a successesful pmps and a question

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IloveLarry

IloveLarry

Member Since 2014
tonight i was able to get the preshot, and then stabbed myself, ouch! so the good news is that i got itm and his bg is only 280, never been that low so far, at shot time.
any thoughts on what to do about tonights shot? he is due now, and gets 3 units of N.
 
Can you monitor in 3-4 hours? If so, you could give 1.5 maybe? Two would be a little agressive, but possible.

It is a lot easier to start lower and raise as you get numbers, then to start high and have to guess how much to lessen the dose. What would you think about starting over at one unit, get the numbers and raise as needed?
 
let me look at the spreadsheet - hang on ...

How late can you stay up?
If you decide to shoot 3 units, have your hypo kit ready in case the glucose goes too low.
It may be prudent to lower the dose to 2 units so you might be safe to go to sleep.

Better too high for a day, than too low for a moment.
 
thank u both. i am so sleep deprived, i dont feel i can stay awake or awaken either in 3 or 4 hrs. so i better go low. i guess i should do 1.5. dont want to take chances. i didnt realize high for a day was much more preferable.
also, its not often i am able to get the blood sample, so i dont want to risk not getting the next sample, and him go hypo.
still learning!
 
I agree, lower the dose for this PM shot tonight. You simply do not have enough test data, to know how low Larry will go with this 280 BG on 3 units.

If you are really tired, and can't stay up much tonight, I'd lower the dose to 1.5U.

If you can stay up a bit to monitor, then you might try no more than the 2U.

It's best to be a bit cautious at this point, especially with the Novolin N insulin you are using.
 
thats a thought... starting low, and starting over. i just thought there were a lot of dangers with it getting/staying high, also. i will have to decide in the morning as i am so exhausted.
i think its a miracle i got the sample and found out what i needed to know from u all. may have saved his life.
i knew he was acting diff. the times he tested a lot higher, he was just laying around acting more lazy. tonight he is perky and so frisky. he attacked my arm! he feels like a new cat for sure :)
 
ok i shot 1.5 to be safe. now, its always possible, i may not be able to sleep. if so, i can test him again, if i am awake :) if i had listened to the vet, and kept him on 5u, and/or not found this board...i could have lost him, tonight, or b4. thank u all SO SO much. i can barely keep my eyes open. thank God i sat there long enough and got a sample, and u all were here to help. cant thank u enuf! hugs.
 
yes sue!
i am still sitting here, due to adrenaline i think. that was a close call i think! ohmygod_smile
my intuition, and the fact he ate less on free feed today, tipped me off. now tonight, he didnt finish his canned food. that has NVR ever happened! its still sitting there! i think hes eating altogether maybe half what he did 3 wks. ago. thats a big deal!
any thoughts on the morning? if i cant get the preshot, especially?
and can any1 tell me where that chart is with units to give based on bg? thanks.
 
Once you get some more data, you'll be able to look back and figure out what his dose did at that number before and whether you'd keep it the same or lower or add. (there isn't a chart for dosing with N)

Re the morning. If he is under 200, wait 20 minutes without feeding and retest. If he is rising and up to 200, either reduce the dose a smidge or stay with the dose, IF you can monitor.

Depending on how the 1.5 worked, you might consider doing a do over and start at one unit in the morning?.
 
There isn't a chart with dosing data. The chart we refer to, is your own SS that you have created for your cat. Based on the pre-shots and the other testing you are doing, you can get some idea of how your cat reacts to the insulin.


ETA: putting things in large text due to Larry's mom have visual issues.
 
ok. IF i cannot get an amps then i think i should only give 1 U? just based on what ur all saying? and not taking chances? i can decide in the morning, but i was afraid to go down that low with what little info i have, unless u all think it best? thank u for the bigger type! and whats ETA? i forget? (memory issues as well)
 
Well, we are just going to plan on your getting a number. :mrgreen: I don't know what to say, if you don't get a test in. It seems like Larry is gradually going down. It may be that one unit won't be enough, but yes, it would be safe.
 
If you can't get an AMPS tomorrow, then the 1U would be safer. Without that pre-shot test, we just can be sure that any amount would be safe.

Perhaps, you can explain your technique for testing, and we can make some suggestions to give you better success.

Here are a couple of thoughts for you on the testing.
1. heating the ear to get the blood flowing
2. two pokes close together, to get a bigger drop to form
3. treats, always give a little treat
4. 3 tries and stop. So Larry doesn't get too annoyed and you don't get too frustrated. Try again later.

ETA means Edited To Add
 
1 more question friends. if i get a amps and its 400 or greater (as it was the 2 nights b4 tongiht. tonight was a shock) any thoughts on whether i should go back to the 3 U? or just drop down to 1 U still?

and i will do my best to answer all those questions u asked on my technique tomorrow. thanks for understanding.
 
I wouldn't go back to 3 units. I wonder if the food and insulin are starting to work together and his insulin needs are decreasing Maybe 2 units if you get a high number?
 
i think so, bc as i said he did not eat much dry food today. he was literally waiting on me to bring him the canned food, and when i waited until i got his preshot instead, he finally caved and ate some dry. so then when he got the wet food, he left a tiny bit. its still there! as i said, in all his life, he has nvr left a drop behind.
i bet the fact he held back on the nightly meal of dry food until the last minute made the difference, bc last night he was at 450 an hr. b4 his shot.
 
so, since i am still up, i unsucessfully tried another test. his ears r now red all over, kinda like a sunburn. is this ok/normal? they also r staying warmer since i have started testing. theyre quite warm right now. they r rarely cold anymore. i hope that is ok?
the biggest issue is i cant fiure out how to use the lancet bc the lancet guard hole is bigger than that tiny milimeter of a spot we aim for. how do u all do it? (how do u line it up with the guard on? i am using the clear guard.) for those who use the lancet? our lives would be bliss and i could test many times a day if i culd figure that out. i am terrible freehand, or wiithout the guard bc i have to use a lot of pressure, or i dont get him stuck at all.
hes super frisky! evn attacked me, playing, which he hasnt done in yrs. (gotta cut those nails. he pierced me some. paybacks r hell. haha)
goodnight all. see u tomorrow. hugs.
 
