Sharon and Poppy Intro - Libre vs Glucometer, Tips to Move to Can Food

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I did read about the SLGS and TR dosing methods. Today, I got a 75 and 71 at +6 after the AMPS. That is the lowest number I have received. And the AMPS was 335. Why would it be so low in 6 hours?
 
That’s not uncommon on unregulated cats. Big drops like that can happen. The good news here is that this dose seems to be the breakthrough dose and now her numbers are coming down. Are you giving food after +2? It helps slow down the drop. Did you give food now? It would be good to give her some LC or MC food to bring the bg back up. Since she dropped below 90, she earned a 1/4 unit reduction so her dose tonight should be 1.75. That’s a good thing.
 
Sorry, just read your notes. I see you gave her food at this last test. It would be good if you can to test her again in 30-60 minutes to see if the food is bringing her bg back up. If not, give her a little more or a snack. When your cat goes under 90, you want to intervene with food to bring their bg slowly back up so they don’t keep going lower into a take action number. You also need to retest within 30-60 minutes to see if the food brought the bg up or if it’s still going down. It’s important for you as you learn this to train yourself to post here and the come back and read the comments to see what we’re asking you to do so you can a) do it and b) let us know what happened. If you get a number lower than 90, post here asking for help, stay online so you can check back and read the comments and directions you get, follow them, and come back and tell us what happened. Makes sense?

I think going from 5am till noon without food is too long unless you’re giving treats in addition to the FF, are you?

I forget if we talked about daily calorie intake? A good rule of thumb is 20 times ideal weight. So if her ideal weight is 12, she should be feeding 240 calories a day and a bit more if she needs to gain.
 
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Also, just a house keeping note, we try to keep threads to no more than 50 comments and this one is getting too long. Do you mind starting a new thread with today’s bg numbers on the title? You can also get more eyes on it that way. Thanks!
 
I will start a new thread tomorrow. And I will get better about waiting for response on the chat.

Poppy has food available to her all day long. When she test low this morning, she had food in her bowl. I am still allowing her to graze. Because I need her to gain weight. She is now eating 3 cans of FF a day. That is 261 calories. But that has only been for the last two days. I give her a treat after every ear piercing. Please let me know what snacks you give.

I am headed to bed.
 
The most important thing is that when you get a low number like you did today, you need to test again to see what the food did to the bg. And also because you need to know if it’s still going low as it may go too low. You need to keep her above the take action number which is 50 and you just don’t know where she was at an hour after the 71. The only way to know is to test.

can you please confirm you reduced her dose? I still see 2 units on the spreadsheet.
 
@Sharon & Poppy Poppy went under 90 yesterday and she earned a 1/4 unit reduction but you haven’t taken it. Please reduce her dose to 1.75 as soon as you read this. That’s how the SLGS method dose adjustments work. By going under 90, she’s telling they dose is too high for her.

From the SLGS method sticky note:
“After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).”
 
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Ale & Bobo & Minnie (GA) said:
The most important thing is that when you get a low number like you did today, you need to test again to see what the food did to the bg. And also because you need to know if it’s still going low as it may go too low. You need to keep her above the take action number which is 50 and you just don’t know where she was at an hour after the 71. The only way to know is to test.

can you please confirm you reduced her dose? I still see 2 units on the spreadsheet.
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I have not reduce her dose yet. That is because she is not really showing any trends yet. It has only been 2 days since we transitioned to the canned food. Also, I don’t have the correct syringes to lower a dose .25. My syringes are scored at 1 unit. Tomorrow we will see the new vet. I will ask for a script for the. .5 scoring syringes.
 
I don’t think you’re understanding how the SLGS method works. You’re not waiting to see signs or trends. You hold the dose for 7 days unless she goes under 90. Every time or anytime your cat goes under 90, you decrease the dose by 1/4 unit. If she goes under 90 2 days in a row, you decrease the dose by 1/4 units 2 days in a row. That’s how you’re going to find the right dose. You don’t decrease only when she has a hypo because you’re trying to avoid that. @Bron and Sheba (GA) maybe you can explain this better than me?

If you’re in the US, you don’t need a prescription for 1/2 unit marked syringes. I get mine at Walmart
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Ale & Bobo & Minnie (GA) said:
@Sharon & Poppy Poppy went under 90 yesterday and she earned a 1/4 unit reduction but you haven’t taken it. Please reduce her dose to 1.75 as soon as you read this. That’s how the SLGS method dose adjustments work. By going under 90, she’s telling they dose is too high for her.

From the SLGS method sticky note:
“After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).”
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It was not perfect. But a week after she was upped to the 2 units from 1.5 I did do a 12 hour curve. At the time she was still on a combination of dry and canned food. Let’s give her a week on the canned food and I will do another 12 hour curve or 18 hour curve.

