12/29 - Jack - PMPS = 83 , +1 = 94, +2 = 63, +2.5 = 69, +3 67 , +4 = 76, +5 = 74, +7.5 104- Shot Low

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JackBlack

Member Since 2014
We are in day 5 of Lantus (only diagnosed 2 weeks ago)

Today's BG results have been a worry (NB I had to leave him during the day so I did not give morning dose and could not take BG readings in the middle of the day)

8am tested 6.2 mmol/L (111 mg/dL)
8:15 am re-tested 6.5 mmol/L (117 mg/dL)
8:30 am re-tested 6.6 mmol/L (118.8 mg/dL)
NO insulin this morning
3:30pm tested 5.9 mmol/L (106.2 mg/dL) (+7.5 after his 8:00am test)
7:00pm tested 8 mmol/L (144 mg/dL) (+11 after his 8:00am test) going up again
8:00pm tested 7.3 mmol/L (131.4 mg/dL) (+12 after his 8:00am test) going down again
SHOT 0.25U (fed him)
10:00pm tested 5 mmol/L (90 mg/dL) (+2 after his 8:00pm insulin) LOW already
11:00pm tested 3.7 mmol/L (66.6 mg/dL) (+3 after his 8:00pm insulin) LOWER - ATE FOOD
11:30pm tested 4.1 mmol/L (73.8 mg/dL) (+3.5 after his 8:00pm insulin) UP a little (perhaps the food helped)
12:00am tested 3.9 mmol/L (70.2 mg/dL) (+4 after his 8:00pm insulin)

will test again in 30 minutes.

I have been supported throughout the day if you are interested in seeing the history..

http://felinediabetes.com/FDMB/threads/new-to-lantus-yoyo-bg-results-today.130487/#post-1341844
 
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I was just reading through your thread (aka "condo") from yesterday. You're doing great. To be honest, this really isn't what I'd call a yoyo. Any test has a 20% variance associated with it due to the meter. So basically, the numbers you've been getting from your +3 are pretty much the same -- and they are great numbers!

You mentioned in your previous thread that your kitty is getting a raw diet. Is this something you're making? I just want to make sure that what you're feeding is nutritionally complete. Cats can do exceptionally well on a raw diet but there are certain supplements that are necessary to make sure they are getting all the nutrients needed in their diet.
 
8am tested 6.2 mmol/L (111 mg/dL)
8:15 am re-tested 6.5 mmol/L (117 mg/dL)
8:30 am re-tested 6.6 mmol/L (118.8 mg/dL)
NO insulin this morning
3:30pm tested 5.9 mmol/L (106.2 mg/dL) (+7.5 after his 8:00am test)
7:00pm tested 8 mmol/L (144 mg/dL) (+11 after his 8:00am test) going up again
8:00pm tested 7.3 mmol/L (131.4 mg/dL) (+12 after his 8:00am test) going down again
SHOT 0.25U (fed him)
10:00pm tested 5 mmol/L (90 mg/dL) (+2 after his 8:00pm insulin) LOW already
11:00pm tested 3.7 mmol/L (66.6 mg/dL) (+3 after his 8:00pm insulin) LOWER - ATE FOOD
11:30pm tested 4.1 mmol/L (73.8 mg/dL) (+3.5 after his 8:00pm insulin) UP a little (perhaps the food helped)
12:00pm tested 3.9 mmol/L (70.2 mg/dL) (+4 after his 8:00pm insulin)
12:30am tested 4.1 mmol/L (73.8 mg/dL) (+4.5 after his 8:00pm insulin) good UP a little without food or honey
 
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I suspect it's fine. The list we use from Dr. Lisa doesn't contain many of the varieties of food that are available internationally. Generally, a commercially prepared food is nutritionally complete. I usually take a look at the list of ingredients and look for taurine. It's one of the few ingredients that are critically important in a cat's diet. The rest of the vitamins and minerals are important but taurine is essential.
 
You are doing an amazing job with the testing. What type of meter are you using - is it a human meter, or is it an AlphaTrak? That information will better help us interpret the numbers, as a human meter's reference range is different from an AlphaTrak's reference range.
 
If it's AM, you might want to edit the info in your first post in this thread.

