Taz was 51 at PMPS, and 60 a minute later (on Alphatrak 2). Do we stall the 20 minutes? Feed high carb? Not give insulin? @Bandit's Mom @FrostD @tiffmaxee @Bron and Sheba (GA) @Wendy&Neko https://www.felinediabetes.com/FDMB...00-1-96-2-49-2-5-60-4-74.266671/#post-2984745
I have to work tomorrow (get up at 6am and it's currently 9pm) but between my hubby and I, we can stay up and monitor. How late would we shoot? I waited 10 minutes, tested again, and he's currently 58. I gave him some medium carb. I don't know if I feel comfortable giving him 2.25 units when he's already considered "low" (under 68). What would happen if he doesn't get a food bump?
What is your medium carb %? Test again 20 mins after the snack? When stalling and waiting for numbers to come up, don't feed and if numbers drop and you have to feed you feed LC and not higher carbs. The second part of this sticky deals with handling low preshots. Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers " If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food. Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he? Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you."
Oh shoot. I panicked after I saw the 58 ten minutes later. How do we handle this since we gave medium carb? I believe it was 13% carbs. I'm scared that if he did get a food bump, it's only because of the MC... although his MC never seemed to prevent his drops when I tried to slow them down. *** just took it at 20 minutes after eating, it's 79.
Yes, that is the rub. You don't know how much the carbs have contributed to the 79. How much after his usual shot time are you? Will you be able to monitor if you shoot? ETA: I see he has a history of ketones. I would not skip.
I gave him his shot 40 minutes late this morning because I almost forgot to give it to him (dealing with injured dog). He's currently an hour later than normal.... but only 20 minutes later than his last 12 hour shot. I need to go to bed in the next hour or so. Can we give him a lower dose? Last time when I shot a 77, I gave a smaller dose so he still got insulin, just less.
I would shoot 2.25U. And be prepared for some heavy duty monitoring for the first part of the cycle. Skipping is not an option with ketones. Feed some LC now but don't fill him up. We may need him to eat every 30 mins tonight. Get a +1. Please take off the 911 now? Thanks!
@SaraMV note that the instructions and BG values quoted on the sticky are for a human meter. If you are using an AT, you need to intervene at much higher numbers. I would NOT want to withhold food at 51 on an AT.
That's why I panicked. Especially when it didn't raise enough 10 minutes later. I should have given LC but I didn't know how long he had been under 68 and all I could think about was trying to get him above it. He just took his 3rd reduction in 8 days, and it really freaks me out that he earned this one 12 hours after his insulin. The only symptom he had of being so low is that he was hungry. His appetite has been off because of pancreatitis.
He was clearing a bounce today and nadirs can be late in bounce clearing cycles - even as late as at the end of the cycle.
Someone mentioned that breaking a bounce can give momentum to drops, pushing them lower. Is a reduction during a bounce clearing cycle typically short lived?
Please don’t feel bad; I think you did just fine. I too would have gone with high carb and/or a bit of syrup. Safety first, always. 51 on an AT is nothing to mess with even if it is late in the cycle. You have no way of knowing whether he was still heading down; low numbers/hypos can last a long time with Lantus.
There are times when a reduction earned due to the additional momentum of a bounce clearing cycle fails. But I would not mess with a 51 on an AT. Just like a drop below 40 on a human meter is an automatic reduction. Good to see he is comfortably higher at +1. How long since he had the MC? The carbs wear off 2 hours after.
He had MC about three hours ago. He was 112 at his +1 and 110 at his +2. We'll check him again at his +3.
