LOTUS PMPS +7 58 +7.5 56 +8.54 +8.75 77 +9.25 117

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Cathy S

Member Since 2012
I was told not to shoot under 8. but what do I do now. She is eating very well and has no other symptoms.
SEE: url=http://www.felinediabetes.com/FDMB/posting.php?mode=reply&f=9&t=77188]Yesterday[/url]
 
Re: lotus is 3.0 metric now what do I do?

Do not shoot and do not feed any more food. When you get a low preshot between 50 and 150, you don't feed and re-test in 20 mins to see which way the numbers are heading (without the influence of food).

How flexible is your schedule? Can you stall for an hour and make that your new shot time? You can adjust by 30 mins at one shot or 15 mins at each shot.

Could you change the subject line on this condo to
8/16 Lotus AMBG 54 ???

You multiply your readings by 18 to get the values used by most members on this board. Sorry.
Also, include this link to today's thread at the beginning:
url=http://www.felinediabetes.com/FDMB/posting.php?mode=reply&f=9&t=77188]Yesterday[/url]

Include a [ in front of the first url and it will look like this.
Yesterday
Liz
 
Re: lotus is 3.0 metric now what do I do?

A 3 (or 54) is too low for you to shoot with the limited data that you currently have. You have two choices:
  • skip the shot
  • stall and don't feed
If you stall, you will need flexibility with your schedule since your PM shot will be 12 hours from when you give the insulin injection. If you don't think you will be able to test on a 30 min. basis or your schedule can't accommodate a late shot, then you have to skip.

Also, are you able to reliably test, do you have extra strips and high carb food in the house?

You may also want to read this post regarding dealing with low pre-shot numbers as well as the section on becoming data ready in the Shooting & Handling Low Numbers sticky.
 
Re: LOTUS 8/16 54???

Anne, I did everything you said I hope I did it right. I just tested her again about 20 minutes from last one it is 3.0 I pulled the food.
 
Re: LOTUS 8/16 54???

I took away her food and locked her in the bathroom. I will go back and test her in 15 minutes. I have taken her food away. I think
she got about 3 tbps. I have lots of strips and high carb food in the house. I am supposed to go to the hospital but if worse comes to worse I will have to cancel it. They will not be happy but forget that.
 
Re: LOTUS 8/16 54???

Cathy

I think she needs to come up quite a bit for you to shoot. How long are you able to stall? When you stall, then you shoot 12 hours from the shot this morning and then make it up in 15 minute increments each cycle or 30 mins a day on one cycle. Can you get that far behind on your shot time for the next few days? I would be surprised if she rises to over 100 to a safe number to shoot within two hours but she might.
 
Re: LOTUS 8/16 54???

The 54 without insulin is not problematic. You need to make a decision whether you want to stall or skip. If you stall, you'll need to re-test every 20 - 30 min. Getting Lotus up to 150 could take a while.

To be honest, I'm inclined to suggest that you skip the shot. When you're getting low pre-shot numbers, it's often best to decrease the dose so that you can shoot regularly every 12 hours. My suggestion would be to drop Lotus' dose to 0.5u. It's likely that if you've moved Lotus to canned food, you may be seeing the difference that a low carb diet makes on her numbers. Or, whatever infection was going on is responding to the antibiotics since infection/inflammation raised BG numbers. Once the infection starts to clear up, numbers can drop.
 
Re: LOTUS 8/16 AMBG 54!

It's safe :-D If you can stall, just keep testing every 20 minutes and posting. Actually, sorry, but we need you to post the test numbers in the subject line. Nso it would be 8/16 Lotus +12 54 and then when you get the next number add it so it would be on the end of the above numbers as +12.25 xx with dx being the number.

We only put AMBG if you skip.
 
Re: LOTUS 8/16 AMBG 54!

Cathy, you are doing great! Marje and Sienne are experts and they are giving you excellent advice.
Liz
 
Re: LOTUS 8/16 AMBG 54!

