29/11 Emmett AMPS 124 +3 106 +6 101 +9 65 (AT3)

KLD

KLD

Active Member
Yesterday:
https://felinediabetes.com/FDMB/thr...-2-65-delayed-no-insulin.296085/#post-3224253

Just when we thought Emmett was doing well at 1.75 :)

I tested Emmett about five minutes ago and he’s at 3.6/65 on the Alpha Trak. I just reduced his dose to 1.75 units today, and he’s coming off of 24 hours without insulin due to low numbers.

Advice for tonight’s insulin? My understanding is that with TR you don’t do back to back reductions, so I’m unsure what to do with him.
 
It’s a bit early yet to see what his PMPS might be, although you are right, usually we don’t do back to back reductions when following TR, unless a cat falls under 40 with a human meter, since it’s often the depot still influencing the BG for 4-6 cycles. That said, you are using a pet meter, and you’ve had no insulin yesterday, where in the am cycle he dropped to 50 without insulin. Hard to say what might be left of the 2u depot at this point since you also had no shots pm cycle of 25th and 26th Nov.

If it were me, I’d take the reduction, although the next question might be whether he continues to drop into PMPS or whether you get a preshot that is safe to shoot. Ideally we would like to find a dose you can safely give both and pm cycles. Have you given any snack with that 65?
 
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You’re right, I’m also thinking about whether I’m even going to be able to give him insulin tonight, because his BG doesn’t tend to rise too much after nadir lately I’m finding. We’ll see in a couple hours.

And yes, he got some MC with the 65. Otherwise he’s been eating LC today.
 
Emmett sure is making life interesting; late nadirs, no shots, drops under 68 again so quickly, I think he’s just messing with us now :p
 
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MC was a good choice, try for a test at +10 if you can, it’ll be good to see if he gets a bump up or not. Hopefully it’s enough to rise into PMPS.
 
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He’s at 4.1/74 at PMPS… I’m not super comfortable giving him insulin at this number given yesterday but would love another opinion.
 
There is absolutely nothing wrong with skipping again, you have to be comfortable. He is above 68 so the number is technically ok to shoot, but it would most likely take close monitoring and intervening with carbs. Given some of what he’s been doing these past few days, it’s likely you’ll have an active cycle.
 
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Christie & Maverick said:
There is absolutely nothing wrong with skipping again, you have to be comfortable. He is above 68 so the number is technically ok to shoot, but it would most likely take close monitoring and intervening with carbs. Given some of what he’s been doing these past few days, it’s likely you’ll have an active cycle.
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Yeah, I’m just afraid I’m going to miss something overnight. If this was the AM cycle I think I would try giving insulin and see how he does. He’s sleeping and doesn’t feel like getting up for food anyway, so maybe I’ll delay a bit and see where he is.
 
The risk with stalling is sometimes the cat will still drop, although he’s been flat since +10. Another option is to introduce MC in the cycle earlier before onset, to help as the insulin kicks in, but I would also say if it takes extra carbs to keep him from earning another reduction and you have to fight to keep him up, then that too says something about the dose.
 
Hmm okay lots to think about. I hate skipping so many doses but I think I just have to for tonight. I’m just really concerned for how low he might go tonight.

Side note, do cats ever get one dose a day, or is that more common for dogs? I only ask out of curiosity because his vet said she had some patients on only one dose a day, and seemed to imply she thought Emmett would end up on a small once daily dose (I don’t think that’s appropriate for Emmett, given how he ended up bouncing after too many missed doses, I think we just need to find the ideal dose for him).
 
Once a day dosing usually doesn’t work, since for most cats the duration isn’t sufficient. I think in the past I might have seen one or two, but if I recall correctly they were on a low dose, and only needed a little insulin but I might be wrong.
 
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KLD said:
Hmm okay lots to think about. I hate skipping so many doses but I think I just have to for tonight. I’m just really concerned for how low he might go tonight.

Side note, do cats ever get one dose a day, or is that more common for dogs? I only ask out of curiosity because his vet said she had some patients on only one dose a day, and seemed to imply she thought Emmett would end up on a small once daily dose (I don’t think that’s appropriate for Emmett, given how he ended up bouncing after too many missed doses, I think we just need to find the ideal dose for him).
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I think you answered your own question. The duration for lantus is around 12 hours. Sometimes there is carry over into the next cycle. Since I have been here I have not seen once a day dosing work. Better to slightly lower the dose if you find yourself needing to skip too much until you get more comfortable shooting lower numbers. I understand not shooting a 74 when using the AT since under 68 earns a reduction. Have you tried feeding a +10 snack of higher lc? So if your regular food is 3-4% carbs you would feed 7-9% so that the bg doesn’t drop under 68. Just a thought.
 
