Last night's BG PMPS=110- No Lantus, this am BG AMPS: 104 still don't shoot??

http://www.felinediabetes.com/FDMB/threads/dosing-assistance-please.190142/

Hello, Under the guidance of the suggested lower dose every 12 hrs - , I now have another question: I'd like to see how he does .....maybe try .25 every 12 hours for a few days and let's see how he does? It seems as if Dante has done well with 2 low doses per day; last night I didn't shoot at all, and again, today's AMPS is still <150.00, should I try to shoot him at half the .25 dose which is .12.5? I bought the caliper, on Saturday, so I can try to measure it in the syringe.

Until you get a little more mid-cycle testing, I'd suggest if you get a Pre-shot under 150 that you stall, don't feed and post for help.

Test again in 20-3o minutes....if the number goes up (without the influence of food), it's probably going to be safe to go ahead and shoot.

As you learn more about how Dante responds, you will learn to shoot lower and lower numbers

Any assistance would be greatly appreciated, thank you!

 

I personally wouldn’t shoot a 104 after a NS. Stall without feeding and see if he goes really up over the next if your schedule allows it.

Human meter or pet meter? On a pet meter this is an « ok » non diabetic number. On a human meter (which reads lower) it’s a bit higher, but might still be on the « normal » range (under 150).

 

Thank you, Stephanie! Aha, I use a human Relion Prime meter. Also I just rechecked and his BG=167, up from 40 min ago. I think his BG goes up when I start preparing his food as he gets so excited...?? Does that make sense? So at 167, it is ok to shoot .25 then??

 

167 looks like it’s going up, indeed! I haven’t heard of food excitement raising BG (doesn’t mean it’s not a thing though).

I can’t tell you to shoot or not, but some things to factor in:

- can you monitor and are you comfortable dealing with low numbers if he falls into them?
- do you have data, looking back at your SS, that can help you « guess » what will happen if you shoot, or don’t shoot?

Lastly, if you don’t shoot, do try to get a couple of tests in there all the same to see where he is going without the shot.

If you shoot you’re definitely going to want to test.

Given my limited experience I’m maybe more conservative than others may be.

 

Hmmm, my question is: did his number rise because of his excitement over food, or because it went up naturally? I guess that is a hard question to answer, if he has a low BG tonight, I won't prepare his food before testing the second time. Yes, it is ok to shoot above 150, so I am not quite sure why I asked that question, sorry, not thinking!

 

Looks like he is at 167 now. If you are able to monitor and have plenty of test strips and supplies, I would shoot.

 

Stephanie, great advice, you're right, if I shoot and BG falls, am I comfortable? No, but if the BG is still low before I go to work at 9am, I will come home and test around lunch. UGH, so ooo difficult, thank you soooo much!

 

Thank you Bobbie, I will shoot right now, Ugh, ...!!

 

Carol -

Are you home today? If you are an are able to monitor, it's likely fine to shoot. If you won't be home, to get a few tests in, you really don't have enough data yet to know how Dante will respond. It sounds like you'll be able to check, which is great. Also, you might want to consider leaving extra food out, just in case.

You don't want to make rapid changes in dose. You should decide on whether you want to follow TR or SLGS as your dosing strategy since the point for where you reduce the dose differs between the two dosing methods as does how long you hold a dose.

Also, there's a way to highlight if you're quoting someone. There is an icon above the text box that looks like the page in a book (4th from the right side of the icons) and if you hover over it, it says "insert." If you click on it, you get a drop down menu and the first option is "quote." You want to have copied the information you want to quote then paste that material between the two sets of brackets.

 

I am glad that you can get another test in before you leave for work. That will help you to know where the cycle could be heading and you could leave some extra food if you need too. Also, glad you can come home at lunchtime to check him.

 

Sienne and Bobby: Thank you! I work M-F 9-5:00, but live about 3 blocks away, so I am able to come home and check. Aha, I will do so next time with the quotes, thank you! I have read and reread the TR and SLGS multiple times, and still on the fence, I will re-read again tonight, and make up my mind. Thank you! If I leave extra food, it is only because his BG is low when I leave for work, right? If his BG remains high, I don't need to leave the food out, right?

 

Since you don't really have the data to tell if he'll come back down during the day it might be a good idea to leave the extra food out anyway.

 

Carla: Got it, thank you!

 

Also, if you want to tag someone, if you put in the @ and then type in their name, it will put an indicator in the "alerts" at the top right side of the page (there are messages and alerts). If you look, I'm tagging you: @Carol & Dante .

