? 12/6 Henry PMBG 65 +13.5 91 + 14.5 76 + 15 77 +17.5 63 +18.5 75 +19.5 75

Henry posted a AMPS 0f (117) (6:00am EST)

If you look at the spreadsheet from 12/04 to current date these numbers are the HUMAN METER.

It appears Henry could drop 60 to 70 points

Need help to guide me thru

Available WET FOODS in CARBS (2, 5, 7, 10, 19, 20)





Previous Thread

 

I would start with a +2 and feed accordingly. He seems to be flattening out and he is at a lower dose now.

The drops are usually more when preshots are high. Hopefully he will have a nice flat Lantus cycle.

I am curious to see if his nadir is still at +4 or later. He seems to be at more or less the same level as +5.5 last night.

 

I will check BG at AMPS +2 (6:00am EST)

 

You could also feed him a tsp or two of his usual LC at +1 to stem any drops at onset.

 

OK

 

Fed Henry (2) tsps of 10% carb at AMPS + 1 (7:00am EST)

 

Just realized that the link to your previous thread doesn't work.
Also, I could be wrong but in the SS, you've put "Fed Henry 2tsp of 10% carb at +1" in yesterday's row. I think that's for this morning?

 

Robert --

My kitty was notorious for fast drops early in the cycle. She also had an early nadir. What I would do is to get early tests. If you look at Gabby's spreadsheet, you'll see I would often test at +1 and +2. If she was dropping at +1, it gave me the information as to whether I started to intervene early. There's no reason to not test as early as you want if your instincts are telling you the your itty may be looking to earn a reduction.

Henry is seeing great numbers. The challenge it to not add high carb too early or too late. It's great to see Henry surfing in lower numbers. It helps his body get used to being in closer to normal numbers. The longer he spends in the normal range, the better. However, if the numbers are dropping fast, you want to have the time to intervene and gradually steer the numbers back up (vs. having to go to really high carb and add to what may be a big bounce). It takes practice as well as nerves of steel.

 

Henry's BG reading at AMPS +2 (85)
Just fed Henry (2) tsps of 10% carb wet food
Will do another BG reading at AMPS +3

 

Henry's AMPS + 3 (54)
Just fed Henry's (4) tsps of 20% Wet Carb

 

Robert

Good morning! Looks like Henry has been busy. Please be sure to get another test 30 mins after he finished eating.

Also, as soon as you get a chance, please take down the 911 and request for help as you have eyes on you. We always ask that as soon as possible after someone responds, that you remove 911s, etc, That frees those helping to help other members. Sometimes four or five members might be working low numbers at once.

I know this was scary. It’s the first time he’s dropped to such a low number and the human meter makes it seem even lower but 54 is normal. The drop is the issue to br most concerned with and I saw Sienne provided you with good info. Just for the future, we expect to see a spike at +1. If you have as much of a drop by +2 as you did. I’d have checked at +2.5. But....to stress the point Sienne was also making, since he was a lot lower at AMPS than when you went to bed, I’d have gotten a +1. No criticism....just a lesson for the future.

Henry seems fairly responsive to carbs so I would have gone with 1 tsp of the HC but....it’s a learning experience and so we shall all see how he reacts and if it stops the drop.

More in a bit. Deep breathe. I’ll check back in when you get the next test. Now my first

 

It will not be 30 minutes but 60 minutes for the test as it is 9:53am EST

 

Congratulations! Looks like Henry earned himself a reduction.
New dose is 3.75u.
Test again In 30 minutes. You may see that 4T HC might have been too much.

 

Remember the other night how I talked about testing 30 minutes after feeding when the BG is dropping and he’s lower...and his numbers were higher then. If it’s been 30 minutes since he ate, p,ease test now.

Hey Sandy!!! So glad to see you. Robert has switched to all wet and might be trying TR. If he is, I’d like him to not reduce again so soon but we can all discuss. I need him to update his signature block because the dry is out of the picture.

Robert...Sandy’s BK took a fast trip down the dosing scale and she’s a great one for handling those grueling slides down.

 

Marje

Henry BG reading @ AMPS + 4 (75)

 

Great! You have +5 in your subject line, though Gave me a pause for a minute.

I’d lay off the food for now and test at +5. He might come back down because the HC will wear off. Sometimes it’s good to give a little bit of LC to hold the green. I’m not sure whether he’s totally processed all that 20% and whether he will continue to climb or come back down but let’s give the food a rest and deal with the +5 when we get there.


