? Tonight's dose - falling numbers after stalling. Advice please!

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Jen and Alfie

Jen and Alfie

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So Alfie is trying a new trick tonight! His PMPS was 18.1 so I stalled without food for 20 mins and now he's at 17.3. I did his first test at what was really +11:45 and the retest was 5 mins past shot time. So I could wait another 20mins and retest? (Poor Alfie's ears!)

What should I do with his shot? Whole dose or reduced dose? If reduced, reduce to what? The other night he hit 3.9 from a 20 PMPS so I don't want to tip him over the edge!
 
Stalled another 20mins, now at 16.9 so still falling.

I've had to feed him now as he's starving bless him. I'm inclined to either do 1U or no shot?

But equally, he's making good progress so I don't want to mess it up by changing dose too much!
 
Not sure with your insulin. Abd feel uncomfortable giving dosing advise. But you fed him lc or mc? Test 20 mins.
 
Where are you in his cycle? +1 +2+3? Is he carb sensitive? Do you have karo or honey in case you need it?

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. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours.
This was for Lantus/ Levemir insulins.
 
He might or might not go as low on a PS of 17-18 as he did the other night. My guess is he won't because he's still bouncing. I think I'd keep the same dose and test at +2. If that worries you, go to 3 u.
 
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I don't get the conversion because I'm in the US. But that seems like a high enough number. Your just concerned with him going down to fast? Do you know his Nadir value? Prozinc is a fast in and out insulin. I don't use it so hoping some others more pro eyes will see your post.
 
I'm at the start of his PM cycle. He's not low, just lower than his usual PM pre shot. I'm in the UK so I'm using mmol/L measurements.
 
That's ok, thanks for your replies!

Yes, was concerned he'd go too low after a low nadir the other evening on a higher preshot.

I've gone with a reduced dose of 1.5U as didn't want to wait too far past normal shot time, better too high than too low! Guess we'll see how this cycle goes.

Thank you:)
 
When you have a bouncy, unpredictable kitty you can't assume that a PS that came before an uncomfortable low on one occasion will result in the same the next time. You just have to make a reasonable decision and be prepared to test at the critical times and intervene with food if needed.
 
Jen and Alfie said:
That's ok, thanks for your replies!

Yes, was concerned he'd go too low after a low nadir the other evening on a higher preshot.

I've gone with a reduced dose of 1.5U as didn't want to wait too far past normal shot time, better too high than too low! Guess we'll see how this cycle goes.

Thank you:)
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Yes always better high than low! :) your welcome just didn't want you to think you were alone. :) hope he stays surfing safely. :bighug::cat: head bumps from phoebe
 
Jen and Alfie said:
That's ok, thanks for your replies!

Yes, was concerned he'd go too low after a low nadir the other evening on a higher preshot.

I've gone with a reduced dose of 1.5U as didn't want to wait too far past normal shot time, better too high than too low! Guess we'll see how this cycle goes.

Thank you:)
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Your peace of mind ranks up there with Alfie's safety. :)
 
Kris & Teasel said:
Your peace of mind ranks up there with Alfie's safety. :)
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I didn't want to get too far past normal shot time so just had to make a call! Wish I'd been braver now, live and learn! Typically it's a night when aim low on test strips, picking up more in the morning. Wasn't expecting to have to do three PMPS tests! :facepalm:

For next time, how long can I wait past his normal shot time and still shoot?
 
Jen and Alfie said:
I didn't want to get too far past normal shot time so just had to make a call! Wish I'd been braver now, live and learn! Typically it's a night when aim low on test strips, picking up more in the morning. Wasn't expecting to have to do three PMPS tests! :facepalm:

For next time, how long can I wait past his normal shot time and still shoot?
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We usually say up to an hour. Any longer than that and the interval to next shot gets too short and you'd have to move its time as well then slowly back up both times to your regular schedule.
 
Kris & Teasel said:
We usually say up to an hour. Any longer than that and the interval to next shot gets too short and you'd have to move its time as well then slowly back up both times to your regular schedule.
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Great, thank you! I'll be braver next time with the lower than I'm used to pre shot numbers. And more patient if I need advice! ;) Every day is a school day on this journey!

This board is such a lifeline, I honestly don't know how people manage without it :bighug:
 
Ok, I assumed he'd be riding high after a reduced shot and have just tested at +3.5, he's at 3.5!!!

He's eating pate food now. He's really hungry! I haven't had a chance to double check the test in case it's a faulty strip.

I've got no idea what's going on if that's accurate.
 
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I've done two tests, the first was 3.5, the second 3.7, so I don't think it's a wonky strip. He's eaten loads of food and has just run upstairs to play!

