SamB
Member Since 2020
http://www.felinediabetes.com/FDMB/threads/2020-05-12-cairo-amps-111.229511/
AMPS was 96 this morning. I have not given a shot. Should I skip?
AMPS was 96 this morning. I have not given a shot. Should I skip?
2020.05.13 Cairo AMPS 96 - No shot?
- Thread starter SamB
- Start date
Sam & Esse
Member Since 2017
Good morning, Sam and Cairo!
I'm sorry you didn't get an answer; I'm assuming you went ahead and skipped?
The 96 could have been a safe number to shoot, but would have required a careful eye through the day. Yesterday you asked if you could just test pre-shots now; the short answer is no. We test pre-shot to make sure the BG is high enough to give insulin -- and this number has a lot to do with the experience of the caregiver, and the testing data they have for their cat. And sometimes how badly you need sleep
However, dosing of Lantus is based on nadir -- the lowest the dose of Lantus takes your cat during the cycle. (A cycle is the time between one dose and the next -- dosing every 12 hours gives you 2 cycles every 24 hours.) Now, you'd think it would be simple to find nadir, but it can be a tricky thing. A cat's lowest point can change from week to week, day to day, and even cycle to cycle. At a bare minimum it is recommended to get at least 4 tests in each day; the 2 pre-shots, a random test during the day around when you think nadir might currently be, and a 'before bed' test to see if the BG has dropped from the PMPS, a good indicator that it's going to be an active cycle and that you'll need to try to get another test in during the night to make sure Cairo isn't going too low. Cats do so love to run lower at night. Of course, many forum users test more, to give them a better idea of how their cat is doing on a specific dose of insulin.
It doesn't help that a cat's insulin needs can and do change, sometimes rapidly. This may be the case with Cairo right now. You'd been giving 1u for a few months, and although you were not testing at the time, you also didn't notice troubling behavior that could have indicated hypo. Now that you are testing, you can see indications that Cairo is needing less insulin.
You've been wondering what numbers you should be striving for with Cairo. As @Nan & Amber (GA) has said, normal BG for a non-diabetic cat on a human meter is 50-120. If you can keep Cairo within this range, it's wonderful! These are considered healing numbers, the ones most beneficial for the pancreas. If you can test often, and can handle possible additional stress, you could try to keep Cairo's numbers below 100. I'm not sure if you've had a chance to read over the TR protocol? I know in your first post you'd been thinking about SLGS, but with Cairo's numbers I think she would be a good candidate for tight regulation. Another number range to keep in the back of your mind is >200. This is because around 200-250 is where most cats' renal threshold is. BG numbers above renal threshold for long amounts of time can be damaging; so all numbers below that mark are good
Finally, any number you get below 50 -- the lime greens -- is a 'take action' number. If Cairo is in the 40s, a low carb snack might be enough to bring her back up into safe numbers (unless her pancreas kicks in, and lowers her numbers further 
) but if she's in the 30s or lower, she needs high-carb food, or karo syrup, honey, maple syrup -- anything that will get her BG back above 50. Don't Panic! or How to Handle Low Numbers and How to treat HYPOS - THEY CAN KILL! Print this Out!!; I'm not sure if you've read these links yet. It's best to get a good understanding of them now, rather than later during an emergency 
As I said yesterday, I can't give dosing advice
This isn't my usual ISG board, and I'm a very bad example of testing. Hopefully some of the regular Lantus users will be by to help with your dosing questions
I'm sorry you didn't get an answer; I'm assuming you went ahead and skipped?
The 96 could have been a safe number to shoot, but would have required a careful eye through the day. Yesterday you asked if you could just test pre-shots now; the short answer is no. We test pre-shot to make sure the BG is high enough to give insulin -- and this number has a lot to do with the experience of the caregiver, and the testing data they have for their cat. And sometimes how badly you need sleep
However, dosing of Lantus is based on nadir -- the lowest the dose of Lantus takes your cat during the cycle. (A cycle is the time between one dose and the next -- dosing every 12 hours gives you 2 cycles every 24 hours.) Now, you'd think it would be simple to find nadir, but it can be a tricky thing. A cat's lowest point can change from week to week, day to day, and even cycle to cycle. At a bare minimum it is recommended to get at least 4 tests in each day; the 2 pre-shots, a random test during the day around when you think nadir might currently be, and a 'before bed' test to see if the BG has dropped from the PMPS, a good indicator that it's going to be an active cycle and that you'll need to try to get another test in during the night to make sure Cairo isn't going too low. Cats do so love to run lower at night. Of course, many forum users test more, to give them a better idea of how their cat is doing on a specific dose of insulin.It doesn't help that a cat's insulin needs can and do change, sometimes rapidly. This may be the case with Cairo right now. You'd been giving 1u for a few months, and although you were not testing at the time, you also didn't notice troubling behavior that could have indicated hypo. Now that you are testing, you can see indications that Cairo is needing less insulin.
You've been wondering what numbers you should be striving for with Cairo. As @Nan & Amber (GA) has said, normal BG for a non-diabetic cat on a human meter is 50-120. If you can keep Cairo within this range, it's wonderful! These are considered healing numbers, the ones most beneficial for the pancreas. If you can test often, and can handle possible additional stress, you could try to keep Cairo's numbers below 100. I'm not sure if you've had a chance to read over the TR protocol? I know in your first post you'd been thinking about SLGS, but with Cairo's numbers I think she would be a good candidate for tight regulation. Another number range to keep in the back of your mind is >200. This is because around 200-250 is where most cats' renal threshold is. BG numbers above renal threshold for long amounts of time can be damaging; so all numbers below that mark are good
Finally, any number you get below 50 -- the lime greens -- is a 'take action' number. If Cairo is in the 40s, a low carb snack might be enough to bring her back up into safe numbers (unless her pancreas kicks in, and lowers her numbers further ) but if she's in the 30s or lower, she needs high-carb food, or karo syrup, honey, maple syrup -- anything that will get her BG back above 50. Don't Panic! or How to Handle Low Numbers and How to treat HYPOS - THEY CAN KILL! Print this Out!!; I'm not sure if you've read these links yet. It's best to get a good understanding of them now, rather than later during an emergency As I said yesterday, I can't give dosing advice
This isn't my usual ISG board, and I'm a very bad example of testing. Hopefully some of the regular Lantus users will be by to help with your dosing questions
SamB
Member Since 2020
@Sam & Esse thank you so much for this response. I'll make a thread for today, but I wanted to thank you for the thoughtful reply and let you know I did read it. 