11/29 Bingo - AMPS 144 +3 69 +7 59 PMPS 90ish - Half dose?

K

Kate and Bingo

Member Since 2025
We use Libre but just checked against Alphatrak and got 107. Should we halve his 1 unit Lantus to 0.5? (UPDATE: Libre is giving 70s-80s 20 minutes later.)

He is still eating wet/dry mix.

Libre is up and down with lowish readings the past few days. He has been trending low but we have also checked low Libre readings against the Alphatrak a few times (I know they are different scales) and Alpha has been in normal range (110-115 on AT) when Libre says low or 40-50.
 
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When are you supposed to give the shot?
And are you able to monitor.
He's not too low to give a full dose but also you dont have too much data since he's newly diagnosed.
Did you feed anything since Pmps?

I'll tag few senior members that hopefully can pitch in.
Also I dont use the Libre but my understanding is it usually reads lower than handheld.
I'll tag Staci @Staci & Ivy and Brianna @Brianna & Xander cause they both use Libre
 
niltse said:
We just fed him dinner a minute ago yes. He was 70s before. Libre is now saying 53!
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How long now since the shot was due? With ketones in the picture, a skip is not recommended. Can you get another test with the AT? Number could keep dropping without food and now that you've fed him you might see numbers head up.
 
BTW, have you not reduced per SLGS when he has dropped below 90 because the AT cross-checks read higher than 90?

He seems to have flipped a switch to regulation and we've seen cats zoom down the dosing ladder when that happens. He might need much less insulin on a low carb diet.
 
Bandit's Mom said:
BTW, have you not reduced per SLGS when he has dropped below 90 because the AT cross-checks read higher than 90?

He seems to have flipped a switch to regulation and we've seen cats zoom down the dosing ladder when that happens. He might need much less insulin on a low carb diet.
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His doctor is monitoring his Libre so we have only reduced when she tells us to do so. I did mention the AT readings to her most recently just so she would know.
 
Karolina is correct that the Libre generally tends to run lower at the low end and higher on the high end than a manual test does (though it's not a rule). Definitely verify against the manual test.

Leaving the below text here for continuity, but I just realized you're using the Libre 2 so it doesn't apply. So sorry!

This doesn't solve your problem right now, but FYI: there is also currently what basically amounts to a recall by Abbott of a certain subset of sensors because they're giving false lows. If your sensor is one of the affected ones, it's possible that Bingo isn't this low and manual testing would confirm it. Please do not take this to mean that you shouldn't treat any potential hypo. I just want you to know that it's a possibility. When you have time, you should enter the serial number of your current sensor on this site. It will tell you if your sensor is one of the affected and if it is, you can submit the form to get a replacement sent to you. Here's some instructions on how to find your sensor's serial number.
 
Brianna & Xander said:
Karolina is correct that the Libre generally tends to run lower at the low end and higher on the high end than a manual test does (though it's not a rule). Definitely verify against the manual test.

This doesn't solve your problem right now, but FYI: there is also currently what basically amounts to a recall by Abbott of a certain subset of sensors because they're giving false lows. If your sensor is one of the affected ones, it's possible that Bingo isn't this low and manual testing would confirm it. Please do not take this to mean that you shouldn't treat any potential hypo. I just want you to know that it's a possibility. When you have time, you should enter the serial number of your current sensor on this site. It will tell you if your sensor is one of the affected and if it is, you can submit the form to get a replacement sent to you. Here's some instructions on how to find your sensor's serial number.
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Thank you so much for this! Looks like the recall is on Freestyle 3 and we are using the 2.
 
niltse said:
His doctor is monitoring his Libre so we have only reduced when she tells us to do so. I did mention the AT readings to her most recently just so she would know.
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You might want to add "vet advice on dosing" or some such to your Signature and SS so that you don't get asked the question on dosing method again and again!

niltse said:
Libre says 50s. AT says 113.
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This is 20 mins after a high carb meal. How about a token dose of 0.5U?
 
The low carb food has arrived in the past few days! He was vomiting Tuesday-Friday so we didn’t want to transition foods, but as of yesterday that has resolved. (Is there a guide for how to account for lowering carbs in the insulin dose?)