Ok...so she's at about 48. Here is my advice :-D Skip this shot, feed her, and reduce her dose tonight to .75u as kitties earn reductions when they are newly diagnosed and the number falls below 50.

By skipping you can shoot at whatever time you want tonight if you would like to change your shot time. If you like your current shot time, then shoot at that time.

Eta: sorry, just saw Sienne's thoughts to reduce to .5u. I think that's a better idea if you have switched food to canned.
And it's ok to take off the 911. We gotcha :-D
 
Re: LOTUS 8/16 AMBG 54!

Do I keep testing her every 15 minutes also do I feed her high carb or the regular stuff.
 
Re: LOTUS 8/16 AMBG 54!

Nope...feed her as you normally would with her canned food. You should check her 30 minutes after she eats to be sure she is coming up. Then I would get a spot check an hour later if she is. I think she will start to rise after you feed. You can leave the AMBG in the subject now...that's ok. Brb with more info but I want you to feed her now.
 
Re: LOTUS 8/16 AMBG 54!

Woohoo, reduction for Lotus! Yay! :-D You can also take off the 911 icon on the very first post. It tends to cause anxiety when we see one of those so we take it off when the crisis is under control.
Liz
 
Re: LOTUS 8/16 AMBG 54!

Ok she has been eating and now she is cleaning her face! I will take a bg at 9.40 should i leave the food available for her during the
day. God what a morning. my computer is telling me to put in updates, a security scan and now the keyboard is doing french things and won`t let me use the question mark!! I should mention that a couple of days ago I tested her at 1.1 (19.8) and that is when I panicked and rubbed syrup in her gums and fed her loads of high carb food which then caused the bg to go up to 31.
 
Re: LOTUS 8/16 AMBG 54!

It's ok,Cathy. Every single one of us had those early roller coaster days and panic. You are in empathetic company :-D

You have to leave soon, right? If you could please post the next test number and let me know how long before you leave. If its soon, I'd leave food out for her if she is still low. Nif you have a couple hours, I'd test again before you go and see where she is.

So you understand about shooting tonight and that you are going to shoot .5u? She is probably going to get up there in BG but don't worry...it's a natural response to the lows today.
 
Re: LOTUS 8/16 AMBG 54!

hang in there! you are doing well! looks to me like putting Lotus on the canned food is making a huge difference. if you can't stay all day to monitor then skipping a shot is just fine. if you are going to be around all day you can stall and wait till her numbers start to show a serious rising trend and shoot then BUT ONLY if it will be possible to do her next shot exactly 12 hours after that time! so if you end up stalling till 1pm, you have to be prepared to shoot at 1am!!!! so, even though you are feeling so desperate to get the insulin in her and get her going on track, skipping one shot isn't a serious issue, as I've learned it's more important to stick to the tight schedule and establish a nice routine for you, her, and her body. So.. if it we my cat, I'd skip this mornign shot all together (call it a fur shot if you like!) and then start again 'new' with tonight's shot. As for the dose.. I'm not experienced enough to really give advice there, but I'd be tempted to reduce a little and work UP rather than having to keep skipping shots.

you have a great support group here! Don't panic! I know when I first started this I was wanting results, and wanting them NOW! and every time I got a number I didn't like or understand from Rupert i'd start second guessing myself - did I shoot wrong? did I shoot enough? did I shoot too much? did I feed him the wrong stuff? is the insulin not working? am I a complete knucklehead? is this ever going to get easier? is it doing any good? blah blah blah. Just know that there ARE no hard and fast answers, and ANYTHING that you do is good for your cat. It does take time, but believe me, it DOES get easier and better. And given how she's reacting right now, it certainly sounds like her pancreas still has a lot of 'oomph' in it so, fingers crossed!!!!

take care. I pm'd you by the way, in case you didn't see the little notation at the top of the board page when you log in.
 
Re: LOTUS 8/16 AMBG 54!

