? 1/28 - Moose - AMPS: 197, +1: 148, +5: 72, +8: 125

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Stephanie & Quintus said:
I hope my mentioning that 36 on the AT was "rush to the ER" was not understood as "anything above is fine, just relax". Not what I was saying.
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I was mentioning this number since your vet used it as a reference. For anyone who has not dealt with a hypo the "rush to ER" number should be much higher than that. If syrup does not bring the numbers up within 15 minutes and the number is lower than the described protocol then a ER visit may be in order. The urgency is much greater if the hypo occurs early in the cycle.


ETA Since anyone could be reading these forums even if they are not members the point needs to be clear that hypo numbers of any sort are to be dealt with promptly.
 
Fwiw, I'd also counsel a reduction here, even if it's not by-the-book. Moose has been giving clear signals that, now that his food change is complete, he's just getting too much juice. I agree with Stephanie-- if it were me, I'd much rather risk a failed reduction than a hypo.
 
Tuxedo Mom said:
I was mentioning this number since your vet used it as a reference. For anyone who has not dealt with a hypo the "rush to ER" number should be much higher than that. If syrup does not bring the numbers up within 15 minutes and the number is lower than the described protocol then a ER visit may be in order. The urgency is much greater if the hypo occurs early in the cycle.
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Definitely agree with this, too! I understand why vets want to give guidelines, but it's about more than just the numbers in isolation, it's the whole situation.
 
Stephanie & Quintus said:
If you look at his spreadsheet (it's not long!) you'll see that I never managed to keep up with him and had to keep decreasing down to nothing.

Not saying that is what will happen here, just that, well, the risk with a back-to-back reduction failing is that you'll have to up the dose again. And the risk with not doing it is dealing with lime greens. So it also depends how much you like "managing" those lime greens. I was trying to get Quintus under renal threshold at first, so I didn't care much if he was a little higher, but I did care if he was "risking hypo" while I needed sleep or was off at work. That was my reasoning.
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He does have a very short SS comparatively!

It has been manageable while I have been home over the weekend, but am unable to manage them once I return to work tomorrow...
 
Nan & Amber said:
Definitely agree with this, too! I understand why vets want to give guidelines, but it's about more than just the numbers in isolation, it's the whole situation.
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My vet gave me this number because I was so afraid of hypos that I was freaking out at 3.6 = 65 -- now, clearly, at 3.6 we need to act, and get the numbers up or at least make sure they don't go down, but for me it was reassuring to know that I still had a little "margin" before real disaster, and if he slipped down to 3 he was probably not going to die immediately. Knowing this allowed me to deal with "hypo numbers" in a much more rational way rather than panicking.
 
Nan & Amber said:
Fwiw, I'd also counsel a reduction here, even if it's not by-the-book. Moose has been giving clear signals that, now that his food change is complete, he's just getting too much juice. I agree with Stephanie-- if it were me, I'd much rather risk a failed reduction than a hypo.
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Reduce by another .25? I will have time to test a few times before I leave, to see how things are going. He is with my parents/sister who have been given the hypo print out..but they do not know how to test. I'm going to see if my sister is willing to learn on the fly.

Honestly, worst comes to worst, I am completely 100% fine with cancelling my plans if it means Moose will be safe. I feel selfish for not doing that right off the bat...had I not made these plans months in advance. My friends will understand though if I need to cancel last minute. Moose's safety is my top priority.
 
Moose & Rae said:
He does have a very short SS comparatively!

It has been manageable while I have been home over the weekend, but am unable to manage them once I return to work tomorrow...
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Exactly, that was also one thing I was factoring in. I was trying to get to a dose that I could safely give before leaving for work (12h away from home, shot to shot) so I would rather have had him a little higher and safe (and be able to concentrate on work).
 
Stephanie & Quintus said:
My vet gave me this number because I was so afraid of hypos that I was freaking out at 3.6 = 65 -- now, clearly, at 3.6 we need to act, and get the numbers up or at least make sure they don't go down, but for me it was reassuring to know that I still had a little "margin" before real disaster, and if he slipped down to 3 he was probably not going to die immediately. Knowing this allowed me to deal with "hypo numbers" in a much more rational way rather than panicking.
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The biggest concern is WHEN a kitty hits a hypo number and how quickly syrup/honey/karo can bring the numbers up. If a kitty drops into a hypo range and it is early in the cycle then the petparent needs to be extra vigilant or if the kitty is showing any distinct signs of hypo...lethargic or unsteady on their feet then the situation may be more urgent. Although, as I said in my previous post, not all kitties will show signs of a hypo. TEST TEST TEST....the best way to keep our kitties safe.
 
If you're going to be away all day at work tomorrow (no possibility of coming home? getting a lunch break test?) then I might even take him down to 1ui, to see how he behaves today, so I can head off serenely tomorrow. If this was me in your situation.

Again, bear in mind other people here have more experience than me, and I have been "not doing as I was advised". Worked for me but no guarantee it's reproducible.

Another thing I'd factor in: you started out at 2ui, where did that come from? Do we have any numbers from "before"?
 
