? 11/4 Eddie AMPS 63 (2x)) AMPS +40 85 +2 94 +4 76 +6 104 +8 135 +10 151 PMPS 180 +2 167

I fell asleep after the 3:30 am test. This morning AMPS 63 (2x): STALLING

WRITTEN AT 3:30 AM: I'm sorry but when I'm up doing a test @ 3:15 am, I'm not the sharpest knife in the drawer. Where do I put the times when it's 11/4 but I'm doing a +7 from a 11/3 PMPS?

Anyway, this is yesterday:
https://felinediabetes.com/FDMB/threads/11-3-eddie-amps-227-3-178-7-135-pmps-128-2-158.255021/

Because he was in the blue at +2 (PMPS), I set the alarm and right now he's 108, which I think is good?

Again, I apologize for the confusing thread title. I'm just tired.

 

You've done it right. All the tests between PMPS and AMPS will go into the PM cycle of that day (even though the date changes at midnight).

Did you feed a little when you got that 108?

Unless he drops below your reduction point, you would hold the dose. Let us see what he does between +7 and AMPS!

 

Thank you! I gave him a very tiny (token) snack for being so patient with me. I’ve got to get a bit more sleep (meeting in the morning) but yes, I’m really looking forward to seeing the AMPS!
I will set alarm for 2 hours from now.

 

@Bandit's Mom As my title says, we are at 63 AMPS, so I'm stalling as I got it twice. I just gave a teaspoon of h/c food. Test again in 10 mins.

I took the shot @11u when we went up to 84 at AMPS+40. I hope giving 11U was the right thing to do and that he hadn't earned a reduction. That's what I've got to learn next.

Also: @Wendy&Neko what do you think?

 

Sorry I didn't see this earlier! You do not shoot below 68 on the AT. You stall without food and test after 20 mins to see if he come over 68 to shoot. If he continues to drop or stay flat, you feed a little LC and test in 15-20 mins.

He has earned another reduction with that dip below 68 this morning. Please take him down 10U tonight. Congrats!

Please do watch him carefully this morning. That's not much of a food bump he got with HC. Please test at +1. You may have to feed HC depending on this numbers.

 

Thank you!! I could not find the don't-shoot-below number in the emails/posts so I waited until he got to 84 @AMPS+40. Then I fed him and gave him 11U.
I'm home today so can watch him carefully. In fact, I just did +2 test: 94 (I missed the +1 with a meeting I had to attend). I'm here now. Will post and hope we can enjoy the reduction tonight.

 

Here's the sticky, but the numbers mentioned there are for a human meter:
Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers

Btw, why do you use an AT and not a human meter? The strips are pretty expensive. Covered by insurance? Apologies if I have asked this before.

 

I'm actually just reading that Sticky right now. I've used AT from the beginning and for no other reason than it was recommended to me by the vet. You're right, the strips are expensive (like over $1/strip) and I'm burning through them. Right now, since joining FDMB I didn't feel confident to switch horses mid-stream (or meters, for that matter) since I was at least comfortable with the AT...so at this point I'm trying to learn 1) when and how to stall and 2) when (what data) to reduce and, finally, 3) what data=no shoot.

As you've seen, I'm particularly challenged when I'm checking at 3:30 am. I think that had i given him a larger snack at that time, he might have been higher at AMPS (but I'm guessing here).

This is what I'm concerned with today with the low at +2 and the approaching nadir: "You are not shooting the number your cat is at now – you are shooting the number your cat will be at when the insulin kicks in. You need to know what that number will be."

 

So the AMPS cell should read 84 since that's what you shot. The others should go in yesterday's +11 cell stating "63@+12 stall"

Its hard to predict what they will be by +2 or nadir, doubly so for acrocat post SRT coming off a bounce lol you just go off trends the best you can. The point of that statement in the Sticky is moreso that BG will continue to rise (in most cases) in the 2 hrs after the shot, so don't be too freaked out by shooting a lower number. On the flip side, it also means don't shoot a low dropping number.

Let's see how he does rest of the cycle...he wants these reductions, and if the middle of the night stuff is difficult for you/you need some sleep it may be better to take a slightly larger reduction tonight and resume with 10U in the AM. There's still larger depot in play as well.

My two cents...I'd consider 75 as reduction point for AT if he were my cat.

As always we'll see what Wendy has to say

 

As we've said before, an acrocat post SRT means caution. Never shoot below 68 on at AT. Take reductions when earned, or even when you think he's close to earning them. This last statement is only for caregivers of acrocats that are going down dose post treatment of some kind (SRT, cabergoline). You can always go back up in dose if you need to, but you seldom do. It's safer that way.

If you were using a human meter, I would suggest 70 as a reduction point. I have no clue what that translates to on an AT. 75, 80, I don't know, just pick a higher number than 68. Using 68 as a reduction point at this point in time in Eddie's diabetes journey, does not give enough margin for safety.

As for tonight, since you didn't shoot a reduced dose this morning, and Eddie has been earning reductions every 4 cycles lately, I think it might help to reduce that depot some by doing a one time BCS or reduced dose tonight. So something like 5-6 units. In addition to reducing the larger depot, you might get a bit more sleep. Eddie could be higher in the AM, but I don't think it'll stop his progress. He's been pretty clear which way his dose is going.

 

Thank you. In addition to monitoring him today, I will, indeed, go with a BCS (just learned what that means .
This is quite an extraordinary time engaging with these reductions (in numbers and in dose). As you say, he's pretty which way his dose is going. It's seems to be happening quite rapidly, too.

 

I'd consider giving a little LC with that 76. Hard to tell when he'll nadir but better to keep him afloat

 

Yes, I did that, thank you!

 

We seem to be sailing along @Wendy&Neko and @FrostD and @Bandit's Mom . A +8 135.

