29/08 Miou, AMPS=175, +2=110, PMPS=149, +2=88, 0.25U

[Elsa]

Hi again everyone

After yesterday's morning condo I had no chance to update Miou's status here. I hope I find you all in good spirits, and good health.

Last night before the PMS she had a +11=138, and a PMPS =139 - a very small rise, far less than the 20% required to make a difference. I was considering to withhold food and wait an other 30 minutes but Miou (and her two sisters) were starving and begging for food for an hour already. So I went ahead skipped the shot and fed the girls.
This proved not too bad I suppose, since the +2 dropped to 111.
Not too good either since this morning she had a +11=170 and an AMPS=175.
Obviously an insignificant rise again, but since she was above 150 I went ahead and shot a 0.25U. Looks good since her +2=110.
This time to draw the 0.25 I used a magnifying glass and was more sure it looked like the pic.
Anyway that's all for the time being. I will test her again at +7, and proceed for tonight with a +11 before ha PMPS.

Lots of kisses and paws from Miou, and hugs from me

 

[Wendy&Tiggy(GA)]

Re: 29/08 Miou, AMPS=175, +2=110, 0.25U

Yep she isnt ready for zero insulin yet. Lets see how you get on with 0.25. If she doesnt go too low we might hold this dose a while.

 

[Elsa]

Re: 29/08 Miou, AMPS=175, +2=110, 0.25U

Yep she isnt ready for zero insulin yet. Lets see how you get on with 0.25. If she doesnt go too low we might hold this dose a while.

Yes she definitely is not ready to go OTJ. I think that now that the depot has drained it will be easier to evaluate if 0,25 is ok.
I just tested Miou, her +7 is 110.

 

[Wendy&Tiggy(GA)]

Re: 29/08 Miou, AMPS=175, +2=110, 0.25U

You are getting the hang of this! How do you feel about reducing your no shot to 130?

Wendy

 

[Elsa]

Re: 29/08 Miou, AMPS=175, +2=110, 0.25U

You are getting the hang of this! How do you feel about reducing your no shot to 130?

I am ok with it, and it feels the normal thing to do at that stage. So from now on I shoot if >130

 

[BJM]

Re: 29/08 Miou, AMPS=175, +2=110, 0.25U

...I am ok with it, and it feels the normal thing to do at that stage. So from now on I shoot if >130

Exactly.

Do you have this:

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}
- 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 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.

 

[Elsa]

Re: 29/08 Miou, AMPS=175, +2=110, 0.25U

...I am ok with it, and it feels the normal thing to do at that stage. So from now on I shoot if >130

Exactly.

Do you have this:

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}
- 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 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.

Yes I have this, thanks to you

I was just wondering if it is considered a fast drop that she has a +2 of 88 after a PMPS of 149
Looking at it more carefully I think its the green numbers that scare me
In the morning she had the same drop and I didn't get scared at all because it was in the blue range
Anyway i will be monitoring her

 

[Wendy&Tiggy(GA)]

Green =good as long as its not under 50 and dropping. You can handle this. Just keep testing , she seems to be surfing now but keep an eye on her in case she drops any more. If she drops under 50 we will decrease her again. But these current green numbers are normal and healthy.

Good news if she drops under 50 she gets another decrease... 0.1 this time.. And if you thought 0.25 was hard to eyeball...

Wendy

 

[Elsa]

Green =good as long as its not under 50 and dropping.

Yeap I know but the couple of times Miou went under 50 were enough to make me fear the green... No worries though I will get over it as I got over the fear of the syringe...

Good news if she drops under 50 she gets another decrease... 0.1 this time.. And if you thought 0.25 was hard to eyeball...

You are kidding me right? 0.1?!?!?!?!?! :shock:
but ... but... I thought after that we went to 0. Plain, old, round 0...
ohmygod_smile ... then a plain magnifier won't do the trick, I will need to get a microscope...
really????... 0.1????

now I really woke up... lol
------
Ok went back and checked at that post I found on the board the other day with the pictures of the low doses... I saw a picture of 0.1 and to me the plunge looked like at 0...

---edit---
just got a +3 she is at 87... I guess this is what you call a surf right?
Looks like I could get some sleep in a bit

good day to you Wendy even though you scared me with that 0.1 lol
me sends her love

 

[Wendy&Tiggy(GA)]

Sometimes bailey even gets "the empty syringe" which is 1 drop. Maybe 1/3 of the 0.1... He is a micro dose cat though. Hopefully miou isn't cause it's a real pain in the xxx to get those small doses consistent.

 

[BJM]

And then there is the empirical approach. On a day you can be home to test, go without insulin. Test every 2 hours and space out the feeding. See what happens. I did that with Dusty last Sunday and discoverd he was low enough to consider an OTJ trial (Off The Juice, ie off insulin).

The worst that could happen is you discover he still needs some insulin, so you resume using it.

 

[Elsa]

And then there is the empirical approach. On a day you can be home to test, go without insulin. Test every 2 hours and space out the feeding. See what happens. I did that with Dusty last Sunday and discoverd he was low enough to consider an OTJ trial (Off The Juice, ie off insulin).

The worst that could happen is you discover he still needs some insulin, so you resume using it.

That sounds waaaaaaay better and faaaaar easier than a 0.1 dose :lol:

 

[Deb & Wink]

You're doing a great job Elsa and Miou! Keep it up and maybe soon, you will be OTJ, diet controlled kitty like Wink. ;-)