09/10 Ivana AMPS=322, +2=324 +6=144, +7=115, +8=86, +9=110, +10=112, PMPS=146 after stalling, +1=212

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Tara & Ivana (GA)

Tara & Ivana (GA)

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Yesterday's post

Newsflash! Ivana actually purred through most of this morning's test! This is a first. Today's task is to label all the food I bought yesterday with their carb value, and sort them into categories in the cupboard.

And now for the first of what will probably be many more questions today: If I can only test once in the AM or PM cycle, +2 is best, right? To catch a potential hypo?
 
Yeah for purring through the test! Good job. :)

The +2 test is usually a good indicator of what the cycle will look like, but will not likely catch a potential hypo. However if the +2 is lower than the preshot, then it's likely going to be an active cycle and if you can't be around the rest of the cycle, it's an indicator you should leave out some higher carb food for her to munch on. Or if you have an autofeeder, to put higher carb food in there for safety. If you get a lower +2 at night before bed, then it may be telling you to set an alarm for later around nadir time.
 
Thanks Wendy. So when you say a +2 won't catch a hypo, is there another testing time that will? Or is it a matter of just seeing what the +2 says and acting accordingly? Why wouldn't a +2 be lower than the preshot, wouldn't the insulin be having a lowering effect? Looking at Ivana's spreadsheet, while I haven't always done a +2, all of the postshot tests bar one have come back lower than the preshot.
 
It's still a little early to be trying to figure out Ivana's "patterns"...You also skipped 2 mornings ago, so the depot has to settle down again. Every time you skip or give a reduced dose, it kind of throws things off

What we can say is that "Most" cats are pretty good about that "+2 rule", but some do better at +3...it can't guarantee they won't go too low during that cycle, but "most of the time", if that +2 (or +3) is lower than the PS (and remember, meters have a 20% variance, so we're talking a fairly significantly lower number), that can be your "early warning system" that later in that cycle, Ivana might be going too low, so if you can't be there to test, it's better to leave some higher carb food down so if she does go low, she has some food to eat and bring herself back up. Most cats will go looking for food if their BG drops
 
From 9/9
Update for last night: I couldn't get a post PM shot test. I tried multiple times at +1, +2 and +3, then gave up. Given that her PMPS wasn't low, and that we stayed up til +5 anyway to catch if anything happened, I don't think that I put her in too much undue danger. I just couldn't get it, no matter what I tried. I've been growled at a few times since testing, but last night I got hissed at too :-(
Click to expand...

Unless you're shooting low, there's really no real good reason to get a +1 except for everyone once in awhile....we pretty much know that most cats are going to have some kind of food spike, so the majority of the time, waiting until +2 is going to give you more information as to what might be happening later in the cycle.

Now if you ever have a low preshot (like under 150 to start with) then it can be a good idea to get a +1 and +2 just to make sure they're staying safe

After you start to shoot lower numbers, (as you gain confidence, you'll gradually shoot lower and lower) ...most of us with enough data on our cats will shoot anything over 50
 
Thanks Chris. Just when I thought I had it all down-pat, new information makes me second-guess again! Yes true about skipping, I'd forgotten about that having an impact. We'll just keep doing what we're doing and then her curve is on Tuesday, hopefully by then some sort of pattern will be starting to emerge.

I'm just wondering though if her fist post-shot number (be it +2, +3, +4) is almost always lower than her pre-shot number and this is an indication of a possible hypo (which for her hasn't happened yet), is her dose correct? At what stage in the cycle should the insulin be starting to lower the BG?
 
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-new-to-the-group-please-read.18139/

If you scroll down through the link you will find a description of the lantus cycle - of course ECID - so it can only be viewed as an example. +2 in a 'normal' cycle is usually around the same as PreShot as the food spike is wearing off and the lantus is just starting to kick in. When +2 is much lower than preshot that can indicate you're going to have a particularly active cycle.

I suspect that she went quite low last night as she looks to be bouncing this morning (don't panic I'm not saying she went hypo). Since you couldn't get a test last night I might have given her some carbs mid cycle/before bed just to be on the safe side. Doesn't sound like not being able to get a test will be an issue for much longer anyway, not if she already purred through her test this morning :) Vyktor used to purr through his tests and after a while he would continue sleeping through them too :cat:
 
Fabulous page, thanks. I've read this post before but it probably didn't mean anything at the time with no data or other knowledge in my brain. Another one to print out :-)

Ok so I need to start testing more often at +2 when possible to catch this. If you have a look at 7th Sept, she started yellow and then went down to blue, stayed there all day including +2 after the PMPS. She was also still blue at the AMPS the next day. Does that indicate she likely went low that night?

