8/06 Butters AMPS 275../PMPS 49/+0.5 59/+1 74/+1.5 103/+2 104/+3 92/+4 139/+6 283

Discussion in 'Lantus / Levemir / Biosimilars' started by Butters & Lyla, Aug 6, 2020.

  1. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Yesterday Butters had her sixth cycle of .75 U, after forcefully earning a reduction. And then she bounced. How long she bounces for, I think it is maybe 2-5 cycles. So do we call this a failed reduction?

    She never saw a green number in the last six cycles. TR says wait 6-10 cycles on a dose before increasing if nadirs are <200, unless the cat is new to numbers below 200. I don't know how you define "new" in this scenario.

    Anyways, I increased the dose back to 1U. Increases seem like a bigger risk to the cat than decreases, and I think are a bit more subjective. Hopefully I did the right thing by increasing.

    Have a good day/evening, all.
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    I hope the new dose brings better numbers. By the way, today is the 6th.
     
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  3. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Thank you Carla. And thank you for catching that. :)
     
  4. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    I'd be ready for an increase with numbers like that. Since you're home and can monitor closely and feed accordingly help her to become more comfortable in the lower numbers. It takes time and patience to do that...but the longer they're in the lower numbers the less bouncie they become.

    Have a great day Lyla!
     
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  5. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    That's good to know. It just felt weird increasing back to the 1U dose that dropped her below fifty only four days earlier. Who knows what she has in store for me next. :)
    Thank you Sue!
     
  6. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    So she gets a haircut late this afternoon, which is why I couldn't get anything after +7. I thought she'd be super stressed from the haircut, and instead she is at 54 for PMPS.

    I know I am not shooting the PMPS number, except, could it be that this is her nadir? I'm confused about what to do. I'll be looking at spreadsheets and posts to see what other people did. Would you shoot?
     
  7. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    I'll test again in 20 minutes to see where we are at.
     
  8. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    This cat...she is now at 49. So I guess I continue to stall for another 20 minutes? Meanwhile, she is eating every single crumb she can find and staring daggers at me. :eek:

    I thought the depot would've needed more time to fill since we only just increased the dose this morning. I'm so confused.
     
  9. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    I guess technically Butters earns a reduction with her 49. So it was a short-lived single dose of 1U.

    So that means I'm shooting the reduced dose of .75 this PM. And if the PMPS isn't the number to hang my hat on for actually administering insulin, I should be able to stop stalling and just shoot and get over it, and then address the below 49 with food (which would be her dinner since we are at PMPS). Do I have this right? I really feel like I do!

    @Sue and Luci @Wendy&Neko @Sienne and Gabby (GA)

    Thanks!
     
  10. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    I shot the 49 at the earned reduction dose of .75U, since 49 earns a reduction.
    She is eating around 1.75oz of LC for her dinner. Fingers crossed for some surfing tonight.
     
  11. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    We don't shoot #s under 50. I may be missing smthg in y'all's history but that is the rule. You wait until you get a shootable # which is 50 and above.
    I do hope this thread gets some attention.
    @tiffmaxee
     
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  12. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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  13. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    @Briere Fur Mom I just realized that, too. I was just reading the sticky on shooting low numbers.

    I'm Canadian and so on my spreadsheet the PMPS number that came out at 49 was not the neon green like on the US one. I got confused and thought it would be ok.
    She is 59 @ +0.5. I will be keeping close tabs on her. I messed up. Feeling like the worst mom in the world right about now.
     
    Last edited: Aug 6, 2020
    Reason for edit: Because I had put the world value instead of the US value for BG #.
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  14. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Hi. Shooting under 50 is not done even with long term diabetics. Please check again in 30 minutes. You know now. You can guide her cycle with 50 if needed. I hope you have mc and hc food and karo or syrup if needed. Maybe she will bounce.

    Next time this happens, stall or post for help.
     
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  15. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Everybody makes mistakes. It's all about learning:bighug: Do keep an eye on her. Nice job getting that .5. Glad she's come up a bit. Yeah when we get a # under 50, stall for 15 minutes, and re-test. Most times the # should be rising due to the insulin losing strength. Sometimes their #s will also go down because of fasting. It's just safer to wait until that # hits 50 and above. If you've never shot that low of a # it's a good idea to let the board members know that's it's your first shooting low green.;)
     
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  16. Butters & Lyla

    Butters & Lyla Well-Known Member

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    I posted for help an hour and 15 minutes ago, said I was stalling and asked for help. I waited 45 minutes. This isn't a complaint, I'm just saying that I did stall and ask. I didn't mean to put my cat in danger. I love her very much.

    Yes I have MC, HC and glucose syrup.
     
