I NEED HELP NOW! 4/10 Champ PMPS 289, +1.5 285

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Patty & Champ

Patty & Champ

Member Since 2011
Yesterday

I would love to see some 100s just once in a while.

I was planning on doing a curve today, but don't know if I should wait until next weekend since he's only been on 1 unit b.i.d. for five cycles (including this morning). His numbers were so flat yesterday, I don't know how much value a curve would be today. Any thoughts on this?
 
Re: 4/10 Champ AMPS 298

a curve is good anytime you can get it!
Go for it. :mrgreen:

Welcome to Lantus Land by the way!
 
Re: 4/10 Champ AMPS 298, +2 296

His +2 is only down by two measly points. Can someone give me the link to the protocol? I think I found it, but it was sooo confusing to me that I'm hoping I was wrong!! I may need an interpreter. And I've been a medical transcriptionist for 20 years, transcribing for endocrinologists!! If you post the link for me, I'll print it out and study it like it's for a test. hahaha.

I hope everyone's Sunday has started out lovely!!

And I have decided to do the curve today...why not? I'll probably have to increase his insulin, as soon as I'm allowed (ya'll will let me know when?) so I'll just do another curve when that happens.
 
Re: 4/10 Champ AMPS 298, +2 296

Morning guys! Curves are always welcome, always a good thing. It will give you valuable data, help you determine where Champs low point is in the cycle. One can never have too much data. :-D

The protocol is located at the top of the board, but here is the kink anyways: Protocol It can be very confusing... alot to grasp. Just ask questions, anytime anything is unclear. I suspect one of the dosing folks can help you out when it's time to change Champs dose. If you wondering if you should, pose the question in your subject line - it helps them know you want help.

Good luck with the curve! He's off to a nice start today, GO CHAMP!
 
Re: 4/10 Champ AMPS 298, +2 296

Hi patty - oh I know, and that is a good thing! .... I remember how it was when Mannie and I first started. I was so clueless.... :roll:
 
Re: 4/10 Champ AMPS 298, +2 296

The stickies are the permanent posts at the top of the Topics list. They have a yellow star by them and are always there. The Protoco; is the third one down.

That 2 point difference is actually right on cue. Reread this Sticky too. New to the Group.... Especially this part;
Example of a typical curve:
+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.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...

ECID (every cat is different), so onset and nadir may be earlier or later than the average and while the shed is still building things are going to be changing around. Roni is right, the more data you can collect, the better you will be able to understand Champ's needs.

If he doesn't come down today don't panic, yellows are definitely better than pinks and the shed may just not be full enough to bring him down yet. Sienne has a saying"Fat yellows are a sign of blues to come."
 
Re: 4/10 Champ AMPS 298, +2 296

I've read the protocol verrry carefully. This is what I interpret from it, so someone please tell me if I right or wrong...

Champ should have been started at 1.5 units b.i.d. Instead, he was started at 3 units b.i.d. He was on 3 units b.i.d. for 12 days at which time I abruptly (like a dummy) reduced it to 1 unit b.i.d. This is his third day of 1 unit b.i.d.

I interpret from the protocol that if after today he still has relatively high BGs, I would increase his dose by 0.5 unit tomorrow morning, to 1.5 units b.i.d. I keep giving him the 1.5 units for 5-7 days. If his BGs are greater than 200 but less than 300, I increase his dose by 0.25 units, to 1.75 units b.i.d. etc., etc.

Am I interpreting this correctly? The way his curve is going, I'm pretty sure he's going to have a dose increase starting tomorrow morning. Let me know. I don't want to jump the gun again and do something either wrong or too soon.

Thanks everyone. You're making something extremely stressful a little bit easier!!! I appreciate you all sooo much.
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287

You do and don't have the protocol correctly interpreted. A "high" number means that the bulk of the nadirs are in the 300s or higher. It looks to me like Champs nadirs are primarily below 300. That means you would increase the dose to 1.25u (i.e., increase by 0.25u, not 0.5u). In addition, you should hold the dose for a total of 3 days (6 cycles). Generally, we don't encourage increasing after 4 cycles unless your cat is sitting in numbers above 300 consistently.
"General" Guidelines:

* Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

* Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

* Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose...

* Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
.
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272

Sienne, I think you may have misunderstood how I wrote something...I said today is the third day (6th cycle tonight) that he has been on 1 unit b.i.d. and I should increase tomorrow morning (7th cycle). But I do understand I should only increase to 1.25 units b.i.d., NOT 1.5 units b.i.d. A cycle is one shot and a full day 2 cycles, right? hahaha. Learning new lingo is killing me!!!

So...do I increase his dose tomorrow morning to 1.25 units? I've never felt so unsure of something in my entire life!! ugh
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304

I don't like his +8 number at all...304. It has no where to go but up from here and that scares me. Someone please make sure to let me know if increasing to 1.25 units tomorrow morning is the way to go. Or if you have any other advice, please, bring it on.
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304

Hi Patty. I am definitely NOT a dosage expert, but I have been reading your posts and can sense that you are unsure and really just looking for someone to reassure you. Champs nadirs are mostly in the 200s and tonight will be his 6th cycle at this dose. You are correct to increase his insulin dose tomorrow AM. You'll increase it by .25U, bringing his dose to 1.25U. Your decisions regarding dosage after that will be based on his nadir. The fact that you doubt yourself is normal and to be expected, not just because this is all so new, but also because you don't want to harm your furry baby. It's OK to ask the same question more than once. There will be patient folks who will answer them over and over again until you're secure and confident. It is of the utmost importance to read all the stickys, more than once. Study them until they make sense. Read other peoples' questions and the answers they get. You have to get more comfortable with all this info so that you can start to think thru some of the more simple steps. All of the people who use this forum have started out not knowing much and feeling insecure. There is no shame in asking, but be pro-active and become familiar with Lantus and its protocol. Very best of luck to you.
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304, +10

Good gracious!! This cat has no idea which way he wants to go!!! He went down to 280 at +10. What a seesaw. He woke him up to check his +8 and he was still lying in the same corner when I woke him up to check his +10. I brought him out into my office so maybe he'd get a little active. He's been a sleepy boy most of the day.

Bev, though I see you're new also, I admire the fact that you seem to be taking this in stride so much better than I. I love hearing from you because you really do calm me down!

So I have ANOTHER question. If Champ is acting like all he wants to do is sleep, and its not his normal kind of sleep, but an "I don't want to open my eyes" kind of sleep, and his BG is in the high 200's, what could this indicate? Is it best if I have him eat something or keep food away from him at that time?
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304, +10

Patty, I wish I could help you here too but I don't have that kind of knowledge. This is a topic for one of the people with lots of experience. I hope someone helps you soon. Hang in there,it will turn out OK.
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304, +10

Yeah, I'm just going to keep checking in here, hoping someone stops by with some ideas. At least it's almost six and I can give him his shot.
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304, +10

Hi Patty,
I'm bumping your condo up to the top of the list so that you can ask your question about Champ's apparent lethargy. Please put "help" in your subject line to get some eyes on your problem. (Go back to your first post of the day and edit the subject line there. You can leave out some of the bg readings to make room.) Your curve today is basically flat. Usually this means that something is about to "happen" with bg numbers. But it could simply be that the original shed (based on 3 units of insulin) has begun to deplete to reflect the amount you are now giving. That may be why Champ is not feeling himself.
Hang in there, and I hope someone will be along to give you good help.

Ella & Rusty
 
Re: 4/10 Champ AMPS 298, +2 296, +4 287, +6 272, +8 304, +10

good work on the curve.
are you planning to spotcheck tonite?
see how the evening goes leading up to AMPS tomorrow.

giving you a bump
 
Re: HELP! 4/10 Champ AMPS 298, +6 272, +8 304, +10 280, PMPS

Thanks for the encouragement everyone! As you can see from Champ's PMPS, it seriously looks like he had no nadir at all...no highs, no lows. I'm going to check him at +3 and then before I go to bed, which is usually 11 or 12 o'clock.

