no shot PMPS

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kds0200

kds0200

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Hello all! I haven't been around in a while (moving and starting a new job have eaten up most of my free time) but I'm entering some new territory with Bailey and wanted to try for some advice. On 12/10 Bailey had a PMPS below 200 so I decided not to shoot; two hours later (after 1/3 can for dinner) he was very high again so I gave him 1 unit before going to bed. A couple of days later, 12/12 he was below 200 again but I went ahead and gave 1 unit after he ate and it kept him too low I think because his AMPS was high again, of course. (All this is on the spreadsheet too, I just wanted to give the basic info here...)

Anyway, just now his PMPS was 121, the lowest it's ever been, so obviously I didn't shoot. He ate 1/3 of a can and I'm planning to test again in an hour (and he'll get another 1/3 can at +4 and +8 because he's being MUCH more cooperative with the timed feeder now - yay!), but I guess I just need some dosing advice or reassurance. Should I let him go all night without insulin, even if he tests high in an hour or two? Would it be better to shoot super low now (like maybe .25 unit)? Or can I give him a small dose if he tests high in an hour or two?

We have an appointment with a new vet on Wednesday, one who specializes in cats, so I'm actually looking forward to that. And I'm hopeful about Bailey's numbers the past couple of weeks. I was afraid the move would rattle him but he's chill as ever, his usual ornery self, playful and purring and cuddling (before suddenly play-biting me, haha). His numbers have been a little all over the place (and this week was rough because I started an 8-5, M-F job and couldn't test as much), but he's been getting more blues and greens at least, which I think is a good sign!

Thanks, as always!
 
Hi Kellie,

Bailey is looking better. I think you were right not shooting at 121. You could give a token dose (like your .25)if he rises to 200 or so. But tomorrow, you'd want to be careful that his morning shot is at least 8 hours from this token shot and that he is definitely rising, not falling. I don't think I'd wait too long tonight because it pushes your next shot too far out.

I think I'd reduce the dose a little. Once you get a long cycle and an unshootable preshot, it means a lower dose is probably wise.
 
Thanks, Sue, that's good to know! He's been kind of all over the place so I just sort of thought to blindly hold steady. He just tested 160 at +1 so I'll see what he's like at +2 before giving him a "token shot" (that way he'll have ten hours until our AMPS). I'll go down to 1.5 for the next several days and see how he does with that.
 
Ha, so at +2 he tested 403 which didn't seem at all right so I tested again a minute later and he was at 285. (Does anyone else have meter problems like this? Mine quite often will give two very different readings a minute apart - and the battery was just replaced a few days ago so that can't be it...)

Gave him a .75 unit shot to boost him through the night. Thanks again for your help, Sue, and your super quick response!
 
Hi Kellie,
I've been wondering where you've been.

Sounds like Bailey is catching up with Hank! :-D

We just went through this very thing (getting 3 pre shots below 200 and wondering what to do).

Wow! That's great! I'm so happy for you and Bailey!! :-D

Kimmie
 
Thanks, Kimmie! I'm glad to see you and Hank are doing so well too! All those blues look so nice.

Bailey threw another blue out for his pre shot this morning (175). I'm going to be gone at work all day but I went ahead and gave him .25 units so hopefully he won't skyrocket. I'm sure I'll stress all day about it but I really don't want him to start hitting in the 500s again.

I'll be checking back in tonight, I'm sure. Wish us luck! :-)
 
Another nice number! It looks like it might be time for you to lower your preshot number like Kimmie and Hank. Carl, Kimmie and I had a good discussion about this idea a few nights ago that might be helpful for you to read.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=129565

The big thing for you to take away from it is that you hold the syringe so you make the choices, you only shoot when you feel it is safe. Since you had to leave this am and couldn't monitor, your dose should nice and safe. It will be a good guide for the next low preshot. If not enough this cycle, then increase a little next time.

It does look like his pancreas may be joining the party as he apparently stayed in low numbers overnight. This does make things a little trickier because you can't be sure when it will kick in and help and when it will get tired and take a rest and not help out.

But don't forget, this is what you have been waiting for and it is great news. Just a little stressful for Moms. :mrgreen:
 
Thanks, Sue and Kimmie! That was a great thread to read through (don't know how I missed it before!). Kimmie, you asked almost all the questions I'd ask, and the answers were super helpful to me too.

