :-D

He did great today...you did great! And yes...it's all volunteer and we have our own diabetic cats so you sometimes might have a tiny wait but we do the best we can. The important
thing is to post and ask for advice like you did.....we encourage tons of questions.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Courtney, people are volunteering on this forum because they really care about cats, including your cat. They want to help your cat into remission using their experience.. So keep posting and asking.

Also if you are asking the questions chances are there are other newbies out there who also want to know the answer so you are helping everyone!!
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Sienne is wonderful and has given me some of the best advice! I'm just having a bad day and really don't want to be a bother to anyone. This has been an emotional rollercoaster... really feeling the lack of control and feeling a bit helpless. I don't want to be "that person" that asks stupid questions every five minutes or comes across as demanding.I realize how generous all of your are with your time and wisdom and I am really indebted to this board. I hope my gratitude translates. I'm trying to learn as quickly as I can and don't want to be an inconvenience to anyone, but still find that I have a lot of questions.
Marje, first pmps +1 is 148 :)

Liz, I realized that after I lost the first ten :lol: I had tried reinsterting several of the strips and kept getting error messages. Weird. It accepts them now if I reinstert. I find that I have to lay the meter flat while it's calculating or I'm much more likely to get an error message. Have you also experienced this or is it just my meter?

Carl, I've also picked up on the trick! I insert just the tip and push it in on my knee when I'm ready.

Wendy and Cindy, thanks for your notes :)

Thank you everyone, for your support and encouragement. I really do appreciate it!
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

WHAT? Sienne and Marje do eat? REALLY? I thought they spent all their time poking cats or dragging us all out of the mud.... o:-)

I LOVE how you're handling these numbers AND that Kismet is throwing them at you!!! Happy nail biting, grinnin' Dance!

BIG HUG!!
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Squeaky and KT said:
WHAT? Sienne and Marje do eat? REALLY? I thought they spent all their time poking cats or dragging us all out of the mud..
Click to expand...

:lol: that's what we'd like you all to think :lol:

Nice +1!

(((Courtney))) ...you are not going to ask stupid questions because if its something you need to know, then it is the right question. Ask away....it's a steep learning curve and we are here for you. We've all felt the same way in the early days...overwhelmed...roller coaster...the whole thing. You wouldn't believe the number of questions I asked :razz: :razz:

Up for a +2? I want to be sure he is not going to come back down when he onsets. Thank you!
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

((( Lyresa and Marje!)))

Just got the +2 a few minutes ago ---149. I left his bowl down a bit longer tonight. He's a bit weary of me from all the poking today and ran from his dinner bowl after I gave him his injection. I only took it up about 15 minutes ago so I'm not sure how this might affect these readings. I will get a +3 before bed.


Today 9/24
AMBG 68
+1----83
+4----72
+5----102
+8----104
+10---111
+11---112
PMPS-104 - shot .5u
+1----148
+2----149
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

A housekeeping detail...

Can you keep your subject line reasonably up to date with your test numbers? We scan the board and having the test info visible helps us to spot where there's something we may want to check on.
 
Re: 9/24 Kismet AMBG 68,+1-83, +4-72, +8-104, PMBG104 ADVICE

Nice surf!!

Did you see Sienne's post? If you can please update the subject line with your PMPS and tests since, we'd really appreciate it. As we are helping, we are constantly scanning numbers so if we see one that seems out of place, we can pop in.

Thank you! Will you be up for a +5 or can you get up?
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

Hi Marje, I got the +4 but am fading fast. DH would not stand for an alarm going off (he has to get up early) so I don't think I will be getting a +5 tonight. He's surfing right now and sleeping happily at the foot of the bed. (Kismet, not DH!) Exhaustion interferes with pronoun usage.

Good night and thanks!
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

Thanks for updating the subject line.

Can you set your cell phone to vibrate? That's what we do so it doesn't disturb the person sleeping.

He has a great surf going...I think if you can't get up, he will be ok but if you can...a test in a couple hours would be good. You don't have to get on and post unless he drops but just a test to let you know he's safe.

If you get a low number in the morning, don't feed...post and ask for help. Dyana is on early and then Sienne comes on a bit later.

Ni Ni.
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

I will try vibrating phone, but DH is light sleeper (I have to type very lightly!)

Just in case no one's on the board in the morning and his numbers are low, shall I go ahead and feed and skip dose? I have to go out for a few hours in the afternoon and won't be able to test. I should be able to get +1 +2 +3 before I go and should be back in time for +7. Can you give recommendation for ballpark numbers for when to skip and when to dose?
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

It depends on whether he's coming up or going down...or surfing.

If you are alone and there is no one to help...which would be unusual, I wouldn't shoot any number less than what you've shot. If you get a +1, +2, +3, you should know where he's headed. You can always leave out HC food for him.
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

Thanks Marje! Looks like I am going to get that +5 after all.

Hi Jane! Thanks very much for the welcome! I just read your profile -- wow! I have such respect for rescuers! You sound like you have a full house with lots of wonderful little personalities. I wish I could afford to adopt more... maybe once Kismet is OTJ and my bank account recovers a bit :D
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

Courtney and Kismet said:
Hi Jane! Thanks very much for the welcome! I just read your profile -- wow! I have such respect for rescuers! You sound like you have a full house with lots of wonderful little personalities. I wish I could afford to adopt more... maybe once Kismet is OTJ and my bank account recovers a bit :D
Click to expand...

Aww, shucks, Ma'am :mrgreen: Thanks! Glad you liked it! Yup, full house down here in Africa, but that's the way we like it :lol:

How long until that (+5)? Kismet sure has had a lovely surf going!
Hugs
Jane
 
Re: 9/24 Kismet PMPS 104, +1 148, +2 149, +3 141, +4 145

Courtney

Jane is going to be your cruise hostess now :-D She is just waking up to a beautiful day in South Africa and will have fresh eyes to guide you...including the morning when you need to shoot.

You did super...get some rest. See you tomorrow! Ni Ni.
 
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