Aug 12 - Reuben AMPS/382, +9/295

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Alexa and Reuben

Alexa and Reuben

Member Since 2012
Aug 11 - viewtopic.php?f=9&t=76917

I've been shooting at midnight/noon (it just worked out that way when we started ohmygod_smile ), and want change it to 9am/9pm. I am going to shoot an hour early this morning, and test at +3,+6, and +9 (this is my goal). I would like to shoot an hour earlier again in the evening, if it is safe.

Regarding the ketone testing strips of any kind at all, I have contacted the hospital pharmacies and they say they don`t have any. This is so strange! My glucose meter does measure ketones - if one has the ketone test strips - which I don`t. Again, no one has these either. Tomorrow I will contact the distributor and ask if it is possible to buy them directly.

My Reuben is eating and drinking well, not as much as before (he was sometimes eating as much as 3 times normal amounts before), I assume because the glucose level is dropping (slowly :smile: ).

We are feeling happy and hopeful for the moment, with the +9/295 reading this morning :smile:
 
I wouldn't shoot an hour early twice in one day. Lantus works by building up overlap between doses (meaning that the effects of one dose are not yet completely gone when the next dose starts working). Shooting early can create extra overlap. Shooting that early twice in a row can create a LOT of overlap. Sometimes you can use that to your advantage, because it almost certainly will make the numbers come down, but you don't have enough data to do that yet. We've seen it happen where the numbers come down TOO much or too fast and it's hard to regain control. You don't want to lose control...

If Reuben is 295 now (+9), then you can get the +11 test. If he is in the pink then, it should be ok to shoot an hour early. If he is rising from the 295 then that will mean that the bulk of the insulin's action is finished for that cycle and he will just continue to rise for the rest of the cycle. But then I would NOT do that again tonight. Maybe try 1/2 hour early tomorrow morning, then another 1/2 hour Tuesday morning, etc. If he is very high then shooting an hour early some of those times might be ok. You can always post for advice if you're not sure.

It's odd that the pharmacies don't have ketone strips! You should be able to find them online.
 
Libby,

Hi. How much should Reuben be rising at +11 -- for instance how many points should the next test be Over 295 for her to shoot early?

Thanks, Libby. I'm going to go and take care of my cat now, Alexa. Libby's here for a while I hope if you have any other questions, right? I have a lot to do this morning, and I won't be able to help anyone else.

Have a good day.
 
Shooting an hour early this morning was fine. I would wait to see what Reuben's numbers look like later in the cycle before making ANY decision about when to shoot tonight. You've also got to be able to test if you shoot early. An early shot acts like a dose increase so it's important that you are able to monitor. Given how late you're shooting and Reuben hasn't yet always been cooperative with testing, you may want to leave the PM shot time at 12 hours from when you shot this morning. Let's see where his numbers are at around +10.
 
oh, ok, you already DID shoot an hour early this morning? I thought you were asking, not telling. :lol: I was looking at the 295 as the most recent test and giving suggestions based on what I would do if he is higher at the next test.

If you already shot an hour early this morning, then I wouldn't do it again on the next shot. Maybe tomorrow, but that will depend on what his data shows today.
 
I haven`t shot early yet. I just did the +11 test and it was 477. (!) Is this 'normal''?

I will never shoot early at night, since I can`t test after it. Thank you for straightening me out on that, ohmygod_smile

I'll get the shot ready right now to shoot early, and will check in before I do, just in case there is any reason not to.
 
go for it. He is plenty high. Then get whatever data you can get today so we can see what he is doing with the dose and the early shot. Hopefully shooting early will help pull him back down.
 
bribery for testing? Yep, that's a great trick. People used to be amazed that I would say "pokey time!" to Lucy and she would chirp and bounce off to the bathroom, which was her testing spot. Every time I went to the bathroom, she would get excited and pester me to death until I gave her a treat (but we had to poke before she got a treat). After she went OTJ, it took months before I could get her to stop wanting tests all the time. :lol: Then when I got Jazzy and she was the one getting tested, sometimes Lucy would barge in and shove Jazzy out of the way so she could get poked instead. Cats love routines, even if the routine is a little ouchy.
 
