Chi Chi amps 176 question

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Laura&Chichi (GA)

Laura&Chichi (GA)

Member Since 2014
Here is the link to previous thread on her #s viewtopic.php?f=28&t=113252

I am getting high numbers for amps/pmps although the numbers during the day are still yellows. I test on Tuesdays every 3-4 hours. Her ss is current and up until the past several days I was thinking the numbers were getting better. I started feeding her more wet food and spreading out to 3x day a little while back(which I noted on ss) and wonder if maybe I should feed her less food or less often. I have kept her on 1.5 and think it might be time to increase. Stumped here..
 
Re: Chi Chi amps/pmps high#s question

Looks to me like Chi Chi may be bouncing for about 5 cycles, then coming down lower again. So, I'd expect the numbers to be high through tomorrow's AMPS and then lower, maybe into the blue range (100-199) at PMPS.

I do think that you could increase the dose a tiny bit, up to 1.75U but not until PMPS tomorrow if you could wait please. That should give this bounce time to clear and we can reevaluate what to dose after seeing the PMPS for 2/13.

I remember your working 6 days a week schedule makes it really tough to get any mid-cycle testing except for Tuesdays. The last we checked with you, you still needed your mom to help with the testing so any tests after PMPS were not possible.

Is that still the case? Is Chi Chi still a bit tricky to test and you need an assistant to help you?
 
Re: Chi Chi amps/pmps high#s question

Thanks Deb, and yes, I still have to have my mom hold on to her to test. Ive been giving her the freeze dried treats afterwards, and it helps somewhat in the beginning but as soon as my mom lets go of her to grab the meter for me, she wants to bolt, and shake her head. Ive had to retest multiple times due to error, not enough blood. This seemed to start when I first started the treats and she maybe just anxious to be done to get the treat. I dont really know, but seems shes getting antsy lately. I would test at night after pm shot but my mom goes to sleep a little early. Perhaps I could grab one as late as +3 if that would help. I will wait before increasing, and I really am leary of increasing while those mid +6-7 numbers are yellow. Wouldnt want her to go too low then. Im going to get a +3 tonight and see what she is.
 
Re: Chi Chi amps/pmps high#s question

Yes, those PM +3 BG tests could help us to see if she's dropping lower.

There's nothing wrong, with giving her a bunch of treats to get her to be more cooperative with the testing. Maybe even a tiny pile in front of her, to get her distracted during the testing procedure.

Or, I used to break up the treats into tiny pieces, hold them in my left hand, Wink was lightly held between my knees as I kneeled on the floor, poke with right hand, massage the ear from bottom to poke spot to milk the ear and get that blood drop to form, hold onto his ear with left hand so he couldn't shake off the blood drop, quickly pick up the meter and sip up the blood. All the while, sneaking another treat into his mouth.

It took a while to get this all coordinated. ;-)

Maybe do a few dry runs, trying different things. Only pretend to poke with the lancet and try to coordinate all the steps on your own.

No, I don't think you should feed her less. That's just going to have her even hungrier for the AMPS/PMPS. Keep up with the more frequent feedings. Besides, you said it was too stressful on your mom, to have the kitties yowling for their food so often.
 
Re: Chi Chi amps/pmps high#s question

Wow..thanks for the tips, I will try what you said. I did start using the lancet tool, only to hold the lancet tho. It helps my aim alot better. Chi Chi LOVES those treats. OMG, she woofs them down, she is a very fast eater whenever she eats, always has been. I will start giving her more to distract her and see how it goes. And that was a great description of your method!!
 
Re: Chi Chi amps/pmps high#s question

Ok. Thanks for getting that +3 this evening.

Let's see what the numbers are tomorrow morning. I'm thinking they will be high again, in the pinks.
 
Re: Chi Chi amps/pmps high#s question

amps 403. so even higher today. I have to work, so will get pmps and post here. She was up early this am and sitting in front of the pantry door..poor baby..
 
Re: Chi Chi amps/pmps high#s question

I think you are going to need to increase the dose with this evenings shot.

Any chance you are doing "fur shots"? This is where the insulin is not going in, or some of the insulin is not going in. It happens when the needle goes all the way through the tent of skin and out the other side of the skin "tent". Or it can be caused by the needle not getting far enough under the skin and you end up squirting the insulin into the fur.

A couple of ways to check for this.
1. Lantus has a medicinal smell, some people say it smells like bandaids. So you could sniff your injection area to check for this smell.
2. Wet fur. Run your hand lightly over the injection area to check for wetness. This helps you to feel if the insulin went in or didn't.