I have kitty chores to do but I’ll post more as soon as I get my two settled in...about 40 minutes. Have some coffee....or a swig of whiskey

 

I haven’t looked at your spreadsheet in a long time What a change! Congrats. Your hard work is paying off.

 

Henry's BG reading @ AMPS +5 (80)

 

Yes!!! I know you normally feed at +5.5 so I’d feed him his normal LC meal at that time and test at +6. Sound good?

 

Henry earned a reduction to 3.75 units @ PMPS (6:00pm EST today)?

I will check his BG at AMPS +6

 

I wanted to give you some more info and also check in with you about dosing.

First, the dosing. You all made the move to all wet so you could give TR a try but, with the last reduction, you reduced under SLGS. You left SLGS in your signature line so is that still the way you wish to go?

The reason I’m asking is we need to be very careful about taking back to back reductions. He’s still at a dose that’s high enough to have a large depot. The depot can affect up to six subsequent cycles after a reduction. That means that the 54 from today could still be from the 4.25u. With TR, we would not take a reduction because he didn’t drop below 54. I know you will ask if he would have dropped below 54 without the HC? I don’t know. It’s possible or, if you had fed LC or MC, it might have just stopped him at 54 and kept him flat there. I’m not saying you shouldn’t have fed HC; a drop that much that early does require a little more than LC. Point is, we dose based on what we see and and what “might” or “might not” have happened.

I’d like you to look at Lucy’s SS and scroll down to about 10/4/2008. Lucy was on TR and headed quickly down the dosing ladder dropping from 3.25u to.1u in a few weeks. And then she hit a wall. Libby had to go all the way back up to 4.25u before Lucy started back down and eventually went OTJ but Libby always said she learned a lesson about taking so many reductions so quickly in such a short time.

To answer your question about the reduction....it depends on whether you are sticking with SLGS or TR. If it’s SLGS, any time he drops below 90, he gets a reduction. IMHO, that “could” result in too many back-to-back reductions too quickly until one reduction is too many and he hits that wall and progress stops or stalls.. I don’t have a crystal ball so I can’t tell you exactly how SLGS will affect Henry.

OTOH, switching to TR means you hold doses until he drops below 50 so he would then not have earned a reduction today. Holding onto good doses longer, especially when they are doing this well, gives the pancreas more time to heal. I know you won’t believe me but there will be a time that numbers in the 50s won’t scare you. But....will you be more tired? It’s likely depending on whether Henry drops and when he drops.

But, it’s really important for you to make a decision. Summary:

SLGS.....reduce the dose tonight to 3.75u
TR....hold the dose

We are here to support you all.

I’ll check back at +6.

 

When I check Henry for his BG readings it takes my wife and I to do this check.
He's a very large cat which requires (2) people
In addition to that my wife has a full-time job with a major corporation and fortunately gets to work at home
She's had several mornings of being tired due to these late evenings let alone asking her to vacate her computer to help me do a test during the day

 

I appreciate your comments but just need you to verify which dosing method you are going to use.

I’m glad to see he’s leveled out at a nice number!

 

1) What Can I expect tonight at PMPS more of the same? So my wife and I can be prepared with no surprise

2) My wife is willing to help to get past this depot situation

3) So lets say this ==> If I reduce to 3.75 units at PMPS and hold for six cycles - I do not want the experience of Lucy's SS

4) I do not want to blow a chance of Henry achieving remission

5) I'm confused

 

I cannot get LUCY's SS to work?

 

Lucy’s SS is really old so let me work on the link. We’ve lost some capabilities of some SSs as google has made changes.

1. I don’t know. We are in new territory with Henry. The only way to know where he’s headed for PMPS is to be sure you get a +10 or +11 test.
2. I’m not sure what you mean.
3. If you reduce tonight, that is SLGS. That means you hold the dose for a week....not six cycles...or unless he drops below 90 within that week and then you reduce.
4. I wouldn’t want to either.

I’m not trying to put you on the spot as I’m not there but, over the years, we’ve had some very big cats here....easily Henry’s size. One kitty, in particular, was not only enormous but he attacked his CG every time she tried to test and she was testing alone. She found a way to do it by burritoing him in a towel so he couldn’t attack her and he eventually was very good with testing. You said Henry doesn’t mind the tests so I’m just having a difficult time figuring out why it takes two people to test him. I’m just trying to help.... so I need to understand what is different about Henry than other really large cats we’ve had here.