I've given him a little bit of food in gravy as he's still two hours away from his nadir! :nailbiting:
 
Whoops cross posted :rolleyes:. Couldn't type fast enough because Maury decided to lay on my left wrist in front of the keyboard and right hand has to go over his tummy :p
Proof:
upload_2017-7-11_17-27-41.png
 
Ok hopefully he didn't eat too much to fill up on. He's probably OK but we still don't want him going much lower since you're using the AT2 :). Hopefully you can catch him and retest in thee 20 minutes :cat:
 
Hold off on giving him anymore food. In case he drops more, you're going to need him to be willing to keep eating.
 
Conventional wisdom is that you retest every 20 minutes, withholding food. If it goes down, you give food, if it goes up, you keep retesting until you have three rising numbers in a row.

However, you are still a ways from nadir, and it sounds like he just ate a bunch, so you could probably test in 30 minutes and re-post. Then we can figure out what to do from there. I'm thinking you might want to test every hour until nadir, or until the rise looks really solid without additional food.

Do you have a lot of test strips? Is your DH around to help?
 
Yup food is working. I would still retest in 20 - 30 minutes and don't feed him anymore HC right now. Let's see if next test he'll start rising on his own. Is he at +4 now? He should be closer to nadir, seems like PM is around +6.
 
I just re-read that, and I think I didn't explain it very well!

Short answer, test in 20-30 minutes and post. :)
 
yes, he's at +4:15 now. Will retest at +4:30.

Fortunately DH went to pick up strips from the vet hospital as I was flapping! So we've got plenty. Hopefully the food will keep him up for a bit. His nadir always seems to be +6 so we're not too far away.
 
I did give him a spot on flea treatment tonight, I've no idea if that's had anything to do with his numbers or if that's just coincidence. The vets said I could keep treating him monthly as normal without any issues.
 
My goodness!! He sure surprised us! I think you're getting to his good dose range but it's happening quickly and he throws in some bounces just to make it interesting. You did the right thing by lowering his dose. :eek::smuggrin:
 
Kris & Teasel said:
My goodness!! He sure surprised us! I think you're getting to his good dose range but it's happening quickly and he throws in some bounces just to make it interesting. You did the right thing by lowering his dose. :eek::smuggrin:
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Yes, so now what to do going forward? The 3u dose wasn't enough. This feels like a smidge too much. Fat 3u? Skinny 3.25u? Or was the 3u the breakthrough and it wasn't enough two days ago, but will be plenty now? Ah for that crystal ball....:)
 
Kris & Teasel said:
My goodness!! He sure surprised us! I think you're getting to his good dose range but it's happening quickly and he throws in some bounces just to make it interesting. You did the right thing by lowering his dose. :eek::smuggrin:
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Looks like I did, but totally by accident! A few hours ago I was beating myself up for probably giving him another high cycle. It's exhausting! :blackeye:
 
Djamila said:
Yes, so now what to do going forward? The 3u dose wasn't enough. This feels like a smidge too much. Fat 3u? Skinny 3.25u? Or was the 3u the breakthrough and it wasn't enough two days ago, but will be plenty now? Ah for that crystal ball....:)
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Yes, that was my next question! What happens tomorrow. All you amazing people are fast asleep when I'm doing my AMPS ;)
 
Just retested, +4:30, he's at 7.6 so on his way up. He ate a lot, he was starving! I thought it was because he'd be super high, oops :confused:

Retest in 30 mins or do you think I can leave it an hour? He's fast asleep like he's had a big dinner!!
 
6am UK time. Though he didn't get his PM shot tonight until 6:40pm because I stalled him twice, so might do AM at 6:30am tomorrow. I've been looking for an excuse to move it a bit later!
 
So something like this so far, yes?

+3.5 = 3.5
+4? = 5.8
+4.5 = 7.6

He's blue now, so if it was me, I'd probably wait 45min to an hour, but I'd of course keep an eye on him, and test earlier if curiosity or worry got the better of me.

The lime greens do tend to wear them out! Hopefully the nap will do him some good!
 
Djamila said:
So something like this so far, yes?

+3.5 = 3.5
+4? = 5.8
+4.5 = 7.6

He's blue now, so if it was me, I'd probably wait 45min to an hour, but I'd of course keep an eye on him, and test earlier if curiosity or worry got the better of me.

The lime greens do tend to wear them out! Hopefully the nap will do him some good!
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Yes, sorry, lots of numbers tonight that are hard to record in the spreadsheet. Tonight we've had:

AMPS. - 18.1
AMPS + 20min stall. - 17.3
AMPS + 2nd 20 min stall. - 16.9

1.5U shot

+ 3.5 - 3.5 and 3.7 (Immediately fed both HC & normal LC food)
+ 4 - 5.8
+ 4.5 - 7.6

I did think it was odd his pre shots were falling. Maybe it is an odd reaction to the flea treatment.
 
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