03/27 Ella PMPS 102 Please HELP for dosing!

Status
Not open for further replies.
tpr

tpr

Member Since 2012
Ella was a bit higher than usual this am. I think I might have given her a bit more food. She was high as a kite last night and drank water a gabillion times.
 
Re: 03/27 Ella AMPS 288

Hi guys .. not a bad start, sunny yellows for ella! Sorry to hear she was so high and thirsty last night .. it's tough to see our kitties uncomfortable .. have a great day guys!
 
Re: 03/27 Ella AMPS 288

Gah....So I wrote a note abot this yesterday and I'm having challenges filling in the world section of the spread sheet. I can switch back and fourth but it won't let me enter the data manually when it's in world. How do I do this?
 
Re: 03/27 Ella AMPS 288 (question about SS)

figured it out but deleted a comment by accident:( oh well!
 
Re: 03/27 Ella AMPS 288

hi tamara!

i want to make sure you have a copy of the Start Low Go Slow Protocol for ella. as long as she's eating dry food, this is the protocol that you want to follow for dosing for her.

the one change from the document that we encourage is to adjust the dose by .25u rather than .50u. according to this, ella is due for a dose increase. she's been on this 3.0u dose for 1 week today and her lowest point was 183. if you decide to do this, her new dose would be 3.25u.

Step 3.
After 1-2 weeks at a given dose, you or your vet should perform a serial blood glucose curve (blood glucose tests every 2 hours, starting at shot time and continuing until the next shot). Follow the cat's normal feeding schedule during the curve. The curve should be evaluated by someone experienced at interpreting feline blood glucose curves, in order to check for signs of rebound and other possible problems. If no rebound is present, follow these guidelines for dose adjustment (smaller adjustments may be appropriate for cats on PZI or Lantus):

If the lowest point of the curve is above 150 mg/dl (8.3 mmol/L), increase the dose by 0.5 unit.
Click to expand...

even though she bounced (rebounded) from that 183, that was still her low point of the curve and i think it's reliable for you to base your dosing upon it.

make sure you read the rest of the page, however, with the rest of the directions for following SLGS.
 
Re: 03/27 Ella AMPS 288

Thanks for the advice Julie. I just did a +9.5 test and she is 232 so she is still in the yellow. I wonder if she got low today...
Could the snacks of soft food have a difference this quick? I just gave her a tbsp of wellness so should I expect a drop in her glucose by PMPS?
Her hunger wasn't satisified the same as it usually is with the dry...she's begging me for more as I type.
Tamara
 
Re: 03/27 Ella +9.5 232 (soft food?)

Tamara, I'm no expert here, but I do know my Daphne responds very fast with the higher carb foods, even a tsp. of it.

Also, I used Contour for a while and found it reads about .10-.20 points higher then my Relion. I had other meters too, and they all vary about .20 points, so just for your FYI.
 
Re: 03/27 Ella PMPS 102 Please Help for dosing

Just tested Ella and she is at 102. She is eating her dry right now but I need help for dosing.

Thanks!
 
Re: 03/27 Ella PMPS 102 Please HELP for dosing!!

My vet said that if she was 103 after eating that I should give her 1 unit and that if she was 102 and hasn't eaten then I should wait an hour and then give her 3 units (her normal dose).

Suggestions?
 
Just so you know, she may have eaten less today as I might have not substituted enough wet for the dry that she usually eats.
She usually gets a +9 snack of 1/8 dry and I gave her 1 tbsp. I think she needs closer to two.
 
Are you about at +1, now? Please test her and let us know what that test number is at +1.
How far off schedule can you be? Meaning, if you shoot now, can you shoot 12 hours later tomorrow morning, no problem?
Also, do you have plenty of strips and supplies for extra testing tonight, if needed?
 
Re: 03/27 Ella PMPS 102 Please HELP for dosing!!

tpr said:
My vet said that if she was 103 after eating that I should give her 1 unit and that if she was 102 and hasn't eaten then I should wait an hour and then give her 3 units (her normal dose).

Suggestions?
Click to expand...

From the looks of Ella's ss, your dosing is all over the place and very likely too high. If you are using Lantus or Levemir, you base your dosing on the lowest numbers in a cycle and never by your ps numbers.

I don't know about the others, but I would say you started at a dose way too high and Ella's bouncing all over the place. I would say you should drop back to 2u BID and hold that dose for 3 or 4 days, but with the dry food in the picture, you will need the higher dose. on the 18th and 19th, that 3u ended up being to high and you had to skip shots, so maybe a 2u dose would let her level off and stop bouncing?

3/15 4u / 4u
3/16 3u / 4u
3/17 4u / 4u
3/18 0 / 3u
3/19 0 / 3u
3/20 2u / 3u
3/21 to now 3u / 3u

Ella's up and down all over the place, and the dry food is not going to make it easy to regulate the numbers.

All your dosing is in whole units; are you using syringes with 1/2 unit markings? eventually, when you get close to her good dose, you will need to fine tune her dose.

If you are switching over to wet food, I think the 2u dose would be safer.... just not a good idea to go back to dose jumping.
 
she was on 3u for quite some time and was only eating dry. Since yesterday I started giving her wet at snack time +9. She usually would get 1/8 dry and I substituted for 1 table spoon. Perhpas it was not enough...she is very hungry now.
 
I think you're going to have to skip tonight's dose. That 81 is like at 51, since you're using an Alphatrack.
I would give her a little bit (like a teaspoon or a teapoon and a half) of low carb wet food, and then test again in 20 minutes. Please let us know what that number is by editing the Subject Line in your first post in this condo.

