Ron, cont.

NatashaL said:
So Ron has been 90 at 6+ for the last two days. Do we hold steady at 1.5U
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Any time that Ron hits that 90 or below reduction point, you reduce the dose by 0.25U.
So his new dose for 5/21/20 AM should be 1.25U
Or if you see this before tonight's dose, reduce for the PM cycle. Down to 1.25U please.
 
Ron has seem to stabilize but it's in around the 160 to 170 range, his PMPS number. That seems high to me do you agree? He's at one unit right now. Do you think we should go up a little? Or does this seem like an okay range?U at 6+ he's between 120 and 140. Thank you!
 
Remind me again why you don't get the AM pre-shot tests? I feel like I should remember, but not getting much sleep lately and the memory retrieval system is malfunctioning.

But, without that pre-shot data, it's really impossible to calculate the percent of the drop from pre-shot to nadir, which we need in order to recommend a dosing change.

So I'm very leery of suggesting a full 0.25U increase, without that data.
Ron could probably use a bit more juice. Do you know how to draw up a "fat" dose or a "skinny" dose?
 
No I haven't heard of that!
He used to not get it because we were leaving food out and it was always very consistent and very high. Now it's because his other numbers are so consistent,so I didn't think it was necessary. And it's at 5:30 in the morning so if it's not necessary I'd rather not do it.
 
Yes, his middle of the cycle numbers are fairly consistent. But we need to put those numbers into context, to understand what is happening to Ron on this dose. You only want to see about a 50% drop, from pre-shot test to nadir. That would help us to determine if Ron needs only a fattened up dose, or a full 0.25U increase.
NatashaL said:
And it's at 5:30 in the morning so if it's not necessary I'd rather not do it.
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It's become important, with Ron's numbers trending in the lower blues and greens at mid-cycle.
 
Hi, everyone. A quick update and request for advice.

Ron's been going down to the point where we are now at 0.75u twice a day. My husband accidentally forgot to give Ron his dose this morning, but didn't notice until +6 when we tested Ron. We expected higher numbers for the next two shots, but they actually were the same as they have been for the last couple days.

Since our goal is remission, do we take this as a sign that we should skip his PM shot and see where his numbers go? Or are we likely to do more harm than good by suddenly going from 0.75 to nothing?

We'll give him his 0.75 dose in an hour if no one is able to respond, but just thought we'd get some input.

Thank you!
 
Didn't see this soon enough to answer, but you probably already have given Ron the PM shot of 0.75U.
A pre-shot of 113 is very low to give the full dose. But if you can monitor in the PM cycle, it should be ok.
Please get a +2 if you went ahead and gave Ron the 0.75U.

If you have not given the shot, you may consider a token dose of his regular dose. A token dose is somewhere between 10 and 25% of the regular dose.

You want to go from 0.75U to 0.5U to 0.25U to 0.1U before you stop the insulin completely.
 
He was 71 at +2! So we'll test him in the morning and he's already now reduced to .50 for sure, but any advice if he's low in the morning? I realize you may be asleep by now. But maybe give him a token dose? What number are we aiming for in general?
 
With that low of a BG so early in the 12 hour cycle, you need to feed Ron some food to bring his BG levels back up. ASAP. Start with low carb food, maybe a teaspoon and please retest. The Prozinc is just starting to onset, or start working, so his BG levels will be dropping more. You need to stay up for a bit, and feed and test Ron, to stop him from dropping too low.
 
We fed him about an hour ago. We'll test him and feed him again. What number should we be looking for in the morning to know if we should shoot him or not? Thanks so much!
 
I've asked member @Panic to help you through the low numbers situation. Can't stay up to help you tonight.

You've shot some pretty low PM pre-shots. But I think you want Ron to be at least 130-150 before you go ahead and shoot. AM or PM. Plus, I think you should lower the dose to no more than 0.25U for the forseeable future.

You are using an Alphatrak, so the higher number, the 150 should be your target I think.

A number that low, that 71, so early in the cycle, means you need to stay up tonight to make sure that Ron's BG levels stay up and increase to >100. That could take several hours or even longer. Sorry, but you are going to lose some sleep tonight, to keep Ron safe. We don't want to see him have a symptomatic hypo, and need a visit to the 24 hour emergency vet.
 
Panic said:
Hi Natasha. I'll stay up with you and Ron. Could you test and post where he's at right now?
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Gosh thank you so much!!!
We just tested him and he is 89. So we'll feed him right now. When should we test him again? So we just need him over 100 before we can feel safe about this? I can't get over how amazing you all are Thank you so much for being here for this!
 
You're welcome! :) Always happy to help!
That was with a low-carb snack? And he's at +3? He's doing good, I might test in another half hour and make sure he doesn't dip since we're still early in the cycle.