Also, it will be very helpful to people who scan the subject lines on the board if you edit yours with the test values. It's a quick way for us to spot someone who may need a hand. If you want to indicate you have a question or want "eyes" on your condo, just put that in the subject line, as well.
 
8am tested 6.2 mmol/L (111 mg/dL)
8:15 am re-tested 6.5 mmol/L (117 mg/dL)
8:30 am re-tested 6.6 mmol/L (118.8 mg/dL)
NO insulin this morning
3:30pm tested 5.9 mmol/L (106.2 mg/dL) (+7.5 after his 8:00am test)
7:00pm tested 8 mmol/L (144 mg/dL) (+11 after his 8:00am test) going up again
8:00pm tested 7.3 mmol/L (131.4 mg/dL) (+12 after his 8:00am test) going down again
SHOT 0.25U (fed him)
10:00pm tested 5 mmol/L (90 mg/dL) (+2 after his 8:00pm insulin) LOW already
11:00pm tested 3.7 mmol/L (66.6 mg/dL) (+3 after his 8:00pm insulin) LOWER - ATE FOOD
11:30pm tested 4.1 mmol/L (73.8 mg/dL) (+3.5 after his 8:00pm insulin) UP a little (perhaps the food helped)
12:00pm tested 3.9 mmol/L (70.2 mg/dL) (+4 after his 8:00pm insulin)
12:30am tested 4.1 mmol/L (73.8 mg/dL) (+4.5 after his 8:00pm insulin) good UP a little without food or honey
1:00am tested 4.0 mmol/L (72 mg/dL) (+5 after his 8:00pm insulin) stable I guess

thinking of testing in 1 hour? that would be a +6 night reading which I haven't done before
 
Since you are using a human meter, Jack's numbers definitely look quite fabulous! You really don't need to be testing quite as frequently, since the bottom of the range on a human meter is 50 (the range is 50 - 120) and Jack is comfortably above that. Don't get me wrong - testing is super important and I love that you are on top of things with Jack! But with the numbers he's got going on, and that he seems to have flattened out a bit, he is in the perfect spot of the range, and you could give both him and yourself a little bit of a break from testing. You can test in an hour (at +6) if you'd like, but at this point, you could probably even hold off until +7.

We usually don't break out high carb food or honey/karo unless the numbers dip below 50 (although there are a few other circumstances where you may break out the HC stuff if the numbers are above 50)
 
I think Amy's suggestion sounds good. The only thing I might add is that you could give Jack some LC food to encourage his numbers to stay where they are. (It may also ease your nerves so you can get some sleep!)
 
Thank you. My vet told me to give honey if Jack was under 5 mmol/L (90 mg/dL) But is was given a lower number on these board tonight and came up with 3.2 mmol/L (57.6 mg/dL) so I guess that's more in the ballpark of your 50.

Good to know Jack's numbers are ok. I just want to find a good dose for him and keep him on it for 6 cycles - haven't managed that yet. He is still getting used to the Lantus and I fear my vet started us too high - 2 units
 
8am tested 6.2 mmol/L (111 mg/dL)
8:15 am re-tested 6.5 mmol/L (117 mg/dL)
8:30 am re-tested 6.6 mmol/L (118.8 mg/dL)
NO insulin this morning
3:30pm tested 5.9 mmol/L (106.2 mg/dL) (+7.5 after his 8:00am test)
7:00pm tested 8 mmol/L (144 mg/dL) (+11 after his 8:00am test) going up again
8:00pm tested 7.3 mmol/L (131.4 mg/dL) (+12 after his 8:00am test) going down again
SHOT 0.25U (fed him)
10:00pm tested 5 mmol/L (90 mg/dL) (+2 after his 8:00pm insulin) LOW already
11:00pm tested 3.7 mmol/L (66.6 mg/dL) (+3 after his 8:00pm insulin) LOWER - ATE FOOD
11:30pm tested 4.1 mmol/L (73.8 mg/dL) (+3.5 after his 8:00pm insulin) UP a little (perhaps the food helped)
12:00pm tested 3.9 mmol/L (70.2 mg/dL) (+4 after his 8:00pm insulin)
12:30am tested 4.1 mmol/L (73.8 mg/dL) (+4.5 after his 8:00pm insulin) good UP a little without food or honey
1:00am tested 4.0 mmol/L (72 mg/dL) (+5 after his 8:00pm insulin) stable I guess
2:00am tested 4.5 mmol/L (81 mg/dL) (+6 after his 8:00pm insulin)

looks like he isn't on the way down - I will feed him and then we can both get some sleep - thanks! Any advice on how to proceed tomorrow would be great. Thinking of trying to maintain 0.25 units for now
 
There's still a lot of time between now an your AM shot. Let's see how he's doing in the morning.