Bailey went high again tonight (391 at +11, 418 at PMPS), but I lowered his dose a bit (1.5 instead of 1.75) so I'm interested to keep gathering data and see where this takes us. The blue pre shots have been nice to see but a little scary, yes. Strange to have this thing that you know is actually good be such a crazy!making event! haha
 
Meters aren't perfect measuring tools. The FDA allows meters to read within 20% of what a lab would get.

If 120% of the low number is greater than 80% of the high number, the numbers may be considered the same.

285 * 1.2 = 342 is greater than 403 * 0.8 = 322.4, thus the 2 numbers may be considered the same.
 
I take my meter with me every time I go to the vet and he gets a reading and so do I - that way I usually have an idea of the difference in his reading and mine.
 
I brought my meter to previous vet visits but the two vets we've seen since this started didn't support home testing (one of them wouldn't even test Bailey during the office visit because he said it would be "totally useless" since the numbers would jump because of stress - and yet, he wasn't willing to look at any of the data I'd gathered doing home testing/curves!), so they wouldn't allow me to compare my result to theirs. I'm hoping the new vet we're seeing tomorrow will be more open to this!

And yes, I understand that meters aren't perfect but seeing numbers that are so vastly different and are just a minute apart is a little jarring (and frustrating), even if I'd known what math to do. Live and learn, I guess. I know high is high and so I dose him accordingly, but it just makes me worry a little that maybe more of my readings have been more inaccurate that I realized.

Oh well though! In any case, whether they're true blues or not, I'm encouraged to have been seeing more of them and glad that my Bailey boy seems like his happy, feisty, usual self ;-)


EDIT @ 7am: His AMPS was 97 and 112 (those are minute apart tests that actually make sense to me, lol) so definitely not going to shoot when I'll be gone at work all day again. Fingers crossed...
 
Wow! Low preshots this am. Looks like his pancreas is definitely waking up. It would be nice to know what is going on midycle, especially at night, as the low numbers are coming in the am. Hope there will time this weekend to get some numbers so you can see what is going on. If he experiences a steady downward curve with the lowest numbers coming at +12, his pancreas is definitely helping out.

Looks like 1.5 is too high for even a red so maybe one unit on the higher numbers?
 
Hey Sue! Thanks for the advice. His PMPS was 330 so I went with one unit and we'll see what happens. I'll set an alarm for his mid cycle tonight and try to get up long enough to test. I'm pretty curious about what's going on there too but this new work schedule pretty much means weekends are our test time now. But Bailey has a vet appointment tomorrow afternoon so I'd like to get a mid cycle test in before he gets (potentially) stressed out and all that...
 
Hey Rachel! Yes, I was surprised by last night's mid cycle too (a little bleary eyed but that's definitely the number, lol). His AMPS was 181 so I'm giving him a token .25 shot before I go to work for the morning. Vet appointment this afternoon will probably stress him out so I'm actually glad I'm able to give him a little insulin...

Because of that overnight low, does that mean even 1 unit was too much? Should I try .75 with the next high pre shot?
 
You may find reducing a bit lets you shoot more consistently.

And the stress from moving, etc., may still be shaking out.
 
Because of that overnight low, does that mean even 1 unit was too much? Should I try .75 with the next high pre shot?
Click to expand...

The nadir was safe. Because you don't know if he went down earlier or later, it's a little nerve wracking. And I definitely think you have some pancreatic action helping out. The scary part of that (although it is wonderful!) is that you can't be sure when it will kick in and lower the number on its own in addition to the insulin.

If I were you, I would be a little daring when I was going to be around. Maybe giving that one unit on a 300+ and planning to test in the 4-8 range just to make sure he stays above 50. And if he doesn't, be ready to feed him low carb and then higher carb to bring his numbers up. If you won't be home and can't test, I would be more cautious.

It's a delicate balance. You want him in lower numbers so the pancreas can take over eventually but you want him safe. As we continue to say, you hold the syringe and you decide what you think is best and safe. Regardless, you are doing a great job keeping him safe and in nice numbers. Just remember that breathing thing - it does help. :mrgreen:
 
Wow Kellie! Your "midnight" (he he ) reading was good!

nailbite_smile dancing_cat

I know what you mean, it is nerve wreaking! :smile:

But you go girl! WooHoo!

