Dose advice please! 20/7 Tucker AMPS ?

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Tucker

Tucker

Member Since 2018
For those of you who have been following Tucker's early morning very low numbers? We did a big reduction last night and I know he is "bouncing". He was doing 5.5 units of Lantus and because he had spent so much time in green yesterday I shot 2.5 last night and his numbers went up. This morning he isn't looking so good-like he did the day he seemed unwell and I brought him to the vet and he was diagnosed. His eyes look 'rheumy' and spacey, he is hollering for food, he fought me like crazy for his blood test. The test? I don't know what to think. His first test was 18, which seemed so high I did a 2nd test on the same bit of blood and it came up 24! I thought maybe it wasn't a big enough sample so I waited a minute for him to relax and started over and got 6.1! What the? So I did one last test and it was 18.......so I have no idea what to do but obviously he is bouncing. Do I stick with the half dose or go back to the 5.5 or the reduction to 5 or what??
 
He is still bouncing. He is probably feeling a bit yuk because of the higher numbers ......but he will come back down in numbers when he comes off the bounce.
Stick with the 2.5 units and keep testing for when he comes off the bounce.
He will probably feel better when he gets food...just the normal low carb. And make sure there is plenty of water for him to drink.
 
I haven't been following Tucker that closely but I'm happy to chime in. (BTW, I think you mean the date to be the 29th unless it's already the 30th in Australia.)

What's going on is the proverbially double whammy -- Tucker is bouncing off of the low numbers AND you cut his dose in half. There's no way to predict where his numbers will settle. At this point, there have been a few back-to-back changes in dose and the depot needs to stabilize.

As for the variation in numbers, it sometimes happens. It may have been a bad strip, not enough or too much blood, a meter hiccup, or the moon and the sun were out of phase. You did the right thing by retesting.

 
I have a husband who is Mr. Clinical, an engineer brain.... So I've gotten the lecture this morning about 'too many variables' and 'it's our boys' life - how can we go from inching up to 5.5, then dropping in one shot down to 5, then skipping doses and then going to 2.5 when he is up at (maybe) 18...or 24...". I've asked him to read the information but he says there is too much guess work in it because cats and diabetes have too many variables--did he eat enough food, was the strip bad, is the meter wonky, is the sample too small........all of which are frustrating to me too but he worries each time he injects that he is going to kill Tucker. I had him shoot 2.5 today, and Tucker is wolfing down cooked chicken at the moment and husband has left for the office. It's hard enough watching Tucker bounce, having husband question everything is not helping. By the way, I did use our backup meter since the first one was giving me readings between 6 and 24........it came up 14.1. Sorry if I'm complaining too much but the last hour has been rough...
 
Tucker said:
I have a husband who is Mr. Clinical, an engineer brain.... So I've gotten the lecture this morning about 'too many variables' and 'it's our boys' life - how can we go from inching up to 5.5, then dropping in one shot down to 5, then skipping doses and then going to 2.5 when he is up at (maybe) 18...or 24...". I've asked him to read the information but he says there is too much guess work in it because cats and diabetes have too many variables--did he eat enough food, was the strip bad, is the meter wonky, is the sample too small........all of which are frustrating to me too but he worries each time he injects that he is going to kill Tucker. I had him shoot 2.5 today, and Tucker is wolfing down cooked chicken at the moment and husband has left for the office. It's hard enough watching Tucker bounce, having husband question everything is not helping. By the way, I did use our backup meter since the first one was giving me readings between 6 and 24........it came up 14.1. Sorry if I'm complaining too much but the last hour has been rough...
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:bighug::bighug::bighug::bighug::bighug:
Of course your DH loves Tucker and worries about him and what is happening to him.
And FD leads us all on a merry dance until it doesn't.
Think of it as a glass of water that we have to fill up to the top but not overflow but it is leaking a bit at the bottom.......we keep putting in the water and adjusting the flow. When the water gets to the top we have to adjust the flow by turning the tap down to a slower speed. (If it overflows we get low numbers.) So we slow it down more. Suddenly the hole at the bottom starts to close so we have to turn the tap off more. If we are lucky the hole closes over and we can turn off the tap.
Does that make sense?
Any living body is a moving variable object....not like a piece of steel that has set properties that won't change much and is much more controllable......a living body changes minute to minute.
 
