Boy 5/4 AMPS 183! 105 +4, 268 PMPS..Uh Oh

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pixiegirls & Boy

pixiegirls & Boy

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Another good AMPS of 183. I did check him last night after PMPS +5 he was 105. He did have a snack then too. I gave him ~0.25u/U40 this morning and a little less than that last night. I am really liking these numbers....especially since he hasn't been lower than 75.

I think that the 0.25u dose is really helping. Will have to keep monitoring to see whether or not he needs the dose lowered even more. I am wondering though, at low doses and decent numbers, what am I looking for to show a need for further reduction?

Hoping to switch my new box of U40's for U100's today. That will help with these micro doses.

Boy has been looking better, a lot more energy (too much sometimes, lol), and back to his incessant grooming, and eyes are even looking clearer (for as clear as they can look with an early glaucoma cloudiness). I also cut down the amount of food I give him at AM/PM feeding. Since he has been snacking with ~ 1 oz. of food between meals, I may have been giving him too much at mealtime and that was the one of the reasons he was leaving food in the bowl.
 
Re: Boy 5/4 AMPS 183!

I can "hear" the confidence in your voice. You are getting the hang of this and Boy is doing well. Always good when they go back to normal playing and grooming.

Let's see what others think. I would be inclined to stick with .25 unless you get a number in the 40-50 range. Once he gets used to the .25 dose, he may throw lower numbers. Or not. I imagine you have figured out this is not an exact science. Even if we had an instruction book for the insulin, every cat metabolizes it differently.......
 
Re: Boy 5/4 AMPS 183!

So that there aren't multiple posts, I am responding to Sue's post from 5/3 here.
Re: Boy...AMPS 163, 5/2 PMPS 280, +5 = 75, +6=98, PMPS=183!

by Sue and Oliver (GA) » Fri May 04, 2012 1:57 pm
It certainly can work to just stop. Carl and I both did that - mostly because we hadn't heard of mini dosing. (we both had kitties who were diabetic before treatments got so "sophisticated") But you do run the risk of his body moving back up into shootable numbers and then starting a do over.

Mini dosing is stressful, absolutely. You are shooting tiny doses but at low numbers. It takes time and lots of monitoring. But usually only a week or two and you are done.

Your choice. We will promise to be here, sweating bullets with you, if you decide to minindose.

nagging here. Much easier for us to keep track of you if you start a new thread each day,with the subject line whatever is happening that day.
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Sue, Carl did mention that to me yesterday. To be honest, sure, I'd rather not have to prick him more than he needs. He's already starting to give me a hard time if I have to prick more than once. For some reason, even with the massaging ear and using rice sock, I don't always get enough blood for the test....even with the OT Ultra2 I've been using recently. I certainly don't want to start stressing him out so that his BG rises and I get an inaccurate result. We were doing great getting samples for awhile, but lately it's off and on. One ear definitely is a better source for a sample than the other.

I suppose either way.....stopping or mini-dosing will both require some sort of "trial" period. I'll just go along with where he is for now until it's time to figure out which way to go and then see what others think.
 
Re: Boy 5/4 AMPS 183!

What size lancet? Sometimes you need 25-27 gauge to get a big enough hole. And you can also quickly double poke - a quick second poke in the same spot.
 
Re: Boy 5/4 AMPS 183!

lol....yes, Sue, I guess I feel like I'm finally getting the hang of things. If Boy was a person instead of a cat....I'd have been cool with that...had training and experience from nursing and relatives with diabetes, but a cat....a whole other ball game, rofl. But really it's just getting used to something you didn't know previously.

Would dropping to the 40's-50's be typical on this low of a dose? Hmm, guess so. You're right, all depends on the individual cat's metabolism and whether or not their body has adapted. So far, he hasn't gone below 53, and seems like that happens shortly after a dose change...so yeah, I'll have to watch for that. He now has had 3 doses of the 0.25u, so if he's gonna drop, it would probably be about now.
Ultimately, I'd like to keep his numbers consistent, just a little lower than the 160-180 for AM/PM PS. One day at a time! :-D
 
Re: Boy 5/4 AMPS 183!

I'm using a 26 gauge. I realized that was part of the issue before in getting a decent sample....had been using the 30 and 33 gauge that came with the monitors (another "duh" moment, lol). I will try the double poke method though....I have restuck close to original poke and sometimes same hole, but after I saw what I could get from just one poke. I know that the "sweet spot" is the best area to get a sample, but how far outside of that range would still get a good sample without causing damage? I've also just hit the vein when the first couple of sticks didn't work and he was getting pissy (didn't want the hg to rise from that) and even that didn't always give me something good.
 
Re: Boy 5/4 AMPS 183!

Here's the sweetspot picture: Where to poke We poked on the edge of the ear, just above the fold, a little lower than the picture suggests. Sometimes one ear bleeds better than the other.
 
Re: Boy 5/4 AMPS 183!

Okay. I have that pic, and another image showing sweet spot, looking at it again, maybe I've been going more towards the bottom of the sweet spot....I'll have to try a little higher. Thanks!
 
