AT- Help! Low #s pmps/126, +1/103, +2/81, +3/88 Lower each day

Lolly 1-25 AMPS/168, +5/150, +7/149, PMPS/209, +2/217

I don't know how to link previous post-- I think that's just the title. Can someone help do that, you need to see post.

Lolly's been "going down the ladder" faster than I can handle, I'm a newbie, she was dx three weeks ago. While great news, I don't know what to shoot now--

1/26: AMPS 105, shot .75u; 59@+5, 69@+5.5; 81@+6 112@PMPS, shot .5u 109@+3, 73@+2.25, 96 @3 there was a good number at +5

1/27 NS 108@+9.5

I have to shoot at 7:30pm if at all. What should I do? If you look at her spreadsheet her numbers are coming down so quickly don't know how to even follow the protocol now.

Note: there was a good number at +5, I then conked out for 11 hours, which is why i didn't shoot this am, or take an earlier reading. I didn't think it could be this low after not shooting,

On top of this, looks like my Alpha Trak may have pooped out-- every number, including dates reset, and I'm certain I did not do this. Sending husband out to CVS for human meter-- which one?

 

I did get the link from last night in. Did something right. Working on the alpha, don't know what I can get at the CVS

 

Maybe it's a battery issue for the AlphaTrak? Try replacing those. I don't know what to get at CVS, we don't have them here. Get DH to ask which meter uses the smallest drop of blood. Walmart Relion Confirm or Micro use the same size blood drop as the AlphaTrak.

If you get a meter in time, test again at +11 and post for advice. That way we can see if she's coming up before preshot.

 

reset the %@# alpha track- so that's ok.

 

When did Lolly last eat? And how much?

 

Thanks Wendy, will do. I'm definitely getting a back up now. Everything's closed here because of the huge storm that didn't hit us, so would have been a REAL problem. I want to shoot at 7:30, so wait till 6:30, or get one now? She is hating the tests more and more.

 

She ate about 3.5oz of FF LC at 12pm EST (+4.5) They do free feed as well, though i pick it up 2 hrs before shot.

 

One thing to keep in mind is that it can sometimes take a couple of cycles for the depot to adjust to a new dose. So, the low that you saw during yesterday's PM cycle may have been due to the low numbers in the AM cycle and the depot not having enough time to adjust to your having lowered the PM dose. (I hope that made sense!)

By skipping the shot this morning, you've definitely given the depot some time to get caught up. Let's see where Lolly is closer to PMPS. Chances are, you'll be able to shoot the 0.5u.

 

The CVS Advanced meter (store brand) is what I started with before switching to the AT. It was easy to use, doesn't require much blood, and the strips are cheap.

 

Sienne, I do understand, thanks, I'm starting to understand some of this, though it's only been three weeks... I just want to alert everyone, though, I was able to stay home for the past 4 days and monitor day and night as needed. And she's earned dose reductions quickly. I go back to work tomorrow evening shift. I can get up to a +4n before I leave, but no one will be home between 5-7 where she seems to nadir. My husband will be back by +10, can test, but he can't consult with you guys the way I do, he's doing what he can, but I have to direct him. He has to give the PM dose! And it'll will be difficult for me to be on the board while I am at work.

So even if it's conservative, I've got to be sure she's safe. If we are conservative, will it mess up her chances for remission, or just delay? Does does conservative mean giving lower doses than she's earned? What would that do?

So worried cause I have to go to work.

 

Martha
Given your circumstances, and especially if sleep is going to be an issue for tomorrow, I think I'd shoot 0.25 units, just to help keep the glucose from skyrocketing.
Yes, it will delay things a bit. And yes, she might wind up higher than optimal for a day or so. Or maybe not, the way she is diving down the doses.

 

Hi Martha - you're getting the hang of things!

you can tell a lot by +4 tomorrow. One option is to leave food out while you're gone. You said they graze - think about when you get low numbers you give carbs to bring the cat's BGs up. You can have the same effect by leaving food out. At +4, you'll know if you can just leave low carb food out or if you need to leave high carb. In a pinch, you can leave a whole can of high carb if you have to. That would do what we call "aborting the cycle." that mean that you KNOW that you're going to cause high numbers but that's the best solution for the moment.

