? Rukia +10 @40 | AMPS @79 | +4 @59 (Updated)

Auora

Auora

Member Since 2019
Hi all. I realise that technically around 119 doesn't count as "Low preshot numbers" however, 47 is the lowest Rukia has ever gone and although she's heading back up, I'm a little concerned to shoot her the same dosage again as her nadir will be around 2/3am for me. I don't want her to dip too low while I'm sleeping. Could I get someone to look at her sheet? I'm wondering if I should lower the dose a bit?

https://docs.google.com/spreadsheets/d/1du5ZipZhZ_jOax_1b8nrGL-X1jJ4DRTv1_cYlw22uFg/edit#gid=0
 
With that 47 Rukia earned a reduction to 8.0 units. She may bounce tonight from the 47, but it may be a good idea to get a +1 and a +2 test tonight to see what she is going to do. Are you able to set an alarm and get up and test tonight if you need to? Or can you leave food out for her and she'll eat it?
 
Yeh. I thought as much. I'll get a +1 and +2 as well. I can also get up if I need to. It wouldn't be the first time. It's better to be sure. If I leave any food out, she'll just eat it immediately so no point really.
 
Since you can get up if you need to, you should be okay to shoot the 8.0 units tonight. Just post here if you need help and update the subject line.
 
Thanks will do! I'll set my alarm.
If in the case that she goes below 50 again, would you reduce again or hold?
 
If she goes below 50 tonight, it's probably from the depot and you should hold the dose unless. However, if you ever get a number in the 30s that is an automatic reduction.
 
Yes, you can look at @Bellasmom SS - she's a pro at staying/getting up late at night to keep a watchful eye on her Bella - sometimes these kitties just like going low at night - and yes, we all lose sleep when they do - nothing like an alarm going off at 1 a.m. 2 a.m 3 a.m. to test the cat to make sure she's not going into dangerous numbers - and be ready to feed accordingly. Best of luck to you!
 
Sue and Luci said:
Yes, you can look at @Bellasmom SS - she's a pro at staying/getting up late at night to keep a watchful eye on her Bella - sometimes these kitties just like going low at night - and yes, we all lose sleep when they do - nothing like an alarm going off at 1 a.m. 2 a.m 3 a.m. to test the cat to make sure she's not going into dangerous numbers - and be ready to feed accordingly. Best of luck to you!
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Seems as though as soon as u get back to sleep alarm is going off AGAIN lol
 
Auora said:
+5 @ 43

She's been fed a bit and checked 30 mins later. +5.5 at 58
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Soooo glad you got up and checked! Looks like she's earned another reduction of at least .25 - great job on the watching her :) You'll want to check her again soon - the food will only prop her up for an hour or so - then if she's still going down may need some more food. This is one of those times when you need to watch closely...:)
 
I never went to sleep :( I'll probably just stay awake at this point. She's getting real tired of me poking her ears though :-/ Poor girl.
 
Auora said:
I never went to sleep :( I'll probably just stay awake at this point. She's getting real tired of me poking her ears though :-/ Poor girl.
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I know how that goes...are you using the antibiotic ointment after each poke to sooth and help heal the ear? Better to have a little sore ear than a hypo...hang in there... :)
 
Here is your last post for some context http://www.felinediabetes.com/FDMB/threads/rukia-amps-459-7-units-general-advice.215050/ We link those previous posts so people can see the history. For the previous posters here, there is a suspicion Rukia may have acromegaly. Suggestions for her should keep that likelihood in mind.

Aurora, did you ever get the acromegaly test done? The pituitary tumour can pulse up and down, changing the need for insulin.

OK, I am going to offer a different opinion from those above, based on my experience with a high dose cat with acromegaly and insulin auto antibodies. First of all, changes in dose when the total dose is between 5 and 10 units, should be by 0,5 units at a time. Unless you are just tweaking a dose and have the data to show that a smaller change is effective. As this is your first reduction earned (congratulations!), stick with 0.5 unit changes for now. After the AM reduction earned you should have gone down to 7.75 units.

Second thing, with higher doses comes larger depots. Larger depots can last longer after reductions are earned, influencing maybe more than the following six cycles. When Neko was on Rukia’s size of dose, I had to be cautions for at least four cycles. If for some reason you cannot monitor as closely after a reduction is earned, and needing sleep or working is a good reason, then you can use a trick to more quickly reduce the depot. The trick is to do a one time reduced dose, either one half, or two thirds of the regular dose, for the cycle following the reduction. Then go to the newly earned dose the cycle following. So if I had been on and answered in time, sorry about that:oops:, I would have suggested shooting 4 units tonight, then down to 7.75 in the morning. Yes, you will see some temporary higher numbers, but she will be safe. If you cannot monitor tomorrow closely, you could still shoot a depot reducing dose in the morning only.

