12/08 Mačka AM 177 stalled for 2.5hours, +1 225

http://www.felinediabetes.com/FDMB/...-soon-airplane-questions.222552/#post-2488148

AMPS 177, never in his life of a diabetic cat.
I know I have to shoot low to stay low, but I am terrified. I fed him, and only after realized I should have stalled and tested him again, but now it's too late.

It's 6 am and I usually go back to bed after the shot but this time I have to stay awake to monitor him, poor baby's ears.

Wish me luck

ETA: I have not shot yet at +1

 

Or should I reduce the dose?

 

While I can't give you dosing advice, with TR you would reduce if you get a number below 50 on a human meter. Will you be around to monitor?

 

Yes i'll stay home today to monitor him.

 

You can also not feed and stall 15 mins and recheck to see if he is coming up.

 

I just did and he's stable at 175 (he was at 177)

 

If you feel comfortable, 175 is a safe number. You may also wait for more expert advice. Wish I was more helpful.

 

I don't feel comfortable, I'm freaking out!! His dose is 5u, I feel like this is too high and he's going to go below 0!

 

It's ok, It can be very intimidating, let me see who is around to chime in. Maybe also put the work "HELP" in your title

@Crista & Ming can you help?

 

There is time, you can shoot a bit late, Hang in there.

 

Yes, I am waiting, it's still only 6:18am

 

If you can monitor and have all the necessary supplies, I would shoot. You can do it, Penelope!!!!

Get a +1 and +2.

 

I have the supplies but nothing tells me he'll be hungry in an hour or 2? Also, how much can HC save a cat if he's going too low? I have no idea as he never did this to me before! I am losing it

 

When is Macka usually hungry? Or does Macka not eat well throughout the cycle?

 

He gets hungrier around +4... so I guess we have a chance here.
Should I test him again now? (that would be 1 hour after AMPS and 1/2 hour after finishing eating, or is this information useless?)

 

You can test you’d like

 

If he does need HC before +4, do you think he’ll eat it? Sometimes cats will like the HC more and eat.

If you do need to “save” kitty from a hypoglycaemic episode, then rubbing honey on the gums is how we treat cats who aren’t eating or can’t eat. Although paws crossed that never happens. But it’s good to be prepared.

 

177 is a very safe, shootable number. Since you will be around to test, I vote for shooting

 

After 1 hour since last test of 177 and after eating 3/4 FF an hour ago (plus some Dr Elsey dry as topping), he's going lower: 166

 

He might, he likes gravy. I don't know how full he is right now.

 

If you’re not comfortable, Penelope, you can shoot a reduced dose. I was hoping Macka would be higher to make it easier for you to shoot.

I don’t think the dose needs to be reduced by half though. I’m a little undecided about the reduced dose. Sorry!

 

@Bobbie And Bubba any ideas?

 

I understand, I have no idea either.

I can wait a little more.

 

You have great opportunity. It is AM cycle and Sunday which means there will be people here to help and encourage. You have to shoot lower numbers at some point to get both you and Macka used to lower numbers.

 

I do agree with @LizzieInTexas. I'm only recommending the reduced dose because you're not comfortable, Penelope, which sometimes is also something we take into account. To me and IMO, 166 essentially is the same as 177. He might be a cat that doesn't have much of a food bump or needs longer/an hour for food to take effect.

 

Just saw you are in Portland. I grew up in the Eugene/Springfield area and my brother lives in Gresham.

 

Lol, you're a local!!!

 

OK, i'll take another test now which is more than 1 hour after he finished eating, and see where he's heading.

 

I moved to Texas in 1985 at age 19. Been back a few times since. I miss the mountains and trees sometimes.

We are planning a cousins reunion in Portland next July.

 

What about missing the rain? :/

 

He is at 167, after 1 1/2 hour... no movement at all, no food bump, is it really safe to shoot?

 

Shoot that cat!

 

@Sienne and Gabby (GA) are you there by any chance?

 

I vote shoot!

 

I would shoot also, and trust in the experienced people giving you advice.

 

A 177 is very safe. We tell members brand new to TR to ask for help if numbers are below 150. It's fine to shoot if you are going to be home to monitor, have strips and high carb food if it's needed.