You don't want to rub or massage the area where you inject the insulin after you have given the shot. Some people have reported doing that and it can force some of the insulin back out.
 
Re: Chi Chi amps/pmps high#s question

Its OK to leave the food down for 10 hours at a time. Just pick it up 2 hours before the next test.
 
Re: Chi Chi amps/pmps high#s question

pmps is 248 You were right Deb..it came down, alto not into blue quite. Should I try to eyeball a 1.75 with these syringes without half marks is difficult, but I can try.
 
Re: Chi Chi amps/pmps high#s question

I gave a smidge more than 1.5 and recorded it as 1.75. I will get another test in +3 and will post #.
 
Re: Chi Chi amps/pmps high#s question

We call those doses that are a bit more than a 0.25U increment "fat" doses.

We call those doses that are smidge less than a 0.25U increment "skinny' doses.

You might see a notation something like 1.5F in the unit column on the spreadsheet for a fat dose, and 1.5S on a spreadsheet for a skinny dose.

You may need to bump the dose up to a full 1.75U dose. It know it's hard to measure. You just have to eyeball the amounts the best you can, trying for consistency if at all possible.

I'll try to stay up for your +3. I have an awful cold that is making me feel pretty yucky right now and I'm just dragging. I'll also check back in the morning to see how Chi Chi is doing.

If you need immediate help, be sure to edit your very first post and put that 911 Post icon on the very first post in this thread to get the attention of people that are scanning the board. Or, you can do a new post. If no one is here, the Lantus TR forum is very active and has many west coast members that are often up much later then I am. You can post there for help too.

I wouldn't worry unless Chi Chi drops under 100,but I certainly don't expect that. Then, you might want to monitor a couple of hours later.
 
Re: Chi Chi amps/pmps high#s question

You're definitely safe to head off to sleep. She sure does go high at +3. Not sure what is going on here with her.

Would you be willing to keep track of the specific food you feed, amounts fed and when you feed it? You could note that in the Remarks column, or some people put a * under the + hour column when they have fed.
 
Re: Chi Chi amps/pmps high#s question

Yes, she goes up + 3,and I wish I could get another +3. Not gonna happen til I can manage it by myself. Moms on medication and shes fast asleep already. A little tricky noting feed times and specific food because I have 3 kitties, and one eats Natural Balance L.I.D. canned for her allergies. The other just eats whatever Chi Chi eats, which is randomly selected FF classic pates or the recently added Friskies special diet pates. I have also been feeding freeze dried chicken liver treats that's for dogs, and break them up. My mom feeds them at 7:30 and then again while Im at work at 1:30, and then at 7:30 pm. She has been super stressed out by all of this and I would have to ask more from her to record specifics. I can try..but cant be sure if she can handle it. I will come up with something, maybe setting out the food for her to give already written down before she feeds and trust she gets it right. I have seen Chi Chi and the other one switch bowls mid feeding. The younger one pushes her out of the way and starts eating her food, so she just goes to the other bowl. Didnt think it mattered much since its all FF or Friskies for both of those two. Only difference is she adds water to Chi Chi's. I will ask mom to keep them separated if she will. Im exhausted, so toes up time. Thanks again! Hope you feel better soon!
 
Re: Chi Chi amps/pmps high#s question

Your mom is already doing so much to help you, we don't want to stress her out any more than she already is. If you could just note on your SS, that you feed at post AMPS, +6, post PMPS and a rough amount, that would be enough.

All those foods you are feeding are nice and low carb, so it's unlikely that the food is causing the inverse (reverse) curve at +3. Most cats, the insulin starts to kick in around +2.

Where are you shooting? Are you using the scruff? (That might be causing very slow absorption of the insulin) Or shooting along the flanks?

Here are some different sites that you can use to inject.


Just trying to think of what is causing that inverse curve.
 

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Re: Chi Chi amps/pmps high#s question

So Chi Chi was 448 this amps. Just got home and tested pmps is 206. I increased from 1.5 to what I call a smidge last nite and again this am. She ate 3oz ff at 7:30 and again at 1:30 today. Will hols shot until I hear from anyone who can advise. She has been testing high in 400's at amps and pmps until tonight. Thanks, Laura
 
Re: Chi Chi amps/pmps high#s question

Oh, and I am pretty positive Im not doing fur shots and I do know that insulin smell! It does smell like bandaids! I usually shoot on top along the side of her spine, maybe 3 or 4 inches down from spine on the sides. Is that a good spot? I can change if I need to. Just wondering what to dose tonite?
 
