01/27 Casper AMPS 201 0.75U +3 LO, +4 87, +5 139, +6 123, PMPS 653

A little bounce but not bad!! I hope he’s feeling better since being home.

If you don’t mind, please, it’s recommended to not include a dose in your signature block as it changes. We just need to know the insulin being used and also ask that you add “TR” after Lantus so we know the dosing method you are using. Thank you!!
 
Marje and Gracie said:
A little bounce but not bad!! I hope he’s feeling better since being home.

If you don’t mind, please, it’s recommended to not include a dose in your signature block as it changes. We just need to know the insulin being used and also ask that you add “TR” after Lantus so we know the dosing method you are using. Thank you!!
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Revised, thank you for the advice! Yes, he does feel a lot better since he's home, time for some good rest I hope. I think I still need Sub-Q fluid to be lined up for him, so he doesn't go dehydrated again to cause all the issues. We don't see him drink water by himself anymore, more like a syringe feed task.
 
I'd test in 20 if possible. When you give syrup, which is what you should do with low readings, test again in 20 because it kicks in faster than hc food. We want to get him up.

Also, I think Lizzie meant to retest casper. When we get a reading like that, we say to retest kitty immediately with another strip because sometimes you get the occasional strip that is wonky/faulty.

How is Casper? How is he acting?
 
I'm glad he's up. Do test again to make sure he stays up. An hour should be good with that 87 and seeing as he is still being fed. I Just want to make sure he doesn't drop below 68 again once you withhold food. I like his fighting spirit though.
Is there a reason you didn't reduce the dose when Casper dropped below 68 yesterday? Just curious if someone helped you decide to keep it at .75u.
Please reduce the dose as of this evening. New dose is .5u.

Sounds like he did not show any symptoms of hypoglycemia?
 
How's Casper feeling? How long ago was the AT2 87 test? Did you feed anything then? I'd get another test 30 minutes after the 87 - we want to make sure Casper is holding his own as the carbs/syrup wear off.

Here's the Low Number sticky which is a good read and reference.

Congrats on the reduction to 0.5u :cat:
 
Butters & Lyla said:
Do test again to make sure he stays up. An hour should be good with that 87 and seeing as he is still being fed
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There is a type of being hungry is: grandma thinks you are still hungry :D I believe he needs to eat at least 1 can a day (5.5 oz.). We normally blend the food with water, syringe feed a small amount each time, every other hour unless his BG drops way too low.

Elise and Brandti's mom are helping me along the way, the doctor first told us to do 1U/2 times/day, then changed to 1U/morning only; with Elise and Brandti's mom's help, we tried 0.5U, then increased to 0.75.
Butters & Lyla said:
Sounds like he did not show any symptoms of hypoglycemia?
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Not really, he walked a little bit wobbly when he first got up, but then he used the litter box well, jumped off well, took his 12 PM noon feeding well...of course, other than boxing with grandma, knocked out the syringe one time and pushed the water bowl out of his sight.

Will retest him in 15 mins at 2 PM.
 
Right now, if you were regularly syringing hc and syrup, which was my understanding, then it's fine. I did mix up in my brain that you're using an AT2.

Elise and Bhooma helped you decide on a .75u dose. But reductions are earned for Casper when he drops below 68 because you are using the AT2. That's different. They didn't mean for you to keep him at .75u indefinitely.

Please take the reduction to .5u today. Next cycle. That "LO" is Casper saying it is too much insulin right now. It isn't safe to keep him at .75u anymore.
 
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Butters & Lyla said:
Okay, please take the reduction to .5u today. If you're continuously syringing hc and syrup between tests, which was my understanding, then it's fine. I did mix up in my brain that you're using an AT2.
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Will do! Reduce to 0.5U tonight. +5: 139
The syrup, high carb. 1-tbsp FF gravy, and 2-tbsp cat milk were only given once at 12PM when I found his number was LO. That's it. Then we continue with low carb., low phosphorus food.
We are using AT2, my old vet suggests that, although it's expensive but cheaper than the clinic visit and we know most accurate information first hand, less guessing.
 
Many of us used a pet meter at one point. Just wanna point out though that the TR protocol was designed with a human meter.

