8/21, Tango, PMPS 131, +127 +78 +10 102

Lori C & Tango

Lori C & Tango

Member Since 2022
@Bandit's Mom @tiffmaxee @Chris & China (GA)

Updated 2:24pm 8/21

Adding @Diane Tyler's Mom @admin

Would really appreciate it if someone could take a look at Tango's SS. We gave him small amount of high carb at 11:30 and are continuing with regular food. Should we expect his numbers to stay where they're at? He's had 5 doses of 2.5.

From 8/19

https://felinediabetes.com/FDMB/thr...-95-4-54-4-1-2-79-6-84-9-279-pmps-557.267330/

Don't know if I screwed up. Tested this morning at 131 and 127 at+1, fed Weruva and gave Tango 2.5. As soon as we tested the doorbell rang and he took off and is hiding in the closet. Our contractor is here so Tango won't be showing his tail for awhile.

Are we still in a bounce? #s were lower on the 19th, up on the 20th and today low?

What do you think?
 
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Lori- I see you've noted TR as your dosing method, but it appears you haven't taken any mid cycle tests in the last 5 days. It is really important to make sure you get at least one test in the pm cycle. At the moment, you are missing half the picture and TR is an aggressive dosing method, and given that you are using an AT2 I'm wondering a little about that 54, which is getting down there on AT2. While we don't usually recommend back to back reductions with TR that's for caregivers who use a human meter, and in those instances we also do say that if you get under 40 on human meter, to take the reduction.

Have you been able to get another test following that 78? You may be seeing a bounce breaking cycle, so additional testing would be a good idea to see if he is dropping further, or flattening out/increasing.

Also, if I understand correctly, did you shoot at the +1 time? If yes, you will need to adjust your shot time tonight, since you'd be shooting an hour early if you stay at your usual time, and shooting an hour early act like a dose increase.
 
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Christie & Maverick said:
Lori- I see you've noted TR as your dosing method, but it appears you haven't taken any mid cycle tests in the last 5 days. It is really important to make sure you get at least one test in the pm cycle. At the moment, you are missing half the picture and TR is an aggressive dosing method, and given that you are using an AT2 I'm wondering a little about that 54, which is getting down there on AT2. While we don't usually recommend back to back reductions with TR that's for caregivers who use a human meter, and in those instances we also do say that if you get under 40 on human meter, to take the reduction.

Have you been able to get another test following that 78? You may be seeing a bounce breaking cycle, so additional testing would be a good idea to see if he is dropping further, or flattening out/increasing.

Also, if I understand correctly, did you shoot at the +1 time? If yes, you will need to adjust your shot time tonight, since you'd be shooting an hour early if you stay at your usual time, and shooting an hour early act like a dose increase.
Click to expand...

Christie -

Mid cycle test - did do one last night. Added to SS. it as 222 at +2 ---- For mid cycle is +2 okay, or do you need one later?
We use both Relion and Alpha Trak - when Alpha Trak was 54, Relion was actually 57. These were the lowest readings for both meters
It's been a little over an hour since last BG test. Will do another one shortly
Did not shoot at +1
 
Mid cycle tests is @+6
Me myself I always got a test in @+3 , +6 during the night cycle
The more the better
Mix up the testing times , like filling in the pieces of a puzzle
Next night I might get a test @+2 , +5
Sometimes even later
 
Ok, great thanks for clarifying.

I always have tried to suggest for those first starting out that your goal should be to try and gather data to determine how your cat responds to the insulin, and by testing, you can get a feel for some of the basics. As Diane said, it's like filling in pieces of the puzzle, don't get too stuck on testing at the same time every cycle, look at the SS and see where you have white (missing pieces) - try and mix it up now and again so you can find out how the insulin is working for your cat. What my cat did on Lantus will not be the same as yours, since every cat is different :)

by moving the testing around, you can get a better idea of when your cat onsets, nadirs and how much duration they typically get.
From the basics sticky:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
  • How to do a Curve - a simple explanation
With Lantus, we often like the +2 because it can sometimes be a good indication of how the cycle will go. If the +2 is higher than preshot, it usually indicates that not much downward movement will occur in the blood glucose levels. If the +2 is the same and certainly significantly lower, then that could signal more testing is required as the numbers may drop a little more quickly. By taking additional tests, that will allow you to monitor and feed to help slow down the drop.

Does this help?
 
Christie & Maverick said:
Ok, great thanks for clarifying.

I always have tried to suggest for those first starting out that your goal should be to try and gather data to determine how your cat responds to the insulin, and by testing, you can get a feel for some of the basics. As Diane said, it's like filling in pieces of the puzzle, don't get too stuck on testing at the same time every cycle, look at the SS and see where you have white (missing pieces) - try and mix it up now and again so you can find out how the insulin is working for your cat. What my cat did on Lantus will not be the same as yours, since every cat is different :)

by moving the testing around, you can get a better idea of when your cat onsets, nadirs and how much duration they typically get.
From the basics sticky:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
  • How to do a Curve - a simple explanation
With Lantus, we often like the +2 because it can sometimes be a good indication of how the cycle will go. If the +2 is higher than preshot, it usually indicates that not much downward movement will occur in the blood glucose levels. If the +2 is the same and certainly significantly lower, then that could signal more testing is required as the numbers may drop a little more quickly. By taking additional tests, that will allow you to monitor and feed to help slow down the drop.