That's a perfectly ok option, so tuck it into your bag of tricks.

I wouldn't worry about tomorrow until tomorrow. It's so awesome that Lolly is doing well - I'd make the decision for tonight when you get the +11 and pmps. When you're giving the times you're wanting to shoot, I'm wondering is that time different than 12 hrs after this morning's shot? is it earlier or later? that can make a difference in BGs if you're shooting early or late.

 

+11 is 124

 

I would stick with the 0.5u. By skipping this morning's shot, you will have interrupted the depot action, and while there are no guarantees about what happens next, for her sake, personally, i'd stick with the 0.5u tonight.

however, if you are too unnerved by it - and we all totally get that - you could reduce to 0.25u and then hold it there until she goes below 68 again. You may have to go back up in dose, or you may not. Some newly diagnosed cats are in a hurry to go off of insulin and we just respond to the numbers we see. No way to know, but as BJM said, when a cat is "on a mission" skipping or reducing a dose in advance doesn't usually set them back much.

So it's up to you what you'd like to do.

 

MARTHA!!! SO glad you got sleep. I was confused when you were asking last night as she did not drop below 68AT to warrant a reduction, but skipping did allow you to sleep. And as it turns out didn't have much impact on her numbers anyway. See what others have to say but I am inclined to shoot the .50 tonight, then if need be get feedback on possibly doing .25 while at work tomorrow (of course depending on her numbers).
She was a bit low last night but not super low. And you saw how well she responded to a little HC to slow things down, This was entirely different than last time when she was on a much higher dose, wouldn't eat, and you shot a much lower to begin with.
She seems to stay fairly steady after she drops...these are actually beautiful cycles. And they just don't have the huge swings typically once the doses get smaller.


If he is going to CVS, I would recommend either Bayer contour or Next or One Touch. But all these strips will cost more than the relion which so many here use. You can only get relion meter at Walmart. If you go that route, you want Relion Micro or Confirm- NOT PRIME (requires more blood, mixed reviews and reliability). All these strips cost less than your AT though.
We used a One Touch mini and loved it. I got strips on ebay to save $$. I had a Bayer Contour Next as a backup meter that was fine also.

How did you come out weather wise? IS there snow up to the roof? Hubby made it home safely so that is good. No chance of a snow day tomorrow?
SO glad you got a good rest in, you needed it! Hope you feel better. And so glad Lolly is doing so AMAZINGLY well, though making you feel like you are in a whirlwind. It happens when they race down the ladder like that.

 

I realized that yesterday I shot 8 am and 8:30 pm. It's taking me longer and longer to get the bg. She was so easy at first. Since I skipped the am dose, can I reset the time? I'd like to get to 7:30, but is that too large a jump even after a NS? Are we certain her depot has emptied out? Or is 8 OK?

 

Yes, since you skipped the am shot, you are long past +12 and can shoot anytime now. Just choose what works best for you, considering where you when you want to shoot tomorrow.

 

there are no certainties - and no, her depot isn't likely to be empty. A previous higher dose can influence even 6 more cycles, so she's still probably getting some blood sugar control from previous doses.

 

II'm losing it, sorry guys, bad info: I shot at 8:15 am and pm (est) yesterday, the 26th. The numbers are on the alpha, better start writing them in the notes on the chart.

 

OK I'd like to go to 7:30, which moves it up 45 minutes. I'll shoot the .5, I can do up to a +4, 5 if I have to. When should I start testing? She is really hating this now.

 

I meant testing after the PMPS-- I'm doing that of course.

 

if you skipped the shot this morning, you can shoot anytime now.

when you're at the crazy going -down-the-dosing -ladder-maybe-fast phase, it's a good idea to get a +1 and a +2 so you don't have any surprises. You can compare the test and hour before the pmps and if it's the same or going down, then a +1 becomes more important.

 

OK-- test, feed, and shoot (.5) here I go...

 

Lolly's gorgeous. I have a weakness for patch tabbies. Hang in there. If I can do this, you can!

 

i'm trying to type this with 3 cats taking turns on my lap, in between me and the laptop, trying to get my attention so i'll feed them NOW! hahahahaha

I just wanted to suggest that you update your subject line so we can see at a glance if you need help. So today's would read:

1/27 Lolly +21.5/108 +23/124 pmps ### AT

Not sure if those times are the right # of hours past the last shot - would you double-check that? then put in your pmps and any tests as you go along tonight. Don't want your needs to get missed in an out-of-date subject line!

