? Lily- shooting advice please- AMPS 151 +2 232, +4 205, PMPS 151, PMPS +30mins 148, +1 59, +2 65, +3

hi all,

Lily's AMPS is 151, a number I'm not comfortable with shooting. Shall I wait to feed, retest in 30 mins and see if she brings herself up a bit?

 

yes, that's a good place to start

 

if she's still around 150 or higher, I'd go ahead and shoot the scheduled dose of .25

Get a +1 and +2 to keep an eye on her in case you need to intervene with some food to keep her from dropping too much (usually, we expect a "food spike" in those first 2 hours, but if she's dropping instead, you should go ahead and feed a teaspoon or two of her regular low carb food)

 

That sounds good. I have to keep reminding myself that if this is the right dose for her, her +1,2,3 should be roughly the same if not only slightly lower than the amps. I get scared because of the huge drops previously encountered.

 

I can't stay to watch you tonight, but hopefully some of our UK, Spain and Australian folks will be around. If you get worried, put that 911 prefix up in your subject line to get some eyes on you as soon as possible

Good luck!! Shooting these lower preshots is the key to making progress.... but boy are they hard on us beans!

 

Hey!

Thanks for the advice. She went up to 238 on her own this morning (wonky strip in the first instance?) so I gave the 0.25.

 

So proud of my baby! 232 +2

 

+4 205

 

She's looking good!

One thought -- the next time you get a number that seems "off," re-test to make sure it's not a bad test.

 

add your + numbers to your heading

 

Lily's PMPS is the same as her amps and a low (for her) 151. Stalling again, but if this keeps happening do you think it'd be safe to shoot the 151?

 

Bump please

 

Hi there did you shoot?

 

I did. I based my decision on this morning and will monitor closely

 

Good Job, that was a good move.

Sorry no one responded earlier. That +1 being a little lower, ie no food spike, might indicate she might drop, I would get a +2 you might find that she heads to the Lagoon(green numbers)
which is good, it's where ultimately we want to see her, just need to make sure she surfs
Remember shooting a lower number usually results in a flatter cycle, a nice flat green cycle is the objective.
You just have to be ready to intervene should she decide to drop too quick.

 

This is so odd. Suddenly she is at 59! Bit worrying

 

Have you given her some food? I would test @+2.5

 

If you haven't fed her test her first seems it's about your +2.5 isn't it?

 

I have given food, I will test again in ten minutes. That will be about +2 ish. I stalled because of the low BG. I gave food about 30 mins ago...despite feeding her MC with her shot as usual.

 

I am a little confused then
you have recorded the 59 as your +2 on your ss.
did you shoot the 150 or the 142?

I'm thinking that you got the 150 stalled and got the 142 then shot.
If thats the case the 150 becomes your +12 of the morning cycle and the 142 the amps.

Is that what happened?

 

Yeah...I'm still getting the hang of the spreadsheet filling in....Sorry.

 

No problem, it's a little harder with the world ss.
You need to put the 142 in the pmps slot then, then put in the comments am cycle +12 150 stalled for XXminutes.
I would usually just stack the numbers in the amps slot

ie I would write +12 150/stalling
amps 142 @ +12.5 (if I shot 1/2 hour late)
then your +1 would be 1 hour from the amps(the actual time you shot)
Its harder with the world ss since it screws with the conversion, not sure how you get around that.

Ok so how long is it since you shot then?

 

Exactly 2 hrs since I shot, we are at 65 now. I am still wary. She doesn't nadir until +5. I finally got her off of dry food yesterday and since then her numbers have just been going down! No idea what to do really. She is just dropping and dropping. Can't do any less than 0.25...My eyes are just not that good.

 

I would give her a little snack of LC to MC somewhere between say 8% and 15 % just a teaspoon and check in 30 min @+2.5

 

I would feed her some extra food, maybe even a little higher carb than usual if you have it.

 

You will need to monitor for a while, have you got plenty of supplies?

Sorry to be a pain about the SS the 150 shouldn't go in the +11 where you have no put it, pop it in the comments section for now as a +12 and indicate you stalled for XX minutes, so that anyone coming on can see by looking at your ss what has transpired, otherwise it may lead to confusion.

