? Feb 19 Chase PMPS 190, +1 175, +2 149, +3 147, +9 196

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Good post-poke low-carb treats are the little freeze-dried meat treats-- hunks of chicken, turkey, etc. They sell packets in petstores and online, decent brands are PureBites and Cat-Man-Doo/Life Essentials, they're just the meat and nothing else. Orijen (pet food company) also sells a variety of freeze-dried treats that make good low-carb rewards (they're a little harder to find and somewhat more expensive).
 
Sandi & Chase in AZ said:
Chase's BG is 190 at +11.25. Am about to shoot recommended reduced dose of .25. And then feed him. :)
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Sandi, I would still get a PMPS test and not shot until +12. Also, feed first then shoot. The ideal way is to Test, Feed and Shoot (T/F/S). That way if for some reason Chase decided not to eat, you wouldn't have insulin on board and then be worried if he would eat for you that cycle.
 
Bobbie And Bubba said:
Sandi, I would still get a PMPS test and not shot until +12. Also, feed first then shoot. The ideal way is to Test, Feed and Shoot (T/F/S). That way if for some reason Chase decided not to eat, you wouldn't have insulin on board and then be worried if he would eat for you that cycle.
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She was going to shoot a little early to get back on schedule.

tiffmaxee said:
I used size 25 Terumo needles. They are very sharp and I never had to poke more than once. My vet preferred needles but used a different brand.
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Her vet showed her to test in the craziest way I’ve ever seen. She showed her to poke the inside of the ear in the middle. It’s no wonder she couldn’t get blood. She has now started poking the outer edge freehand with a lancet and I think that is a good option for them right now.

Sandi: we discussed a few things for the binder you are putting together. You might have already printed these but here they are again just in case:
Symptoms of and How to Treat a Hypo
Dealing with Low Preshots...this was primarily written for TR followers but the basic info about stalling, etc. applies. The numbers cited refer to BGs taken with a human meter, not an Alpha Trak.
How to Handle Low Numbers...BG numbers referenced are also those taken with a human meter.

And this post by Julie is really helpful if you are looking for information and no one is around: Where Can I Find

Lastly, it’s ok now to edit the subject line, leave "2/19 Chase” but delete all the other numbers and start over again with his PMPS. Thank you!
 
Islandmomma said:
Sandi - I'd be asking for my $30 back! :joyful::p
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I would, too!

Sandi...that's a nice cycle going so far but because the +2 is less than the preshot, I believe he will continue to come down for a while. This is a great example of the importance of the +2: similar to or less than preshot, be prepared for an active cycle.

I certainly don't want you to poke him unnecessarily but, right now, he's coming down at about 26/hour. He could speed up or slow down.

My thought is to feed him a couple of good tsps of LC food and see if he will be a good boy and go until +3.5 for the next test. How would you feel about that?
 
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Isn't the +2 supposed to be less than the preshot, since they usually come back up at the end of a cycle, and it's now been 2 hours since I gave him insulin?

I'm still not understanding when I should be testing, I guess. I mean... I don't mind testing him. I want to see what he's doing. I guess I just don't understand the comment, "but...". Gosh... I'm feeling really dim, right now. :(

Seems like the better question for me to be asking is... when do I NOT test? This has been one of the longest weekends I have had in a very long time. I will test him at +3.5. But I'm worried that I won't know if I should stay up later and keep testing, or if I should set my alarm? Can you just tell me when I can stop testing for the day? Or is that why you suggest that I keep testing?

I know I must sound like a broken record, but I wouldn't be asking if I didn't care so much. :)
 
Yes, the +2 is supposed to be less than the preshot so that's great. Sometimes, they continue down at the same rate they've been coming down, sometimes they speed up, and sometimes they either stop or go back up.

As an example, if we wait two hours to test again, and he continues at the same rate he's coming down now, then before he even gets to nadir (lowest point/peak action of insulin), he would be in the 90s. That is still a safe number but he would still, theoretically have two hours until nadir if he nadirs at +6. Make sense?