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It does. And that is why I'm here, so that kind people like yourself can give advice and encouragement and support. It's hard enough trying to do the right thing, but when he gets frustrated or questions so much and I honestly don't have the clinical response........it is way way harder. I know he is starting to panic because we are going to be out of the country for over a month, leaving late September and our daughter will be in charge of Tucker. There is no way she will be home during the day to do tests except for the weekends and he is saying it isn't going to work with me away-we have to get to some sort of stability before we leave. I'm saying we have 2 months to work something out.
 
We will help provide that stability while you are away. With more persistence we can develop Tucker's custom insulin therapy formula
- your daughter can per part of the equation
- including the spreadsheet and your account here.

I agree with your husband. It is frustrating. :banghead:

Guess what? Many of us have had the same issues. Both Wendy and I had Acromegaly cats. Wendy took her cat twice to from Vancouver to Colorado for SRT (Radiation). I took Leo once (Austin, TX to Colorado) for SRT. That shows our dedication to our kittehs. Then there is the ever adjustable dose for our cats after that. Unfortunately Wendy's cat (Neko) died of other stuff. Leo is no simple case though, and he has small cell lymphoma in addition! We spent considerable time and money getting that under control.

You may want to relay this to your husband. Some of your helpers here - we have lots of experience. It is a variable situation that we are trying to stabilize. And we get frustrated at the setbacks too. But at the core of this, is sweet Tucker. We all want him to be healthy.:bighug:
 
I understand. I'm trying to help him to understand but he is unable to deal with the grey areas-he wants it black and white. It comes from a long history with our beautiful cat TG who passed away 2 years ago. Long story but in a nutshell: He got a scratch on his eye, instead of referring him to an eye surgeon the vet hospital operated. He then lost his eye anyway. Told he would be perfect after it was removed. TG had a heart attack in my arms that night. ICU 5 times and told he had 3 weeks or 3 months.......he lived 3 years. Vet bills: 11k plus meds of 300 a month for 3 years. Many, many scary trips to hospital and oxygen tents, and total devotion at home. We loved him so much, he died asleep in my arms when he had a seizure at 4am one night. During the seizure he attached to my arm-24 hours after we lost him I was in ICU because of infection where his seizure had punctured my arm. A week in hospital and 2 operations to save me from blood infection, then 4 months on antibiotics. Kurt loves his cats but we went through the ringer with TG emotionally, and he is mostly scared Tucker will die on our daughter's watch while we are away. She was with me when we lost TG, Kurt was away camping. He is reacting out of frustration, fear and history. It isn't anything negative against any of you, he wants Tucker 'fixed' and he's scared.
 
We are here to help you. It frustrates us too. I am sorry to hear about TG and your devotion to him. It is really hard losing any of our furkids. TG was lucky that you were his parents. That is too bad that TG tried to take you with him. Poor kitteh. But you did give him a loving home and an additional 3 years.

We could get lucky with Tucker. He may stabilize. I wish it was as easy as "dose him 1 unit twice a day and call us back in a month". You are now devoted to Tucker and doing the right stuff. We just need to fine tune the equation.

Tucker's BG today
AMPS +5 = 10.1 (U.S. 182) is actually a good response. At this rate, I would probably dose him 2.5 again at PMPS. Lets's see if he comes up from that value.

A "fun" story about Little Buddy
We had Little Buddy until 2005. He was 20 pounds. He had just gotten in a cat fight, he started it with the neighbor cat. I tried to pick him up. He bit me right thru the thumbnail. OUCH. I cleaned the heck out of it. I got lucky and nothing happened. The only side effect was that I got a good story to tell at work for the next 2 days. He was a great kitteh. I miss him too.
 
Oh, ouch! Apart from the heartache of losing TG in my arms, the ortho specialist that operated on me said my wounds were the perfect cat puncture wound example......so they are in some Aussie medical journal now. Cool photos....eep? I would share them but don't want to creep anyone out! Tucker seems comfortable now. I'm going to wait another hour and do another test to see where he is at. I was going to ask at what point does he have to get down to in order to stick to the lesser dose.
 
