Charlie pmps 508 +1/522, +2/555, +3/595 :/

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EllieKozak

EllieKozak

Member Since 2014
Hello all. I hope I did the right thing by increasing him to 7 u with an amps of 462. He again seems to be feeling good. Neg ketones and eating well.
 
Re: Charlie amps 462 increased to 7 u and 1 u r

Hi Ellie!

I keep thinking about Charlie's acro test result - I've never seen a result like "4." Was the test done by Michigan State University? A normal result for acro is up to 80-100ish, so 4 just seems like an odd number. Would you just double-check with your vet on that and let us know?

Yes, I think you were right to increase. Assuming he's got iaa, you have to be aggressive and 264 (most recent 'low') is still high.
 
Re: Charlie amps 462 increased to 7 u and 1 u r

Sandy's having internet woes, but she's raised a good point. We're being aggressive with Charlie's dose, but at some point we're going to hit a breakthrough. What you want to be watching for is quickly dropping numbers.

If we get a bounce clearing combined with all the R that's being used that could really drop him. He also showed some action on the 4th cycle of the 6.5u dose.

Those are factors that combine to mean that you want to be extra-vigilant as we move forward.
 
Re: Charlie amps 462 increased to 7 u and 1 u r

Julie the test was done at michigan state. I have been trying to figure out how to do the links/Etc on signature link. I have the link but it's giving me trouble. I'm not the most computer savvy person. It is definitely "4" but I'll try to fix the link right now. What other things can I do to be extra vigilant if/when he drops? Should I test more frequently and if so how often? And I'm afraid of bouncing again. Is there any way to prevent a bounce or make it less severe? His numbers after the amps were 355, 344, 333. Too funny. See the pattern?!
 
Charlie FINALLY able to link/view acro test result!

I finally was able to get the acro test able to view. I logged off and was able to view as a "stranger". Please let me know if you still cant view it. I will also upload his ultrasound report and create a profile for my sweetheart right now as well :)))))
 
Re: Charlie amps 462 increased to 7 u and 1 u r

Hi there :cool:

Yay for negative ketones!!!
Good call on the L increase.and the R
julie & punkin (ga) said:
We're being aggressive with Charlie's dose, but at some point we're going to hit a breakthrough. What you want to be watching for is quickly dropping numbers.

If we get a bounce clearing combined with all the R that's being used that could really drop him. He also showed some action on the 4th cycle of the 6.5u dose.

Those are factors that combine to mean that you want to be extra-vigilant as we move forward.
Click to expand...
testing +2 +6 +10 Would be good -those test results will tell you if further testing and intervention is needed.

Gotta run -will bbl
what time do you shoot?
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Hello friends! After 2 days of arguing with my computer I was FINALLY able to get all the links in order. Please let me know if anyone is still having trouble reading any of the reports. And when you get a chance, check out his profile, I added some pics. Isnt he beautiful!? The pics are before he got diagnosed. He is MUCH thinner now.
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Ohmygosh! That picture of him under the blanket is so CUTE! Yes, I can see all the docs now. :-D

Good luck with this increase.
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Wendy&Neko said:
Ohmygosh! That picture of him under the blanket is so CUTE! Yes, I can see all the docs now. :-D

Good luck with this increase.
Click to expand...
Thanks Wendy! He has quite the personality. That pic was taken when he was at the vet. He used to hide under the blankets there. He is much more accustomed to going as of late and isn't shy there anymore. In fact, he thinks he owns the place now! :)
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

LOVE the pics! that adorable little half pink/black nose is just too cute!

I can see the acro results. i just find it really strange - the "parrot mouth" is something that acro cats can get - although typically it's after the growth hormones have made the jaw grow. So it wouldn't precede an acro diagnosis, i wouldn't think. The insatiable hunger is another typical acro sign, although cats with high blood sugar also eat a ton. But . . . 4 is 4, and it's definitely negative, so the only other reasonable option is iaa. i think i mentioned Cushing's to you before - but the fragile skin from Cushing's usually makes that obvious before a professional diagnosis is given.

In any case - great story for Charlie - he found his forever home. :-D
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Thanks Julie! He was too sweet of a cat to not have him in my life. He dosent really have any symptoms of cushings but I will not leave a stone unturned. Been out sick from work all week but will bring him in tomor for the insulin resistance test and if that's neg I'll do the ACTH stim test for cushings. He's very happy that I've been home all week. He's been a cuddle bug :)
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Hi there :cool:

Charlie is beautiful! That was some rough start though. . .

EllieKozak said:
And I'm afraid of bouncing again. Is there any way to prevent a bounce or make it less severe?
Click to expand...
The R you are using to fight ketones by getting more insulin into him, will also help keep a 'ceiling' on a bounce.