Here's what another member said to another kitty we stayed the night with:

once in safe numbers, do not feed but test every 30 minutes for next hour, then one more test an hour after that.
if the cat falls below 68 (AlphaTrak), you must respond accordingly and the 2 hour clock starts over again.
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So if he's alright in 30 minutes, hold the food and check again in a half hour. I'll be here.
 
Panic said:
You're welcome! :) Always happy to help!
That was with a low-carb snack? And he's at +3? He's doing good, I might test in another half hour and make sure he doesn't dip since we're still early in the cycle.

Here's what another member said to another kitty we stayed the night with:



So if he's alright in 30 minutes, hold the food and check again in a half hour. I'll be here.
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I'm in tears over here for how grateful I am for your help! Thank you again.
So we'll test in 30, take away the food and test in another 30 minutes?
 
Snooped through some older posts since I'm not familiar with low Alphatrak numbers. Deb said to stay above 90-100 so if he's still below that we'll feed another teaspoon, okay?
 
That should be fine. The idea is more to not fill him up too early. We'll check again in a half hour okay? Glad to see he's not dropping too much.
 
Wonderful! A half hour first without food, then if he's still good another hour without food. You can set a timer and catch some Z's if it's late where you are.
 
You both are doing great! :D

Same for me, over here on the east coast. I'm entertaining myself with some shows since I'm not toooo tired. :)
 
Another thing you can do is put in the remarks section when you were feeding and stalling so you can use it as a reference for next time and so others can help you with him based on prior experience. :) And add the half hour tests as well! You can put them in the same cell, like for example 78 (+2), 74 (+2.5) and then manually color the cell.
 
Panic said:
Another thing you can do is put in the remarks section when you were feeding and stalling so you can use it as a reference for next time and so others can help you with him based on prior experience. :) And add the half hour tests as well! You can put them in the same cell, like for example 78 (+2), 74 (+2.5) and then manually color the cell.
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Sorry, I'm so tired I did the last post wrong. But anyway he is 120! So now can we just go to bed and test him at 5:30 like we usually do? That's when we usually shoot him.
 
Hi again! So Ron was 111 at 6+. Does Deb's advice still stand that we don't shoot (tonight, I mean) unless he is between 130-150? Or was that just last night when he was in danger?
 
Oh, we gave him .25 this morning because he was 140 if I remember. But now at the nadar he is 111. So do you think if tonight he is below 130 we should skip? And then from now on?
 
Wait sorry I misread your first post...guess I wasn't fully awake yet lol. I think Deb would ideally prefer you to be closer to 150 to shoot but if below 130 she recommends skipping - and that's for AM and PM shots. Unless she says otherwise. :)
 
Panic said:
Wait sorry I misread your first post...guess I wasn't fully awake yet lol. I think Deb would ideally prefer you to be closer to 150 to shoot but if below 130 she recommends skipping - and that's for AM and PM shots. Unless she says otherwise. :)
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Yes, that is what I meant. Pre-shot needs to be closer to 150, skip the insulin if the pre-shot is <130 for both PM and AM shots. Until we see how Ron is doing on the lower dose, we want him to be safe.

When using an Alphatrak, you want the pre-shot tests to be a bit higher before you go ahead and give insulin
Closer to the 150 BG level with an Alphatrak will be safer for Ron.

@Panic Thanks so much for staying up and helping Natasha last night, with her first "pajama party". I was exhausted, wiped, dragging with "both knees on the ground tired" and could not help her myself. Good job, the 2 of you keeping Ron safe.

Ron is actually the first cat with feline diabetes that I've seen on the message board where it looked like he had been overdosed for some time. Natasha didn't have the SS (spreadsheet) setup then, only a document with a long list of numbers and some dates to go along with that. Her more computer savvy husband helped her set up our SS and get the data from her old document into the new SS. It was a real team effort, and it has REALLY PAID OFF.

At this point, I believe that Ron is trying to go OTJ, off-the-juice, insulin being the juice. All paws crossed for Ron.

Did Ron get his 0.25U dose this morning, 6/27?20? I don't see any updates on the SS, is why I'm asking.
 
Hi, it's been a true team effort! Thanks to y'all he is not getting more and more insulin!!

My computer savvy husband has not yet updated it but, Ron tested at 140 this morning so he did get his dose. However he tested at 111 PMPS so he did not get a shot tonight.

I'm surprised that this is the first cat you have seen that has been overdosed for so long. I would have assumed this is more of a commonocommon with vets not knowing what to do and not suspecting overdose!
 
NatashaL said:
I'm surprised that this is the first cat you have seen that has been overdosed for so long. I would have assumed this is more of a commonocommon with vets not knowing what to do and not suspecting overdose!
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Let me rephrase that. This is the first cat where it was pretty obvious that the dose was too much. Usually, the overdosing is more subtle and not always so obvious.
 
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