Cashew AMPS ~331.53, PMPS ~ 102.70, + 1 326.13

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cashewsmomma

cashewsmomma

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Hi Everyone,

One of the members suggested I post on here for further guidance, I am hoping someone can shed some light on a strange drop (and quick rise) in Cashew's bg levels this weekend.

He was diagnosed on Feb 28/10 and is currently on 3 units of Lantus in AM and 3 units in PM. He recently lost some weight but I feel the past week or so he has gained this back. He behaves the same, isn't as docile as he used to be when he was a baby but I think he is learning to defend/speak up for himself (just something I have noticed over time).

His water intake has gone down as far as I have noticed...his waste although ranges. The day his bg was low he had hardly used the litter box. I have noticed soft stool twice already (once today and once on April 9th)...I am sorry if this is TMI but I think it is related to where I am going here.

4/10 @ 0600 AMPS ~18.2 mmol/L or 331.53 mg/dl - fed him 1 1/3 of canned wet food and gave 3 unit shot
4/10 @ 1800 PMPS ~ 5.7 mmol/L or 102.70 mg/dl - fed him a bit more than the usual 1 1/3 wet food, some kibble and skipped insulin shot entirely
04/10 @ 1900 ~18.1 mmol/L or 326.13 mg/dl
04/10 @ 2100 ~ 18.3 mmol/L or 329. 73 mg/dl

On Sunday, we were scheduled for a curve so here are the results:
04/11@0600 AMPS ~19.4 mmol/L or 349.55, fed him 1 1/3 wet food and gave 3 units shot
04/11@0900 ~ 19.1 mmol/L or 344.14
04/11@1100 ~ 18.9 mmol/L or 340.54
04/11@1300 ~ 17.1mmol/L or 308.11
04/11@1420 ~ 18.9 mmol/L or 340.54
04/11@1620 ~18.6 mmol/L or 335.13
04/11@1800 PMPS ~ 18.2 mmol/L or 327.93, fed him 1 1/3 wet food and gave 3 unit shot
04/11 @2330 ~17.1 mmol/L or 308.11

And, today:
04/12 @0600 AMPS ~16.9 mmol/L or 304.50, fed him 1/1/3 wet food and gave 3 unit shot
04/12@1810 ~17.4 mmol/L or 313.53, fed him 1 1/3 wet food and gave 3 unit shot
04/12 @2200 ~17.0 mmol/L or 306.30

He was put on an all wetfood diet as of April 1st. Every time we increase his dose, it looks like it goes up (low 20's) and stays there for a good number of days (3-5). I can see that he is not happy during this time and had started peeing on our sofa downstairs. I have added a 2nd litter box which remedied this situation (PHEW!)

I know that bg can go up when increased insulin dose but what could be the reason in that drastic drop? We try to keep him off kitchen limits but he managed to find his way into a small packet of jam Friday night (April 9)...

I speak to his vet tomorrow and for some reason and am leaning towards a decrease in dose. I am not experienced in this at all but for some reason I think Cashew is doing a lot better than his blood sugar is showing us...

Sorry for the long winded message! It does feel reassuring I can let all this out to those who will understand what on earth I am speaking about!

aah ok, time to turn laptop off and cuddle with cashew.

NidaXcashew ~O)
 
Hi Nida and welcome to Lantus Land.

Have you started keeping a spreadsheet? If so, could you provide the link? If not, you may want to take a look at the spreadsheets that we use. It's a great way to consolidate all of the test data you're gathering. The info is in the Tech Forum.

Nida & Cashew said:
fed him a bit more than the usual 1 1/3 wet food, some kibble
Click to expand...
1-1/3 of what kind of food (and do you know if it's high or low carb) and what is the amount -- cans, ounces, tablespoons? Are you feeding dry food consistently or did you do this to raise Cashew's numbers on 4/10? If the latter, you may want to consider using high carb canned food. The dry stuff takes a while to work and it takes even longer to get out of the system. The canned food works quickly to raise numbers and is metabolized far more quickly.

It's hard to know where one number is coming from. It's possible that Cashew's nadir was late in the cycle that day. It may have been a wonky meter reading. With several meters if you don't have enough blood, you get a false reading vs. an error code. I'm inclined to think this was a meter issue since the next two readings were more consistent with what you are usually seeing as BG results.

Could you tell us how you got to the 3.0u dose? What dose was Cashew started at? Importantly, what was Cashew's dose at the time you shifted him to wet food? Did you see any change in his numbers around the time you changed to wet food? When you were increasing the dose, how much additional insulin were you adding to the dose? This information is helpful in trying to determine whether an optimal dose was missed.

It's important to know if you are feeding low carb (LC) food. If you transitioned over from dry food to LC canned, you should have seen a drop in BG numbers if you were home testing. If you weren't testing at the time, your instinct to reduce Cashew's dose may be on target.
 
Welcome to Lantus Land!

If you can collect more data over the next few days, that will be very helpful in seeing what is going on.

My opinion is that he went low that day, and that the 102 was already on the way back up. He went straight up fast from there, and is not unusual for them to hang out in the higher numbers for several days after they have gone lower than they are used to. If that is what happened, we will likely see more lower numbers tomorrow or the next day. I do want to add that 102 is NOT too low at all, it's nothing to be scared of, but it would be a good idea to do some more testing so we'll know exactly how low he is going.

Meter error is definitely another possibility, but again, collecting data the next few days will help make that clear.

Sienne's questions are important, so please do answer them when you have a chance. Thanks!
 
Hi again,

Please find Cashew's SS attached...I hope it works!

I did not see a huge drop since I put him on wet food, today his sugar level was 16.2 mmol/L...I just think that he is either not responding as much to the insulin or there is too much insulin inside of him....what do you think?

i hope the ss helps, sorry the template on the forum here didn't work so I had to copy paste from what I keep at home.
 
