HELP! AMPS (+10) 64. !0/31/10 Squamee

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judy and squamee(GA)

judy and squamee(GA)

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AMPS (at + 10) 64. ARRRRRGH! An hour later, she is 58. I am feeding her regular food and wondering if I should switch to higher carb. Is this an emergency?

And I was vaguely aware that she was eating all night (I have been leaving food all over, so there is some in my bedroom)---so who knows how low she went! I am befuddled. Obviously I will not shoot till she hits 150, but then what? Back to 1U?

to recap previous 3 days:
10/28
AMPS 345 .8U
+6 242
PMPS over 500 1.2U
+3.5 311
+5 222

10/29
AMPS 281 1U
+4 134
+6 251
PMPS over 500 1.2U
+3 266

10/30
AMPS 372 1.2
+4 164
(+14) PMPS over 500 1.4U
+2 345
 
I think Hypo numbers are below 40. Hypo seizures can start at 35 and below depending on the cat.

When Harley dropped to 42 I fed him some Friskies 8% carb food and he came up very gently, he usually eats 4% carbs so doubling the carbs brought him up without sending him zooming hi.
 
I am unsure how to record new test levels. (i.e. hours after last shot last night, or hours after AMPS this AM) So let's says these numbers are hours after the AMPS this morning.

AMPS (at +10) 64 fed Mac Cat GC adult chicken and Liver. Also allergy pill pocket with Fortiflora

editing these numbers to show that no insulin was given this morning.
+11 58 fed some more
+12 55 Gave her some FF beef feast in roasted gravy
+12.5 82
+13 68 Gave some more FF beef with gravy.

Tested myself on the meter and it was 94.
 
Thanks for the quick response, Rob. I am going a bit crazy. I think the FF was high carb. It's a new label and I am not sure of the carbs, but it has gravy so I am assuming it is high. I was thinking of shooting .4 but I am waiting at least another hour.
 
I don't blame you, they do like keeping us on our toes don't they.

I tend to be very conservative, remember, I would probably go lower like .2u because now you have only 9 or 10 hours until PMPS and you want a shootable number then.

But it's your call, you know Squamee and her situation better than anyone else, go with your gut feeling.
 
+15 AMPS 248 .2U
Thanks so much Rob! I have made a pact with myself that when I am unsure, I should go low. And I can't stay up till +12 to shoot tonight, so what you said made a lot of sense to me.
Who knows what happens next?!
 
hi judy, i missed all the action. so glad robin was here for you.
fwiw, just becuase there is gravy does'nt mean it's a gravy high carb. it has to say on the 'in gravy'.
please keep a small supply of your high carb cans seperate from your regular low carb food.
a hypo is not the time you want to be looking up labels and such.
the can actually has to say 'with gravy' ok.
you did great in this low number...now to rethink dosing.............hmmmm.
 
Sorry I'm late. Quite a ride you guys had. I'm about positive you will see a very high number at +12. So the dilemma becomes what to shoot then.

Other than the very slight dose increase is there anything that you think that could account for the larger than expected drop?

Then the current rise might have something to do with a higher carb food.

If nothing apparent in the reasoning for the drop then I might be tempted to try 1u or even 1.2u tonight on a very high number?? You could be conservative and then just suffer though another cycle where she runs high just to remain cautious I guess.

Sorry I got a bit of a late start today and I'm being kept busy today. I'll try to check in here again in a bit.

Joanna in her previous posts to you was talking about experimenting with lower doses??
viewtopic.php?p=293119#p293119
 
Nothing to account for the drop. But doesn't 64 at +10 mean she was probably lower than that during the night? I am turning into a real chicken. I don't think I can shoot higher than 1U. And the latest I can shoot will probably be +10 or maybe +11.
 
judy and squamee said:
But what about the fact that she was eating on and off all night?
Click to expand...
Isn't that what cats should do? I think Joanna mentioned something about the potential for when they are NOT eating that the pancreatic action does not happen and this *might* make the number go higher. I will say I'm not a subscriber to that argument but if you placed the opposite argument in this case her eating could have made her numbers go lower via pancreatic action. And it might explain the very late nadir - that the pancreas was actually doing some work in this case.
 
I was also looking at the SS you are using. The +time columns seem a littler odd to me that they do not contain +11 but go + 10 12 PMPS. So I guess 12 is actually supposed to be +11. Anyway I was looking at this because if this trend continues where you are getting these crazy numbers at PMPS to see what happens right before that at +10 and +11. To see how "bounce" they look if going with some of Joanna's thinking.

Also as far as you SS goes too you might want to start a new worksheet/tab. So you would copy that "Numbers" tab/sheet and then name the new tab/sheet something new. Then go in and delete out all of the old info in the new sheet meanwhile leaving all the old data in the old tab/sheet.
 
You are saying I should try to get some +10 and +11 readings? I assume that is not tonight, since it looks like her numbers are going straight up (and she and I are very weary of testing.--I think I did a lot of unnecessary testing today-- I was hoping to get some indication of when her nadir is, but I guess the insulin shot was too low to have any effect).
I am thinking about tomorrow and if there is a repeat performance of today. Probably will not be so low since I am reducing the dose, but I have to be out on and off tomorrow, so that means she may be without insulin in the morning. Guess there is no help. I can only do what I can do.
 
