Help for Molly #3

creating a new thread from High number, Help for Molly #1 and #2

 

Let's see where her BG is. Exciting day!

 

It jumped and she wasn’t a happy kitty

 

That's a bounce number with possibly a bit of kibble influence. you can leave her alone now until PMPS. This exercise is also showing us how bouncy Molly is - ie., prone to rebounding higher after a big drop. We'll take that into account when we decide on the back to work dose. It's good info to have.

 

So she is a bouncing Kitty? She wasn’t happy with the last test. She’s sleeping now

 

It seems so on the basis of today's numbers. Time will tell. Her food switch isn't complete and we're not sure of her dose yet. It's possible to figure things out even if she's bouncy. Teasel is an Olympic level bouncer! That's why he can go from pink to green in 12 hours.

 

I picked up the new monitor. But I’ll start using it after the other strips are gone. They look the same though?
Same testing for tomorrow as today? She hasn’t had an kibble since this morning. She doesn’t seem hungry this afternoon.

 

The strips are the same but the ones packaged as AT2 strips have been batch tested to determine which code to use on the AT2 meter. The other strips will work but the results won't be as accurate because you don't know what code to use on the AT2 meter.

Testing for tomorrow will depend on what Molly's AMPS is. If it's like today or higher, then yes......if it's lower then an earlier test might be in order. This is the type of decision that usually can't be made way in advance at least until you hone in on the best dose. She is probably tired from the bounce. I always found it interesting that my girl would be very hungry at high and very low numbers but in the range in between she would eat if food was offered but she wasn't trying to chew my leg off for it!

 

Overall, not a bad day for Molly's BG. Let's see how she does tomorrow.

 

I agree. A decent day for Molly so we'll see what tomorrow brings.

 

Thanks ladies

 

Another lovely yellow! Try your next test at +3.

 

Ok, I have to go out today at 930 this morning. Should only be an hour!

 

Nice start to the day.

 

Yes, she a pink now +3 might be from the kibble?

 

I guessing she ate a bit more heartily this AM?! Looks like a food bump. See what she does at +5 today.

 

She did eat more this morning than yesterday morning.

 

She’s in the red

 

Don't worry. Ups and downs like this are normal and it's possible the kibble is part of the reason. Because it's high carb, when she eats it in the cycle and how much she eats can have quite an impact on BG. Another possibility is that she dropped lower in the night and was on her way up into a bounce.

I suggest you try to reduce the kibble even more - maybe 1/4 cup total per day - because it'll be harder to stabilize her if it's involved.

 

Ok, I’ve only given her 1/4 cup today. There’s still some in her dish. She had some FF for lunch.

 

Just keep on with the plan. She's a bouncy girl but we can work around that.

 

9.7 this morning do I still give her insulin? @Kris & Teasel @MrWorfMen's Mom

 

Wow! First, I need to know if this number is from the Alpha Trak meter or your new meter. These ups and downs recently tell you that we're in the good dose range but the fine tuning can be stressful. Here are your options:

• don't feed her, retest in another 30 minutes and if her BG has gone up you can try giving the 1.5 u dose but be prepared to track her BG starting at +2 and give very small snacks of FF as needed
• drop her dose to 1.25 u - that has to be eyeballed on your syringe but with half unit marks it's not too hard.

We're trying to find the dose level that is both safe for Molly given what she eats and while you're at work starting Tuesday but also lowers her BG to a better range. This AM's pre shot BG is one where a person experienced with giving Lantus would give the usual dose. However, you're still learning how Molly responds and there's still that tricky kibble in the mix.

How does that sound? @MrWorfMen's Mom ?

 

Test is from the Alpha track meter
She only wanted her kibble, not she’s eating the wet
So test her still in a half hour?

 

If she's already eaten the kibble so the waiting without feeding isn't going to be useful nor is the test in a half hour. How about reducing her dose to 1.25 u and test again at +2? Do the best you can eyeballing that dose. If you have to give that 1.25 u dose for a while you might want to make up a "reference" syringe with coloured water up to the 1.25 u mark and use it as a comparison every time you draw up insulin. It's more important to be consistent dose to dose than to be completely accurate.

Remember - the goal is to find a dose that will be good when you're back at work. It's bit tricky but we'll get you there.

 

I just tested her she’s at 4? So I’m thinking a shot is a no?