So is the consensus that tomorrow I start the 1.25 units?
 
Re: HELP! 4/10 Champ AMPS 298, +6 272, +8 304, +10 280, PMPS

I think so , unless someone more expert chimes in. We actually aim for a flat curve, just a bit lower than you are giving. Champ's body is adjusting to all this and that could be the reason for the sleepiness. And it isn't unusual to get that little fluctuation late in the cycle

As Roni said a flat yellow curve often leads to some good action. The +3 and before bed sound good.
 
Re: HELP! 4/10 Champ AMPS 298, +6 272, +8 304, +10 280, PMPS

So, where to start....

If today was any indication of a pair of sleepy kitties, you could add my two. I'm not sure what the weather is like where you are, but the warm weather here had my guys snoozing. I was in another condo earlier and someone mentioned that their cat tends to eat less and is less active in the warmer months. So, that might be one factor.

Champs also looks like he's surfing in lower numbers. If you think about it, most of our cats were probably in high numbers well before we realized something was wrong. Their bodies adjust to those high numbers and regard it as the new "normal." Once we start giving them insulin and their numbers come down, it probably makes them feel weird. That may also be contributing to Champ's wanting to sleep.

As for the numbers, Lantus has a characteristically "flat" curve. In fact, this flat curve is desirable especially once a kitty is in lower numbers. You're seeing a flat curve today. Also, it's worth keeping in mind that there's about 10 - 20% variance that's related to the meter. It's easy to fix your gaze on each individual number especially when they switch colors on your SS. In reality, all of the BG tests from today are pretty much the same.

I think you have plenty of room to increase Champs to 1.25u tomorrow.
 
I don't know what's going on with Champ. His BGs are completely flat today in the high 200's, but he refuses to get up and move around. He has slept all day, the kind where when I pick him up he's all floppy and when I put him back down, he just closes his eyes again. I'm getting worried. I don't know what this means and if I should just ride it out.
 
i don't know but will bump you up. why don't you remove the BG numbers all together from your first subject line so that it gets attention. another option is to put a 911 on your subject line - i assume that's ok since you are really concerned. you could also call your vet.

maybe this is unrelated to his blood sugar.

hugs!
 
Hi Patty,

I seems disconcerting that when you pick him up he just sort of flops. That does not seem normal. Do you have a 24 hour ER veterinary clinic you could call for advise?
 
Do you have a backup meter that you know the difference it runs from your main meter? You could recheck him with another meter. His numbers really aren't bad at all. I agree with Julie...maybe something else is going on. There's definitely a difference between just being sleepy and not wanting to wake up.
 
I'm pretty sure the meter is fine because I checked my own BG (I do this on an irregular basis) and mine was where it normally is. He actually ate a couple freeze dried chicken pieces, drank some water, laid down, stretched, yawned, and went back to sleep. Even though Las Vegas is notorious for being hot, we still have cool weather out here and my house, because it faces north/south, stays even cooler...its registering 68 in the house. So I don't know if weather is playing a role. My daughter said that we all have days where all we want to do is sleep and Champ is probably no different. I don't know. I'm thinking I'm overreacting because he's not acting like his normal self. I need to remember he will no longer be his normal self...there is going to be a new normal. He just, as I'm typing this, got up and jumped up onto his table and bed next to me and had a snack of a couple pieces of freeze dried chicken, jumped down, got in his basket, and curled up. He's not looking exhausted right this minute. I'll check his BG again at +3 and see how that looks, but I'm sure it will be about the same as the others.

