? Help! 10.2 PMPS Test

Status
Not open for further replies.
Okay he's high enough for full dose. Will you be able to monitor a bit though since this is the lowest he's been at pre-shot for dosing?

Here's what you put on the SS to make it make sense: 10.2, 11.6 (+12.20)

You'll have to color the cell manually, I would color it blue since that was the lowest number.
 
Panic said:
Okay he's high enough for full dose. Will you be able to monitor a bit though since this is the lowest he's been at pre-shot for dosing?

Here's what you put on the SS to make it make sense: 10.2, 11.6 (+12.20)

You'll have to color the cell manually, I would color it blue since that was the lowest number.
Click to expand...

Yup, I can monitor for a bit see how he gets on. He'll be glad to be getting some food!

Will update the spreadsheet

Thank you @Panic
 
So, just to know for future. If the number is below the no-shoot threshold (11.1), would you always stall 20/30 mins, retest, and if the numbers are going up (above this threshold) then go ahead and continue with feeding and then shooting?
 
Typically yes, because if the numbers are going up on their own they're going to keep climbing if you were to skip. Here's a refresher from the Caninsulin guide:

Q: Is my cat’s BG high enough for insulin?
For those NEW to treating feline diabetes, and/or those who don’t have much data about how their cat responds to insulin, we generally recommend that you post to either this forum or the Health board and ask for help if the pre-shot BG is below 200 mg/dL [11 mmol/L] on a human meter. Experienced members can walk you through the options of what to do if you have a lower than expected pre-shot number.

Q: It’s time for my cat’s shot, but the BG is a little too low. What now?

  • If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
    • Stalling is waiting - without feeding your cat - for 20+ minutes, then retesting to see if the BG has risen to a suitable level.
    • You are looking for a number that is rising, not falling, and is high enough to give insulin.
    • If you have time, you can repeat the stalling process to see if the cat’s BG reaches a number you can shoot.
  • If you cannot stall do to time constraints, if numbers are continuing to drop or if you do not have a supply of strips and high carb food on hand, it will be safer if you skip the shot.
  • Note: As you gain experience with home testing and have gathered data to show how your cat responds to insulin, you will become more confident and better able to shoot progressively lower numbers.
  • Ask for help on the forum before giving insulin if you are unsure, as you can never ‘un-shoot’ insulin.
  • If your cat has history of ketones or DKA, or other health issues, or you are concerned, DO post on the Main Health forum for further advice
Douglas_my ginger cat said:
Ha, so offended! I was trying to distract him but he was not having any of it!
Click to expand...
These kitties are not to be messed with when food is involved! I used to have to hide in closets and spare bedrooms when opening any sort of can - even if it was just something for me! :woot:
 
It does start to get a bit nightmarish when you start shooting lower than usual numbers. Your 10.2 and 11.6 aren’t really much different and although the key is to shoot “on the rise”, ie when numbers are going up, at that kind of number I would exercise caution. He may start going up again quite quickly in which case shooting now should help to stop too steep a climb, or he may have been surfing in the blues in which case a full dose might drop him a bit too fast. It’s one of those situations where you just have to stay alert and get a few more tests in early in the cycle to monitor what’s happening. Good luck!
 
Look for any hint of a 'hunger uptick' from +1 onwards as that can signal dose onset time (varies, but usually between +1 and +1.5).

Test at +2 to potentially get advance warning of a big drop. Test at +3 minimum to see how low the dose is going (most of the drop usually occurs by then, but nadirs can be later).


Mogs
.
 
Douglas_my ginger cat said:
So, just to know for future. If the number is below the no-shoot threshold (11.1), would you always stall 20/30 mins, retest, and if the numbers are going up (above this threshold) then go ahead and continue with feeding and then shooting?
Click to expand...
'Stalling' is a very useful option if the preshot is 'close' to a shootable number, but is just a bit too low.
With Caninsulin you do certainly want to see that the number is 'shootable' and is rising.

If the preshot is technically shootable but is lower than usual then you have several options. You could skip the shot. You could give a reduced dose, maybe a half dose, maybe a small token dose. Or you could give the full dose. But ideally in that last situation you DO need to be prepared to monitor blood glucose and to keep the blood glucose at a safe level if it looks like it might drop too low.
Do take the course of action that you feel most comfortable with. And you always have the option of giving a lower dose, which can be especially helpful if it is the evening shot and you know you really need to get some sleep....

Douglas seems to get the lowest number of the cycle later than is typical with Caninsuln, and anywhere between +5 - +7 (maybe even later on occasion...).
It may be an 'uneventful' cycle this evening. But if you are at all concerned, Anna, then DO post here for advice. And the lovely folks here will guide you through any situation that may arise.

BTW, that was a lovely PM cycle yesterday.... :cat:

Eliz
 
Critter Mom said:
See if Douglas starts behaving as though he's looking for food (e.g. going to his bowl). Sorry I didn't explain properly first time, Anna. :oops:


Mogs
.
Click to expand...
To be honest, Douglas has been looking for his bowl for the last few days. I mean he's definitely been a bit more 'active' and vocal including letting me know he's leaving or coming into my bed at all hours of night! Which in some way is nice as its a little like his old self, prior to diagnosis.

If he does look for food, should I give him some?
Elizabeth and Bertie said:
BTW, that was a lovely PM cycle yesterday.... :cat:
Click to expand...
Its lovely to see his numbers so low but does put me slightly on edge as I dont want them to go too low.. Its almost like a double edged sword for me

@Diana&Tom paws crossed!
 
