2/3 Disco AMPS 127, +0.5 145, +1.5 207, +5.75 182, +11.25 62–what do I do now??***

Yesterday 2/2: http://www.felinediabetes.com/FDMB/threads/2-2-disco-amps-374-2-294-6-316-pmps-259-2-287.225129/

I’m reading up for info now… Still learning. I read that if my pre-shot level was below 150 don’t give insulin, if between 150 and 200 the three options are give nothing, give token dose, feed as usual and test in a couple of hours.

It’s it’s 8:00am and that’s usually when I give his dose so I think I will feed and test in a couple of hours unless I hear back quickly. Then I have to read what I do when I give the insulin late, I know I read that somewhere…

***Update: 7:45pm +11.25 62! Freaking a bit. Gave his AM inj about 30min late at 8:30am due to his AMPS. His +’s are in this posts subject line and i have updated/corrected SS I have not fed him yet

 

you have shot a 113 a couple of days back.
if you haven't fed, stall for 15-20 mins and see if Disco is headed up or down.

i think if you can monitor, you should be good to shoot.

from the SLGS/TR sticky:

"If the preshot number is far below usual preshot numbers:

• Do you need to stay on schedule? Then skip the shot.
• Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
• Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.

If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat."

 

If you can monitor and steer with food. I think you can shoot. It's what you've been working towards.

If you shoot late, next shot is 12 hrs from it. Depending on how late that is, it's takes time to get back to normal. If it's to late i think its best to skip and stay on schedule.

 

Thx for the quick reply! I did feed him already though he is a grazer and only ate about 1/3 of it. Yes, by accident I did shoot at 113 last Saturday because i misread the meter as 213, and we had a wonky day but eating HC brought him out of it. I am home today and able to test frequently so will do that and keep everybody posted.

 

Thx for the input! I went ahead and gave him the 2.75u and the dose was about 30 min late.

 

It IS scary to shoot numbers lower than one is used to. I too am still getting used to it. I skipped a shot once and regretted it since it set us back some.

 

Looks like Disco is bouncing already

 

Wonder how low he went last night before that AMPS?

 

I know! Now I feel like I should’ve woke up in the middle of the night at least once

 

Hah! Well, just make sure to get at least one more midday test today-- we don't know for sure he's bouncing, so he still could move downwards today.

Kind of exciting, the change in numbers the last few days. Looks like Disco is starting to get the hang of this feline diabetes thing!

 

You changed your dosing method to TR from SLGS. So the above no longer holds. On this forum, if following TR, the guideline if you get a preshot below 150 is to NOT feed, and post for help. Shooting lower numbers leads to flatter cycles with Lantus. Think of lower numbers as a gift for both you and Disco.

FWIW, the guidelines you quoted above are in the SLGS section of the Sticky Note under the heading "in the beginning....". Later on there is a section about what to do when you have more experience and data. That is where you are now, if you had been still following SLGS.

 

Oh my gosh! I will add this to my notes! It does get confusing for me... I’ve never been a good studier, so I really appreciate you clarifying everything and simplifying it for my aging brain!

 

+5.25 182

 

Really nice day for Disco today!!

 

Whenever I wake up and test Bandit at night, she is high and on days that I decide to skip, I wake up to a nice low AMPS and I am left wondering what I missed. ARGH!!!

 

***Update: 7:45pm was his regular PMPS time, so this is +11.25 and it’s 62! Freaking a bit. Gave his AM inj about 30min late at 8:30am due to his AMPS. His + numbers are in this posts subject line. I have not fed him yet. Updating SS now.

 

test again at 8:30pm (new shot time) and see if he is headed lower or higher.

hopefully by then someone with more experience will be here to advise you.

if you can, update his SS?

 

and since he is so low, i would think it is fine to feed him some LC food.

 

Thx! Taking deep breaths now and pausing til 8:30pm

 

is he 62 at 10.25 or 11.25? your post header says 10.25.
you have put 62 in PMPS om your sheet, btw.

 

Fed him 1 portion of Sheba Purrfect Portions Pate (1.3oz)

 

You know, I just had a feeling that Disco had more downward action in him today! Sheesh, though-- 62 at +10??? A little dramatic, there, Disco, you can tone it down a bit!

I won't be able to stay up with you if you shoot tonight, so hopefully either Disco will start moseying on up, or someone who can stay will pop on. Something does seem to have happened with Disco recently, something clicked into place for him or else his pancreas is starting to wake up a little bit. He's going to start "asking" for reductions soon, I think...

 

My mistake, its 11.25, I’ll fix it

 

OK, if he's still on the downslope, that might help pump the brakes a little. But don't feed any more before PMPS, unless he does drop (especially if he drops below 50!). Tonight especially, you'll want to get a PMPS number that is not influenced by food.

