1/31TerraAMPS 149 PMPS143 +3 158

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KarenAmelia

Member Since 2012
Terra's definitely in new territory here. Last night's numbers were good:

PMPS 194
+3 179
+6 133

I'm not comfortable yet - don't know if the dose she's at now will suddenly be too high. Seems like some unknowns here: was she eating dog's food before, thus keeping her on high carbs unbeknownst to me? I went ahead and shot but gave a slightly smaller dose than the 2.75. I hope this is not a situation where she has a sudden need for far less insulin. Will be watching closely today.

My vet says that the glucometers , in the lower range, give falsely low reading (i.e. they read lower than they should) He had no more information than that. I think he tend to take low readings less seriously. Does anyone have information on this? Possibly my vet is working with outdated information.
 
Re: 1/31 Terra AMPS 149

If this is your lowest preshot number watch her closely. Others with more experience will be along to advise, but in the meanwhile it would be a good idea to test her at +1 and +2 to see what she is making of it.

The experience we have had is that the meters are more accurate at lower numbers and read low at higher numbers.
 
Re: 1/31 Terra AMPS 149

Really nice start for Terra! I agree with Linda. You might want to get a +1, +2, +3 since this is the lowest you have shot. Have a great day!
 
Re: 1/31 Terra AMPS 149 +2.5 171

Wow! What a great job you and Terra are doing!

Some questions:

1. What kind of meter are you using?
2. What brand and % carb food are you feeding?


I agree with the other posters, if this is new territory for you then you want to get all the info you can while you're here to keep kitty safe. You got a +2.5 that looks good, but remember Terra's numbers are going to go lower as the cycle progresses till she reaches her nadir, and that's normal so don't get nervous until you start to see double digits.

Keep the readings coming! :mrgreen:
 
Re: 1/31 Terra AMPS 149 +2.5 171

To a large extent, it depends on what meter you're using. Some meters are better than others. Recently, there have been problems with the FreeStyle Lite meters (or more accurately, the strips). Historically, many people have had problems with the CVS and Walgreen's True-type meters.

The best way to know if your meter is in the ballpark is to bring your meter to the vet's office. You and the vet can test off of the same blood at the same time. You need to be aware, though, that if the vet is using a meter that's calibrated for animal blood (e.g., an AlphaTrack meter) or is using a serum chemistry analyzer, there will be approx. a 30 point difference in the way a human meter vs. these other means of testing are calibrated. The animal meters are 30 points higher so a 50 on a human meter would be an 80 on the AlphaTrack.

In a way, the vet is right -- human meters read lower. It's not an inaccuracy, though. It's they way they are calibrated.
 
Re: 1/31 Terra AMPS 149 +2.5 171

Hi guys .. beautiful numbers for terra! I hope these last for you guys .. they are exciting and nerve wracking at the same time aren't they? Have a great day guys!
 
Re: 1/31 Terra AMPS 149 +2.5 171

+4.5 174

Terra's holding steady. I'm expecting a drop sometime soon - it's getting close to the time of her nadir. She's been sleeping a lot and I brought her food and even water at +3. She didn't get up to eat or drink, but she took the food pretty well - about 1/4 can and some chicken liver.
 
Re: 1/31 Terra AMPS 149 +2.5 171 +4.5 174

A bit nervous: she's dropped to 140 at +6. I have to leave home for a few hours, and this is the critical time. I gave her a teasp. dry food (about 10 little kibble pieces) , out of nervousness about her blood sugar plummeting. Maybe not the best idea but scared she'll drop into scary territory while I'm gone.
 
