? 4/14 Benny AMPS 145 Did he hypo overnight?

https://felinediabetes.com/FDMB/threads/benny-amps-452-2-344-then-blue-curve-questions.261942/

Hello everybody?

This may be a wrongheaded question, and if so I'm sorry! Benny's AMPS was 145. I took it twice and it was the same both times. I'm happy about it, but...did he likely go hypo in the night, since the nadir was probably passed earlier?

I gave him a half dose because that's what the vet told me to do if under 200 but I should be talking with her today and going over what I'd like to do regarding SLGS or TR. I don't intend to keep giving only a half dose.

 

In this case we just don't know. But remember that hypoglycemia on a human meter is under 50. We reserve the phrase "hypo" for an actual symptomatic hypoglycemic event, which usually are under 30/40. Each cat is different, some become symptomatic before others - mine has been as low as 32 without symptoms (but you don't ever want them that low!).

Realistically, no I don't think he went that low. He bounced, and then broke the bounce. When they break bounces it's often a later nadir, sometimes even at shot time.

Since you haven't picked a dosing method the question is more did he go below 90 and therefore earn a reduction? We just don't know, so if you end up choosing SLGS especially you'll want to keep a lookout

 

my goodness Benny a blue AMPS!!! This is wonderful imo. Let's put those black squares behind us Benny!

 

Yes, that's what I was afraid might have happened with Benny. It is good to hear that you don't think that happened!

I've read about the bounce, but I confess I am still not fully understanding the details. Did the bounce show up in his numbers of 4/13?

Thank you!! Poor guy, all it earned for him was a double ear stick when I had to take another AMPS to make sure, lol. But I'm really happy!!

 

I suspect it was an odd combination of a delayed bounce plus the half dose. He had a big drop on 4/12 AM cycle and spent some really nice time in blues, that would cause a bounce in a fair amount of cats. He didn't come up too much, and I suspect if you had given full dose yesterday AM he may have stayed flatter.

But you can see he kept climbing throughout the 4/13 day because there wasn't enough insulin to offset the BG, and he continued to climb through at least part of the night. Then full dose got him back where he needed to be. It may not have been a bounce, but the PM cycle has the hallmarks of one.

Now I would have recommended another test about 20 minutes after the first time you got the 145, just to see if he was flat/rising. We have to be cautious if shooting a dropping number.

 

I did not think of that. I always think about the "give insulin at the same time every day" but may be too literal about that. What do you think is an ideal time to test him again? I'm trying to keep it to a minimum whenever I can because he really hates them. Planning on getting the Libra soon so hopefully can avoid that.

 

When you shoot a lower than usual number it’s best to get a +1 and +2. Please test when you read this as it’s close to +3 I think.

 

I had to leave the house before reading your message. I just tested at +5 and he was 81.

I'm confused; I'm hearing that the 1.5 units I'm giving is too low. Is it actually too high for a number like his AMPS?

 

So I am going to let melissa continue to answer some of this. However I will add that lantus dosing is not based on AMPS or pmps...rather based on how low the dose takes him. So the vet saying to base how much you give him on his preshot number is imo very wrong.

 

Can you test again in an hour after that 81? We want to make sure he's stopped the drop.

My girl often did a pink to blue slide overnight. When a cat is breaking a bounce the nadirs could be later. It's likely he was safe overnight cause the +2 last night didn't show an active cycle.

 

Oh, and feed the guy a couple tsps of his regular low carb food to see if we can get him to hang out in those nice healing numbers. 81 is a good number, let's try and keep him there.

 

Right now he has a mish mash of a depot. So it's not the 1.5U thats too high it's potentially the 3U or somewhere in the middle that is, but only if you're following TR.

Did you talk to the vet yet?

See what Wendy and Elise think about dose

 

Of course all this would be happening when I'm in meetings. At +7 he was at 66. I did feed him his usual LC food so that should help.

Should be later today. Are the different doses confusing his system? Is that what you mean when you say a mish mash of a depot?

 

Are you using the AT per your spreadsheet or the Contour next per your signature? 66 is too low on an AT and still fine but getting lower on the Contour. Any chance of another test after that 66, I don't like to see he's still dropping. And if you are using the AT, he needs to come up, which might mean high carb food.

We find that with our dosing methods, it's best to stick with the same dose, unless of course the cat goes too low or we see they need an increase. We dose based on how low the dose takes the cat. Since you haven't decided on dosing method yet, it's best to be conservative and I'd go to 1.25 units next. That's what SLGS dosing method suggests you do.

 

[

I'm using the Contour. I listed that on the spreadsheet but did not know how to make a nice banner, lol.

So with his PMPS of 247, a shot of 1.25 would be the better way to go than 1.5? The 1.5 got him down to 66 at one point, which is low, but...was that the depot being filled by the 3 units from the night before? I'm stalling for now.

 

The color coding needs to be changed since you are using a human meter. @Bandit's Mom can do that for you.

If following TR shoot 1.5. If SLGS you need to reduce to 1.25.

 

Thank you!! Shot 1.5. Will do more tests.

 

There is some effect from the 3 units dose, but you also did two 1.5 units doses before that. SLGS says to immediately reduce by 0.25 units if the cat goes below 90.

 

Ok if TR is your official choice please add to signature and spreadsheet

Not sure what you mean by banner? It's cell G3 roughly that has the meter. Row 41 notes the change to the contour which is good, but you'll want another one above the first row of data saying AlphaTrak - just so we know the first few months were AT. And yes the ranges need to change if you know how to do that with conditional formatting

 

It's not official yet. My vet was supposed to contact me today, but didn't. The clinic is open tomorrow; I'm going to pursue that conversation as early as I can.

Maybe Bhooma can help me because I'm lost.

His +2 was 323.

 

Ok, I just assumed since you're sticking with the 1.5U. No worries!

Looks like a bounce, as to be expected. He tends to clear them quickly so I'm curious what happens tonight and tomorrow. I would get a +7 tonight just as a piece of the puzzle...I'm not expecting much but he might be sliding down into AMPS like he did today. Hard to say how long he'll bounce for.