 

If she's at 4 after eating kibble, definitely no shot. How much time went by between her eating the kibble and you testing her again? Exactly how much kibble did she eat?

 

She didn’t eat very much. I have to give her something or she won’t stay still. Tested her at 6 when she ate a little. Tested her at 630 again and now it’s lower.

 

I have to leave in about 30 minutes and will be gone 6+hours. I hope @MrWorfMen's Mom can look in on you. If she's busy, here's a plan for you:

• no shot this AM
• feed Molly a snack of FF or even wet S/O soon
• test again at +2 to see where she is because the 1.5 u dose can still be having an effect
• put all those test numbers on your SS as soon as you get them

You need to do a bit more testing - maybe +2, +3 to see if she's levelling out. If she gets lower than 3 you need to give her wet S/O and maybe a TINY bit of kibble.

 

Ok I’ll test her again at +2
What if she doesn’t want to eat?

 

Try kibble. If she doesn't want to eat just monitor her BG at +3, +4, etc. It'll likely start to rise by mid day or sooner.

Good luck! I hope Linda can check in. If not, you'll be fine. Focus on how she's feeling, her behaviour, etc. We can sort this out later.

 

Ok I'm around for a bit. I'll keep an eye on things.

 

Should I test at +2 or at +3?

 

Yes I'd get another test at +2 to see what she is doing.

 

6.1 and extremely hyper

 

She's coming up a bit and that may be from the kibble. Roughly how much kibble did she eat?
When you say hyper......in what way......is she wanting food? If so give her a bit of FF low carb.

 

I gave her 1/4 cup of kibble in her dish. There is some left.
Hyper as in running from room to room, literally trying to climb the wall.

 

I take it this is unusual behaviour for Molly. Did she ever race around before she was diagnosed with diabetes? Perhaps she is just feeling frisky due to the those lovely low BG numbers. The high numbers can make them feel sluggish and when the numbers drop, sometimes they feel so much better they let loose.

 

I have found lately she’s been hyper. She use to be like that before the diabetes. It’s good see her like that again.
When’s the next test?

 

Let's test again at +4 and see what she is doing.

ETA it's nice to see them go back to their more normal activity levels.

 

11.9

 

I think you can give Molly a bit of a rest from testing now. She is safe. She is likely to bounce high for tonight due to those lower numbers this AM so don't panic. She will get back on track. Test her again around +10 and we will decide what dose is best for tonight.
It would be really helpful if you could get a test in every night before you go to bed so we can see what she is doing during the night cycle. It appears she may have gone lower last night later in the cycle.

 

Ok, I will test her at the +10 and I will do a test before bedtime tonight.

 

Even though I expect Molly will be well over 250 BG at PMPS tonight, I think you should reduce the dose down to 1.25u (half way between the 1 and 1.5u marks on the syringe). You will have to eyeball it but just do the best you can. It doesn't need to be precise.....just something you can do consistently and a bit less than the current dose. The 4.9 reading this morning earned Molly a reduction according to the SLGS (Start Low Go Slow) dosing method used here and we usually only make dose changes of 0.25u at a time.
Then get a test at +2 and again before bed if there is still time before you hit the sack.
I have to leave the house shortly so I wanted to give you this before I leave as I am not sure just when Kris will be back online.

 

Ok, thank you! I’ll get the tests done as suggested. Probably start using the other monitor tonight

 

I'm back. I have family visiting from out of town and was occupied longer than I anticipated. I'm glad Linda was here to help. I agree with her suggestion to drop the dose to 1.25 u. It might be better to wait until tomorrow morning to start using the new meter. That way you can finish up today's numbers with the AT meter so they relate to each other better. The human meter will read lower so it's best to switch on a new day.

 

Ok, I gave her 1.25 u. I hope that it was right . I only have one strip left for the alpha left. Do I test her at +2 or before bed?
I don’t need to set up the new monitor do I?

 

When is bedtime? If it's around +3 you could wait until then.

Re new meter: is it a Freestyle Lite? Check the instruction book. There's no code to set on it like the AT but you can set time, date, loudness of the beep it makes when testing, etc. If it's this meter, the strips and the way they work are the same as for the AT meter.

