10/09 - Gizmo PMPS 69 (with AT), + 20 min=202, +1=312, +2=264, +3=279, +4=333, +5=354

Status
Not open for further replies.
LizzieInTexas

LizzieInTexas

Member Since 2016
Ok, still going with 2.75u - that number seems really low to me but I will test +1 to check.

Just tested - will feed in about 2 min and inject in about 1o min.
 
Make sure you have supplies on hand, shooting that low can be dangerous. Now is the time to make sure you have LOTS of test strips, and HC supplies Gizmo will eat, honey, maple syrup, karo syrup anything that can bring his numbers up if he drops low. When Jack is low, I have tested 6-8 times in two hours. You have a bit of time before the insulin kicks in, so be aware you could easily go through 10 or more test strips tonight. Since he is already on a high carb diet, it could be tough to get his numbers to come up. Be vigilant about testing, that is a very low number to shoot on an alphatrack.
 
It looks like you are shooting these low numbers because of the higher carb food. Is the Hill k/d the only food Gizmo will eat? He could probably be on a much lower dose if he is going that low with high carb food. When you get a chance, can you create a signature and give us information that would help us help you. Info: meter, food, any health issues? insulin, date diagnosed.

ETA: He could probably be on a lower dose on a low carb wet food, under 10% carbs.
 
LizzieInTexas said:
But I work Monday and Tuesday so I won't be able to do much more than amps and +1 in the mornings.
Click to expand...
Tonight is the important one, it may be a long night. From yesterday's numbers he started low, numbers went high after feeding(a food spike) and then plummeted. Generally when numbers bounce around like that the cat can "bounce" where they perceive the drop to be too big or too fast and release glycogen as a defense mechanism which raises the BG. If it were my cat, I would be sure to test around +6 and +8 when the insulin really starts working and the food starts wearing off.

I'd like to get some more experienced eyes to see this thread to make sure you can keep Gizmo safe tonight. You don't have a lot of data yet on how easy it is to get his numbers up when they go low, or at what time he typically hits his low point.
 
saltycat said:
Tonight is the important one, it may be a long night. From yesterday's numbers he started low, numbers went high after feeding(a food spike) and then plummeted. Generally when numbers bounce around like that the cat can "bounce" where they perceive the drop to be too big or too fast and release glycogen as a defense mechanism which raises the BG. If it were my cat, I would be sure to test around +6 and +8 when the insulin really starts working and the food starts wearing off.

I'd like to get some more experienced eyes to see this thread to make sure you can keep Gizmo safe tonight. You don't have a lot of data yet on how easy it is to get his numbers up when they go low, or at what time he typically hits his low point.
Click to expand...
Yes, good point and if you are working Monday and Tuesday and get numbers this low on an AT2 and can't monitor pass +1, if makes me nervous for your cat.
 
I will get the info into the signature line.

Gizmo has pancreatitis (not active right now), crf/ckd and diabetes.

He was diagnosed in August 2016. Started with 1U for appx 3 weeks, upped to 2U. 2U for 2 weeks with glucose curve and frutosamin test showing 500-600 numbers. 09/20 increased to 3U until yesterday.
 
Lizzie:

I don't think you have the data to have shot that low. Please get a test in at +0.5 -- 30 min. after your shot and I'd encourage you to start testing every 30 min.

To put this in perspective, for those following Tight Regulation which is a much more aggressive approach to dosing, a 68 is when you reduce the dose if you're using an AT meter. For SLGS, you reduce if numbers are below 90 on a human meter. Seeing the PMPS, at the very least, you may have needed to reduce the dose. We generally suggest that if you get a pre-shot number at around 200 if following SLGS that you post and ask for help when you are still new to managing your cat's diabetes.

Can you stay up to monitor Gizmo? Please read the sticky on Shooting & Handling Low Numbers. It was written for TR but the instructions for managing low numbers is pretty much the same. Regardless of when your cat "normally" eats, if you are steering numbers, you test, if numbers are low, you feed high carb food, syrup, etc. and re-test in 20 - 30 min. You repeat the process until your cat is in safe numbers. Since you're already feeding HC food, you can add a few drops of Karo, honey, etc. to the food.

Do you have any honey, Karo syrup, etc. in the house if needed?
 
Sienne and Gabby (GA) said:
Lizzie:

I don't think you have the data to have shot that low. Please get a test in at +0.5 -- 30 min. after your shot and I'd encourage you to start testing every 30 min.

To put this in perspective, for those following Tight Regulation which is a much more aggressive approach to dosing, a 68 is when you reduce the dose if you're using an AT meter. For SLGS, you reduce if numbers are below 90 on a human meter. Seeing the PMPS, at the very least, you may have needed to reduce the dose. We generally suggest that if you get a pre-shot number at around 200 if following SLGS that you post and ask for help when you are still new to managing your cat's diabetes.

Can you stay up to monitor Gizmo? Please read the sticky on Shooting & Handling Low Numbers. It was written for TR but the instructions for managing low numbers is pretty much the same. Regardless of when your cat "normally" eats, if you are steering numbers, you test, if numbers are low, you feed high carb food, syrup, etc. and re-test in 20 - 30 min. You repeat the process until your cat is in safe numbers. Since you're already feeding HC food, you can add a few drops of Karo, honey, etc. to the food.

