? 11/21 Eddie HYPO AVERTED AMPS 142 +3 97 +5 70 +8 196 PMPS 319 +2.5 76 +3 74 +3.5 147.6 +5 194

Jodey&Eddie&Blue

Jodey&Eddie&Blue

Member Since 2021
Good Morning:
Here's yesterday's story for reference:
https://felinediabetes.com/FDMB/thr...-173-2-155-4-131-6-160-pmps-212-2-308.255700/

What I don't understand is that @ PMPS 11/20 he was 212 and at +2 308. We decided that it was a night off at that point but then his 11/21 AMPS is 142, suggesting that he might have gone (nadired) much lowerin the night?? I don't know.

But here we are AMPS 142. I will take the shot as I did 11/19 when it was low and will be able to keep an eye on him.

Thoughts welcome, please. @Wendy&Neko @FrostD @Bandit's Mom (if you are still around).

Also, a question: does anyone have any suggestions/recommendations/remedies for me to use on Eddie's poor ears? Repeated testing has made them pretty sensitive.

Thank you.
 
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A test in an hour will tell you if he's angling for a reduction. Or if it's just a dose with nice nadirs.

Some comments here on ear care: Testing and Shooting Tips

What size lancets are you using? I eventually moved to the thinner One Touch Delica.
 
Wendy&Neko said:
A test in an hour will tell you if he's angling for a reduction. Or if it's just a dose with nice nadirs.

Some comments here on ear care: Testing and Shooting Tips

What size lancets are you using? I eventually moved to the thinner One Touch Delica.
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I'd say he's angling for a reduction. +5 70 . Would you agree?

I'm using the lancets that go with the infernal AlphaTrak2 : 28 guage. I'll look the ear care tips.

Thank you!!!
 
@Wendy&Neko I just did a +8 and it's 196 so I'm assuming there's no call for reduction? Also, do you think I ought to have done a +6 which might have shown he went lower than @ +5 70?
I feel like I'm not doing the best job here.
 
Jodey&Eddie said:
I'd say he's angling for a reduction. +5 70 . Would you agree?

I'm using the lancets that go with the infernal AlphaTrak2 : 28 guage. I'll look the ear care tips.

Thank you!!!
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78 is your reduction point, so yes he earned a reduction to 8U
 
That was a fairly gradual decline to 70. Remember take action on an AT is 68, so I'd have fed just a tsp MC with that 70 just in case (because it's likely that was nadir and don't want to feed much after nadir). When they're flirting near 68 should test every half hour til they're 80-ish, then hourly unless you catch another dip
 
It might help you to make a flowchart/table to stick in your testing area, that's what I did for quick reference. I'd always post here and ask for help, but if it quiet - some loose guidelines:

Below 60-ish: HC + honey/karo, testing every 20 mins. Rinse and repeat until higher than 60 (see categories below). How much depends on how low and how long til nadir. If you think you're almost there, 1-2 tsp and 1 drop. Long way to go, more like 1-2 tbsp. *

60-68: HC, test every 30. Rinse and repeat til in the next BG range (69-78-ish). Again, how much depends how long til nadir. 1-2 tsp if you think you're close to it, 1-2 tbsp if awhile to go. *

69-78 ish: MC, test every 30-45 minutes. Rinse and repeat til 79 or higher. Same deal with amount of food relative to nadir.*

79 and above - try not to feed, maybe some small LC snacks.*

*Special consideration: diving BGs. Big dives may need MC, possibly HC depending on numbers and how big the dive is. Smaller dives could usually use LC to help slow it down.

Now that I've written out I'm sure some others would handle things slightly differently, with slightly different BG ranges, or other points of clarification. Always best to err on the side of safety - extra tests, extra food.
 
FrostD said:
It might help you to make a flowchart/table to stick in your testing area, that's what I did for quick reference. I'd always post here and ask for help, but if it quiet - some loose guidelines:

Below 60-ish: HC + honey/karo, testing every 20 mins. Rinse and repeat until higher than 60 (see categories below). How much depends on how low and how long til nadir. If you think you're almost there, 1-2 tsp and 1 drop. Long way to go, more like 1-2 tbsp. *

60-68: HC, test every 30. Rinse and repeat til in the next BG range (69-78-ish). Again, how much depends how long til nadir. 1-2 tsp if you think you're close to it, 1-2 tbsp if awhile to go. *

69-78 ish: MC, test every 30-45 minutes. Rinse and repeat til 79 or higher. Same deal with amount of food relative to nadir.*

79 and above - try not to feed, maybe some small LC snacks.*

*Special consideration: diving BGs. Big dives may need MC, possibly HC depending on numbers and how big the dive is. Smaller dives could usually use LC to help slow it down.

