9/12 Jasper PMPS 174 +2 171 +5 121 AMPS 60

I'm no expert, so I'm mostly here for moral support.

I assume you're following SLGS? If you are, you wouldn't shoot with a PS that low. Keep testing every 15-20m to make sure that HC is doing its job and getting his numbers up out of the lime greens.

If you are doing TR, I'm not sure you can make a good call on shooting since you've already fed HC, so you won't be able to tell if his numbers were trending up, or if they're just being inflated by food. Either way, test often!

Here's the advice from the sticky: Obviously, since you're using an AT, the 50mg/dL is not your cutoff, so alter that to the AT value (68?).

  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
 
Cali S said:
I'm no expert, so I'm mostly here for moral support.

I assume you're following SLGS? If you are, you wouldn't shoot with a PS that low. Keep testing every 15-20m to make sure that HC is doing its job and getting his numbers up out of the lime greens.

If you are doing TR, I'm not sure you can make a good call on shooting since you've already fed HC, so you won't be able to tell if his numbers were trending up, or if they're just being inflated by food. Either way, test often!

Here's the advice from the sticky: Obviously, since you're using an AT, the 50mg/dL is not your cutoff, so alter that to the AT value (68?).

  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
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Thank you. We haven't been in this situation and I was not sure if i should feed him but i did because I didn't want his numbers dropping any lower waiting fir a response.
 
Rachel and Jasper said:
Thank you. We haven't been in this situation and I was not sure if i should feed him but i did because I didn't want his numbers dropping any lower waiting fir a response.
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Definitely understandable! Have you done another BG test?

Are you doing SLGS or TR? Either way, certainly for tonight's shot, Jasper's earned a reduction to 2.0U.

There is certainly advice for shooting that low with TR, but it's also dependent on human meter numbers, so I don't know what the AT-equivalent is.

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • 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.
 
We are doing TR I just don't feel comfortable enough that I understand the numbers to shoot this low. I am definitely feeling very overwhelmed already. I have been waking up 3 or 4 times a night to test his bg and I am pregnant. It's really taking a toll on me. I am now really worried after this experience. I tested again 20 minutes after high carb food and his bg is 80.
 
Okay. I’m back. I know how scary it is to see lime green. Jasper has earned a reduction to 2.0 starting tonight since under 68 on a pet meter. Since you fed some hc I would skip the morning dose.
He seems to have flipped a switch and it’s now going to be important to get some later tests to catch the nadir. It’s very possible he was under 100 on the night of 9/8 and why there was a pink bg the next day. If you can’t set an alarm for later get a +11 or +11.5.

Next time you get a low preshot try feeding lc and testing again in 20-30 minutes as the bg will likely rise enough. There was nothing wrong with feeding hc though. You just want to see if he will rise with lc.

Good he’s on the way up feed. Little lc and test in an hour now. You will need to check a few more times but he will likely rise.
 
tiffmaxee said:
Okay. I’m back. I know how scary it is to see lime green. Jasper has earned a reduction to 2.0 starting tonight since under 68 on a pet meter. Since you fed some hc I would skip the morning dose.
He seems to have flipped a switch and it’s now going to be important to get some later tests to catch the nadir. It’s very possible he was under 100 on the night of 9/8 and why there was a pink bg the next day. If you can’t set an alarm for later get a +11 or +11.5.

Next time you get a low preshot try feeding lc and testing again in 20-30 minutes as the bg will likely rise enough. There was nothing wrong with feeding hc though. You just want to see if he will rise with lc.

Good he’s on the way up feed. Little lc and test in an hour now. You will need to check a few more times but he will likely rise.
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Should i feed him some low carb as well? He got a whole can of high carb wich is about the equivalent of his normal breakfast.
 
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Rachel and Jasper said:
No those were both after food. I fed him immediately because I was scared.
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OK. You said it was 40 mins since he ate the HC, so I assumed you fed 20 mins after the first test of 60 which was an hour back.