At some point, you have to bite the bullet and shoot lower. Just an FYI, the 241 that you shot on 11/16 is not significantly different than the 177 when you factor in meter variance.

 

I only wish I could gain years of experience in 5 mins. I would love to be able to help better.

Thank you for stepping in!
@Crista & Ming
@LizzieInTexas

 

That's what I keep telling myself, but I feel like a little chicken right now How fast can a cat drop? within a 1/2 hour? 1 hour? 2 hours? How fast can I catch a drop and keep him safe?

Okay, I'll do it.

Thank you all for being so kind and helpful.

 

Did you hear about hurricane Harvey?

 

Test at +1 and +2 and we will go from there.

Maybe see your first green today?

 

Penelope --

Most cat's don't drop within a half hour. It doesn't look like Macka has an early nadir. My Gabby did have an early nadir and as a result, her numbers could drop early in the cycle.

One way for you to have a good sense of how your cat is responding if you shoot low is to get early tests. It will allow you to see what happens and if numbers are dropping, you will know and can intervene. If you'll be reassured, get a test after a half hour, at +1 and then go from there. I doubt you'll need to test every 30 min but it's up to you. If Macka's numbers do drop, then look at this post on how to handle low numbers.

 

I agree with taking advantage of a blue number to shoot as long as you are available to test . Even if you reduced the dose ( which I would not) the first 1/ 2 of the cycle will be under the influence of the higher dose anyway.

 

I was still debating and tested again at 8am (AMPS +2.5) and he is back at 164.
Still not sure what to do, even though you're all kindly telling me to shoot

 

I think you will also be getting to a point where you won't be able to shoot as it will throw off your next shoot time. (Just my thinking)

 

OK I shot the full dose.

I will test at +1 and +2 as a start.

 

That's what the karo/honey is for.

My thoughts. Eventually, you are going to have to shoot a blue number. It's a Sunday. You are home. Better now than when you are in France and have a time difference of 9 hours. There may not be as many people online at your AM shot time. (I am assuming since you are there for 5 months that you will be adjusting Mačka's shot time.)

 

I have a couple questions, in your signature you have got human and pet meter. You have dry food in there, and says you are doing TR. This is confusing to me because I am unsure about where your number come from and also can't do TR with dry food. Any way to clear that up?

 

Thank you. Yes I will adjust his time, slowly forward by 3 hours to reach the 6am/6pm schedule again. There will be less people online for sure, because when you guys will be sleeping I'll be awake and vice versa

I am in panic mode right now. I know I have to get used to shooting lower numbers, that's the goal. But still....

Karo and all kinds of MC and HC are ready just in case.

 

Yes, I went from AT to Human meter (I could make it clearer in the signature, thanks).
I give Mačka a few dry kibble after each shot, as a reward. He eats Fancy Feast classics (sometimes with dry topping if he does not eat much, to encourage him, like this am).
I only feed him LC dry food when he is sick, as he won't eat anything else when crummy, or has an upset tummy.

 

surf safely, French kitty!

 

Good job! And remember that your PM shot will be 12 hours from when you shot.

 

+1 225, going up.
This means that it takes him about 3.5/4 hours to have a food bump (it's 9:30am, he ate at 5:30am).

Should I test again in 2 hours? I feel like taking a +2 would be too soon.

 

Please don't give Macka any kibble.

If you are as nervous as you seem about where your kitty's numbers are possibly heading, TEST!! There's nothing like having data to put your fears at ease. And, should numbers be dropping, you'll have plenty of advance notice.

 

Wishing you and Macka all the best. I know how scary it is, but you are there with supplies to keep him safe and smart people here to guide you.

 

Not necessarily. It could be that the lack of insulin (delayed shot), at least, is part of it. Lantus likes to grab lower numbers which helps the "surf" you see on regulated kitties.