Is last night's bounce indicated by the relatively high AMPS this morning? Should I give her some carbs now and test again at +5 in about 30mins?

Unfortunately the reason I couldn't get a test last night was because apparently I drained her ears of all their blood yesterday... nothing would come out! She bled so so well during the day, and then either not enough or nothing at all at the night. Strange!
 
Bounces go UP, not down

When they bounce, it's because either their blood glucose went too low, it dropped really quickly (like from 400-200 in 2 hours is a FAST drop) or their BG is just lower than their body has gotten used to being. (or a mix of all 3 reasons)

When any of those things happen, their liver thinks there's an emergency and dumps stored sugars and hormones into the bloodstream to bring them back up...but it's not very accurate and lots of times they zoom zoom zoom WAY high....that's a "bounce".

Basically, back when our cats were wild, if their blood glucose dropped too much (like from starvation) their liver would "kick in" and release those stored sugars and hormones to bring them back up so they would have a chance to hunt again and (hopefully) save their lives. Unfortunately, the liver hasn't learned that our civilized kitties aren't usually going to starve to death!

The same kind of thing happens if they drop too much, too fast...the liver doesn't understand that dropping from 400-200 isn't a "dangerous" number..200 is still higher than we'd like, but it "thinks" something is wrong so there go those sugars and hormones again!

Reason #3....our diabetic kitties were probably diabetic for quite some time before we started seeing the signs and found out, so their body got "used to" living in those higher numbers....When the insulin brings it down, even in a "good way", there go Ms Liver again....coming to the rescue when she doesn't need to!

Now as their bodies get more used to being at better numbers, the liver can re-learn what it's like to be there again, and not respond so much, but some cats will bounce all the way to OTJ
 
Ok right, so it was this morning's high number that was the bounce, not now. The last one pretty much the same as this time yesterday. So the drop is just coming out of the bounce. I will test her again at +8.

Sorry for all the questions, information overload resulting in confusion :banghead: :)
 
No problem!! That's what we're here for!! Keep asking those questions...that's how we all learn here!!

Bouncing is one of the harder concepts to grasp around here...and they're one of the most frustrating parts of the sugardance too, but when China and I first started here, one of the things people kept telling me and I just had to accept was "Cats bounce until they don't"
 
I appreciate the help of everyone here so so much!! Imagine if I called the vet as often as I post a question here haha

Do I need to give her a bit of carbs now or just test again at +8?
 
Thanks Wendy! I just gave it to her and I don't know if she's more shocked at getting fed a special afternoon tea 'meal', or being allowed to eat on the bed :-) +9 is about 20mins, is that enough time for the effects of the food to show?
 
I'm so nervous now! Hubby is doing the PMPS and shot tonight as I won't be home. What do you guys suggest is the lower safe limit for him to shoot at? It's in about 3 hrs.
 
Here we suggest 150 as the number where you do not feed, and post for help. You've shot a 164 before, so that's not much lower. Is hubby going to be able to monitor tonight? Plenty of strips and high carb food? Unfortunately it's getting late in North America, so you might not have anyone around to help. You might want to review the Sticky on Shooting Low Numbers for your options. A good first choice if your schedule can handle it, is a stall for 15-20 minutes, without feeding, to see if her numbers come up to where you are more comfortable shooting.
 
Ivana's shot is due at 6pm, and I'll be home at 6.30-6.45pm so I can help monitor her then. I will tell him if it's lower than 8.3 to not feed, wait, then test again. Then if it's over 8.3 to shoot as normal. If it stays below 8.3, can he do a reduced dose or should we just skip it? The last time we skipped it (the AM shot) she was high all day. Although we will be home tonight to monitor her, we will both be out most of the day tomorrow if that makes a difference.
 