Just for the future, the convention for subject lines is:
date kitty's name AMPS-#, +time - #​

It's helpful to have the date and your cat's name in the subject line,
 
Welcome! Jack looks great! After only two weeks you should be really encouraged! We generally don't give hc food or honey unless they drop under 50 or like I do to keep my cat from dropping and needing a reduction before he is ready for it. What is helpful is to have a mc food to give if dropping too fast or getting close to 50. Is Jack eating exclusively raw?
 
8am tested 6.2 mmol/L (111 mg/dL)
8:15 am re-tested 6.5 mmol/L (117 mg/dL)
8:30 am re-tested 6.6 mmol/L (118.8 mg/dL)
NO insulin this morning
3:30pm tested 5.9 mmol/L (106.2 mg/dL) (+7.5 after his 8:00am test)
7:00pm tested 8 mmol/L (144 mg/dL) (+11 after his 8:00am test) going up again
8:00pm tested 7.3 mmol/L (131.4 mg/dL) (+12 after his 8:00am test) going down again
SHOT 0.25U (fed him)
10:00pm tested 5 mmol/L (90 mg/dL) (+2 after his 8:00pm insulin) LOW already
11:00pm tested 3.7 mmol/L (66.6 mg/dL) (+3 after his 8:00pm insulin) LOWER - ATE FOOD
11:30pm tested 4.1 mmol/L (73.8 mg/dL) (+3.5 after his 8:00pm insulin) UP a little (perhaps the food helped)
12:00pm tested 3.9 mmol/L (70.2 mg/dL) (+4 after his 8:00pm insulin)
12:30am tested 4.1 mmol/L (73.8 mg/dL) (+4.5 after his 8:00pm insulin) good UP a little without food or honey
1:00am tested 4.0 mmol/L (72 mg/dL) (+5 after his 8:00pm insulin) stable I guess
2:00am tested 4.5 mmol/L (81 mg/dL) (+6 after his 8:00pm insulin)
6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)

Hi there, So this is what the last 24 hours looks like. I began yesterday worrying in 6.2 mmol/L (111 mg/dL) was too low to shoot, now I am 1 hour from shoot time and Jack is even lower! Now what? I can stick with him today. Do I shoot?

Could he have regulated with diet and the insulin kick started his pancreas (dare I even go there?)

Merrin
 
In answer, yes Jack is eating exclusively raw (raw meat used to be part of his diet anyway along with free range biscuits) He has been on only raw for 2 weeks.
 
Looking great! I hope you're fast asleep right now.

I'd encourage you not to carb him before he gets below 50. As I mentioned yesterday, newly diagnosed cats have a good chance of having their pancreas heal and can possibly go off of insulin and become diet-controlled. Sometimes all cats need is to have the dry food (if they were eating it) disappear and to have their food switched to all canned low carb or raw diet, along with a short-course of insulin to get their blood sugar back under control.

The reason that i think it's important for you not to carb him until he's under 50 is because if this dose can get him under 50, then you need to know it. That's the line that causes a dose reduction, so if he gets below 50, you would reduce his dose to 0.1u per the dosing protocol. Cats are not in any danger in the 40's, but they are the zone where we take action and pull them up over 50 for safety. Non-diabetic cats are often in the 40's. We've had some cats go OTJ that want to hang out in the 30's. My point is that he isn't in any danger if you let him drop below 50 before carbing him and as long as you are monitoring the drop, you'll be able to give him honey and pull him up back above 50. According to my calculator, 50 divided by 18 = 2.78, so I wouldn't carb above that point. Giving low carb as Sienne suggested is a great technique for helping a cat surf along in healthy green numbers.

At this point, you want him to spend as much time as possible in the 50-120 range. That's normal blood sugar for a cat on insulin and that is the zone that allows the pancreas to heal.

by the way, the US tab is there - I may have been looking in the wrong spot for it.