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  17. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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  18. tiffmaxee

    tiffmaxee Well-Known Member

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    Good. I wasn’t on then. There’s so much to learn with FD. I’m glad @brierefurmom saw.
     
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  19. Butters & Lyla

    Butters & Lyla Well-Known Member

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    Other people were on helping others with dosing advice at that time. I tend to think that if everyone around me is getting help but I'm not, that it means I'm asking a dumb question and that it's fine to proceed. I know that not everyone has the same knowledge nor does any one person have time to help everyone, so totally my fault for just going ahead. I figured we were so far past her shot time that I was okay to just get on with it or someone would've given pause and addressed the 49. That said, I take 100% full responsibility as I am the person who shot up my cat at too low a number.

    Thank you. I truly didn't intend to do anything that was outside of the TR protocol. I had edited my title again, that time to say I'm shooting my lowest number ever. I guess nobody was on then who knew it was not okay to shoot 49.

    @Briere Fur Mom @tiffmaxee Thank you for jumping in to steer me through the mess I created.
     
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  20. Sue and Luci

    Sue and Luci Well-Known Member

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    I'm sorry I didn't see this - I don't get to visit the forum much when I'm working...it's been a long day.

    Ok, so you made a little boo boo...don't beat yourself up over it. We've all made mistakes...and to be honest, I did the same darn thing!

    Thankfully @Briere Fur Mom was available to help you earlier. Now you know what to do next time and you're prepared for a busy evening - if she doesn't come up on her own. Get out your arsenal and use it freely. You may be in for a Pajama Party tonight - lots of late night folks who may be able to join you a bit later...although I'm an early to bed, early morning kinda gal...so I won't be around tonight to pitch in.

    Hang in there and don't feel badly at all! Just move forward! You've learned an important lesson this evening :bighug::bighug:
     
  21. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Don't beat yourself up:bighug: It takes time to get the hang of things.;)
    Do remember you're in control of the cycle so, don't be too nervous. Nerves are a good thing to have around because they make you more aware. Just don't let the nerves take over:bighug: You will be fine and will definitely take something away from this experience.
     
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  22. tiffmaxee

    tiffmaxee Well-Known Member

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    There’s no such thing as a dumb question around here. It’s not asking that can not be wise. If ever you don’t get a response and it’s crucial put up 911. I wouldn’t normally recommend you do that unless there’s a crisis but that will get attention. The remove it immediately after you see a response. Don’t use that unless it just can’t wait though as it’s Really for medical emergencies.
     
  23. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Get a +2.
     
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  24. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Did Butters go to the vet or a groomer for the haircut? I ask because some cats go lower than usual shortly after a vet visit.
     
  25. Butters & Lyla

    Butters & Lyla Well-Known Member

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    I won't make the same mistake twice, that's for sure.

    No apology needed for not being here, but thank you.:bighug: I'm still learning who is around and when. I am also early to bed and early to rise. Pajama parties were never my thing. This one would be on me, though. :arghh:
    At least my arsenal is well stocked.
     
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  26. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    If you need help, change your Subject line to say something like...Stalling need HELP... and use the ? Sign.
    Sorry no one was online to help you.
    I would keep testing frequently at the moment to see that Butters continues rising. You can always give some higher carb food to bring Butters up further if needed.
    If you see someone online you can tag them for help
     
  27. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    It was actually done here in my home. I do it because Butters has this wildly thick fur and she gets miserable in the heat.

    A mobile kitty groomer/former vet tech comes and we lock ourselves in the bathroom and she shaves her while I distract her. Butters gets super dramatic about the whole process, which I had thought would raise her blood sugar (ie from stress). I'm curious why are cats lower after going to the vet?
     
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  28. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    That I'm not sure of. Some cats do and some cats don't. Rover always went low after a vet visit.
     
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  29. Butters & Lyla

    Butters & Lyla Well-Known Member

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    I think my problem is asking too many questions. I feel like I constantly have a question, especially the last few days with the reducies and increases. I do have it firmly in my head that 911 is only for cats who drop under 30, but I'll keep it in mind if something is super duper urgent...like tonight's 49 at PMPS.

    Thanks. :bighug: I can't believe how complicated this all is. My first vet was like, "give insulin twice a day and don't think about anything else, oh and here's some special dry food that she has to eat now". :facepalm: We have come a long way since then thanks to the people here, but still a very long way to go. I don't know where we'd be without this group.

    Got it! Thanks. Instead of phrasing like a question, I'll add HELP to my title edit.

    I will test lots.
     
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  30. Butters & Lyla

    Butters & Lyla Well-Known Member

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    I have been doing pretty much nothing except staring at Butters so I got a +1.5, which is 103.
     