 

Probably around +3 or +4 for bedtime tonight!
Yes it’s a freestyle lite

 

That's what I use. All human meters read lower than pet meters like the AT. The difference will be larger at high BG levels and less at low BG levels. For example, if your AT meter reads 400 the FS meter might read 300. If your AT reads 65 your FS meter might read 50. There's no way to convert FS readings to AT readings. You just learn by using it what too high, OK and too low is on the FS meter.

On average the Freestyle Lite meter tends to read on the low side compared to other human meters too. That's not a bad thing when Molly drops lower. What you see on the FS meter is probably a little lower than another human meter would give you so it's a bit of a cushion. It's preferable to reading a little too high when BG has actually dropped low.

 

Ok, just worried about the AMPS I won’t know what’s high or low?

 

We’ll know. In general you can give the regular dose if she’s 11 or higher on the Freestyle meter. For tonight and tomorrow AM that dose will be 1.25 u.

 

Was unable to get a reading tonight on my last strip, came up as an error

 

You can try the new meter if you like. You can just note in the comments that the reading was taken with the Freestyle meter. It really does help to get at least one reading at night so we can put a picture together of how the insulin is working for Molly.

 

Ok I got it done is it up or low?

 

She may be down a bit but I think I would probably consider it more of a flat reading.........certainly not a significant drop. She is fine. That's great that you got the reading tonight. It looks like she is clearing the bounce nicely so we'll see how the lower dose works for her. Do you leave food out for her at night for a snack? If not, you can leave a bit of FF for her to eat if she needs/wants it. Sometimes giving them food to snack on at night helps even out the cycles a bit as many cats do tend to go a little lower at night. The only caveat to that is that you don't want her eating 2 hours before her AMPS test so if you don't get up that early, you won't know when she ate the food. A lot of folks use timed feeders to be able to leave a snack out at night. Something to think about going forward.

 

Ok, how am I going to understand the readings now? Just worried about the AMPS? I’ll leave a little FF out tonight for her. Possibly look at a timed feeder.

 

With a human meter you would not give insulin for a reading under 11.0 mmol. If you happen to get a reading not far below 11, you can stall for 30 minutes without feeding Molly and then retest to see if her BG is rising on its own and post for assistance. Kris is usually online early but with her company she may be busy tomorrow. I'm usually up early and will check in to see how things are going.
Just to confirm, what time zone are you in and what time do you do Molly's shots? Not sure if my earlier guess was correct. If I know roughly when you might be posting I can make sure I check in at that time.

 

14.3 this morning do I give her insulin? She’s not hungry this morning either.
I’m 2 hours behind you. In the mountain time zone

 

Oh my you are an early bird!
Did Molly eat at all? You just need to know she will eat something. She doesn't need to eat a full meal. I guess since she loves her kibble, you could try a bit of that (tsp or so) to see if that gets her going.

 

She ate a little kibble not much. Just a lick of her FF do I still give her insulin?

 

My goodness, considering she had no AM insulin yesterday this is quite a good AMPS. She also got out of the inflated bounce BGs quickly. Those are good patterns to know about.

You can give 1.25 u this AM even with that little bit of food. Try giving her a little bit more in the time after her shot. Lantus usually starts working about 2 to 3 hours after it's given.

 

Re appetite: her appetite might be reduced as she spends more time in lower BG range. You don't want her to go on a food strike because of the reduction in kibble and you want to keep an eye on how she's feeling, her behaviour, activity level, etc. Do as much as you can to reduce the kibble even if it takes longer than you thought it would.

I'll be around until mid day today and then out doing family stuff after that.

 

I agree....that is a good AMPS given the missed shot and bounce. And ditto on giving insulin and slowing the transition from dry if need be.

 

I had to give her a bit of the kibble. She didn’t eat much of it. None of the FF just a lick, I find it hard to eyeball the 1.25. She’s playing so she must be feeling alright.

 

Playing speaks volumes! Behaviour is a good gauge of how kitty is feeling and sometimes better than numbers.

 

When do I test her again?

 

You'll get better at eyeballing the 1.25 u. You might want to buy a pair of cheap drugstore reading glasses in a high-ish magnification even if you don't wear reading glasses. They can be very helpful in seeing the syringe lines.

I mentioned in an earlier post (I think) that making up a reference syringe with coloured water drawn up to your best estimate of 1.25 u is helpful. That way, you have something to compare your insulin level with every time you draw up 1.25 u. It helps you be consistent dose to dose.

 

Try +3. There insulin should be starting to take effect by then.