ETA: pls try Lucy’s link now. It just worked for me when I relinked it.

 

Marje

If I chose TR for the current time

How would I proceed with PMPS shot number do you shoot reqardless of what it might be

 

Henry most of the time purrs while my wife holds him and it allows me to prick him

Henry will not do the same for me he would squirm and he's extremely strong I mean really strong he could probably bench press 30Lbs

Also Henry is very high anxiety if a towel or anything out of the ordinary game over he's gone

 

This is what I get with Lucy's hyper link

This site can’t be reached
Check if there is a typo in %20https.

• If spelling is correct, try running Windows Network Diagnostics.

DNS_PROBE_FINISHED_NXDOMAIN

 

Can I do this change the 90 threshold for reduction to 70 moving forward?

 

It’s working fine for me now when I click on the link. I have all Apple devices so can’t run Windows but, again, it works fine for me. See what happens if you just click the link below:

https://docs.google.com/spreadsheets/d/1C_b57n4BlE_tI1scgl0ffw_QFC7I-zduokrvKspf_HY/pub?output=html

I wasn’t suggesting you burrito Henry. That’s just what Bonnie had to do with Junior because he seriously would attack her and draw blood.

If you choose TR. you would not reduce the dose. It’s safe to shoot anything above 50 provided you are available and able to test and you have all supplies. You haven’t shot a number below 100 yet so if you got a number below 100, it would be smart to have a member help you through it just as with the first times you shot blue numbers.

 

At some point as a member gathers enough data and can deal with most situations on their own, they can modify SLGS to change the reduction point. At this time, I wouldn’t suggest that for you all.

Before a member starts modifying SLGS, they need to understand their cat’s patterns including being able to identify onset, nadir, and duration.

 

OK I think SLGS is the way to go for now.
So 3.75 units at PMPS tonight
I will post AMPS +11 tonight
If Henry's PMPS reading has gone up from the AMPS +11 number then shoot 3.75
You do not like the delay and skip approach just deal with the numbers and feed to keep the insulin in check - Would it be OK to shoot under this method?

Now my wife is taking vacation from Dec 21 thru Jan 3 2021 FYI

 

Remember Lantus can get a second dip so the PMPS might be lower than +11. That shouldn’t influence whether you shoot on time or not. In fact, experienced members shoot dropping numbers at PMPS to take advantage of carryover and overlap.

I would suggest you shoot any number 90 and above on time with 3.75u since you have chosen to reduce.

Please be sure and get a test by +7.5 or +8.

 

Please be sure and get a test by +7.5 or +8.

I glad you brought that time frame up this was his lowest point of sugar under the VET care but here (the forum) it occurs sooner go figure

OK I will shoot at PMPS if 90 or above but under 90 delay and shoot when a rise is apparent.

Is a bounce possible tonight?

 

Yes. It’s always possible for a bounce to occur.

 

Marje Henry just clocked a (75) BG reading @ AMPS +11

If he's very close to 90 what would be the consequence of a skip dose

I'm scared

 

Marje
If delay every 20 minutes test (no food) and this method finally reaches 8:00 pm EST (two hours past PMPS)
I might as well skip the shot until the next morning correct?

 

Yes. If he continues to drop, then we will want to skip at the +14 point. Let’s hope he’ll start to rise; I’m pretty certain this is all due to the higher dose (4.25u) depot but let’s see. If, by any chance, he hits any BG in the 40s, feed him one tsp of LC.

 

We panic and fed him (2) tsps LC food (10%) minutes ago Will this influence the number in a big way?

 

Yes. It will. At this point, you should probably skip his shot because you fed him after +12 and we don’t stall any longer than two hours (to +14).

I’m not sure why you posted the “HELP, etc” when I had already responded In that response, I indicated that your plan to test every 20 minutes was correct and, if he got to the 40s, feed him. You have to get past this panicking at normal numbers. It isn’t doing him any good and it certainly isn’t doing you all any good. I can understand why the 54 this morning scared you but I had hoped we explained all of that. However, a 65 is a “no big deal” number. By following the procedure we’ve done before, he might have come up on his own; or not. And if he didn’t, we would have addressed it.