 

She ate, then hid. I had trouble finding her, she definitely is avoiding me now, she NEVER used to do that. Then the test didn't go well. Anyway, she got her shot at 8pm, so much for the reset. I wish I could give her a break from the testing, but not possible. She eats her treat, but doesn't even want me to handle her ears now. I think because this hs been so fast, she's had so much testing, almost non-stop. And I'm sure I could be better, but its harder now, because she jerks her head away. I'm dreading the +1

 

Thanks Mary and Julie!

I'm scared about what's going on so fast now, but this is amazing, so I had to share: Lolly climbed to the top of a six foot ladder today!!!!!


She hasn't done that in years! (We were changing a lightbulb) (it was a little scary, as she couldn't figure out how to get down

 

Good job shooting tonight! Next time she hides, just put out the ladder.

It's great to hear how much better she's feeling.

 

Having trouble with the tests, I can't believe this. +1 is 101.

 

hehehe she sure is on a mission. You could give her a little extra low carb food now (just a couple o tsp) to encourage her to surf it. Could you please also update your subject line (per Julie's earlier post) so that people can see what's happening now so that they know you might need some help

 

Way to go, Lolly!

I wouldn't get a OneTouch. It's an awesome meter...my favorite....but it takes a large drop of blood and the strips can be expensive.

 

That would be really helpful. Keeping the spreadsheet updated too. I'm worried you're not going to get help you might need because people have to wade through 31 posts to figure out what's going on.

For example, if i'm reading things correctly, you shot a 124 and at +1 she's at 101. Do I have that right? If so, that's really important.

We would have expected to see a little spike in BG from eating at +1, not a decrease of 23 points.

Did she eat a full meal at preshot? Does she always eat everything or is she a more "delicate" eater? In other words, can you always count on her to eat more? If so, would you give her a little more regular low carb food now, please.

 

her bg is going down -- +2 is 81

 

Martha...have you ever tried testing her on her paw pads?

If her ears are really tender (which I'm sure they are by now!) it's something you might want to try to see if she tolerates it better

 

Did you feed the +1 with low carb?

That is getting pretty close to 50 on a human meter and early in the cycle I think I would give a tsp of HC now if you've already tried the LC - and maybe even if you didn't!

Martha - please please update the subject line so people logging on can see at a glance what is happening

 

I updated spreadsheet and post headline. Wow- She didn't even move. I thought it would hurt more on the paw pad. Any pad?

 

I didn't try any LC at +1 -- she just at at +12. This seems to be a repeat of last night, except I didn't do a shot this time. Victor's Mum, can you review last night's thread-- same thing--

Lolly 1-25 AMPS/168, +5/150, +7/149, PMPS/209, +2/217

Giving her a little gravy now.

 

Your "need to intervene" number on an AT is 68. Before she gets to 68, your only goal is to slow her dropping down. She's not in any danger. Even low carb can slow down a drop most of the time. You want her to spend as much time as possible in that range just over 68 - say in the 50 points or so above it. we don't have good data on the AT to say what the normal range is, but it's somewhere in the range just above 68. That 68-160 is only our best guess.

Did you give her 0.5u tonight? the dose cell is empty on the ss.

 

The storm veered off a couple hundred miles into the ocean, so we just got about 3 inches here. New England got slammed though. I'm glad I got a snow day, but I'd actually rather work and not have to shovel 2 ft of snow off my car -- which happened twice last year! Unfortunately (fortunately?) Lolly's doing her thing again, running down the numbers. Gave her the .5, now I'm doing a little of the HC gravy.... please let it not be a late night!!! (work tomorrow-- )

 

julie, I gave her the full .5u. I'm waiting to test in 15 minutes.

 

can you add it to the ss? that's our go-to spot to see at a glance the whole picture - that way the help you get is as good as we can make it! See you in a bit for that next test. I'm sending "surfing" vines to miss Lolly!

 

+3 = 88 That's after 1 tsp HC an hour ago.