Re: Chi Chi amps/pmps high#s question

Those injection sites should be fine.

Lantus works best with consistency in both shot times and dose. Stick with your new dose for at least 3 full days, unless she goes too low (< 50 mg/dL on a human glucometer; < 80 mg/dL on a pet specific glucometer), or you don't feel safe shooting that low yet.
 
Re: Chi Chi amps/pmps high#s question

Ok, Thank you! I stayed with the fat 1.5 dose tonite and i feel ok with it. She has been going up after pm dose..strange, and I will get a +3 tonite to be sure.I did however miss the time by 15 min. or so, (wanted to see if I got a reply), and will adjust am dose time accordingly.
 
Re: Chi Chi amps/pmps high#s question

15 minutes is OK to switch back tomorrow.
 
Re: Chi Chi amps/pmps high#s question

amps is 413, so I assume still do the 1.5f and then if still high tonight I can increase to full 1.75. I was pleased with the pmps last night and never did get that +3 test..mom was sick and couldnt help me. I watched her til 12 am. She was grooming and purring and content. Then # back up high this am.
 
Re: Chi Chi amps/pmps high#s question

Ok, I have some questions about air bubbles. Is it possible that this is why my dosing is off and perhaps Chi Chi isnt getting the correct amount of insulin? i always get them in the syringe, and I thought I just flick the syringe a few times to get the bubble to the top. Sometimes I try to pull more out and then expel some to get the bubble out, but it doesnt work, Please explain the proper way to draw out insulin as I have seen post that say do not inject air into vial and some say do! Now Im worried I havent been giving enough sometimes because of the air.
 
Re: Chi Chi amps/pmps high#s question

It may reduce bubbles if you do the following:
Work the plunger in and out several times first.
Push in and hold the plunger as firmly as possible while inserting into vial or pen.
Draw in the insulin.
 
Re: Chi Chi amps/pmps high#s question

Trying to get those bubbles out is difficult. Can someone tell me if I'm supposed to inject air into the vial or not. I've heard yes and no. pmps was 333 and gave 1.5f. It just dawned on me this morning that if there is air in the syringe, then it displaces the insulin, and therefore maybe under dosing. Just trying to figure out these numbers I'm getting..
 
Re: Chi Chi amps/pmps high#s question

For a vial, inject air.

For a pen, avoid injecting air as it has a pressure mechanism to help the insulin go out.
 
Re: Chi Chi amps/pmps high#s question

I have been dosing 1.5f for 3 days and not alot of decrease in bg# amps/pmps. I think I will go ahead and bump it to 1.75 in the am. Darn it though, I am really not sure if im getting those .25 increase correct. I have just been eyeballing the best I can and being consistent. I dont have half marks to guide me, but right now Im lining up the middle of the plunger head right on the line for 2u. That might even be 1.75..wonder if its safe to just go to even 2u. Or should I just increase a teeny smidge and call it skinny 2u. I really want to see more yellows and blues and I've really been increasing really slow, like weekly, and then some. She was dx on the 18th of Jan, started her on 1u twice a day, so that was almost 4 weeks ago and have only increased up to 1.5f. If someone can chime in here Id appreciate it. I am off Tues and will be doing another curve then.
 
Re: Chi Chi amps/pmps high#s question

You might find calipers helpful to make sure the dose is consistent.

Another option is to get a sturdy ruler with millimeter tick marks, line it up with the syringe barrel in a consistent location, and measuring to a specific mark on the ruler.

And I find magnifiers really helpful for the small dose adjustments.
 
Re: Chi Chi amps/pmps high#s question

I do think you need to go up to 1.75U. We need to see Chi Chi in more of those lower numbers, even down in the blues and greens would be better for her.

Eyeballing the dose for consistency is the right thing to do. Just do the best you can.
 
Re: Chi Chi amps/pmps high#s question

I am off work today, so will be posting +3 #s all day. Also, just wondering if I got bad strips a week ago as seems thats when numbers were starting higher. Im just gonna go buy more today to see what happens. I do not like the reds and pinks! I bought pack of 100 cause thats all they had. They are all stuck together and wonder why, and if it makes a difference?
 
Re: Chi Chi amps/pmps high#s question

The test strips seem to stick together with a combination of static, and maybe because they are cut in layered sheets like paper.


(You should fan reams of paper before putting them in a printer or copier to break that friction and reduce paper jams!)
 