Just saw your post above - the answer is yes. Your testing will tell us what is happening. For now, I'd keep giving the 0.25u and try to catch him going below 50 so you know to reduce his dose.

from the TR protocol page:

Reducing the dose:
  • If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

    Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
    • If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
    • If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
    • Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
      Please ask for advice.

  • If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.

    Keeping YOUR cat safe is the #1 priority of the FDMB.
    Let's keep all our kitties in the Lantus Tight Regulation ISG safe by suggesting and taking appropriate reductions.

  • If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

    Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
  • Since 2006 we've encouraged those practicing Tight Regulation to attempt reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission.

Remission:

  • From Tilly's Diabetes Homepage:
    Phase 5: Remission

    "14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs. Don't stop feeding low-carb and try to avoid cortisone if possible. Test the cat's BGs once per month.


    Approximately 25% cats that achieved remission using this protocol relapsed and required insulin again (frequent causes are hyperthyroidism or bouts of pancreatitis). Therefore, it is important to keep your diabetes kit up-to-date. Then you can react immediately by giving insulin and home testing. Importantly, the sooner you react to a relapse (i.e. preventing hyperglycemia and initiating other necessary veterinary treatment), the more likely a second remission will become.

    The longer a cat has had diabetes, the less likely it will go into remission. Many long-term diabetics get stuck in Phase 3 or 4. Yet there is a benefit of using this method for such a cat as well: keeping the cat's BG levels as normal as possible is much healthier for it long term. Insulin requirements will often decrease to very low levels too."
 
I didn't see your question in the previous post about dosing in an hour. Can you get your preshot test about 15 minutes early, so +11.75 and post the # in the subject line with "should I shoot?" and we can take a peek at what's going on. Are you home today to monitor him? Do you have plenty of testing strips and high carb syrup or gravy?
 
Yes I will test at +11.75. And yes I am home all day and have just kitted myself out with new lancets and test strips. He likes honey and that is what I have if I need it. Thanks Julie!
 
Yesterday 28th Dec thru to this morning 29th Dec:

8am tested 6.2 mmol/L (111 mg/dL)
8:15 am re-tested 6.5 mmol/L (117 mg/dL)
8:30 am re-tested 6.6 mmol/L (118.8 mg/dL)
NO insulin this morning
3:30pm tested 5.9 mmol/L (106.2 mg/dL) (+7.5 after his 8:00am test)
7:00pm tested 8 mmol/L (144 mg/dL) (+11 after his 8:00am test) going up again
8:00pm tested 7.3 mmol/L (131.4 mg/dL) (+12 after his 8:00am test) going down again
SHOT 0.25U (fed him)
10:00pm tested 5 mmol/L (90 mg/dL) (+2 after his 8:00pm insulin) LOW already
11:00pm tested 3.7 mmol/L (66.6 mg/dL) (+3 after his 8:00pm insulin) LOWER - ATE FOOD
11:30pm tested 4.1 mmol/L (73.8 mg/dL) (+3.5 after his 8:00pm insulin) UP a little (perhaps the food helped)
12:00pm tested 3.9 mmol/L (70.2 mg/dL) (+4 after his 8:00pm insulin)
12:30am tested 4.1 mmol/L (73.8 mg/dL) (+4.5 after his 8:00pm insulin) good UP a little without food or honey
1:00am tested 4.0 mmol/L (72 mg/dL) (+5 after his 8:00pm insulin) stable I guess
2:00am tested 4.5 mmol/L (81 mg/dL) (+6 after his 8:00pm insulin)
6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin) SHOULD I SHOOT?

This is the lowest result Jack has ever had PS
 
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Merrin, typically we would stick with a dose and shoot most numbers over 50 (as long as the cat isn't sick or not eating) until the cat goes below 50 on a dose. The drop below 50 triggers a dose decrease.

As long as you're home and able to monitor, it's probably a good idea to go ahead with the full dose. Often shooting the full dose into normal numbers turns the Lantus curve into more of a line and the cat's BGs might only move a few points in the whole 12 hours. Of course there is no way to know how jack is going to respond until you do it.