 

Thx! His PMPS is due in 10 minutes

 

OK, I'm totally confused now-- how much time until your PMPS??? Are we around +10.5 or +11.5 now?

Edit: whoops, simultaneous post there, you just answered that

 

so you have over an hour till his shot time? i would test him every half hour till then.

 

10.25 is an hour and 45 minutes before PMPS. do you have any more BG readings in that time?

 

OK I need to get on my laptop and tap this out to type this out because I’m getting confused on my phone. His AMPS was at the usual time at 7:42am 127. Next test at 9:05am 145. Next test at 9:51am 207. Next test at 2:17pm 182. Next test at 7:42pm 62. Just tested at 8:31pm 69 (this would have been his PMPS)

 

OK, I got it So, if I understand, the 62 came a half hour before what will be (soon) his PMPS. In the meantime, he ate a small portion of LC food.

That means that his PMPS might have some small food influence (lucky it's LC, and probably less than a half hour's time), but we'll deal with that.

 

Yes, about 45 min before PMPS due and yes, he ate small portion of LC food. I just got a 69 at 8:31pm 12 hrs from his last shot

 

OK. I can't advise that you shoot tonight. These are shootable numbers with data, but you just don't have enough data for that yet, plus as I said before I can't stay up with you and the boards seem kind of quiet right now (@Bandit's Mom , I know you are around, but you have quite enough to deal with yourself right now until Bandit is out of the woods on that extra insulin!).

Even with skipping, you should keep testing for a while tonight, in case Disco is headed further down. On 2.75U he's still got a pretty big depot to work with, even if you skip a shot.

 

I messed up the times. Here are the exact times/tests:
His AMPS was at the usual time at 7:42am 127. Next test at 9:05am 145. Next test at 9:51am 207. Next test at 2:17pm 182. Next test at 7:42pm 62. Just tested at 8:31pm 69 (this would have been his PMPS)

 

Thank you SO much. I will continue to test tonght, should it be every 30 min or 1 hr?

 

I'd test at the usual +1, then go from there. You may just need a +1 and a before-bed test at +3 or +4 or whatever if he seems to be behaving himself. Usually we'd only go to every 30 when they have gotten below 50.

I think I just saw a post from @Wendy&Neko , tagging her in case she's able to pop in quickly to give her take on things.

 

Thx!! Taking a big breath, forgot to ask about how to feed for the evening. So far he's had the small portion of LC food and thats all

 

I need to log off and go to bed now (midnight where I am). Good night, hope all is uneventful!

 

Sleep well

 

Feed as you normally would, I think, unless he goes lower and you have to hit the HC.

 

i am here for moral support, but I am of no use other than that since I'm a newbie too!
keep updating his SS if you can, so people can track him. easier than looking through the thread.

 

Morally supporting you, too

 

he is heading higher. i guess we can expect a nice bounce from the lows and the skipped shot

@Wendy&Neko @Nan & Amber (GA) in situations like this, would a token dose (say 1 unit or less) be preferable to a skipped shot? asking for myself in advance!

 

oh yeah, hope my knees can take the trampoline, HaHaMeow! And i also wondered about the token dose

 

9:37pm 94
10:39pm 260
11:32pm 320

 

and that's a wrap. i think you can safely go to bed now!

 

Just crawled under the covers along with Disco and Coco and Brighton. What time is it where you are?

 

Actually no - you don't want to feed if less than 2 hours to preshot, unless below 50. Otherwise your preshot number is influenced by food.

For future reference - you might want to print off and read Tight Regulation: Becoming Data Ready to Shoot/Handle Lower Preshots

It's good you got those extra tests after your normal PMPS. Now you know it would have been a good idea to give insulin - and probably full dose.

 

thanks for this (sorry for giving wrong info, Teri!). Would you know if the 2 hour window is longer for kibble? as in, should the "no food before shot" window be longer for dry food?

 

just saw this. I am in Mumbai, India. That's 13.5 hours ahead of you at this time of the year.

 

What does this mean?
"We have to be a lot more careful with the cats who eat only dry food, because they don’t have access to the tools the rest of us use to keep our cats safe"

 

I think it means cats are on dry food (higher carb) already don’t have any higher carb options to help them through. For those of us that are on a low-carb food, we have high carb options to help us, like fancy feast gravy lovers or even kibble.

On a sidenote, I just woke up at 3:30 AM to pee and tested Disco and his number was 571…a bounce to the moon! But also, i skipped a dose but that’s his highest number ever!