Does this help?
Click to expand...

Need to do more mid-cycle testing and move times around. I do read the sticky notes and honestly, those can be confusing.

I will continue testing and for tonight's dose, He will get 2.5 unless his his PMPS is less then 68 on AT. If it is, I should decrease to 2.25 or 2.0? I know TR you shoot with lower BG readings - just always panic when BG is below 150 and you should still shoot normal dose :(

Just tested BG - 85 @ +5

Is this correct?

Thank you!
 
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I have been doing this for 6 years, and I still go back to the stickies, there are a lot of them and a lot of good info to continue to absorb :). Keep asking questions when you got 'em, that will help you process all the information.

Yes, you are fine to keep to 2.5u provided that he's at a safe number to shoot and that you are comfortable doing so. If you haven't caught a test yet following the 78 might be time to sneak one in depending on where you are at. Sometimes a +10 or +11 can give you great info and those spot checks can be priceless, since they can tell you whether his numbers are trending upward which indicates the insulin dose is waning. If the preshot is lower than the +10 or +11 that can be a Lantus double dip, where the kitty goes a little lower at preshot, but not as low as nadir of the cycle. That's when some of these spot checks can be helpful, since it gives you data to get a feel for whether he's still dropping (bounce breaks can often be later nadirs) or whether he's on the rise and safe to shoot.

You've had enough cycles on 2.5u to where if he does show you under 68 you should reduce to 2.25u; the previous depot can influence up to 4-6 cycles after a reduction.
 
Just caught your +8.. nice little surf, Tango :cool::D

img_0652-jpg.63769
 
Christie & Maverick said:
I have been doing this for 6 years, and I still go back to the stickies, there are a lot of them and a lot of good info to continue to absorb :). Keep asking questions when you got 'em, that will help you process all the information.

Yes, you are fine to keep to 2.5u provided that he's at a safe number to shoot and that you are comfortable doing so. If you haven't caught a test yet following the 78 might be time to sneak one in depending on where you are at. Sometimes a +10 or +11 can give you great info and those spot checks can be priceless, since they can tell you whether his numbers are trending upward which indicates the insulin dose is waning. If the preshot is lower than the +10 or +11 that can be a Lantus double dip, where the kitty goes a little lower at preshot, but not as low as nadir of the cycle. That's when some of these spot checks can be helpful, since it gives you data to get a feel for whether he's still dropping (bounce breaks can often be later nadirs) or whether he's on the rise and safe to shoot.

You've had enough cycles on 2.5u to where if he does show you under 68 you should reduce to 2.25u; the previous depot can influence up to 4-6 cycles after a reduction.
Click to expand...

Sorry, another question. His BS at +10 is 102. I'm guessing in 2 hours it won't change that much and at PMPS it will be the lowest # he's had. The next lowest was 170 on the 18th. We lowered dose, but he also had a below 68# same day, which earned a reduction. Today his lowest reading was 78 - so, even if PMPS # is lower than 125 - 150 - still do 2.5U?
 
Just a small clarification, although time wise mid cycle may be +6, it's not always the best time for you to test. It depends on the cat. As Christie mentioned in post #5, you goal is to learn how Tango responds to insulin. Some cats nadir as early as +2-+3, some as late as +12. You want to try to get a "mid cycle" test around the time Tango nadirs. Keeping in mind that nadirs to and can change from cycle to cycle. So mixing up the test times can be best. Over time you'll start to see patterns in Tango's blood sugar numbers, and get a feel when you need to test earlier vs. later.
 
Wendy&Neko said:
Just a small clarification, although time wise mid cycle may be +6, it's not always the best time for you to test. It depends on the cat. As Christie mentioned in post #5, you goal is to learn how Tango responds to insulin. Some cats nadir as early as +2-+3, some as late as +12. You want to try to get a "mid cycle" test around the time Tango nadirs. Keeping in mind that nadirs to and can change from cycle to cycle. So mixing up the test times can be best. Over time you'll start to see patterns in Tango's blood sugar numbers, and get a feel when you need to test earlier vs. later.
Click to expand...

Yeah, understand it takes awhile to figure out a pattern. While knowing, this I don't feel as confident when his #s go off course then need to decide, 'do I shoot same dose', 'do I increase/decrease' or skip. I know there are protocols for various situations - what's hard is that there are ifs and buts. It's not black and white.

I also know that with more experience, there is less uncertainty and more self confidence.

That being said, I'm testing again in 35 minutes and not sure what to dose if his PMPS # is less than 150.
 
Lori Callagy said:
Yeah, understand it takes awhile to figure out a pattern. While knowing, this I don't feel as confident when his #s go off course then need to decide, 'do I shoot same dose', 'do I increase/decrease' or skip. I know there are protocols for various situations - what's hard is that there are ifs and buts. It's not black and white.

I also know that with more experience, there is less uncertainty and more self confidence.

That being said, I'm testing again in 35 minutes and not sure what to dose if his PMPS # is less than 150.
Click to expand...

Wendy&Neko said:
You shot 131 this morning. And 92 a couple days ago. Why the concern about under 150?
Click to expand...

My bad... I was only looking at PMPS #s. Thanks for the extra pair of eyes.

His PMPS is 157 - will shoot 2.5.

Thank you!
 
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