What can I do to help you all so you can take the time to post and read through the posts that have been left for you before you take an action? I’ll be happy to help you any way I can.


ETA: please everything from the subject line except the date and his name and just put
PMBG 65

You’ll also want to test him again in 30 minutes or so after he ate just to be sure he’s headed up but I’m not ok with you shooting any kind of food spike even if it’s small.

 

Marje I'm very concerned I'm wearing you down

I appreciate all your help.

 

Thank you but I’m good. I know you are appreciative. I may sound frustrated and it’s more that I feel I’m evidently not teaching you appropriately or giving you the confidence to trust me; I feel sure that we could have shot him by +14 tonight. That’s why I asked what I could do to help and ease your panic.

Be sure you do test him tonight to make sure he comes up or at least doesn’t drop any more. The depot can cause the BG to continue to drop even if insulin isn’t given. If you want to change your shot time, do it in the morning. With a skipped shot, you are free to shoot earlier or later if you want to change the time. Dose will still be 3.75u.

 

Looks like he’s fairly flat. You can probably let him go until +17 or +17.5.

Sorry to be so picky but it does matter to those watching. You have the PMBG recorded correctly in the subject line but because you didn’t shoot, the subsequent numbers will be from his last shot this morning. What you have as +1.5 should be +13.5 and so on.

To have it as you do will confuse people as to whether you shot or didn’t shoot. Thank you!!

 

OK I will test at AMPS +17.5

I changed the title to reflect BG readings AMPS + 13.5 (91), AMPS + 14.5 (76), & AMPS + 15 (77)

Thank You

 

You’re welcome and thx for fixing the subject.

 

Henry BG reading @ AMPS + 17.5 is (63)

 

So do I check his BG at 18.5 to see how the food is affecting his BG and if his BG reading is going down?

 

@Marje and Gracie , @Wendy&Neko , @Chris & China (GA) , How long should Robert continue to test Henry? He is still pretty flat despite the skip (some depot!)

 

Bandits Mom I just checked Henry BG reading at AMPS + 18.5 (75)

 

I think she could probably stop testing and start over at the usual AMPS time. Leave a little low carb food out for Henry just in case

 

I want to verify that at the AMPS if Henry is below 90, he should still receive a 3.75 dose, right? Then we continue to test him every hour or should it be every 30 minutes?

 

At the AMPS, is there a BG number that we wouldn't shot him at?

 

Robert, this is what Marje said earlier. Since you are following SLGS, you do not shoot below 90. I guess he should start rising towards the end of this cycle.

 

You’ve been at this a while and so, if you are comfortable, I’d shoot anything above 90. Be sure and get a +1 and a +2. There are a lot of people that could help you but mornings can be hectic for the people that are working.

If he gives you a number below 90, stall without feeding and test every 20-30 mins and shoot the rise above 90 with 3.75u.

 

ok this is what we will do. We really appreciate everyone's help!

 

Chris the last bg reading of +18.5 (75) could have ticked up due to being fed an hour earlier

 

it's still a nice safe number and you haven't given any more insulin in over 19 hours so the chance that he'd drop back down under 50 are slim and none (and I'm betting on none)

That's why I said you could leave a little low carb food down for him if you're concerned

 

I need to separate him we have (3) other cats
By the way his BG reading @ + 19.5 (75)

 

Not dropping any more. He will be fine. Take a break, Robert. You must be exhausted.
Feed him a tsp of the lowest carb you have - if it will worry you less

 

Yes I'm very exhausted

Have you had episodes like this?

 

I've never personally experienced such a prolonged depot action! Bandit hasn't been on such a high dose.
I know it's exhausting, but Henry is doing so well! You don't want to lose momentum. Sorry if I am adding to the pressure you feel!

 

Has people achieved remission for their cats under SLGS method?

 

I've been here only a year and more people here follow TR now, but from what I've read, SLGS was the method that was followed before TR came along and cats did go into remission with SLGS. I think TR gives the cat more opportunity to stay in lower numbers which helps.

Why not worry about this on another day? Who knows what will work for Henry? And these decisions are not set in stone. Once you get comfortable in lower numbers and have more data to understand how Henry behaves in lower numbers, you can always switch to TR.

Now off to bed. AMPS is but a couple of hours away!

 

OK I'm going to bed

Thank You