So, you are an hour beyond your shot time. Do you have flexibility in your schedule to shoot late? It's possible he could zoom quite a bit from here.
 
I am fortunately home all day today to test and monitor and definitely want to do whatever is best for him. I am an hour and 10 beyond his shot time now.
 
If you can monitor and have enough testing supplies and higher carb food, I would give him 2U. Don't feed him now since he has had a whole can of food an hour ago and we want him to be able to eat through the cycle. Get a +1 and +2. Feed a little LC (a tsp) after each test.
 
Yes. Stay with LC unless he dips much lower and you need to intervene with higher carbs.
Do you think he will let you get another test before you shoot? That would be ~1.5 hours since the 60?
 
Rachel and Jasper said:
Ok I just gave 2 units abd will test in an hour and give him 1 tsp of low carb food at that time.
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Good. Can you please take off the "help please" from your thread title. You can add it back later in you need help later in the day. Thanks :-)

His AMPS would now be 181. You would record his numbers as "60 @12, 80@+12.25, 92 @+12.5, 143 @+13 and 181 @+13.5" in the AMPS box.
 
Bandit's Mom said:
Good. Can you please take off the "help please" from your thread title. You can add it back later in you need help later in the day. Thanks :)

His AMPS would now be 181. You would record his numbers as "60 @12, 80@+12.25, 92 @+12.5, 143 @+13 and 181 @+13.5" in the AMPS box.
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How can I add these to the spreadsheet? I wrote it all down but not sure how to add the .5 times to the spreadsheet?
 
I see Jasper has learned the fine art of waking up the person with a low first thing in the morning. :rolleyes: Glad you had some help and managed to get a shot in. Hopefully next time you see a morning low (yes it will happen), you'll have a better idea how to handle it. The Sticky Note on Handling Low Preshots has a lot of info in it too.

One housekeeping request, could you add today's date to the subject line.
 
Oh yes, I hadn't even had coffee or food yet, it scared me quite a bit but I am sure I will get better at all this. I went and read the note but I still felt totally frazzled so I am super grateful for all the guidance. And yes, silly me I will add the date right now.
 
@tiffmaxee would you mind giving me some guidance as to what to do for the rest of the day? Do I just keep testing every hour and giving his a tsp of food? He didn't eat the food at +2 and I wondered if I should give him his normal lunch of one can at +6? Also should I stop with the 1 tsp 2 hours before PMPS? Sorry lots of questions. And I am assuming I give 2 units again tonight at PMPS time 12 hours after the first shot? Also what should I plan for tonight? Im assuming I need to test a lot tonight as well but not sure what that should look like, it will be late by then so I figured I ought to make a plan. Thanks!
 
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Sorry I wasn’t around. Yes give 2.0 12 hours after your a.m, shot. Looks like he will be high enough to shoot. No more tests needed until pmps. Tonight I would start with a +1 and+2 unless he bounces. If high at pmps then start with a +2. The higher depot will likely effect up to 6 cycles so if there’s a big drop, you can give mc or if really low some hc.
 
I figured ypu probably just weren't available, but i just started to worry about tonight. Is it likely his bg will be low again tonight? I guess now I have a better handle on how to deal with it if it is.
 
tiffmaxee said:
It’s very possible unless he bounces.
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Ok and if he is low again. I just stall for 20 minutes and ask for help? Its gunna be pretty late tonight and I just wanted to be prepared incase no one is here to answer questions, I do feel I have a better grasp now if what to do but it seems it can also go differently every time.
 
tiffmaxee said:
Are you about 45 minutes before pmps? If not joe long until pmps? I suspect he will be in the blues or higher. I will check back.
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His normal shot ti.e is 8:40 but today he didn't get his shot until 10:05. Do I keep his normal schedule, I was actually assuming I adjust to the 10:05 time for tonights shot. It's definitely gunna make tonight a late night. Also should I test beforethen?
 
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