Do you have any honey, Karo syrup, etc. in the house if needed?
Click to expand...
Yes. I have both. Did you see the + 20 min?
 
When you get the chance get update his test numbers to the thread title, lets folks helping see what's going on without trying to find the numbers in the thread. Really helps if he gets into trouble numbers
 
Gussie's mom said:
When you get the chance get update his test numbers to the thread title, lets folks helping see what's going on without trying to find the numbers in the thread. Really helps if he gets into trouble numbers
Click to expand...
How do I edit the subject line?

Figured it out.
 
Last edited:
Please get a test in @ no later than +1. That number may be due to the HC you just fed him or his numbers may be on the way up because he is bouncing from having dropped into green earlier.

If it's a HC food spike that you are seeing please be aware that his numbers could plummet when the HC wears off, that's why I suggest you get a +1 and a +2 at the very least. If by +2 +3 his numbers are still rising and you haven't fed any additional HC then you should be in the clear. A cat will typically have onset of insulin (when the insulin shot starts to work) between +2-+3, though some onset earlier and others later. That is why I am suggesting further monitoring early in the cycle.

A few things concern me not least is the way you have arrived at the dose, frankly taking it up in 1u increments is too much. In effect you increased his dose by 50 % by going from 2 to 3 u and with only the limited data your vet collected, numbers that were likely influenced by vet stress, but equally as Julie explained on your other post if those vet curves were done during a bounce then the numbers would have been artificially inflated due to his liver panicking and dumping glucose into the bloodstream, once the bounce clears, the numbers can return back to a lower range, so the 1u increase may have been too aggressive a dose change. If you look at georges ss and look back to the 2015 tab back when he started on insulin you can see how a dose change of just 0.25 u took him fom a sea of pink and red to seeing blue and green. 0.25 u changes can make a big difference.

I realise you are feeding high carb on this forum that would limit you by default to following slgs. Please read the sticky for this, Julie provided this for you I'm the other thread. When following that method, typically you would not shoot below 90 (to begin with) and you would take reductions when kitty drops below 90, so gizmo has earned another reduction to 2.5.

I see some others have joined the thread while I was writing, 1am for me here so I will say goodnight,.
 
I appreciate everyone.

Please keep in mind that I was not encouraged to home test until last Thursday. I was only following my vet's instructions. I am doing the best I can.
 
LizzieInTexas said:
I appreciate everyone.

Please keep in mind that I was not encouraged to home test until last Thursday. I was only following my vet's instructions. I am doing the best I can.
Click to expand...
It's ok, it's all learning..I'm grateful you stayed on the board tonight..you are doing fine...it will be ok:bighug::bighug:
Keep posting those numbers as it looks like he's starting to drop..
Hang in there, you have great help standing by..
 
LizzieInTexas said:
I appreciate everyone.

Please keep in mind that I was not encouraged to home test until last Thursday. I was only following my vet's instructions. I am doing the best I can.
Click to expand...
Please know that we are not criticizing you. We understand that you are new to this and we are just trying to help you keep Gizmo safe. Please review the SLGS stickie that was linked for you above. Any questions, please ask, we are here to help.
 
No one if giving you a hard time because the vet discouraged home testing. Rather, you're in good company. Very few vets encourage people to home test and you're among a select group of caregivers who actually do home test. So, kudos to you.

I think we may have cross posted when you noted the PM +0.3 (that's 20 min). One possibility I neglected to mention is that your PMPS could have been a bed test. Sometimes, you have a bad strip, the strip doesn't fill quite the way it should (and you don't get an error message), or the meter has a "hiccup." If you get a test that seems out of sync, it's helpful to re-test. That may be the case with the PMPS given how high your +1 is. It's also possible that this is the effect of the K/D.

 
Sienne and Gabby (GA) said:
No one if giving you a hard time because the vet discouraged home testing. Rather, you're in good company. Very few vets encourage people to home test and you're among a select group of caregivers who actually do home test. So, kudos to you.

I think we may have cross posted when you noted the PM +0.3 (that's 20 min). One possibility I neglected to mention is that your PMPS could have been a bed test. Sometimes, you have a bad strip, the strip doesn't fill quite the way it should (and you don't get an error message), or the meter has a "hiccup." If you get a test that seems out of sync, it's helpful to re-test. That may be the case with the PMPS given how high your +1 is. It's also possible that this is the effect of the K/D.
Click to expand...
But it has been low every pre-meal test
 
Much of this will make much more sense after experiencing it..the main thing you need to do tonite is lots of testing so that if he is going to do a dive as we call when the numbers fall fast you can catch it and try to prevent a hypo using food and syrup/honey. There is help here, it's all very confusing but you will look back at some point and say why was that so foreign to my brain..
Hang in there
 
Ok, +2 264

I have some questions I want to ask before everyone goes to bed on me. :)

I usually give 1 can k/d @ +3 in the evening. I will do so tonight unless someone tells me not to (or another alternative). I can extend this by 2-3 hours.