The last time he ate anything was at +3? I know you gave him a lot then. I'd still get an insurance test in an hour just to make extra, extra sure that he isn't going to come back down. I would not want to take any chances after getting a "LO" reading on a meter.
 
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Butters & Lyla said:
the TR protocol was designed to be used with a human meter.
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Yup, I read that on the TR SLGS guideline, the method is designed to be used with a human meter ONLY. But I think the same methodology can still be applied or that's not even the case? I can pick up a human meter with supplies, keep Atraphtrak2 handy as a reference. Any particular one you would suggest?
The last time he ate was at +4, 10 ML low car., will test him again at +6.
 
Sounds good about the test. Honestly, we'd all cheer if you'd put the AT2 away and just use it for your vet.:D It's not the same when you follow TR with a pet meter.
@Bandit's Mom could help you change your spreadsheet over to a human meter one once you get your supplies.

I'm in Canada. @JaxBenji do you know the best/cheapest human meter? Is it the ReliOn? Thanks. I believe you want the ReliOn, Yuling. Susanne should be able to tell you.
 
Yuling & Casper said:
TR SLGS guideline, the method is designed to be used with a human meter ONLY.
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I don't think this is true - it's just known that TR protocol and (separately) SLGS dosing method are all written in human meter numbers. The caregiver can use any meter they wish but I (a former pet meter user) found there is less confusion when using a human meter since that's what the dosing methods were built using. On TR, the reduction point on human meter is 50 and on a pet meter is 68; on SLGS, the reduction point is 90 for both meters.

Butters & Lyla said:
@JaxBenji do you know the best/cheapest human meter? Is it the ReliOn? Thanks. I believe you want the ReliOn, Yuling. Susanne should be able to tell you.
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ReliOn Prime is very popular. Order from Walmart (or order pickup if you have a Walmart nearby). Really any human meter will work but ReliOn Prime is cheap ($9 I think) and strips are $0.17 each or something like that. And FWIW, I still use my AT2 lancet with the ReliOn - it takes a little bit more blood but I really didn't have an issue with getting enough blood.
 
Susanne's right. It's not that it cannot be used with a pet meter. But human meter was used by the people who developed the protocol, and in general we all find it easier when people use human meters. Many have switched.
 
I’m so glad you tested when you did and gave him syrup. I’m also glad he’s safely up.

Susanne is correct: TR and SLGS are two different methods and both were designed using human meters. You can do them and use a pet meter, if you wish. Just know that if you are doing SLGS, you would use the same BG for changing doses as we do with human meters. For TR, the reduction BG is a drop below 68.


Yuling & Casper said:
Revised, thank you for the advice! Yes, he does feel a lot better since he's home, time for some good rest I hope. I think I still need Sub-Q fluid to be lined up for him, so he doesn't go dehydrated again to cause all the issues. We don't see him drink water by himself anymore, more like a syringe feed task.
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Thank you!!! That’s perfect.
 
@tiffmaxee Welcome back Elise. :bighug: Thank you!
I just received his phos-bind, Epogen, Cerenia, LRS, B12 injection, admin set, and needles. He has started potassium and B12/B9 complex since yesterday. Will talk to the vet about the plan and see what he would add or advise.

JaxBenji said:
The caregiver can use any meter they wish but I (a former pet meter user) found there is less confusion when using a human meter since that's what the dosing methods were built using. On TR, the reduction point on human meter is 50 and on a pet meter is 68;
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Got it! I will make the reader switch, may not be tonight though...not sure when we are going to finish with the vet (appointment at 5). Since Casper is anemic, I wanted to do more research on that, the least amount of blood would be the best for him. Every time I poke him, I feel guilty.
Also, I found this article from Diabetes Technology org., quite interesting studies on various products:
https://www.diabetestechnology.org/surveillance.shtml
 
We need clarification as to whether you want to follow TR or SLGS. In reading back from when I started looking at your condos on 1/14 I said to hold the dose for 6 cycles unless a reduction was earned. Rather than look through all since then, which method are you going to follow? It matters in terms of advice we give. If you choose one and it’s not working for you, it’s fine to change. A reduction was earned on both today so you have time to decide. Thanks.
 