Yes, reduce another 1.25 [edit: Stephanie just posted a recommendation down to 1.0U, and I wouldn't argue against that given the work situation :)]. It's been a while since the pre-shot test-- can you get another test now, just to see where he is? Since he's eaten, there'll be some food influence, but I just want to make sure he's not doing something unusual. Assuming he's going up now (from food and just from the expected pattern), it'll be a couple hours before this next dose starts to take effect.
 
Tuxedo Mom said:
The biggest concern is WHEN a kitty hits a hypo number and how quickly syrup/honey/karo can bring the numbers up. If a kitty drops into a hypo range and it is early in the cycle then the petparent needs to be extra vigilant or if the kitty is showing any distinct signs of hypo...lethargic or unsteady on their feet then the situation may be more urgent. Although, as I said in my previous post, not all kitties will show signs of a hypo. TEST TEST TEST....the best way to keep our kitties safe.
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Definitely. In complete agreement here. Just... for me it was useful to distinguish between the "act" limit and the "disaster" limit. And having some idea how far apart they were.
 
As has been advised by others I would take the further reduction. With the complete change to LC wet just recently that can certainly affect the glucose requirements. You can always go back up if the numbers start creeping upwards again.
 
Stephanie & Quintus said:
If you're going to be away all day at work tomorrow (no possibility of coming home? getting a lunch break test?) then I might even take him down to 1ui, to see how he behaves today, so I can head off serenely tomorrow. If this was me in your situation.

Again, bear in mind other people here have more experience than me, and I have been "not doing as I was advised". Worked for me but no guarantee it's reproducible.

Another thing I'd factor in: you started out at 2ui, where did that come from? Do we have any numbers from "before"?
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Yes I can come home at lunch for a check, I suppose my concern is that based on the last few days he has been dropping at around +2 and that usually falls around the time when I have just gotten to work so I won't be home.

I'm thinking the 1U would be a good idea...for peace of mind.

He "relapsed" a year ago and AMPS were in the 400s...vet started him out on 2U, then upped to 2.5U, then we went back down to 2U after his E.R. visit for hypo. I do have one older curve on my phone, from June last year (I had done curves after that, but this is the only one I tracked in the notes on my phone. Others were tracked on pen and paper which I need to hunt down.)

8am - AMPS - 415 mg/dl
8:15am - 2U
10:41am - 475 mg/dl
1:15pm - 432 mg/dl
2:32pm - 373 mg/dl
5:44pm - 424 mg/dl

Mind you, he was still eating dry food at this point...vet increased his dose to 2.5U after I gave her the above curve.

I just recently started using the SS and am trying to gather all of the previous curve information. I didn't keep it all in one place (stupid, I know!) but since I would report every curve to my vet, she should have it. I'm going to call tomorrow to get a record of his previous curves.
 
Nan & Amber said:
Yes, reduce another 1.25 [edit: Stephanie just posted a recommendation down to 1.0U, and I wouldn't argue against that given the work situation :)]. It's been a while since the pre-shot test-- can you get another test now, just to see where he is? Since he's eaten, there'll be some food influence, but I just want to make sure he's not doing something unusual. Assuming he's going up now (from food and just from the expected pattern), it'll be a couple hours before this next dose starts to take effect.
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197! Feeling a bit better about that AMPS than the one earlier. I'm going to go ahead with the 1U.
 
148 @ +1...he was 145 @ +1 yesterday and then dipped to 68 at +2 so I'm trying not worry. I may feed him a bit more before I leave just in case...
 
72 @ +5...really worried that he reached hypoglycemic level while I was gone but there isn't much I can do now about what may have happened.
 
He's at a good level now, at least, although he's close to the "take action" number of 68. Maybe give him a little low-carb snack now, although if he doesn't seem very hungry you might want to hold off in case you need him to eat later. He seems like he is an early-nadir kind of cat, but you never know and there are several hours to go in this cycle.
 
By the way, we try to keep with the one-post-per-day rule (you can see why, with the length of this thread!), so you'll want to start a new thread tomorrow :).
 
Yikes! I’d be tempted to skip Monday before work to see what happens if I couldn’t be there to monitor (jumping the gun probably and based on my one data point)
 
Nan & Amber said:
He's at a good level now, at least, although he's close to the "take action" number of 68. Maybe give him a little low-carb snack now, although if he doesn't seem very hungry you might want to hold off in case you need him to eat later. He seems like he is an early-nadir kind of cat, but you never know and there are several hours to go in this cycle.
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It was close to dinner time, and I ran out to get some more hypo supplies so I fed him dinner when I got home (about 5 minutes ago). I'll test him in an hour and see where we are at.
 
Stephanie & Quintus said:
Yikes! I’d be tempted to skip Monday before work to see what happens if I couldn’t be there to monitor (jumping the gun probably and based on my one data point)
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Same :( I may call out of work tomorrow. I'm going to see how tonight goes. Not sure that I can go to work if I'm up all night testing! Hopefully my boss will understand...she's not much of a "pet" person...
 
Well, let's see how it goes. By reducing all the way down to 1.0U, you have helped to drain the depot quite a bit, let's hope it's enough to keep Moose out of those pesky lime greens in the future!
 
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