3/14 - Wally +12 56,+12.5 96, AMPS 176,+1=204,+2=168, AT2 & +12 45,+12.5 67, AMPS 124 ,+1=156 Rel

[Ginger Cat]

Previous thread: https://www.felinediabetes.com/FDMB...t-amps-182-2-5-263-7-308-pmps-392-rel.244610/

Do I give him a token dose this morning or skip? I'm feeding him now and his shot is due in 30 minutes. No obvious signs of hypo, other than screaming for food.

He's up to 96 on the AT2 and 67 on the Relion after eating AMPS +.5

He dropped from 401 PMPS+2 on the AT2 last night!

I'll retest him after he eats, but am hesitant to give a full dose even if his numbers start to come up.

I swear his numbers go down after he has a bowel movement. He hadn't had one all day yesterday, then had one overnight and another this morning...

 

[Gill & George]

Just give him a teaspoon of LC see if he will come up.

 

[Gill & George]

From the how to handle low PS sticky


Some general rules when stalling (ECID):

• 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
• 40s or lower – you have a couple of choices.
  • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.

• • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
    
    • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitiv

 

[Ginger Cat]

Just give him a teaspoon of LC see if he will come up.

Too late - I fed him as it was AMPS time and he was starving since he'd had nothing to eat for 10 hours. His numbers are coming up, within 20 minutes of eating his usual LC food, and he does normally get a food spike so I'm in a quandry.

 

[Gill & George]

If you have given wally his full breakfast, you have three options.

1) Wait two hours and shoot the full dose.
2) skip and shoot the full dose tonight.
3) if after an hour it is clear he is bouncing, then you could shoot.

So it depends on whether you can be of schedule or not.

(this is the second drop into lime green for Wally on this dose)

 

[Ginger Cat]

If you have given wally his full breakfast, you have three options.

1) Wait two hours and shoot the full dose.
2) skip and shoot the full dose tonight.
3) if after an hour it is clear he is bouncing, then you could shoot.

So it depends on whether you can be of schedule or not.

(this is the second drop into lime green for Wally on this dose)

Okay. I'll test him again in an hour and see what his numbers are like. Regardless, he's earned a .25 reduction going forward, right, even with this morning's dose, IF I give him insulin?

 

[Gill & George]

he's earned a .25 reduction going forward, right, even with this morning's dose

No he is a long term diabetic, he needs to drop below 40 to earn a reduction. (on a human meter)

Or if he drops 3 times between 40-50, on this dose on different days, you could try a reduction then

 

[Gill & George]

could you take the 911 down please, emergency over.

 

[Ginger Cat]

Tha

No he is a long term diabetic, he needs to drop below 40 to earn a reduction. (on a human meter)

Or if he drops 3 times between 40-50, on this dose on different days, you could try a reduction then

Thanks for all of your help. He's up to 176 on the AT and 124 on the Relion so I'm giving his shot now. He's only off schedule by 30 minutes so that's not too bad.

 

[carfurby (GA)]

I hope Wally surfs safely today.

 

[JaxBenji]

Easy there, Wally. Can you monitor closely and get a +1 and maybe even a +2 just to make sure he's bouncing? Reading your condo, it sounds like you shot a breakfast(food) influenced #? There's also some cleanup on your SS when you have time that may be helpful to others reviewing your SS...

• The number you shot goes in the AMPS cell
• In PMPS +11 cell, you can put your other numbers - e.g. for the Relion #s: 45@+12, 65@+12.5 (color this cell lime green with black writing). In your remarks, I would put what you fed at +12 (or whenever you fed breakfast).

Your title for today would read: 3/14 - Wally +12 56,+12.5 96, AMPS 176 AT2 and +12 45,+12.5 67, AMPS 124 Relion

I think I have that all right...basically any number you get before you shoot insulin is counted from hours since the previous insulin dose. Hope that makes sense

 

[Gill & George]

. He's up to 176 on the AT and 124 on the Relion so I'm giving his shot now. He's only off schedule by 30 minutes so that's not too bad.

I'm not sure this is a definite bounce.
Do at least, check him at +1 and +2 he may still have an active cycle.

Next time he gets 40's just before PS, stall without feeding, see if he comes up after 15-20m or just give him a teaspoon or two of LC. (as he hadn't eaten for 10 hours today a teaspoon or two of his LC food, may have been the better choice)

 

[Ginger Cat]

Easy there, Wally. Can you monitor closely and get a +1 and maybe even a +2 just to make sure he's bouncing? Reading your condo, it sounds like you shot a breakfast(food) influenced #? There's also some cleanup on your SS when you have time that may be helpful to others reviewing your SS...