I'm just interested in those if we keep having that 499+ trend at PMPS. From what it seemed like before it was happening fairly quickly at the end of the day. But really looking back I did not have any real proof of that.
 
I think your ok to shoot at +10 especially if she is high then. It looks like that .2u didn't do a darn thing.

Also, a tip someone on this board gave me was to write the carb % on the top of the food can with a sharpie, that way in an emergency there is no guessing at what you're feeding.

I've been doing that with my mid & hi carb foods. It seemed a little silly until Harley threw me that 40ish bg, I was panicky, but releived that I had the option to choose between 8% & 12% without having to think about it or run around and try to figure it out.
 
I keep thinking about what could be different to account for the lows. The only thing that is different--as of Sat AM we stopped the gabapentin. That definitely was greatly agitating her morning and night---but it's hard to believe that could result in this kind of low. Also, the phenobarb has been building up in her system since we increased to TID and I have successfully been giving her the pills (anti-jinx!). Her mouth symptoms have decreased, so I guess it's safe to assume she is in less pain. But this is not a dramatic all at once change.
 
All I can say is that it can happen at any moment to our non-standard issue kitties. When it would happen to me I would generally have a pretty good clue [like a reduction in eating] going into shot time that something may be up. Sometimes those clues never panned out so I would be cautious and then undershoot. Then sometimes he would go into full food protest and start needed 1/2 or less the dose he was getting until he got over it - then ZOOM it was off to the races again. It is just a crazy balancing act.

But it can all be used for later - the next time she pulls something like this you know to shoot a little more than .2u when she's back on the up swing.

I've never understood how other beans that use insulins other than PZI get it to work out with their non-standard issue kitties.
 
so glad some peeps were around to help you!!! I am just getting to the board now and my internet is cr*p tonite, so I may not be here long.... one thing you can do when you don't know what to do is go back to the last known good dose - my internet won't let me get to the SS at the moment, but I am thinking it was something around maybe 0.8 when you last got a good U-curve? Anytime you don't see a nice curve I get suspicious, which is why I'm suspicious of the 1.2s. They can be really sensitive though to small changes - for instance with Bix he'll take 1.2u nicely on a 280 PS, I shot it the other day (what was I thinking? ohmygod_smile ) on a 210 PS and got something crazy 12 hours later, like a 94 or something, which I'm guessing means I overshot. So it could be she is just fine with 1.2 but 1.4 is too much, hard to say for sure.

As long as you aren't seeing ketones there is no need IMO to overstress yourself with trying to find the perfect dose or keep her in green #s. Of course that is the ideal, but it's not always realistic, and unless they have ketones you have some leeway. If it were me, I would probably pick the highest dose I felt comfortable with, maybe 1u, and go back to that for a couple days (barring low #s of course that suggest a dose reduction). If the #s go higher and stay there, then I'd go back to 1.2u. Again this is all without being able to get to the SS for the moment, so the #s are just ballparked from what I recall. If those doses are scaring you, I'd go back to something you feel comfortable with. Although some may disagree, my philosophy (in the absense of ketones) is you have to understand your doses and prove to yourself they are right. If that means you end up undershooting for a couple days to see what a lower dose does, and that gives you the confidence to raise it, then that's what you need to do (not to intentionally undershoot, but to experiment how you need to to get the data you need to decide what to do).

Hoping that made sense. :) Sorry for your rough day, hope things are better by now!!!!!!!!!! (((hugs)))
 
was able to get to the SS - if it were me I would probably revisit things around 0.8u, maybe ranging from 0.7 to a skinny 1 - 1u and higher is where the #s start looking suspicious to me

just my 2c - my take could be totally wrong, that's just what I'm seeing and what I would try I think in your shoes (barring ketones, in which case I would try shooting early to head of #s going higher, if I were able to do so)

I would also try some deep breaths and take a step back - if you are seeing nadirs that are in blue #s, IMO that is probably good enough for now. You can aim for better #s at some point, but if her eating is inconsistent and you are trying to get other meds under control, I'd say the goal is to keep her in decent #s, and not stress about it beyond that. Again just my 2c :) everyone has their own approach...
 
was able to get to the SS - if it were me I would probably revisit things around 0.8u, maybe ranging from 0.7 to a skinny 1. 1u and higher is where the #s start looking suspicious to me

just my 2c - my take could be totally wrong, that's just what I'm seeing and what I would try I think in your shoes (barring ketones, in which case I would try shooting early to head of #s going higher, if I were able to do so)

I would also try some deep breaths and take a step back - if you are seeing nadirs that are in blue #s, IMO that is probably good enough for now. You can aim for better #s at some point, but if her eating is inconsistent and you are trying to get other meds under control, I'd say the goal is to keep her in decent #s, and not stress about it beyond that. Again just my 2c :) everyone has their own approach...
 
PMPS 489 .9U

Thanks, all, for your help. Today was a most exhausting day. Hope tomorrow is better. The good news is that she is still loving the Fortiflora, and taking the phenobarb with no difficulty. What a godsend! She licks up the plate even after it is all gone--she can't get enough of it. And I do think her mouth symptoms are reduced.
 
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