6/14 Boots |AMPS 259|+2 218|+4 188|+6 184|+9 211|PMPS 137

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Megan and Boots (GA)

Megan and Boots (GA)

Member Since 2015
So this is just me being a newbie and panicking because we're still new to even numbers in the 100s, but this was the lowest yet, and it was his PMPS at 137. He was hanging out in the 180s around 4-6 which seems pretty typical for his nadir (I think... still trying to make sense of all the readings when he clearly doesn't understand what a "curve" is supposed to be shaped like!). He often times seems to have his lowest reading (that we get, anyway) of the day at either the +3 to +5 neighborhood, OR sometimes his PMPS is the lowest, lower than his AM cycle +3ish.

Can someone help me make sense of his numbers by checking out his spreadsheet? I know we're just starting still, and we only have a couple weeks' worth of numbers. We also haven't been doing any mid-night readings to speak of; just catch a +3 most nights before bed during the week, sometime a later one on weekends. His night cycle seems to be lower, but then bounces back up for his AMPS reading which tends to be high.

I guess I'm just still trying to figure out what his nadir really is. Now that we're getting more regularly near the "normal" range (albeit the high end still), I want to be sure I really understand how he's reacting to the Lantus, and I am feeling frustrated and helpless that his numbers just don't seem to be consistent enough that I feel confident in saying that I know exactly when he hits his lows during the day. Do I just need more time / more readings? I am hoping that one of you more experienced folks with a more well-trained eye than I have can look at his numbers and help me make a little sense of them.

Also, re: dosing, should I just stick at 2.5 for a few more cycles to see how he handles that dose?

Any insight and advice is appreciated!
 
It's nice to see him starting to respond!!

Since you shot a number lower than you've shot before, I'd plan on getting a +1 and a +2 tonight and see how he's doing

You'd want to hold this dose for at least 8 cycles unless he drops below 50 or starts to get some green nadir's. If he starts to get some green nadir's, you'd want to hold it 8-10 cycles. If he drops below 50, that's an automatic reduction of .25

Since he did have such a nice blue number at PMPS tonight, I'd plan on holding this 2.5 dose for at least 8 cycles before thinking of increasing again

Are you still using the AlphaTrak?

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
Click to expand...
 
Hello and Welcome Megan and Boots! For those wanting to follow a little history, here are your first post Introduction and in the Health forum. Considering that you are using an Alphatrak meter, Boots is starting to look good at this dose. Since you are using an AlphaTrak, the reduction point for you is 68.

The first time you shoot your lowest ever preshot, it's a good idea to get a +1 and a +2 test to see what the cycle might look like. Since he was dropping into PMPS, it could be an active cycle tonight. If you haven't already, I'd ready the posts marked Sticky Note here. Lots of good information. For tonight, the post on Shooting and Handling Low Numbers is a good one. When I started, I printed off that one, just in case I needed to refer to it and couldn't get on the internet for some reason.

It looks like he might want to nadir around the +4 or +5 time sometimes. However, the nadir is the lowest point of a cycle, and isn't always the same time in every cycle. Some cats are worse than others. Neko reliable nadired somewhere between +3.5 and +13 when she was on Lantus. :rolleyes: If cats are bouncing (see the second post here) and then break the bounce, their nadirs can be later. Another post you might find helpful is the one called Where Can I Find Info On, that you might want to bookmark.
 
Thanks! I am encouraged to see him getting 100s more frequently, just a little startled today to see such a drop for the PMPS! Like I said (and his SS shows), I know sometimes his PMPS has been his lowest reading of the day, but I guess I was figuring those 180s would be the lows for the day, so it surprised me (in a good way, I guess!).

We are still using AlphaTrak 2 and the AT strips. I have Freestyle Lite strips too but haven't used them since restocking on the AT2 strips.

So the bad news is I didn't catch your messages in time for a PMPS +1, but we did snag a +2 and he's up at 159 now (you can see his SS comment, the 137 surprised us so we did another check and got 149). With the exception of 6/10, he normally drops a bit after his PMPS (normally we read a +3 and it's down a smidge), so we'll do another check before bed (will be a +3) to see where he is. Maybe the 137 was just a low fluke? Stupid question - I know high stress levels (as seen during vet visits for example) can raise BG. Can low stress make it drop? I ask because right before his PMPS, I had taken him out to the backyard where we were just sitting at the patio table relaxing and enjoying the evening (he's an indoor kitty, but we occasionally take him outside on a leash for backyard walks or to sit at the table). He seemed super relaxed and calm and enjoying himself, which is why I ask :)

Chris - when you say to hold the dose for 8 cycles, would that be 8 more, or 8 total (started 2.5 two days ago)?

