03/05 Chippy, AMPS 297

[Chippy & Ingrid]

Good morning!

So, another day, another surprise. After skipping his shot again last night I was expecting to see an unusually high number this morning. Instead, the number was essentially the same as yesterday morning. We also tested his urine this morning and no ketones. It almost seems like Chip's on a 24 hour curve, with his low point falling at evening meal time. Is that even a possibility?

I plan to try to test every 2 hours today, but am wondering if I can infer anything about his overnight numbers by all this daytime testing. I am completely mystified!

 

[Gill & George]

We need to get you in a position where you are comfortable shooting lower PS.
On SLGS eventually you would be shooting everything over 90.

I don't know that it is necessary to run a curve today, but you can if you want to. There is no harm in that.

It almost seems like Chip's on a 24 hour curve, with his low point falling at evening meal time. Is that even a possibility?

Lantus cycle lasts about 12 hours in cats (some get better duration than others) but it won't last 24 hours, however, because of the depot, Chippy AMPS this morning will have been affected by the depot of the previous doses he has had.

Last night after you skipped, you can see he was back up in the yellow, without insulin, at around +3. If you had shot, Lantus would have onset around +2, and would have probably held his numbers down in the blues and you may have seen him nadir in green, rather than have what looks like a flat yellow cycle, which although better than seeing pink is still above the renal threshold and not where you ideally want him to be, keeping him below the renal threshold protects his organs (kidneys especially) What I cannot say is if he would have earned a reduction by dropping below 90???

Whatever you do testing wise this morning, get a +10 and +11 (especially if it is looking like you are going to have a low pmps), knowing whether he is actively dropping at the end of the cycle, holding flat or rising is more informative than the actual number at PMPS, it also gives you time to come up with a plan if he is visiting those lower blues.

 

[Chippy & Ingrid]

Thank you for the detailed response, that's very helpful!

I'll take your advice and do the +10 & +11 today and skip the every 2 hours. Part of the decision last night is that he was continuing to drop even half an hour after eating. by the time we tested him at one hour after eating he'd gone up a small amount, but was still just below the 150 at which the slgs protocol recommend skipping (for nervous newbies.) That said, I kept second guessing myself, and if it's right at that edge again will likely choose to shoot. So far the only pattern I've been able to identify is that he's almost always significantly lower at the evening shot than the morning shot.

 

[Gill & George]

Thank you for the detailed response, that's very helpful!

I'll take your advice and do the +10 & +11 today and skip the every 2 hours. Part of the decision last night is that he was continuing to drop even half an hour after eating. by the time we tested him at one hour after eating he'd gone up a small amount, but was still just below the 150 at which the slgs protocol recommend skipping (for nervous newbies.) That said, I kept second guessing myself, and if it's right at that edge again will likely choose to shoot. So far the only pattern I've been able to identify is that he's almost always significantly lower at the evening shot than the morning shot.

Maybe get a +6