Smudge Day 4

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allicatmeow

allicatmeow

Member Since 2023
295 @ AMPS. Very hungry boy eating up breakfast now. Purred through his poke! Doesn't hate me today as I feared.

Yesterday's thread: https://felinediabetes.com/FDMB/threads/smudge-day-3-at-home.281053/#post-3099860

Hendrick Cuddleclaw said:
whew. 295 @ AMPS

been refreshing that ss for an hour! was so worried about Smudge and that 4U depot!
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Sorry!! I had to get the kid off to school, then my husband helped me hold Smudge since he is off today. A great single poke success WITH Vaseline. :)

Suzanne & Darcy said:
Poor boy! That is a lot of new stuff to adjust to in a short period of time. I hope y’all will be able to spend some quality time together too. And keep the treats coming! Hopefully you can use your new blood ketone meter soon too. But keep trying to get the urine test of not. Some people use a long handled ladle to catch a little urine— so that they don’t have to get right behind the cat while he is in the litter box (cat is wondering: “What are you weird humans doing anyway?)
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I try to work in there during the week as much as I can (when my tiny one monitor laptop is feasible to use). He will sometimes snuggle me, but yesterday wanted nothing to do with me. The ladle is a great idea! He did have a negative blood ketone test yesterday, which was relieving.

Hendrick Cuddleclaw said:
what a journey poor Smudge and Alli have been on here. Warms my heart to see so many members pitching in to help keep Smudge safe and out of hypo territory.
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It warms my heart too! I'm SO thankful. And I'm very lucky he's such a good boy for a stranger like me.
 
So btw, with a so-called depot insulin like Lantus, when there is a dose change it takes 2-4 cycles for the depot to refill. (an insulin cycle is the 12-hour period from one shot to the next, which you probably know already)

Not sure if anyone mentioned that before of maybe you read it in a sticky post but essentially it means that even though he is on 2U now, he's probably not quite done being on 4U as today is only the 2nd cycle on 2U. By PMPS tomorrow that depot should be reset to 2U.

So just a heads up that his BGs could still be quite...exciting today. ;)


Also, I just HAVE to mention that it continues to baffle me how far you've come in only a few days. At the end of MY first week with Hendrick we didn't even have insulin yet, and at the end of two weeks after his diagnosis had not yet successfully done a home BG test. It took several weeks of failing, with my wife and I both, before we even got our first blood drop..... Which was too small of course!! @#$% err4 I hate you forever. :mad::mad:

I was pretty much convinced that it was impossible. Then one day I was working from home, wife at work, and his AMPS was the lowest we had ever seen and I said to myself "well, just going to have to suck it up you wuss, and try to test him solo you have GOT to know what that insulin is doing to him right now"

And of course without @Diane Tyler's Mom , Suzzane, Melissa, Sienne, Bron, Elise, Bhooma, Wendy, and so many more I would have continued failing. But thanks to them I succeeded that day.

I made the video in my signature a couple weeks later. :bighug::bighug::bighug:






...dammit where's that tissue box :arghh:
 
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Hendrick Cuddleclaw said:
So btw, with a so-called depot insulin like Lantus, when there is a dose change it takes 2-4 cycles for the depot to refill. (an insulin cycle is the 12-hour period from one shot to the next, which you probably know already)

Not sure if anyone mentioned that before of maybe you read it in a sticky post but essentially it means that even though he is on 2U now, he's probably not quite done being on 4U as today is only the 2nd cycle on 2U. By PMPS tomorrow that depot should be reset to 2U.

So just a heads up that his BGs could still be quite...exciting today. ;)


Also, I just HAVE to mention that it continues to baffle me how far you've come in only a few days. At the end of MY first week with Hendrick we didn't even have insulin yet, and at the end of two weeks after his diagnosis had not yet successfully done a home BG test. It took several weeks of failing, with my wife and I both, before we even got our first blood drop..... Which was too small of course!! @#$% err4 I hate you forever. :mad::mad:

I was pretty much convinced that it was impossible. Then one day I was working from home, wife at work, and his AMPS was the lowest we had ever seen and I said to myself "well, just going to have to suck it up you wuss, and try to test him solo you have GOT to know what that insulin is doing to him right now"

And of course without @Diane Tyler's Mom , Suzzane, Melissa, Sienne, Bron, Elise, Bhooma, Wendy, and so many more I would have continued failing. But thanks to them I succeeded that day.

I made the video in my signature a couple weeks later. :bighug::bighug::bighug:






...dammit where's that tissue box :arghh:
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Oh boy, another "fun" day of numbers! Luckily husband is home all day to help with tests. Your explanation of the depot is helpful. It sounds like he may have a little spike too once his body is out of the 4U depot and into the 2U? And this is why people explain "earned increases" if necessary?

Thank you for the compliment!! I am very determined. I am an expert cat piller (been pilling cats daily for 5+ years and my CKD cat gets pilled 3x/day right now) and an expert fluids giver, so this process felt like just another challenge to conquer! Insulin is easy-peasy because of my fluids knowledge, but I'm nowhere near conquering lancing. It is far more difficult than I expected, but your video and everyone here have truly sped up the process.
 
allicatmeow said:
It sounds like he may have a little spike too once his body is out of the 4U depot and into the 2U?
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really quite impossible to predict right now, not enough data. We have no idea how he is going to do on 2U.

I believe you're thinking of what is called an "earned" decrease. Which, under TR, means that if the cat's BG is tested and found to be under 50 on a human meter or under 68 on a pet meter, then you reduce the dose .25U. To say the cat earned it is sort of tongue-in-cheek. But often those decreases do only come with a lot of work on both the carge-giver's part and the cat, so it is certainly not far from the truth that it is well-earned -- by all!

