? 15/09 Eddie: AMPS 317 +3 119 +5 50.5 +6 76 +7 88.2 !!!!!! LOW

For continuity: previous post
https://felinediabetes.com/FDMB/thr...4-increase-in-thyroid-medication-also.254251/

At the +5 with the LOW, I gave a little low-carb food. At +6 we've got 4.2.

That was a ride. Does this have anything to do with increased Thyroid medication??

Phew.

 

Yikes! That is way too low on AT2 meter, glad he came up for you with just some LC.

2.8=50 on US mg/dL, most members here follow that measurement, so perhaps going forward if you don't mind putting those numbers instead in your title. I understand the mmol/L because I'm in Canada

Your SS says 3.2 but either way, that's still too low on AT2.

The +3 was quite a bit lower than your preshot, so that signalled you would have an active cycle. It might have been worth getting a test at +4 to see what he was up to, and try and slow the drop with some higher carb food.

Regardless of which dosing method you'd like to follow, that 50 (or 57?) earns a reduction down to 13u, but it might be worth re-reading them if you haven't already, since there are also differences in how long to hold doses, in addition to when to take a reduction.

Dosing Methods

Just another observation, when you get a number under 68 on AT2 that would warrant closer monitoring and I would suggest for next time not waiting an hour, but retesting between 20-30 minutes, since you don't want them lingering under 68. It is also suggested you intervene with a teaspoon or two of HC, depending on how carb sensitive your cat is. This time LC seemed ok, but something to consider if (when) you have low numbers again. Here is the info post on How to Handle Low Numbers

While the references are for human meters, the idea of intervening with HC and testing more frequently remains the same.

 

Hi Christie, I'm also in Canada and I was filling out the SS using the World mmol/L. There's another page on the SS that should open showing the other system as it converts automatically. Anyway, when I made the post, I was kind of shocked at what I saw. I entered 3.2 because that was the second reading. The first one was 2.8!!!!! As soon as I saw that I gave the food. I do have an emergency hypo kit. I was on a conference call in between the reading, the feeding and the next reading which showed the increase to 76 from 50.4. Just retested @ +7=88.2

I'm not always able to test. I have to test when I'm working from home but had a meeting elsewhere today.

 

waving to you from Calgary . Thanks for clarifying, I wasn't sure if there was a typo. It sounds like the 3.2 was just after the 2.8? I would have been shocked too, very good job for you to not panic and retest again to see if it was a wonky strip. Congrats on the reducie!

 

Hi, yes, the 3.2 was about 40 seconds after the 2.8, just as long as it took me to discard the strip and the lancet, and reload and gather kitty.

I'm home and will be keeping a close eye on him...Thank you!!!

 

Also, P.s. waving to you from Kelowna!

 

@Wendy&Neko @Christie & Maverick

Eddie went back up again to 218 so I'm assuming we stay at 14u??

 

N

No, no. Dose is based on nadir, and since this dose took him too low, you reduce to 13U.

Any time you get a number below 68 on an AlphaTrak you reduce the next shot, and hold that reduction for at least the next few shots until you can determine if it's a failed reduction, or he earns another reduction.

 

Yes, yes, you're right. I went into the kitchen and went "whoa! it's not the PMPS number! It's the nadir!!" and I came back here and see you've just answered! Thank you and the light went on!

Thank you!!!!!

 

Oh good I was hoping to catch you before you gave the shot. You'll get the hang of it! I edited post above to clarify but you probably didn't see - you hold the 13U until you can determine if it's a failed reduction, or he earns another reduction.

For now I'd suggest any time you're thinking about changing the dose to post here first.

 

Thank you!!!

 

Late again, but Melissa did a great job helping with dose. I am in Victoria this weekend, so slow to get on line.

With close together reductions, and after SRT, I would consider a slightly larger reduction next time if he does this again. Some post SRT reduction come in bunches. Combined with thyroid med change makes it interesting.

 

Hi Jodey, sorry was caught up in a few things, I mentioned in my post #2 earlier to take a reduction to 13u

 

Got it, thank you!

 

Yes, it's so great having this support!

It's also really intriguing this reduction series: SRT "bunches" says it all. He's now in day3 of his thyroid increase, too.

I'll check him again tonight.

Goodnight and thank you all!!!

 

This is only true when following TR, otherwise with SLGS reduction under 90. And no concept of failed reduction with SLGS, caregiver holds the dose for 7 days and reevaluates, unless another reduction is earned in the meantime. Jodey, that's one of the differences in advice given depending on following TR or SLGS so it would be worth having a look at the dosing methods as I said before.

 

@Jodey&Eddie What thyroid medication is he on?

Remember, when a dose reduction is warranted, it’s warranted. Sit on your hands when you see a high number later in the cycle and resist the urge to stay (or go) to a higher dose. The low number drives the decision process.

 

I've been in training (since I started a SS) to follow TR in this past while, with support from this group. The vet (internist) that I've spoken of before is a follower of SLGS and had me holding the dose for 7 days followed by a BG curve. Nothing changed, not really. Up and down with the same results and not really thinking the SRT had anything to do with Eddie's numbers. I know the vet cares about Eddie but even as an internist seems not to know much about acromegaly and seems to want to treat Eddie like a bona fide diabetic cat.t

I have booklets filled with BG curves and even when Eddie was going into the blues and even the greens, I was holding the dose for the 7 days and it just seemed we needed to go another way.

 

Yes, I believe she said she was trying to follow TR?

Edit: I see her reply. Jodey, if you're sticking with TR would you mind updating your signature and spreadsheet so we know?