 

Sienne, Thank you, yes, I was trying to figure out how to tag, and couldn't find instructions. I am asking so many question as it is, thank you! I just tested again, and the Lantus has kicked in as his BG is down to 172 already. I will come home and check again in a few hours.

 

I doubt the excitement of food spiked his BG. I think it was on its way up and time to shoot. You are getting a great response.

 

Don't worry about too many questions, we have all been there with questions and being confused. We are here to help, so ask away!

 

Thank you Bobbie, will do, all of you are so patient, thank you! Dante's BG is at 169, so I am glad I shot this am!

 

You can also simply highlight the text you want to quote with your mouse and click on the "reply" overlay button that shows up. It will send the quote right to the box you'll reply in at the bottom of the page.

 

Wow, Sienne, Stephanie, I like the 'highlight' bit (both ways) to reply to, that makes it so much easier, thank you!

Hah, I thought it may have been a longshot, but as both tiffmaxee and Stephanie said, food excitement was probably not a factor in raising his BG...I was just thinking out loud! Thank you for responding! @tiffmaxee

BTW, I thought I was monitoring closely, hah, until I saw everyone else's SS, now I can fully appreciate what I am seeing when I view everyone's SS. My vet stated that a small percentage of cats actually go into remission, and none have ever heard of going into remission twice, clearly they have never been on this website! Seeing OTJ patients here and studying their SS, (monitoring and shooting practices), really gives me encouragement that it is possible, thank you for sharing!

 

Well......Bubba has been in remission 3 times before. The first time , about 6 weeks and the second time was 6 months. . The first time he was taken out by a bad tooth. The second time was a perfect storm of a dental visit, guest in the house for 4 days and tapeworms ( he was an indoor/ outdoor cat that hunts) . We are presently trying for +4 OTJ. And I admit, I am a test- a -holic and it is not necessary to follow TR and test as much as I do , but, I am home full time and can so...... poor Bubba

 

Just looked at the SS and with the +2 being a bit lower could be an active cycle , so be vigilant and get another test in before you go to bed for sure to see what is happening.

 

Bobbie, Mondays at work are always overwhelming, and with reading so much more info here on the site over the weekend, I think my brain was totally taxed. I could barely keep my eyes open writing that last note, so I went to bed immediately after my last post and woke up 9 (!) hrs later a little before 5am!

Yes, I was reviewing your SS and saw OTJ several times which is exactly(!) why I wrote that comment about vets never seeing remission 2x!!! Constant comments of never getting him back into remission has been irritating(!) and I even told the vet, "Is it so difficult to give someone hope?" Her response was "I don't want to give false hope", my response, "If there is no hope, one might accept that, unfortunately, I can't, that is why I am trying Chinese herbs, adjusting dosages, keeping daily record of his BG's; do you think that perhaps because you have never heard of it, it doesn't mean it can't be done, right?" Well, Bubba, China and others here are living proof! I first started here when diagnosed, and saw all of you were so above my head, that it was too overwhelming, now, I can totally relate with a clear head! Seeing all the info is still overwhelming, but due to having experience now, I can relate/deal with it. Also frustration over closed minded vets brought me back here; your SS and others along with guidance will give me the option I was looking for, remission once again!

I can relate, the vet said Dante was remission 1 month after diagnosis, but a heart failure totally rained on that parade, so I hear ya'! Correction: It is not "Poor Bubba" instead, "Lucky Bubba", there must be millions of diabetic cats who would LOVE to be cared for in such a way! Animals know when there is something wrong with them, they also know when you are trying to help, that is why Bubba allows you to be a test-a-holic, he knows he is loved, period! His brothers see that so they know if anything were to happen with them, they would receive the same treatment, so granted, they may be happy they aren't requiring special attention(!), but I guarantee they support Bubba to 'keep on keeping on'!

So, Dante's BG's are <150 again AMPS, the second number was not food-excitement induced, so I actually would be comfortable shooting him at this number...whew, see there is progress here. Previously, I would shoot at <150, but would be scared stiffless, now I am less scared stiffless, haha!

 

Atta Girl Carol! I am glad that you are feeling more hopeful and glad that you are back here and getting the support that you can't get from your vet ( most of us can say that too) and reading and absorbing all the info here for us ( I learn sometime new everyday )

You are so right about the kitties knowing we are helping them. I feel so badly that I had to take Bubba's outdoor freedom away while he is back on insulin and poke him a lot, but at the end of the day, he jumps up onto my bed and lays in the crook of my arm until we fall asleep and stays there most of the night. So, how much can he hate me, right?