I appreciate you trying to get us to the advanced level. But I still don’t feel like I have my bearings yet with the testing. Today was our 6th day testing and it is 3 days being totally on the canned food. I did start another thread.
 
Those blues you were getting at night were an indication she could be potentially going too low overnight. The low 70 you got yesterday is a confirmation the dose is too high for her. I wish you had tested her again after that to see if she went even lower. I honestly don’t think you should wait to give her the dose adjustment. Waiting is not going to benefit her and the longer you wait the higher the risk of developing insulin resistance.
 
Ale & Bobo & Minnie (GA) said:
I don’t think you’re understanding how the SLGS method works. You’re not waiting to see signs or trends. You hold the dose for 7 days unless she goes under 90. Every time or anytime your cat goes under 90, you decrease the dose by 1/4 unit. If she goes under 90 2 days in a row, you decrease the dose by 1/4 units 2 days in a row. That’s how you’re going to find the right dose. You don’t decrease only when she has a hypo because you’re trying to avoid that. @Bron and Sheba (GA) maybe you can explain this better than me?

If you’re in the US, you don’t need a prescription for 1/2 unit marked syringes. I get mine at Walmart
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In NJ you need a script for syringes. That is the law. You can get 10 a day without a script. More than that you have to have a script. The syringes are one of our toughest issues.

Believe me - I feel that there is a prejudice against people who ask for them. I have been to Walmart, CVS, Costco trying to get just the 10. And people are judging and coming up with excuses not to give me the syringes. The script I have now is for 100 with 1 unit scoring. I had asked the Vet three times to call in the exact ones in your picture. And it still has not been done. I need this syringe problem resolved. Hopefully, tomorrow with the new vet.
 
It’s hard to eye ball a 1/4 unit but let’s see if Bron has any suggestions. Could you draw on the syringe you have now with a marker where the 1/2 unit mark would be. That might be easier than a 1/4 and then from there maybe eye ball 1/4. We all have to do that since there are no 1/4 unit marked syringes. Some folks use calipers though. I’d hate for her to be getting more insulin than she should right now because of the syringes.
 
Hi Sharron and Poppy and welcome to the forum. I’m a bit late to the party but thought I would pop in and say how glad I am you have found us. I hope the new vet is suitable.
I live in Australia where we can’t get 1/2 unit syringes and I have had to get used to giving smaller doses using the syringe with only 1 unit markings. What I did was always use a magnifying glass in a good light. I mentally divided the 1 unit space into 4. I started off dividing it into 2, so half and half. And then divided the half into half again. So that made 4 quarters.
Have a look at this syringe below. You can see it has half unit markings, which are the smaller lines inbetween the longer lines.
So what you see there in that photo is how to draw up 0.25 units or 1/4 unit insulin. So if you can imagine the half unit line is not there, which yours does not have, you can see how 1 unit can be divided in to 4.
If you count the number of units in the syringe below by counting the longer lines, you can see it is just showing 5 units in that photo. The 5 unit line is longer.
I hope I have not confused you.
Also what are the syringes you are using? Are they the 3/10 ml syringes? That is, do they have 30 units in them? Or are they larger.?
I am so sorry you are having so much trouble with being able to access syringes.

Re the dose: Ale is correct in that you need to reduce the dose any time Poppy drops under 90.
You don’t wait for trends when it comes to reducing the dose. Our first priority here is to keep your kitty safe and we do that by using our dosing methods that have proved time and time again to stop kitties dropping too low and having a hypo event, which none of us want to happen ever. It is wonderful you are hometesting which ensures you are in control, and changing the food over to a low carb food. Poppy is so lucky to have you. But there is no point in hometesting if you don’t reduce the dose when the BG tells you to (ie she drops under 90.) Does that make sense?

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I also just want to add that I’d encourage you to try to keep testing her at +6 since that’s when she’s shown the lowest bg. She’s been getting a lot of blues which lead me to think she’s going under 90 numerous times but you’re just not catching it. Like yesterday for example :)
 
@Sharon & Poppy far as snacks and treats go
Sharon & Poppy said:
In NJ you need a script for syringes. That is the law. You can get 10 a day without a script. More than that you have to have a script. The syringes are one of our toughest issues.

Believe me - I feel that there is a prejudice against people who ask for them. I have been to Walmart, CVS, Costco trying to get just the 10. And people are judging and coming up with excuses not to give me the syringes. The script I have now is for 100 with 1 unit scoring. I had asked the Vet three times to call in the exact ones in your picture. And it still has not been done. I need this syringe problem resolved. Hopefully, tomorrow with the new vet.
Click to expand...

as long as you have any script for syringes you may be able to just order the half-unit ones from Chewy and provide the the script.
 
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