• The number you shot goes in the AMPS cell
• In PMPS +11 cell, you can put your other numbers - e.g. for the Relion #s: 45@+12, 65@+12.5 (color this cell lime green with black writing). In your remarks, I would put what you fed at +12 (or whenever you fed breakfast).

Your title for today would read: 3/14 - Wally +12 56,+12.5 96, AMPS 176 AT2 and +12 45,+12.5 67, AMPS 124 Relion

I think I have that all right...basically any number you get before you shoot insulin is counted from hours since the previous insulin dose. Hope that makes sense

That makes total sense. I've updated the spreadsheet, as you suggested.

 

[Gill & George]

Thanks for updating the SS.You should reflect the delay in the box for amps, so that it is immediately obvious that you stalled, so alongside the 124@amps, write 124@+13(or whatever it was)

I don't understand something though, you said you were 30minutes past usual shot time?
that would be +12.5? but you have +12.5 as 67 and then 124 was when?

Are you testing, feeding, then waiting 30min before giving the shot?
With Lantus, you should be testing feeding and shooting all within 10 to 15 min.

 

[Ginger Cat]

Thanks for updating the SS.You should reflect the delay in the box for amps, so that it is immediately obvious that you stalled, so alongside the 124@amps, write 124@+13(or whatever it was)

I don't understand something though, you said you were 30minutes past usual shot time?
that would be +12.5? but you have +12.5 as 67 and then 124 was when?

Are you testing, feeding, then waiting 30min before giving the shot?
With Lantus, you should be testing feeding and shooting all within 10 to 15 min.

Because Wally can scarf and barf I do wait 30 minutes before shooting. I let him eat 1/2 of his food within the first 15 minutes and make sure he's keeping it down, then give him the rest and shoot after 15 minutes.

 

[Gill & George]

I let him eat 1/2 of his food within the first 15 minutes

could you not shoot after he has eaten his first half of breakfast? then shoot ? then at least you would be shooting within 15min of amps. O
Once you have shot give him his second half of breakfast?


10 hours is a longtime for a diabetic cat to go without eating, are you doing the same in the am cycle?

You ideally want to keep his scheduled feeds about the same am and pm.



So can you clarify when you actually shot? 124 was how many hours after normal amps?

 

[Ginger Cat]

could you not shoot after he has eaten his first half of breakfast? then shoot ? then at least you would be shooting within 15min of amps. O
Once you have shot give him his second half of breakfast?


10 hours is a longtime for a diabetic cat to go without eating, are you doing the same in the am cycle?

You ideally want to keep his scheduled feeds about the same am and pm.



So can you clarify when you actually shot? 124 was how many hours after normal amps?

124 would have been 1 hour after his normal AMPS. I do feed him LC FF several times during the day and give him a FF snack before I go to bed, usually around 11 pm so it's usually about 9 hours during the night that he doesn't eat. He seems to have been okay with this arrangement. I can try feeding him within 15 minutes of his eating his first half and see how he does...

 

[Ginger Cat]

At AMPS +4=112 AT2 and 78 Relion. Have been feeding him LC FF after each test to try and keep him from crashing. Will continue to test.

AMPS +6 =140/+9=245,PMPS=331, +2=417 AT2 and
AMPS +6=100,+9=171,PMPS=270, +2=334 Relion

 

[Gill & George]

AMPS. I do feed him LC FF several times during the day and give him a FF snack before I go to bed, usually around 11 pm so it's usually about 9 hours during the night that he doesn't eat. He seems to have been okay with this arrangement

The problem with not feeding past about +2, is that if he starts to active pm cycles, with not enough food on board, at regular intervals through the night you run the risk of him dropping too low.

Have you got an automated feeder that you could leave snacks out for him so he could have a snack at +4 and +6 (for example)?
Another issue with him being so hungry by morning is that he will be more likely to scarf and barff and some kitties can get acid tummies if they go too long without a snack, that may also contribute to him vomitting.

 

[Ginger Cat]

The problem with not feeding past about +2, is that if he starts to active pm cycles, with not enough food on board, at regular intervals through the night you run the risk of him dropping too low.

Have you got an automated feeder that you could leave snacks out for him so he could have a snack at +4 and +6 (for example)?
Another issue with him being so hungry by morning is that he will be more likely to scarf and barff and some kitties can get acid tummies if they go too long without a snack, that may also contribute to him vomitting.

If Wally were the only cat in the house, I could leave food out, but I have 3 others and they'd eat his food before he'd get to it. And one of my cats is very overweight and I have to restrict the amount of food she eats. And there's no way to separate them at night either.. The only solution might be getting up in the middle of the night and giving the boys a snack.