Ollie - AMPS 218

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Klaree and Ollie

Klaree and Ollie

Member Since 2010
Hi everyone,

Ollie and I are new to FDMB and think that it is an amazing place full of wonderful people. I wish I would have found you guys when he was first diagnosed. Here is Ollie's background: neutered 12 yr old male, 17 lbs, Dx August 2008, on Vetsulin 8/2008-6/2010 with VERY mixed results, switched to Lantus 7/1/2010. Took all dry food away on 7/14/2010 and began feeding only Wellness. My spreadsheet is current and I am confused by the numbers I am getting. 3 days ago he had an excellent day - all blue and green numbers. His PMPS on that day was 63 so I reduced the dose from 2.25 to 1.75. His numbers have basically been rising since then with a small dip yesterday during AM Nadir ~80. Does anyone think he is getting too much? Does this look like he's trapped in a rebound?

Thanks!
Klaree and Ollie
 
Hi! Welcome to LL! I'm not an advisor, they'll be around soon. It looks like you have been adjusting the dose a lot, Lantus likes stability and takes the cat at least 6 cycles to settle in, When you keep adjusting it the way you do Vetsulin, you get a lot of wonky numbers. Bounces can last for 2 or 3 cycles, Tess just had one that started to go down and then went up again. No need to panick. Patience is something we all have to learn w/ Lantus.
So glad you got rid of the Kitty Crack (dry food.) That in itself should make a big improvement and the carbs from the dry clearing his system could have been the cause of that sudden drop.
 
Thanks for the info, it's really helpful! Ollie was addicted to the Kitty Crack like no kitty I've ever seen before! I'm still shocked that he eats the Wellness although it's a bit of a struggle to get the minimum amount in him. I'll keep checking my post, thanks again!

Klaree and Ollie
 
Welcome to Lantus Land!

Great job with getting your spreadsheet (SS) up and running. I do have a couple of comments on Ollie's SS.

First, you noted that you are pretty sure you gave a fur shot on 7/15. Never give a second shot. You have no way to know how much insulin may have gotten in. I've had any number of time when I thought I'd given a fur shot only to see Gabby's numbers drop during that cycle. If you give a second shot, you could easily overdose Ollie.

Lantus is an insulin that likes consistency. If you read the starred, sticky notes at the top of the Board, especially the one pertaining to the Tight Regulation Protocols, you'll see that doses are held for at least 3 days. This allows the dose to settle and the shed to adjust to a new dose. If you move doses around too quickly, you end up with numbers that don't seem to make a great deal of sense. We also increase and decrease in small amounts -- typically 0.25u. Dropping the dose from 2.25u to 1.75u may have been too much and you're seeing numbers creep up, as a result. I wouldn't worry too much -- you can always raise the dose.

Actually, I think Ollie's numbers are looking good. There may be some small bounces from the greens to the yellows but overall, it looks like Ollie likes Lantus.

Please read the sticky notes. They will help you understand the way LL (Lantus Land) operates. There's also a huge amount of information about how Lantus works, posting conventions, the shed/depot, and our dosing protocols. Please ask questions -- there's a huge amount to learn -- and visit our condos (condo = each cat's thread for the day) and look at our spreadsheets. It's a great way to learn.
 
Thanks for the reply! I'm so glad you think Ollie likes Lantus and that his numbers look okay! I'll read the stickies, I've read the Univ. of Queensland Protocol, and I have already been pouring over everyone's spreadsheets. They are all really inspiring!

Should I hold the dose at 2.25 for a couple of days? Do you think it is too much?

Thanks,
Klaree and Ollie
 
Hi Klaree,
welcome to the Lantus forum.

Sienne has given you good info to start with, especially the link to the protocol.

One of the ways to see how a dose is going is with spot checks. Depending on your schedule throughout the day and/or evening, try to fill in as much as possible in your spreadsheet.

The following chart might help you with a curve and spot checks.
You can find in the Lantus forum stickie New To The Group I've included all the links for Onset, Peak, Duration etc.

Learn how YOUR kitty is responding to insulin:
Onset ---> the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir ---> the lowest point in the cycle
Duration ---> the length of time insulin continues to lower blood glucose

How to do a Curve: you don't have to test every hour. Typically curves are every 2 hours in a 12/12 cycle. Or a mini-curve, about every 3 hours.
Depending on where the numbers are, you may have to re-test frequently and offer food to help steer numbers.
I've bolded the common test times, BG numbers can change, especially the "peak". As you collect more and more data, you may catch when Ollie hits his lowest point in a cycle.

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.

Carryover ---> insulin effects lasting past the insulin's official duration
Overlap---> the period of time when the effect of one insulin shot is diminishing & the next insulin shot is taking effect
Insulin Depot ---> (aka "storage shed" in Lantus Land) "spare tank" of insulin, which has yet to be used by the body
More on the Shed ---> Lantus & Levemir Insulin Depot AKA Storage Shed


Keep checking back thru the day for more feedback. Others will be by to review your spreadsheet too.
Again, welcome to Lantus!
 
Thanks Sienne and Ronnie, this is all very helpful. I'm having trouble getting blood from Ollie's ear....I warm it up but I've been poking them for 2 years now, and a heck of a lot lately, and they seem to be scarring? Has anyone else experienced this? Am I doing something wrong? Are there other places to get blood on the body?

Thanks,
Klaree and Ollie
 
I haven't been at it that long, but I do test a lot. I think i'm the only bean advised to back off. :lol: Where do you test on the ear? I vary it a lot anywhere between the edge and the vein. Not just at the on the outer edge. The inner edge often works better for me. I know people test in the paws pads, too.