Re: Boy 5/4 AMPS 183! 105 +4

Boy's +4 glucose was 105. No big drop!

Sue, I think I may have found the better way of getting blood from Boy. I had only used the outside of the ear before once, but tried it again and bingo.....got blood. Easier to see his veins from the fur side anyway. Going to go grab some neosporin w/ pain relief so it beads up better with the fur there. Might help with him getting antsy too, lol. dancing_cat
 
Re: Boy 5/4 AMPS 183! 105 +4

Anywhere along the entire edge of the ear can work, as long as you are between the vein and the edge. From what I experienced and what I've read other people say, if you hit the vein directly, you can get a higher reading. The meters are calibrated to read capillary blood rather than venal blood. The key though is letting the blood get sipped up the strip rather than being flooded by sticking directly in the drop of blood.

Has anyone detailed the "test, feed, wait an hour, test again, etc" procedure you can try when you get a number you aren't comfortable shooting into yet?

Boy's numbers are low enough where you might want to try that to see what happens.

Carl
 
Re: Boy 5/4 AMPS 183! 105 +4

Thanks Carl. I didn't want to go too far down the ear. Makes it tough to rotate sites. I think I've hit the vein 2-3 times, but still sipped up from the edge. I'm going to try the outside again tonight to see if that works well again. It's also easier holding Boy and his ear that way.

Has anyone detailed the "test, feed, wait an hour, test again, etc" procedure you can try when you get a number you aren't comfortable shooting into yet?
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No, so far his PMPS numbers haven't been too low to shoot. I think a BG of 160 was mentioned as a good no shoot number for Boy, but I can see he might be heading towards that. He's been close at 162. Testing him that way does sound like a good idea. I would just give him insulin at some point if he needed it then?
 
Re: Boy 5/4 AMPS 183! 105 +4

Yes.
You test him, and let's say you get a 150. So you feed him, wait an hour, and test him again. You would expect a higher number from the food. Then you test him again 30-60 minutes later. What you hope to see is a number that has fallen or held steady since +1. That would be him trying to self-regulate. If you don't see the decrease, but instead see an increase, then you know his BG is rising, and you can shoot the tiny dose at that point. Once he crosses your "line in the sand", you can give him just a tiny bit of insulin.
Now, that just screwed your "schedule" all up, assuming he needs another shot later that day or night. But, in most cases, you would end up going through the same "wait and stall" process 12 hours after you gave that shot. And that is exactly what you hope happens. You hope that Boy will screw up your schedule for a couple of days and nights in a row! Because that would mean that he's just about to kick the insulin habit, and you would be able to take off your dancing shoes in the immediate future.

Carl
 
Re: Boy 5/4 AMPS 183! 105 +4

It makes sense to me! I think I like that better than continuous or longer period of mini dosing. Does it not matter a whole lot what the bg is after eating, or just really waiting to see what the bg is post food? Also, if the bg at say 30 mins is still not what you were looking for, do you wait the 60 mins since he could be metabolizing differently.....any max period to keep testing to make sure it isn't still the food keeping the bg up? How often does testing need to be done at that point if still all under 160 (my no shoot)? Isn't that big of a deal messing up my schedule....do that enough on my own.

It's definitely worth a try. He's getting close to being under the 160 mark for both AM and PM pre shot too.
 
Re: Boy 5/4 AMPS 183! 105 +4

Also, if the bg at say 30 mins is still not what you were looking for, do you wait the 60 mins since he could be metabolizing differently.....any max period to keep testing to make sure it isn't still the food keeping the bg up? How often does testing need to be done at that point if still all under 160 (my no shoot)?
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Of course, the ECID disclaimer takes precedent.
But I guess I think about it from a "kitty isn't diabetic" standpoint, where I believe all this stuff just happens instinctively. I am guessing that the food goes in, kitty starts to digest it, turns it into glucose. Pancreas secretes insulin automatically, causing the cell walls to become more receptive to absorbing glucose, so it goes from the bloodstream to where it belongs, and the BG just goes up and back down pretty fast.
Now, with a diabetic but healing kitty, I am guessing that there is a "lag" in there. Where the BG stays in the blood longer until the insulin he produces triggers the absorbtion.
So the theory is that in the first hour or so after eating, you see that BG in the blood, and then in the next hour, you see it start to go down. It may happen slower or faster than that. But the key is the baseline number you establish with the pre-food test. If it's 150, you might see it go up to 200 maybe and then fall back down to 180, then further down to 150 or even lower. As far as a timeline goes, I would think that most of the food is done making the BG rise in 3-4 hours. And most of the rise probably happens right off the bat in the first hour or so. So any drop you see after that in the first 3 hours, say, I would think it has to be the pancreas doing what nature intended for it to do - regulating BG.
They must, however, still get some sort of "boost" from food later in the cycle, because otherwise, why would their BG continue to rise after nadir? What's pushing it up once the insulin wears off? Mid-cycle meals, maybe? I don't know.
There are a couple of beans (Cathy comes to mind most recently) whose spreadsheets should show you the "no insulin let's see what happens" experiments that they did when they were close to going OTJ. I'll see if I can get her to give some input on this thread....