Haha, that`s a cute story! And a really hopeful one too! :smile:

I bribe him for the shot too. He is so addicted to tuna that i just put some down and let him indulge while I look for some skin under the fur to shoot into. Otherwise he won`t let me do it!

I had just given him .5 ml metaclopramide when I took the +11 reading - now that I think of it -, and I wonder if that might have helped drive his number up. It tastes very sweet to me... just a thought. Anyway, we'll know more in a while; I`ll test at +3.

Thanks so much for being here for us this morning!



　 ／l、
ﾞ（ﾟ､ ｡ ７
　l、ﾞ ~ヽ
　じしf_, )ノ
 
Is the metaclopramide a liquid? A lot of the liquid medications has a syrup base because the drug itself is bitter. For some reason, vets seem to be clueless that they are giving a diabetic cat a sugary liqid. Are you able to pill Reuben? If so, metaclopramide comes in pill form.
 
Yes, the metaclopramide is liquid. And it`s not hard to give him pills; I will ask at the pharmacy if they have them. I take nothing for granted anymore, after the whole ketone testing strip situation!
 
congratulations! you've made great progress testing reuben! it will become easier as time goes on.

i can't blame you for wanting to change his shot times from 12am/12pm and happy to see you shot an hour early this morning. like libby said, you *might* be able to shoot an hour early again tomorrow if he's rising at the morning shot time... and if you're available to monitor. generally speaking, you don't want to shoot early twice in one day.

you're doing so well with reuben! :mrgreen:
 
Check with the pharmacist or your vet to make sure the dosage is the same. The dose in milligrams may not be the same as in milliliters (or cc's).
 
thanks jill! you guys are making it possible.. :mrgreen:

and thank you sienna for the heads up about checking the metaclopramide dosage. i will make sure it is right.

QUESTION!! It is time to do the +3 reading, but he is sleeping so soundly on a nice full stomach right now - (he has been uncomfortable and not always sleeping deeply lately) - that I want to know what you guys think about healing sleep vs much needed information about how he is reacting to the insulin. Would a +4 reading be acceptable information?

Thank you!
 
max&emmasmommie said:
Libby,

Hi. How much should Reuben be rising at +11 -- for instance how many points should the next test be Over 295 for her to shoot early?
Click to expand...

there is no magic number of points to be seen when wanting to shoot early.

generally speaking, until a caregiver has collected enough data to be able to predict their cat's response to food and insulin in the coming cycle (note: some kitties never become predictable), we don't suggest shooting early unless kitty is traveling in very high numbers OR unless we're seeing blood glucose numbers zoom upwards towards the end of the cycle.

once a caregiver "knows thy cat"... knows their response to the combination of insulin and food... and can predict what their cat will do... shooting an hour or two early becomes less about high numbers than it becomes understanding acquired knowledge. for example, i'll often shoot alex on any numbers over 50 anywhere between 30 minutes to 2 hours early because i can *usually* count on her well earned reputation for horrendous food spikes (eg. - a small piece of freeze dried chicken can boost her numbers 30 or more points depending on where she is in the cycle). however, shooting early *can* backfire on even the most experienced caregivers from time to time. monitoring closely is a must.

also, a series of well thought out early shots is sometimes used as a tool to help bring a cat down from consistently high numbers. personally, i don't recommend this method unless the caregiver can monitor closely and is working very, very closely with an experienced caregiver... someone who fully understands the action of the insulin used, has the ability to interpret the data, and has used the method themselves.

bottom line, shooting early is much like shooting an increased dose. it's not a practice to be taken lightly and is best done under supervision.
 
