5/7 Nefeli +12 81 PMPS (+13) 79 0.5U (+2)85 (+3) 65

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nina_nefeli

nina_nefeli

Member Since 2010
AMPS 146 this morning and I was afraid of maybe dropping too low with 0.75 so I reduced dose to 0.5
PMPS 81 and in 20 min I am going to give her her 0.5 shot,isn't it too risky to do it?
Should I do it and just be prepared for hypoglycemia?
 
Re: PLS URGENT DOSE ADVICE

I think what you are seeing is shed from the .75u dose. It can affect up to six subsequent cycles in some cats. The 81 would be the lowest you've shot since Nefell came back on insulin. A few options

Options
1. You can stall and see if she rises and then shoot on the rise. This will depend on how late you can be in shooting over the next few cycles as you will have to slowly move the shot times back? If you select this option, do not feed but test every 20 mins and then shoot the .5u dose when she rises.

2. You can shoot the .5u dose again and monitor carefully...do you know how to handle low numbers? Do you have plenty of HC food, gravy, syrup, strips?

3. You can shoot even less of a dose but because of the cumulative nature of lantus...you still have the shed and the cycle will probably play out the same as shooting .5u.

4. You can skip

Because you don't have any tests after +3, I don't know if she's on her way up or is getting a second dip.
 
Re: PLS URGENT DOSE ADVICE

Have you retested? Have you withheld food? Any update? :-D

There are two links in my signature...one for dealing with low preshots and another for handling low numbers.

I can check in on you for another several minutes and have a course of action planned.
 
Re: PLS URGENT DOSE ADVICE

you are right I should have measured in between as well...

1. if I stall, then how do I go back to 9 o clock in the next days?
2. I have honey I can give her and HC food
3. if I shoot 0.25 can I shoot 0.5 next morning if the numbers are normal?
4. I dont think I want to skip it
 
Re: PLS URGENT DOSE ADVICE

Marjorie and Gracie said:
Have you retested? Have you withheld food? Any update? :-D
There are two links in my signature...one for dealing with low preshots and another for handling low numbers.
I can check in on you for another several minutes and have a course of action planned.
Click to expand...

she ate a little bit, and just measured 83. No shot yet (10 minutes late).
 
Re: PLS URGENT DOSE ADVICE

If you stall...no food until after you shoot...then you can get back to your normal time by shooting early 15 min each cycle starting in the morning or by 30 mins once a day starting tomorrow night. If you have fed, you'll have to stall longer to be sure what you shoot isn't food influenced.

If you've already been stalling, I wouldn't shoot .25u since stalling serves as a reduction. How late are you on the shot now?

Keep in mind that you hold the syringe and while we normally don't stall and shoot a lower dose, it's up to you. But yes, if you decide to shoot .25u, you can shoot .5u tomorrow morning. You still need to test tonight until she is safely up.

Please let me know what her most recent test is, if you've fed, and what option you prefer. Thank you :-D
 
Re: PLS URGENT DOSE ADVICE

we are at +20 minutes already;
will measure at +30' and see. The intention is to shoot 0.5u and monitor.
HOWEVER, the previous strips are finished, and must now switch to BAYER that give a lower reading (see ss).
So we may stall for 1 hour to be on the safe side.
 
Re: PLS URGENT DOSE ADVICE

If she's up and you have been keeping a comparison and they appear to be fairly close, I'd probably go ahead and shoot.

Are you ok with handling low numbers if she goes low or do I need to get someone to take over for me? I have an appointment in one hour so I can only stay with you a while longer. I will definitely be here for your next number, ok?
 
Re: PLS URGENT DOSE ADVICE

ok thank you so much!
in two min I am measuring again.
I dont think I ll see a big difference though...
 
Re: PLS URGENT DOSE ADVICE

ok, 56 with the new device that is around 63 with old one.
so I will wait...
If she wont go up should I skip it or should I shoot when she is up again even if it is 2-3 hour later?
 
Re: PLS URGENT DOSE ADVICE

I'm sorry....someone came to my door and I had to deal with that.

You should either skip or you can continue to stall without feeding to see if she comes up. If you skip, then shoot your normal dose at your normal time tomorrow or you can move it to any other time if you wish to change times. The amount of time you stall is up to you.

Most people don't stall past two hours because of how long it takes to make it up but there is no rule that you can't stall three hours. However, just keep in mind that if you stall until midnight, you have to shoot tomorrow morning twelve hours from that time minus 15 mins if you are going to make the time up that way.

Ok? Please let me know what you'd like to do. I'll see if someone is available for you if you decide to continue to stall.

FWIW, I think it's often best to go ahead and shoot when you have a shootable number above 50 and then FEED and monitor. Thwt often will bring the number up. If you don't, then you can often get into a situation like this where you have to skip. Something to keep in mind for the next time around.
 
Re: PLS URGENT DOSE ADVICE

Surfing...good. If she's still surfing or up at the next test, I'd shoot, feed, and monitor if you can stay up or set alarms to get up. I can be back in 30...I was able to push my appt back a bit.
 
Re: PLS URGENT DOSE ADVICE

10.00 79
since it is going up I am going to shoot 0.5 and pray...

I have HC food and honey so I dont think something bad will happen...
Thank you for your help, enjoy your day I dont want to keep you, I am going to stay up as it seems...
 
Re: PLS URGENT DOSE ADVICE

Great...yes shoot and feed. Be sure you get a +1 and a +2 to see where she's going. I'll see if Julie is around to check in. Could you please also use this same condo but change the subject line to

5/7 Nefell +12 81 PMPS (+13) 79

I'm not sure if I have those numbers and time right but you get the idea :-D I hope she has a nice surf.

