10/11 Clyde PMPS 131 +1 135, +2 157, +4 150, +6 152

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fun2doimpossible

fun2doimpossible

Member Since 2013
I'm trying to get Clyde on the tight regulation protocol and am have some questions with dealing with low preshot numbers. I am testing as often as I can find the patient. He's getting better, I found a low carb cat treat he likes. (EVO Wild Cravings Turkey & Chicken Formula, it appears to be only 6.6% carbs).

On 10/6 I dropped his dosage from 1.5U to 1.25U following a glucose curve, where his nadir was 43. At the same time, I began using 175 as the minimum number to shoot. However, after doing a lot more reading, looking at his numbers, and doing a lot of head scratching. :smile: I think I need to start trying to follow tight regulations.

I'm not quite sure where to begin and what I should be doing. I did a glucose curve today in an attempt to find the nadir. It' been going down almost all day. At +11 he's at 85 so the curve just started to bend upwards for the first time since +1. Based on other data, I don't see it getting to a level I'm comfortable shooting at without help.

I think I have all of the materials I need:

Lots of time to be there
Plenty of test strips
Karo
Fancy Feast Gravy Lovers (Max, non-sugar cat will finish the can if needed :smile: )

I'm just not sure what I'm doing. Based on the FAQ, it sounds like I should stall for time and test every 20-30 minutes after the PMPS. Should I still feed him on his regular schedule?

I have on my list of things to do is start more PM testing and I'm going to try and make foodsicles tonight :smile:
 
Re: 10/11 Clyde AMPS 318, +11 85

For your first time shooting low, it is recommended that you do not shoot a dropping number. If you stall, DO NOT FEED, and keep retesting every 20-30 minutes until the numbers stabilize or start rising. Food can influence the BG numbers so you want a non food influenced numbers. Clyde should not get any food for at least 2 hours before his shot. Once the numbers start rising without food, then you can feed and shoot.

Can you accommodate a change in preshot time? If you delay tonight, you have to shoot 12 hours later tomorrow morning. You can move the shot time back by 15 minutes a shot or 1/2 hour once a day.
 
Re: 10/11 Clyde AMPS 318, +11 85

Wendy&Neko said:
For your first time shooting low, it is recommended that you do not shoot a dropping number. If you stall, DO NOT FEED, and keep retesting every 20-30 minutes until the numbers stabilize or start rising. Food can influence the BG numbers so you want a non food influenced numbers. Clyde should not get any food for at least 2 hours before his shot. Once the numbers start rising without food, then you can feed and shoot.

Can you accommodate a change in preshot time? If you delay tonight, you have to shoot 12 hours later tomorrow morning. You can move the shot time back by 15 minutes a shot or 1/2 hour once a day.
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At +11 his number started to rise for the first time today. Regretfully, I have to leave for work at about +1.5 from the AMPS tomorrow so I have a limited amount of time I can play with in the morning. I will post his PMPS in about 30 min when I take it.
 
Re: 10/11 Clyde AMPS 318, +11 85

Welcome to Lantus Land for both you and Clyde!

It looks like you've been concentrating on getting curves. A curve can be helpful for trying to sort out when Lantus onset starts and where the nadir falls. Beyond that, getting spot checks, when possible, will help to fill in the blank spots on Clyde's SS. One observation, though, is that you should try to get more tests during the PM cycle. At the very minimum, a "before bed" test every night will help you to better understand what's doing on during the night. If you don't get any tests at night not only are you missing half of your data, but you could also be missing dose reductions. Many cats like to run in lower numbers at night.

If you are needing to skip shots routinely, it may be worth considering lowering Clyde's dose. Lowering the dose would allow you to shoot the same dose twice each day vs. skipping.
 
Re: 10/11 Clyde AMPS 318, +11 85

Sienne and Gabby said:
Welcome to Lantus Land for both you and Clyde!

It looks like you've been concentrating on getting curves. A curve can be helpful for trying to sort out when Lantus onset starts and where the nadir falls. Beyond that, getting spot checks, when possible, will help to fill in the blank spots on Clyde's SS. One observation, though, is that you should try to get more tests during the PM cycle. At the very minimum, a "before bed" test every night will help you to better understand what's doing on during the night. If you don't get any tests at night not only are you missing half of your data, but you could also be missing dose reductions. Many cats like to run in lower numbers at night.

If you are needing to skip shots routinely, it may be worth considering lowering Clyde's dose. Lowering the dose would allow you to shoot the same dose twice each day vs. skipping.
Click to expand...

Thank you for the welcome!

I am planning on starting to try and collect more PM data. I had been having trouble finding him at night to do the check. I found aa low carb cat treat (evo wild cravings turkey and chicken) today that makes him come running to me so it should get easier to find him.

I don't know enought about Lantus to know what I should be doing with dosing. The vet originally increased from 1 to 2U and then decreased it to 1.5u based on the data I collected. I dropped it to 1.25 since I had a nadir in the 40s. I understand the theory behind it, but don't know enough about it to put it into practice. :smile:
 
Re: 10/11 Clyde AMPS 318, +11 85

This may help you understand some of the numbers.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Re: 10/11 Clyde AMPS 318, +11 85

There are a couple of necessary questions: Are you going to be home this evening and able to monitor Clyde's numbers? Do you had a stock of strips and high carb food if you need it?
 