reuben'smom said:
QUESTION!! It is time to do the +3 reading, but he is sleeping so soundly on a nice full stomach right now - (he has been uncomfortable and not always sleeping deeply lately) - that I want to know what you guys think about healing sleep vs much needed information about how he is reacting to the insulin. Would a +4 reading be acceptable information?
Click to expand...
waiting until +4 to test should be fine today.

eventually reuben will hardly notice if you test him while he's sleeping. alex barely acknowledges testing when she's sleeping. she'll often open her eyes for a moment and then go right back to sleep. however, i'm always careful to let her know i'm there to test her because i don't want to startle her.

i wouldn't be concerned about waking him when you think testing is important. if he's tired, he'll go right back to sleep. :mrgreen:
 
thanks guys :smile:

well, he woke up on his own to pee (a major activity) so I took the +3 reading. it was 410 (down from 477 AMPS).

I am concerned that he is so upset when i do the reading that he pees in the burrito towel, and then when i am done he just lies in my arms for about 10 minutes, in the towel even, if i don`t take him out. He`s not purring, but he`s not asleep, he is just lying there. he responds a little to me but basically it reminds me of if i were really sick and so weak i just didn`t have the energy to move. then eventually he just gets up and jumps down like nothing happened. have you ever heard of anything like this? silly cat!! confused_cat they need an icon for 'confused mommy' hahaa, so i just put the confused cat :-)
 
Gosh the numbers are high today... making me nervous! nailbite_smile It is possible that i mis-shot and he got no insulin? Would his numbers go down and back up like this if I did? I`m sorry if I am asking something that I should know...

AMPS 477
+3 410
+6 354
+9 459
 
Are you able to test Reuben without burrito wrapping him? It sounds like he's very stressed by being wrapped.

It takes 5 - 7 days for the Lantus depot to form. Until the depot is in place, a little bit of what you're shooting goes to the depot. Unlike other insulin Lantus doesn't grab BG and yank it down. It's unlikely you would see as much of a drop as you did if you gave a fur shot.
 
Please don't be worried that you "should" know something, especially at this stage, for heaven's sake. There are no stupid questions, either. I have never had anyone say that I should not have asked or I "should have learned this by now" (even if it was true ;-) )
 
sienna, he hasn`t let me test him without being wrapped yet - i'll see what i can do to hurry that along. poor baby! :cry:
i am happy to know that i am injecting successfully... as i was feeling really badly thinking that i hadn`t. the numbers still look 'scary' to me though...but it looks like maybe i can shoot early again tomorrow. i`ll ask advice about it in the morning.

maxandemma'smommy - thank you for saying that :-)
 
The good news is that he just let me test him without the towel wrap!! Yeay! thank you for encouraging us Sienna :-)

The 'bad' news is that his BG is over 500. The meter doesn`t give a reading above 500, it just says 'HI'. What should I put on the spreadsheet?
 
Fur Shot???

oh nooo, i think i just gave my first fur shot. i don`t know how.. but there is a wet spot that smells like medicine where i shot... (i can not WAIT for the AMPS/PMPS times to not be when I am so tired... argh) what do i do now? i remember that i read that i can`t re-shoot because it is impossible to know if any went in him or not. with the pre-shot reading of over 500 i am quite upset...
 
It's Alexa, right? Jane here - Hello!

Sorry about your furshot. They just happen - don't beat yourself up over it, k? Many of us have done them. They're unfortunate, but then, so are those stringy bits on bananas :mrgreen: Move on from it.

One good thing is that if Reuben's numbers this cycle seem to confirm what you're quite sure about - that you didn't get all or even any insulin into him, and ended up doing a furshot - you're probably safe to move up your shot time again by more than the normally recommended time, so you can get close to the shot time you want. Let's see how this cycle goes, and then we'll be able to assess the early-shooting question towards the end of the cycle, ok?

Breathe. You're doing fine!
Jane
 
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