Re: 4/6 Tasha Alphatrak Curve: AMPS 150, +2 166, +4 110
Please note that I typed this before Tasha fell into low numbers today.
Good morning Karisa,
Here's the link to
yesterday's condo.
I'm confused, why did you shoot the full dose last night on the same PS that was too low to shoot yesterday morning? Please take a look at the
Data Ready sticky
There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin.
Let's talk specifically for Lantus and Levemir. This is about fine tuning your curves.
Are you data ready to handle a lower preshot number?
This is where the very early cycle spot checks (those +1's, +2's) and those very late cycle spot checks (the +10's, +11's) come into play. Call them the "neglected" spot checks. Everyone gets those +6 spot checks, but there is a reason to collect data in the very early and very late part of the cycle.
Say you get a preshot of 150. Well if you've collected the data on the average time it takes the insulin to start having any effect for your cat and what happens after +12, then you might see that shooting a 150 is actually very safe in your cat. Kitty will be in the 200's before the insulin starts working. You are then using the lag time (aka overlap and carryover) between shooting and effect time to your advantage.
You need to collect the data to get ready to shoot lower numbers....it's risky to shoot those numbers without the data, and we are all about safety here.
In addition to stalling without feeding when you get a low PS, when you shoot your lowest PS ever, we encourage you to get at least a +1 and +2, and further tests as dictated by the numbers. Take a look this post by Libby about
Dealing with Low Preshots.
Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.
The 61 you saw last night is equivalent to a 31 on a human meter...quite low. In that situation, you should give HC and/or karo and retest in 15-20 minutes to make sure she is rising. You don't want her hanging out in numbers that low. Cats can go from seeming fine to full blown symptomatic hypo in a very short time. You cannot judge by behavior alone, you need to test often and keep feeding until her numbers are in a safe range (above 80), and then continue to test to make sure she doesn't drop again after the HC wears off. Please take a look at this post by Sienne about
Handling Low numbers.
I would urge you to print out those linked stickies and posts so you have them on hand when you need them.
Tasha earned a dose reduction by falling below 80. Please take a look at the second table in the linked protocol, there is a specific table for AlphaTrak meter users.
TR Protocol
Please reduce Tasha's dose. I would reduce at least to 1.0u, since she was still low 24 hours after skipping a shot, but she NEEDS to be reduced by at least 0.25u. This dose is clearly too high....she needs a reduction for safety's sake.
I have no direct experience with clavamox, so I will let others address that concern.
I know it's difficult to trust people on the internet over what your vet is telling you, but I am very concerned about Tasha's safety if you continue to follow your vet's advice regarding shooting low numbers without adequate safeguards. We shoot low numbers all the time here, but the difference is that we have collected the data to know how our kitties will respond, we test vigilantly to make sure they stay in a safe range, and we follow a proven protocol regarding dosing. Please look at other people's SSs, read their condos....see how others are managing their cat's numbers.