Good to be cautious too. You're doing great!

Kimmie
 
Thanks, as usual, to everyone for the words of advice and encouragement! It really means a lot to Bailey and me.

He was high before the vet visit (383) and even higher when we got home (583 - which I knew he'd be high but we haven't had a solid black in a long time!) so I went ahead and gave him 1.5 units tonight, as per the vet's suggestion.

The vet visit went about as I expected, though some things were surprises. But this vet, she's the one, I think. I'm really glad to have finally found someone who is interested in looking at my numbers from home testing -- I brought my laptop to show her the spreadsheet and she scrolled through and asked questions and made comments and then asked me to email it to her. She was glad when I told her about being on FDMB -- "Did you find that through catinfo.org?" she asked. "Yep, that's the one," I said. And she said, "They're great, I'm really glad you've found those sites!"

So anyway, the quick version: Bailey needs to have his teeth cleaned again (they were done back in February, when he also had two extractions) but she wants to get him OTJ before going through all that - and she's optimistic that we can get him there in the next couple of months (though I take talk like that with a grain of salt and a knock on wood). They did a full blood workup, which they should be calling me with the results in three to five days. She also wants me to increase his food from two cans a day to three. Something about the calories...but also he's at exactly 12 lbs. which, for his bone structure, is on the thin side (I knew this but I wanted to hear it from a vet).

Starting in the morning (since we knew he'd be high tonight and I could shoot high), she wants me to pick a small dose (.25 or .5) and stick with it through the weekend. She wants me to do a full curve on Saturday or Sunday and then email her that info as well. She's fully supportive of home testing and also fine with keeping him on Prozinc (she usually prescribes Lantus and carries it in-house, but she said she'd order a bottle of Prozinc when I need another), especially since he's getting better numbers now.

Basically, after the last two disastrous vet visits, I am very happy to have found this place and this vet. And Bailey is currently very happy to be home, dashing from one end of the apartment to the other and occasionally stopping to give me a swat and a love-nip (haha).

Whew! What a day. Bedtime for me. I may attempt another mid-night test ;-) but am not counting on it... :cool:
 
Well, we had a good day of yellows and blues and suddenly, at +9, Bailey gave me black numbers. Could it be a food spike? He had 1/2 can at +8, but my goodness that's a big jump in just two hours.... Or is this maybe fairly usual when a cat starts getting lower numbers to have a big jump up? Sorry to be my usual worrying self, this is just all new territory for us and I always get a little wigged out when I see numbers that high. He's been acting fine all day, sleeping a lot but also playing and really high energy and so forth. I'm about to go out for a dinner date but will be back for the PMPS, of course.

I guess because in the past I've been able to clearly tell what made his numbers skyrocket (like the vet on Wednesday) and today there's just no explanation at all so that's why I'm worried. He definitely didn't get into any food he wasn't supposed to have.... confused_cat
 
Do you take a second test (sometimes a good idea if you get a strange number). And remember, it 'a only one number.

So if he jumped that much, maybe a bounce, maybe .75 is too little. Hopefully more numbers will make this cycle make more sense?
 
I'm sorry, I feel dumb for even posting about it. I'll just quit worrying. It's not like he's never been high before, and I know he'll come down again, it just seemed a big jump to go from 166 to 546 in two hours with no obvious cause. Probably just a fluke or a bounce.

And I know meters aren't perfect, that's why I tested twice - 546 and 542 within a minute of each other. We'll just keep on keeping on :-)
 
Don't feel dumb! I'd worry about a suddenly higher number if it was me. I'd say, though, to remember it is just one number. That doesn't mean you are dumb for worrying, but it's just something to keep an eye on. Could be a fluke, could be getting into something with lots of carbs, could be a bounce, could be any number of things. If it becomes a pattern, it is something to try to find more info on, but for now, I'd just keep an eye out.

Glad you retested! That was exactly the thing to do...that way, you can be sure you got a real number.

Don't feel bad about posting. That's part of the point here! If you could see some of the long, rambling posts I used to have when my kitty threw me for a loop! :lol:

Let's see where the cycle goes and take it from there.
 
Take a look at my signature link Secondary Monitoring Tools for other assessments you can make to evaluate your cat. Intake, output, weigh monitoring, behavior, are part of your cat and can provide clues when things are going well or need adjusting.
 
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