? 12/03/2019 Blackie AMPS 159 PMBG 60 +12.5 75 +14 113

Christie & Maverick said:
With SLGS it is not recommended to shoot a number under 90. Can you stall for 20 minutes, don't feed and see if Blackie comes up over 90. He is on the end of the cycle, another test will help to see what he is doing.
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Hi! I can stall but I just feed him. Should I still test in 20 minutes. Sorry I'm still learning.
 
I learn something new here every day ;), I'm sure you'll remember for next time. What % carb did you feed? I see @Nan & Amber (GA) is here too, I need to quickly do my routine with Mav, but depending on the carb, next test will likely be carb influenced. That's why it's good to try and stall without food so we can see that the number is rising naturally, not artificially with carbs :)
 
Here's your thread from this morning:

12/03/2019 Blackie AMPS 159

We try to keep it one thread per day-- easier to keep track of the whole history. You can always edit the title when the situation changes from AM to PM questions.

Anyway, on SLGS you don't shoot under 90, but let's see where he is on the re-test (accounting for the meal as best we can). Hopefully he doesn't make it tricky for us :).
 
Nan & Amber (GA) said:
Here's your thread from this morning:

12/03/2019 Blackie AMPS 159

We try to keep it one thread per day-- easier to keep track of the whole history. You can always edit the title when the situation changes from AM to PM questions.

Anyway, on SLGS you don't shoot under 90, but let's see where he is on the re-test (accounting for the meal as best we can). Hopefully he doesn't make it tricky for us :).
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Hi! I didn't know that about one thread. I'll remember that too. Thank you . Just tested he is 64. He ate about half a can of Friskies Pate.
 
Sue and Luci said:
Sherry, could you please update your SS to add a star and a note about Blackie's trip to the ER for a glucose drip the other night when he went down to 20. He may be extra sensitive to insulin still - and Christie has given you some good advice.

Be very careful...

I'm not going to be around but it looks like Christie and Nan are going to be with you for a while.
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Thank Sue I will.
 
Sue and Luci said:
Sherry, could you please update your SS to add a star and a note about Blackie's trip to the ER for a glucose drip the other night when he went down to 20. He may be extra sensitive to insulin still

Be very careful...

I'm not going to be around but it looks like Christie and Nan are going to be with you for a while.
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Oh dear...that's exactly true, and he's nowhere near usual preshot numbers. A skip may be required.
 
Sue makes a really good point about insulin sensitivity after the extreme lo last week. You dropped the dose from 3 to 2.5, but he may need to go down a bit more for you to be able to shoot safely, consistently.

Given how flat he is so far after his meal, I'm leaning towards a skip tonight and a re-assessment of the dose in the morning, but we can see if he's shooting to the moon on the next test.
 
Nan & Amber (GA) said:
Sue makes a really good point about insulin sensitivity after the extreme lo last week. You dropped the dose from 3 to 2.5, but he may need to go down a bit more for you to be able to shoot safely, consistently.

Given how flat he is so far after his meal, I'm leaning towards a skip tonight and a re-assessment of the dose in the morning, but we can see if he's shooting to the moon on the next test.
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Ok. I'll post back in just a bit. Thanks !
 
Hi!
He's at 75. He's about 30 minutes past evening shot.
He is snuggling with his brother Popeye.
 

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Christie & Maverick said:
75 is still not shootable. And, from my perspective, now seeing that you had recent hypoglycaemia that needed vet intervention, I would not be comfortable saying anything other than you need to skip. That's just my 2 Canadian cents for what they are worth these days :rolleyes:
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Hi! Your help is invaluable. It's worth millions to me. . I agree we will skip tonight . I'll get a few more tests in before bed. Thank you Christie.
 
Well, that settles it!

Skip tonight, and Blackie has earned another reduction. It's special circumstances with his history, so I'm going to tag a moderator, @Sienne and Gabby (GA) (I think she's around right now) for dose suggestions for the morning. My recollection was that during the extreme low, a dose of 1.5U was suggested-- maybe that, or something between that and his "official" new dose of 2.25, would be worth a try.