tiffmaxee said:
I think you answered your own question. The duration for lantus is around 12 hours. Sometimes there is carry over into the next cycle. Since I have been here I have not seen once a day dosing work. Better to slightly lower the dose if you find yourself needing to skip too much until you get more comfortable shooting lower numbers. I understand not shooting a 74 when using the AT since under 68 earns a reduction. Have you tried feeding a +10 snack of higher lc? So if your regular food is 3-4% carbs you would feed 7-9% so that the bg doesn’t drop under 68. Just a thought.
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So, food is a struggle with Emmett. He’s allergic to chicken, and generally hates poultry as a whole, so his food options are really limited. Over on the Prozinc board, we were trying to troubleshoot finding slightly higher, but still low carb, food that Emmett could eat. I wasn’t super successful. For a while I was just feeding him around 12% around +2 (when he used Prozinc) because he would often have steep drops early on, but he was never consistent enough on that insulin to have a good idea of how it was working.
 
KLD said:
So, food is a struggle with Emmett. He’s allergic to chicken, and generally hates poultry as a whole, so his food options are really limited. Over on the Prozinc board, we were trying to troubleshoot finding slightly higher, but still low carb, food that Emmett could eat. I wasn’t super successful. For a while I was just feeding him around 12% around +2 (when he used Prozinc) because he would often have steep drops early on, but he was never consistent enough on that insulin to have a good idea of how it was working.
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I’m not that familiar with Emmett but, unless you can’t monitor him, stalling or skipping when he’s above 68 on your AT is for you and not him since you are doing TR. Shoot low to stay low (low being above 68 on an AT or 50 human meter). He could still be using the 2u depot but it should have drained some so with that 65, you could reduce to 1.5u and see what he does.
 
Marje and Gracie said:
I’m not that familiar with Emmett but, unless you can’t monitor him, stalling or skipping when he’s above 68 on your AT is for you and not him since you are doing TR. Shoot low to stay low (low being above 68 on an AT or 50 human meter). He could still be using the 2u depot but it should have drained some so with that 65, you could reduce to 1.5u and see what he does.
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Well you’re definitely right about that one. I was all committed to giving him insulin tonight as long as he was above 68 and then just got scared lol
 
I hope that Emmett is starting off nicely today :). I must admit his numbers of Nov 28th still confound me a little, mostly because of my own personal experience; there’s no chance I’d have seen such a string of greens after 2 skips, so I suppose that’s where my conservative approach to last night’s preshot came from.

I was also thinking if you have some food challenges, you could always try and mix what you have for MC and your LC which would give you a higher LC. I’ve done that on occasion depending on the BG number and where Mav was in the cycle, when I felt MC might be too much but LC wasn’t quite enough. Just some more food for thought.
 
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Christie & Maverick said:
I hope that Emmett is starting off nicely today :). I must admit his numbers of Nov 28th still confound me a little, mostly because of my own personal experience; there’s no chance I’d have seen such a string of greens after 2 skips, so I suppose that’s where my conservative approach to last night’s preshot came from.

I was also thinking if you have some food challenges, you could always try and mix what you have for MC and your LC which would give you a higher LC. I’ve done that on occasion depending on the BG number and where Mav was in the cycle, when I felt MC might be too much but LC wasn’t quite enough. Just some more food for thought.
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So, Emmett dipped low again last night. I have no idea what’s going on with him. Sorry, haven’t updated anything yet because I’m just so tired. He was at 3.9 this morning so I skipped.

I just think he’s getting way too much insulin. He had this weird pattern when on Prozinc where he would very suddenly drop his dose over the course of days or a couple weeks max… and I’m talking from like > 3 units down to 1 very rapidly. And then have to go back up. I had a really hard time being consistent. I’m just wondering if he’s doing something similar now.

I can definitely try mixing the food.
 
Well now I definitely feel better for supporting you to skip last night :p. Like I said, I’ve never seen such results from so many skips, arguably the 2u depot is gone. I guess you just have to go with Emmett’s flow, he’s the one in charge here.
 
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I suppose he thinks he can do what he wants, because he’s such a handsome boy :smuggrin:. He apparently didn’t care to read our dosing and info stickies lol
 
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I see the data now for last night, just getting to poking my nose in. :eek: that he hit 59 (3.3) midcycle again after the skip. No wonder you were tired this morning :bighug:. Even the low blues today after another skip would be within normal using AT3. It will be interesting to see if he shows you more greens again later in the cycle. Hope you and Emmett are able to get a catnap in today :cat:
 
Christie & Maverick said:
I see the data now for last night, just getting to poking my nose in. :eek: that he hit 59 (3.3) midcycle again after the skip. No wonder you were tired this morning :bighug:. Even the low blues today after another skip would be within normal using AT3. It will be interesting to see if he shows you more greens again later in the cycle. Hope you and Emmett are able to get a catnap in today :cat:
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It’s so bizarre. I meant to test him again this afternoon because I was paranoid he would go back down but I ended up falling asleep lol. He’s been sleeping beside me all day so I think last night took it out of him as well. He only perked up when my dad dropped off a catnip plant lol
 
Out of curiosity, how is Emmett acting/behaving since his new adventures in Greenland? :D Other than enjoying the fresh catnip of course.

