Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Night

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Critter Mom

Critter Mom

Member Since 2014
Hello all,

Saoirse and I have just joined the Relaxed Lantus Group and we're very happy to be here. :smile:

Saoirse's FD story since her diagnosis in early June of this year is in her new profile document (link in signature). She was initially treated with Caninsulin but when her numbers got lower it became unsafe to continue treatment with that particular insulin because of its hallmark steep BG drops. Saoirse started on Lantus on 19 August. At the moment my little Munchkin is recovering from a pancreatitis flare-up. She is responding well now to tiny doses of Lantus and has mini meals of low carb wet food.

Saoirse's BG is measured on an Alphatrak II glucometer. I hope people will be able to make sense of her spreadsheet. The colour coding on the standard 'human meter' template was wrecking my head, especially seeing blues where there should have been greens. I didn't have a proper feel for when Saoirse was doing well, and also I found it a bit confusing/worrying when I needed to make decisions about whether or not to give insulin as her PS numbers got lower. The numbers in the ranges are aligned to the thresholds defined in the TR protocol (adjusted to Alphatrak values per guidance notes in the TR documentation) with the exception of the blue range (now split into pale green/teal colouring - to show progress towards better numbers and help me with dosing decisions). All of the ranges and colour coding are defined in the sheet headers. I hope people can understand it OK. nailbite_smile

We can't follow the full TR protocol because I have health problems that affect my sleeping pattern. Saoirse's numbers are OK but she tends to run low at night and because I can't wake to an alarm - or sometimes pass out due to extreme fatigue - I am afraid to give her insulin most of the time on PM cycles because I can't guarantee being awake to keep her safe.

I wish I could be more consistent in my dosing of Saoirse's insulin because I worry that not being able to keep her numbers low will affect her chances of achieving remission. I'd very much welcome any comments or suggestions about any strategies I could apply to help keep Saoirse safe in the healing number range whilst working within the limitations imposed by my own disabilities.

I'd be very grateful for any feedback on how well/badly I am managing Saoirse's BG.

Also, sometimes when she hasn't eaten for quite a while her BG spikes. I'd be grateful if anyone could shed light on reasons why this might be? confused_cat
 
Re: Saoirse (September) 25th AMPS 5.4, +6 7.9 After Long Fas

All I have to say is WOW! On the spreadsheet now I feel like such a slacker... :lol: That is one of the most complete and well reasoned out sheet I've ever looked at.

Hon, I actually think if I'm reading it right you already have an OTJ cat if you'd just let her pancreas do it's job. Because if those numbers are coming from that little of a dose and with a p-titis flare we all want your cat! @-)

Okay now for why her BGs elevate after long fasts, because she's a mammal with a functional liver? Its exactly the same reason they jet up after a near hypo because the liver panics, says Kitty Going Down and starts throwing out stored sugars. That's its job. Food becomes glucose when eaten and digested, in normal mammals that triggers the pancreas to produce insulin which is the key that opens the body's cells to receive the glucose, so the liver just goes along for the ride all nice and happy just eliminating waste all happy and content. But if we don't eat when hungry what happens? Our blood sugar drops and if we don't eat for a long enough period of time our liver releases its stored glucose to bring us back up. No difference just because she's a cat. :-D

Mel, and The Fur Gang
 
Re: Saoirse (September) 25th AMPS 5.4, +6 7.9 After Long Fas

Hi Mel,

Thanks for having a look at Saoirse's numbers. I'm relieved that the spreadsheet makes sense to you. :smile:

Thank you, too, for the assessment of how Saoirse's doing and the explanation of why Saoirse's numbers went up so much mid-cycle today. I had noted that there were times when she would have gone a few hours without food and I'd get what I regarded as a 'hunger anxiety stress spike' but they always coincided with Saoirse actively looking for grub. During the AM mid-cycle period today, she was just relaxing comfortably on the sofa and showing no signs of being hungry. Indeed, she was in really good form so I was very disheartened to see the high number because when she's been as good as that in the past her numbers have been towards the lower end of the euglycaemic range. I feel much better after reading in your post that my little Bonnie Munchkin might be a candidate for remission (anti-jinx, anti-jinx nailbite_smile ).