I'm so tired of being scared.
 
of course you're tired of being scared! i'm thinking it must be just about time for your +3 - is that right?

you know champ better than anyone else - if you think he's not his normal self, i think it's perfectly ok to call your vet and ask for advice. nothing to lose by asking, and they will know the "right" questions to ask you to determine if it's important and he needs to be seen or not.

when you look at the rest of his behavior, other than the sleepiness - how are the rest? did he eat, drink & use his litterbox as normal today?

how is he now?
 
Hi Patty - I hope all is well with Champ. Maybe it is just one of those days, a sleepy one. It sounds like he is responding now? It could very well be that he just feels different than what he is used too, and just wants to sleep. I just don't know. Is an ER visit needed?

And I know on the being tired of being scared. We have all been there, it will get better the more time you spend dealing with FD. Hugs to you, and understanding.
 
Knowing I'm not alone in this is really touching. I've always been a very strong person, able to handle major stressors at work, etc., but when it comes to my kids (my daughter and my kitty), I'm a freaking basket case. Kind of embarrassing!

Well, I just checked his litter box to see how he did today. I clean it first thing every morning so I know how much he's going in one day. The last two days (not counting today), he had increased thirst and urination again and his litterbox was pretty full every day, though not as bad as when he was diagnosed. Today, his box looks very normal. He pooped and it looks like he peed three or four times, but normal clumps, not huge ones. For the past couple of days, he was also eating a lot (13-14 ounces of Wellness in a 24-hour period), but today he's cut back and ate 2 ounces this morning, 1.5 ounces at about +1 this morning, and 2 ounces at his 6 pm shot. I'm planning on leaving out 2 ounces when I go to bed in case he wants something. Everything about what he's doing today is normal...except the sleeping and the type of sleeping.

I just checked his +3 and its 309 so now I get to be scared as I go to bed today. Crap. I'm going to stay up for a couple more hours and I'll check it again before I go to bed.
 
Patty, I am a newbie also. These ladies have helped me immensely with my Java. I only want to pipe in to say he was a very sleepy guy also. He got diagnosed after a bout of pancreatitis and longtime steroid use for IBD. we started lantus in feb and at one point I got very concerned because he would seem "spacey". We always joked he was narcoleptic since he was a kitten because he could fall asleep anytime, anywhere. But this was different. You have to trust your gut and at the very least maybe make a call to your vet. It will put your mind at ease and hopefully it will be just that his body is getting adjusted. I also noticed at times he seemed "sweaty" or "clammy", kind of chilled but damp. Again it was nothing but well i don't know what. Each time something like that came up I came in here and asked around and called or emailed my vet. This does get a little less nerve-wracking trust me. but don't take chances, if something seems off, check it out. you never know. Java is doing great now, down to .50u form a high of 1.75. He is totally back to his old self-attitude wise. Good luck, we are here for you. And Welcome!
 
Has he opened his eyes enough for you to look in them? Does he look back at you?

Has he gotten up to eat? We always ask about the 5 p's: Pee, poop, purr, play, preen (clean). Sounds like the first two are in order.

Never be embarrassed to care so much about your kitty.
 
He's actually up right now drinking and he just gobbled down 1-1.5 ounces of his Wellness. He gave himself a bath a little bit ago and is doing his full body stretch. Ooohhh he's going pee.... good think I got some Ketostix today!! Checked his ketones and it looks to me like its between normal and trace.

When he was at the vet and was diagnosed with the diabetes, I had them do all the tests, including to check his pancreas, and the vet said everything except his glucose was normal. I'm going to check his ketones again tomorrow if I can catch him taking a tinkle.

I'm kind of scared to call my vet because how do I tell her that I changed his dose on my own (from 3 units to 1 unit b.d.). I'm worried she'll be pissed and immediately want to put him back up to 3 units. Anyone else have the experience of having to tell your vet that you're not following their orders?
 
Thrilled to hear that Champ is up and peeing! :lol: We are a weird bunch here sometimes. He sounds okay, overall, but I know you'll monitor him. :mrgreen:

Lots of people have had these tough conversations with their vets. Ask that question again in the morning, you'll get good feedback. Try putting it in your subject header.