911 removed. I will make every effort to test at +1 and +2.

Okay we will look to reduce to 0.75.
 
niltse said:
Libre says 50s. AT says 113.
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It's also worth noting the Libre delay. Please feel free to disregard if you're already aware, but it may be helpful for anyone who comes along to this thread later.

The Libre will always lag behind manual testing since it measures interstitial glucose rather than blood glucose. So the number you see on the Libre is likely what the blood glucose was ~15 minutes earlier, whereas the manual test is obviously current. There's a video that has a helpful illustration of it. But that can also be a reason for a difference between the two, not necessarily that it's inaccurate. 😊 Especially with HC food kicking in, that difference would make sense!
 
niltse said:
The low carb food has arrived in the past few days! He was vomiting Tuesday-Friday so we didn’t want to transition foods, but as of yesterday that has resolved. (Is there a guide for how to account for lowering carbs in the insulin dose?)
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There is no specific guide for lower insulin dose for a food transition, but you'd follow the dosing method you're following (TR or SLGS). Sometimes cats just flip a switch and don't want to follow a protocol and just want to race down in dosing!

I guess you already know that you want to introduce the new food slowly and complete the transition over a week to prevent GI issues due to the food change.
 
Let's see the +2? Can you grab one on the AT?

Even with a token dose, the depot will continue to affect the first part of the cycle. The carbs in the food might prevent him dropping too low.
 
Yes, it's pretty overwhelming and a sharp learning curve. More so with a DKA in the mix. You're doing great and it looks like Bingo is on a mission (anti-jinx). Cats can take weeks, if not months to see greens and flatten out like he has.
 
Bandit's Mom said:
Yes. Could be a combination of the token dose last night, as well as some bouncing from lows.

Good luck with the reduction :-)

Are you starting the food transition from today?
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I began mixing the new low carb wet into his "old" wet this morning. Might have overshot on proportions as so far he is not engaging well with it. :-( I'm going to reread that awesome list of ways to transition food (especially wet) and try some additional tricks.

He was feeling great today on the 0.75. He was running laps through the living room at AMS +7! But somehow the exercise seemed to make him go hypo? Is that a thing?

By the way, is this still how we determine his next reduction with a Libre? Would the low episode he's having right now count?
"Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."
 
Kate and Bingo said:
I began mixing the new low carb wet into his "old" wet this morning. Might have overshot on proportions as so far he is not engaging well with it. :-( I'm going to reread that awesome list of ways to transition food (especially wet) and try some additional tricks.
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Is he eating the R/C wet and dry? Do you think it would be possible to stop the dry? Maybe replace it with some freeze-dried meat if he wants a bit of a crunch every now and then?

Kate and Bingo said:
He was feeling great today on the 0.75. He was running laps through the living room at AMS +7! But somehow the exercise seemed to make him go hypo? Is that a thing?
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I've read that exercise can help blood sugar, but I'm not sure. What you might be seeing is a later nadir because he's clearing the bounce. Some cats can nadir as late as at the end of the cycle when clearing a bounce (or even at +13!).


Kate and Bingo said:
By the way, is this still how we determine his next reduction with a Libre? Would the low episode he's having right now count?
"Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."
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Yes. With SLGS every drop below 90 is a reduction. You could try 0.5U from tonight. If you can stop the dry, you could switch to TR.
 
Bandit's Mom said:
Is he eating the R/C wet and dry? Do you think it would be possible to stop the dry? Maybe replace it with some freeze-dried meat if he wants a bit of a crunch every now and then?


I've read that exercise can help blood sugar, but I'm not sure. What you might be seeing is a later nadir because he's clearing the bounce. Some cats can nadir as late as at the end of the cycle when clearing a bounce (or even at +13!).



Yes. With SLGS every drop below 90 is a reduction. You could try 0.5U from tonight. If you can stop the dry, you could switch to TR.
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Ah I just got to this post somehow. This is very helpful as well. Thank you, thank you. It might be possible to stop the dry and go just to wet— I can try.
 
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