Discussion in 'Feline Health - (The Main Forum)' started by Adrienne Vanderhoning, Mar 10, 2019.
created new thread from previous threads
6.8 is it safe to shoot? @Kris & Teasel @MrWorfMen's Mom
Didn’t give any insulin wasn’t sure what to do
Sorry. I just got home. I think you could have given Molly her shot. I take it you have now fed her. Otherwise I might have suggested you go ahead and give her reduced dose shot. She will be fine without and will catch up soon enough as she already showed us the other day, so no worries.
That’s ok and yes she has eaten. What’s the safe number if she is low tomorrow morning?
.25 for tomorrow morning?
Any AMPS 150 or more is fine. Will you be coming home to test Molly at lunch tomorrow? If so, then I would suggest any AMPS over 140 should be fine. As Molly's numbers improve we try to reduce our no shot levels to keep the momentum going. The final decision is always yours to make and you can decide to skip anytime if you are not comfortable shooting. Remember this is about both you and Molly and we don't want you feeling anxious all day. Rest assured Kris and I are both conservative dosers but we have been at this for awhile so even if we are comfortable, you may not be and that is OK. Lantus however is very good at maintaining BG and actually better at maintaining than at pushing BG down so it is possible to safely shoot lower numbers but there is also the question of monitoring to be taken into consideration until we see what Molly's response to the new dose is.
Yes, I’ll be home tomorrow for lunch. I didn’t know what to do tonight. So decided not do give Molly insulin.
I’m worried about tomorrow if she is low like she has been. I won’t be home to watch her. I’m really happy that she is getting better, as in eating less kibble and her BG lower. You don’t know how happy I am. To have you ladies helping me and Molly. It’s been very stressful past 3 months. But I feel so much better about testing. Hubby is even finally starting to feel better about the testing.
Many apologies, ladies! I had an unexpected visitor ...
Another observation: thanks to the wonderful spreadsheet, you have data on what happened when you gave her 0.75 u on a PMPS of 137 (7.6) the evening of March 06. That's not much higher than this evening's PMPS of 122 (6.8) so 0.25 u would have been safe. Looking back at your data can be a guide if you're stuck not knowing what to do.
Adrienne, Kris and I have both gone through this and understand how hard it is to adjust to those green numbers. Molly has had some lower numbers but has been no where near any dangerous lows. We will take it slowly and as I said, if at any time you are not comfortable with any suggestions, it is up to you what you choose to do. No one is going to get upset if you decide to skip a shot because you don't feel good about shooting even if we have suggested you do so.
The fact that you are testing Molly and have done everything possible to help her is paying off. Molly is in great shape. It's hard when you're starting out but you have good instincts and are making good decisions. There are no right or wrong answers about whether to shoot or not sometimes. Most of us didn't have to deal with those beautiful and scary green numbers so early in our journey so we were more seasoned when they occurred. While I can't say I'm not a bit jealous in that respect (took me forever to see a green number), I understand completely how difficult it is for you leaving Molly and wondering if she'll be OK. I learned to be conservative and sometimes let my needs trump my kitty's.
This is a bit of a balancing act but it is manageable.
Kris makes a good point. Your spreadsheet data is what we use to make recommendations. Chances are also good Molly's pre-shot tonight was the start of a little bounce so shooting the reduced dose tonight would have been fine.
Linda is absolutely right about you having to balance how you feel about giving insulin versus our advice (what we know would likely be OK at a given PS level). You're definitely getting a good feel for this and Molly is doing very well. I'm glad your husband is becoming more comfortable with the testing too.
I still have to weigh Teasel's BG numbers against my comfort level. He can nosedive unexpectedly so I try to dose in a way that allows me to go about my business, leave the house or sleep through the night with less worry. It's the only way I can balance it all and stay sane.
I never thought to look at the data. I have before but last night my mind was somewheres else I guess. I see green and kinda panic she hasn’t been there before, and I know it’s a lower number.
This morning she only wanted kibble gave her a few. Hasn’t touched her FF yet! Also forgot the bedtime testing.
Not bad start to the day given the skipped shot last night. Did she dive into the kibble and just being a "cat" about the wet food or is she being hesitant about eating anything?
She dived into the kibble. Wasn’t very much and then I gave her a few treats. I had to wrap her in a blanket this morning to test her. One of those mornings
Hey it's Monday. Everybody hates Mondays! LOL!