Thanks. Don't worry, we're here with you.
 
Gayle -- This cat is not following TR. The guidelines for how long to hold a dose are different. She has, in fact, held the dose for the past 14 cycles.

Tamara -- are you able to stall further and still manage your schedule tomorrow? Whatever time you shoot tonight, your AM shot will be 12 hours later.
 
I'm using the contour now! So the number is 81 on the contour!

I also used the AT at PMPS and it gave me the exact number as the contour.
 
I can't change my schedule that much. The latest I can leave my house tomorrow is at 8:45am
 
The dose of 3u is too high now that the food change in progress.
Stalling is fine, but the dose is going to need to be decreased, and are the syringes with 1/2 unit markings?

I can clearly see that the dose of 3u was held a length of time, but that length of time means little once you change the food.
 
So basically, you need to shoot soon. (FYI: 8:45 doesn't mean anything to me since I'm not exactly sure what time it is now in Toronto.)

It doesn't look like you've ever shot this low. You have a couple of choices:
  • Skip the shot.
  • Shoot a reduced dose.
  • Stall further (and don't feed)
If you skip, the trade off is that Ella's numbers are likely to be high tomorrow. If you shoot a reduced dose, you are going to need to stay up and monitor which is also true if you stall and then shoot.

Do you have a preference or do you know what will work for your schedule?

There's more info on shooting low numbers here.
 
tpr said:
no the syringes do not have half marks
Click to expand...

As you get closer to Ella's good dose, and as her dose keeps dropping while you are switching to all wet food, the 1/2 unit markings will come in handy so you can give her doses like 1.5u or 1.75u.
 
It's 8:45pm in Toronto. If you are in Chicago we are on the same schedule.

I don't know what to do here... will I need to test every hour of the evening?
 
if I stall then how will i give her the 12 hour dose tomorrow if I leave at 8:45am?
 
tpr said:
It's 8:45pm in Toronto. If you are in Chicago we are on the same schedule.

I don't know what to do here... will I need to test every hour of the evening?
Click to expand...

when did you test her last? can you test her again and see if her numbers are still dropping or are they rising.

when did you feed her last?

Toronto is Eastern Standard Time.
 
I'm in Central time -- It's 7:51 at the moment.

If you can't stall, then your options are limited. It's OK. And I can't say how long you will need to test. That depends on Ella and we all know how cats are!!

How about getting another test to see if her numbers are heading up. Have you been feeding?
 
Tamara,

It looks to me like you can't stall any longer. If that's the case, you will need to skip this shot...you are not ready to shoot this low, even if the numbers were not dropping. I would go ahead and feed Ella and skip the shot. It would be very helpful if you could get some further tests tonight, so you can see when she starts to come up. It looks to me like you will need to reduce the dose tomorrow morning...below 90 is a dose reduction for SLGS, and since you are transitioning to wet food, it appears to me that her insulin needs are decreasing. Those tests tonight will help us figure out how much to reduce the dose.
 
have not been feeding. just tested her 25 minute ago. should i re-test now or wait a bit longer?
 
But she has already eaten her food for the day so should I feed her more?
I am leaving for work in exactly 12 hours if that makes a difference.

Also, I just started wet yesterday and it was in the smallest amounts. 1 tbsp at +9. Could that have such a crazy effect?
 
Are you able to stall longer? What time is it where you are...my world clock says that it's 8:58 PM your time...if that's correct, and you need to shoot by 8:45 AM tomorrow, you will not be able to stall any longer.

Yes, I would get another test now. She's dropping and you want to see if she is still headed down.
 
i think taking laurie's advice is the way to go tonight, tamara. she's changing in what she needs, likely because of the food changes.

so glad this came up before you increased! *whew*

if you give her insulin you will have to test tonight. sounds like skipping the shot, getting some tests in tonight and regrouping in the morning is a better way to go.

edited to add - i see you've had another word from laurie - i would defer to laurie and sienne's advice and will step out so you're not getting bombarded. good job catching the number, tamara! way to go!
 
Hey Tamara,

With Elie, we had to skip a few shots early on due to normal/low pre shot numbers. At that time, we were transitioning from dry food to wet food, and it made a huge difference as you can see with Ella. We felt more comfortable skipping and adjusting the dose according to some great advice we received here.

Tanya
 
she's starting to come up now so what should i do? I can leave for work at 9:00am tomorrow which is 12 hours from now.
 
That's the dry food kicking in...you fed dry food at 7:30, right?

I'm glad to see her coming up. You have a couple of choices....you could shoot a BCS dose and monitor. She may still drop, there are no guarantees. Some cats have a dramatic response to the diet change. If you choose to shoot insulin, you need to have all the supplies...HC wet food, plenty of strips and you need to stay up and monitor.

You could skip as I suggested initially. She likely will be high in the morning, but it would give you a chance to gather some data tonight and reduce the dose in the morning. I would still try to get some tests tonight, as I said before.

It's your choice. If it were my cat, I would probably skip.
 
Tamara,

Are you going to try to give wet or dry tonight?

What is happening today reminds me of Elie on 3/13 and 3/14...we skipped both pm shots due to lowish pm numbers. I will defer the advice giving regarding tonight to others.
 
Yes I fed her at 7:30pm and she is not supposed to recieve anymore food tonight...unless she goes hypo.

How often will i need to test tonight. Will not giving her dose make her bounce dramatically in the next couple of days?
 
Status
Not open for further replies.
Back
Top