 

I guess she’s tired of the tuna FF. Opened the beef and she’s eating that. I get paranoid when they don’t eat.

 

Yes - they must eat. There are quite a few FF low carb pate foods to choose from. Try all of them.

 

She's just being a cat!

 

I won’t be home for them+3 I have to get ready for my job tomorrow. She’s under the covers sleeping.

 

Just do a test before you leave then. Are you leaving food out for Molly to eat while you are away during the day?

 

Ok, I was going to leave some out before I go to work tomorrow. My husband will be home for lunch maybe. Was going to leave some in the fridge. He can feed her

 

Ok did a test 12.5? It’s 830 here do I put it in the +2 or +3?

 

If it was 2.5 hours after the shot put it in the +2 box. If you want to add "@+2.5" in the same box you can but then you have to manually colour in the box. To do that go to the menu bar at the top of your SS and find the little tilted can with the drop (paint can icon), click on it and choose bright yellow from the chart.

 

I’ll just put in the +2 box. Is there something I can follow with these numbers? What’s good and what’s bad? To ease my mind

 

Normal with the human meter is 2.8 to 6.7. You don't want Molly to go below 2.8 and if she is that low, you need to intervene with food. That number doesn't mean she is hypoglycemic....it simply means she is low and needs to be propped up a bit. Right now Molly is a bit high but she is dropping but not fast or drastically so all is good.

 

Ok, so she is more a pink than a yellow?

 

Do you mean would she be pink on the AT meter? Hard to say for sure. It's best once you switch meters to focus on only one and not try to imagine what the number would be on the AT meter. This will get easier over time.

 

I kinda wish I didn’t switch meters now. I don’t know if she’s high or ok or what.

 

Give it time. You'll learn to love the cost savings of using the Freestyle Lite. Here's a very general guide:

• blacks and reds - too high (but not dangerous in the short term)
• pinks - high
• yellows - high-ish but not bad
• blues - pretty darn good
• dark green - ideal
• lime green - take action now because BG is dropping too low.

What you need to know about your SS: you have the pet meter version set up. It will give a lime green whenever BG drops below 3.8. Now that you're using a human meter the "take action" number is 2.7. Unless you switch spreadsheets to the human version you'll see a lime green if your Freestyle reads 3.8 or less when actually Molly is still safe.

There are people who can change your SS for you if you wish or you can try setting up a second one yourself in the human meter version.

 

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Go down to where it has the link for the "world spreadsheet for human meter" template and follow the instructions.

 

Re that guide to BG colours above: you can see that how we understand the colours using the Freestyle meter is the same as how we understand then with an AT meter. The main - and most important - difference is where the "take action" boundary is. It's at 2.7 for the FS meter whereas it was 3.8 for the AT meter. That's really all you need to focus on.

 

Try to get another test with the Freestyle meter around +6 or +7 so we can see better how this 1.25 u dose is working. So far it seems this might be a good dose for tomorrow but more data is helpful.

 

Have a new SS now. I put the new numbers in from last night and this morning. I called it Molly's SS

 

That's great! Now you won't see lime green at 3.8 which is still safe on a FS meter. I promise you'll get used to the new meter.

 

That's a very nice blue at +6.

 

WhooHoo! Loving that blue! 1.25u is looking promising.

 

Very happy

 

Fingers crossed

 

8.4 I can give her insulin correct? @Kris & Teasel @MrWorfMen's Mom

 

Yes you can give her insulin but you may need to monitor a little longer tonight. Are you ok with monitoring till say 10:30 to 11pm.? Is Molly eating well again now?

 

I won’t be able to stay up that late. I have to get up at 5:30am. She’s not eating much

 

Very nice. Molly is "surfing" in blue as we describe it. That means she's spent several hours staying flat at a nice BG level.

 

Do I give her insulin? She only had a few treats and kibbles, not interested in FF

 

You could try 1.25 u and test her at +2. It's possible she might drop into dark green tonight but you'd have to set an alarm for somewhere around +6 to see whether that happens.

Another possibility is to drop the dose to 1 u because you're at work tomorrow and won't be able to test. That might be the safest option for now. What do you think @MrWorfMen's Mom ?

 

I'll make a decision for you: give her 1 u. Test again at +2 just before bed. Leave some food out for her for night time snacking.

 

Giving the 1u dose is certainly another option. I'd want to be sure Molly is eating well again now regardless of dose though.