Did you give 0.25 u last night? The run of flat yellow yesterday *could* be a sign that the 0.25 u is a too low a dose but let's see how she does. It could also possibly be one of the cycles of yellow that precedes a drop back to lower number - not hypo scary, just lower.
She's doing very well!
Yes I gave her .25 units last night. She’s in the blue this morning
You forgot to put last night's dose on your SS. That's why I asked. Do you feel confident to try 0.25 u this AM? Looking ahead: you might eventually need what we'd call 0.10 u. That's where the plunger *just* touches or comes close to the zero line but isn't actually zero. Yes, that's a dose that is sometimes used.
I gave her .25 this morning. There’s such a thing as .10? I feel now she’s barely getting any. I gave her no kibble this morning. First time see how that goes
Yes there are smaller doses! They are a bit finicky to draw up but they are possible.
She’ll be ok with the .25 unit this morning?
She will be just fine. You can leave a bit of FF out for her to eat should she want it.
Yes, she'll be fine.
Very nice AMPS today! I think 0.25 u should be fine. Start practicing those 0.1 u doses I mentioned earlier. You might need them soon.
Molly is looking good!
Thanks ladies I haven’t been able to do the bedtime testing. Been so busy in the evenings. Tonight I’ll be able to get a test done
Good numbers so far today.
Yes, I’m happy with the numbers today . Will she ever go in the lime green numbers? If so what do I do?
Molly is doing fabulous! Love today's cycle.
Using the SLGS (Start Low and Go Slow) method of dosing, which is what we have you doing, your chances of seeing a lime green reading are pretty slim. Not going to say it can't happen, but it's not likely. Using this method, we reduce doses at readings of 5 mmol (90 US), long before lime green readings occur and if you were to get a reading close to 50, you'd intervene with food to prevent her from dropping any lower.
If you ever do get a reading under 50, retest to make sure the reading is correct. If it is correct, then feed Molly a tsp. or 2 of high carb food (preferably wet as it's digested faster than kibble) and post a new thread for some assistance/support using the "911" prefix on the title. That tells folks you need assistance right away and we are always on the alert for those type of messages. You'd then retest Molly 20 to 30 minutes after the high carb food to see if her BG has come back up above 50 and by then you should have some help to guide you.
It is a good idea to keep some medium and high carb wet food in the pantry and to have some honey or corn or maple syrup on hand just in case of low numbers along with an extra vial of test strips. You don't want to find yourself low on strips if you do happen to have to deal with any low numbers.
Ok good to know I’m hoping I won’t have to see those numbers. I would probably panic.
What decides when they go into remission?
Remember those tiny doses we were talking about the other day like 0.10u and one drop.........well, we keep reducing until hopefully we get kitty to sit in all dark green numbers. The odd smatter of low blues on SS are fine. We keep giving insulin to support the pancreas as long as possible but eventually there is no room for any more reductions. Hopefully by then kitty is sitting in great numbers so you stop the insulin, continue testing for 14 consecutive days to see if the cat can hold good normal BG without insulin support. If the cat stays in good numbers for 2 weeks, we declare them in remission. It's a step by step process. Today Molly had a wonderful cycle of blue from start to finish. Hopefully she will progress to having cycles starting in blue, some dark green in the middle and back to low blue.
One thing to know is the the Freestyle Lite meter you have tends to read a little lower than some other human meters. That means that if you see a lime green that's close to 50 (2.7) chances are good that Molly's actual BG is a bit higher than that. You'd still intervene with a little high carb wet food as Linda described above.
It's worth practicing those 0.1 u doses with some coloured water so you know how to draw them up in real insulin when necessary.
Ok perfect she started out blue this morning
When a cat goes in remission. Do you still need to test them so often? will the diabetes come back?
Remission is not a cure. It means that for the moment, the pancreas is working as it should be and the cat no longer needs exogenous insulin. Diabetes can rear it's ugly head again so we continue to test our kitties for the rest of their lives so if there is any indication they are falling out of remission we can catch it quickly. Often an infection or dental issues can cause elevated BG which if discovered and dealt with promptly can prevent a relapse or at least, alert you to the need for more insulin therapy to hopefully get kitty back into remission.
There are different schools of thought as to how often to test a cat in remission. It's recommended that you test weekly test after the 14 day OTJ trial for at least another month or a few months, then some folks go to monthly testing. I personally want to catch any issues ASAP with my girl so I have continued to test weekly and have no plans to change that regimen.
OH WOW! Just saw that green reading mid cycle today. Go Molly!