Note that the depot reducing amount can vary by cat. When Neko first started earning reductions, she bounced so much I didn’t have to lower the dose. Later on, a 2/3 dose was OK, unless she went really low (below 35) when I would do 1/2 dose. I suggest you be conservative at first, to see how Rukia responds, then modify that if you need to.
 
Wendy&Neko said:
Here is your last post for some context http://www.felinediabetes.com/FDMB/threads/rukia-amps-459-7-units-general-advice.215050/ We link those previous posts so people can see the history. For the previous posters here, there is a suspicion Rukia may have acromegaly. Suggestions for her should keep that likelihood in mind.

Aurora, did you ever get the acromegaly test done? The pituitary tumour can pulse up and down, changing the need for insulin.

OK, I am going to offer a different opinion from those above, based on my experience with a high dose cat with acromegaly and insulin auto antibodies. First of all, changes in dose when the total dose is between 5 and 10 units, should be by 0,5 units at a time. Unless you are just tweaking a dose and have the data to show that a smaller change is effective. As this is your first reduction earned (congratulations!), stick with 0.5 unit changes for now. After the AM reduction earned you should have gone down to 7.75 units.

Second thing, with higher doses comes larger depots. Larger depots can last longer after reductions are earned, influencing maybe more than the following six cycles. When Neko was on Rukia’s size of dose, I had to be cautions for at least four cycles. If for some reason you cannot monitor as closely after a reduction is earned, and needing sleep or working is a good reason, then you can use a trick to more quickly reduce the depot. The trick is to do a one time reduced dose, either one half, or two thirds of the regular dose, for the cycle following the reduction. Then go to the newly earned dose the cycle following. So if I had been on and answered in time, sorry about that:oops:, I would have suggested shooting 4 units tonight, then down to 7.75 in the morning. Yes, you will see some temporary higher numbers, but she will be safe. If you cannot monitor tomorrow closely, you could still shoot a depot reducing dose in the morning only.

Note that the depot reducing amount can vary by cat. When Neko first started earning reductions, she bounced so much I didn’t have to lower the dose. Later on, a 2/3 dose was OK, unless she went really low (below 35) when I would do 1/2 dose. I suggest you be conservative at first, to see how Rukia responds, then modify that if you need to.
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Hi Wendy,
I couldn't get the acromegaly test done as it isn't available here in Australia. So far the vets have told me they they wouldn't be able to process the sample to send off in the required time. I have an appointment on Jul 10th with a feline diabetes specialist....hoping they can help me find some alternate ways to test. The waiting list to even have a consultation with this doctor was very long :(

At the moment.... My partner can get home at about +4 to check Rukia during the day. I don't feel to bad about messing with the dose AM. Night is when I get worried. It affects my sleep a lot at this point but I'm sure it's something I'm just going to have to deal with and/or get used to for the time being.

After last night and before I could read your post this morning, I reduced the dose yet again by .25 just to be safe. She was teetering between 40-50 and eventually I had to go to bed around 3am. Anyways, she's at 7.75 now and seems to be doing alright today.
What you said about reducing the depot makes sense. I'll keep that in mind for those situations. Thank you.
 
We have had members in Australia get the test done. Dr. Jacquie Rand at U of Queensland has done several studies where she has excluded acromegalic cats from her studies of diabetic cats, so she too has gotten the tests done, I had to find out how to get the tests done here (Canada) and send the information to my vet. Good luck. The 10th isn’t far off now.
 
@Wendy&Neko @Auora
There is now a vet in Sydney who operates on cats with acromegaly so I would think there must be a place to test for it here somewhere. I will ring the place tomorrow and ask them the question and let you know.
 
Updates...just tested preshot @101. This will be the lowest she's been at PS. I'll check again at +1 and +2.
 
@Wendy&Neko
I checked her periodically last night. Woke up 2 am and she was at 65. When my bf woke up at almost 6am, she was at 40. Advised him to give her breakfast early.
When I woke up, she had gone up a bit but was worried about giving the full 7.75 since I would be heading to work and not able to watch her. Gave her 4 units to be safe. She still ended up dropping low today. I'm guessing that's the depot still having an affect on her. Should I drop the dose again for her evening shot? Maybe to 7.25? Or just wait it out? I can watch her carefully tonight.

@Bron and Sheba
Thank you! This will at least be useful to know for when I go to the appointment next week.
 
Yes, it could still be even the 8.25 unit depot impacting today. Sorry I wasn't on before your PM shot, but I think your decision was the right one. I would stick with 7.25 units in the morning and let her tell you if you made too big a reduction or not. It's possible you have broken through some glucose toxicity as well, and her dose needed to come down a bit.
 
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