Re: 1/31 Terra AMPS 149 +2.5 171 +4.5 174 +6 140

i know you're nervous, but if you have canned high carbs it is so much better to give that food than the dry food. it takes a cat too high - although you're not going to be around to measure how high - and they'll stay there longer. that'll make it look like she needs more insulin . . . 140 is still higher than a non-diabetic cat. non-diabetic cats run between 40's and 120ish.

i read back through the past few days while i was gone to catch up on what was going on with terra. i don't think anyone mentioned it, but if i'm repeating info, please forgive me. for the first 6 months i was here i had a hard time reading punkin's spreadsheet. so if i thought he needed a dose change i posted a few hours ahead of time and in the subject line asked for "dose advice?" or something like that. we don't base dose changes on the preshot number, but on the nadir, so you don't have to wait til the preshot number to ask for advice.

there is just so much to absorb on how lantus works and what might be NDW, or a bounce, or when a dose just needs time to settle in, it's easier if you just hold the dose and let someone look carefully at terra's spreadsheet when you want to change the dose. when you tweak more than one factor (ie, the dry or canned food, increase/decrease the dose, a late shot or early shot) at a time, then we don't know which factor needs adjusting.

the only time that you have an automatic reduction is when they go below 50 we always drop by .25 units in a newly diagnosed cat. at least at the beginning we always drop the dose - some cats we learn after a while need to have a modification of that plan, but that wouldn't be terra's case yet.

anyway, the point is that if you think you need to change the dose, just give a holler a few hours in advance so someone can look at terra's ss and let you know if it's time to change the dose or not. there are many people who would be happy to do that for you.

once you have a little more solid data you'll know whether or not she normally would go down after +6. just from lots of days of testing, i know punkin is generally at his lowest at +5.5 and it's not typical for him to go down after then. if he does it's not usually much. you'll be able to tell those kinds of patterns on terra before too long and that will help you not feel as nervous about when you do need to leave her! :YMHUG:

so glad she's eating a little bit today! i'll bet you are too!
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Please bump! Waiting on advice before giving PM shot, which is due within next 15 minutes...


Terra's eating now, at pre shot time , b/c of the lowish BG. Afraid to give her usual dose, with her staying in such low numbers. I don't know what a flat curve like this means. A spoonful of dry food at +6 only produced a rise of ca. 40 points by +9.5
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

I know these numbers are pretty good and not something, in another cat, to be nervous about. However, Terra went two day ago from 400 to 45 and back up to 500. So I'm just not sure what kind of drop she might be anticipating, keeping the dose the same at 150. I expect some more experienced folks will know. That's my concern: the huge jumps she's been experiencing. And what about flat curve? That's ideal but don't know how much to trust it. I'm holding off on the shot for a bit longer.
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Karen, you may want to go back and read Julie's post above.

As she says in there, the only time you change the dose is if Terra drops below 50 for a BG.


Giving Terra dry food earlier today, combined with adjusting the dose on the fly is not good for her. Also Lantus is not dosed based on the BG reading at shot time but on the nadir in the cycle.
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

First, can you do something to make the numbers on your SS legible?

When numbers are highe (e.g., 400s) a cat can drop into the 40s (and bounce right back to the 400s in one cycle -- Gabby's done it). When numbers are low, they generally don't plummet the same way. That said, you do still want to monitor. FWIW, I shot an 85 about 10 minutes ago.

Terra's numbers are flattening out now that kitty and drooler kibble are out of the picture -- providing we can change your mind about reaching for the dry when you're getting panicky. I suspect what you're seeing now is a double dip -- numbers reached nadir at +6, came up, and have now dropped -- they dipped twice. For your comfort level, it's fine to stall. However, when you stall, DO NOT FEED. You are giving yourself a false reading by having given food.
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Thanks, I'll go ahead and shoot. I feel as if people are not acknowledging or responding to the details in my posts. Yes, I understand what the TR protocol says, but I asked specifically about the magnitude of the swings of her BG. From 400 to 45 and back to above 500 doesn't inspire confidence in giving the same dose when she's at 150. Esp. in light of high reading for the past month. I just don't understand this , obviously, but repeating the same thing over and over doesn't help me to feel as if my concerns are being addressed.

Thanks. I was out this afternoon and have to leave again. I will give Terra the 2.75 and then will be back in a couple of hours.

I do sound impatient, but please don't take it personally. I know you're impatient with me , too. Gratitude for all the help!
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Thanks Sienne, you responded to my concerns. I didn't see your post when I wrote the above reply. I appreciate your giving me a bit better picture of how the Lantus works.