 

i'd hold off on more HC. you can give some low carb regular if you want - a couple of teaspoons can help kitties surf along in green.

if she doesn't have a great appetite so you can always count on her to eat, then i might just give her 1 tsp of low carb now.

 

by the way, if you can continue through the evening updating the subject line with the most recent tests i'd sure be feeling better. that way others will see the most current information.

just edit out the old info so you have room for the new info. the most significant at this point are the pmps and tests afterwards.

 

Will do-

This is the exact thing that happened last night (except that I skipped shot this am). I can't keep monitoring her until +5 every night. Can I shoot a .25 tomorrow safely at 7:45 (15 min earlier)? I cannot get back till 5:30pm, (+10) though my husband can test at +4 and +9

I was trying to move her back, but had problems today. I can only get a +1 tomorrow if I shoot at 7:30, and that would be a 30 min shift from tonight. Can I do that? Or on .25, will my husband's +4 be enough?

Thanks

 

Anyplace you can get blood is a good place!!

I always worried about the risk of infection (litterboxes and all) but for now, if using the paw pad is easier on both of you, go for it!!

 

The biggest thing I can tell you is that when a cat is going down the dosing scale quickly like this, including skipped shots and having all the blood sugar tests for the past 2 days be in normal numbers . . . it's a really good sign and while it may be intensive at the moment, including late nights, it is likely that you're going to have a kitty go OTJ before long.

I hesitate to say that because there are no guarantees, but everything in her spreadsheet says that's where she's going. I just want to encourage you to hang in there. The next lower doses would be 0.25u and 0.1u.

For tomorrow morning, since you can't test afterwards, i think i'd be inclined to skip again tomorrow morning and then shoot at pmps, or even early tomorrow after you get home from work. That may make the pm cycle tomorrow night end up being more than 12 hrs, but she's holding her BGs down ok and i think it would be all right to do that in this case. If she were mine, that's what I'd do.

 

Thanks julie. I wish I could be home and try .25, but I'm just scared about not being able to test.

If her bg is normal when I get home, would you hold off on the pm shoot till her normal time? (I'd get an hour and a half head start by shooting when I get home)

For the pm shoot, would you continue with .5, or go to .25? Officially, wouldn't I have to see a nadir 0f 68AT to reduce?

 

I think i'd post tomorrow night and see what's going on at that time. it's hard to predict in advance. just speaking generally, i'd probably go back to the 0.5u until she goes below 68 on the AT and then reduce. that's part of why i wouldn't have given hc tonight - just because if the dose is too high, we want her to tell us. it wasn't a terrible choice or anything - i'm not criticizing - just saying that i'd have held off and just used LC unless i needed the HC to pull her up over 68.

That said, i think if you want to come back with a 0.25u dose that's not unreasonable to try. probably depends on what she does between now and then. cats going down the dosing scale can sometimes just decide they are done. they all do it differently.

if she is in normal numbers when you get home, sure, you could hold off til your regular time. i was just thinking if she is higher it would let you get on top of things before she goes even higher. she may not do that though. that's why it's a great idea to post tomorrow and let someone look at her ss and help walk you through your options.

 

+4 @ 95 Looks pretty good- about the same as last night (and she probably has no lantus depot) so I think I'll check +5 then call it a night

 

Fingers crossed for OTJ soon!

 

Thanks for watching everyone

Julie I wish I hadn't given the HC too -- I even had BJ's steering numbers in my computer notes function. I chickened out... but I think you all may be right, this girl will be finished before her Momma learns how to do things right... Fingers crossed!

 

no one can promise anything - and often we don't say anything ahead of time because no one wants to get a person's hopes up when we can't guarantee anything. but i know it's exhausting to be up late and working all day. i just want to encourage you because she does look good - sometimes it's a really intensive time but with a huge pay-off if the cat can go off.

 

Great work, Martha! Sure looks like Lolly's skipping down that ladder!!!

A suggestion regarding testing, no matter where you do it - maybe try some false runs - instead of actually poking Lolly, just let the lancet make the noise & let Lolly feel the pressure against her ear (or paw) - & give her a treat. I did this multiple times with Tigger several times a day & pretty soon he was flopping down into my lap to be tested so he could get his treat!

Paws crossed Lolly gets to the finish line soon !!!!!