I phoned the hospital and told them I had a family member in emergency so I couldn't come in for therapy.They weren't happy but tough. She is sleeping right now but in 10 minutes I will test again and post it.stay tune!
 
Re: LOTUS 8/16 AMBG 54!

Cathy...as you post your numbers today, they will be counting from the time you last shot. So if the AMBG of 54 was at +12 and her test after you fed her and waited 30 minutes was an hour later, then it will be +13. Tonight, when you get to an hour before you shoot, it should be +23. OK?

I also recommend that you go back today when you have a moment and read through all the posts in this condo. When we are posting quickly,sometimes we cross post and it's easy to miss something. Often there is very important info.
 
Re: LOTUS 8/16 AMBG +13.5 63

test again and she is up to 3.5 (63) will test in an hour I think as it looks like between food etc she is going up. thank God and this
website!
 
Re: LOTUS 8/16 AMBG 54!

I think you can give her more time than that unless you are worried. You didn't shoot and her depot will start to drain a bit. But I always go for the comfort so if you prefer, you can test in an hour.

Could you please update the subject line with test results (I explained above) so I can keep track of her? Thanks!

You are doing great!!!
 
8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

sorry Marje I didn't know you wanted a continous line. Will do immediately! does that look right now? Ok I will wait until 11.00 a.m. and then test again. Every time I put food near her she eats so I am hoping for good things :) Need to go wash my face brush my teeth
and put ice on my knee! back in one hour
 
Re: LOTUS 8/16 AMBG 54!

Perfect but you can only edit it where we can see it by going to the first post of the day, clicking edit, changing the subject line, then click submit. If you change it on a later post, we can't see it on the forum :-D
 
Re: LOTUS 8/16 AMBG 54!

I would feel more comfortable if she tested in an hour after that 63, as Lotus was still dropping just recently, and the food helped her to rise to 63. She may have a decent shed already.

Okay, back to work...
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Now its perfect! Thanks, Cathy.

So go ahead and grab that test an hour after 63 ok? Thanks...see you then.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

will be back at 11.00 a..m. my time with results keep fingers crossed.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Just had very long talk with my vet. She is very concerned about the up and down etc etc. Bottom line is that I am taking Lotus to the vet right now and they will keep her today and around 4.00 p.m. will do another ultra sound on her to see if the nodule on her pancreis has grown at all from April. She is also concerned it is still inflamed and talking about giving her a different drug. Thanks for all your
help and once I have something else to report I will ome back on line.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Cathy

Good luck. One thing I want to equip you with is some info on bouncing. Many vets will look at her SS and tell you she has Somogyi rebound so don't be surprised. And I will save that debate for later. But you had a lot going on...changes in dose, changes in food...numbers are going to be up and down.

All cats bounce initially. Some get through it faster...some take a long time. When Lotus was diagnosed, her body had gotten used to higher numbers. Once the insulin is started and numbers come down lower (not necessarily low but lower than what she is used to) or numbers drop quickly, the liver releases hormones to counterbalance that...so BG goes up. When a cat is just bouncing but is in normal numbers when the bounce clears, we hold the dose. Bouncing is natural! We just ignore those bouncy numbers, which can take up to six cycles to clear, and focus on the numbers when the bounce does clear.

Lotus also had food changes and so Sienne recommended you drop the dose even more than we normally do. With a lower dose that is given consistently, I hope you will see less up and down and wonky numbers. We are here to help you.