It takes time however the bounces will gradually soften and one day you may find yourself asking "where is the bounce?"

Right now you are trying to beat back so may things as they pop up, and continue to pop up.
And you are doing it while trying to walk on a tightrope,fall to one side land on ketones, fall to the other and charlie has potential for going too low.

BTW - fantastic job testing around the clock these past 2 days -
The value of that data under these circumstances is priceless. Being 'data ready' serves as a safety net -it's the numbers that guide you and help you make the best dosing decisions.

Gotta run - have to meet a friend at 655pm eastern.
will check in later tonight
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Thank you Sandy. He's a very special guy. I'm a bit discouraged bc his pmps is 508. Just gave 7L and 1 R. I'm wondering if I should increase the amt of R? (Too late for this cycle in sure but for tomorrow?)
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

What a handsome fellow, and what a story! He looks like he has a little Maine Coon or even Siberian in him. Those tufts on his paws look like my Siberian.

You are an awesome bean, Ellie, and your DH is a keeper for sure! Thanks for sharing Charlie's story. I hope you get this figured out and he starts getting a little more stable. He's definitely worth it!
 
Re: Charlie finally have acro test/profile/pics/ultrasound l

Thank you Tricia! It means a lot!! His +1 is 521 and he just got R an hour ago! Isn't it supposed to start working pretty quickly?
 
Re: Charlie pmps 508 +1/522, +2/555

Hello. I'm in a panic bc his +1 was 522 and +2 is 555 and he got a unit of r on top of 7 u of lantus! He's been eating like a maniac today/tonight. He's eaten 8 cans today and will eat 2 more before morning. I just gave him 150 ml lrs just to keep those damn ketones away. Idk what else to do.
 
Re: Charlie pmps 508 +1/522, +2/555

what you are doing with those crazy all night long every 2 hour tests (sorry!) is exposing every last corner. no doubt there are no lower numbers in there.

It would be helpful if you would put the R scale that Sandy gave you into your spreadsheet so it's available as a reference. I inserted a "line above" and then did a "merge cells" to make one long horizontal line across and put the R scale in there. Holler if you need directions on how to do that. Or put it in the comments section and change the color of it so we can find it readily.

Right now I think you're giving 1uR if he's over 300- is that right? Did Sandy extend that to higher numbers for you? One possibility might be
>400 give 1.5uR
>500 give 2.0uR

I think at +6 if he is over 400 still, you could give more R. I am uncertain of an exact amount to suggest. On 8/29 you gave him 2uR on a 600+ BG and it brought him down 350 points. Typically we think of using R to pull down blood sugar just enough to give the L an opportunity to work better, usually just 100 points or so. But his insulin needs are changing more quickly than we are keeping up with right now.

Sandy's analogy of a tightrope is right on - we don't know exactly what's going on, just that his needs are changing quickly. If you want to, you can consider giving the 2uR again tonight, but then he'd need to for certain get checked 3 hrs after the R shot. So if you are exhausted and aren't certain you'd wake up, I'd wait til amps.

How does all of that sound to you?
 
Re: Charlie pmps 508 +1/522, +2/555

Oh Ellie, your little Charlie is certainly a beautiful guy, I love his story and those pictures are absolutely adorable, especially the ones of Charlie as a kitten fur ball! :-D He sure did have a rough start, my hat is off to you for taking him into your home, your DH too! I am sorry he has had these problems getting regulated but I know with Wendy, Julie, Sandy, Marje and the other pros, he will get better! Hugs to you both! :YMHUG: :YMHUG:
 
Re: Charlie pmps 508 +1/522, +2/555

julie & punkin (ga) said:
what you are doing with those crazy all night long every 2 hour tests (sorry!) is exposing every last corner. no doubt there are no lower numbers in there.

It would be helpful if you would put the R scale that Sandy gave you into your spreadsheet so it's available as a reference. I inserted a "line above" and then did a "merge cells" to make one long horizontal line across and put the R scale in there. Holler if you need directions on how to do that. Or put it in the comments section and change the color of it so we can find it readily.

Right now I think you're giving 1uR if he's over 300- is that right? Did Sandy extend that to higher numbers for you? One possibility might be
>400 give 1.5uR
>500 give 2.0uR

I think at +6 if he is over 400 still, you could give more R. I am uncertain of an exact amount to suggest. On 8/29 you gave him 2uR on a 600+ BG and it brought him down 350 points. Typically we think of using R to pull down blood sugar just enough to give the L an opportunity to work better, usually just 100 points or so. But his insulin needs are changing more quickly than we are keeping up with right now.

