Stalling. Help please low PMPS

Discussion in 'Lantus / Levemir / Biosimilars' started by Sharlyn, Feb 28, 2021.

  1. Sharlyn

    Sharlyn Member

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    Aug 1, 2020
    Chester is at 59 on the Relion Prime meter. I switched him from the AT meter last week. I checked it also and it says 88. This is his PMPS number. I am holding off on his food for 30 minutes. Any help would be appreciated.
     
  2. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
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  3. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Hi Sharlyn, Please post Chester's number here as soon as you get it at 20 minutes.
     
  4. Sharlyn

    Sharlyn Member

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    Aug 1, 2020
    I just checked at 30 minutes. He is at 74 on the Alphatrak. We gave him half a can of gravy lovers FF
     
  5. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Do you have a previous post here on FDMB? It would be helpful if (after we figure out what to do about tonight's dose) to add that to your condo for a better picture of the history of you and Chester - so we can all see what's been going on.
     
  6. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Why? Now we really don't know what his actual number is because now he's food influenced...

    Perhaps under the circumstances it would be better not to shoot tonight.

    I get up at 5 a.m. so I cannot stay here with you this evening and so far no one else appears to be around to help you in case the numbers drop.

    Please update your title to show the date, kitty name and AMPS (per the standard recommended format).

    If the food is what's propping him up now, his number may fall again in an hour or so...

    Will that work for you?
     
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  7. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Since you are following SLGS, we usually don't recommend shooting under 90. Continue to stall, don't feed, and retest in 20 minutes, to see if he is on the rise.
     
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  8. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    In the meantime, this stickie would be very helpful for you to be prepared for next time:

    https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/

    First rule of thumb when getting a lower than expected pre-shot number is to STALL, DON'T FEED, test again in 20 minutes. Is the number going up or down?

    Also where are the other tests today? It's extremely important to get mid-cycle tests, especially at night. Please try to get some more tests so that next time he's falling you'll have a heads up.
     
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  9. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Thanks for responding Christie! She's already fed gravy lovers...

    I've got to sign off...can you add anything further? At least I think we all agree that shooting tonight isn't a good idea...
     
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  10. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    I think at this point, since you've fed some high carb food, and you don't have much data with shooting low preshots, although you did shoot a 90 the other night, it would be best to skip. Sometimes the HC can artificially inflate the preshot number, and you end up having a very active cycle when the HC wears off, and next dose kicks in. And, as I said before, we don't usually recommend shooting under 90. Your dose tomorrow will be reduced to 1.5u, since Chester came down under 90 this cycle.
     
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  11. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Just for future notice.....if he's above 68 on the AlphaTrak, there's no need to intervene with high carb food. If using a human meter, it's below 50

    Just skip tonight, get at least a couple more tests in tonight to make sure that once the food wears off, he doesn't drop again and plan on reducing his dose in the morning!

    Don't feel bad....the first time China went too low, I knew I could give her syrup but wasn't real clear on how much so I dumped about a cup-full into a bowl. She liked it!!....Needless to say, her numbers went up...and up....and up!!

    I learned later that I was supposed to use a drop or two of syrup, not half the bottle!...LOL

    We live, we learn!!
     
  12. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    @Sharlyn if I can also make a suggestion, even with SLGS, it is important to gauge how the dose is working, since preshot numbers don't always tell you how low he is going, any spot checks, especially at night time will give you an idea of how low the dose is taking Chester. Since you are using Levemir, you may find that he might be hitting his nadir around +8 or later, sometimes the nadir ends up being the preshot, so in order to avoid skipping shots, catching a few tests at different times will help tell you what he is up to.

    Ideally you want to learn how the insulin is working for Chester, which means knowing when he onsets, nadirs, and what is the typical duration.

    Here are some of the basic concepts:
    • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
    • Peak/Nadir - the lowest point in the cycle
    • Duration - the length of time insulin continues to lower blood glucose
    • How to do a Curve - a simple explanation
    By getting additional tests in each cycle, you'll be able to determine how the dose is working.

    And, even with SLGS, it is recommended to run a curve, every 7 days and evaluate the dose based on that data. Just a few thoughts, hope that helps, please do ask any questions, we are here to help.
     
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  13. Sharlyn

    Sharlyn Member

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    Aug 1, 2020
    Thank you! It was just a really low number for him so I got scared. He is at 202 this morning. I did skip the shot last night so hopefully I don’t mess him up too bad. I really appreciate the help.
     
  14. Sharlyn

    Sharlyn Member

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    Aug 1, 2020
    Thank you for the advice. I really appreciate it. I am going to get more tests in today and do a curve this weekend when I will be home all day.
     
  15. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Sharlyn,

    Can you please update your SS today? We're just wondering how Chester is doing after his low number. Is he bouncing?

    Can you please start a new condo/thread today? With today's date, Chester's name and AMPS?

    THanks so much!
     
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  16. Sharlyn

    Sharlyn Member

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    Aug 1, 2020
    Just did, thank you!
     
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