AT Give PM Dose? Evening bg Low AMPs/165, +5.5/100, +11/92

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Martha and Lolly (GA)

Martha and Lolly (GA)

Member Since 2015
Here we go again-- yesterday Lolly was 158 for AMPS, 108PMPS, and I didn't know whether to shoot normal dose of 1u. I gave a BFCS .5, she leveled out ok.

Today she was higher for AMPS, 165, then has gone lower in evening. 92 at +11. This is after she had food at +9. Another BFCS? Has she earned a reduction?

I still have to do the PCMPS, but problem-- good news is that my husband is doing tests-YEA- me having the flu was the push he needed.

Bad news- he doesn't understand the whole FD thing yet (like I do!) and when I yelled back that 92 might be to low to shoot, he put food down. Looks like she had herself a nice chow-down for about 15 minutes - until +11.25.

Why is she high in the AMPS, low in the PMPS; now the PMPS will probably be inflated by the food, I'll post.

Hopefully, be well enough to get curve with husbands help tomorrow.
 
Lolly - you sure aren't making this easy! Since this is early days for you, and 92 is lowish on the AlphaTrak, I think it might be best to skip the shot tonight. She's eaten, so any test at +12 will be influenced by that food, so we won't know if she's going up because she was going to anyway, or it's the food influencing numbers. There is an option to keep delaying, perhaps an hour more, but then your schedule tomorrow will also be off by an hour.

Although Lolly hasn't technically earned a reduction, it might be better to go to .75U, so you will get numbers that you can safely shoot twice a day. Then once you've gotten some more data on Lolly, it might be safer to go back up to 1.0U if you need to. She was higher this morning because you only gave .5U last night.

Kudos to DH (dear husband) for learning to test! :) He is officially part of the vampire club now.
 
The glitch here is that you don't have a re-test that isn't influenced by food. I'd still get the test at PMPS time and let's see where Lolly's numbers are.

Many cats experience "dawn phenomenon." Numbers rise in the early morning as the result of stress hormones being released as a means of preparing us for the stresses of the day.
 
how long can you comfortably stall and not feed? Remember you have to consider tomorrow's shooting schedule too

You can move back to your preferred time 15 minutes per cycle or 30 minutes per day, so depending on how long you stall, you could be "off schedule" for several cycles
 
Thanks -- Wendy, I forgot about the .5u affecting the morning bg. I'll get the +11 now, but it's a bummer she got fed. I can push back, but I'd have to bring it forward by Monday. Would a 15 min stall make a difference?

I was going to a curve tomorrow- will it be adversely affected by skipping tonight? Or will it still give me info on nadir, etc.
 
It usually takes 2 hours for food to get out of the system, so you'd have to wait until at least +13 if she last had food at +11.25. You can move back on schedule by 15 minutes a shot time, or 1/2 hour once a day. So you could get your hour time back by Monday. Any delay beyond that would be hard to make up.

As for the curve, if you skip tonight, it won't give you a good value for the nadir because the depot will be depleted.
 
Her PMPS is 98. Real bummer about the curve. I still have Sunday to do one. I don't totally understand the stall thing. If I can only move back on the shot schedule 15min, how can I stall until +13? So I guess it's a skip, not even a chicken shot?
 
If you stall until +13 tonight and then shoot, here's an example:
You shoot tonight at 7pm instead of the "Usual" 6pm

Sat morning shoot at 6:45am, Sat evening shoot at 6:30pm
Sun morning shoot at 6:15am, Sun evening shoot at 6pm....and you're back on your schedule by Monday

If you decide not to shoot at all, you can go right back to your regular schedule in the morning
 
With that 98, it's still pretty low on an AlphaTrak. Check again in 1/2 hour? If you see her zooming up, that would be the time to shoot, provided it's not too late.

You can move back 15 minutes per shot. So tomorrow you can move back 15 minutes in the AM, another 15 minutes in the PM, and similarly make up the rest of the half hour on Sunday. Actually, Monday morning you could move another 15 minutes up.
 
I've been trying to read up on the Lantus and TR articles. I assume all the numbers are for human glucometer measurements? I think someone wrote that there's a 2/3 ratio difference between AT and human glucometers, but that it didn't hold true and the ends of the spectrum. Is there anyway someone could draw up a chart for me showing the equivalencies for the whole range os usable numbers- say

human: 60 70 80
AT x x2 x3

etc. It would make it easier for me to read the articles.
 