I can give some dry purina kibbles before I go to bed (if I give can @ +3) - if you think it is a good idea. I will try to last until 10:30p to test @ +5 but doubt anyone will see (I could be wrong). I get up @ 3:45am so alarm will come quick for me.

I want to reduce to 2u tomorrow a.m. - I am scared to leave him w/o monitoring - good idea/bad idea?

I will post another reading @ +3.
 
LizzieInTexas said:
Ok, +2 264

I have some questions I want to ask before everyone goes to bed on me. :)

I usually give 1 can k/d @ +3 in the evening. I will do so tonight unless someone tells me not to (or another alternative). I can extend this by 2-3 hours.

I can give some dry purina kibbles before I go to bed (if I give can @ +3) - if you think it is a good idea. I will try to last until 10:30p to test @ +5 but doubt anyone will see (I could be wrong). I get up @ 3:45am so alarm will come quick for me.

I want to reduce to 2u tomorrow a.m. - I am scared to leave him w/o monitoring - good idea/bad idea?

I will post another reading @ +3.
Click to expand...
When you gave the injection, did you give food at that time?
 
Bobbie And Bubba said:
I would give what you usually give him @+3 food wise for now. I am going to tag some people that are on the west coast that might be able to be available for you tonight should you need them. @Tricia Cinco(GA) & Harvey , @Chris & China , @Marje and Gracie . If you can get through +5 that would be great and would give you an idea if any further test are necessary to help steer. Wow, 3:45 AM is an early day!
Click to expand...
I so appreciate this. Tears in my eye. Very grateful.

Early and long days. Story of my life.
 
LizzieInTexas said:
But it has been low every pre-meal test
Click to expand...

There is not a lot of history to review to see how Gizmo responds to the insulin. Yesterday he started at 123 and got down to 67 at +8, on an Alphatrack that is where most of us would start giving high carb food to bump up the numbers. Tonight he started out even lower. It looks like you fed at shot time based on his numbers. I would follow the same routine for now and give the usual snack. The high carb content will help keep his numbers up. A lot of us set an alarm and do a quick test then go right back to bed. If you shot around 6:30pm, when you first get up will be about +9, getting a quick test then will help in filling in the spreadsheet so you know how Gizmo responds to the insulin. If it were my cat, I would want to get a test in somewhere between +6 and +8 if you can. Keeping Gizmo safe is priority one.

Hopefully some other members can give advice for a morning dose, I agree that not being able to test it would probably be a good idea to reduce the dose. Would he get his usual snack during the day tomorrow?

I'll be up till at least 11:30 EST tonight and will check in on Gizmo, but hopefully some other more experienced eyes with can take a look since I don't have any experience with kitties on high carb diets.

Hang in there, you are doing a great job testing and learning as you go. All of us here learned what we know by asking a ton of questions.
 
LizzieInTexas said:
I want to reduce to 2u tomorrow a.m. - I am scared to leave him w/o monitoring - good idea/bad idea?
Click to expand...
I think that is a very good idea since you can't monitor him tomorrow. The larger depot that he has had the last few days might still be in play so can you leave some food for him to eat through the day? Remember, if he is 90 or below tomorrow AM do not shoot insulin. Better that is too high for the day than too low. You are doing a great job to be here and to be learning so you can help Gizmo. All of us know how scary and frustrating it is in the beginning. We are here to help just like the people here helped each of us. :bighug:
 
Since you normally give a full can of food, and we are not yet sure if Gizmo will drop tonight, I would give less than normal at +3(maybe 1/4 can), then test again at +4. You can give him more food then. Depending on what number you get, test again at +5 and give the rest of the food. The reasoning is that if he is dropping a lot at +3, you don't want to fill him up too much that he won't eat later when the effect of that food wears off. Does that make sense to you?

Do you have a timed feeder, or do you just leave food out when you go to work?

I have to run to the grocery store, but I'll be back to check on you in 30 minutes or so. There are plenty of others watching you, even if they aren't commenting.

You're doing just fine.

I just want to add that you are by no means the first person to get advice from your vet regarding FD that doesn't really make sense. Most of the vets I've dealt with, including at the top vet school in the country, do not encourage home testing. I will never understand why, considering the things I've seen happen to cats that were given insulin without monitoring. You are a wonderful mama to be taking this initiative, and you are in the right place to learn how to keep Gizmo safe. :bighug:
 
Gizmo is fed three cans/day 0, +12, +15. All three cans, every single time are gone in less than 5 minutes. He is ALWAYS hungry. He will eat. Only time eating has been an issue is with a pancreatitis flare.

I can run home tomorrow @ lunch I think.
 
Tricia Cinco(GA) & Harvey said:
Since you normally give a full can of food, and we are not yet sure if Gizmo will drop tonight, I would give less than normal at +3(maybe 1/4 can), then test again at +4. You can give him more food then. Depending on what number you get, test again at +5 and give the rest of the food. The reasoning is that if he is dropping a lot at +3, you don't want to fill him up too much that he won't eat later when the effect of that food wears off. Does that make sense to you?
Click to expand...
Really good point, Tricia, thank you..
 
Status
Not open for further replies.
Back
Top