New Member Izzy

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Looks like she might be bouncing off the greens, can you get a before bed test tonite? It's always a good idea so you know how the cycle will be.. If the +2 is higher generally means an inactive cycle, but if its lower or the Same the cycle is more likely to be more active.

Great numbers though!
 
yes I will do a bedtime test. Poor thing has had such a snotty nose and runny eyes. I have been running the vaporizer for 24/7. She is up now.....alert and ate a little bit more. I am concerned that I haven't see any stool from her..though maybe she hasn't eaten that much? I'm in the process of moving so I went an dug out my food scale so I can start weighing at least her breakfast and dinner. In between it's hard to say if Salem helped any.
 
How often does she normally poop?

Looks like she is coming down, you might want to get a +5 if you can to make sure she doesn't drop too low..

Wendy
 
amps at 6am 87. her last shot was only 10 hours ago because of my work schedule. I need to get her back on to a 6 am scheduled M-F, so her Sunday shot I wil move up 45 minutes.
 
With Lantus, we change times no more than 15 minutes per shot or 30 minutes 1 time per day. This is because of the depot/carry over effects. Otherwise, when shifting earlier, you may get unexpected lows that require monitoring and frequent feedings of high carb foods to prevent hypoglycemia.
 
BJM here is my problem. I work 2 jobs one job M-F leave home at 6:30 am and get home at 4:pm, 2nd job Saturdays I leave at 9:30 am and get home at 7:30 pm. So 15 minute increments to get her back on her Monday scheduled is not going to work for us. So what do you suggest? I always skip her Saturday PM shot? and start her back on at 6:30 am Sunday? I am 40 minutes from work so I can't drive back and forth every day to change her schedule in 15-30 increments.

I checked her BG at 6am she was at 87. She had some kibble and I held off her shot because i know it's too soon.

Wendy: at 7:30 she was at 131 and I gave her .5 based on how yesterdays numbers went (she was at 98 amps and 131 2 hours later). I am off today, Sunday (my only day off to keep up with constant vet bills) and I will monitor her. No my syringes don't have 1/2 marks so I simply eyeball it squeezing out one droplet at a time.

I just don't know what to do to keep her dosed correctly when I have 2 conflicting schedules :(
 
Remember Lantus is a depot insulin which means it builds up in the cats system over time, so although you shot 0.5 yesterday, you wont instantly see the effect of that reduced dose. It can take a day or two to see the effect of a dose change. And of course you gave 1 unit last night so we wont know now. I suggest you try the 0.5 for a few days to really give the depot a chance to catch up.

Saying that you look like you will need better syringes as eyeballing can be a little inaccurate ie Relion 3/10cc 30 & 31 gauge short, BD Ultra fine 3/10cc short, Terumo Thinpro Insulin Syringe 31G 3/10cc.. or buy calipers.

Hows this for a dosing plan? Lantus allows 30 mins flexiblity to move each day and so this works?
Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 6.45pm
Saturday 7.00am & 7.30pm
Sunday 7.30am & 7.00pm

Wendy
 
Given that shooting early acts like a dose increase and shooting later acts like a dose decrease, what you may want to do is a slight reduction in dose when you need to shoot earlier and just tolerate the slight increase in glucose when you need to shoot later. As you collect data, you may be able to develop a standard amount that you'll reduce when shooting earlier.

You may be able to tweak the carb level of the foods to help with the time shifts, too. A smidge higher carb when shooting less than 12 hours; a smidge lower carb when shooting longer than 12 hours, with an intermediate level for the standard 12 hour shot cycles.

Maybe note the schedule issue in your signature block?
 
Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 6.45pm
Saturday 7.00am & 7.30pm
Sunday 7.30am & 7.00pm

Saturday reality is I won't get home until 7:30. If I test her, get her food ready and give her time to eat, then the shoot is more like 8pm-8:15pm.

I will look for those syringes. Costco only had one kind so that's what I originally purchased.
 
ok hows this?

Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 7.00pm
Saturday 7.15am & ~ 7.45pm (shoot her while she is eating)
Sunday 7.30am & 7.00pm
 
Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 6.45pm
Saturday 7.00am & 7.30pm
Sunday 7.30am & 7.00pm

Then Monday again at 6:15? that 45 minute diference is ok?
 
When you have to make the 45 minute jump to an earlier time, you might 'skinny' the dose to avoid going unexpectedly low.
 
ok maybe this - revised Sunday

Monday - Thursday 6.15am & 6.15pm
Friday 6.15am & 7.00pm
Saturday 7.15am & ~ 7.45pm (shoot her while she is eating)
Sunday 7.15am & 6.45pm
 
Yep, let's give it a few days to see how it does. It takes 3 days or so for the depot to build up and see the full impact of a new dose . Unless she drops under 50 in which case we would reduce again.

Also you might see a higher than normal preshot tonite. Don't panic. This is a bounce off her probably too low numbers last night as its likely she dropped lower than the 79. Just hold the course.
 
I won't panic since I forgot to get the preshot number <sigh>. I have her her SubQs and she ate and I forgot the test. Damn it.

I need to get into a routine. I hate poking her every hour or 2, her poor ears. I surprised she lets me near her! She is still so stuffed up I'm surprised she is eating anything, since I doubt she can smell :(
 
You don't need to test every 2 hours. Always get a preshot test. Then it's good to get a mid cycle (5-7hours after shot) and before bed. Any signs of a low and you check more often.

If before bed is same or lower than preshot then you might want more tests but if its higher then you can probably go to bed.
 
For congestion, a warm, wet washcloth may be used to wipe off any disharge from the eyes and nose.

A preservative-free moisturizing eye drop may help loosen the congestion from the top - their eyes drain into the sinuses.
 
so in the mornings...I just have to take it on faith that it's ok...since I will never be able to take a a mid day test :(

I have been wiping her eyes and nose with a warm cloth. I have had the vaporize running all the time.

she has her good moments and her not so good. She walked into my closet today...that is the furtherest she has gone so far. At least she can stand and walk :)
 
Well you can get mid day cycle tests on sundays and you might want to do a test around 11 or 12 at night to get the midcycle once or twice a week?
 
Dosing adjustments for Lantus insulin are made on the lowest point or nadir. That is usually in the middle of the cycle, +5 to +7.

I see you work 6 days a week. Ouch! ohmygod_smile

Wendy has already suggested the nadir tests on Sunday.

Some other ideas for you:
Take a test as soon as you walk in the door from work. M-F. does not need to be every day, but some days.
Saturday mornings, you can probably get a +2.
That 'last test just before you go to bed' is another possibility.
Then there is the dreaded 'set the alarm to wake up at night mid-cycle test'.

These don't have to be all the time. Just some options to think about for filling in those bare spots on the SS. These are some ideas to see what the BG numbers are doing at other times of the day.

Because of your work schedule, it sounds like you want the SLGS or Start Low, Go Slow protocol.
 
ok I need to create a schedule to make this into a habit.

are we talking a couple times per week?

If so I am thinking my new world looks like this:

Monday - Thursday 6:15 AM & 6:15 PM shots
Monday and Wednesday - BG tests as soon as I walk in the door (4Pm) + her pmps 5:45 so she can eat and be shot @6:26, and another BG as bedtime.
Tuesday and Thursday - set the alarm for midnight for a BG
Friday 6:15 AM and 7:00 PM
Saturday 7:15 AM & 7:45 PM (shoot while eating)
Sunday 7:15 AM & 6:45 PM and made sure to get a +2, +5 and +7

Back to Monday Schedule and start over?
 
Not sure what you mean "BG tests as soon as I walk in the door (4Pm) + her pmps 5:45 so she can eat and be shot @6:26"?

heres how I do it based on your timing
6pm test. Immediately after test give treat
6.05pm put food bowl down immediately after test. Ensure cat starts to eat.
6.10pm Shoot... cat may still be eating - means is distracted.

Wendy
 
it was suggested that "Take a test as soon as you walk in the door from work. M-F. does not need to be every day, but some days."