Great shooting Nina! Hope you get some rest.
 
Re: PLS URGENT DOSE ADVICE

ok I shot 0.5U at 10.12
I think it is going to be ok, I am confident, thank you so much Marjorie for all you help and for postponing your appointment for us!!!
 
Re: PLS URGENT DOSE ADVICE

in fact, i am here! i'll be glad to keep checking in with you, nina.

can you please get a +1 and a +2 so we can see what nefeli is doing?
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

i'll check back with you after you've got your +1 and we can see what's next.

by the way, where are you located?
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

i would have thought we might see a little bit more of a food spike at +1, but obviously she's not in any trouble with an 83.

can you get a +2 and repost it? if the +2 is still around 80, then i think there are no worries. when the +2 and preshot are about the same, that usually signals a "gentle" cycle.

i'll be back in another hour to check in with you and we can see when the next BG check should be.

didn't know we had any members in Greece - that's fantastic! glad to meet you! :lol:
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

Hmmmm +2 80...

Yes I think there might not be another one in Greece taking care his diabetic cat like this, there is a lack of knowledge even from vets, we have tried too many. This forum saved Nefeli the previous time, we are so grateful to all of you, thank you for one more time :smile:
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

glad to see nefeli's holding steady.

i know it's night time for you. if this were punkin, i'd probably check every hour or so until past the BG's low point (nadir), but i don't know nefeli.

can you check again in another hour and repost? i'll be here still.

you've dealt with low numbers before, right? you know how to give high carbs if nefeli goes under 50?

it'd be a good idea to give a couple of teaspoons of your regular low carb food to encourage a nice little green surf.
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

I ll be awake for +3 and I ll set the alarm for +4
I will try to feed her a bit now.
It is ok if she drops below 50 I will feed her with CH (if she takes it because she is really picky with food) and if it gets lower like 30 or smth I will put some honey in her mouth. But we will see...

What if tomorrow morning she has AMPS 80 again? What should I do then? I am asking now, because I know you will be probably sleeping at that time.
And since I shot at +1 (22.10 instead of 21.00) should I shoot tomorrow morning at 9.55?
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

i'm not sure i understand the times, but the basic answer is that you want to shoot tomorrow morning 12 hrs after you shot tonight.

tomorrow morning if she is low again, i'd refer to this post to get guidelines. it's been revised and is pretty clear to follow. it depends on what else is happening, so it's hard to just say now what you should do in the morning. Read the part on "HOW TO DEAL WITH LOW PRESHOT NUMBERS:"

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

+3 65
she has eaten 30 min ago.
Shall I feed her again? I will measure in an hour again. Usually she gets her lowest at +4. She is sleeping on the rug next to my bed, snoring... :roll:
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

i would give her another 2 teaspoons of low carb and check her again in 30 minutes or so. but this is a nice gentle curve and if she usually gets her lowest at +4, she's probably going to be fine.

i'll be here in another 30 minutes and watch for your next test.
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

whenever it makes no sense, it's good to get another test. sometimes strips are wonky and don't read right.

grab another test. if it is 178ish, then nefeli might have bounced.
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

ok I did it twice with different drops from different spots of the ear
1. 87
2. 86
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

ok, so we'll assume that was a bad strip - it happens. i've had a couple of weird ones like that.

i have to go out, but it seems like you've got things under control. there are several others on the board right now, so if you get a number that you want help with, just post. it really helps if you keep editing the subject line of your first post of the thread so that the main forum page shows your latest information. many people skim the main page and will open a post if it looks like the person needs another eye.

if you get scared, you can also hit the 911 and someone will give you a hand. looks to me like you know what you are doing, though! great job. nefeli is looking really awesome - these are wonderful numbers for her.
 
Nice shooting!!

I just want to tweek a comment about getting a +2. If you look in the "New to the Group" sticky, there's a breakdown of what to expect with an ideal curve. Ideally, the +2 is roughly the same as your pre-shot. However, this can really vary from cat to cat. It looks to me like Nefeli may have an early onset and early nadir. You're often seeing numbers dropping by your +2. That can make it hard to sort out whether you're going to see a big drop by nadir or whether it will be a more typical (for Nefeli) cycle. Right now, I wouldn't necessarily conclude that Nefeli's nadir is at +4. You don't have much data from +4 through the rest of the cycle. Not having tests from the middle to later in the cycle may be skewing your interpretation.
 
Re: 5/7 Nefeli +12 81 PMPS (+13) 79

julie & punkin said:
when the +2 and preshot are about the same, that usually signals a "gentle" cycle.
Click to expand...
Just to clarify a little, in a "typical" Lantus curve (with a cat that has onset between +2 and +3) a +2 that is the about the same as preshot means that the numbers will probably be going down. You just don't know how far or how fast - this is a good reason to get a +3 or +4, just like you did. :smile: In most cats on Lantus, +2 is about when the insulin starts working. Nefeli's onset might be different, but at this point we don't have the data to know for sure.

If +2 is much lower than preshot, then you definitely need to pay attention. If +2 is much higher than preshot (in a cat with onset of +2 to +3) then you might be seeing the beginning of a bounce and might have an easy cycle. If +2 is about the same as preshot, then you can usually expect a descent into nadir. It might be a fast descent or it might be a slow descent (or, because we are dealing with cats, they might surf or they might turn around and go back up).
 
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