By giving him a break until +3, we are hoping he will continue down at this rate or less. That would put him in the low 100s.

However, there's no guarantee the drop will continue at this rate.
 
I'm also not sure when I can or can't feed him. I fed him after I gave him insulin.... but only a little bit. Then after I tested at + 1 I fed him a tiny bit more. And after +2 I fed him the rest. During the week I won't be able to do this... not at all. I will have to give him all of his food in the morning. Since I can't feed him before I test him and I can't be here for a long time before I got to work... until I can afford a timed feeder, my hands will be tied. :( I mean... in the morning. In the evening, I can monitor him and feed him however I need to. :)
 
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I'm sorry...it was a typo....I did mean +3.5 but it's ok.

So he's basically stopped. i just wanted you to give him a couple tsp at +2 :) so we could just spread it out a bit tonight since he was coming down. I was afraid if he continued down and he had eaten all his food, he might be full.

What some members do is make catsicles out of the food so the kitty gets some of it at AMPS and while you are there but then you could leave the little frozen pucks of his cat food out to thaw and for him to eat while you are remgone u til you get a timed feeder. It's best for him to have some "minimeals" spread out a little, when possible.
 
My lower back is absolutely wrecked... for getting down on the floor so many times to test him, over the weekend. I can barely get up without having something to pull myself up on. Time for the heating pad... and bed. I will set my alarm to get up in another 2 hours to test him for the last time, tonight... unless, of course... he has dropped a LOT, for some reason. Then I'll get up every one or 2 hours all night long if I have to.
 
Sandi & Chase in AZ said:
My lower back is absolutely wrecked... for getting down on the floor so many times to test him, over the weekend. I can barely get up without having something to pull myself up on. Time for the heating pad... and bed. I will set my alarm to get up in another 2 hours to test him for the last time, tonight... unless, of course... he has dropped a LOT, for some reason. Then I'll get up every one or 2 hours all night long if I have to.
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Sounds good. I suspect he flattened out due to the food.

Hope you get some rest.
 
Does that mean I shouldn't feed him after he gets a shot? Or is this the way it's supposed to work? Isn't this a dance, of sorts? LOL.... I feel like I know less than I did a couple of weeks ago.

Wait... nevermind. I'm certain that I'm starting to sound like an arguing kid. I think this weekend has takena toll on my brain and my back. LOL. I'm just so very grateful that Chase is doing as well as he is. And am eternally grateful for ALL of you. You know... angels, like all of you... are a kitties best friend. :)

Thank you, all, for putting up with me.

Good night. cat_wings>o
 
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Sandi & Chase in AZ said:
Does that mean I shouldn't feed him after he gets a shot? Or is this the way it's supposed to work? Isn't this a dance, of sorts? LOL.... I feel like I know less than I did a couple of weeks ago.

Wait... nevermind. I'm certain that I'm starting to sound like an arguing kid. I think this weekend has takena toll on my brain and my back. LOL. I'm just so very grateful that Chase is doing as well as he is. And am eternally grateful for ALL of you. You know... angels, like all of you... are a kitties best friend. :)

Thank you, all, for putting up with me.

Good night. cat_wings>o
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Sorry... I was just offering a reason for why he likely stopped coming down. It's a good thing to know that the LC can get him surfing.

He's doing great and you are learning :)
 
Hi Sandi, I haven't stopped by and met you yet, but just wanted to give you a little encouragement. Seems like it's been a rough weekend. The beginning of this is the worst, but in a week or two you'll be amazed at how easy it will be. The more you understand, the more things will make sense. So keep asking questions, read, read and read more, and this will become much easier.

For pokey treats we gave Punkin cooked bits of chicken breast. Cooked a couple on the stove in water, diced them small (1/2" cubes), froze most of it and kept a couple of tablespoons worth in the fridge. That's enough to last for a couple of days, then reload from your freezer supply. Two chicken breasts lasted at least a couple of weeks.

When you're giving pokey treats, think small - just a little treat to let him know that you recognize the indignity of him being poked and you're rewarding him for enduring it! Many people give freeze dried meats too. Whatever is zero/low carb and will make Chase happy for a moment.

