7/23 Toeby AMPS 133, PMPS 85, +1 70, +2 79, +3 113, +4 133.

Thursday's Thread: https://www.felinediabetes.com/FDMB...mps-149-2-5-178-pmps-178-2-101-3-5-97.250192/

Lowest morning preshot since his last sub-50 hypo level ten days ago.
I will have to keep an eye on him this morning

 

Nice numbers. He is really liking this increase.

 

PMPS 85 - Stalling

I have a note not to shoot under 5 mmol/L and he is 4.7 = 85 mg/dL

Should I retest him in 20 minutes and skip his shot if he is still under 90??

 

20 minutes after 85 PMPS he is 77

He is hungry and wants supper.... can I feed him and give him his insulin later, or should I just simply feed and skip his shot tonight?

 

Laura, you are on TR. You are supposed to shoot anything over 50 but only if you can monitor and feed when necessary. Hopefully, some one will step in to assist you.

 

Thanks Summer... I have been searching for a quick answer and cannot find one...
When I have notes like this for myself it makes me nervous to proceed without confirmation
We are feeding him now

 

Are you able to monitor if you shoot? That number is not too low. @carfurby Can you step in here? I think she should shoot but only if she can monitor him tonight.

 

I can monitor tonight.... however, I am sure he is going to go low on me.... absolutely sure of it.... he has been low all day
Maybe TR is not the right approach for me because this doesn't feel right.
He is eating right now.... I will give him his insulin and keep the high carb food very close by

 

I fell asleep watching our suppertime news and woke right when it was time to test him and feed him...
Maybe I was/am a little befuddled as a result, but I saw this note I had, in big letters, stuck to my computer, not to shoot under 90 so I kind of panicked.
Sorry all...
Giving him his insulin now... he has eaten his supper

 

It is the weekend and sometimes folks aren't around. I know you stalled but then fed. Can you get another test? I think that as long as you are able to be home and continue to test then you should shoot. Hopefully, we will hear from the pros.

 

Laura, your spreadsheet says you are on TR which means you should shoot any number over 50. If you are not comfortable with that then switch to SLGS. Shooting a 77 is not risky if you can be around to test and feed if the numbers drop. Can you test again now?

 

Summer I already answered you....

 

For clarification: I mistakenly thought I could not shoot under 90 under the TR protocol.
As Summer reminded me, I am supposed to shoot anything over 50.
Toeby tested 85 at PMPS, then 77 twenty minutes later.... I fed him, and gave him his regular dose of 0.40 units Lantus
I AM able to test him tonight, and will test him at +1 after his shot.

I apologize for any misunderstanding or tags to moderators - I was confused but I thank @Summer and Susie for reminding me that I am supposed to shoot anything over 50

 

What are you talking about? What answer did you give me? I'm sorry but I am a little confused with your statement. I thought you said you had a note on your computer not to shoot anything under 90 but you also have listed that you are on TR which means you shoot anything over 50 if you can be around to monitor. Doesn't matter. I'll let the pros come in and advise.

 

Now I'm going to get my head cut off for advising. I am not in the position to advise. I hope you hear from someone who is. Just test him. The 77 was not a bad number. You just need to test him every 30 minutes and feed as required to keep him up or raise his number. For me, if Susie drops below 50 I always feed high carb. If she is in the 50s I feed medium carb. If she is in the 60s I will give a tsp of l/c. It is all about monitoring to make sure they stay safe. Hope you hear from someone soon and good night.

 

PM +1 70
I gave him a bite of MC food, I'd rather be safe than sorry
Will keep an eye on him and check again in another hour.

 

bump

 

+4 133
It looks like giving him the 13% snack early in this cycle at +1 may have bumped him up too much, but I did what I thought was right for us.
I thought he was setting up for a big drop tonight after being green most of the day, and with a lower preshot reading than I am used to.
I don't think his readings in the last 4 hours since his evening insulin are excessively high, but they're probably not low enough by the TR standard.

 

Hi Laura, Sorry no one got back to you tonight. I've been working a lot and have not been on the board much but it looks like you did all right tonight. Toeby seems to be reacting well to the budesonide everyday. For a kitty on steroids, Toeby is doing great as long as he's feeling and acting well and not bouncing into any yellows and going above renal threshold.

 

Hi Katherine,
No problemo!
Like I tried to explain, I woke up from an unexpected nap right when I was supposed to be getting him looked after and I was in a bit of a flap because his 85 preshot reading was the lowest I've had since April.
(Which is actually a positive thing, I guess).
I find it difficult to find a definitive answer to some questions quickly on this board - there is just SO much information in so many places... I was using the search function with the word "stall" and reading links and not finding a simple answer.
I have a list of the general guidelines for TR, with dose increases and reductions, on my wall but I also had a sticky (maybe left from when I was on SLGS) that said to stall when he was that low...
All good, at least until the next dopey panic...

I think this lower dose of budesonide is doing good things, even on a daily basis?
I'll be writing his new vet in a week's time or so to report...
One thing, this new vet does NOT think it's wise that I am trying to control his BG's tightly - she said she'd rather see him safer up in blues than going too close to hypos in low greens.
So that's on my mind a bit too.
Laura

 

As an example, there's a Sticky for Dosing, TR and SLGS, that is easy to find quickly when you're in a rush.
It clearly lays out a protocol for "How to handle a lower than normal preshot number:" for SLGS only.
I don't see where it says, clearly, to shoot any number above 50 if you are following TR.
It could say something to the effect of, "If you are following TR, and your cat has a lower than normal preshot number, as long as it is above 50 and you can monitor, proceed with his shot"
But it doesn't...
Unless I am missing it when I am reading this sticky??
@PerfumedCatMom, am I missing something?