? 1/15 Jade amps 278 PMPS 70!?!!

Hiya! She seems to be doing pretty well as of late. Her appetite is still down and I’m still hoping it’s because she’s becoming regulated with her insulin. The in home vet is coming Friday morning for a blood sample to check her thyroid level and see if she needs a dosage tweak. Thank you for asking!
 
@tiffmaxee How? 70?!?
just gave her some LC with a bit of MC gravy.
I’m so confused! At +5 she was at 163 and I left for a few hours. Came back at around +10 and she was fine ( didn’t test). Went to test a bit ago and she was at 70… did I miss a near hypo?? She wasn’t wobbly or out of sorts when I came home.
Also, she can’t dip further after 12 hours and no PM shot, can she? I don’t want to stay up poking her all night. She’s already mad that I just triple poked her. The first read was 60 ,then 80 ,then 70. Had I gone to work this evening and not been due home for a couple more hours, would she have been ok? I’m kind of sick to my stomach.
@Suzanne & Darcy
 
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Hi Jill, Since you're doing SLGS, you're right to skip a PMPS below 90. I would make it a habit of testing her at +9 or +10. Then you would have an idea of where she was heading and you could feed some LC 2 hours before shot time to know that the number wasn't food influenced. Lots of members here only test the early part of the cycle, but I find the later part of the cycle to be equally as important in gathering data for how a cat will trend towards shot time. Otherwise it's just a guess why she dropped.
 
Katherine&Ruby said:
Hi Jill, Since you're doing SLGS, you're right to skip a PMPS below 90. I would make it a habit of testing her at +9 or +10. Then you would have an idea of where she was heading and you could feed some LC 2 hours before shot time to know that the number wasn't food influenced. Lots of members here only test the early part of the cycle, but I find the later part of the cycle to be equally as important in gathering data for how a cat will trend towards shot time. Otherwise it's just a guess why she dropped.
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Thanks for responding. Unfortunately, that’s not often an option as I work evenings in a restaurant and often come home an hour or two after her amps ( I slowly adjust her shot times). She’s never not been back to a higher number at her AMPS or PMPS that I can recall.
 
Katherine&Ruby said:
How is Jade behaving? Eating? Alert and affectionate?
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Yes, perfectly normal. She was sleeping when I got home and I hung out with her and rubbed her belly. We played for a bit and then she sat by her bowl for food. I decided to get her PMPS and give her her evening thyroid meds ( it’s a chew and a pill pocket) and then I was going to feed her and give her a shot about 30 minutes after she ate. I was SHOCKED when I saw her #.
So, she ate the LC with MC gravy and played for a while and now she’s sleeping.
She can’t hypo after 12 hours and the food, can she?
 
Katherine&Ruby said:
I'm glad she seems ok!

It's unlikely, but to be sure, I would test her again at +2 after the food has cleared. You're never truly off the hook even after a skipped shot. Test to be sure. :)
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I sure will. Thank you again. I’m really upset. All that I thought I knew just went out the window. :(:(:(
 
Jill & Jade said:
I thought that after Nadir, they start to rise again? This really hit me from left field. I’m trying not to think of the “what if’s”.
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Lantus isn't strictly out of the cat's system after 12 hours. It's a depot insulin, so it gets stored in the subcutaneous fat and gets released slowly so it can be in effect for 14 or 48 hours even. This is why we tell caregivers following Tight Regulation "shoot low to stay low." Lantus is great at keeping low numbers really steady, so if you give insulin when a cat is in green numbers, you take advantage of carryover and overlap, and the cat can stay in those healthier lower numbers for longer. You have to think of the way insulin works as waves rather than a curve that goes up at shot time.

Jade is still unregulated, so you won't see that smile shaped curve with a clear nadir in the middle of a cycle that one should get on Lantus. She will get there, but only once you become less afraid of shooting lower numbers.
 
Katherine&Ruby said:
Lantus isn't strictly out of the cat's system after 12 hours. It's a depot insulin, so it gets stored in the subcutaneous fat and gets released slowly so it can be in effect for 14 or 48 hours even. This is why we tell caregivers following Tight Regulation "shoot low to stay low." Lantus is great at keeping low numbers really steady, so if you give insulin when a cat is in green numbers, you take advantage of carryover and overlap, and the cat can stay in those healthier lower numbers for longer. You have to think of the way insulin works as waves rather than a curve that goes up at shot time.

Jade is still unregulated, so you won't see that smile shaped curve with a clear nadir in the middle of a cycle that one should get on Lantus. She will get there, but only once you become less afraid of shooting lower numbers.
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So confusing me to me even when it’s explained as simply as you just did ( thank you for that). Do you think she went dangerously low before I tested her? I know there’s no definitive answer here, just speculation. Also, do you think she would have kept dropping had I been at work for a few more hours? How do I keep her out of harms way? I really left at +5 for a few hours feeling confident at her 163.
 
Katherine&Ruby said:
Lantus isn't strictly out of the cat's system after 12 hours. It's a depot insulin, so it gets stored in the subcutaneous fat and gets released slowly so it can be in effect for 14 or 48 hours even. This is why we tell caregivers following Tight Regulation "shoot low to stay low." Lantus is great at keeping low numbers really steady, so if you give insulin when a cat is in green numbers, you take advantage of carryover and overlap, and the cat can stay in those healthier lower numbers for longer. You have to think of the way insulin works as waves rather than a curve that goes up at shot time.