Douglas_my ginger cat said:
To be honest, Douglas has been looking for his bowl for the last few days. I mean he's definitely been a bit more 'active' and vocal including letting me know he's leaving or coming into my bed at all hours of night! Which in some way is nice as its a little like his old self, prior to diagnosis.

If he does look for food, should I give him some?

Its lovely to see his numbers so low but does put me slightly on edge as I dont want them to go too low.. Its almost like a double edged sword for me

@Diana&Tom paws crossed!
Click to expand...
Yes, unaccustomed numbers can be scary that’s for sure. It is a fine balancing act as you’re now starting to see.
If he wants food, I would give it to him, yes, just small amounts though, and keep testing, especially if he starts acting strangely. If he keeps dropping from the 8.5 in the next hour, say below 5 or 6, you may want to get out some higher carb food as a kind of first defence against a further big drop. 5 or 6 are lovely normal numbers but you don’t want to be seeing them too early in a Caninsulin cycle when there may be further drops to come. Let’s not expect hypo numbers but you’d know what to do if that did happen, would you?
 
Diana&Tom said:
Yes, unaccustomed numbers can be scary that’s for sure. It is a fine balancing act as you’re now starting to see.
If he wants food, I would give it to him, yes, just small amounts though, and keep testing, especially if he starts acting strangely. If he keeps dropping from the 8.5 in the next hour, say below 5 or 6, you may want to get out some higher carb food as a kind of first defence against a further big drop. 5 or 6 are lovely normal numbers but you don’t want to be seeing them too early in a Caninsulin cycle when there may be further drops to come. Let’s not expect hypo numbers but you’d know what to do if that did happen, would you?
Click to expand...
Just read up about it again so ready to go. Going to test again in about half hour. Although I am literally staring at the clock and waiting to test again!
 
Douglas_my ginger cat said:
Just read up about it again so ready to go. Going to test again in about half hour. Although I am literally staring at the clock and waiting to test again!
Click to expand...
Tense times I know. I think you’ve got this under control but again, if you do need help, post an urgent message and someone or several people will respond. It’s getting late for most of us in the UK but Mogs may be up as will people elsewhere.
 
Hmm. That's a good question. With the longer-acting insulin you wouldn't break out the HC unless they dip below 2.8. Caninsulin doesn't have that luxury really. Perhaps medium-carb food would be warranted if they dip under 5, then if still dropping, bring out the HC.

You can test in half hour increments if you're nervous too! Caninsulin works quickly so it wouldn't hurt.
 
FDMB uses 3.8mmol/L // 68mg/dL as the hypo threshold.

The FDMB Caninsulin Beginner's Guide has this to say about nadir BG:

Q: How low should my cat’s BG drop on Caninsulin/Vetsulin?
Usually it's best that newcomers aim for a nadir no lower than 90 mg/dL (5 mmol/L) as measured on a human glucose meter. This insulin can drop the BG quite sharply. Trying not to let the BG drop below this level as it gives an initial safety buffer while you are learning the ropes.

If you are using a pet meter you may want to intervene earlier since pet meters are calibrated differently and typically read higher than human meters.
Click to expand...


FDMB has various studies that provide evidence for the human meter thresholds that are used in the dosing protocols. This isn't the case for pet meters (where only the hypo threshold and the top end of the normal reference range is mentioned in FDMB guides.

When Saoirse was on Caninsulin I was really uncomfortable when her BG went below 6.0mmol/L (Alphatrak). When she started ducking below that level I switched insulins.


Mogs
.
 
Douglas_my ginger cat said:
I dont think I'd be comfortable increasing the Caninsulin dosage with such steep drops/elevations
Click to expand...
Quite.

Even when you get a much higher preshot BG reading, the same dose can tank numbers straight back down again.

When I hit the Caninsulin 'dosing wall' my heart was in my mouth on every single cycle. I had to stop. My vet held off a little while before issuing the Lantus Rx to see whether Saoirse was in remission. I didn't think so. I was right. Her numbers started trending upwards shortly after suspension of Caninsulin. I had to wait for her numbers to rise a good deal before I was prepared to give her Caninsulin again (and I switched to U100 syringes to try to measure smaller doses properly).


Mogs
.
 
I'll be signing off shortly. Hope all goes well with Douglas, Anna.

If you do need help, shout out. If you're badly stuck and Feline Health is quiet, try posting on the Lantus board for help (usually more traffic there), and include a link back to this thread for members to follow you back here. Put a question mark flag against the title of the Lantus board post to attract more attention to your thread. If Douglas were to go down into the low 80s or 70s and you can't get numbers back up again, set the thread title flags to 911 on Feline Health and also on the Lantus board if you don't get a prompt answer on FH first.


Mogs
.
 
Critter Mom said:
Woot! :woot:

I suggest giving Douglas some low carb to eat: it's still early in the cycle.

I'm sorry I can't stay with you tonight, Anna. :( (Not very well and wouldn't be able to stay the course.)


Mogs
.
Click to expand...
Please don't apologise, thank you for your help and support. I hope you feel better soon :kiss:

Panic said:
Don't want him any lower than that! Give him a LC snack and maybe test in 20 to check.
Click to expand...
He's quite happily hoovering up some LC food, will test again in a bit. Thank you
 
Wow. Stay vigilant, Anna.

I agree, give Douglas some food now (this is why you don’t want to over feed him too early; you don’t want to fill him up so he’s not interested in food if you need to get high-carb stuff into him).

I’m afraid I’m not going to be able to stay awake much longer either but Mogs has pointed you in the direction of help if you need it.
 
Status
Not open for further replies.
Back
Top