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  31. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    The only dumb question is the one not asked. Like Kel said, modify the subject line to include the relevant question bits. If you just have a “?” prefix , we can’t tell if it’s urgent or a question about food or best grooming brush, etc.

    Nice food bump.
     
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  32. Butters & Lyla

    Butters & Lyla Well-Known Member

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    So interesting. I wonder if Butters went low because of the haircut. I couldn't get her one for a long while because of the COVID restrictions, so this is her first one since being diagnosed. I'll have to keep track of this.
     
  33. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Putting aside that I did something terribly wrong, I have questions about her numbers tonight and what they are telling me?

    If I hadn't have stalled in the first place when she was at 54 and just shot then, I likely wouldn't have seen that 49 and she maybe wouldn't have had to take a reduction back to .75U after only one cycle at 1U. Is it possible that I didn't give the .75U enough cycles to try to work? Maybe she was still in a bounce?

    Or based on what Red mentioned about vet visits bringing Rover's numbers low, Butters' low could've just been the effects of her visit from the groomer that caused the low. She doesn't normally nadir this late in the cycle.

    Because I saw the 49, I have to go back to .75U for another six cycles minimum, correct? Why? Is this because Butters is too newly diagnosed for us to know what is causing this low, so it is simply safer to do that?

    @Wendy&Neko in the vein of there being no dumb questions, I noticed somewhere you said your Freestyle Lite BG monitor lives at the back of your cupboard or something. I took it to mean you didn't care for it. May I ask why? That's what I have been using but I actually seem to waste a lot of test strips with error messages, and I have seen others note that the numbers run lower than with other monitors. I know there is an allowable margin of error.

    Is it okay to ask what you ended up using when you tossed your Freestyle lite aside? I and was thinking of switching to something else when my supply of strips runs out but don't know how to choose. I checked the post on glucometer reviews but it is several years old.
     
  34. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Are you inserting the strip all the way before poking the ear? If so, insert the strip partway in, poke the ear, then insert the strip the whole way. Strips can time out after a very short period of time.
     
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  35. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    92 @ +3. She is dropping.
     
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  36. Butters & Lyla

    Butters & Lyla Well-Known Member

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    My problem is mainly that I think i have enough blood from one poke, but the FS Lite decides I don't, and then it errors out before the second poke. And also if I pull the strip partway out at that point, I get an error message. Did you ever try a different glucometer with Rover? Or was it FreeStyle Lite always?
     
  37. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Going to feed her a couple tsps of LC because I'd normally do that around now.
     
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  38. Butters & Lyla

    Butters & Lyla Well-Known Member

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    So being 92 @+3 and then 139 @+4 indicates she is stable and safe, and unfortunately zooming right up out of those greens. I'm thinking the crisis has been averted.

    What is my next dose? I use a non-US monitor and so I'm still confused as to how my number, 2.7, which shows in the "safe" green colour on the world spreadsheet, became a neon green 49 on the US spreadsheet. I shot reduced to be safe (ok I shouldn't have shot at all), but did she really earn a reduction again? After the .75U reduction appeared to not work for the past seven cycles?

    Would someone mind taking a peek at our spreadsheet and giving me advice for tomorrow's dose? @tiffmaxee @Wendy&Neko

    And thank you so much to all of you who helped me and Butters through my stupidity tonight. Lesson Learned!
     
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  39. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I would get a+6 tonight to ensure Butters doesn’t drop again
     
  40. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    @Bron and Sheba (GA) I will do. Are you by chance able to look at my spreadsheet and advise on what dose to give Butters tomorrow, also based on my comments above your comment?
     
  41. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    At the time I used the Freestyle Lite, there was some problem with them, can’t remember the details now. But if you look at Neko’s first spreadsheet, you will see a radical change in numbers when I switched to the Relion Confirm. At the time, it registered WAY lower than other meters in high numbers. Myself, and quite a few others at the time, were not increasing fast enough or by large enough amounts due to the falsely low readings. It was rare to get anything over 300. For those of us with big gulpers, or people with ketone prone kitties, it was a bad meter to use. The problem was solved I think later that year, but by that time, that ship had sailed for me.

    Bounce breaking cycles tend to have later nadirs and some action. That is what you saw today.

    When you reduce due to an earned reduction, you hold the reduced dose until the bounce clears. If the nadirs are not green, the reduction failed. Some cats take six cycles to clear a bounce, some less.

    Since Butters is family new to diabetes, I would take the reduction and see how she does. Worst case, you go back up.
     
  42. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Thank you for this information. It is hugely helpful. I will have a look at Neko's spreadsheet.

    283 @ +6. Bouncing once again, I guess.

    I will stick with the reduction back to .75U.
     

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