I can't remember now Becca, have you found that Lily is quite carb sensitive?

 

Lily's numbers literally came down into a normal range as soon as she came off of the royal canin diabetic kibble. She seems reasonably carb sensitive, yes. I think this low may be because I fed two tins med carb today instead of three
I have enough strips for now, yes...I am worried about another bounce. I know it is really good to have the cat in the green but I worry she dropped too fast....she dropped by 80 points

 

so far we have
150+12
stalled
142 amps fed MC
+1 59 fed what? more MC?
+2 65 fed what?more MC?

If she is dropping by +2.5 you may want to try some higher carb than your MC if that hasn't been making her numbers come up, as you have already noted it's early in her cycle, just a small amount might help her surf.

How long is it now since she has had the kibble?
Did she have less because she wasn't hungry? She free feeds doesn't she? or have you gone to a more regulated schedule?

 

She has not had kibble since the evening of friday 11th. She had 1x tin MC (14%) with her AM shot, then 1X tray tuna pate (2%) around lunchtime, Another few spoons of MC just before 1700 (+10) and the rest of it with her shot at +12.5. She then had half tray LC at +1.5 and at +2 1 tbsp MC. She does free feed, but I have no timed feeder atm so have just been doing it by hand. Dread to think what I will do tomorrow when I am at uni all day.

 

You did what you could to try to mitigate that you fed MC at amps, and spotted that there could be a problem so were able to jump in at +1 with more food.

It hasn't been that long since you stopped the kibble that may still be causing things to be topsy turvy.

She may well bounce from the fast drop, but don't worry too much about that, we all hate to see our kitties in those higher numbers, but it is part of the process, often when our kitties spend longer in better numbers they start to bounce less.

Cross that bridge when you come to it. She may be bouncing, but if she is not you can always give her some HC in the morning and leave more of it out for her.

 

have you got a +2.5 test in yet?
How are you both doing?

 

She's just pulled out a 41...Hmm...I have put some high carb down

 

I would give her a drop of honey with it too.
Was that at +2.5 or +3?

 

test her again in 15-20 minutes?

 

that was +3...Just fed her two spoons at 30% carb

 

OK thanks for clarifying, don't wait an hour for next test. You need to keep testing every 15 to 20 minutes until we see her back in normal numbers.
Keep feeding the HC/honey every time you test until she comes up into the 60 range, small amounts if the high carb you use has gravy you can use a couple of teaspoons of that rather than filling her up on too much solids.
How is she in herself?

 

She seems perfectly fine. She is asymptomatic, which is really odd!
(apart from inhaling that high carb!). She is still playing, chasing bugs up the wall etc. Very alert kitty and is responding well to me. she has been rolling on her back looking cute...

 

That's good.

Lily not sure all that running about is going to help get your BG up!

 

Back to 59...Really strange

 

a bit more food and test in 15 20 min see if we can get her to get over 60, but good to see her up from the 40's.

 

Odd girl.
I'm staying up until midnight (her nadir)

 

You can't get too confident with their Nadirs, they do move them around

I know you need to get some sleep so you can get to uni tomorrow, but I would probably set the alarm and test her two hours from when she last had high carb just to make sure that she is maintaining her levels herself, the HC can wear off and they can drop again, with her coming off the kibble so recently she could get up to shenanigans.

 

Thanks, I shall do that. She is a mischievous little one. She always does this when I have somewhere to be. Maybe she wants me to stay with her and she knows if she drops her sugars she will get her wish!

 

It's in the How to Ruin the Beans Plans chapter in the FD manual that they all get on diagnosis

I think I remember reading somewhere it could take a couple of weeks for the delayed effects of the kibble to wear off, but I might just be imagining things, so she may throw wonky numbers for a while.

I'm up for a little longer possibly till just gone your midnight (1 am here)

 

Bloody 52!
What the hell...
More high carb fed

 

good call on the HC and I would check in 30min

 

Well, at least for the most part, I have managed to keep her in the nice greens.