When I walk in the door is around 4pm. That doesn't count as her pmps blood glucose test...correct? if not, then

I would be doing a blood glucose (BG) test at 4 and another one at before her insulin.

For some reason I thought I was suppose to wait 20-30 minutes after she ate to give her insulin. If that is not the case, then yes I could be doing it closer.

She isn't big on the treat thing. She does't care whether she has them or not and sometimes she doesn't want them at all....based on the SubQs she has been getting for a while. The insulin shot and even the ear poking is nothing compared to the SubQ fluids and how long they take. I choose to use a smaller needle rather than the harpoons the Vet gives me...so it takes a while.

If I do not put myself on a set schedule, my changes of missing testing is likely. I have much more to do than just her, although at the moment she is top priority. I still have 2 other cats, a dog and 2 horses...and it doesn't take much to get me side tracked in shoveling a stall or something to get myself off schedule with her.
 
Fluids tip: I saw a vet tech put the bag under her arm and press it like bagpipes to get the fluid in faster.

You may already be warming the fluids to body temp; that helps with comfort for a cat having trouble staying warm. Some folks sit the bag in a bowl of warm water to take the chill off.
 
ok I need to create a schedule to make this into a habit.
Click to expand...

Your tentative testing schedule looks good. Try it for a bit and see what adjustments you need to do. Lot's of other animal care responsibilities on your plate. Basically, do the best you can.

I think doing a testing schedule with your extremely busy life is a great idea. Wish I had thought of that with Wink. ohmygod_smile I just kind of did random tests when I thought of it. As well as a curve now and then.

The 'walk in the door' test does not count as the PMPS test. You want the PMPS test to be within 5-10 minutes of the insulin shot.

With Lantus, you can test, feed, shoot as quickly as you can get it done. No waiting required to shoot theLantus insulin after you have tested. Many people shoot while the cat is eating. Some insulins do require you to wait and make sure the cat has eaten enough, but not Lantus.

It will get easier with time. It will become a routine. Right now, you are still trying to get into the groove of testing and shots. It takes a few adjustments. Hang in there, we are here to support you and offer other suggestions if something is not working out.
 
Is there a way for me to follow this thread so I don't have to hunt for it every time I log in?

Izzy's amps was 271 this morning. .5 given so.

I do warm her fluids. I have an infrared thermometer and I try for 100 degrees or she gets cranky. I hang the bag high so I can make sure she doesn't get more than 100ml.
 
yes - at the very bottom of this page, in the pale blue bar to the left is a link that says "subscribe topic". Click on it and you will get an email with a link every time someone responds.

Wendy
 
Ideally yes but at the same time you don't want her too low. We need to give the dose time to settle and tweak if need be..
 
The insulin vs glucose relationship often makes a smile shape. It may be fairly steep in some cats, flatter in others.
 
Its ok - below is the logic around what we are doing here and when the dose will change. Remind me though what food she is getting? For some reason I thought it was just FF pates but I see on your SS she is now getting dry too? what kind is it?

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive 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 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive 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 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further. If an attempted reduction fails, go right back up to the last good dose.
Click to expand...
 
She always has one or more of these available to her. Fancy feast pate, Sheba pate or Frisbees pate. I did pick up some merrick and BG Closeout which she doesn't seem to like

My other cat... The kibble crackhead has Now Grain Free (which previously was Ok for Izzy CRF) which is now mixed with Instinct which is not good for Crf but better for diabetes.

If she doesn't have access to food she throws up bile.

She doesn't eat dry often... But does occasionally.
 
Ok are you testing at home for ketones? Please test ASAP.

I am going to get some dosing experinced people over here to advise tonites dose.

Wendy
 
I only quickly scanned your condo.

From looking at your spreadsheet, I would think it's okay to give the 0.50 dose.
It looks to me like the green numbers you saw on the two AMPS tests on the 6th and 7th were partly due to the previous 1.00 doses. I would continue to get tests at every mid-cycle you can, like at nights, on workdays.
 
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