Many of us use Neosporin, I add a drop of Vitamin E oil as well. That is used to prevent scarring for people. I use the combo about twice a week.
 
I mostly test on the outer edge/vein. I have to hit the vein to get enough blood to use. Good call on the Vit E oil and Neosporin. I'll get some today. He is starting to get a little grumpy about it, particularly when it's meal-time and I'm trying to stick him before he's had food! I really don't think he'll let me do his paw-pad....but we'll try just about anything once!

Thanks!
Klaree and Ollie
 
The ointment also helps the blood to bead up so you don't get it diffusing into the fur. Also, I don't use the lancet pen I do it freehand. Much easier to aim. Hold the lancet at about 45° and a little twist will help too. As long as I get any sign of blood I can "milk" it to get enough.
 
Hi - welcome Klaree and Ollie!

I see that Ronnie and Luna sent you an example of a typical lantus curve. That's good information, and judging from my experience, Ronnie loves to send it out, so don't be surprised if you see it again sometime (or maybe that was just me!). But seriously, lots of stuff to read and learn - it becomes second nature pretty quickly. And there are always people to ask - both experts and people like me who are just willing to share our own experience.

I've noticed that some days I have trouble getting blood from Kasha's ear (I used the outside edge - sometimes the very, very edge will result in a nice little bead of blood). I have yet to come up with a theory for why she bleeds so well for me for weeks on end and then one day I'm sitting there squeezing her ear and wasting test strips!

It sounds like you're off to a good start - nadirs in the greens (under 100) are nothing to sneeze at!
 
Hello and welcome to Lantus land!

You get a A+ on your condo setting! Well done.
I hope Ollie and you will like lantus. A lot of kitties do.
Since you have already been bombarded with all kinds of info, I will stick my post to the minimum... ok, a bit more than the minimum.

here it goes:

- lantus is very different than vetsulin.... Ollie will be fine, however you, my friend, will likely require retraining.... (read use swiffer in brain to wipe out all remnants of other insulin training). That means, for the most part, same-dose-same-time unless a change is required or have other circumstances.

- could you confirm what kind of glucometer you are using. Pet vs human ones are slightly different and most people use the human one. If you are using an alphatrack, make sure to add the note to your signature for easy reference.

- pick up a few cans (cans only) of high carb (HC) food such as, but not limited to, fancy feast some meat with gravy (grilled variety) or anything else your cat's heart would desire off the Janet and Binky's food list. Have the cans in your house and mark them with a sharpie. It's easier to get ready when you don't need them.

And lastly, so you come back tomorrow... ask questions and look around. There is lots of information in this forum. Again... welcome!
 
kryskat said:
Hi - welcome Klaree and Ollie!

I see that Ronnie and Luna sent you an example of a typical lantus curve. That's good information, and judging from my experience, Ronnie loves to send it out, so don't be surprised if you see it again sometime (or maybe that was just me!).....
Click to expand...


:lol: :lol: Krys! Yea I love that curve chart a bit too much dont I? :lol:
 
Thanks everyone! I use a One Touch Ultra Mini. I am learning to re-train myself! I can't believe how different Lantus is.....how much better! I can't seem to stop kicking myself for not doing my research online and finding FDMB sooner. One last question for tonight....Ollie isn't eating all of his food at dose-time. He needs at least 1 can Wellness Chicken per day to get enough calories and is eating 1/4 of a can at a time. When should I feed him more? (FYI: he's hungary ~every 3 hours). Should I try to do it during nadir? Doesn't that move around? Should I just be consistent, like every 6 hours? Also, this works for me right now, but I'm going back to work in September and my schedule will change and fussing with him every 12 hours would be ideal.

PMPS....158 :).

Thanks guys!
Klaree and Ollie
 
Klaree and Ollie said:
Thanks everyone! I use a One Touch Ultra Mini. I am learning to re-train myself! I can't believe how different Lantus is.....how much better! I can't seem to stop kicking myself for not doing my research online and finding FDMB sooner. One last question for tonight....Ollie isn't eating all of his food at dose-time. He needs at least 1 can Wellness Chicken per day to get enough calories and is eating 1/4 of a can at a time. When should I feed him more? (FYI: he's hungary ~every 3 hours). Should I try to do it during nadir? Doesn't that move around? Should I just be consistent, like every 6 hours? Also, this works for me right now, but I'm going back to work in September and my schedule will change and fussing with him every 12 hours would be ideal.

PMPS....158 :).

Thanks guys!
Klaree and Ollie
Click to expand...


Hi! I know this is last nite's thread, but thought to answer you anyways.
I too am on 1 can a day of Wellness (the 5.5oz size)

One of the things suggested here is small meals, doesn't apply to all kitties, but has been known to work well for most - you will find a feed schedule that works for you and Ollie,,,,
as an example, break up the AMPS portion into smaller portions, most kitties will eat more at breakfast and dinner, we then like to offer food at +1, +2 and a bit at +3....if you have to leave for the day, a timed feeder may be the way to go, or just leave plenty of food available.
If you are home, some of us do offer a little snack at +6 and +8 or +9...remember, no food after +10 in either cycle to avoid a food spike in next preshot number.

Nadir can change. Ours was +3 or +4 for a while and eventually we moved up to +5 and +6.

Consistency works best. I see you track your meals on Spreadsheet - keep doing that and note any time you make changes to snack times. This will help you find Ollie's patterns.
 
Welcome too from Us & start a new condo everyday so we can follow Ollie's progress--Good Job so far--Looking for your new condo today! :mrgreen:
 
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