Very sad story about TG. It is always heartbreaking to lose our furkitties.
Tucker said:
I was going to ask at what point does he have to get down to in order to stick to the lesser dose.
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Are you referring to 2.5units? If so, we are waiting to see if that dose can keep him most of the time in high green/ love blue numbers without dropping him too low, once the bounce clears. When he bounces, that doesn't mean that the dose is wrong....it is just Tucker's body reacting to the low numbers he has been having because his body has got used to the higher numbers. If it drops him under 50 he earns a reduction in dose. If the 2.5 units drops him into higher than 50 green numbers we would hold the dose at 2.5 units. Also it is the nadir that we look to to decide the dose NOT the preshot.
 
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I am listening and doing what you suggest. It's hard to say about his nadir, because sometimes it seems to be at the preshot? He has dipped a little bit in the last 2 hours. He was crying for food so I just fed him some roast chicken. I guess I'll have to wait a couple of hours now for his next bg test, but I couldn't stand seeing him cry for food.
 
His nadir is the lowest point in a given cycle. It might be +6 or could be the next Preshot or any point in that cycle.

During the day when you test you don’t have to worry about food in relation to testing unless you are waiting to see if he will come up from a low number without food. Also the two hours before Preshot. It would be fine to test now.
 
Tucker said:
I just fed him some roast chicken.
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A little plain protein shouldn't effect the number much anyway.....a lot of times we'll suggest a little baked chicken snack for kitties that just have to have an extra nibble later in the cycle (to keep them from starving to death before the next scheduled mealtime.....you know how they are....lol)
 
Well, we have a PMPS of 12.1......what to do now? My husband wants to go back to his 'normal' dose of 5. I'm fighting an uphill battle here. Can someone look at the numbers from the last couple of days and weigh in, please? Thank you
 
Tucker said:
Well, we have a PMPS of 12.1......what to do now? My husband wants to go back to his 'normal' dose of 5. I'm fighting an uphill battle here. Can someone look at the numbers from the last couple of days and weigh in, please? Thank you
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The dose should stay at 2.5 units.
If you go back to 5 units you risk a hypo, if you look at the last few days and see how he is responding to the doses.

What does DH base his reason for going back to 5 units on?

If you look at the SS you can see he is getting better numbers now than he was at any other time.
Please do not increase the dose back to 5 units. We are trying to get the depot to fill and Tucker onto a more stable dose and this is the way to do it
 
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:bighug:

Sad about TG. :(

Has your hubby read about how the depot works with Latus and Levemir? It might help if he has not.

http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

Have you ever wondered why, when you are giving the same amount of insulin every time, the response is different in each cycle? Sometimes the numbers go up for the whole cycle, sometimes they go down, sometimes they stay flat, and sometimes they actually “curve.” The answer often lies in the depot. Did you skip a shot or give a partial shot at some time in the past few days? That can result in higher numbers for several days as the depot replenishes some of its lost stores. Did you increase the dose? This can result in a change in the size of the depot and can lead to a temporary adjustment in the amount of insulin available for use. Did you decrease the dose recently? A dose reduction will usually result in a need for less stored insulin. The excess may be released into the bloodstream faster than usual, especially if several dose reductions are done back-to-back.
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Above is just part of the post, the entire post is helpful.
 
Hey Patty, I agree with Bron and Jeff, and Sienne, this dose has to be held until it's stable to know where to go from 2.5. It takes 4 cycles for the depot to fill and that will be at the end of tonight's cycle. That will give us some more good information about this dose. Look, he's all ready back into blue numbers! YEAH.

It is possible that he could have to go up in dose BUT, we would only go up by .25 of a unit . We raise in increments of .25 of a unit so we don't go over the best dose and risk a hypo.

I read today's thread and I am so sorry about TG. That must have been just horrible for you all to go through. Most of us have lost a beloved pet so we can relate. It is understandable your husband reservations coming off an experience like that one. It's hard not to attach those emotions to the present. Feline diabetes is certainly a very frustrating dance especially in the beginning with all that has to be learned. We are here to help you through this. Every step of the dance. And we will help your daughter too while you and your husband are away.

Tucker is making such great progress even though it all seem unpredictable to you right now. Hang in there Patty. We'll help you help Tucker in the best possible ways.
 
Tucker said:
He is on his way back up. At +2 he was at 13 and now at +3 he is up to 15.
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Tucker could still drop back down later in the cycle, so it might be good to test in a few hours and if he is dropping again keep in mind he likes to drop late in cycles ready to startle you at AMPS.
Hope you manage to get a good sleep
 
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