Re: 10/11 Clyde AMPS 318, +11 85

Sienne and Gabby said:
There are a couple of necessary questions: Are you going to be home this evening and able to monitor Clyde's numbers? Do you had a stock of strips and high carb food if you need it?
Click to expand...

Yes...I am home all night and can monitor him. I just bought a new pack of 50 strips today and have 4 cans of Fancy Feast Gravy Lovers cat food and Karo syrup.
 
Re: 10/11 Clyde AMPS 318, +11 85

Great!! I would get another test just to insure that numbers are heading up. If they are, go ahead and shoot. If not, post and let us know.

If you shoot, you'll want to get a +1 test. Whenever you're shooting lower numbers, you want to begin with a +1 and a +2 test.
 
Re: 10/11 Clyde AMPS 318, +11 85

Sienne and Gabby said:
Great!! I would get another test just to insure that numbers are heading up. If they are, go ahead and shoot. If not, post and let us know.

If you shoot, you'll want to get a +1 test. Whenever you're shooting lower numbers, you want to begin with a +1 and a +2 test.
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I tested him and he was at 131.

He ate a bit of food and I gave him the shot. I will check in 1 hour and will let you know what happens.

Since I delayed the shot tonight by almost an hour, how should I handle this in the morning? Should I test at my regular time, 12 hours from now, or at about 11.5 hours and go from there?
 
Re: 10/11 Clyde AMPS 318, +11 85

You have a couple of options for the morning. If you need to move your shot time, you can either move the time by 15 min. at each shot time until your back on schedule. Alternatively, you can move the time by 30 min. once a day until you're at your preferred time.
 
Re: 10/11 Clyde AMPS 318, +11 85

Sienne and Gabby said:
You have a couple of options for the morning. If you need to move your shot time, you can either move the time by 15 min. at each shot time until your back on schedule. Alternatively, you can move the time by 30 min. once a day until you're at your preferred time.
Click to expand...

I think moving it once in the morning to 30 minutes earlier would be easier to get back on track. In addition to +1 & +2, should I also attempt to test at +5 or +6 tonight?

And before I forget, thank you for your help.
 
Re: 10/11 Clyde AMPS 318, +11 85

We'll need to punt for now about the rest of the testing. The +1 and +2 will help to guide you re. when to get the next test(s).

Also, could you update your subject line with Clyde's PM test data?
 
Re: 10/11 Clyde AMPS 318, +11 85 PMPS 131

That's not a large food spike. You'll definitely want to get a +2.

Also, since there will be a few of us keeping an eye on Clyde along with you, it helps us to see all of the numbers in the subject line. If you run out of room, you can always delete the AM cycle numbers.
 
Re: 10/11 Clyde AMPS 318, PMPS 131 +1 135, +2 157

I think you could probably go two hours and get a +4 test.
 
Re: 10/11 Clyde AMPS 318, PMPS 131 +1 135, +2 157

i'd probably get a +3 or +4 and see if he's going to continue up. post the new number in the subject line again - it helps people who are watching you know what's going on.

great job getting tests! you won't always need to test so often as you did today, but it sure does tell what his blood sugar is doing.
 
Re: 10/11 Clyde AMPS 318, PMPS 131 +1 135, +2 157

wendy posted while i was writing - i think a +4 is enough too. you want your 50 strips to last at least a little while!
 
Re: 10/11 Clyde AMPS 318, PMPS 131 +1 135, +2 157

I agree -- a +4 (or sooner if you prefer) would be good. Given the size of the drop during the AM cycle, it's very likely that Clyde's numbers will bounce up into the higher ranges. However, there's no guarantee that this will happen.
 
Re: 10/11 Clyde AMPS 318, PMPS 131 +1 135, +2 157

+4 it is...Clyde will appreciate a slight break from being a pin cushion. :smile:
 
Re: 10/11 Clyde AMPS 318, PMPS 131 +1 135, +2 157, +4 150

+6 sounds like a good idea. If he's around the same or up, you can call it a night.
 
Hi Will

Another warm welcome for you and Clyde.

Good job tonight and good goal to get on the TR protocol and learn to shoot lower.

Please let us know your questions...we're here to help :-D
 
Thank you again for your help and welcoming me to the board. His AMPS this morning was 208, so I shot as normal. I was able to get a +11 last night and will be getting the +1 shortly for this morning. I'll see where he is tonight and go from there.
 
Hello and welcome. Looks like you did a great job with steering Clyde with food, and all his numbers are very much in the safe range.

Your username caught my eye and reminded me of this Chinese proverb,

The person who says it cannot be done should not interrupt the person who is doing it
Click to expand...
 
Great cycle last night!!

You want to start a new thread (we call them "condos") for today. The general idea is one condo per cat per day. The daily post is a way to keep a day-to-day record of what's happening with your kitty. You also want to link the previous day's condo to the current day's condo. To link the threads:
  • Go to the previous day's thread
  • Copy the URL location from the top of your browser
  • Open a new topic (not a new post in the old thread) for the current day
  • Click on the URL button that's at the top of the text box. This will insert a code that looks like this:
  • Paste the location of the previous day's condo between the two sets of brackets: location code goes here
  • If you want to be fancy, it looks like this: Yesterday's Condo or whatever you want to call it
 
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