Sandy's analogy of a tightrope is right on - we don't know exactly what's going on, just that his needs are changing quickly. If you want to, you can consider giving the 2uR again tonight, but then he'd need to for certain get checked 3 hrs after the R shot. So if you are exhausted and aren't certain you'd wake up, I'd wait til amps.
Click to expand...
I will mess w the ss tomorrow after work. I don't think Sandy mentioned the larger doses of R but it is definitely good to know. In all honesty I'm not sure I can muster the strength to stay up all night again. I'm fighting a cold and must go to work tomorrow. I will set my phone alarm and hopefully it will wake me up. This weekend I have no plans other than to monitor and snuggle with Charlie. His +3 is 595. He is still eating like a lunatic and even figured out how to open the auto feeder! He eats purina dm and the carb is 10%. Would that account for the high bg if he's eating more than usual?
 
the volume of food means more carbs, 10% is more carbs - it's important that he not lose weight, but perhaps switching to a lower carb food would be a little helpful.

we have several kitties on the board now with IBD, but Charlie isn't one of them, is he? If not, perhaps you can switch him to something more like 4-6%. There are a lot of foods in that range.

I doubt that the food alone is accounting for the numbers, though.

If you aren't certain you can stay awake, wait on the R until morning, or just give a smaller amount.
 
Yikes on tonight. I think you are definitely safe to get some more sleep tonight. I hope he comes down some overnight.

As for what could be influencing the numbers, there could be a number of things. He could be seeing some New Dose Wonkiness. The 10% and quantity isn't helping, but I don't think it alone would be enough. The other thing that could be happening if Charlie has IAA is a delayed bounce. The worse of Neko's bounces are usually three cycles after the event that sent her lower.
 
Jeepers :shock:

Clearly the R scale needs to be extended for times when BG over 450 (until that is no longer the case)

One thing about R scales - they evolve as you go along. I have some of BKs on the 3rd tab of his ss - have a look.

In the meantime here is an amended scale:
Remember you don't want to beat the numbers down and trigger bounces but rather use R to keep a lid on any highs.

I could not help noticing that, although he tested 347 at PM+6 last night and 333 at AM+6, you did not give 0.5u R on those occasions.
Wendy mentioned the 'delayed bounce' that can be characteristic of IAA. IAA has a weird way of stretching time; at times delaying responses.
I always felt that was the case with BK.
If Charlie is IAA you may get better results with the R if you shoot at +6 when the numbers warrant shooting.
It may go a long way toward keeping a ceiling on a bounce.

I know it's rough. After his 2nd round with DKA I shot around the clock for about 5 weeks straight with BK - 06/26/2008 - 08/06/2008

It's a steep learning curve - trial and error, always with safety first.

Take care of yourself - Charlies journey is going to require endurance.
Keep putting one foot in front of the other - you will get there. :cool:
 

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Was Charlie tested for acromegaly? I ask because the attachment in your signature is called Acro Test, but shows only the negative result of 4 for IAA.
Is Charlie's IGF-1 test result still pending?

With Charlie being ketone/DKA prone, I think you need to be fast tracking his dosing, holding a dose for only FIVE shots, then upping the dose. When you get something like the 139 at shot time, it's good to test again to double check, hold back food, and test again in 30min…. if rising, you could go with a half dose.

You may find that the odd time, with acros at least, you will get some odd 'good' number out of the blue, but it's most times nothing except maybe a hint that you MAY be getting close to your dose. Dose increases will be full units once you reach a dose of 10u until you are getting better numbers, maybe in the 200s for most of your cycles.
 
Was Charlie tested for acromegaly and IAA? I ask because the attachment in your signature is called Acro Test, but shows only the negative result of 4 for IGF-1 .
Is Charlie's Insulin autoantibodies test result still pending?

With Charlie being ketone/DKA prone, I think you need to be fast tracking his dosing, holding a dose for only FIVE shots, then upping the dose. When you get something like the 139 at shot time, it's good to test again to double check, hold back food, and test again in 30min…. if rising, you could go with a half dose.

You may find that the odd time, with acros at least, you will get some odd 'good' number out of the blue, but it's most times nothing except maybe a hint that you MAY be getting close to your dose. Dose increases will be full units once you reach a dose of 10u until you are getting better numbers, maybe in the 200s for most of your cycles.

If Charlie is found to be IAA positive, you are going to need to be much more aggressive and push for numbers under 50, or your dose will just keep rising. If the 2nd test was not done, you may want to have a draw sent in.
The ketone/DKA issue is a big concern as I know of another person with an IAA cat who had the same issues, was at dosing around 10u+, but she's got her IAA cat down to a dose of 1u or less at times. You will need numbers under 40 to earn your decreases.
 
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