4/5 Tasha AMBG 89 Dose Question--New Question

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Karisa and Tasha(GA)

Karisa and Tasha(GA)

Member Since 2011
4/3 pmbs 128

4/4 amps 191 gave 1.5 units
pmbs 107 waited 30 min gave 1.5 units (DH)
+2:45 85 I got home from work (7:45)
+ 3:15 84 gave 1/4 can w/d for HC
Ta was acting fine, very playfull wasn't too worried

4/5 amps 89 did not give shot don't wanna put her in the toilet

going to show the vet her numbers today, and hopefully find out from her how much to give when she is running low, since i don't want her sugar to go up too high.

SS is updated

I just got a +3 AMBG at 101 should i shoot or talk to vet first?

The way my scedule works it's hard to get here every day, like this coming weekend, i work fri thru mon 12hr shifts. I keep a log here at the house, and will update like I did this morning. Hopefully soon i can get a full curve done and dont run out of strips.
 
Re: 4/5 AMBG 89 Dose Question

Hi again, Karisa,

Did you feed Kasha this morning? Whether or not the +3 reflects food, I would skip this shot. You are already 3 hours late and shooting now would play havoc with your schedule. Please feed her now if you haven't fed already. After 2 hours of stalling, it is best to skip and FEED. Gotta have food!
Please put Tasha's name in the subject line: "4/5 Tasha AMBG 89 Dose Question" (I'm sorry that I unintentionally left it out when I was advising what to put in the subject line!!!)

Good luck today. You're doing fine. I hope you get some dose advice before you get to your vet.

Ella
 
Re: 4/5 AMBG 89 Dose Question

Good. Now, just one more thing!!!!! I forgot to tell you that in order to change the subject line you have to go back to your first post of the thread and change it there. Otherwise the change will not show up in the list. This is true for every subsequent change or addition to the subject line: edit it from the first post.

Carry on!!

Ella

p.s. It would be good if you could get a +11 this afternoon and post that number along with your question of dose. Be sure to say that you skipped the shot this morning. Any other tests you could get today would also be helpful for the knowledgeable people who will be along to help you.
 
Re: 4/5 AMBG 89 Dose Question

Good morning guys .. Glad that Ella helped you out with your question .. just wanted to add those are some nice looking numbers tasha! Have a great day guys!
 
Re: 4/5 AMBG 89 Dose Question

Karisa:

You may want to put Tasha's name in your subject line.

From what you indicated, if you don't have a stock of strips, HC food, and can't be around to monitor, you can't shoot a low number. It's just not safe. As I noted in your other condo, you do not yet have the data to shoot low.

If you shoot at +3, are you able to shoot 12 hours later and still be on schedule? The most you can shift shot time to get back on schedule is 30 min. per day. From your post, I doubt that your schedule will allow you to stall for that long. As a general rule, you may want to skip the shot if you're more than 2 hours late.
 
Re: 4/5 AMBG 89 Dose Question

Thanks much, I just skipped the dose since i wont be around. I plan on doing a curve tomorrow though. will be home all day.

It seems to me that those numbers are low. Could someone here tell me (no link) what I should be "shooting" for. I have read the sticky's but they are kind of confulsing to me for some reason-could be sleep deprivation :lol:

I guess I'm too used to human numbers, since i tend to be hypo. So numbers under 80 spook me. Will take some getting used to.
 
Re: 4/5 Tasha AMBG 89 Dose Question

Just want to welcome you to LL since I have not yet posted in your condo as of yet very nice amps for Tasha today :mrgreen:
 
Re: 4/5 Tasha AMBG 89 Dose Question

New question:

I have to give her antibiotics for a possible UTI. Not sure which one yet since I'm picking it up later today. How will it effect her sugars?
 
Re: 4/5 Tasha AMBG 89 Dose Question

One way that a cat within one year of diagnosis earns a dose reduction is to have BG numbers drop below 50. The research done by Jacqui Rand, DVM would never have seen the light of day if this were a dangerous dosing protocol that established this as a means for cats to earn dose reductions. That said, you don't want to have a kitty surfing in the 30s or 40s for an extended period of time. You also need to differentiate between low numbers vs. symptomatic hypoglycemia. Most of our cats will drop into lower numbers briefly but are completely asymptomatic. Also, normal BG range is 50 - 120. There are some cats whose "normal" is in the 40s.

It does take some getting used to. On the one hand, you don't want your cat in a hypoglycemic crisis. On the other hand, if a cat is sitting in high numbers for an extended period of time, there's an increased risk for diabetic ketoacidosis or kidney problems. Neither alternative is good. Keeping our cats in safe, healthy numbers is the goal.
 
Thanks, that's much easier to understand. So normal is between 50 to 120 and can go to 40's and be fine as long as it's not for an extended amt of time. That helps so much, because i was worried thinking she was on the low side of normal in the 80's.

Signing off--have to go to class

Thanks again everyone, you have all been so helpfull! Makes this h3!! a little easier to bear.

Karisa
 
Hi Karisa, I haven't posted in your condo yet, so welcome!