 

That's beautiful! Would be great if he doesn't bounce this time but he is climbing a bit fast

 

Yes, and I wonder if it's because nadir was so early??? I'm going to test again @ +10 (and of course +12) and wondering if given the +8 (and depending on the +10 and +12) if @Wendy&Neko still recommends " to reduce that depot some by doing a one time BCS or reduced dose tonight. So something like 5-6 units."

*******The +10 is 151 so slowing down a little.********

In other words, given the numbers (and depending on the next two) my question (decision) will be: am I giving the BCS [5-6U) or just reducing to 10U????

 

That 84 this morning was after stalling without food? Because it actually looks like he nadired at +12, possibly a little double dip after. So it's a little uncertain what he may do at PMPS and a little after.

If it were me, yes I'd take the BCS, if nothing else for a little breather. I think he probably has a little too much depot behind him still. Wendy mentioned yesterday I think that BCS are usually about 1/2 dose, but she liked 2/3 for Neko - I liked 2/3 for Mr Kitty as well unless he was really coming down hard. But thats a little bit of "know thy cat". So I personally would do 7U but still keep an eye on him, but the 5-6U she mentioned is a safer bet. Then 10U in the AM unless low numbers overnight.

 

Let's see what the PMPS number is, but because you shot the old dose today, the larger depot is still in charge and I'd like to see it smaller. Think of it as an experiment.

 

Yes, the 84 was stalling without food. And, yes, I wondering about the nadiring too. I'm assuming when you say +12 it refers to the numbers at AMPS this morning? Which then gets complicated because although I stalled and got the 84, giving the does was part of the double dip. I think I can see that if that's what you mean.

I'll take the BCS. The only reason I was asking was because he started to climb but then at the +10 here, he seems to be levelling out so I had to ask.

This is so incredibly detailed. I have to say, though, that with you all here guiding my hand, I've learned more about Eddie than i ever did while he was just following the internist's "give him 14-15U for 7 days, do a BG." It wasn't enough and I don't think it addressed the SRT.

 

Yes, I'm prepared to do that.
Given the PMPS, the BCS will reduce the depot? Just going to take Max (dog) out for a walk and I'll be testing and posting again at PMPS, which is about 1.5 hours from now.
Thank you all for guiding me into the harbour.

 

Ah what I mean about the double dip is that AM +3 wasn't necessarily nadir, sometimes Lantus does a double dip, but Wendy would know far more about that than I would. I haven't seen it often.

I'm theorizing that your shot from this morning maybe hasn't done it's work yet, and you may see a +14 ish nadir from that. But I'm really not sure. The other option is that this morning's shot onset at normal time and helped keep him lower today vs bouncing... probably the more likely scenario.

 

About the vet - I've said it 1,000 times and I'll say it 1,000 more - this forum has saved Mr Kitty's life at least 3 times. First, when I found it and really learned about FD, home testing, dosing. Second, when he had pancreatitis the emergency vet did not do nearly enough, he lost so much weight, and through guidance here I was able to get him back. Third was the acro diagnosis and cabergoline info, and rapid fall into remission. Forever grateful to have Wendy along for that ride helping me out.

Edit: I'd argue a 4th time as well - the chylothorax diagnosis. Although nobody here had much familiarity with it, it was the lesson learned here that do your own research as vets aren't experts in everything. The recommendation at dx was to put him down because it's a death sentence, but here we are 4 months later.

 

@Wendy&Neko @FrostD @Bandit's Mom So, here we are at PMPS 180, which is relatively high, I guess, given the day but still worthy of the BCS, I imagine?

And absolutely YES to doing the research. I long ago decided that when it came to Eddie (or Blue) that I was fine with being seen as the either the Ideal Client or the Client from Hell because I wanted to ask questions.

 

PMPS 180...About to feed him and load for the shot. Given the PMPS would you go for 6u or 7u?

 

I hope I have done the right thing. PMPS 180. I decided to go with 6u for the BCS.

Speaking of vets: I know mine would flip out about this except that he never remembers what Eddie's dose is anyway.

@Wendy&Neko @FrostD and/or @Bandit's Mom : is there anything I need to look out for overnight???

Further, if all goes well, I will go with Wendy's suggestion in the morning of 10u.

Thank you.

 

- Said all of us, every time we took a non standard reduction at the very least it will be a good data point.

It does appear the AM shot helped cut the bounce a bit perhaps. Just the usual, a +2 or +3. If flat or yellow, can probably take the rest of the night off, maybe grab a +6/7 for good measure. If a drop, well... hopefully Bhooma's around lol I wouldn't expect anything too crazy with the BCS though.

 

It’s my first time BCS

 

I would start with a +2 or +3. If he's on the way up, call it a night.

There is no right or wrong answer for a BCS the first time. All part of that experiment to find out what works for Eddie, and you. Chances are he'll be a little higher in the morning. Not to worry. Stick to 10 units. (and don't forget to update the spreadsheet )

 

At +2 he's going down. PMPS 180 +2 167. So I guess I'm setting my alarm???
@FrostD ?

 

Sorry! I'm EST so I think about 4 hours ahead of you, by your +2/3 usually asleep. But yes with a slight drop (also factoring in BCS) I'd have checked again in about 3 hrs. +8 is ok but remember you want to try to test ahead of nadir to slow him down if needed.

He may be heading down towards shot time, or he may have nadired on/around that 121...AMPS will tell.

 

Good morning,
I’m about to do AMPS test soon. I had to get last nights’s test at +8 in as recommended by @Wendy&Neko because of the BCS. I chose +8 because by +2 I was already so tired I was falling asleep waiting for that one!
Anyway, the recommendation is to go to 10u so we’ll see what AMPS looks like. Fingers crossed!