 

possibly, but i am feeding Bandit YA zero carb kibble.

and wow! Disco is bouncier than Bandit. 571!!!
anyway, the first low pre-shot number for newbies is invariably a skipped shot. and it's probably safer that way. we learn as we go along!

 

I fed Disco YA zero carb years ago when I was trying to get him to lose weight (he was up to 16 pounds) but it didn’t work for him for weight loss and I haven’t tried it since as he’s on primarily raw since his ABD diagnosis in 2012

 

Oh my goodness yes, that there is a bounce for sure!

Sorry I wasn't able to advise you to shoot on those numbers last night-- just couldn't do it in good conscience without also being able to stay up with you or knowing for sure that someone else would be able to do so. As Wendy says, at least now we have a little data that will give us a hint of his plans the next time he does this! Eventually, you'll be shooting numbers like that without batting an eye, but it takes a little time to work up to that.

 

YA is pretty high in calories. not sure it would work for weight loss?

 

That's a good question. There are a few factors involved. The most important is ketones-- if at all possible, a cat who has recently had an episode of ketones should get some insulin, every shot time. Other than that, I think there are some different approaches. Any change to the shot amount, whether reduced or skipped, will disrupt the depot, and I think there is some thought that a reduction should be less disruptive than a skip. In most situations where this question arises, in newly-diagnosed cats that probably aren't well-regulated yet, I tend to feel that that concern is swamped out by others if the only worry is having some difficulty interpreting spreadsheet patterns for a couple days. However, in cats on higher doses, it may be more of a concern because they really need that big depot at their back at all times. Another situation in which the token dose might be used is in a cat who tends to have huge, extended bounces, in hopes that that first zoom up might be tempered a little bit. In Disco's case, he zoomed up so high mostly because he was bouncing, not the skipped shot, but having a little insulin on board at +2 or +3 might have helped slow him down some. I didn't recommend this route for the same reasons I didn't recommend shooting the full dose-- we didn't have enough information about the direction he was headed, and there would be no one around to help Teri in the opposite situation from what actually happened, if he were moving down and the insulin added to his momentum .

So, it depends! As a personal inclination, I usually lean towards the "call it a fur shot" approach and skipping altogether, but that's really more of a personal quirk.

It is always important, though, whether reducing or skipping, to do as Teri did last night and keep testing for a while. With a depot insulin, you cannot assume that skip=safe in low numbers. That depot always gets a say!

There are also a couple of things you can do to try to keep yourself out of the most difficult form of this problem, where we just have no idea which direction the cat is headed. One is the "stall don't feed" after getting a low pre-shot: just like it sounds, you stall and hold off on shooting for a half hour, you don't feed to keep the number free of food influence, and then see if the next test is moving up or down. The other thing you can do is on the other end of the pre-shot, trying to get late-cycle (+10 or +11) tests so that when you do the pre-shot, you know where the cat is coming from.

No matter what, though, these cats are always going to make us do some guessing games!

 

Truer words haven't been spoken!
Btw, what would be considered a high dose?

 

No apologies needed...and your help before you had to hit the hay is much appreciated!

 

Wow, what a wealth of information! As wiped out as I feel this morning, kind of like a limp noodle even though I got a 82% sleep night according to my Phone app, I did get a +7 overnight (571, his highest reading ever) but when this happens again, I will know to get a +10 or 11.

Also, should I have given him his usual 2.75u dose last night when he tested over 200, which was at 10:39pm. Or is 3 hours late too late and better to skip?

So this morning, do I test him at 8:00am, moving him up from the 8:30am late dose yesterday?

 

I think you can test and shoot at your usual time today, after a skip. And no, we wouldn't recommend shooting 3hrs late, generally. The goal when moving shot times is to keep it to 15mins per cycle, or 30mins per day. Shooting 3hrs late means that you can't shoot at your usual time [edit: at the next cycle] because it would only be 9hrs after the last shot--- too much overlap in insulin action. So, even though it's just one shot, you'd then have to be off-schedule for several days while you slowly moved the shot time back to your usual.

 

so how is Disco at 8am today?

 

422 @ 8:12am

 

Not bad at all after that 571!

 

That’s what I thought, too

 

Yeah, it was almost hilarious actually. It was when the food company was first starting and I was one of their participatnts in a weight-loss trial. At first they had me feeding some huge amount and I knew that wasn’t gonna work but I was going to follow their protocol and then when it didn’t work they had me cut it back and it still didn’t work and I can wondered if he would actually was getting enough nutrition because he wasn’t eating very much. It didn’t last for long but I think on my blog I have a multiple posts about the trial and his progress

 

Now they say on their website that their food is pretty calorie dense and a cat would need to eat less of it than other kibble!