You are using an AlphaTrak meter, so your number range will be higher than what you see most people here shooting for... normal range for AT meter is 80-150. You want Tasha to spend as much time as possible in that number range in order to allow her pancreas to (hopefully) heal. Shooting an 89 is like shooting a 59 for those who use a human meter....so it was a good call to skip this morning. The numbers you have been seeing are pretty low, and I agree that you should have gotten more testing in last night after you saw the 84, it isn't a good idea to give HC food and not test...I can't count the number of times we have seen cats continue to drop even with HC food.

Not too many here use the pet meters....they are much more expensive, and if you run out of test strips, they are not readily available. You might want to consider switching to a human meter.
 
I probably will get a human meter sometime in the future, but as much as it cost I want to use the alphatrak
for awhile anyway.

Talked to the vet, and she said that if she's running 80's to feed her and watch how she eats. If she eats good then shoot her if she just picks or doesn't eat than don't. This is the part that is confulsing me.

She also doesn't want me to adjust her dosage either, just watch how she eats.

what to do??
 
karisa, i think only you can decide what to do in conflicting advice between your vet and here. i've had the same situation and i opted to follow the advice here. i love my vet, i think he's very good, but i also know he isn't an expert on cat diabetes. they have 1 other diabetic cat in their practice and there are 3 full-time vets there. the people here do feline diabetes 24/7 and there are years worth of zillions of cats' experiences that they are drawing on. to me, the scale tips in favor of here.

edited - had some wrong info in there! whoops!
 
Hi again, Karisa,
You need help and in my opinion your vet is not giving it to you. Please don't follow her instructions at this time. Wait until you get advice from some of the very experienced people here. Sienne, Libby, Laurie, Jill, and others will be able to help you. There are many vets who do not have a good understanding of Feline Diabetes in general, much less of how a relatively recent insulin like Lantus works (it is very different from the insulins they learned about in vet school).

Sorry to be blunt, but Tasha's well being is paramount here.

Ella
 
Karisa and Tasha said:
I probably will get a human meter sometime in the future, but as much as it cost I want to use the alphatrak
for awhile anyway.

Talked to the vet, and she said that if she's running 80's to feed her and watch how she eats. If she eats good then shoot her if she just picks or doesn't eat than don't. This is the part that is confulsing me.

She also doesn't want me to adjust her dosage either, just watch how she eats.

what to do??
Click to expand...
Karisa, it's perfectly fine to use the AlphaTrak if you want to, I just wanted to throw that out there for you to consider. Please make sure that you keep an extra supply of test strips on hand, since they are not easy to get your hands on and it's Murphy's Law that you will run low when you need them most and the vet is closed! I would get a human meter as a backup even if you don't plan to use it...but that's up to you, of course!

What your vet is telling you (feed a number in the 80s and then shoot) is much more suited to the shorter acting insulins. Many vets have little experience with Lantus, and don't understand how different it is from the other insulins they have prescribed...the shed makes a difference. If you feed, and then shoot 30 minutes later, you will have no idea if Tasha is rising naturally, surfing, or dropping. Even if you test again after feeding, the test result will be food influenced, and you won't know if she is rising naturally or from the food. If you shoot a higher food influenced number, you run the risk of her dropping again when the food spike wears off and then the new dose onset starts....she could drop dangerously low. I would NOT do what your vet is suggesting.....and I am not one to bash vets, so please understand that I'm addressing this purely from a safety aspect.

I'm looking at Tasha's SS, and her numbers have been pretty low. I'm concerned about the preshot numbers you are shooting and not getting spot checks. It's very possible (even likely) that Tasha is seeing low numbers that you are not catching, and the fact that her PS number this morning was too low to shoot prompts me to suggest that you reduce Tasha's dose tonight. You need to reduce so that you can shoot consistently on a 12/12 schedule, and so that Tasha is safe when you are not able to monitor. It's very important to try to get spot checks in each cycle so that you can see where she is heading, and catch those lows. For the AlphaTrak, she earns a dose reduction by falling below 80...as you can see, she was quite close last night, and she may have gone lower than you realize....I suspect she did based on her +12 number this morning.

Can you get a test an hour before shot time and post the results here? It would help to decide how much you should reduce.
 
I agree with everything Laurie said.

I adore my vet. She is committed to trying to keep up with the current literature. In fact, she's a big fan of prescribing Lantus (unlike the ER vet who put Gabby on Humulin N). However, she'd never seen the journal article on the Lantus dosing protocol. I sent her a copy and it's the standard that they now use in their all cat practice. Even for a vet practice that specializes in felines, it's hard for the vets to stay current on every aspect of feline health. It's got to be even more difficult for a vet who sees not just one species.

With numbers at or around 80 on your meter, if it were me, I would think long and hard about shooting, and I've been at this for a while now and I will shoot low numbers. I won't shoot in the 40s (or what would be less than 80 on your meter). If you have a number in the 80s, there are other alternatives than shooting the full dose. Our overriding concern will always be about a cat's safety.
 
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