I hope her pancreas is better. Will the vet do another spec fPL test as an U/S can be inconclusive. Hope lotus is feeling better. We look forward to your report.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

HI Marje,
I want to thank you for all your support. I am on my way to the vet now after having a long talk with Lotus. My problem is that all
my life my cats have died from things no vet had ever seen before except in textbooks. I had a beautiful Maine Coon named Ira that I adored. He died of a blood clot when he was 2. Apparently heart problems are now genetic in Maines due to breeding problems. I
had a cat die of intestinal problem which three vets had never seen before. I had to say this but I figure that even though they say
cancer in the pancreas is extremely rare in cats I figure that is what they will find when they do the second ultra sound. She had this
6 mm nodule in April and the vet wants to see if it has grown or if her organ is still inflamed. I suspect it has grown. I can't afford exploratory surgery and so I figure by tonight she will be gone. Sorry to be such a downer but that is my luck.
Off to the vets with my precious furbaby.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

(((((Cathy))))) Lotus is feeling good and eating so there is no need to make any decision today. Sending positive energy for a good vet visit.
Liz
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

(((Cathy))) I understand. But keep up the hope...ok? When my Gus was about 10, he had acute onset pancreatitis with a nodule. We treated the pancreatitis aggressively. He is 16-1/2 now and his pancreas has been clear all these years. I'm not trying to tell you the same thing will happen with Lotus. I'm not a vet. But there is hope. Sending you prayers.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

THINK POSITIVE!!!!!!!!!!!!!!! I hope it all works out fine. and, as others have said... remember that most vets have very little 'up to date' info on diabetes in cats and often will tell you stuff that will get you super depressed and also is incorrect! I gave up on our first vet (Cat hospital by Elk lake) because although she was smart enough to put us on Lantus immediately, she had NO clue about the protocol, nor the diet. As most vets do, she was pushing the 'special vet approved f/d food'.. which turns out to be EXACTLY the opposite of what kitties need. So... no matter what your vet tells you re the diabetes I strongly advise you run it by the people here first!!! as has already been pointed out, the up/down is NORMAL when cats first start on Lantus, this is something a lot of vets just don't seem to get. it takes a while to find the perfect dose.

hopefully the u/s doesn't show anything horrific. and frankly, with her numbers being in those nice low ranges today, I would be inclined to think that she is doing really a lot better than you think she is!hang in there!
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Thank you all for your support and kind words. I know I sound like I am giving up but (here comes the soap opera) before these
strays showed up I have 5 different ones. Three years ago I lost them all in the space of 9 months. Two died in one week.
They were all fairly young ie 8 years to 2 years and died so suddenly and unexpectedly of weird things like blood clots cancers
etc that I was totally numb for a year. These fellows came along and I promised myself I would care FOR them but I wouldn't
care ABOUT them so it would not hurt so much when they left. Fat chance. Furbabies know a good thing when they meet one and they worm their way into your hearts no matter how hard you try to keep them out. I am sorry this is probably not the right place to
be posting this. The ultra sound is supposed to be done around 3.00 p.m. and once I hear anything I will let you know. God bless
you all for your caring I hope one day I will be able to pay it forward to someone else.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

good luck! I hear you, we have FIVE right now! three of them that just moved right on in despite my protests of 'NO MORE CATS' because it it so so so very hard when you lose them. But, they do weasel their way in to our hearts don't they! And yes, they DO know how to pick us don't they!

good luck. fingers crossed, update as soon as you get home!
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

You're a crazy cat lady, just like we are. :lol: :lol: You are with family here.
Liz
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

This seems an appropriate place to post this:

It came to me
That every time
I lose a cat
They take a piece
Of my Heart with them,
And every new cat
Who comes into my life
Gifts with me a piece
Of their Heart.
If I live long enough
All the components
Of my heart
Will be cat, and
I will become
As generous and
Loving as they are.



this is also out there as a dog saying......I've seen it both ways.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/+19.5 19.9

Finally heard from vet and the really good news is that the ultra sound showed 'nothing scary'. It is no longer inflamed and the
nodule has not grown. She is still puzzled by the fluctuations in blood sugars. she has done some research and thinks 'maybe' Lotus is a cat who Lantus stays in longer than just 12 hours does that make sense? you know it last 12 hours for other cats but for her it could
be 14 hours.
anyway they took her blood sugars at 3.30 and they were 11.1 which is 19.9. she says lotus is doing fine. grooming herself and seems
chipper. she wants me to feed her again and test at 8.00 p.m. if it is 10 under don't shoot over 10 to 12 half a unit and 12 and over one unit. she thinks that maybe she will only need one unit in the morning and one half in the evening. what do you people think?
No don' worry I am not asking you act as my vet just need your voice of experience
Running to the car to pick up my furbaby back shortly.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

