AMPS = 465

[Melissa and Celle]

Was the increase too much? Too soon to say? I shot 1.25 again this morning on the theory of not changing things based on one reading, but I'm not sure that was the right thing to do.

 

[pamela and tigger]

Was the increase too much? Too soon to say? I shot 1.25 again this morning on the theory of not changing things based on one reading, but I'm not sure that was the right thing to do.

I think the consensus on the Health thread you started was that 1 unit was not enough and to try 1.5 units. I am afraid with this infection that things need to be stepped up a little. I know you are trying not to go past the 'ideal' dose, and you may have to back down on the dose later, but I think with the infection you need to be careful about her not having enough insulin.

I know even without an infection I would be increasing Tigger's dose with these numbers.

How is she feeling, acting? Is she eating well?

Hopefully you were able to get some spot checks in today and after tonight's shot as well.

 

[Melissa and Celle]

Celle's eating well, and she seems to be OK. Maybe a little off, but nothing that I would really even think about if not for these numbers.

I couldn't get any spot checks today, but PMPS = 311. So good news there. (Yes, a 311 is good news these days.)

I am afraid with this infection that things need to be stepped up a little. I know you are trying not to go past the 'ideal' dose, and you may have to back down on the dose later, but I think with the infection you need to be careful about her not having enough insulin.

I know even without an infection I would be increasing Tigger's dose with these numbers.

You're right, I'm just hesitant to increase too fast because we had such a hard time detecting when the dose was too high. The 465 this morning was unusually high, but otherwise her values even with the infection haven't been that unusual (I hate to say), so it's hard to see why the infection alone should be reason to increase faster than normal (normal being a little slower than the Tilly protocol based on when we can get enough readings). I guess because the infection creates additional concern about the high numbers?

My inclination now is to see if we can stay on 1.25 until Friday when I can get some spot checks in at +7 to +12 and then evaluate another increase to 1.5 from there. Presumably the antibiotic might start making a difference soon. It was 48 hours ago that she got her first dose.

 

[Vicky & Gandalf (GA) & Murrlin]

Celle's eating well, and she seems to be OK. Maybe a little off, but nothing that I would really even think about if not for these numbers.

I couldn't get any spot checks today, but PMPS = 311. So good news there. (Yes, a 311 is good news these days.)

That is excellent! When making a dose increase or any change for that matter, there is often a higher than normal BG response. No one really knows why that is, but most of us have seen it and no not to be overly concerned. But it's hard when you're just starting out and anything over 400 seems frightening.

I am afraid with this infection that things need to be stepped up a little. I know you are trying not to go past the 'ideal' dose, and you may have to back down on the dose later, but I think with the infection you need to be careful about her not having enough insulin.

I know even without an infection I would be increasing Tigger's dose with these numbers.

You're right, I'm just hesitant to increase too fast because we had such a hard time detecting when the dose was too high. The 465 this morning was unusually high, but otherwise her values even with the infection haven't been that unusual (I hate to say), so it's hard to see why the infection alone should be reason to increase faster than normal (normal being a little slower than the Tilly protocol based on when we can get enough readings). I guess because the infection creates additional concern about the high numbers?

Yes the infection does create concern. Infection changes the whole ball game, so to speak. We look at BG values differently then, because they are partly due to the insulin's inability to overcome the effects of the infection. Levemir does not handle the resulting higher numbers from infection well, I don't think any insulin does.

My inclination now is to see if we can stay on 1.25 until Friday when I can get some spot checks in at +7 to +12 and then evaluate another increase to 1.5 from there. Presumably the antibiotic might start making a difference soon. It was 48 hours ago that she got her first dose.

With getting the 311 tonight, that seems reasonable to stay at 1.25U until you can get more BGs throughout a cycle. Have you been able to get some ketone test strips? That's more important than a curve right now. Although if you are able to get up once at night and test too, that might be reassuring for you.

You're learning a lot - many times people new to FD have to learn faster than they would prefer to! I appreciate that you ask questions and want to know if what you did was best. You'll get there, this is just a detour for the time being. :thumbup

 

[Melissa and Celle]

Thanks for the help again!

Have you been able to get some ketone test strips? That's more important than a curve right now.

Can you recommend what to get? How often do you test? I've been avoiding this on the theory that I don't know what I'd do if she did have ketones. I just don't want to go the route of hospitalization unless it's pretty near certain they could help her.

 

[Vicky & Gandalf (GA) & Murrlin]

Sure, Wal-Mart sells Reli-On brand ketone strips. You may have to ask for them at the pharmacy counter or have someone get them out of a case. You want just the ones for ketones, not ketone + urine glucose. you're home testing, the glucose part isn't necessary.

I know the feeling of avoiding finding out about ketones. Unfortunately you would need to take her to the vet because ketones can turn serious very fast and the sooner they are caught and resolved, the less expensive treatment would be and the better the outcome. Since you've had her diagnosed with an infection, they would be able to treat the ketones quickly because they would know the cause, instead of having to treat the ketones plus having to figure out what kind of infection she had that caused the ketones. Does that make sense? So don't be worried. Since she's eating well, she probably is fine, but better safe than, well, you know.

There are quite a few tricks and tips to getting clean urine that you can test with the strips once you get them. One of my favorites was covering the litter with plastic wrap! If Celle isnt much of a digger that works well, but some cats would notice it and not want to walk on it.

One of the easiest tricks is to empty the litter pan - cats will often go without any litter because that's where they are used to doing their business. Others put in a small layer of fish tank gravel instead of litter because the gravel won't affect the urine test and wouldn't absorb the pee.

Hope that gives you some ideas. Others can even take a large spoon or ladle and hold it under the cat to catch the pee, but that takes a calm cat and a steady hand, also the luck of catching the cat in the box!

 

[Sheila & Beau GA & Jeddie GA]

You can get ketostiks at any pharmacy - they are usually in a case or behind the counter with other diabetic supplies.

I used to follow Beau into the bathroom and stick the strip in his urine stream. He always pees facing in (the back of the box) and once they start peeing they can't stop... :roll: . You can also sometimes shoo them out the second they are done and dip if there is enough to form a puddle that takes a few seconds to soak in. Both Jeddie and one of my females almost always stands up as they pee and pees on the side of the box (it has a lid) so there are drips running down that are enough to test also.