Need Advice on Reduction1/18 MooCAT AMPS294 +2 226 +4 99 +5 75 +6 57! AT2

Moocat

Moocat

Member Since 2018
Since Monday's Blues and Green of 88. I had 3 days of high BGS in the 200's and 300's. I was surprised to see such a drop but looking at my spreadsheet it seems this is how it has been. My only concern is that he was @+5 75 and he ate about an 1oz of food 20 minutes earlier. If he hadn't eaten, would he have gone lower than 68?
ETA- +6 57! What on earth is going on? on a drop? Just fed him some FF Chx pate again. will test again in a few minutes. 15 min later 64. just tested 15 min later 70. The protocol says he earned a reduction but his numbers have been so strange. What do I do?
 
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Here is your last post for history http://www.felinediabetes.com/FDMB/...101-4-88-5-143-at2-meter.209428/#post-2319917

In looking at Moo's SS, I honestly can't say that I understand what is going on, but what I do think is 57 on AT2 is too low and would earn a reduction, even if you weren't following SLGS. My only suggestion since he's only on a drop dose at the moment, might be to give higher carb food, like something around 9-10% carb at +2 when you see a significant drop from preshot like you did today, and maybe also again when you 99 at +4. Not sure what % carbs you are feeding at the moment, but it seems he does some bouncing after quick drops and low numbers, then takes a few cycles to clear the bounce.

Hope you get some additional feedback, maybe @Wendy&Neko or @Bobbie And Bubba are around tonight? In any case, my reply has bumped you up, as you do need advice.
 
Thanks for giving me some feedback on this. I have been giving him 7% carb food and haven't been able to find a pate that he will eat that has higher carbs. He's a little picky. I'm not sure about giving him a shot tonight. Just tested him @9hrs 15min 113. This has been difficult for me (mentally)because I'm not always home to watch him.
 
Yes, a 57 low as 68 is the "take action" number. It's a bit crazy because the rest of his numbers are not OTJ worthy.

By looking at your comments today it looks like he barfed after staining to poop and didn't eat well which would contribute to the lower number today. And I see where there were a few "insulin smells" on his fur lately which would mess up the depot.

I don't thing taking him off insulin right now is the right thing to do, especially if eating is an issue.
 
Let's see what some other think. If he is eating okay now a 113 is a nice safe number to shoot if you can monitor and he's eating okay.
 
57 is too low on the AT. 68 is our take action number and reduction point if following TR. I would try witholding insulin for a couple cycles, and see what happens. Are you testing regularly for ketones?
 
Bobbie And Bubba said:
don't thing taking him off insulin right now is the right thing to do, especially if eating is an issue.
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I want to explain what I meant by this. It seems when looking at his SS comments the times he's had some lower numbers, vomiting has occurred which would leave him lower. That clouds the issue some.
 
Bobbie And Bubba said:
Yes, a 57 low as 68 is the "take action" number. It's a bit crazy because the rest of his numbers are not OTJ worthy.

By looking at your comments today it looks like he barfed after staining to poop and didn't eat well which would contribute to the lower number today. And I see where there were a few "insulin smells" on his fur lately which would mess up the depot.

I don't thing taking him off insulin right now is the right thing to do, especially if eating is an issue.
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He did eat before @+2.5 andafter the barf about 1-1.5 oz of food then continued to eat at+4 total of 3.5 oz throughout that time period . The food I gave him at preshot was 4% carb and not his usual food. So you think I should probably go ahead with the shot tonight? When I do the preshot test what number should I consider a go ahead number any suggestions on this?
Thanks for replying, I'm baffled and inexperienced. The help you are giving me is all I feel I've got going for me right now.
 
Bobbie And Bubba said:
I want to explain what I meant by this. It seems when looking at his SS comments the times he's had some lower numbers, vomiting has occurred which would leave him lower. That clouds the issue some.
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Okay, got it. I didn't see that. I'm going to look back at my notes. Thanks!
 
He barfed about 1/2 after +2 test he ate food after +2 test went to poop, barfed, ate some more food.
ETA I looked at the notes, the other time he barfed was after the low numbers not before. I'm going to make better notes going forward with time details.
 