If he were mine, that's what I would do. However, if you are uncomfortable with that, you could shoot just 0.1u (pictures on the New to the Group sticky). You could also wait until he's risen higher and then shoot, or you could skip the shot.

Which direction do you want to go? I'm around today and can check in with you throughout the day - and if I have to go out I can arrange someone else to monitor with you.

If you choose to shoot anything, you'll want to get a +1 and a +2 to begin with.
 
Hi Julie, I think I will give him the 0.25. I am here today and will monitor him. I am committed to gathering the data, trying to keep him on one dose for as long as possible and now feel safer to give him glucose only under 50. He seems happy enough and is eating when I offer it to him - he is sleeping a lot but that is normal for him!
 
6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin)
8:00am SHOT 0.25 U (hardly ate anything)
9:00am tested 4.7 mmol/L (84.6 mg/dL) (+1 after his 8:00am insulin) So far so good
 
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6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin)
8:00am SHOT 0.25 U (hardly ate anything)
9:00am tested 4.7 mmol/L (84.6 mg/dL) (+1 after his 8:00am insulin) So far so good - ATE some food
10:00am tested 5.1 mmol/L (91.8 mg/dL) (+2 after his 8:00am insulin)
 
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6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin)
8:00am SHOT 0.25 U (hardly ate anything)
9:00am tested 4.7 mmol/L (84.6 mg/dL) (+1 after his 8:00am insulin) So far so good - ATE some food
10:00am tested 5.1 mmol/L (91.8 mg/dL) (+2 after his 8:00am insulin)
12:00pm tested 4.0 mmol/L (72 mg/dL) (+4 after his 8:00am insulin)

Latest test - still in safe range, feeling good that I did give him is shot this morning - thoughts about when I should test next?
 
Is this daytime for you?

I'd get a +6 and then another one at either +7 or +8 or so. It's nice to know when his nadir (low point) is. When you see the BGs starting to rise then you can stop testing until the next preshot.

If his ears are hurting or he's giving you grief about testing, then I'd just get the +6 and post to see if you need to test again or not.
 
Hi, Yes I am in daytime now.

In half an hour it will be +6 and he looks happy enough so I will test then. He has been asleep all morning, but will eat if I bring it to him and encourage him.

He isn't complaining about the ear pricks so much but I am having to prick a few times. I hope I am not damaging the vein with the constant pricking. I will post the +6 result in 1/2 hour.
 
He isn't complaining about the ear pricks so much but I am having to prick a few times. I hope I am not damaging the vein with the constant pricking. I will post the +6 result in 1/2 hour.

A cat's ears seem to recover quickly. In the beginning remi's ears looked a bit of a mess but they healed up just fine. I found it best to hear the ear with a rice filled sock (gently heated in the microwave) to bring blood to the ear. Then I aimed for the bit of the ear between the vein and the outside of the ear and put gentle pressure on each side of the bit I had just pricked. I would alternate between doing the top side of the ear and the underneath side and ofcourse from one ear to the other.

You are doing really great.
 
In the beginning they don't have as many capillaries so it's really common to have to poke multiple times to get blood. After about 2 weeks of poking, more capillaries grow and then you'll get blood every time. Heat does help. You could be doing everything right and still not get blood those first couple of weeks - just hang in there.
 
6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin)
8:00am SHOT 0.25 U (hardly ate anything)
9:00am tested 4.7 mmol/L (84.6 mg/dL) (+1 after his 8:00am insulin) So far so good - ATE some food
10:00am tested 5.1 mmol/L (91.8 mg/dL) (+2 after his 8:00am insulin)
12:00pm tested 4.0 mmol/L (72 mg/dL) (+4 after his 8:00am insulin)
2:00pm tested 4.8 mmol/L (86 mg/dL) (+6 after his 8:00am insulin)

Good result - will it be good for the data to test again in 1 more hour? Maybe we have passed the nadir?

He doesn't mind the pricking mostly and it's summer here so the blood is flowing when I hit the right spot!
 
I think he's surfing along and probably past his nadir. What a great day for him!!! and you, too! well done with shooting this morning!

If you're up for testing it would be great to get another test in an hour or so. Since this is the first time you've had this situation it'd probably be good just to make sure he's holding up and not dropping.