Welcome to the group!

julie
 
julie & punkin (ga) said:
Hi Sandi, I haven't stopped by and met you yet, but just wanted to give you a little encouragement. Seems like it's been a rough weekend. The beginning of this is the worst, but in a week or two you'll be amazed at how easy it will be. The more you understand, the more things will make sense. So keep asking questions, read, read and read more, and this will become much easier.

For pokey treats we gave Punkin cooked bits of chicken breast. Cooked a couple on the stove in water, diced them small (1/2" cubes), froze most of it and kept a couple of tablespoons worth in the fridge. That's enough to last for a couple of days, then reload from your freezer supply. Two chicken breasts lasted at least a couple of weeks.

When you're giving pokey treats, think small - just a little treat to let him know that you recognize the indignity of him being poked and you're rewarding him for enduring it! Many people give freeze dried meats too. Whatever is zero/low carb and will make Chase happy for a moment.

Welcome to the group!

julie
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Thank you, so much. :) Nice to meet you!
 
I fell asleep before getting the +5. :( But I did just get +7 and it is 196. I doubt he came down that much but DARN IT.... I missed the time I was going to test. Well.... this is better than not getting a test in at all. I will get a good curve next Saturday and will be pre-testing spot checking all week.
 
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Marje and Gracie said:
Sorry... I was just offering a reason for why he likely stopped coming down. It's a good thing to know that the LC can get him surfing.

He's doing great and you are learning :)
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Thank you, Marje.... SO much. I fell asleep again. :( But I did just get a +7. He is at 196. I may have seen a very consistent cycle... but I fell asleep... AGAIN. :( I set an alarm but the t.v. was up so high. I should have gone to bed. But I missed my mark. Will do a good curve next Saturday and will try to stay on top of his BG the week... especially in the mornings.
 
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Hi Sandi.

You've had quite a time of it, but you are so lucky to have Marje there in Tucson with you (my home town). She is one of the people that helped me when I joined the Board, and helped to save my Cinco's life. She is very knowledgeable, caring and patient.

This is all so overwhelming when you first start, we know. But hang in there. It will get easier, I promise. :bighug:

Sandi & Chase in AZ said:
But I did just get a +11. He is at 196.
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I was just looking at your spreadsheet and I want to mention that the 196 you got was actually at +7. We count hours from the last shot, and this test was 7 hours after you shot. A +11 would be one hour before your next shot, and that would make it 0535, I think. Are you military? It's not often I see someone using 24 hour time (AF brat and AF wife here).

Remember to take some deep breaths. You are not alone - you have joined a wonderful family of people that love their cats as much as you love your Chase. We're going to help you get him feeling better.
 
Tricia Cinco(GA) & Harvey said:
Hi Sandi.

You've had quite a time of it, but you are so lucky to have Marje there in Tucson with you (my home town). She is one of the people that helped me when I joined the Board, and helped to save my Cinco's life. She is very knowledgeable, caring and patient.

This is all so overwhelming when you first start, we know. But hang in there. It will get easier, I promise. :bighug:


I was just looking at your spreadsheet and I want to mention that the 196 you got was actually at +7. We count hours from the last shot, and this test was 7 hours after you shot. A +11 would be one hour before your next shot, and that would make it 0535, I think. Are you military? It's not often I see someone using 24 hour time (AF brat and AF wife here).

Remember to take some deep breaths. You are not alone - you have joined a wonderful family of people that love their cats as much as you love your Chase. We're going to help you get him feeling better.
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Hi Tricia. I'll get the hang of it.... at some point. I just know that I won't give up. :) Thank you for mentioning the SS. Did you fix it? Or did Marje? I don't do very well when I've fallen asleep and then wake up and do something like test. :( I guess that will take practice, too. I will admit, though.... there are SO many things to learn and remember.:banghead:
 
I just want to add a"Welcome" from us, too! You are doing great...as you said, there is a lot - but fortunately there are lots of people here to help. We've all been at "the beginning", too, so we understand the feeling. Just ask questions as often as you need to. You're not alone in this!
 
