? Keep stalling? And what about next cycle?

[Squeakycats]

Hi, all--

My kitty has a much lower than usual pre-shot number. I'm trying to follow TR. We took his pre-shot measurement an hour later than usual (got home late); it was 53 (confirmed with a second test--46). Fed and stalled for an hour; he's up to 65. Do I keep stalling? Go ahead and shoot? If I do go ahead, do I do the full dose (.5)?

And let's say I end up giving him his usual .5 an hour from now (at what would normally be +3). What do I do tomorrow morning? Do I go back to his regular shot time (which would mean a big overlap), or start working backward from the new one? (For example--if his normal time is 7, and I give him his shot at 10 tonight, when tomorrow arrives, do I do the usual 7 a.m. shot--or do 9:30 or so and try to work backwards to 7?) I've read the sticky on low pre-shot numbers but wanted to check in with the awesome experienced people of Lantus Land.

I am able to stay up tonight if necessary and to be home tomorrow. Any advice is much appreciated! (I'm not sure if his spreadsheet has a ton of relevant data--we only switched to the Relion meter when he was very close to going into his now-failed remission--previously I used an AlphaTrak, which is recorded in a separate spreadsheet.)

 

[Susan G & Jimmy G]

Relatively new but from what I understand when you stall his shot you want to withhold feeding so you can see if he's rising on his own. The 65 could then be possibly food influenced.

I think with relation to the timing and overlap of shot it will depend on your schedule. You always have the choice of no shoot and treat it like a fur shot and get back on your 7 o'clock schedule.

What are his numbers now?

 

[Squeakycats]

He made it up to 82 at +2, but that probably was slightly food-influenced. So I compromised and gave him .25 (half the usual dose). I'm thinking I'll work back toward his regular schedule in 30 minute increments, watching carefully (I need to get him back to 7:00 on Monday so we can do our usual pre-work ritual). I'll definitely be testing again in a couple of hours, and more frequently after that if it seems necessary! Thanks for your help! Jimmy is so cute.

 

[Susan G & Jimmy G]

He made it up to 82 at +2, but that probably was slightly food-influenced. So I compromised and gave him .25 (half the usual dose). I'm thinking I'll work back toward his regular schedule in 30 minute increments, watching carefully (I need to get him back to 7:00 on Monday so we can do our usual pre-work ritual). I'll definitely be testing again in a couple of hours, and more frequently after that if it seems necessary! Thanks for your help! Jimmy is so cute.

Sounds like you have a good plan.

Misha looks like Jimmy's mama. What a sweet picture.

 

[Wendy&Neko]

Here's a post about getting back on schedule. Moving 1/2 hour a day is a good options (or 15 minutes a cycle).

And here's the link to your previous post here: http://www.felinediabetes.com/FDMB/threads/post-relapse-woes.181685/

You have two weeks of Relion data, that's enough to be relevant. Next time you see a low at preshot time, do NOT feed, and post for help. For next time, and with cats there always is a next time, , you might want to read the Sticky Note on Handling Low Preshots.

 

[Squeakycats]

Thanks, Wendy! I swear I read the sticky--I was just nervous about the 53 number because the second test was 46, and because it was an hour later than our normal test time, so I thought that if anything, he might have had lower numbers when we usually would've tested. And I think I got confused because I was flipping between here and Tilly's page, and the section on low numbers there says "A second alternative is to feed the cat, wait 1 to 2 hours, test again, and when the BGs start rising, give the normal dose." It's not like I consciously noticed that the sticky and that tip conflicted about feeding and decided "I'll go with the Tilly second alternative thing"--I think my anxious brain just saw that, said "Oooo, that sounds good--I can go ahead and feed him! Then his numbers will surely go up and I'll be able to do the shot and not have to skip! Skipping is bad!"--which meant that I (unconsciously) ignored the "don't feed!!!" instructions here. Now that I think about it, it seems obvious that feeding would just screw up the data and thereby interfere with making a good decision

And of course I did post for help, but only after I had cluelessly fed him! I didn't want to be a pest and keep bumping the thread after that (is that the right thing to do if you've got a question post and it's falling lower in the list, when it's not an actual emergency?). So the feeding damage was done long before Susan kindly came to help, and the "I'll give him half a dose" decision was made just shortly before--I didn't know if I'd be able to get any advice and figured I had to either shoot something by +2 or just skip.

I keep messing up...I'm sorry! I'm truly not trying to ignore the resources/advice here! I think part of the problem is that I get too anxious about things and don't think clearly, especially if I'm tired. I'm going to get my husband, who is Mr. Rationality, to read everything so he can help with these decisions. Up to this point I've generally only called on him when I couldn't be here to test. I've had him shoot a couple of times just so he knows how to do it, but managing the kitty has generally been my thing. There's no reason why that should be the case, really; I think he's willing to be more involved. So maybe that'll help. And as you say, there will unfortunately be many more opportunities for practice.

And now I have to look for some threads/sticky commentary on what to do when you've got a petsitter. I am simultaneously really happy that we're starting to see a little green again and really worried about what's going to happen when we go out of town August 19-22. Our petsitter is a professional and has given injections before, but she hasn't done testing, and I don't know how cooperative he'll be when he's scared. She can't stick around for hours after visiting, and I can't even confirm that she can come 12 hours apart for sure--I just realized I'd asked her whether she had experience taking care of diabetic cats and whether she'd be willing to try to test, but had NOT asked "what kind of insulin were the cats on?" I may have to get a friend to come once a day if the sitter can't guarantee she can keep things 12 hours apart (which I can't immediately find out--she has just left town and won't be back until the 16th, and we normally communicate by email, which she's not checking/answering). So do I have her/them keep giving him .5 no matter what? Hedge my bets and have her give .25, even though that may not do much good? Ask her to do whatever it takes to test him, even if he's freaked out? If we go that route, does that mean I can't leave any food out for him (so we'll know the numbers aren't food-influenced)? That would be different than what he is used to (we usually leave a few bites out during the day because we can generally take the food up a couple of hours before testing time). And it would make me extra nervous; I am always comforted by thinking that if he goes low while nobody is here, he can at least help himself a little by eating some low-carb food.

How do people manage this for years at a time?!?!? I'm guessing my situation is actually comparatively simple, since he's on a low dose and doesn't have a bunch of other hard-to-manage concurrent health issues, and since in an emergency, I could call in to work sick and stay with him--but it doesn't feel simple! Back at the very beginning of this adventure, before I learned about home testing, we went about a week giving him 2 units as instructed by the vet, without any idea of what his numbers were, and he came through that ok--he was hiding under the bed a ton and may have been somewhat hypoglycemic, but he tolerated it. So maybe I just have her keep on with the .5? I'm sure other people must have asked about this a million times, so I'm going to do a little searching...I am so grateful for your help and will continue to try to do a better job for my kitty, even if that process continues to include a lot of and and.

 

[LizzieInTexas]

Don't beat yourself up. It is a lot to learn. What helped me was realizing that 5-10 min doesn't make all that much differrnce. Take a moment and compose your thoughts and formulate a plan. Be sure to go back and document what you did on the SS or in your notes so the next time you will have it as a reference. Kitties are pretty resilient, they just roll with what we do.

 

[Squeakycats]

Thanks, Lizzie! You're right--they are good at going with the flow...