3/31 Emmy PMPS 85 ALPHATRAK NEED ADVICE - NOT EMERGENCY

Greetings,

Two major changes this week and I need advice. One, the dry food is gone, gone and Emmy's BG has been in the greens and blues all week (well, except on a fur shot)

Two: My vet has apparently forsaken me. It was the Roomp-Rand paper that did her in. She gave me a "simplified" rule to follow as well as telling me I didn't need to check Emmy's BG during the day or even at shot time since "she is doing so well":

ALL AT SHOT TIME:
60 or less - OK to skip injection
60-80 - reduce by 1 unit
80-100 - reduce by .5 unit
100 or higher - give regular dose (2.5u)

Obviously, this doesn't address adjusting by the lowest number, etc. So let's forget that advice. I will be checking her BG often and at shot time. Sheesh.

Emmy's BG at pre-shot tonight is 85. I'm using ALPHATRAK. I gave her some food and will check again at 9 pm. Emmy's BG has dropped so much this week that I feel like I can't keep up with dose changes. She has gone from 3.5u to 2u this morning which has her at 85 tonight. I can monitor through about midnight.

1) what should her "regular" dose be right now?
2) should I reduce tonight's dose and if so, to what?

I will give her 1.5u at 9 if she looks okay. I know you folks shoot much lower than 85 but I can't monitor all night and am worried that she's at 85 +12.


We thank you!
Judy&Emmy

 

bumping you

 

Thanks Rhiannon - dropped far fast!

Emmy was 156 at +14 so that became her PMPS - gave 1.5u

 

The remarks in your spreadsheet say that you gave some gravy food at PMPS, I think? Normally, when we're stalling to see if the cat is going to surf or rise or drop in BGs, we don't want to give food as that will influence the test.
I see how you are skipping lines on your spreadsheet when you are taking more tests at PS time. You can also just put both tests in that the PS box. It would look something like this:
85
@+12
156
@+14
and would be all on that one box, and you would need to manually change it's color.
It does sound like your vet doesn't understand Lantus, but that is not unusual.
Lantus works best with a consistant dose and every 12 hours. How about trying to stick with 1.5 AM and PM for a few days to see how she does on that dose, as long as she doesn't go below 68 or so? Are you following the Tight Regulation protocol or using the SLGS approach?

Tomorrow morning, you'll need to give the shot 12 hours after you gave the shot tonight. Is that doable for you?

 

Would you test again 2 hours after the 156.? The gravy might wear off .... Let's see where she goes....

 

I think getting a test at +2 is an excellent idea. Emmy is doing well on the insulin and some cats come down the dosing scale very quickly in leaps and bounds. I think this is a phase of extra vigilance for you - as her pancreas sputters back to life and begins to put out insulin, you'll have to reduce the amount you are shooting in response to her body. We don't usually give gravy in order to boost a preshot number to shoot because gravy carbs can wear off fairly quickly and could result in her coming down more than you'd expect.

I also like Dyana's suggestion of sticking with 1.5u unless she goes below 68. Actually, since you aren't following Tight Reg, I'm assuming, you would reduce if she goes below 90 on a human glucometer, or 30% higher (about 120ish) on your AT. Tight Regulation requires at least 3 tests a day, both preshots and one mid-cycle. Actually, many of us think that's essential for any cat on Lantus/Levemir, just for safety.

 

Thanks all. I hope this posts correctly. How the heck do you cancel a post you are working on? I go away and come back three hours later and it's still hovering in the box.

Emmy was fine at +2 (176) and is doing well this morning.

I suppose I am not following either protocol because I can't seem to meet the qualifications for either one of them. I stopped the dry food so I could do Tight Reg but now I can't "qualify" without a midday test. Not going to happen. I have a job and they won't let me bring the cat.

So I'm just working to improve her health.

I will keep her at 1.5 for several cycles and see how she does. Thanks again!

Judy&Emmy

 

it doesn't Have to be mid-day.... it could be the moment you walk in.... or just before you leave....

it helps if you try to think outside your usual box.....
for example, i started with a shot time of 8 and 8 and then after a month or two.... realized that if I got up with my dh ( at 5:45am ) and did the
test, feed,shoot.... i could run back to bed .... sleep a bit more.... get a +2... before running off to work....
you learn to make time for an out the door test.... or an in the door test....
and that also opened up my evening testing where I could get +5 even before going to bed.....

i didn't want to change my sleep pattern but once I thought about it and I did it..... it made everything so much better.

and then you try to get mini curves on weekends....
and if you wake up in the night to use the bathroom, grab a test then too.... keep the testing stuff near you all the time so you don't have to fully
wake up....
we call that sleep-testing....

 

Libby has a bunch of great tips in her post on working full time and doing TR.http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/

 

i'm definitely not trying to discourage you! Just trying to figure out how we help you best - that's all.

 

Thanks again - I do usually get one or more tests during the day. And I also feel I have gotten a fair share of mini-curves and regular curves.

I have severe sleeping issues. I cannot wake up for a five minute test and go back to sleep. If I wake up anytime at night, I am up all night. I can only afford to do that on Fridays and Saturdays.

I feel comfortable with the amount of monitoring Emmy gets. I always monitor more when I feel "iffy" about the situation. If I express a preference for one protocol or the other someone always tells me how what I am doing does not meet that protocol, so it seems best to forgo an allegiance -- I just want to improve her health. Honest.

Judy&Emmy