I hate to say this given the work that you've put in, but it will help us enormously if you can use the SS template. The color coding gives a much better visual of what's going on and the organizational format is one that is in common to the Board. Take a look at Gabby's SS so you have a sense of what I'm talking about. I also realize this is geocentrically biased, but the majority of us don't use mmol/L - we use mg/dL (i.e., US numbers for BG test results). You are welcome to post both since we are an international group but the majority of the members will not be able to convert your entire SS to US units. If you need help and post in mmol/L, we will not be able to respond quickly since we will be busily multiplying numbers in order to know what you're talking about.
 
I see you made it over here - that's great - you will get a lot more help.

Another reason why it's so important to use the SS template is it's easier to see what's going on if people use hours (ie: +2, +4, etc.) instead of times. If you post times then people have to calculate what hour you are referring to and it's just too much work. You'll get the hang of it and it will be easier for you too!

We'd like to see a picture of Cashew too!
 
Hey hey,

I know, i know i just am not good with technical stuff and spread sheets so need to dedicate sometime to transfer it all over...Cashew's my babe is a handsome one....hope the attachment came through.

I will hopefully figure out how to use the template that transfers mmol/L to mg/dl sometime tonight.

Thanks again! I had a dream cashew was better.
xo
 

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Awww what a cutie!!! :)

You will get used to the whole multiply by 18 thing.. I think in world units.. my meter is in world units, I talk to her doctor in world units.. and everyone here talks in US units.. too bad it's not a terribly useful skill to have :).
 
If you can make a SS.. and give me a link to the actual editable doc.. I can request permission to edit it and fill in the numbers you have so far.. at some point tonight after I'm done work if you like.
 
Aww Dawn! you're a sweetheart, I can't do that to you - too much work!! I promise to take sometime tonight and sort it out...just when I get home from work the last thing I want to look at is the computer screen cat(2)_steam

hmmm still waiting for vet to call me nailbite_smile
 
I spend a good chunk of my life staring at those spreadsheets.. you'd be surprised how little time it would take.. plus like I explained.. you have to do all the grunt work first anyways of setting it up :).
 
Dawn-

I've got some Excel spreadsheets to do here for work - can I send them over to you to type up????
:lol:
Just kidding.
It is very nice of you to offer to help!!!
 
Traci and Boomer said:
I've got some Excel spreadsheets to do here for work - can I send them over to you to type up????
Click to expand...

For a fee.. I charge based on a 30wpm typing speed by the hour..and I type over 90 ;).
 
hi again!

Is there a spreadsheet that would take both mmol/L and mg/dl? the one on the forum doesn't work and I hate to think I am going to have to keep track of two logs instead of one...please let me know..i am trying to enter all the data now then have to convert units...will keep you posted.

x.
 
Hi Nida
Welcome to Lantus.
I understand the issues with creating the ss.
I am in Canada so we also use mmol.
Have a look at Max's ss.
You will see at the bottom that I have 2 tabs.
One is Us and the other is Canadian (the US divided by 18) which I did the formulas.
Also, it might be easier to leave off the decimals.

You might not know us very well yet but if you are offered help, as Dawn did, it is from
the heart. You will ask many questions over time and that is okay.
That is what the board is here for.
Getting the ss up and running is key for the help you will need here.

Cashew is very very handsome. So glad to meet you.
 
Hi Nida. I just stopped in to say "Welcome to Lantus Land" :-D
Cashew is a very handsome boy. You will get lots of help here, and you have come to the right place, for support and guidance. The group as a whole has a wealth of experience to share, and very very kind people to help you through this.
 
Thank you, thank you, thank you!! Cashew's vet clinic say Cashew is the awesomest cat and me the cat nurse but YOU GUYS ROCK!

I have been plugging away and converting the doses, unfortunately I will have to add a 2nd tab later and just carry on adding doses on as of tomorrow (?)

If anyone has the time, could you please take a look at what I have right now and see what you think? Dawn, I wouldn't mind some help with more conversions *teehee* :o

To answer Sienne's questions and a quick recap, Cashew (6 years) was started on 1 unit of Lantus, he has maintained his appetite and was started on 1-2 cans of the Medcal canned food I get from the Vets and 1/4 - 1/2 cup of the dry food per day. I eventually switched this to all wet food on March 30 (started using 141 g of Halo wet food and 1/3 of Vet's)...cashew absolutely loved the halo products but I wasn't seeing a decrease in his numbers and occasionally an increase so I freaked out thinking the fruits and veggies are adding to his sugar level.

I slowly weaned him off of Halo and have stuck to the Medcal wet food (1 1/3 can each meal) only to realize that the persistent high numbers were probably because his body was adjusting to the increased PM dose...On April 1 when I saw the huge AMPS score I flipped out and the vet advised I pay attention to trends instead of worrying about an oddly high number. She also pointed out that she noticed a bigger gap between AMPS and PMPS when switched to wet food...this is when we increased his PM shot by 1 unit. This gap seems to have decreased over time (?)

Anyway, since the strange drop on Saturday I am feeling more and more positive that Cashew is taking more insulin than he needs (although I am not as educated or experienced in this)...his vet is a doll and entire team call and check up on him but have not responded to my recent blood curve submission today (seemed like there was an emergency at the clinic today)..

Other than that, he is an indoor cat, his lifestyle is not super-active but we try to play games. He tends to jump on kitchen counters (for which I got SSsscat) so he has gotten a bite of human food on several occasions but I don't think this caused I huge drop/increase in his bg levels but other than his diet is controlled as much as possible...eeeek! I hope this helps for now...

thanks guys xoxo
 
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