I'm nervous of stopping her insulin treatment too soon after what happened when she had to stop Caninsulin. I'll have to wait to post more about these concerns till tomorrow because I'm banjaxed right now and I need to set up ladyship's timed feeders and take another BG reading to make sure she's safe before I pass out. :roll:

Thank you for the reassurance, Mel. It's so much appreciated. :smile:
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

So much for bedtime ...

It appears that Saoirse is confirming Mel's assessment that her pancreas is working OK. I'm now worried that her pancreas may have stepped up a gear and she has Lantus in her system.

This is a very late nadir for Saoirse (normally between +2 and +4) and she runs low at night. Needless to say I'm monitoring her closely but I'm not sure about how to feed her through this (if she was lower I'd know to feed her Purina DM canned). I'm very nervous of upsetting her digestive system and also of spiking her BG level.

I'm also worried about how long to monitor her given the depot nature of Lantus. Also, Saoirse had a fair amount of carryover from Caninsulin in the past and i am wondering if Lantus could have a similar effect. Her doses were skipped for the previous two cycles and she received < 0.25 IU this PM cycle. This is really important for me to get a handle on because I live alone and I have major problems with fatigue. I want to keep my girl safe and I worry that exhaustion might overcome me. Having an idea of how long I need to keep going would help me to keep going longer.

I feel like I'm in uncharted territory again. I'd be very grateful for help and advice. All numbers are up to date in Saoirse's spreadsheet. (ALPHATRAK GLUCOMETER).

24 September

PMPS 6.3 - Dose withheld.

25 September

AMPS - 5.4 - Dose withheld.
+6.75 - 7.9 - after 4+ hour fast)

PMPS - 7.4 - 90 mins after food - gave very skinny 0.25 IU.
+2 - 5.1 - 2.25 hrs after food.
+4.75 - 5.1 - 45 mins after food.
+7.5 - 4.9 - 90 mins after food.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Well the good news is she's past the mid point of her cycle so its not going to be 16 hours of hypo watch :-D

Now for feeding...what's her normal diet?

Mel
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Tonight your gonna steer a curve with food. Take her normal diet and feed her about a teaspoon at a time. Fed a spoonful, wait 30 minutes retest, rinse and repeat as needed.

Mel and The Fur Gang
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Thanks so much for responding Mel.

Saoirse's currently on Liquivite liquid recovery food - very low carbohydrate, not very high protein, 89% moisture. Her typical mini meal is 2 tbsps Liquivite and a tbsp of water - approx 12 kcal per feed. She has had 2 feeds since the last test.

I have some Purina DM canned. Would it be better to feed her a little of that?

Clinical signs are good. She's very alert and switched on - tried her with her wand toy.

Just off to take a BG reading. BRB ...
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Good news - BG rose to 6.0 - list updated below. (Googledocs acting up so can't update spreadsheet at the moment.)


24 September

PMPS - 6.3 - Dose withheld.

25 September

AMPS - 5.4 - Dose withheld.
+6.75 - 7.9 - after 4+ hour fast

PMPS - 7.4 - very skinny 0.25 IU - (PMPS taken 90 mins after food.)
+2 - 5.1 - 2.25 hrs after food.
+4.75 - 5.1 - 45 mins after food.
+7.5 - 4.9 - 90 mins after food.

- Mini meal of Liquivite LC immediately after +7.5
= Second Liquivite LC mini meal at PM+8.25

+8.5 - 6.0 - 15 mins after last feed. Gave freeze-dried chicken treat.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Good she rising off the food, just hold her steady. Don't want to fill her up and don't want to over carb her either this is where the dance comes into play. She's going to tell you what music she wants to dance to, you have to follow her lead. Check her in another 30 minutes if dropping again same steps regular food just a touch to bring her back up until she holds or starts rising.

I take it the Recovery is from the P-titis?

Oh and there is an unwritten rule around here....if we have a kitty in trouble whoever responses first stays with you...so you no sleep, I no sleep until your precious girl is back in safe waters. You're now family and family doesn't leave family alone until all are safe. We might hand you off but until your safe and feel in control someone will have eyes on you.

