5/21 Topper AMPS 140 I Could Slap Myself

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J

Jan and Topper

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http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=95778

I couldn't make myself shoot him at 140. I'm so darned mad at myself. I told him we need lower PS's, he complied and what did I do?

I couldn't get online and didn't know if I should shoot a reduced dose or feed and wait two hours so I decided to feed and wait, in 2 hours his bg was 215. I shot at that time.

It seems like all I do is mess him up. He's felt so good today too, he's been racing around and even "attacked" a neighbor cat through the window.

I hope waiting to shoot doesn't set him back. Darn it.

He's having diarrhea again, and this time I haven't given him boiled turkey or anything else. I'm thinking about starting him on Probiotics, I can't afford the Ultimate Flora I've seen discussed here. Is there a cheaper one that is dairy and gluten free? I was giving PB8 to an IBD cat, but it is made from dairy.
 
You did not feel comfortable about shooting that low. That was the right decision to make, to delay the shot.

Think about what you would want to do next time he has a low number. Do you have high carb (HC) canned food? plenty of test strips? time to devote to the testing? would some lost sleep monitoring him impact something you need to do later that day or the next day?

Sometimes, you have to skip or delay the shot. Remember, this is a marathon, not a sprint. It takes time to get the numbers regulated, to feel comfortable shooting those low numbers. There is a lot to consider.

You gave the dose, 2 hours later than normal.

You can move the shot time 30 minutes once a day or 15 minutes per cycle.
 
Thank you Deb.
I'm not sure what to do next time, right now I'm not comfortable shooting below 180, but can probably do 160 or 150 - I'm thinking about it!!

I was hoping his PS's would come down gradually and give me time to get used to shooting lower and lower - big joke, I know.

I do have everything I need, HC, test strips, Karo Syrup...my own health is the problem if I need to stay up with him, it really impacts me when I lose sleep, but I know the possibility of needing to do that is part of this.
 
No slapping allowed!!

Here are the instructions for dealing with a low pre-shot. You might want to print this out so you have it handy if you can't get on-line.

What you might think about is that typically, if you're stalling, you don't want to feed. The only time you do feed and stall is if your kitty's numbers are in the 40s and then you give a small amount. Also, I wouldn't wait 2 hours. I'd suggest re-testing after 20 - 30 min. to see if numbers are rising.

Shooting low can be a gradual process. What I would suggest though is that you factor the 20% meter variance into how you lower your "no shot" threshold. If you're comfortable shooting 180, then the 20% meter variance would be roughly 30 points. So, how about shooting 150 or above next time?
 
Thank you Amy!
Sienne, I had printed out and was following this from the "Relaxed" forum:

What to do with low preshot test numbers

Q: My cat's pre-shot level was way below the usual value. Should I give the injection?

A:
There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
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I did actually retest 20 minutes later and the bg was 142. So then I decided to feed and wait a couple of hours.

When I tested at +2 and got the 215 bg, I realized, wait, that didn't make sense - of course the bg was going to come up, 140 was not that low of a number, why in the world wait two hours when it is going to take another 2-3 hours for the insulin to kick in? Catch it on the doggone rise!!

So I thank you and totally understand/agree. At least I didn't skip the shot altogether. Sheesh.

Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
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You handled everything beautifully! :-D You said Topper is feeling feisty? That shows what a great job you are doing, Jan.
Liz
 
Thank you Liz. I really feel like I mishandled this. But as I said, at least I didn't skip the shot entirely.

His numbers have been so crazy, at least to me, I guess all of you are used to crazy numbers, but I feel like I don't know if he's going to go up or down.
 
No, you didn't mishandle anything. You did a great job. And, yes, the numbers look crazy at first but you start to see patterns after a while. Keep asking for help - we are HAPPY to answer your questions. :-D We've all been there and want to help you and Topper. I think we are just as crazy about everyone else's cats as we are our own. :lol: :lol:
Liz
 
I think the one issue with SLGS is that when it was written, the long-acting insulins (i.e, Lantus and Lev) were not used as much as they are now. As a result, the instructions are geared more toward insulin like Humulin N, the older iteration of ProZinc, or Vetsulin/Caninsulin. Feeding and then waiting 2 hours may have made more sense (maybe). With Lantus, there's a longer period of time between shot and onset so there's much more time for numbers to rise.

Much of this process is figuring out what works for your cat. You did fine and you'll remember this for the next time -- and there will be a next time!
 
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