If you can get another test before you walk out the door, that would be great to see if you need to give any food to steer.

If his next test is lower, then give him a bit of MC food to bump him up a bit. Do you have an autofeeder or a way to leave a small snack for him?

 

Thank you, I waited until your response before shooting, I just shot .16 at 7:25, see, still scared, but not frozen! What is MC food? No, I only give wet food, hmmm...yes, absolutely will test before 9am...

I betcha' Bubba would rather be poked and prodded temporarily than go outside and become sick. Clearly he tells you that every night when he cuddles up with you!

 

BG before work= 102, will come home and test again

 

I am glad you can come home to test today to give you peace of mind. Sometimes when you stall they continue to drop. But since you don't have any data on shooting that low this time around, I do understand your concern while you are at work.

Let's see what he does with the dose you shot this AM. The goal is to get a dose that you can shoot every 12 hours so you can get him level. Once they get use to being in lower numbers, the cycle stays rather flat.

 

MC is Medium Carb food and those would be the Fancy Feast Roasted ones. It's a good idea to have a little LC ( Low Carb), MC ( medium carb) and HC ( high carb foods on hand for steering when you need to. Just mark the tops of the MC and HC with a marker and keep separate so you don't give them accidently.

 

Bobby, thank you, got it, will do. I just checked his BG: 118, perfect!!! Whew, this would be the time that the Lantus would peak? 5-6 hours after shooting?? I feel better about dosing this am! Thank you for your support!

 

Beautiful! Yes, usually the nadir is somewhere around +4-+7 for most cats, and that said, they can switch up their nadirs whenever they want to ( because they are cats ) so the more data you get you can see if he switches the nadir up on you.

 

Bobbie, (sorry, I just realized I have been spelling your name wrong, I can be such a dipstick sometimes, sorry)Thank you for checking in on his SS, even though his BG is not perfect, it is for me...for now! He seems to be going at the right pace...for me, as it is allowing me to adjust and feel confident about shooting low, thanks to you and everyone else who has given me support! Ugh, I really see the inadequacy of the lack in testing as more info would really come in handy now - so I live and learn!

To be truthful this quote does scare me, it will definitely keep me on my toes, so I can see why more testing must be done continuously, gee, why can't it be simple???? I guess it is, when you have a lot of info to work with, I know, I got it!

I spoke with my boss's wife today concerning coming home and testing on a daily basis, she is totally fine with it; however, I told her I would only do so if the AMPS is low enough to make me uncomfortable, otherwise I will test at least twice in the am, and several time before going to bed...any thoughts? Should I make it a habit to come home and test every afternoon or is several times in the am/pm enough? Or, only when I feel uneasy? On weekends I will start shooting much more frequently to build up a base of numbers that can at least show some history.

 

Your comfort level along with keeping him safe is number 1. If it were me, I think I'd come home as often as I can right now to fill in the SS more so you can get a handle on his pattern and see just how low he is going.

ETA: Good job shooting tonight! Tomorrow start a new thread with the date as this one is getting long and we like to start a new one each day for that reason. And connect this one as a link to tomorrow's so people can easily see what transpired the day before. You are doing super Carol and I am excited for Dante and his response to such a small amount of insulin.

 

Thank you for your prompt response, ok, will do, I kinda' figured you would say that!

In addition, just confirming that the Relion syringe, 31 gauge, 8 ml, 3/10 measures 1 unit at .65 on the caliper, so .25 units is .16. I have never used a caliper before so I watched the video multiple times and use my phone's flashlight for the lighted backdrop. Does this sound right? I guess at this point, even if it were wrong, that dosage seems to be working; however, it is for my own sake of accuracy....25 = .16 is such a tiny amount, I wonder how it manages to even affect him, and yet it does. Before, when giving him .5 units, he was getting the high and low swings, now, with a constant .25 units since last Thursday, he seems to be adjusting to it, or so she thinks, right? Thank you!

 

I use the same syringes as you and I also use calipers but my husband set them to inches and not mm. Not sure why he did that so I can't say for your calculation. The important thing is consistency and with the calipers you will be getting that.

 

As Bobbie said with calipers, the important thing is you measure the dose consistently. It doesn't matter if your measurements are the same as anyone else's.

 

Bobbie and Carla; aha, too concerned with detail and missing the elephant in the room, gotcha! Thank you!!!