If you didn't shoot last night, could you put NS in the dose cell. Thanks.
 
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Wendy&Neko said:
Out of curiosity, how is Emmett acting/behaving since his new adventures in Greenland? :D Other than enjoying the fresh catnip of course.

If you didn't shoot last night, could you put NS in the dose cell. Thanks.
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Overall he’s doing much better. More energy, less bullying of my other cat lol (I was having a problem where his extreme fluctuations in blood sugar seemed to be contributing to him being a bully to my other cat—they are a bonded pair and literally have never had issues until recently—which was causing my other cat to have stress related medical issues). Emmett has always been a very lazy cat, but at least now it seems his laziness is by choice if that makes sense haha

Today he seems just very tired. He’s just wanted to sleep all day. He had a bit of energy for a little while but went back to sleep.

That being said, I can definitely tell when he drops below 5 mmol.
 
Some cats do fly down the dosing scale. I have seen that happen. Marje suggested 1.5 if the pmps is over 68. I’m kind of reluctant to say shoot unless over 100. Do you have a human meter by any chance?
 
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tiffmaxee said:
Some cats do fly down the dosing scale. I have seen that happen. Marje suggested 1.5 if the pmps is over 68. I’m kind of reluctant to say shoot unless over 100. Do you have a human meter by any chance?
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Yeah, based on the last few days I’m reluctant as well. I do have a Freestyle Lite and some test strips as back up.
 
When we originally were going to try 1.5u that was before last night’s cycle where you didn’t shoot, as well as today’s. Considering that he dropped to 59 last night and he’s stayed in low blues again so far without insulin, and his patterns of dropping lower later in the cycle, I have a strong feeling he won’t give you a shootable preshot.
 
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Christie & Maverick said:
When we originally were going to try 1.5u that was before last night’s cycle where you didn’t shoot, as well as today’s. Considering that he dropped to 59 last night and he’s stayed in low blues again so far without insulin, and his patterns of dropping lower later in the cycle, I have a strong feeling he won’t give you a shootable preshot.
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Yeah, that’s fair. We’ll see in a bit. I keep anticipating a major bounce. I’m shocked it hasn’t happened so far.
 
KLD said:
Today he seems just very tired. He’s just wanted to sleep all day.
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Neko hid under the bed her first green streak. I liken higher BG's to higher levels of caffeine - it keeps you going. Try cutting back and your body feels it. But perhaps his body is getting used to green, he doesn't seem to be bouncing as high.
 
Wendy&Neko said:
Neko hid under the bed her first green streak. I liken higher BG's to higher levels of caffeine - it keeps you going. Try cutting back and your body feels it. But perhaps his body is getting used to green, he doesn't seem to be bouncing as high.
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Emmett is pretty infamous for bouncing, but yeah, I’m pleasantly surprised at how well he’s been doing at not bouncing so much, or as extremely.
 
Well to me, we were pondering 1.5u before we got 59 last night on no insulin, and before today again no insulin, so I’m giving credit to the 59. I previously used a pet meter, and under 60 is pretty low IMHO. In my mind it’s the same as those who use a human meter taking a reduction under 40 regardless of whether it is back to back. I know there isn’t a direct correlation, but when I used the pet meter, mentally I always told myself under 60 was an automatic reduction.
 
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Sounds good to me. It does seem pretty low, and I definitely do not want to overdose my cat. I’m just trying to make sure I’m being good following protocols to the best of my ability lol. I’m afraid of overdosing him but also afraid of making too many big changes and it backfiring haha. But I guess with all the missed shots that’s kind of out of the window anyway
 
I think that’s one reason why Elise asked if you have a human meter, since the dosing methods were based on use of human meter, so we are kind of guessing on how low these numbers under 68 really are. Maybe let’s see where he is at closer to preshot and decide then?
 
Christie & Maverick said:
I think that’s one reason why Elise asked if you have a human meter, since the dosing methods were based on use of human meter, so we are kind of guessing on how low these numbers under 68 really are. Maybe let’s see where he is at closer to preshot and decide then?
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I can cross check it with the freestyle lite tonight. I’ll create a proper thread for today. Insulin time is in about fifteen minutes.
 
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