 

@Gill & George Thank you for steering me through this tonight! I would go mad if I didn't have this board! I know what to do all evening/and morning as it may be now...

 

You have done a good job of keeping her in the nice greens. The one thing I would suggest is when you get a large drop like you did at +1 is maybe to think about moderate carb just there and then and also when early in the cycle and they are in the 50's I would test in 30min intervals, you might have been able to catch that drop earlier.

 

You are welcome, I have had my hand held by others, so happy that I can help someone else.
Lily is looking good tonight, even if it is a bit nerve wracking from the ss it looks like she has had quite in long run below the renal threshold today

 

113! What is the renal threshold?

 

Lily is quite the active little girl tonight isn't she. Glad Gill was here to help you through the dropping numbers.

You changed her diet to low carb wet 2 days ago and I think this is the result.

 

Renal threshold of cats is around 285 but can vary a bit. You are not even close right now

 

OH! So thats a really good thing? Nice

 

I kinda feel rewarded now for all of the effort involved .

 

It's the point above which glucose starts spilling into the urine. It can vary a bit between cats for George we stopped getting a positive result for glucose in the low 200's .

Yes it's a good thing

 

One very last thing before you scoot off to bed...How long does it usually take for HC to wear off? I am wondering whether it is safe to just leave food out and go to bed without waking in the middle of the night. I will be getting an 11.5 (0630)

 

although she is going up now with that blue remember that it is possible that the carbs can wear off and we like to see numbers still up two hours after you last gave HC, so when was that?

 

It was an hour ago. So if I wait until 0130 and retest it should be fine? (it is 0030 here atm)

 

Yes that's right, you've got it!

I'm testing BFG and of to bed. Hope she stays in some nice blues for the rest of tonight.

 

Hope Big Flat George has lovely numbers!

 

How about giving Lily a bit of low carb food and testing in 30 min?

 

Hey She is coming up on 2h after high carb. There is low carb down for her but she is having a nap atm. I will be testing in 25 minutes and if she has sustained herself I will be off to bed for the best 5 hours I have ever had. I hope.

 

Just a reminder that she earned a dose decrease with the 41 tonight. So even though it is hard to measure, you have to reduce the 0.25u. There are photos of the small doses here that you can look at. A good light, a magnifying glass will both help you. It is important not to give the 0.25u dose again because you now know that it can get her to 41. That test isn't on the ss yet, but it's the most important one tonight. You can always put it in the comments if you can't figure out how to put it in the ss. The ss gets easier as you get more practice!!

You also were doing a lot of carbing her to keep her safe tonight, so that dose decrease is extra important.

As far as morning goes, I would play with your 0.25u dose and see how many drops are in it. Somehow you have to figure out how to reduce the dose. And since she's got the recent history of DKA, skipping isn't a great option. Although high carb food will likely make her happy. The very smallest dose is one that you can "vacuum" up - hold the plunger in tightly to the syringe so hopefully, all the air is out. Put the needle into the insulin and release the plunger. That should "vacuum" up a very small amount. Practice with these, however, so that you are confident about the dose you give in the morning.

A couple of questions you asked about - renal threshold varies from cat to cat. Some folks have found that their cat spills glucose into their urine as low as 150. The only way to know for sure would be to test her urine. . . but honestly, I doubt you need to worry about that. I agree that these lower numbers are because you've changed her diet - kudos to you for getting her switched over!

How long does it take for HC to wear off? Another one of those ECID (every cat is different) things. When punkin had low numbers, I tested until he was clearly rising and past his nadir, and I wanted at least an hour after having given him HC. Take good notes and you'll hopefully be able to figure that out for Lily too.

 

171 at +6...My work here is done.
I have no idea how i am going to manage dose, especially when i drop her at the cattery and they are giving her the 0.25...just don't know how they will do it unless I can get her running slightly higher but just on diet alone? I dont know. :s

 

Some cats go off of insulin with a change to an appropriate diet and a little bit of time on insulin to allow the pancreas' beta cells to heal. No one can say if Lily is one of those or not, but it does happen.

I wouldn't worry about the cattery until the day before you go. Let us help you with a dose at that point.

Hope you can get some sleep in.