I will finally learn: do not feed when stalling. I had it wrong: thought that feeding was good to help bring her numbers up. Oh well. It is good to feed before shot though, right, so as to be sure not to be giving shot to a fasting cat?

also, how are numbers illegible? I don't know what to change - please give specifics. When I look at SS I can read it fine. Maybe some transmission problem?
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Karen --

I realize that it may be counterintuitive. However, I'd encourage you to look at some of our spreadsheets. There are a number of kitties, including Gabby, who are known to dive. Gracie and Mannie have been taking diving lessons from Gabby. You'll see differences from when they are high vs. in low numbers.

The basic principle is "shoot low to stay low."

There's a BIG "however" here... If you can't be home to monitor when you're shooting low, you should skip or shoot a reduced dose. You have got to provide full information. I would never tell someone to shoot low and leave. You need to be able to get a +1 and +2. Keeping your cat safe is essential. I do now know your cat's cycles well enough to suggest you can leave.
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Karen:

If I understand what you wrote, you got a +12 of 143 and then fed her. Is that correct?

Terra is doing great right now....clearing her bounce of the high numbers and the 143 is a safe number to shoot IF you can be home
to monitor her and get a +1 and +2. Once you shoot, you can feed her but you can't leave. If you absolutely have to leave, then I would suggest
you skip the shot because even if you give a reduced dose, you may not see the effects of it immediately and she "might" drop lower still
this cycle.

If you want to keep her momentum going, you do need to shoot consistently and monitor her. There have been many times that many of
us have made plans that we have had to cancel in order to stay home, give our cats their insulin, and monitor them until they are safe.

Sienne was also trying to tell you that, normally, if the 143 is still a little low for your comfort, you can stall and see how much she comes up. The problem
now is that you fed her and if you test her again and see a higher number, any increase in number is going to be a food-influenced number. If she rises 30 mg/dl, you might feel safer about shooting and leaving but in reality, it's a food spike. So you still have to be there to monitor her.

She is also letting you know that next time you get a number that makes you nervous about shooting, don't feed Terra....post and let us walk you
through it because then stalling to get a higher number becomes a reasonable plan.

Can you please tell us if you shot her or not, what dose, and will you be there to test her? THanks!!
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Hi Karen. I know how it is to worry about the wild swings from 400 to 40 and back, and then think about that 360 point drop, and then wonder if Terra will drop 360 points, when she is at 143, but that won't happen...she won't go into the negative numbers, and she won't drop as fast or as much as she did when in the higher numbers. Her curve will flatten out, as you see it did today.
I do have a question, though, when I look at your spreadsheet; on 01/29, it looks like you shot the AMPS, but then I see squares that say 49@15 and @20 48. If you shot the AMPS, then shouldn't the 49 just be in the +6 column? I'm not sure what you mean by the @15. Or what you mean by the @20 in the +9 column.

Keep up the good work. I hope Terra continues to surf those beautiful blues.
 
Re: HLP1/31TerraAMPS 149 +2.5 171 +4.5 174 +6 140 +9 183 PMB

Karen:

What I'm seeing on your SS is your PMPS from last night and tonight are in a darker blue background and it's difficult to read the numbers. It would be helpful if they were in the lighter blue of the other blue spaces OR if you put the numbers in white so we can read them.

Thanks....and I'm hoping that by seeing the 143 in the PMPS box tonight that you have not shot and left nailbite_smile nailbite_smile nailbite_smile
 
Hi all,

Thanks for all the good fill-in info. I will say, in answer to Dyana's question, if I test off the hour I have written the @ symbol and then how many minutes past the hour. So @15 in the +3 box means 3 hr 15 min past shot time. Is there a convention for this being used on this site? I'll gladly change my notation.

I did go ahead and shoot 2.75 u, then I had to go to a class and returned at +2.5. It was helpful seeing Sienne's post about the Lantus curve flattening out when cats get into lower numbers and so I felt I would go ahead and take a chance. I don't know what shooting low means. "Shoot low to stay low." That's somewhat cryptic. Where can I learn more about this? Does that somehow mean lowering the dose? The advice that I got before shooting was not to change her dose, so I went with that advice.