I am so glad to hear the ultrasound did not reveal anything scary, whew! The wise ones here will advise you on dosing. Lantus is slow acting so most people give the same dose for a few days, long enough to see how the kitty is responding before making a change. I have seen posts that indicate Lantus may last longer in some cats than others, figures, they are cats. Your own data for Lotus will tell her story.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Hi Cathy,

Your vet is suggesting you adjust the dose based on the preshot test, as if Lantus acted like Prozinc or PZI (which I understand because that is what I used). The problem with that is that isn't the way that Lantus works. The AM and PM dose should be the same, and it should be kept constant for several cycles until the kiity adjusts to the dose (unless you see very low numbers at nadir that would indicate that a reduction is needed).
If you dose lantus in various amounts from one shot to the next, what you'll end up with is numbers that are much harder to understand. Lantus has a cumulative effect, and the amount you are shooting "right now" isn't necessarily going to have an immediate effect on BG numbers. They will also be influenced by the depot that has been built up from the previous few shots.
In other words, shooting a lower dose tonight may not have as much of an effect on the next 12 hour cycle as you might think it will.

I am not sure what her dose should be tonight, and I'll let someone who has lots more experience with Lantus answer that question. But I do know that "custom dosing" based on her preshot test results is not the proper way to base the dose.

Carl
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

that is what I thought. How can you decide based on one blood test. She kept saying about maybe it is because we have had to change the dose then she tells me to monitor the blood and dose on the bg reading. I don't understand that thinking. I also don't think she realizes just what the difference in with the insulin.
I will wait to hear from others and then see what her bg readings are at 8.00. in the meantime no food.
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Hi Cathy,
You're on Pacific Time, right? I'll see if I can get some experienced eyes to take a look well before shot time.

Carl
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Great news about the U/S! And could you please update your spreadsheet with the readings that you have from today? In the shot entry, you can put 0 or NS for no shot. Also, what has she eaten today? It's useful to know when, how much and the carb content. You can summarize that here or in the spreadsheet or both.

That 11.1 corresponds to 199 in US numbers (not 19.9).

Sienne has suggested a shot of 0.5u tonight. Can you get a test about 7:30 and post that? Put it in the subject line of the first post and also post a reply (that will put your condo at the top where it will get more attention). You can also use the ? icon and "dose question" in the subject line. If it is below 200, you will definitely want to get some help. Don't feed after the test, if she is below 200.

You've had a crazy day and you've done a great job!
Liz
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/

Cathy

I'm so glad that Lotus's pancreas looks better!!! Is she eating ok?

Unfortunately, as much as many of us love our vets, the sad story is they really know very little about managing FD. Many of them might be more familiar with PZI which is made for cats and where you would dose a sliding scale based on a Preshot. We do not do that with lantus and that is the best way to get wonky numbers. We try to find the dose that will keep them at a safe number that you can shoot consistently. After reading through your condo from yesterday and studying her SS today, I still think that .5u is the way to go. Then we can see if we need to adjust from there. She might need more insulin but, in the case of a newly diagnosed cat with little testing data, it's much better to have to increase than to have you needing to feed her to keep numbers up.

Liz has a good suggestion to post a +23 test (which would be one hour before you shoot tonight) and let us see what it is. Then we can confirm the dose.

You may have to educate your vet once you get your feet more solidly on the ground with the TR protocol. You wouldn't be the first one here who has had to do so :-D :-D
 
Re: 8/16 Lotus +12 54/ +12 15 49/ +13.45 63/+199

I am trying to change the spread sheet but it is stuck on 'saving' again. So instead of 7.30 I should blood test at 7.00pm?
 
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