Hang in there, Sandi! It's been rough this weekend but you've learned more than you realize right now in your frazzled state. I like that you lowered his dose to 0.25 u. Gives you a little "breathing room".
 
Sandi & Chase in AZ said:
I'm still not understanding when I should be testing,
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Hey Sandi, the below might help, it is from New to the Group Stickie. It gives an idea of an active cycle.

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:
  • Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations." http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus and Levemir Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).
A full understanding of the following concepts will go a long way in helping you regulate your kitty's blood glucose when using Lantus or Levemir:
  • Carryover - insulin effects lasting past the insulin's official duration
  • Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
  • Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body
  • LANTUS & LEVEMIR: WHAT IS THE INSULIN DEPOT?
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Bobbie And Bubba said:
Hey Sandi, the below might help, it is from New to the Group Stickie. It gives an idea of an active cycle.

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:
  • Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations." http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus and Levemir Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).
A full understanding of the following concepts will go a long way in helping you regulate your kitty's blood glucose when using Lantus or Levemir:
  • Carryover - insulin effects lasting past the insulin's official duration
  • Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
  • Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body
  • LANTUS & LEVEMIR: WHAT IS THE INSULIN DEPOT?
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
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Thank you so, so much. I know that there is so much good information on here, I have just been overwhelmed with facts and numbers, and tight scheduling, and taking hundreds of notes. I don't have a working printer so I'm going to have invest in one. I do much better if I have things printed out that I can pick up and read. I was going to put my notebook together over the weekend but Chase kept doing the "Dipty Dip". LOL. I was exhausted. I also deal with chronic pain... neck injury and severe arthritis in the lower back. All of the getting down on the floor and up again to test Chase put a horrible strain on my back. Pretty soon, now that I've learned how to shoot properly, I will put him on my bed to do it. For now, though, since he's still a little skiddish about being poked, I need to sit down on the ground, put him between my legs as he is laying down and facing away from me to keep him still. Then I test and pull my self up onto something to stand back up. LOL. We are quite the pair, here.
 
Sandi & Chase in AZ said:
Thank you so, so much. I know that there is so much good information on here, I have just been overwhelmed with facts and numbers, and tight scheduling, and taking hundreds of notes. I don't have a working printer so I'm going to have invest in one. I do much better if I have things printed out that I can pick up and read. I was going to put my notebook together over the weekend but Chase kept doing the "Dipty Dip". LOL. I was exhausted. I also deal with chronic pain... neck injury and severe arthritis in the lower back. All of the getting down on the floor and up again to test Chase put a horrible strain on my back. Pretty soon, now that I've learned how to shoot properly, I will put him on my bed to do it. For now, though, since he's still a little skiddish about being poked, I need to sit down on the ground, put him between my legs as he is laying down and facing away from me to keep him still. Then I test and pull my self up onto something to stand back up. LOL. We are quite the pair, here.
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You poor thing, before I was going to suggest for you to put a towel on your kitchen counter so you wouldn't have to get down on the ground but I see where keeping him corralled between your legs is the reason for being on the ground. I do the counter height method and keep an arm across his back to keep him from escaping but, now he is so used to getting tested he is cooperative.
 
Bobbie And Bubba said:
You poor thing, before I was going to suggest for you to put a towel on your kitchen counter so you wouldn't have to get down on the ground but I see where keeping him corralled between your legs is the reason for being on the ground. I do the counter height method and keep an arm across his back to keep him from escaping but, now he is so used to getting tested he is cooperative.
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Chase is a BIG boy. I have a very small apartment so counter space is very limited. I'll try the bed once he gets more accustomed to all of this. LOL... and once I get accustomed to all of this. :confused:
 
Bobbie And Bubba said:
PS, and I understand about being overwhelmed. I copy all the info that is valuable and save on word doc so I can find it easier than trying to look it up on the forum .
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Hey... great idea. I'm going to do that right now. At least I'll have one central place to look at the docs most important, right now. Oh... how I wish Starbucks delivered. For now, my hot tea will have to do. :coffee:
 
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