Mel
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

(((Mel))) Thank you. I'm very, very grateful not to be alone, for both the advice and the company to help me stay conscious (PTSD makes things very tricky in that respect). nailbite_smile

Yep. From the pancreatitis although I didn't specifically seek out a recovery food. At the height of the flare up the only thing Saoirse could tolerate was poached chicken and broth, and I was desperate to find a complete food for her with no success: even tiny amounts of the foods would worsen the diarrhoea and/or nausea. Thankfully Eliz (Elizabeth & Bertie) recommended the LIquivite. It has taken several weeks to transition her onto it fully, but it is doing her an absolute power of good. She shed most of her coat during the flare, but it is growing back well and getting better. Today it was glossy for the first time since I don't know when and it is as soft as it was when she was 1 or 2 years of age. Neither my vet nor myself can get over the improvement in her overall condition.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

I need to go feed my brood here shortly but I will be checking back in with you two and my phone is set to alert me when new posts arrive here so even if I'm not actively on the computer I can still watch from the smart phone.. Eliz is a peach.

You'd be amazed at my civies that joined the family after we went to all canned low carb diet, just as sleek and shiny as a wet seal and soft as a bunny. Its amazing what just ditching the dry will do for a kitty. :-D

So how exactly do you pronounce her name and is there a meaning behind it? As you can tell from my signature I love unusual names for my fur kids so when I see a new one I always have to ask.

Mel and The Fur Gang
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Thank you for watching over us, Mel. :YMHUG:

I love your cats' names! :-D My little one's name is pronounced 'Seer-shuh': it's the Irish for 'freedom.' I named her brother Amadán - Irish for 'fool.' (GA) They were born on April 1st. (Their story is in Saoirse's profile.)

I have a number of heart names for her as well, one of which is Bonnie Munchkin. My at-home civvie is Lúnasa (Irish for August, when she was born). My other civvie is now on 'permanent foster' with a dear friend, and her name is Olwen (Welsh for 'white footprint'). She's a long-haired calico, and could have been separated at birth from Stacia's Tasha. My other little ones at the Bridge are Danú (a celtic goddess), Tara (seat of the Irish high kings), and Tara's brother, Psycho Fatboy the Third (meant to have been called Conor but plans went somewhat awry).

Off to do another test ...
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Love it when I get close figured her name was either Irish or Welsh. Although not enough strange vowel placement for Welsh lol. Duvessa is Irish for beautiful dark/night and her brother is Myrrdin (Merlin) so very familiar with the old gaelic tonque. Lol and incredible familiar with who Danu is as well as most of that mythology. Might say they were my bedtime stories growing up as well as my ex being Welsh lol

Mel
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

It was Myrddin that first caught my eye! :smile:

Slight drop to 5.9. Table updated below:

24 September
PMPS - 6.3 - Dose withheld.

25 September
AMPS - 5.4 - Dose withheld.
+6.75 - 7.9 - after 4+ hour fast)

PMPS - 7.4 - very skinny 0.25 IU - (PMPS taken 90 mins after food.)
+2 - 5.1 - 2.25 hrs after food.
+4.75 - 5.1 - 45 mins after food.
+7.5 - 4.9 - 90 mins after food. Mini meal of Liquivite LC given immediately after +7.5. Second Liquivite LC mini meal at PM+8.25.

+8.5 - 6.0 - 15 mins after last feed. Gave freeze-dried chicken treat.
+9.5 - 5.9 - 75 mins after last feed. Gave freeze-dried treat. Normal LC mini meal fed at +10.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Looking good so far she's surfing nicely.

Some of my kids at the Bridge are Arwen, Morrigan and Luge of the Celtic vein them their is also Muse, Artemis and Ceres and Herne (drooler)

My mother and grandmother would have been considered Tuatha Dé Danann back in the day. While everyone else is gearing up to celebrate the October holiday of Halloween for my household its still Samhain

Mel and The Fur Gang
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Definitely Samhain. I was born on Oíche Shamna. ;-)
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

I missed being born on Beltaine by 9 days. And was married on Mabon. Never met an unlucky black cat in my life ;-)

Mel
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Neither have I. It grieves my heart to think of how reluctant some people are to adopt black pusscats from rescue shelters. :sad:

Amadán was a tuxedo cat. Tara and Psycho were completely black. Lúnasa (aka Noodle) is tortie black with one milky paw.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Duvessa and Myrrdin are both tuxes. Autumn is my Avatar and she has white toes, we just lost our solid black long haired male Onyx to cancer last year and before him there was the lovely raven haired Morrigu and her mother Nightmare both now at the Bridge.

