? 66 BG reading, should I give night dose?

Doing the curve today. Goofy's latest reading was 66. Before that it was 81. The vet recently up his dose from 1 ml twice a day to 2 ml twice a day. 66 seems low. I'm concerned about giving him 2 ml tonight. Any advice is welcome. First time posting here thank you

 

What insulin? When was this reading? How long after the last shot? What meter is it?

 

Lantus, 5pm reading (hour & half ago),his shot was 9 hours ago, glocometer (not sure of brand)

 

Hi Tracie, I don't usually give dosing advice so I will try to see if anyone more experienced is on the board right now to help. Maybe @Chris & China???
Aw perfect , just saw Janet's post re. what type of meter and other important info to help guide you.

 

I think most people using Lantus would agree that 2 ml twice a day is too big of a jump from 1ml. We don't usually increase that fast.

 

I would not give him 2ml tonight and am wondering what others think about giving him any insulin at all for his pm shot. Without having a lot of testing history to go on, might skip to be safe, but keep testing and see where he's headed.
Another important consideration, does Goofy have a history of DKA?

 

Hi @JanetNJ are you still on?

 

I dont know what DKA is...
I was also thinking about not giving 2 ml tonight and just keep testing his blood sugar

(Thank you all for your prompt replies. I really appreciate it)

 

It stands for Diabetic KetoAcidosisis. It's a serious complication that can occur from diabetes. If Goofy has had that condition diagnosed along with his diabetes, you would know because he would have had to be treated for it! I was just asking because cats that have had DKA are in danger of getting it again if they're insulin requirements are not met.
Sounds like that is not a concern for Goofy, which makes it bit less complicated if you decide to skip the pm shot. My kitty never had DKA, and i definitely skipped a few times when he was going too low.

 

Oh ok. He has no history of dka

 

Hi,
Do you test the blood sugars regularly?
Why did the vet increase the dose from 1 unit to 2 units?
See what the preshot is before deciding what to do but I would not increase to 2 units.
It might be safer to either skip the dose.
But safety first always

 

GREAT!!!

GREAT!!!

 

Also can you tell us if your meter is a human meter or an Alphatrak 2 meter please

 

How long have you been giving insulin? When was DX?

 

Alpha track 2 is the meter. Goofy was dx’k about 4 weeks ago. I’ve been giving him 1 ml lantus twice a day for 2 1/2 weeks. After I gave the vet the results from a curve I did after two weeks of lantus, he raised his does to 2 ml. Goofy has been on 2 ml for only about 5 days. Today is our first curve on 2 ml

I just tested his blood, and it reads 159

I’m so confused how it can go from 66 to 159 in 2 hours

Our readings today were every 2 hours
223, 277, 170, 81, 66, and now 159

 

Tracie, please let is know the type or brand of meter you are using. We don't want Goofy's numbers to drop any lower if you are using an AlphaTrak II

 

It is an alpha track 2. His number just went up to 159

He ate an hour 1/2 ago

 

Ok, deep breath. I know this is all pretty new, and can get confusing. This place is a great resource and really saved my cat's life and MY sanity!

 

So 159 is the PMPS number?

 

Ok, if you are using the Alphatrak 2, the 66 is too low and if that happens again, give some high carb food or a drop of honey to get the blood sugar level up over 68.
By the way it is 1unit or 2 units not mls. Just FYI.
Where are you up to now with the cycle?

 

Thank you. I’m so new I have no clue of some of the lingo....PMPS for example. No clue

 

Hi Bobbie, I think today is Tracie and Goofy's first day!!!
Tracie PMPS stands for PM PreShot number.

 

I think it is now 10 hours after Goofy's am shot. Is that right?

 

That's ok we are here to help you but we need information.

 

He earned a reduction because he went below 68 today. So, you were giving 1 unit and the vet increased to 2 units., right? We raise the dose by increments of .25 of a unit. We are at a little bit of a disadvantage because we can't see the dose and numbers in a linear fashion. We use a Spread sheet here to record all data. Could we get you to set one up and put all data that you have in it? The instructions are Here

PMPS is Pre shot PM test.


Here is an explanation of the way we talk in hours after the insulin is given. Since we are all from all over different parts of the US and world, this helps us to understand where a kitty is in a cycle.


On the spreadsheet... It's really not hard!

AMPS is the AM Pre-shot test (always test before shooting to make sure they're high enough to give insulin)...then the U column is for "Units" (how much you gave)

The +1, +2, +3, etc are for how many hours since shooting...so +2 is 2 hours after the AM shot, +9 is 9 hour after, etc.....Since we're all over the world here, saying "he was at 148 at 8pm" doesn't tell us anything...we need to know how long since his last shot

At the end of a 12 hour cycle, it's PMPS time! (PM Pre-shot) and the whole thing starts over

 

Yes, 159 is his pre shot number. And yes it has been 10 hours since his am shot

 

Wow, ok, thank you. I’m checking out your link to the spread sheet now

 

BTW Goofy is REALLY CUTE!

 

Error on the link

 

10 hours after his am shot would be +10 so you have 2 hours to go before the next shot is due. Is that correct?

 

The cycles are in 12 hours increments so if it's 10 hours since his AM shot, then he is at AM +10. Can us post the number you get at 12 hours or PMPS?

I just realized that the link has been broken. I need to serve my family their dinner. Anyone following along.....can you find the SS instructions and link for Tracie.

I am imagining that Goofy, will only be higher then. If it were my kitty, I would take him to 1.25 dose and track that for a few days. The jump from 1 unit to 2 units was too big and we might have missed his dose.

What do others think of the dose to go to 1.25? Or even 1.5?