I see she's on her way back up. I suspect you may not have a problem shooting low tonight. Once people have the data to do so, they will shoot below 150, but it's easier if you work your way down. The first few times you shoot lower numbers, you should do so when you can monitor and gather data. Neko took it easy on me, the first few times I shot low, she bounced right away. :rolleyes: Shooting a reduced dose is also an option, though sometimes the first part of the cycle may still see some action due to the nature of the depot. Either skipping or shooting a lower dose would impact the next cycle (tomorrow). No matter what option you choose, getting at least one test in the night cycle is a good idea.
 
She's pretty much the same at +10 as she was at +9. I won't be able to do any more testing before hubby does the PMPS as I'm leaving for work soon. Fingers crossed Ivana gives him nice number :-)
 
HELP! I don't know whether to shoot or not! Her numbers are only very slightly moving up from +9 til the PMPS now. Should we shoot a reduced dose (was planning on doing 1.25u as per SLGS as she dropped <90 today), but I don't know whether these numbers indicates she's on the move up or still steady.
 
Hi Ivana
Most of the U.S. is asleep at the moment.
Wendy said to stall and test in 20 mins. Did you do that?
The numbers for +9 through to PMPS are really much the same, so her numbers are not coming up much.
If you have tested again and the numbers are the same, I think it would be best to skip the dose tonight.
She will get back on track and the main thing is to keep her safe.
I will watch for your reply
 
Hi Bron, we have just tested right then and it was 8.1, so we're going to feed her and give 1.25u (instead of 1.5u as per the SLSG as she went <5 today). Will test again in +3 to make sure everything is ok.
 
So she was 6.4 at PMPS, then 30min later 6.7 (not much change really), then 60min after that (so PMPS+90min) she was 8.1 and starting to come up.
 
Ok, so she is on the way up. I would get a +1 and a +2 as this is the lowest you have shot.
I will watch for your posts and will stay with you.
 
Yes, that is good.
Did she eat a good meal?
I should have explained about the PMPS better.....what I meant was that in the PMPS square where you normally put the number...can you put all the information I mentioned into that square please?
You will then have to go over to the U.S. numbers page and manually put it in there too in US numbers
 
Yes she ate the same amount she normally eats. She never eats her whole meal in one go.

I think I fixed it now, let me know if not.
 
You done good Tara!!

Yes, Ivana earned a reduction by dropping below 90, so you were right to reduce to 1.25....she was never "in danger" last night, 86 is still a VERY safe number, but we didn't want her dropping any lower which is why we recommended the snack.

Then at PMPS, (since you don't have enough data yet to shoot too low) you did right again and stalled, didn't feed, and waited for her to come up to a better number....and then shot!! :)

Don't be surprised if she goes straight up for awhile now...that 86 could very well trigger another bounce up today, so you may get a nice quiet night!
 
Yes, that is what I meant except you need to indicate that the +13.5 was the PMPS. I know you have written it in the remarks but it needs to be in that square....sorry to be a pain.
 
Thanks Chris, so glad I had Bron here to confirm what to do (I was going to call you if no-one answered in a reasonable time!)

I can't edit the thread name as it's too long, but +2 was 11.4/205. Is it safe to go to bed?
 
She looks like she might have an active cycle because it is coming down a bit....it is hard to know as we don't have much data on her yet. If she was my cat I would get a +4 or a +5 and that will tell you a lot more. Can you set the alarm and get up and test?
 
+4 is fine.....If she had dropped quite a bit you will need to check again at either +5 or +6
If not, she should be OK to leave. You will get to know how she is likely to react in time.
If you are doing the Go Slow method I think at 5 I would give some food......But I don't know that method very well.
I would leave some normal food out for her now in case she wants some more.
In any case, post if you are unsure. I am not sure if I will be awake but I think Chris will.
 
Oh goodness I wouldn't expect you to be awake at that time! Thanks for all your help tonight, much appreciated. If I have any trouble I'm sure someone will see.
 
Tara & Ivana said:
I can't edit the thread name as it's too long, but +2 was 11.4/205
Click to expand...

When that happens, just take out some of the AMPS numbers...easy, peasy!!

As for the +2 being lower, that's actually about the same number...remember there's that pesky 20% variance so both the +1 and +2 are really the same number

Get a test at +4...if she's going up, I think you can go to bed....if she comes back down by then, I'm sure there will be people around here by then,even if I'm not

The US side of the world is waking up :)
 
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