I see you gave her the 0.25u again tonight and that is perfectly fine however according to the SLGS method, she just earned another reduction because she went below 90 today. That said, we know your meter reads a tad low so not taking the reduction tonight isn'r a problem. We are going to have to watch her AMPS and decide if a reduction is needed tomorrow. If she is running about the same as today's AMPS, 0.25u should be fine but if she is lower, a little less insulin would be warranted. Let's see what she's at in the morning.
Aww crap never took notice to that. I was happy to see the green. If she’s low tomorrow morning, I gave her the .10?
Yup. I'll check in around 8:30 my time to see where she is at in the morning. If Molly happened to be below 90 at AMPS, then we'd suggest skipping the shot particularly since you won't be home tomorrow to monitor her. This weekend if she keeps up the good work, you may find a little more monitoring will help plan for next week. All good stuff going on and Kris and I will make sure Molly stays safe and you stay sane.
Ok remember I’m 3 hours behind you. I’m up at 5:45am my time. Thanks ladies for all your help.
Yes, I'll check in 8:30am my time (5:30am yours) with my and wait to see what little Molly is up to. Have a good rest tonight.
OMG! She's doing SO well! I'm glad you weren't as frightened by that green. I hope you've been practicing the 0.10 u dose.
Do I still continue with the .25 this morning?
Well that is another nice start to the day. I'd give her 0.10u today as I have a suspicion she went to green again during the night and that 160 may include a tiny bounce.
.10 it is I’ll be home at lunch today to test. I had to give her puffer this morning.
Don't be concerned if Molly is up rather than down at lunch time. It's normal. She has to get reacquainted with those lovely numbers and may go a bit higher again like she did a few days ago when she went into green numbers.
That’s what I figured, she’d be up at lunch time.
3.9 at lunch
WOW! That is terrific! Go Molly! She is still very safe but leave a little food out for her to munch on this afternoon.
What about the dosage for tonight?
Let's wait to see what her PMPS is. If it's similar to this AM's you can give 0.1 u again and get a +2 evening test. The weekend is here so you can be a little braver if needed.
Right now I'd say stick with the 0.10u but of course that would only be if her PMPS is high enough (not much lower than today's.)
5.9 do I give insulin?
Question, can you monitor a wee bit longer tonight? If yes, you can give her the 0.10u and get the usual +2 test. If she has dropped at +2, feed her some LC and retest at +3 to see if she has slowed down. Generally you can tell how active a cycle will be by the readings at +2 or +3 and if the cycle is active you can put the breaks on using some higher carb food. I'll check back in at 11:30 my time to see what Molly is up to.
Yes, I can monitor tonight she just ate so ok to give her insulin?
Shoot!...I mean YES!
I see we have another green. Looks like this could be an active cycle tonight. Feed her some LC food or medium carb if you have some and then retest @ +3. I'll check back in around 12:30am.
She’s eating some FF and a few freeze dried treats.
Is the FF pate or something else? I.E. is it low or medium carb? Freeze dried treats don't add any carbs into the picture.
Pate beef I have the SS wet left?
Not sure what that means?
Oh my lights just came on.....you mean the SO wet right?
Sorry should’ve said the SO wet for her crystals high carb
Ok. Let's see what the LC does for Molly. Good to know for future. Don't want to pull out the higher carbs unless necessary. I'll check back in 40 minutes or so.
Molly is doing great. Since this is the lowest pre-shot you've shot, a little more monitoring tonight would be ideal. How are you feeling? Molly didn't come up much from her snack so she may just surf along around the same numbers or she may drop a bit more. Can you stay up another hour to check her at +4? if she is not coming up then, and you need to turn in then, you can give her a bit of the higher carb food to slow her down and leave some food out for her to nibble at if she needs it. I will stay up to check on you if you're game.
The other option is to feed her some higher carb food now and leave LC out for her nibble on through the night.
While it would be nice to see what she is up to, you need to look after you too so it's your call. .
I’ve gone to bed and Molly is laying next to me. I can get up in the night. When she gets up to feed her?
Ok. How about setting an alarm for +5 and if Molly is steady or up, give her some LC food. If she is down, you can give her some SO wet to boost her up. If you have any questions or concerns, post for assistance with the 911 prefix on the title.There are usually folks from Australia and Europe on during the night. to assist. I'll set an alarm too just in case but I don't think you'll need me.
Oh my I probably won’t sleep now worrying. Should give her some kibble maybe?