Think this is the first time in 30 years of being owned by cats there isn't a solid black in the house.

Mel and The Fur Gang
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Up again to 7.2 - table updated below. Saoirse was definitely hungry. It's tricky monitoring her because she's taking cyproheptadine at the moment so appetite upticks don't always give an indication of BG level. There might be some discomfort, too, because she's due her doses of ondansetron and cyproheptadine in about an hour, and she was lip licking a little at her latest meal. Galls me to see her in any discomfort ... :sad:

24 September
PMPS - 6.3 - Dose withheld.

25 September
AMPS - 5.4 - Dose withheld.
+6.75 - 7.9 - after 4+ hour fast)

PMPS - 7.4 - very skinny 0.25 IU - (PMPS taken 90 mins after food.)
+2 - 5.1 - 2.25 hrs after food.
+4.75 - 5.1 - 45 mins after food.
+7.5 - 4.9 - 90 mins after food. Mini meal of Liquivite LC given immediately after +7.5. Second Liquivite LC mini meal at PM+8.25.
+8.5 - 6.0 - 15 mins after last feed. Gave freeze-dried chicken treat.
+9.5 - 5.9 - 75 mins after last feed. Gave freeze-dried treat. Normal LC mini meal fed at +10.[/quote]

+10.75 - 7.2 - 45 mins after last feed. Gave freeze-dried treat and normal LC mini meal after test.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

Down again to 6.3 - table updated below. Slightly hunched just before latest test (meds worn off). Ondansetron and cyproheptadine administered after +11 test.

I'm so exhausted I can barely see/type. nailbite_smile

24 September
PMPS - 6.3 - Dose withheld.

25 September
AMPS - 5.4 - Dose withheld.
+6.75 - 7.9 - after 4+ hour fast)

PMPS - 7.4 - very skinny 0.25 IU - (PMPS taken 90 mins after food.)
+2 - 5.1 - 2.25 hrs after food.
+4.75 - 5.1 - 45 mins after food.
+7.5 - 4.9 - 90 mins after food. Mini meal of Liquivite LC given immediately after +7.5. Second Liquivite LC mini meal at PM+8.25.
+8.5 - 6.0 - 15 mins after last feed. Gave freeze-dried chicken treat.
+9.5 - 5.9 - 75 mins after last feed. Gave freeze-dried treat. Normal LC mini meal fed at +10.
+10.75 - 7.2 - 45 mins after last feed. Gave freeze-dried treat and normal LC mini meal after test.

+11.95 - 6.3 - > 1 hr after last feed. Gave freeze-dried treat and another normal LC mini meal.
 
Re: Saoirse (September) 25th PMPS 7.4, +7.5 4.9 ALPHATRAK

BG level holding in the sixes.

24 September
PMPS - 6.3 - Dose withheld.

25 September
AMPS - 5.4 - Dose withheld.
+6.75 - 7.9 - after 4+ hour fast)

PMPS - 7.4 - very skinny 0.25 IU - (PMPS taken 90 mins after food.)
+2 - 5.1 - 2.25 hrs after food.
+4.75 - 5.1 - 45 mins after food.
+7.5 - 4.9 - 90 mins after food. Mini meal of Liquivite LC given immediately after +7.5. Second Liquivite LC mini meal at PM+8.25.
+8.5 - 6.0 - 15 mins after last feed. Gave freeze-dried chicken treat.
+9.5 - 5.9 - 75 mins after last feed. Gave freeze-dried treat. Normal LC mini meal fed at +10.
+10.75 - 7.2 - 45 mins after last feed. Gave freeze-dried treat and normal LC mini meal after test.
+11.95 - 6.3 - > 1 hr after last feed. Gave freeze-dried treat and another normal LC mini meal.
+13.5 - 6.2 - < 1hr after last feed. (2 LC mini meals eaten since prev reading). Gave freeze-dried treat and another normal LC mini meal.

I have food set out plus some timed feeders. Saoirse has her appy stimulant and anti-nausea meds on board. It's now 14.75 hours after Saoirse's insulin injection, and all her clinical signs are good. Her nibs just finished a feed and made a somewhat desultory attempt at burgling one of the timed feeders before taking herself off to do a mistress-of-all-she-surveys number on the windowsill. Bless ... cat_pet_icon

Mel, thank you from the heart for answering my alarm call, and for helping me to stay conscious so I could keep my Saoirse safe. Blessings to you and your furry family.