Re: Chi Chi amps/pmps high#s question

My test strips always tend to stick together a bit, almost like they have a bit of a static charge to them. I usually buy the packs of 100 and have never had an issue, but there can sometimes be a problem.

Maybe test yourself with a fresh lancet to see what your own BG is.

Looking forward to that curve today for Chi Chi.
 
Re: Chi Chi amps/pmps high#s question

I finished the curve on Chi Chi today, and the numbers aren't where they need to be yet, maybe need 1 more day to see that dose increase effect. I feel like were headed to 2u soon. She is looking better and is grooming, purring alot and her attitude is better. Shes starting to roll over for her belly rub again, and she got up on the cat tree today. Her peeing is a tad improved and she seems to be drinking a bit less as well. I am still adding water to her food as well. Never made it to get new strips, so Im just gonna keep using these for now. I was just concerned it had to be something wrong somewhere. I think Im just getting impatient and frustrated. I just want her better..
 
Re: Chi Chi amps/pmps high#s question

Yes..I just tested and she is 176 amps. I will not be home today and will be leaving here soon. I feel ok giving her shot and just have my mom keep an eye on her. Any thoughts?
 
I'm concerned she may have to deal with low numbers which need steering. Can she test?

If yes, she should be prepared with high carb gravied food, Karo syrup, an oral syring, and ample test strips.

Snag a +2 which may clue you in to the potential for a rapid drop.

If that is OK, snag a +5 and start monitoring the nadir period over at least the next 2 hours.

If he is getting down in the 50s on a human meter (80s pet-specific) by +5 or sooner, then
Feed 1-2 teaspoons of low carb, wait 20 min, re-test, and repeat if still in the 50s. Do this over the next 2-3 hours until nadir is past and numbers beginning to rise.

If he is getting down in the 40s (70s pet meter) by +5 or sooner, then
Feed 1-2 teaspoons of medium (mix low and high carb together) to high carb, wait 20 min, re-test, and repeat if still in the 40s.

Lower than 40s is high carb gravy and/or a few drops of Karo, feed, wait 20 minutes, test repeat.

High carb wears off fast, so you must keep monitoring until steadily rising and past nadir.
 
No, she cant test, it still takes both of us! I am still at home and was planning on going in late around noon(just told my boss)after a +4. Guess that wont be happening..no risk taking here!
 
Re: Chi Chi amps 176 updated

+ 1.75 hours test is 263. I shot her 15 min. late @ 7:45 I will retest in 1 hour.update.. +3 is 280 and wonder why it went up? is this still food? Will get a +5 and then update. +5 is 191 +6 is 220
 
It may be OK, but I'd rather you be safe than sorry, hence the previous instructions on steering numbers.

It takes Lantus roughly 2 hours to start showing impact on glucose. This can be offset by a food spike, so you may not see it right away.

If you do see a drop @ +2, despite food being on board, that can indicate an active cycle (ie "dive, dive!").

The +5 is looking reasonably safe. If still above 50 mg/dL at +7, you're probably safe to go into work.
 
I did a +6 and she was up already to 220 so I fed her at normal time (plus 15 min) @ 1:45. She has been eating mid day at 1:30, (but occasionally at 2 if my mom is distracted). Too late to go to work..already took the day off and hopefully no repercussion from my boss! They are aware of my situation and have been understanding thus far. I have missed 1/2 day (twice) due to kitty concerns in the past month. Hopefully Chi chi will do well on the 1.75u and not dip too low going forward nailbite_smile
 
Shooting late acts like a dose decrease because the depot drains somewhat and shooting early acts like a dose increase due to increased overlap.

To adjust shot times for Lantus, you generally shift by 15 min per shot for a total of 30 min per day.
 
So I will retest at +9 and then pmps and give the same 1.75 dose at 15 min later @ 7:45..that will be alright? Is it fine to keep her on 1.75 for now, since she did ok, or wait till the pmps# to decide. I know you shoot based on nadir and she wasnt very low today at lowest #.
 
Just did +9 and she is 297. Im thinking stay with the 1.75 tonite since her numbers were not very low today, all yellow and 1 blue at amps. Oh, and I tested by myself!!She was bathing herself and I just casually poked!She really is a sweet kitty..mom gets too stressed and I know it makes Chi Chi stressed too.
 
Good job on the testing!

You might consider posting in one of our Lantus forums now, since you've got both testing and a spreadsheet wrking.

Definitely go read the sticky posts in the Lantus TR forum to learn more about how Lantus works in cats, rules for adjusting dose, and the protocol for steering low numbers (print that one out).
 
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