Now that I've written out I'm sure some others would handle things slightly differently, with slightly different BG ranges, or other points of clarification. Always best to err on the side of safety - extra tests, extra food.
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Thank you for this. I find sometimes that in the thick of things there's so much to remember and I've obviously forgotten my own reduction point. I had been waiting to hear from Wendy and just kept on. Then I thought because he went up instead of down (since I forgot reduction #) that reduction was no longer on the table. I did feed him twice. Once after the +3 (1 tsp) and again after the +5 (2 tsp) both times, however, were LC. Then I saw he went up and hence my uncertainly.

You might not believe this but I'm not usually such a slow learner! :bookworm::confused:

So, just to confirm: we are over the 10th cycle of 8.5. He earned reduction with the +70 and now I can, in fact, go with 8u tonight.

Thank you also for the quick reference guide. I'm printing it out now.
 
Yes, he went below the number which is your reduction point, so you reduce tonight.

As far as Melissa's guidelines above, remember that ECID when it comes to carb sensitivities. Also ECID on how long it takes for the carbs to impact the blood stream numbers. It's good to have a guideline as to what to feed for what numbers, but you might need to change what works for Eddie. Neko was quite carb sensitive. I was at one point giving her 21% carbs and found it was too much. You want to higher carbs to boost them up around 30 points or so. I settled on something 16-17% carbs for her. And over 50 on the human meter (68 on your AT), LC was good enough. Of course, another thing to factor in is timing in the cycle. In the early part of the cycle when the insulin effect is stronger, you may need higher carbs than later in the cycle after nadir when the insulin effect is diminishing.
 
Wendy&Neko said:
Yes, he went below the number which is your reduction point, so you reduce tonight.

As far as Melissa's guidelines above, remember that ECID when it comes to carb sensitivities. Also ECID on how long it takes for the carbs to impact the blood stream numbers. It's good to have a guideline as to what to feed for what numbers, but you might need to change what works for Eddie. Neko was quite carb sensitive. I was at one point giving her 21% carbs and found it was too much. You want to higher carbs to boost them up around 30 points or so. I settled on something 16-17% carbs for her. And over 50 on the human meter (68 on your AT), LC was good enough. Of course, another thing to factor in is timing in the cycle. In the early part of the cycle when the insulin effect is stronger, you may need higher carbs than later in the cycle after nadir when the insulin effect is diminishing.
Click to expand...

Thank you for this. I see the point here is that the carb ratio/sensitivities in regards the fact ECID are every bit as significant as the numbers that show up in the course of a day. Phew. I'll have to experiment with the LC-MC-HC differences.

I'm excited for Eddie to get a reduction. We are seeing the vet tomorrow (the one who still thinks Eddie is on 14u/BiD all day, all night) and I'm going to try to explain the how and why Eddie and I are doing TR. I'm going to bring my computer to the clinic to show the numbers: the vet refuses to look at the colours (go figure). He's the old school, nearly retired but only internist in the Okanagan, but he renews prescriptions. Eddie's have a blood panel done tomorrow to compare with the one he had a short while ago. This is what the vet wrote to me about tomorrow's appointment:

Making changes to insulin doses needs to be correlated to physical examinations, on his last labwork (Oct 5th) there was elevated protein, albumin and mild elevated creatinine. I assumed that it was very mild dehydration but the trend of these values needs to be looked at to rule out that if it is not due to mid dehydration but the start of chronic inflammation in combination with beginning renal insufficiency. Therefore, there is 1 months between data collection to see what the trend says. On Nov 22 I would like to repeat blood for CBC, Biochem panel and UA.

Anyway, thank you for the response and the additional advice regarding the carbohydrate significance in relation to the numbers and the place in the cycle.
 