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Wendy&Neko said:
57 is too low on the AT. 68 is our take action number and reduction point if following TR. I would try witholding insulin for a couple cycles, and see what happens. Are you testing regularly for ketones?
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I checked last few days while numbers were high and no ketones. I am following SLGS, isn't that protocol more conservative? He currently takes budesonide for IBD ( my vet said he probably won't go into remission) Having said that, she also said she could no longer advise me after I told her that I would not increase the insulin to 1 unit back in December. He was diagnosed in November. Using Lantus since 11/16/2018. I figured that TR would be too hard for me to do with my work schedule. I am not home to do mid-cycle tests to catch a low number 4 days out of the week. Sometimes I have to leave at +2.
 
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Moocat said:
He barfed about 1/2 after +2 test he ate food after +2 test went to poop, barfed, ate some more food.
ETA I looked at the notes, the other time he barfed was after the low numbers not before. I'm going to make better notes going forward with time details.
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I think to be safe, I'd skip the shot tonight since he ate after the barfing and still went that low.
 
Hi Bobbie and Bubba,
I tested MooMoo last night at +3( I skipped shot)- he was at 271. I was looking at the details of my notes and realized that I gave Moo his shot late by 35 minutes the night before because I go to school at night so yesterday's shot I brought back to the normal time 8:45 yesterday morning. (35 min back) Maybe that shot the night before had not worn off and caused the big drop? I never had a problem with it before. I tested him this morning and he was at 304. I gave him his insulin. I'm going to make sure to just adjust the shot back by 15 minutes at a time going forward.
What do you think about this? There doesn't appear to be any other explanation.
 
Moocat said:
Hi Bobbie and Bubba,
I tested MooMoo last night at +3( I skipped shot)- he was at 271. I was looking at the details of my notes and realized that I gave Moo his shot late by 35 minutes the night before because I go to school at night so yesterday's shot I brought back to the normal time 8:45 yesterday morning. (35 min back) Maybe that shot the night before had not worn off and caused the big drop? I never had a problem with it before. I tested him this morning and he was at 304. I gave him his insulin. I'm going to make sure to just adjust the shot back by 15 minutes at a time going forward.
What do you think about this? There doesn't appear to be any other explanation.
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It could have impacted the drop. Any thing more than 30 minutes earlier would be like giving an increase.
 
Bobbie And Bubba said:
It could have impacted the drop. Any thing more than 30 minutes earlier would be like giving an increase.
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Thanks for the reply, I also just put in an Rx for lantus pen. I'm covering all bases with moomoo here. When originally dx'd in November, my vet Rxd the vial and did not instruct me not to shoot excess insulin back into the vial. I did that for about a month until I became a member of FDMB and read that it was not good practice and could affect the integrity of the insulin. So, I don't know, but perhaps the weird numbers are due to funky insulin. Anyway, I also hear that it's easier to get doses from the pen. Do I just press the plunger in on the syringe and stick the needle in to the the pen vial with the plunger depressed, then release and pull the needle out? Or stick the needle in,then depress plunger? Just want to make sure I understand how to get the drop dose from the pen. Any feedback and/or instruction is appreciated.
 
Moocat said:
Do I just press the plunger in on the syringe and stick the needle in to the the pen vial with the plunger depressed, then release and pull the needle out?
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Yes, that is the way to do a drop dose.

Too bad about the vial and shooting the excess back in. I don't blame you for not wanting to trust it. Keep the pen refrigerated also and the efficacy will last 6 months. Hopefully, Moo will be done with this dance before the Lantus can go bad. :)
 
Bobbie And Bubba said:
Yes, that is the way to do a drop dose.

Too bad about the vial and shooting the excess back in. I don't blame you for not wanting to trust it. Keep the pen refrigerated also and the efficacy will last 6 months. Hopefully, Moo will be done with this dance before the Lantus can go bad. :)
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Thanks Bobbie and Bubba! You've been so helpful and I really appreciate your sharing your knowledge and experience. :)
 
Hi Bobbie and Bubba,
I got the Lantus pen today. I'm going to use it tonight. Is there anything I need to do for 1st time use? Or just treat it like I would a vial except no shooting of air?
Sorry if I'm asking too many questions but I just want to make sure I do everything correctly.
 
Moocat said:
Hi Bobbie and Bubba,
I got the Lantus pen today. I'm going to use it tonight. Is there anything I need to do for 1st time use? Or just treat it like I would a vial except no shooting of air?
Sorry if I'm asking too many questions but I just want to make sure I do everything correctly.
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There is nothing that you need to do for first time use. No problem asking questions, that is how we all learned. Good luck with the new pen!:)
 
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