Carl
 
Re: Boy 5/4 AMPS 183! 105 +4

I just checked Cathy's SS sheet. That looked great. Thanks. Saw where the last shot was....right around where Boy is now. Looks like she was reducing insulin down until she was only using 0.1....and can see where she had to give some skinny 0.1 after a rise. Then once off the bg's really went down and I didn't see where any insulin was needed.

I know the carbohydrates are metabolized first, then proteins, then fat to maintain energy, so I guess even an hour, hour and a half max should no longer be food that wasn't already broken down. Off insulin, their bodies will establish their own metabolizing patterns again too. Can only monitor and see.

Great info though.....I appreciate it!

Lori
 
Bummer....Boy's PMPS was 268....he had been doing so well. Guess I have to expect some quirky numbers at times. I'm going to try and just give him the 0.25u tonight and see how it goes instead of raising the dose again. Was able to get a great sample though!
 
I think sticking with the dose is a good idea, and this is just a wonky number. Only he knows why, but he was probably reading over your shoulder earlier when you were thinking about test/feed/don't shoot, and he figured this would be an awesome practical joke!

Carl
 
rofl!! You know....there may be something to that. He was sitting with me when I was typing some things. Buy I wouldn't be surprised. Apparently he knows the word "vet" too. Went to take him one day, and bolted up the stairs to hide under the bed. All day he'd come up and come when I called him. He didn't see the crate, nothing.....just "knew".

I did give the 0.25...figured if I changed the dose I might only be messing up what was working well for him. He was pissy when I went to get the bg....kept trying to bolt again...treat or no treat. I know stress can make bgs go up, but can't imagine going up that far that fast. I even used the neosporin. Might have just been in a funky mood and his bg matched!
 
Good morning -

A couple of things...

First, the needles. At this point, with your mini-dosing, I would NOT get the U40 needles. Too hard to gauge the doses accurately. U100s allow you to be WAY more accurate. If you're near a Walmart, you can buy the U100s w/ the half-dose markings by the bag of 10 (if you want to give them a try - about $1.80 if I remember correctly), or by the box of 100 (~$13). MAKE SURE before you check out, that they're the right needles, as they won't be returnable! Th number on my box of ReliOn 3/10 mL 31 gauge 8 mm short needles is 81131-0311-78.

Secoond point, the "Sweet spot". I've often referred to grayson as "my little Turnip" as he's not a bleeder either. I have gotten blood from just about the entire perimeter of his right ear. Typically I do better down near the bottom, just above the double flap. When I was first struggling to find a good spot, someone told me they go to the tip of the ear (he REALLY didn't like that!). And the distance in from the edge, sometimes I go as much as 1/4" in. When they don't bleed well, you gotta do what you can to find blood. That's what it took for me!

Looks like you're on the road we'd all like to be on! Consider yourself blessed, and ride the wave! You're one of the lucky ones! Good luck!
 
Morning Lu ~

With the needles.....I have a couple left of the U40 and a whole new box (unopened) that I will try and exchange with the vet for U100. I agree....not at easy to use the U40's with mini dosing. Until I can do the switch Monday, might as well use up the 4 or so syringes I have left. I don't think when I bought them in April that neither the vet I thought he would need to be using the U100.

Boy was also not happy with sticks closer towards the tip.....understandably with the increased amount of nerve endings. So far, the last 3-4 bg tests I've done I used the neosporin w/ pain relief, then poked on the fur side. Each one so far has been good. I think he's still a little miffed at me for the multi pokes I've been having to do and wasn't even cooperating sitting in my lap. He's always been pretty good with just about anything that the vet, or I have had to do to him. I think after a couple more quick and one poke bg tests, he'll calm down again for them. Sure the neosporin helps too. But it is true....gotta so what we gotta do to get some blood. Hopefully we found a way that will be more consistent.

I do feel lucky....and blessed he is doing so well. Would be great to see all of the kitties doing well, and sometimes hard to grasp why some do well, others take longer, and some not as well, but we'll probably never know the answer to that.
 
Hi again, will give a little now from phone and more later from computer. You may want to start fattening or skinning up your .25 depending on PS, if amps is yellow too you might need a tad more, like to see green every cycle at this point.

the food test is as Carl says. For the test if you get a PS that is too low to shoot, or since you shoot pretty low maybe below 170, feed a small meal and test in one hour. You're hoping not to see a food spike, the number should hold for the first hour and maybe even drop in 2 hours.at this point it is best to break food into 6-8 small meals, and you just keep testing and feeding until the p poops out and you have to give a little insulin to help.can be a little screwy because you may have to shoot at off times but this doesn't last long. Look up Holly and Josie for another good example
 
Hi Cathy,

I did use a fat 0.25u last night for PMPS, then just normal 0.25 today since he was only at 203. I did also start with the smaller meals more often. He had been leaving food in his bowl anyway. Although with this change, the other 2 kitties have to adjust too, but haven't had any problems. Who knows....maybe smaller, frequent meals can prevent them from ever getting diabetes.
 
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