But remember: This is your cat. If this were your child, you would insist on being an active partner in your child's health. Vets aren't used to participation, but they can be trained. :-D Show the vet the documents from the "convert a vet" link viewtopic.php?f=28&t=2509. You have the University of Australia veterinary school, one of the best in the world, providing a proven protocol. It's a well-documented treatment plan (and my Kitty will attest to it!).
 
Anyone else have the experience of having to tell your vet that you're not following their orders?
Click to expand...
Uh...that would be most of us. :lol: I know you want to have a great working relationship with your vet but you have to remember the vet works for you; not the other way around. Most vets have a real problem with we peeps taking advice from an internet group. Not my vet....she looked at the forum and said "they know much more about managing FD than I do because they are obviously dealing with it 24/7". We go over Gracie's SS and I keep her informed but she doesn't interfere with how I manage Gracie's diabetes. I would suggest you take your SS to your vet, the protocol, and if you have a laptop and they have wireless or you have a smart phone, you can show the vet the site and other SSs. I'm sure you can build a good case for why 3 units was too much for Champ. Some people in this group have been through several vets!

You will eventually not be so scared but sometimes it is hard....my girl loves to surf in the 40s and it's kinda stressful for me; she also loves to drop from 80 to 50 right at PMPS...also nail biting time. But you'll gradually learn to deal with it and guess what?? You also have ALL of us!!!

Hope you get some rest tonight. BTW, 309 is ok...it's not up that much from his PMPS...so he's ok. B-R-E-A-T-H-E....that's what they kept telling me. :-D
 
So agreed with what marjorie said., We've all been there, My vet now lets me decide on dosage. I've brought her Mannie's SS too, she can see the results, she and I work together, yet dosing is up to me.

Glad that Champ is up and doing Champ things. :-D
 
Thank you for the good words guys!!. He's curled up in his basket again so the activity didn't last too long, but at least he showed me he was very alert. I'm going to call the vet tomorrow and let her know what I'm doing and see if she wants to have a consult to see all the data and Champ's spreadsheet. I'm also going to try to check Champ's ketones again tomorrow before I call so I can let her know I'm on top of that also. Does anyone know...if it is the trace range, is a trip to the vet necessary or do I wait to see if it gets worse. I'm just couldn't tell with his first test. It looked in between negative and trace, I just couldn't make a call.
 
hi there,
sorry you had a scary moments there, quick question, are you adding some water to his food? that can help "flush out".
some of us make the food "soupy" if kitty will tolerate it.

if you're uncertain about the ketones check, try it on yourself.
You're strips for ketones are within the expiry date? check the date on the bottle.
you want a clean sip, without any litter in there. about 15 to 30 seconds count should do it.

the fact that Champ is eating, using the box, and bathing - those are good things, I know my kitties get really sleepy some days, it seems all they do is nap. especially the warm sunny days. Hope it goes well in the morning.
 
my vet was more than supportive and I sent him info from the website along with the food list. the first big change for us was not using rx food. my vet was very conservative on dose so I didn't have to ruffle feathers there. I email him Javas SS once a week and if we need to talk he calls me otherwise we speak by email. I think he has been very impressed with the help I have been given here and he trusts that I know the risks and benefits of tight regulation and I am prepared to take care of my kitty in any situation. Just be firm but polite and if your vet is totally against this, well you have to make that call. It is your cat after all.
 
With regard to a ketone check, make sure you are following the directions exactly. If you get distracted and don't check the color on the strip when you're supposed to, the color can change and your reading will be invalid. Ronnie's suggestion to test yourself so you have an idea of what the strip should look like is a good idea.

If there are trace ketones, since you're calling your vet, I'd mention this. Adding water to food will help to flush ketones out of Champ's system. More than a trace amount of ketones is a vet/ER visit.
 
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