Katherine&Ruby said:
Hi Jodey, Maybe it would help if you wrote your reduction point down in your signature? Then you won't have to try to remember it and anyone helping you will know that it's 78 and not 68 as it usually is for AT users.
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Oh, gosh, I thought I did. I just checked and it says "Lantus:TR Red 78/". I think I ought to have spelled out "Reduction" so it's probably not clear. Thank you for pointing that out! :facepalm:
 
By the way, good luck at the vet tomorrow! Sounds like you have your work cut out for you explaining TR to your semi-retired vet. Just remember that you are the best advocate for your cat.
 
Jodey&Eddie said:
Thank you for this. I find sometimes that in the thick of things there's so much to remember and I've obviously forgotten my own reduction point. I had been waiting to hear from Wendy and just kept on. Then I thought because he went up instead of down (since I forgot reduction #) that reduction was no longer on the table. I did feed him twice. Once after the +3 (1 tsp) and again after the +5 (2 tsp) both times, however, were LC. Then I saw he went up and hence my uncertainly.

You might not believe this but I'm not usually such a slow learner! :bookworm::confused:

So, just to confirm: we are over the 10th cycle of 8.5. He earned reduction with the +70 and now I can, in fact, go with 8u tonight.

Thank you also for the quick reference guide. I'm printing it out now.
Click to expand...
Yep!

And to Wendy's point above - it helps to note any feeding you do with the intent of steering the curve. So if you give LC at usual time, don't bother noting it. But if you give it at a different time, or MC/HC it's good to note (and I see you have some in SS). But also include carb % as well (my SS has examples starting around July 4th). Over time it helps you know how they react to carbs.

Then as you go you can fine-tune, figure out if what I put above works, or maybe needs some tweaking.

Congrats on another reduction!
 
FrostD said:
Yep!

And to Wendy's point above - it helps to note any feeding you do with the intent of steering the curve. So if you give LC at usual time, don't bother noting it. But if you give it at a different time, or MC/HC it's good to note (and I see you have some in SS). But also include carb % as well (my SS has examples starting around July 4th). Over time it helps you know how they react to carbs.

Then as you go you can fine-tune, figure out if what I put above works, or maybe needs some tweaking.

Congrats on another reduction!
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Thank you, again! Re: the percentage of carbs: I’ve found a carb calculator online but if you have one that you recommend I’d really appreciate you sharing it.

I’ll be doing a +2.5 tonight. Goodnight snd thanks, again!
 
Looks like it’s been at least 15-20 minutes since the last test so I would test again now. If the BG is lower, I’d go straight to HC and add a bit of Karo syrup.

319 to 76 in 2.5 hours is a heckuva drop.

@tiffmaxee
 
Jodey&Eddie said:
Just added a bit of Karo to HC: he's @ +3 74
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I’d test again in 15-20 minutes and keep close tabs on both BG and how Eddie is acting. 74 is a safe number but he’s early in the cycle and you might need to continue to prop up his numbers.

@tiffmaxee can you stay around for awhile? I need to step away.
 
JL and Chip said:
I’d test again in 15-20 minutes and keep close tabs on both BG and how Eddie is acting. 74 is a safe number but he’s early in the cycle and you might need to continue to prop up his numbers.

@tiffmaxee can you stay around for awhile? I need to step away.
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@tiffmaxee too. Just gave karo and HC. @ +3 he's 74. I will test again in 20 mins. Eddie is not showing any of the listed signs of hypo but he is a bit grouchy. Like when I was putting down the HC food, he was really impatient and yowling at me.
 
He’s not having a symptomatic hypo. Just low numbers. The hc should bring him up but you need to keep a close watch and test every 20-30 until he stays up without needing hc/honey. I’m heading to bed.
 
Jodey&Eddie said:
Yes, that's correct (except I'm less certain of the MC status: it was a tsp of Whiskas "cuts and gravy".

Just tested again and we are back up to 147.6 @ 3.5
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I guess that's the HC and karo talking. I would get a test again at +5 which would be 2 hours after the HC/karo to see if he continues to stay up.
 
Good catch!

That dive fell under the asterisk category - that wasn't a big dive, it was a full-on skydive! Crazy cat. That is why HC and karo were suggested - huge dive, still time to nadir. Unfortunately there's no straightforward guidance I can think of for diving because it depends so much on the numbers. Best thing I can say is assume the BG will continue to drop at a similar rate til nadir, and decide what food you need to stop that.

The reason you won't reduce again is because the larger depot is still there. If he had gone lower and fought coming up we'd have considered a BCS.
 
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