12/8: Jude: AMBG 92; +4 307; +9 517; PMPS 455; +2.50 329

Bandit's Mom said:
Have you fed him? Can you monitor if you shoot?
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I did feed him. I cannot monitor all day. We are 40 minutes past his regular shot time, so I think I will not shoot this morning. I'll monitor as much as I can through the cycle to gather data.
 
Can you get another test now? If it was a bad strip or he has zoomed up after food, you could still shoot. You might have to adjust future shot times accordingly.
 
Bandit's Mom said:
Can you get another test now? If it was a bad strip or he has zoomed up after food, you could still shoot. You might have to adjust future shot times accordingly.
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I just retested; he's 142. That is after eating. Also, this morning when I tested, I did two tests to double-check. He was 92 and 94.
 
With SLGS you can shoot over 90. He might just head up from here or might not. If you can get monitor in the first few hours of the cycle, you could still shoot. Would you be comfortable doing that?
 
Bandit's Mom said:
With SLGS you can shoot over 90. He might just head up from here or might not. If you can get monitor in the first few hours of the cycle, you could still shoot. Would you be comfortable doing that?
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I can't monitor in the first few hours of the cycle, so I don't think I will run the risk that he might go low with me not being here.
 
Sorry Mary, I didn’t catch you in time. Usually when you get a lower than usual preshot, you can try and stall, not feed and retest again to see if the BG numbers are rising on their own. Even with a no shot, it might be worth leaving some food for him while you are out and testing when you get home. It’s possible that the depot will still influence at least the first part of this morning’s cycle.

Nice green, Jude, but you could have made it a less surprising :woot:
 
@Bandit's Mom and @Christie & Maverick, Thanks for the feedback. I have some other questions, if you don't mind. If this happens in the future, and if I cannot stall, if he's above 90 at the AMPS, will he likely go up, as he's done today, or do we just not know? Given his up and down and all over the place, this makes me nervous.

As I said earlier, my thinking this morning was that he is on 3 units (which seems like a lot to me), and if he is so close to 90, if I give him 3 units of insulin, he'll go drastically (life-threateningly) low. (I think I just don't understand how the insulin works. I see other cats are in the greens on both ends of the cycle, yet they still receive insulin, and their numbers stay flat. I guess this is what it means by surfing--we are giving insulin in the correct dosage to balance the high bg the cat is producing.) So if I were to give Jude 3 units when he is at 90, and if he becomes hypo, will the hypo tools (food and syrup) be enough to keep him from a life-threatening situation. I live in an area where we do not have emergency vets, so if something happens to him at night or on the weekends, there are no options, unless I can get a vet to come into the office, which is not something I want to bank on.
 
To an extent because Jude went into remission so quickly, this time around you’re faced with some new aspects, like shooting lower numbers which you never did before, but for a few BG in the beginning between 136-159. This would have been your lowest preshot, so even if with SLGS where you can shoot anything above 90, since you’ve never shot this low, and the number was way below the usual preshots since he’s been back from remission, better to err on the side of caution, stall, not feed and see if you get to a number that you are comfortable shooting. If you get another preshot under 150 again, it might be worth stalling, not feeding and retesting and if you are able to monitor, and with SLGS until you collect enough data when faced with lower preshots, the general guideline from the Dosing Methods is:

Below 150, don’t give insulin.
Between 150-200 you can:
-give nothing
-give a token dose (10-25% of usual dose)
-feed as usual and test again in a couple of hours and make a decision based on that number.

Your use of the pet meter complicates things a bit, since those numbers in the dosing methods sticky are based on human meter values.

Gradually, as you see how those cycles play out, you may be more comfortable shooting the full dose at lower numbers.

Lantus is known for often giving nice flat cycles, and yes, you’ll often see people saying shoot low to stay low, but since you’ve not had to face a lower than usual preshot I think it was wise to skip and until you get more familiar with how Jude reacts at lower preshots, perhaps follow the 150 BG level as noted above.

Does this answer your questions?
 
Yes, that makes sense and answers my questions. Thank you. I was re-reading the dosing method this morning as I was trying to decide what to do, and the "below 150, don't give insulin," was what I was looking at, and it worried me to shoot him. That said, he's at 517 now, which was exactly what I feared would happen. I am going to be switching to a human meter at the start of the new year. I truly don't like this disease.:(
 
I know it can be hard to see those high numbers, he’ll get back on track, it’s likely a combination of hitting a lower number again he’s not used to and bouncing plus the skip :bighug:.

Stalling and retesting after 20 minutes, when you get a lower preshot can help make your decision, sometimes the cat comes up nicely to a number you are comfortable with, or you can continue to stall again another 20 minutes and see where he is at then. While you are stalling, you can post for help. You can include in your post title, Help, Stalling, BG xxxx and that might help you get some eyes on your post and hopefully experienced people to offer some suggestions based on Jude’s SS numbers.

It is also a matter of whether you can monitor when shooting a lower preshot, and of course there is an unwritten rule here on the forum that anyone who advises you to shoot a lower number like you had today should stay with you and help guide you through the cycle. You wouldn’t be left alone. :bighug:
 
Woohoo, first green today!:D. Even if he did choose an inconvenient time for it.

Once you have some more experience, you can move to the second section on shooting lower preshots, that starts "with experience". That section describes a different strategy for those following SGLS. Christie has given you lots of good advice on how to handle those lower numbers.
Marielle said:
he is on 3 units (which seems like a lot to me)...So if I were to give Jude 3 units when he is at 90, and if he becomes hypo, will the hypo tools (food and syrup) be enough to keep him from a life-threatening situation.
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I don't consider 3 units to be a lot of insulin, but then, my girl got up to 8.75 units. A cat needs however much insulin they need. What is important is the BG numbers, not the size of dose. Lantus doesn't behave differently with small, medium, or larger doses. Similarly, Jude could go into low numbers when he starts at with a high preshot, just as easily as with lower numbers. Neko's first below 50 (I followed TR), she was in the high 400's at preshot. And I saw her surf flat numbers when I shot green preshot numbers - even with double the dose Jude is at now.

There are never guarantees a cat will be safe if they go into low numbers, but if you are monitoring closely and have higher carb food and syrup, those are the tools to keep him safe. That, along with following the dosing methods and knowing how low a dose is taking your kitty, so he doesn't get to too high a dose.
 
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