10/14 Clare AMPS 376;PMPS 192;+3 106;+5 128

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Georgette and Clare

Georgette and Clare

Member Since 2014
Good Morning, Lantus land Neighbors!

Yesterday's Condo

We're sending healing wishes, hugs and scritches to the kitties and beans who need them today.

Today's News:

AMPS 376
+3 223
+5 131
+6 107
+7 95 :mrgreen:
+9 110

+12 139 (tested again: 120)

PMPS 192 (@ AMPS +13.5)
+1 160
+2 93 :mrgreen:
+2.5 96
+3 106
+5 128

Because Clare's +12 test was so unusually low, we stalled and came to the board for advice. Subsequently, after talking about the advice we'd received, at +12.5 I thought that we'd given Clare her dinner and the shot and DH thought that I'd said that she should be fed but not given her shot! ohmygod_smile We didn't discover our miscommunication until +13.5 and by that time Clare's BG had come up to 192. We gave her the shot then, at the usual dose.

So she's been tested, fed and had her shot, and now we're continuing on from there. We'll work our way back to her normal schedule on 1/2 hour-per-day increments, and we'll continue to test tonight. We'll feed her the usual 2 tsp of 8% at +1 (otherwise known as AMPS +14.5) and test her then and again at +2, since even with the rise in BG she's still a lot lower than we're used to.

What a crazy night so far! :o

Let's hope things settle down now. It seems like it's a good night for Clare, but it's not doing great things for my blood pressure! :lol:

- G


*************

~O) ~O) ~O) Just waking up and the cats are way ahead of me this morning, playing with the new crinkle tube we bought yesterday. We already had one, so DH strung them together with Coral's favorite scratch pad and it's a regular runway stretched across the living room. Just what they need for these rainy fall days!

If Clare doesn't come down today, we'll get some new insulin and up her dose. The vial we have is dated July 26th and we've kept it in the refrigerator, so we think it should still be good, but maybe not? She's been so consistently high and it's one way to explain that.

Later: Yay! Clare's sliding down. It looks like the 8% we're giving her at +1 is helping to slow her dive. We'll see how long she can surf. Maybe this 0.25+ dose will work after all. :smile: We'll give it some more time.

Have a great day, Everyone!
 
Re: 10/14 Clare AMPS 376;+5 131;+7 95

Nice slide for Clare today. It looks like she saw the dosecrease threat in her condo. How neat on the crinkle tubes.
 
Re: 10/14 Clare AMPS 376;+5 131;+7 95

Clare, it's nice to see you rolling in the green, but, um, a nice smooth surf would be nice right about now.

Marilyn and Polly
 
Re: 10/14 Clare AMPS 376;PMPS 120 Stalling:low pre-shot

Clare's PMPS was 139 so we tested again and it was 120.

Although I know it's not that low, this is the lowest pre-shot number we've had. We're wondering if it's okay to go ahead and give her dinner and her insulin (0.25+).

Thanks,

Georgette and Clare
 
Re: 10/14 Clare AMPS 376;PMPS 120 Stalling:low pre-shot

What we wish for. Then it happens. Ooooops, what to do?

I do not give advice. Can't figure out what's happening here!

Just copied the sticky above "How to Handle Low Numbers." Hope someone with more experience, knowledge stops by.

Whatever you decide to do...it'll all work out.


You just tested your cat’s preshot number, and there is a much lower than usual number staring back at you. What do you do?

There is no one-size-fits all answer, but there are some general guidelines. As with everything else, each cat is different (ECID) and each caregiver is different too.

The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if the cat is less than 50 then usually the best option is to wait until they are above 50 to shoot. While you’re waiting, the shed is draining, so you want to get the insulin in as soon as it makes sense to shoot.

If it is your first time shooting green, then we will likely suggest that you stall the first time, even if the number is 80-100. That will let you collect data on what your cat will do when you stall. One thing you can do if you are having a low cycle is to get a +10 and +11. Those will give you a good idea of how quickly the cat’s numbers are rising (or not) when preshot time arrives.

Beyond the general guidelines, there are other factors we consider when we are helping someone with a low preshot.

If the low preshot is not part of that cat’s normal pattern or there is reason to think something might be wrong, we will be more conservative.
If the cat is not a food spiker or tends to have an early onset/early nadir then they may not want to shoot as low. If the cat has a late nadir, then they will HAVE to learn to shoot low.
We will also be more conservative in some cases because of the person – if you are not able to monitor then you want to be more careful, or if you are not sure that you can get back to the board to keep us updated throughout the cycle. Trust me, if you shoot low, we will be watching for your updates and we will worry if we don’t see them.
We have to be a lot more careful with the cats who eat only dry food, because they don’t have access to the tools the rest of us use to keep our cats safe.
Also, when it comes to very low preshots, there is an unwritten rule that whoever helps that person shoot low should expect to sit with them through any low parts of the cycle. There have been times when I knew a cat’s number was likely shootable, but I also knew that I could not be around to help if the shot resulted in low numbers later in the cycle. For safety’s sake, if I could not find someone else who would be available to support for the next several hours, I would most likely suggest that the shot be reduced or skipped. I will not encourage someone to shoot low and then abandon them.
There are a lot of other scenarios, and you always want to keep your cat in mind.


Some general rules when stalling (ECID):

** 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
** 40s or lower – you have a couple of choices.

When 40’s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
--- Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?


** Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.

Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.

Using the overlap by shooting low is a great way to take advantage of Lantus/Levemir’s long, flat cycles, once you have learned to do so safely.

~ written by Libby and Lucy
Click to expand...
 
Re: 10/14 Clare AMPS 376;PMPS 120 Stalling:low pre-shot

As long as you'll be home to monitor and have plenty of strips and HC, it's OK to shoot. You'll want to get at least a +1 and a +2 test to start.
 
Re: 10/14 Clare AMPS 376;PMPS 120 Stalling:low pre-shot

Okay -- thanks, Marilyn and thanks, Sienne --

We'll give her the usual dose and test frequently. We'll be here to monitor and we have all the supplies.

Thanks for being there,

Georgette and Clare
 
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