Jade is still unregulated, so you won't see that smile shaped curve with a clear nadir in the middle of a cycle that one should get on Lantus. She will get there, but only once you become less afraid of shooting lower numbers.
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I’m sure you’ve checked her SS and see that she’s never been that low at at PS. :nailbiting:
 
Jill & Jade said:
So confusing me to me even when it’s explained as simply as you just did ( thank you for that). Do you think she went dangerously low before I tested her? I know there’s no definitive answer here, just speculation. Also, do you think she would have kept dropping had I been at work for a few more hours? How do I keep her out of harms way? I really left at +5 for a few hours feeling confident at her 163.
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She’s at 224 an hour after I fed her the mix. What number at +2 should let me know that I can leave her alone for the night?
 
Don’t be hard on yourself. A lot of the diabetic journey is going through what are now and learning from the experience. I have no idea if she dropped lower than where she is now, only way to know is to test. Leaving food in a timed feeder may provide some peace of mind for you. I know when Ruby goes low she wants to eat. I don’t know if Jade is the same way.

Jill & Jade said:
She’s at 224 an hour after I fed her the mix. What number at +2 should let me know that I can leave her alone for the night?
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If she is at 224 now, she is bouncing and she will be fine for the night. Tomorrow she will likely be high because of the bounce and the skipped shot. Test her at +2 and see, but you should be able to sleep without worry this evening.
 
Katherine&Ruby said:
Don’t be hard on yourself. A lot of the diabetic journey is going through what are now and learning from the experience. I have no idea if she dropped lower than where she is now, only way to know is to test. Leaving food in a timed feeder may provide some peace of mind for you. I know when Ruby goes low she wants to eat. I don’t know if Jade is the same way.


If she is at 224 now, she is bouncing and she will be fine for the night. Tomorrow she will likely be high because of the bounce and the skipped shot. Test her at +2 and see, but you should be able to sleep without worry this evening.
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Thank you. :bighug: I do always leave food out for her when I leave for more than an hour or two. LC Sheba Pate.
 
Katherine&Ruby said:
Don’t be hard on yourself. A lot of the diabetic journey is going through what are now and learning from the experience. I have no idea if she dropped lower than where she is now, only way to know is to test. Leaving food in a timed feeder may provide some peace of mind for you. I know when Ruby goes low she wants to eat. I don’t know if Jade is the same way.


If she is at 224 now, she is bouncing and she will be fine for the night. Tomorrow she will likely be high because of the bounce and the skipped shot. Test her at +2 and see, but you should be able to sleep without worry this evening.
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She’s VERY sensitive and quick to respond to MC/ HC food, thankfully.
 
This may be a dumb question but if I gave her a partial fur shot, would that lack of insulin trigger the depot to empty into her system to compensate?
 
No. I do not believe it would cause it to be released at any rate greater than normal. We often use skipped - or half - shots on purpose to “drain the depot” a bit, but not because we re causing any kind of dump. I believe the depot in the cat will be released at a fairly constant rate, if that makes sense.
 
Jill & Jade said:
This may be a dumb question but if I gave her a partial fur shot, would that lack of insulin trigger the depot to empty into her system to compensate?
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It doesn’t work that way. Nothing can trigger the depot. Think of it as a balloon with a very small hole. Every shot fills the balloon up again. Skipping the shot will allow the depot to drain a bit so you won’t have as much tomorrow to contend with. But this also means that you have to build the depot back up for Lantus to work well again. This is why after every skipped shot you see higher numbers. With SLGS you keep her on the same dose for a week so that should be more than enough time.

and there are no dumb questions! ;)
 
So that is why, even when you shoot a reduced dose or skip a shot, you won’t see an immediate increase in your cat’s glucose. They may still drop lower than you wish.
 
Katherine&Ruby said:
It doesn’t work that way. Nothing can trigger the depot. Think of it as a balloon with a very small hole. Every shot fills the balloon up again. Skipping the shot will allow the depot to drain a bit so you won’t have as much tomorrow to contend with. But this also means that you have to build the depot back up for Lantus to work well again. This is why after every skipped shot you see higher numbers. With SLGS you keep her on the same dose for a week so that should be more than enough time.

and there are no dumb questions! ;)
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Thanks! She’s at 305 now ( 2 hours after food) and she has earned a reduction for falling below 80, yes? Safe to stop poking for
Katherine&Ruby said:
It doesn’t work that way. Nothing can trigger the depot. Think of it as a balloon with a very small hole. Every shot fills the balloon up again. Skipping the shot will allow the depot to drain a bit so you won’t have as much tomorrow to contend with. But this also means that you have to build the depot back up for Lantus to work well again. This is why after every skipped shot you see higher numbers. With SLGS you keep her on the same dose for a week so that should be more than enough time.

and there are no dumb questions! ;)
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Thanks! So she is at 305, two hours after her MC gravy. Safe to leave her alone?
Also, she’s earned a reduction at 70, correct?
 
A lot of this involves a leap of faith. I know you work and that takes you away from the house and from Jade so it’s natural to worry. I would too. Perhaps in the future you can consider shooting blue numbers when you can monitor. That will prevent the high bounces.
 
I would give it a few/ several hours. She’s pink now so you can sleep and set an alarm if you want to see where she goes i. The latter part of her pm cycle.
Does she sleep with you in bed?
 
Suzanne & Darcy said:
I would give it a few/ several hours. She’s pink now so you can sleep and set an alarm if you want to see where she goes i. The latter part of her pm cycle.
Does she sleep with you in bed?
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She either sleeps with me or next to my bed. I hate to keep poking her tho, she’s starting to get pretty sensitive and I know when I do it this often, it stresses her and the last thing I want is to trigger a cystitis episode.
 
Katherine&Ruby said:
A lot of this involves a leap of faith. I know you work and that takes you away from the house and from Jade so it’s natural to worry. I would too. Perhaps in the future you can consider shooting blue numbers when you can monitor. That will prevent the high bounces.
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She’s never had a blue # for a PS.
The one time she did, I didn’t shoot because she didn’t eat.
 
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