Yes, the TR protocol was written with human meters in mind, as that's what most people use. The most important number to know is that the reduction level for an AlphaTrak is 68 vs. 50 for the human meter. For numbers below 100 on the human meter, the AlphaTrak is about 18 points higher. I've also seen that the AlphaTrak is 30-40% higher than the human meter. That would make 100 on the human meter somewhere between 130 and 140 and 200 between 260 and 280 - ish. You use those numbers for the protocol and determining how long to hold the dose and how much to increase. Remember that the manufacturers can be 20% out, so it's not exact.
 
you're being given a wild start here. I think Wendy's idea of dropping the dose to 0.75 in general so you can get 2 shots a day in at the same dose is a good one.

That doesn't help with your decision tonight, of course.

The AT thing is pretty confusing - as Wendy said 68 is the most important number. Most people switch to human glucometers before very long into this, primarily because of cost, but i suspect also because of the confusion.
 
+12.5 was 97, so I guess no shot tonight. Will I ever get her regulated? Since her numbers will be high tomorrow, I'll give her the 1u tomorrow. But I don't know how to get her to two equal shots. I don't want to be on the board every night asking about her shot :confused:

I'll be able to do a curve on Sunday.

Thanks everyone, as usual!
 
See my signature link Glucometer Notes for feline reference ranges using human and pet meters, in mg/dL and mmol/L.
 
If you want to skip tonight, I'd go ahead and drop to the 0.75u in the morning and hold the dose there for a few cycles. Even if your vet wants the curve info, I wouldn't do it this weekend. I'd just explain that i had to reduce one shot and skip another because she was too low to shoot.

As far as predicting about getting her regulated - i would say that having her in good numbers (which she is) on 1u is a good thing. There's absolutely nothing going on that wouldn't say that she could become regulated. It's just not a quick thing for most cats.
 
Martha said:
Since her numbers will be high tomorrow, I'll give her the 1u tomorrow. But I don't know how to get her to two equal shots.
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I'd start with .75U tomorrow morning. I hope that's how you'll get to giving her two equal shots each day.

And yes, she will get regulated. Lolly is looking really good for this early in the dance.
 
lots of people love the calipers once they start using them - it really does seem to help with accuracy. we have seen that markings on syringes are not particularly accurate and for cats a tiny difference in dose can make a significant difference in blood sugar.
 
MARTHA))))

Dang Lolly. Here is the truth. She is keeping you on your toes BECAUSE she is doing so well. She is responding to the insulin and these numbers are a reflection of that. These are GREAT numbers..just slightly low to be shooting as a newbie. I did not understand the lowering of the dose thing in the beginning either, but the idea is to try and find a dose you can shoot consistently (without facing skipping, etc) so she levels out more. Then you bring that flatter line down. She earns a decrease if going below 68/AT (50 human) in a cycle. The easiest way to do conversions from AT to human....is to figure human numbers at 65% of AT. SO your 92 is like a human 59-60. It is a bit to low to shoot as a newbie..though in time and as your dose drops you may.

As an FYI, Hank responded really well to Lantus like this too and we had many nights of uncertainty of what to do..to shoot, do a BCS, etc.. and late nights too. It was because of his PROGRESS. At times I wondered how I could keep up. But in a matter of weeks we were down to a drop then soon OTJ.
I know you are tired plus feel rotten anyway which makes it worse, it seems impossible to keep up at times, but is actually REALLY GOOD NEWS.

and YeeHa for hubby with the testing. I have a feeling it may be for you like it was for me....he was moving so fast I didn't really have a chance to get my arms around things and how it all worked, I had to rely on others who could see what I could not. It all made more sense to me after we were on the other side. At this point I still think your best bet is to keep posting for guidance, as Lolly clearly has a mind of her own... and we just have to try to keep up.
 
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If you don't have calipers, another option is to practice dosing by taking off drops. Fill a syringe to 1.0U, then twist the syringe to get out a drop. Count how many are in 1.0U. Practice with a used syringe and colored water. Once you are consistent on number of drops in a unit, take 3/4 of them and that's the new dose.

Calipers are available at Harbor Freight, and a lot of metal/woodworking tool shops. DH might be willing to help you find a set.
 
Martha said:
Thanks Wendy and Julie, will do. I'm eyeballing off a syringe marked in single units. Have to get a vet scrip for .5s. Thanks for the link BJ
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Both Walmart and Sam's have syringes w/ 1/2 unit markings. They may not realize it however...so you may have to tell them they have them.
they are inexpensive- like $13-14 for box of 100.
 
Wow, I love that you guys are so inventive-- the night we were near hypo, you came up with a dry food slurry; now calipers and drop measurement- def going to try the drop thing tonight. Where there's a will there's a way.
 
Inventive-R-Us ;)

pretty much everyone works on a budget and ya gotta be creative to get it all working.

another trick is to keep a sample syringe with colored liquid (food coloring, tea, coffee) as a comparison syringe.
 
Some people have made paper calipers. I got mine from Harbor Freight and they have made it much easier. They are pretty cheap and there are always coupons on line and in the newspaper and mail where I live.
 
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