08/30 Nola AMPS 190 +2 204 +4 154 +6.5 96 +8 137 +10 130 PMPS 178 (AMPS/PMPS questions)

Jo & Nola

Jo & Nola

Member
Hello all!!

Is it normal that her BG was following a pattern (that makes more sense to me: after +2 insulin starts decreasing the BG) and then since yesterday it flipped? Its now her AMPs are decent and after the shot her BG just goes up?

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Meter variance is 20% so about the same. You can get a good spike and onset can vary from cycle to cycle . All to say it’s normal. The +2-3 if a lot lower can mean there will be an active cycle which might mean more testing needed. Otherwise the nadir is what you need to watch. Also you had a nice run of green last night so possibly a little higher due to a mini bounce if not meter variance. Nice cycle last night.
 
tiffmaxee said:
Meter variance is 20% so about the same. You can get a good spike and onset can vary from cycle to cycle . All to say it’s normal. The +2-3 if a lot lower can mean there will be an active cycle which might mean more testing needed. Otherwise the nadir is what you need to watch. Also you had a nice run of green last night so possibly a little higher due to a mini bounce if not meter variance. Nice cycle last night.
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Thank you Tiffmaxee! So you suggest more testing at +2 & +3, Ill get on that.

Just verifying this info, which Im not sure if I got from the vet or from reading here: At which AMPS/PMPS if any, should I not administer an insulin shot? Whats the protocol in those cases, wait 'til it rise to X and then shoot (the full dose or partial)?

BG Below 50 = administer quick simple sugar (ie honey) + reduce -0.25 from dose as of next schedule shot?
 
You never will give insulin if the bg is under 50. Eventually with TR you can give insulin if 50 or higher. Being newly diagnosed since you have shot around 170, I think if the bg is on the way up at shot time you can shoot 150. If you can monitor you could shoot a little lower. if low 100’s or green you want to stall to see if it continues up in 20-30 minutes without food. Having the Libre in allows you to see if the bg is going up at shot time or at least not continually dropping. You would not want to shoot a low dropping bg being new. If that happens after stalling, you have the choice of shooting a one time reduced dose of about 20-50% of the current dose. The first half of the cycle might be active if you shoot a reduced dose though.

Under 50 calls for a reduction in dose and then you would feed hc food preferably or honey with regular food. When that happens you need to feed a small amount and test again in 20-30 minutes. Honey will raise the bg in about 15 minutes but will not last as long as hc food. Hc food will take 20-30 minutes to raise the bg. You want to keep Nola hungry so don’t overfeed. You need to be able to see the bg stay up for 2 hours without hc food or honey before it’s safe to stop monitoring.
If ever in doubt just ADD the question mark prefix to your subject and ask for help. Nice to see the green nadirs. Nola looks good.
 
tiffmaxee said:
You never will give insulin if the bg is under 50. Eventually with TR you can give insulin if 50 or higher. Being newly diagnosed since you have shot around 170, I think if the bg is on the way up at shot time you can shoot 150. If you can monitor you could shoot a little lower. if low 100’s or green you want to stall to see if it continues up in 20-30 minutes without food. Having the Libre in allows you to see if the bg is going up at shot time or at least not continually dropping. You would not want to shoot a low dropping bg being new. If that happens after stalling, you have the choice of shooting a one time reduced dose of about 20-50% of the current dose. The first half of the cycle might be active if you shoot a reduced dose though.

Under 50 calls for a reduction in dose and then you would feed hc food preferably or honey with regular food. When that happens you need to feed a small amount and test again in 20-30 minutes. Honey will raise the bg in about 15 minutes but will not last as long as hc food. Hc food will take 20-30 minutes to raise the bg. You want to keep Nola hungry so don’t overfeed. You need to be able to see the bg stay up for 2 hours without hc food or honey before it’s safe to stop monitoring.
If ever in doubt just ADD the question mark prefix to your subject and ask for help. Nice to see the green nadirs. Nola looks good.
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Sorry if Im being repetitive, I just want to make sure I fully understand the instructions:
  • Don't shoot if BG<50= Feed her a little high carb food and test again in 20-30 mins til it raises to above 50 for at least 2 hours before monitoring less frequently. Reduce recurrent doses -0.25 u.
  • After she gets to 50<AMPS/PMPS<99 (neon green)= what should I do in this situation?
  • If 100<AMPS/PMPS<199 (green)= Check BG trend in monitor. If its increasing and BG is 150 or higher: shoot full dose. If BG is in the low 100s: stall food and insulin shot for 20-30 mins. If after stalling, BG is still low (but higher than 50) shoot a 1 time reduced dose (20-50% less).
When you say the first half of the cycle might be active, do you mean the BG will be higher after reduced dose?

Thank youuu,
Jo
 
If under 50 do not shoot ever. If you give hc skip the shot. If you give kc and the bg rises you can shoot in a couple of hours but if it were me I would skip the shot.

When I say if you give a token dose the first half of the cycle might be active, the bg may stay green or low for the first half of the cycle. You will likely see higher bg the second half and possibly the next cycle or longer. If lime at shot time and you skip, you may see the bg bounce high in reaction to the low bg. Every cat is different. That’s why you can try stalling without food to see if the bg rises in its own.
Make sense?

After stalling if the bg doesn’t rise much I personally would not give insulin. If 75 I’d consider a reduced dose IF you can monitor as long as needed. There’s nothing wrong with skipping in that situation.
 
tiffmaxee said:
If under 50 do not shoot ever. If you give hc skip the shot. If you give kc and the bg rises you can shoot in a couple of hours but if it were me I would skip the shot.

When I say if you give a token dose the first half of the cycle might be active, the bg may stay green or low for the first half of the cycle. You will likely see higher bg the second half and possibly the next cycle or longer. If lime at shot time and you skip, you may see the bg bounce high in reaction to the low bg. Every cat is different. That’s why you can try stalling without food to see if the bg rises in its own.
Make sense?

After stalling if the bg doesn’t rise much I personally would not give insulin. If 75 I’d consider a reduced dose IF you can monitor as long as needed. There’s nothing wrong with skipping in that situation.
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Yess its making more and more sense thank you!!

Summary=
  • If BG<50= DONT SHOOT, skip dose. Feed her a little high carb food and test again in 20-30 mins til it rises (Monitor frequently until BG>50 for at least 2 hours. Reduce recurrent doses -0.25 u.
  • If 50<AMPS/PMPS<99 (lime green)= Stall food and insulin shot for 20-30 mins. If after stalling, BG<75 skip dose + feed. If BG >75, then shoot reduced dose, feed & monitor frequently (every 15 mins) as long as needed.
  • If 100<AMPS/PMPS<199 (green)= Check BG trend in monitor. If its increasing and BG is 150 or higher: shoot full dose. If BG is in the low 100s: stall food and insulin shot for 20-30 mins. If after stalling, BG is still low (but higher than 50) shoot a 1 time reduced dose (20-50% less).
 
Once you see how Nola responds to food and how much the bg rises you will get to the point that you can shoot if over 50. Being new I feel it’s important to be conservative. Better a day or two high than a hypo event. The first time you see lime if you are at all like most of us, you will probably overdo it with carbs. I did more than once. As you learn how Nola responds to higher carbs you will learn what is needed. Max was very carb sensitive so usually would come right up. I still have several pj parties in the middle of the night though.
 
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