Seeing as he was at a 69 yesterday around this time, are you going to get a test in soon? Probably a good idea.
 
Hendrick Cuddleclaw said:
Seeing as he was at a 69 yesterday around this time, are you going to get a test in soon? Probably a good idea.
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Yes I am. Husband is just about done with the lawn and I will be enlisting him for a +3 (or sooner if he's done sooner). It went so much smoother this morning and Smudge purred through it.
 
allicatmeow said:
Well I did not expect this - +3 @ 312.
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There are several possible explanations. Most likely is bouncing from yesterday's low numbers:

BOUNCE: When a cat’s BG numbers drop into a low range, drop fast, or drop into a range the cat is no longer used to, the liver and pancreas may respond by releasing a stored form of glucose along with counterregulatory hormones. This causes numbers to spike back upward. It can take up to 3 days/6 cycles for a bounce to clear
 
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Hendrick Cuddleclaw said:
There are several possible explanations. Most likely is bouncing from yesterday's low numbers:

BOUNCE: When a cat’s BG numbers drop into a low range, drop fast, or drop into a range the cat is no longer used to, the liver and pancreas may respond by releasing a stored form of glucose along with counterregulatory hormones. This causes numbers to spike back upward. It can take up to 3 days/6 cycles for a bounce to clear.


But also, there is something called "new dose wonkieness" which is a silly way of saying...when the dose gets changed, especially by a large amount like 2U, you can see some kinda weird and odd numbers for a couple days until things settle into the new dose.
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Thank you! I will not panic and stay the course. He is acting fine and happy, eating normally. I'll test at +6 next.

*repeating DONT PANIC DONT PANIC DONT PANIC in my head over and over*
 
Honestly, I think you are very close to the point where daily condos over at the Lantus forum might be best. Perhaps starting tomorrow with his AMPS

If you look at that forum you'll see threads are posted with a specific format, the thread title getting updated throughout the day as more BGs are taken. And always a link to the previous days' condo in the OP.
 
Hendrick Cuddleclaw said:
Honestly, I think you are very close to the point where daily condos over at the Lantus forum might be best. Perhaps starting tomorrow with his AMPS

If you look at that forum you'll see threads are posted with a specific format, the thread title getting updated throughout the day as more BGs are taken. And always a link to the previous days' condo in the OP.
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I agree with you. Now that I have a handle on what's happening, I feel comfortable posting there (and not totally clueless).
 
There is no NDW or New Dose Wonkiness when you reduce the dose. It just occurs after increases. Today's higher numbers are either the result of a bounce and/or too low a dose. The latter of which are a concern with recent DKA.
 
Wendy&Neko said:
There is no NDW or New Dose Wonkiness when you reduce the dose. It just occurs after increases. Today's higher numbers are either the result of a bounce and/or too low a dose. The latter of which are a concern with recent DKA.
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323 @+6. So maybe too low and 3U was more appropriate?
 
Hard to say at this point. Bouncing will mask what is happening at this dose until the bounce resolves. But if you see any ketones, it can provide a clue. Alternatively, if you see the number progressively trend up, that could indicate too low a dose. Too early to tell right now.
 
Wendy&Neko said:
Hard to say at this point. Bouncing will mask what is happening at this dose until the bounce resolves. But if you see any ketones, it can provide a clue. Alternatively, if you see the number progressively trend up, that could indicate too low a dose. Too early to tell right now.
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Thank you. I will stay the 2U course for now and see what tomorrow brings, as I'm sure tonight will be wonky as well. Would you take food away for more time before PMPS to prevent any higher climbing?
 
If his numbers are still high towards the end of the cycle, I'd still keep feeding the frequent meals. With DKA, you want to get lots of food in him - not enough calories is one other part of the formula for DKA. The reason we suggest people not feed for a couple hours before preshot, is in case kitty is in lower numbers at preshot. You don't want to shoot a number that is influenced by food - but that only matters if close to a number too low to shoot. Over time you will learn how much of a numbers bump he gets with food, and will be able to take that into consideration.

If you see ketones before tomorrow, that would be another reason to increase back up sooner.
 
Wendy&Neko said:
If his numbers are still high towards the end of the cycle, I'd still keep feeding the frequent meals. With DKA, you want to get lots of food in him - not enough calories is one other part of the formula for DKA. The reason we suggest people not feed for a couple hours before preshot, is in case kitty is in lower numbers at preshot. You don't want to shoot a number that is influenced by food - but that only matters if close to a number too low to shoot. Over time you will learn how much of a numbers bump he gets with food, and will be able to take that into consideration.

If you see ketones before tomorrow, that would be another reason to increase back up sooner.
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Thank you Wendy. I will let him keep eating. He still has a great appetite and was very sweet for his +6 test, so he is feeling okay. I'm going to let him be til PMPS and will try to get a ketone test tomorrow morning.
 
allicatmeow said:
PMPS 286.
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Not bad. :) Is there a reason the number is stricken in the spreadsheet?

I’ll be curious what the +2 might show. If it’s the same or lower than the PMPS, it can be a clue that the cycle might be “active” (so you might want to monitor more closely and/or possibly get another test).

Did you get a ketone test?
 
JL and Chip said:
Not bad. :) Is there a reason the number is stricken in the spreadsheet?

I’ll be curious what the +2 might show. If it’s the same or lower than the PMPS, it can be a clue that the cycle might be “active” (so you might want to monitor more closely and/or possibly get another test).

Did you get a ketone test?
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Something is wrong with my Sheets file. I don't know why that had a strike through and now it is giving me view only access for no reason.

+2 is 268.(cant update the spreadsheet for now)

I did not get a ketone test tonight.
 
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