One heads-up - some cats on Lantus have what is called a "double-dip" where they drop a bit at the end of the cycle. That's nothing to worry about as long as the preshot is higher than the nadir of that previous cycle. So as long as he's over 72 at preshot, it's ok if he's dropped back down from the 86 you just got.
 
6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin)
8:00am SHOT 0.25 U (hardly ate anything)
9:00am tested 4.7 mmol/L (84.6 mg/dL) (+1 after his 8:00am insulin) So far so good - ATE some food
10:00am tested 5.1 mmol/L (91.8 mg/dL) (+2 after his 8:00am insulin)
12:00pm tested 4.0 mmol/L (72 mg/dL) (+4 after his 8:00am insulin)
2:00pm tested 4.8 mmol/L (86 mg/dL) (+6 after his 8:00am insulin)
3:00pm tested 4.6 mmol/L (83 mg/dL) (+7 after his 8:00am insulin)

Not really sure how to analyze this day apart from Jack being nice and stable. The lowest reading was 72 at +4. But as you say Julie as long as he is over 72 at this evening's pre-shot test I will shoot 0.25 U again. Might give him a rest from tests for now? Or do another maybe at +10? +11?
 
Hi Merrin!

I haven't had a chance to welcome you and Jack yet due to the holidays. Julie asked me to check in on you all as she had to step away for a bit.

I see from his SS that he's still surfing the 80s. Great job! I think you can easily give him a break for a couple hours. How does that sound?
 
Merrin...

Did you see my post above? I'd definitely give him a break at least until +9 but you can try +10 if you both need some time off. Hopefully, he will surf from here and perhaps not see a drop until his 2nd dip. I'll be around tonight and can check back in at his +10.

Sound good?
 
Sorry had to go and deal with my 2 legged child!

Sounds great. I will kick it off again at +10 (that's 6pm NZ time - in an hour and a half)
 
6:00am tested 4.4 mmol/L (79.2 mg/dL) (+10 after his 8:00pm insulin)
7:00am tested 4.0 mmol/L (72 mg/dL) (+11 after his 8:00pm insulin)
7:45am tested 4.7 mmol/L (84.6 mg/dL) (+11.75 after his 8:00pm insulin)
8:00am SHOT 0.25 U (hardly ate anything)
9:00am tested 4.7 mmol/L (84.6 mg/dL) (+1 after his 8:00am insulin) So far so good - ATE some food
10:00am tested 5.1 mmol/L (91.8 mg/dL) (+2 after his 8:00am insulin)
12:00pm tested 4.0 mmol/L (72 mg/dL) (+4 after his 8:00am insulin)
2:00pm tested 4.8 mmol/L (86 mg/dL) (+6 after his 8:00am insulin)
3:00pm tested 4.6 mmol/L (83 mg/dL) (+7 after his 8:00am insulin)
6:00pm tested 4.7 mmol/L (85 mg/dL) (+10 after his 8:00am insulin)

Still looking good, the numbers would suggest 0.25 is a good dose for Jack (today anyhow) Let's hope I can replicate the same 0.25 U I gave him this morning. I am finding anything under 1 Unit hard to see on the syringe. I went and bought some magnifying glasses today.

If he is still testing in this range at his pre shot test tonight, I should still go with 0.25? Will I need to test him after that (ie this evening)
 
Yes, you basically want to keep doing what you did today. Keep the same dose unless he goes below 50.

I can't predict what you'll need to do tonight except to say that I would test enough to keep him safe. Go by the changes from one test to the next in deciding when to test next. That's not a perfect answer but you may be in for an intense few days. When I had to test punkin at night I set my cell phone alarm and slept on the sofa with the light on.

Food is your tool to use. If you can leave food available for him during the night, many cats will eat if they feel their blood sugar going low.

He has every indicator of a cat that is likely to become diet controlled. Hang in there.
 
I should add that there usually are people checking in here for another couple of hours tonight. Wendy and Elise are often on late, and Serryn is in Australia and may be on too.

If you get a test less than 50, give Jack some honey, then post here for help. You can cross post in the Main Health too in case someone is on there. Put "need help now" or something like that in your subject line. You should look now at the "how to handle low numbers" sticky - do you know where that is at the top of the Lantus Lev page? I'm on my phone and can't copy the link for you.
 
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