I'm so sorry. I'm not trying to scare you Adrienne and I don't think you will need any assistance at all but this is new territory so I felt you should know what to do if you did happen to get a reading you were concerned about. You can give Molly some SO wet food now and set an alarm for +5 or +6. Better to get a few extra tests in on the weekend so we can plan for next week. I suspect when you test the next time, Molly's BG will be up but I can't guarantee she won't surf along in those beautiful greens either. Just being conservative.
Ok I’m getting up to test her now. Then feed her
3.5 @MrWorfMen's Mom
That's fine but she has dropped. If you gave her some SO wet, give her a tsp of kibble to munch on just to give her an little extra boost. I hate to do this to you but I would suggest, testing again in an hour. Again, this is the lowest pre-shot you've shot and we just don't know what Molly's plans are so that's why we monitor when we can so we know for the future.
I gave her SO wet and she ate it and she’s eating the kibble now. I’ll test in an hour what’s my safe number?
Any number over 50 (2.8mmol) is safe (and we know your meter reads a bit low). If you should get any number below 50, give Molly a tsp of the SO wet and another teensy bit of kibble. The higher carbs should boost her up and she will be at or close to nadir by then. I'll check back in an hour.
Alrighty. Molly is coming up a bit (partly the higher carb too though) but she should be at or near nadir now so leave her a bit of LC food out and then go crawl under the covers. Molly will be fine. Good job tonight. Sweet dreams.
I'm so glad Linda was around to help you. It's amazing that she was in those greens on such a tiny dose. Here's the way you draw up a "one drop" dose:
push the syringe plunger in firmly on the empty syringe
insert the needle into the insulin vial
release the pressure on the syringe plunger (this is enough suction to drop a tiny drop of insulin into the needle)
withdraw the syringe needle carefully from the vial without touching the plunger.
Here's how you inject it into Molly:
insert the syringe needle under her skin where you usually inject
push firmly on the syringe plunger to get that one drop dose out of the needle
keep the firm pressure on the syringe plunger as you withdraw the needle from Molly so the drop isn't sucked back into the needle.
You might want to practice these actions before you try them with Molly. I know this tiny dose seems crazy but it's not unusual for a kitty to need a teeny tiny bit of insulin like this as they go along the road to remission. It's best to ease them off the insulin this way rather than to stop it cold turkey.
It's likely that you'll need to give only a drop this AM but we'll know better once you have the AMPS number.
Her AMPS is up this morning do I still give .10? I’ve been practicing my .10 and I hope I’m getting a drop for her.
I gave her .10 sorry she’s 40 min late.
That yellow is likely a little bounce from the greens. In case I wasn't clear, Adrienne, that 0.10 u dose you've been giving is a different dose from the drop I described above. The drop is the next dose down if the 0.10 u proves to be too much. So it's: 0.10 u ---> one drop (two different doses).
Sorry Adrienne. I was typing as you posted. It's fine that you gave Molly the 0.10 dose this morning but tonight we'll reduce to the one drop dose.
One drop is done by holding the plunger in as tightly as you can, insert the needle into the pen while still holding the plunger in tightly and then let go and withdraw the needle from the pen.
Ok I understand now the .10 is different from the drop dose.
Will start the drop dose tonight. I’ll test her at +2 I will be gone for 3 hours this afternoon.
No problem. Get the +2. I expect Molly may stay pretty flat today. Or she may surprise us. You can decide on how much to test today depending on what she is up to. In any event, you did great last night and Molly had a wonderful cycle. Did you finally get some much needed sleep?
I fell right to sleep last night after the last testing, I figured she was going to be ok. She came came back to bed with me. I could use some more sleep. But she’s more important! Thanks for your help last night. I hope you got some sleep!
I guess I wasn’t awake yet when I read your post . But understand now
Glad you slept well. I got some shut eye but I slept a bit later than usual this morning and got pounced on by one very hungry furry creature while the other two sat off to the side giving me the stink eye for being late opening their restaurant!
Molly doesn't seem to hold her bounces very long which is great! Nice +3. If you can, grab another test before you leave this afternoon. You can leave some LC food out for her to munch on in your absence.
It’s been a busy day I did a +9 test.
Try that "drop" dose tonight and get a +2.
How do you record the drop dose in the spreadsheet?
Just put "drop".
Try a drop dose again today if her AMPS is similar to what the others have been. Exciting times for you and Miss Molly!
New thread tomorrow, Adrienne.
Ok will do
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