Wendy - thanks for the links (both to our stuff and the reading for me). I'll check the bouncing and Info posts out!

I'll check back in with our +3 for the night. Progress is exciting, but I have to tell you that I am nervous about reaching the point where we start to get lower numbers. It's good, but the thought of hypo is scary, especially since we don't feel confident that we know exactly when his low will normally be. +4-5 seems about right ... most days ... Guess Boots might be about as reliable as Neko!
 
Here is the quote from the Tight Regulation Protocol Sticky:
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
Holding for at least 8 cycles would include the 4 you've done already, so 4 more cycles, unless he goes under 68 before then.

I've not seen low stress lower numbers, but exercise will if he was walking around a bit.

Low numbers are scary the first few times. If you ever see a number you are nervous about, post here for help. Do you have some high carb food (greater than 12% carbs) around? Or a drop of karo/honey/syrup on his regular food will do as well. It's always good to have lots of test strips and some high carb food. You never know when they'll decide to have an interesting cycle.
 
Thanks - we'll hold 2.5 then for a bit and hopefully start to - slowly! - get used to some of these 100s we're seeing more of. While of course I want him to get to "normal" yesterday, I also am scared of those low numbers we have ahead of us, so I'm fine with it if he takes a couple days to ease his way down til he's getting more and more 100s. God help me when he hits <100, I'll be a nervous wreck and will definitely be posting for help and guidance!

Well, hard to call it exercise, honestly. We go outside, and he meanders here and there on his leash with an occasional plop down to roll around on the concrete (LOVES rubbing his face on it and rolling). But I guess it was more exercise than he got all day inside, so maybe that was it. Go walks! :)
 
Oh, and yes we have high carb food on hand. Polly hasn't been transitioned to wet food yet so we have her kibble around still. Also have honey and corn syrup and maple syrup on hand... just in case.
 
I did mean to ask what you were feeding Boots. Any chance he's getting into any of Polly's food. Kibble isn't the best choice as a high carb food as it can take longer to raise the BG's and hang around longer. Looks like Boots is pretty flat tonight.
 
Once you start getting those green numbers, you'll get addicted to them!!

Everyone comes here thinking "I could never let my cat get that low!!" because they've been warned and scared to death of hypo's, but one of the main reasons we're so big on home testing is that as long as you're testing, you're in control....it's the people who shoot blind that are at the biggest risk of coming home to a tragedy.

The first few times he drops below 68, you'll learn how well he responds to high carb gravy or Karo/syrup/honey and you'll gain confidence each time that you CAN handle this!
 
Hi Megan! Just want to add my welcome - and kudos for shooting that 137! Looks like Boots is at a dose that is good and he's starting to make progress.

One thing I'd like to mention is that Lantus has the quality of holding blood sugar flat when the cycle starts lower. So as you work your way to shooting lower numbers, you'll see some flatter cycles. With an AT you want to work to shooting everything over 90 if you're following Start Low Go Slow, or 68 if you're following Tight Regulation Protocol, provided you can monitor afterwards and you have high carb supplies and at least 20 strips. As you shoot progressively lower numbers, notice how the cycle will flatten out - like tonight, you shot a 137 and it looks like he's holding around 150AT in the first few hours of the cycle.

If you get a lower preshot and you're on your way out the door, that's not the time to shoot low (ie, shooting the full dose into normal numbers.) If you have that situation, post here and ask for someone to give you a hand figuring out how to proceed. The sticky on "Shooting and Handling Low Numbers" also has a section on your options if you have a preshot lower than you've had before.

Glad to have you here - looks like you're off to a great start and Boots is responding really nicely. Keep asking questions!
 
Thank you everyone! What amazing support and knowledge there is here from all of you, it's so comforting to know that so many others have been where we are now!

To answer a couple questions: We are doing tight regulation. I am 99% confident Boots hasn't gotten into Polly's food. He's on two kinds of canned food currently - Nutro chicken senior soft loaf and FF Classics Chicken Pate. We have two other kitties - Emily is nicely transitioning to wet food now. Polly - not so much! She is one of those cats who just doesn't recognize canned food as food, so it's going to take time with her. So for now, we're still feeding her Blue Indoor kibble, but we're super careful about monitoring to make sure she eats her meals (she eats very quickly) while Boots is eating his (in another room), then we put her kibble bowl away (on a shelf so high, *I* can barely reach it, zero chance he could get to it). So there's always the chance a stray kibble or two rolled on the floor under a chair or something and he got it, but I doubt he's doing any real damage. We switched him to freeze dried chicken treats, too. But I'll grab a couple cans of something with some high carb gravy to have on hand if that'll work faster than kibble.

And do you know how scary the thought of shooting a 68 sounds to me?! I guess I'll slowly get used to the lower numbers.
 
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