That's ok, you will have another opportunity. I completely understand your hesitation. We are all that way in the beginning, then you get to where you are addicted to shooting lower numbers and testing

 

I live for that day! I can’t even imagine how I can ever be at peace with the FD dance. It took me many tears this morning to finally shoot :/

 

Penelope:

Take a look at Charlotte's spreadsheet. I suspect what has you worried is that if your pre-shot number is in the 500s, Macka can drop into the low 100s. Thus, if you shoot in the 100s, will the numbers drop so low as to cause severe hypoglycemia. Charlotte's spreadsheet tells a different story.

The desired Lantus curve is flat. Our basic mantra is "Shoot low to stay low" and you see that on Charlotte's spreadsheet.

It's just something for you to consider.

 

Back in August, you shot a 187 (though after a delay) and that was on an AT, so possibly even a lower number on the human meter. You have some data of what happens when you shoot lower numbers.

Don't let the size of dose influence your decision. A kitty needs whatever size dose they need. The size of dose does not change how much they drop. An example with a higher dose than Charlotte is Amethyst's SS. She has acromegaly and IAA, like my girl did, so her dose is higher. Amethyst is on Levemir, but the type of insulin action is the same, just delayed a couple hours.

Shooting lower numbers means flatter cycles which are much more predictable that what happens if you shoot a higher number. I'll admit that I was worried the first few times I shot low blues and eventually greens with higher doses, but data is your friend. One you have data to see how Mačka responds, it'll be much easier.

 

That's a beautiful SS!

I second this. It is frightening and scary at first and it probably will be for a while. But the more it happens, the more knowledge and experience you gain. Eventually, it won't be as scary.

I've done this too. I remember begging not to shoot a blue number and the good people here helping me get through it.

 

What strikes me in Amethyst's SS is that when the pre-shot number is in the blues, it actually means a longer cycle. It's very clear on her spreadsheet.

Yes I did! i remember this one, because it was the only other time it happened The only difference was the dose size, and yes, since Macka is now at 5 units, it scares me way more. This morning, in my panic, I worried that he would go below zero with such a dose, starting in the 100s.

That's exactly my fear. Charlotte's SS shows me that blues at pre-shot are very positive. They announce better curves and numbers to come. I would be way less worried to shoot a 1u than a 5u though... I have to keep in mind that the size of the unit does not influence the drop.

Thanks to both of you!

 

ohhh... If you were using the AT meter, you were probably used to high numbers. I understand your hesitation now.. I freaked out when we first got blue numbers and haven't switched to the human meter yet ( It's on the way). Once you see you can do it - it'll be so much easier to handle the next thing.
Paw crossed but -you've got this.

 

Yes! We used to have numbers as high as 700s. So seeing a blue is still a shock

 

Penelope! I'm so proud that you were able to finally listen to the supportive advice you were getting and that you had the courage to give Macka his insulin.

It will be less scary each time you shoot lower numbers. My dear, what ever are you going to do when he starts to improve and you have to shoot a number lower than 100? Many of us do it so you need to be brave - weigh the factors (that were discussed with you this morning)...are you home to monitor, are you prepared in the event of falling numbers. Please try not to be so afraid that you're not able to help Macka heal. He's depending on your to help him get better...so tell yourself that anytime you have to give him insulin - you are saving his life!

Be brave, take a deep breath and so what you need to do to help him get better. Lots of people here to help and support you but only you can do what needs to be done to help Macka! Sending you hugs!!

 

Thank you Sue. I am not as strong as I’d like to be. I’ve had the life of other dear, dear cats in my hands and wasn’t able to save them. Thus my hesitations, fears, guilt. Having the power and control in my hands is more of a curse than a blessing, at least that’s the way I experience it. My heart is very much broken by the loss of my previous cats over the last few years. Macka is the last baby and we are so bonded.
But you’re right, I have to remind myself to breath and that I am healing him, not putting him in danger

 

I'm so sorry that you have had those experiences and were unable to save those cats. Since I'm unfamiliar with those circumstances I cannot comment - but I'm sure that you did everything that was possible to help them! And you will do everything you can to help Macka too! It does take mustering up your courage sometimes to do what needs to be done - but try to remember that you do have help and guidance - and you're not alone - but it is up to you to help him by giving him his insulin - he depends on it and on you to help him. He'll continue to improve - you've both come so far already!!

Have a great evening Penelope!