:YMHUG:
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

I saw your post earlier tonight just as I was on my way out the door and was quite happy to see Mel with you. Glad that everything went smoothly and she surfed nicely along those greens for you! :mrgreen: A job well done!
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

it was all Mel's doing, KPassa! :smile:

You can't beat the pre-bed BG check. Ironically, if Saoirse had been lower I'd have been fairly OK with feeding her higher carb food. Mel guided us through the night without needing to ply Saoirse with carbs. I would have lost consciousness without her watching over us. PTSD is E-vil when it comes to catching you at the wrong times. You can't sleep when you should, and you can't stay awake when you need to. :evil: Every time I sat down last night, my eyelids felt like they had lead weights attached to them, and when I stood up to walk around I kept getting really dizzy. :roll:

I'm going to see how my Bonnie does on her own for the next few cycles. If she does OK, then maybe we'll do an OTJ trial. I'm very nervous about it because things went badly pear-shaped for her in the space of a week after her insulin treatment was disrupted when she got too low to continue Caninsulin safely. I don't want to do anything to put undue strain on her pancreas, especially after her flare-up.
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

Wow, I'm so glad Mel was here to guide you! :) I loved reading about the meaning of your cat names. Make me feel like a slacker for unoriginal names though! LOL
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

Good morning and so happy to see you both safe and sound. I would have stayed with you longer last night but we lost power about the time I fed my bunch for the last time then the phone battery died...Some days you can't win for losing..lol

The worst thing that is going to happen if you start an OTJ trial and she doesn't hold it is you go back to insulin. But with her numbers right now I'd say its worth a shot or maybe that should be worth "no shot" ohmygod_smile And look at her spreadsheet and all the missed shots she's already had. Personally I'm not sure she is safe to keep shooting and definitely not on a 12/12

Mel and The Fur Gang
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

Morning, Mel!

Thanks again for getting us safely through the night. I am relieved to hear from you because i was worried if everything was OK with you. nailbite_smile Hope your fur babies enjoyed their dinners. Please give them some of these from myself and Saoirse ... cat_pet_icon ... and tell them thank you for sharing their mammy bean for a while. :smile:

I agree wholeheartedly with you about withholding the Lantus. I learned so much from you last night about what the data can tell me. It was highly educational to see Saoirse's BG levels fluctuate in response to her meals. Just wish it didn't involve using her poor little ears for pincushions ... :sad: I think the plan of attack is to monitor her BG with her pancreas flying solo and if there's a sufficiently large upward drift to maybe give intermittent token microdoses as required to gently nudge her system into settling at a set point back in the euglycaemic range. I'm thinking of using Angel's spreadsheet numbers as a general yardstick to give me an idea of what to look for after insulin therapy finishes. Would that be a good strategy?

The lady of the moment has been very purry and content in herself this lunchtime. She's currently snoozing contentedly on the sofa, her body completely relaxed. It lights up my heart to see her the way she should be, instead of being in a tense heap or lying flat out behind a curtain the way she was a couple of weeks ago. I love her so much. (((Saoirse)))

And while the hug fairy's about it ...

:YMHUG: Mel :YMHUG:


Laura, I'm glad you like my little one's names. :-D I'll have to dig out some pics to go with the names and add them to Saoirse's profile. Hug for you, too! :YMHUG:
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

Works for me Hon

Not sure which Angel's spreadsheet you are referring to (I know several around here...lol) And I know it's not the one that is currently sitting on my shoulder wondering why I ate all my bacon and didn't share with her.. ohmygod_smile Since she doesn't have a spreadsheet nor is she diabetic and most days not terribly angelic. haha_smiley

Now of course if Her Meowjesty can run 14 days without insulin and keep herself between 3.8 to 8.3 according to the Alphatrak then we're going to party our paws off for her. party_cat We simply love OTJ parties around here even when they aren't for our kitties.

Mel and The Fur Gang
 
Re: Saoirse 9/25: PMPS 7.4; +7.5 4.9. Safely Thru A Long Nig

hi Aine
so happy saoirse did well overnight
so exciting that she might be otj. hope you can get some rest. take care.
nadine
 
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