 

Awe! He is lil lamb chop
I basically rescued him from a coworker that was not caring for him properly. He was 20 pounds when I got him. He is now 12 pounds.

 

Yes. Correct

 

Bobbie, I agree with the 1.25 dose amd see how it goes.

 

I really appreciate your concern, knowledge , and advice. Thank you

 

Here is an explanation and the most likely cause, very common!

"Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Bounces are a temporary condition that a lot of cats do and we don't change the dose if kitty is just bouncing due to see a number lower than it is used to."

 

Here you go, try this link for setting up the Spread Sheet (SS)

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

We need to get your signature sorted out too as that has lots of information we need.
Here is the link
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

 

Thank you @Barbara & Uncle for sending out a heads up over in the Lantus forum.

 

Aw, that's super cool of you. And getting him down to a normal weight must have been a project!

 

Thank YOU & BRON

 

Tracie, do you have syringes with half unit markings on them?
To get the 1.25 units of Lantus that Bobbie and I both think would be the best dose to give, you draw up the insulin half way between the 1 unit and the 1.5 unit markings on the syringe. Does that make sense?
Below is a copy of syringe markings.

 

Here's the Information on setting up the FDMB spreadsheet

If you run into problems, let me know. I'd be happy to set it up for you

 

I have the whole unit scale syringe

 

I only have an iPad available right now. Not sure if I can set up a spreadsheet

 

If you are not sure if you have drawn up the correct amount of insulin, take a photo of the syringe and post it and we can check it for you

 

There are directions further down in the instructions on using a tablet/phone

 

Ok then you will just have to estimate a quarter of a unit past the one unit mark. Do you have a magnifying glass? That makes it a bit easier.

 

Update...I'm still figuring out the spreadsheet. Just tested his blood sugar. He is a 206

 

Okay, he is in bounce mode from going into those lower numbers today.

At PMPS TIME( 12 hours from the AM Shot) I think you will be fine shooting 1.25. As Bron said, you’ll need to eyeball it using her graph.

From your profile, looks like you are in FL? I use the Relion syringes from Walmart. They are super cheap , 100/ 13 bucks. They have the 1/2 unit markings on them.

I like the 3/10 ml 31 gauge 8 mm ( short needles).

It will be extremely helpful to have the syringes with the 1/2 unit markings for all the doses in between on unit to the next. We have pictorials to help with dosing.

I’ll go to my tablet and get one for .25 of a dose.


ETA: to add 13 bucks

 

I realize you don't have the 1/2 unit markings right now but that will give you an idea of the plunger placement between the 1 unit and the 2 unit mark.

 

Hey All, I'm going to sign off for the night as I have a gig, otherwise I would stay on.
Tracie, you are in the best hands.
Bron, Bobbie and Chris are my mentors, I have so much gratitude for their help and guidance as I learned how to do this dance.
I will check in tomorrow to see how you and Goofy are doing.

 

What time EST are you shooting so I can look for you? Get a +1 and +2 to start.

 

You all have been the best!!

 

I’m giving him st shot at 9. (In a Half hour)

 

So glad you are testing and caught that low number. Shooting without testing can be really dangerous. My aunt has a diabetic cat and just refuses to test. I gave up trying and just pray she doesn't overdose her.

 

Tracie, please post when you get the +1. I want to check in on you before heading to bed.

 

I just got a 279 reading
I was in between the 1.25 and 1.5 w the units on the syringe

 

That is a bit more than a food bump. Grab a +2 and if that is lower than the PMPS number then it could be an active cycle and could require some more monitoring. If it's higher then maybe try and grab a test around +5 or +6 ( 5 or 6 hours after the insulin shot) and see how he is doing.

If you get into trouble of need help, change your prefix title to HELP!! @Bron and Sheba and @Chris & China , are either of you going to be around to look in on Tracie? I am heading to bed.

ETA: I think I am confused. Is the 279 the number you got for the PMPS or is that the +1 number? Without a Spread Sheet to look at it is easy to get confused.

 

It's only 2pm Sunday here so I will around. Have to go to the shops later but I will have my mobile with me to check if necessary.
Sweet dreams Bobbie

 

Shot was at 845pm. The 279 reading is from 9:45pm. I will be doing a blood test closer to 11 tonight

 

That's what I thought.

 

Thanks Bron!

 

I'm around too!! Goodnight Bobbie!!

Great job getting the spreadsheet set up! @TracieLLL

 

@TracieLLL
Good job getting the SS up and running!
You have said you have 2 units at PMPS.... you gave between 1.25 and 2.5 didn’t you?
You could call that 1.25F (fat)

 

@Chris & China is that the correct sheet for alphatrak ranges?

 

good catch!!!

@TracieLLL …..the spreadsheet you set up is for human meters. If you're using the AlphaTrak (and intend to keep using it) you'll need to use the spreadsheet for pet meters.

Most of us use human meters because the cost of the strips is too high

 

Oh goodness!! I’ll fix it tomorrow.. I’m so tired
He justed tested w a blood sugar at 210. Thank you everyone for everything!

 

I think you will need to get another test in a bit later in the evening. Can you set the alarm for 3 hours time to test at +5

 

We totally understand!! All this information is overwhelming at first, plus the stress of just dealing with the diabetes!!

 

@TracieLLL
I'm not the best one to say this because my self care is horrid, but make sure to do as much as you can for yourself. Hot baths, chocolate, whatever works. You will be tired for a bit no matter what you do though *hug* hang in there.

 

I wake up pretty early. I’ll test then. Thank you for everything. It warms my heart with all the responses I got tonight!

 

**HUGS**

 

Hi everyone! AM pre shot is 317 before food. I will test again through out the day. And I will check out the Lantus board

 

Here's some good information on Making the most of your Lantus forum experience