I think I'd get at least one more test in tonight too, even though you didn't shoot. Just to make sure he's behaving himself :D. Ah, you just posted to say you were doing just that-- great minds, and all that!

Have a great night, maybe join in on that snuggle-pile!
 
Nan & Amber (GA) said:
Well, that settles it!

Skip tonight, and Blackie has earned another reduction. It's special circumstances with his history, so I'm going to tag a moderator, @Sienne and Gabby (GA) (I think she's around right now) for dose suggestions for the morning. My recollection was that during the extreme low, a dose of 1.5U was suggested-- maybe that, or something between that and his "official" new dose of 2.25, would be worth a try.

I think I'd get at least one more test in tonight too, even though you didn't shoot. Just to make sure he's behaving himself :D. Ah, you just posted to say you were doing just that-- great minds, and all that!

Have a great night, maybe join in on that snuggle-pile!
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Thank you Nan. That's what we will do. I was thinking that's where he was headed . I'll await dosing recommendations for the AM. And yes it's definitely snuggle time. Have a great evening.
 
I’ve merged the threads.

@Nan & Amber (GA) and @Sue and Luci: it’s very doubtful that he’s still insulin sensitive from the lows a week ago.

@sherry mccormick I’d reduce the dose to 2.25u since he dropped below 90. In reality, if Sherry could have shot late and slowly gotten back on time, she could have shot 2.25u when she got the 113.

One other clarification for all involved. While SLGS states we usually don’t suggest shooting below 90, remember that for experienced CGs who have data; know their cat’s onset, nadir, duration, and response to food; and are available to monitor, they can determine what preshot is a safe number to shoot, even if it is below 90.

One other thing, Sherry. You might want to change your user ID to not include your last name and also remove the location from your signature block for security and privacy. We do have scammers that visit this site.
 
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Marje and Gracie said:
I’ve merged the threads.

@Nan & Amber (GA) and @Sue and Luci: it’s very doubtful that he’s still insulin sensitive from the lows a week ago.

@sherry mccormick I’d reduce the dose to 2.25u since he dropped below 90. In reality, if Sherry could have shot late and slowly gotten back on time, she could have shot 2u when she got the 113.

One other clarification for all involved. While SLGS states we usually don’t suggest shooting below 90, remember that for experienced CGs who have data; know their cat’s onset, nadir, duration, and response to food; and are available to monitor, they can determine what preshot is a safe number to shoot, even if it is below 90.

One other thing, Sherry. You might want to change your user ID to not include your last name and also remove the location from your signature block for security and privacy. We do have scammers that visit this site.
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I agree with the dose reduction - but I wouldn't have been comfortable shooting last night either - so I guess it was up to Sherry - after all she has to weigh how long she would have been able to stay up and after the run to the ER 6 nights ago for a glucose drip I can understand her reluctance to shoot when he was in the 60's.

It's always good to learn from our experiences and next time weigh all the factors - but with so many IF's at play it's still challenging to know the right thing to do. I didn't want to discount what Christie and Nan were saying - and we all felt that to be conservative last night might be a better option. So just for clarification - how long is a kitty 'sensitive' to insulin after an event like Blackie had the other night?
 
Yes, it's true that the no-shoot-under 90 is a guideline for beginners rather than a hard-and-fast rule under SLGS. But, also for clarification for anyone reading this, we do always want to consider the specific situation. In this case, we had the following:

PMPS: 60
(meal)
PMPS+0.5: 64
PMPS+1: 75

With a meal on board, the numbers were staying flat, so there was a possibility that Blackie was still heading down but was getting propped by food a bit (it's hard to say for sure with the food on-board, without the hindsight of seeing numbers later in the night as we do now). In addition, Sherry has never shot a number under 165, so this would not be a gradual working down to shooting under 90.

I agree that it might have been possible to shoot when she got the 113 at +2, although I don't think I would have done it, either. That's definitely a situational call, balancing the caregiver's tolerance for schedule disruption and a possible late night with the disadvantages of a skip.

Sue and Luci said:
So just for clarification - how long is a kitty 'sensitive' to insulin after an event like Blackie had the other night?
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I would also like to know the answer to this question, so that I can give more correct advice in the future.
 
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