:YMSIGH: :( tried my best this morning but larry is so hungry and anxious for food in the mornings. he wouldnt be still. plus his ears r still red all over and very warm. he does not want them touched. he acts ok, so i am torn between 1U, .5 and skipping the shot?
i am so frustrated, and couldnt sleep last night for worry. :(
his ears must really hurt. is it normal that they r warm and red? after a few tests?
if any1 is here, i would appreciate ur thoughts/suggestions
feeling lousy :?
 
also, he did not free feed overnight much, once again. he held out for the canned food. ate it happily and quickly.
 
1. Be sure to use a fresh lancet each session you poke
2. put the Neosporin with pain relief on the ears after, wiping off any excess
3. after the poke, press down on the ear gently to stop the flow of blood and help it to clot
4. bath his ears with a wet washcloth, cool water only.

What do you think about giving him just a tiny bit of food like a teaspoon or two, to take the edge off his hunger, test, then give him more food?

Larry only wants to eat the good stuff, huh! ;-) You can leave some canned food out overnight for Larry to eat. I know it might be hard with all the other kitties in your home.
 
deb he is getting worse about having his ears touched. i do everything u said. he is just very upset about me touching his ears. maybe i hurt him? did u see me say theyre red and warm? is that normal? if i could afford to leave food out i gladly would. plus, without testing, i dont want a drastic diet change. i cant do a total diet change until i can monitor. have been going slowly so he wont crash.
i just dont know what to do abt this mornings shot?
 
Are you testing in the same spot, or going up and down the edge, above the fold? Any place along there is okay.

I am very reluctant to tell you to shoot, as his insulin needs seem to be decreasing. How about feeding him, waiting an hour and a half and trying another test. Then based on that number, giving insulin?

How is he about having his feet touched? You can paw test.
 
sue, now that i know there is more leeway, i will go lower. i do usually aim at the sweetspot because he folds his ears and its hard to get to the bottom. can only reach the higher up usually.
so he had 1.5 U last night and is 370 amps.
 
it is after food. ok, thanks! i may try the paw later.
i was supposed to go to a dinner tonight. i desperately need a break, but am afraid to leave him, until things get more stable.
 
so after all day of trying every couple hrs. getting either nothing, or 3 times getting TINY drops that just ruined the strip, and didnt register, we got a bg reading. at approximately 8+ larry is at 415 bg :( he received 2 U of N this morning. now i am unsure if lowering him to 2U is a good idea.
at least i know u all said high is better than low. its about 3 hrs. until his next shot now.
at this rate, we will go thru strips, and lancets fast! i had no idea how quickly they go. i try really hard not to let one get wasted.
 
Hard to know what went on. He could have dropped low and bounced or it could be 2 units wasn't enough.

I know you can really go though strips, but the more tests, the easier the puzzle of Larry is to figure out. These early days are all about gathering data, see what this dose does at this number, does this dose make it better or worse?

You are also dealing with N, which is a short acting insulin, so we can't be sure whether it is wearing out before the next preshot or whether the dose is too low.

The only sure thing I see is that 3 units was too high a dose because you got a yellow at +12, 4 hours after the N would normally wear off. Long cycles often mean a dose that is too high. So I wouldn't go back up to 3 units.

The more information (numbers) you can give us, the better advice we can give you. But we realize it's hard in the beginning - you're just learning how, Larry's ears haven't toughened up. So both of us have to be patient, and we will give you the best advice we can in the meantime.
 
thank u very much. appreciate the help and patience of every1. plz know i am so so so tired, so if i forget and ask u something twice or get confused, plz forgive me. also still learning. :)
we appreciate u!
Larrybug and me :)
 
new question. larry doesnt look right to me. i am thinking his sugar is climbing...going to test again. with N is there a # where i would need to give his shot early? and what would the number be?
like how high is a 911?
 
It isn't the glucose level we're most concerned about. It is ketones.

When there isn't enough insulin and the food can't be used for fuel, fat is broken down for energy. A by-product of this breakdown are ketones. Urine ketone testing is very important while you are working on testing and adjusting the dose. You can get the strips at many pharmacies, though they could be behind the pharmacy counter. Two of the 3 kinds of ketones have distinctive odor - like nail polish remover (acetone) or a fruity smell.

An additional issue with the fat breakdown is that it moves the liver, causing it to swell. This squeezes closed the bile ducts which carry bile to the digestive tract. Without bile to help digestion, it gets so deranged the cat can become very ill and die.
 
ok. i can do 2.5. wasnt able to get blood ths time. if i do 2.5 now, am i covered until morning on the shots?
i need sleep desperately. i need to do w/e is best for him that will enable me to go to bed soon (get up laterifi wake up) bc i am getting to where i cant evn comprehend what u all r telling me.
 
ok 2.5 and feed as usual? well, he s already eating his dry, now. then when do i need to be up to either test or shoot again?
yes ketones tmrw! thanks bj
 
We need to talk about diet tomorrow. :-D gotta get rid of all the dry. I think you are safe sleeping all night. Of you are worried, leave some food out for him
 
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