My cat care is a balancing act, as it is for all, I'm sure: balancing cat care with one's other commitments. So if it seems irresponsible to have left after shooting, I will own that. Terra would be dead from not being treated for diabetes, and she is alive and having much improved welfare thanks to insulin, imperfect system that it is. So I'll allow there to be some risks and I'll do the best I can but will allow my cat care to be flawed. I had an amazing miracle happen at my house recently which caused me to accept that I'm not completely in control here. I hope that you all will forgive my imperfections and just keep helping me along.
 
"Shoot low to stay low" means you need to shoot low preshot numbers to keep the BGs in the cycles low. In effect, if you don't shoot lower preshot numbers, the BGs will stay on the high side so you're basically spinning your wheels.
 
Karen:

Shoot low to stay low means shooting the green preshot numbers above 50 in order to keep the kitty in normal numbers. We try to help you learn to shoot low safely and highly urge new members to take advantage of our help the first
few times as they gradually learn to shoot lower.

Terra would be dead from not being treated for diabetes
Click to expand...

I'm not sure you understand that the "risks" you are referring to can include a very painful and horrible death from hypoglycemia. Yes..hyperglycemia can and does kill and it does it slowly until the end. We have had a cat in FDMB pass away due to hyperglycemia....the end was tragic. But hypoglycemia is terrifying.....possible seizures, convulsions, ataxia, loss of bladder/bowel control, vomiting, coma....and no assurance that a dextrose drip at the vet will bring them back....and if it does, possible brain damage due to brain cell death from lack of glucose. Is this really what you want to come home and find? And you ARE in control of hypoglycemia. You have testing and food/karo at your disposal to control her numbers.

Following a TR protocol requires a commitment to Terra by you. I think if you are not able to make that commitment to her, than a different protocol (SLGS) is better in order to keep her safe. The TR protocol is for those of us who are trying to get our kitties as regulated and in normal numbers for as much of the day/night as possible. If you just want to keep Terra treated for diabetes but don't want to worry about her getting too low, then it might be better to take her dose down and focus on just keeping her below the renal threshold ...basically around 200 although ECID. But this will also very likely shorten her life span. IMHO.
 
We all have to balance commitments -- work or classes or other functions. What helps us to help you is to know if there are obligations, like needing to leave, that have to factor in to your decisions (and our offering guidance). Usually when someone is shooting a number lower than they've previously shot, there are a few considerations:
  • will you be available to get a +1 and +2
  • do you have extra strips
  • are you stocked with HC food (or the equivalent)
  • if you opt to stall, can you afford to be off schedule at the next shot time
No one would suggest you shoot a low number if you're not prepared or can't be available to monitor. Terra's safety is always a primary concern. There are other options, like shooting a reduced dose. You may want to review the information in the post on handling low pre-shots.

"Shooting low to stay low" reflects that a Lantus curve is ideally flat. So if you are shooting low, ideally the numbers will stay low and flat. If you look at Sam Siam's spreadsheet, you will see an example of this.

It is your decision how much risk you're willing to tolerate with respect to Terra's care. What makes me uncomfortable is that I'm not willing to tolerate that same level of risk for your cat. I don't want to ever be in a position where something I suggest causes someone else's cat harm.
 
Re: 1/31TerraAMPS 149 PMPS143 +3 158 +11 123

Appreciate the most recent posts. Thank you for spelling out the risks and your expectations of me. I will say that I do need to be away this a.m. from +3 till+5 or 6. Those are critical times. Terra is doing great right now: she has wonderful energy, is acting like her old self, no apparent discomfort other than that she's hungry (no I did not feed.) I will get an AMBG and see if numbers are increasing. Her numbers seem to be moving in the right direction. I'm encouraged and also a bit uneasy, based on the last month of experience.
 
Re: 1/31TerraAMPS 149 PMPS143 +3 158, +11 123

I hope she goes up a little bit, so you feel safe shooting. I will probably be off line by then. Come on Terra, a nice 135 would be good.
If she goes up and you shoot on schedule, please get a test at +2, and another before you leave. You can always leave some food out for her to eat, while you're gone.

Have a good day. Terra is doing great.
 
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