9/7 Zeke - PMPS=189;+2=125;+3=66;+4=84 (AT)

Status
Not open for further replies.
Re: 9/7 Zeke - AMPS 453 (Results of yesterday's fur shot)

Good luck...darn fur shots!
Have a great Caturday!
 
Re: 9/7 Zeke - AMPS 453 (Results of yesterday's fur shot)

Fur shots are furstrating! I'm sure Zeke will get back on track soon. Have a great weekend!
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);Help 1 hr from PMPS.

Wow, this number is so surprising. I haven't tested since +6 (typically nadir) which was at 259 because I expected it to spike from there due to last night's no shot. We had a fur shot last night so I figured Zeke would have some high BGs for a couple of days and see him bouncing around a bit. Today, was different as he's apparently been dropping all day. He ate at +6 and +9.5.

Just reaching out to you in case we're faced with a lower BG at PMPS. We're newbies but have already been faced with some low numbers. Our lowest PS 173 was on 9/1 and we shot 1.5u. He's currently at 1.25u.

Probably jumping the gun a little but just in case: If his BG is 130 (AT) or less, I see that we have 3 choices as per the Protocol. I'm inclined to chose option 1 (feed him and reduce the dose by 0.25u) but I just wanted to get your opinion based on his ss. I really don't expect to be faced with a 130, but as I stated above, I didn't expect his BG to continue to drop today from typical nadir of +6, so I'm just thinking ahead.

Thanks,
Laura
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);Help 1 hr from PMPS.

Where did you read to decrease the dose if you have a low pre-shot? Can you link the information?

You have 3 choices if you are uncomfortable with your pre-shot number:
  • skip the shot
  • shoot a reduced dose (the amount isn't always a reduction of 0.25u)
  • stall (don't feed) and see if the numbers are coming up
The question that I would have given your +11 is whether this is a dropping number. If you can get a test at +11.75 we'll be able to tell if Zeke's numbers are dropping or if they level off.
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189

OK, so Zeke's at 189 PMPS. Up slightly from +11=181. So, I guess we'll give him the full dose of 1.25u. We'll watch closely next couple of hours. We have plenty of strips, MC, HC and maple syrup, as well as oral syringe.
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189;but drop to 173.A

Was just getting ready to shoot and decided to test. His BG has actually decreased (this even after a little food). He's now at 173. We've feed him a little, so is it too late to choose the stall option? Do we need to just skip?

Need additional advice?
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189

A 181 and a 189 are pretty much the same number. You're fine to shoot. Even the 173 is within 20% attributable to meter variance. You're good to go.
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189;Drop to 173. Stal

MrZ said:
I'm looking at page two of the attached:

Protocol using AlphaTrak.

Again, this would only apply if 80-130. Getting ready to test.
Click to expand...

I can't open the link to Protocol using Alpha Trak page two.

I think you're fine to shoot the full dose. The meters are allowed a 20% variance, and that 189 and 173 are within variance, another words they are about the same number.
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189;Drop to 173. Stal

Thanks. We shot just 11 minutes past the +12. We'll be watching him very closely next 2 hours to see if indication is active cycle.

For now, I'm leaving the 911 until we have an indication that we're not gonna have a huge dip. I hope that's ok.
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189;Drop to 173. Stal

Your link to the AlphaTrack info doesn't work. You need to set the access permission to anyone with the link. Are you using Table 3 that's in this link?
Initially test which of the alternate methods is best suited to the individual cat:
  • a. Feed cat and reduce the dose by 0.25-0.5 IU depending on if cat on low or high dose of insulin
  • b. Feed the cat, wait 1-2 hours and when the glucose concentration increases to >100 mg/dL give the normal dose. If the glucose concentration does not increase within 1-2 hours, reduce the dose by 0.25 IU or 0.5 IU (as above).
  • c. Split the dose: feed cat, and give most of dose immediately and then give the remainder 1 to 2 hours later, when the glucose concentration has increased to >100 mg/dL.
    If all these methods lead to increased blood glucose concentrations, give the full dose if pre-insulin blood glucose concentration is 50-100 mg/dL and observe closely for signs of hypoglycemia. In general for most cats, the best results in phase 2 occur when insulin dose is as consistent as possible, giving the full normal dose at the regular injection time.
Click to expand...
Most people do not have the time to stall and split the dose. We've also found that splitting the dose opens up a host of problems with overlapping nadirs. Waiting 1 - 2 hours and shooting after you've fed also means your potentially shooting a food spike. I'd strongly encourage you to read what we recommend for dealing with a low pre-shot number. Our modification is based on the original protocol. The protocol was published several years ago and Rand has not changed this table despite modifications made by her co-author, Kirsten Roomp that can be found on the German Lantus board.
 
Re: 9/7 Zeke-AMPS 453;+11=181(AT);PMPS=189

Yes, that's what I'm referring to (Table 3B). I was just preparing in case we we're faced with a =>130. As Zeke wasn't that low we just did the shot. My concern was that his had BG dropped just before the shot, but as explained the drop was within the margin of error for the glucometer. Additionally, I was a little nervous about the fact that his BG has been dropping all day (not just through nadir).

I have read the guidance provided but like to post on the board for advice from those of you who have much more experience with application of the Protocol. Guess my confidence is just not there yet. I like the reassurance you provide.

I agree with you points on the low-shooting options and if faced with an 80-130 PS, my preference would be to test the first option - reduce the dose by 0.25 and shoot as scheduled.
 
Zeke's earned a reduction tonight. We're monitoring closely, testing every 30 and feed MC and LC to guide him to safe number. He still has 2 hours to nadir. Gonna be up as along as necessary to make sure he's up and not going back down.
 
Status
Not open for further replies.
Back
Top