I thought we've been doing TR. That's why even his BG went so low yesterday, I held the dose at 0.75 this morning until I was advised to reduce or increase. Am I not doing the right thing?
 
Yuling & Casper said:
I thought we've been doing TR. That's why even his BG went so low yesterday, I held the dose at 0.75 this morning until I was advised to reduce or increase. Am I not doing the right thing?
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On TR - link to the dosing method here - you reduce by 0.25 if kitty drops below 50 on a human meter or 68 on a pet meter. Looking at your SS, you should have reduced last night since Casper was <68 during the AM cycle. When kitty drops, it's their way of telling us it's too much insulin.

I read the dosing method stickies (well, all the stickies :p) over and over. Keep asking questions - the dosing methods were designed to keep our kitties safe.
 
Also, just wanted to add, you would reduce if following SLGS too (the reduction number is 90 for both human and pet meters).
 
Got it! Sorry, I really thought I am not supposed to do anything but hold the dose for 6 cycles, in case that would be any bounces from the time at the vet (we had low before, but we held the dose). Now I understand fully. To recap, we are doing TR. Thank you :bighug:
 
Talked to my old vet for 20 mins, this is probably the longest time he ever spent with us. He wanted to let me thank you all for doing such an awesome job when he wasn't available for help. THANK YOU!!

He said 0.75U is too much, and definitely not 1U. I need to do 0.5, and 2-cycle curve tomorrow and Sunday, come back see him on Monday. He is giving Casper a B12 injection tonight, sending him home 2 more bags of Sub-Q (I have 2 at home) and mitrazapine. 100 ML Sub-Q for every 24 hours, until he could see Casper again on next Monday.
 
Yuling & Casper said:
I thought we've been doing TR. That's why even his BG went so low yesterday, I held the dose at 0.75 this morning until I was advised to reduce or increase. Am I not doing the right thing?
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Me too but I was told someone thought SLGS. Add it to your signature and spreadsheet.
Yuling & Casper said:
Talked to my old vet for 20 mins, this is probably the longest time he ever spent with us. He wanted to let me thank you all for doing such an awesome job when he wasn't available for help. THANK YOU!!

He said 0.75U is too much, and definitely not 1U. I need to do 0.5, and 2-cycle curve tomorrow and Sunday, come back see him on Monday. He is giving Casper a B12 injection tonight, sending him home 2 more bags of Sub-Q (I have 2 at home) and mitrazapine. 100 ML Sub-Q for every 24 hours, until he could see Casper again on next Monday.
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Thankfully he agrees with us.
 
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tiffmaxee said:
Add it to your signature and spreadsheet
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Thought I did that too....
Now I am just glad we have a vet can go to, decent enough to know what Casper needs, doesn't argue with my requests. And most importantly, he agrees with you, humble enough to ask me to pass on his "thank you note". I guess it was just our bad luck in the past 2 weeks, this vet was out for 14 days for the vaccine reaction. His clinic was still a chaos tonight though, an old lady was yelling all the time, someone threw up in the lobby which was packed with 33 people last time I counted...not sure about 6-ft social distancing...lucky if we could get 3.
 
I’m surprised they let you go in. Most don’t. I’d wait in the car next time and ask them to call you when it’s your turn. Don’t be surprised if you get a bounce at PMPS after the lo.
 
I don’t know. See if his breathing regulates. The high bg is not the issue. It’s the anemia I guess . I just don’t know how to help him.
 
I’m not there so I don’t know how bad he is. If he’s breathing okay you might be able to wait for you vet. You will have to make that call. His bg is high so if he doesn’t eat tonight it’s okay.
 
We are on the way to the ER. Other than his rapid breathing and threw right up the food we fed him, he is quite normal, active. Will see what the vet say.
 
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The ER ordered full panel bloodwork and X-ray just now. Saying Casper is breathing with the mouth open...they mentioned any stupid move, stress or too long without oxygen may make him crash really fast.
I don't understand, is that because I didn't reduce his shot this morning?:banghead::banghead::banghead::banghead::banghead::banghead:
 
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