? 6/5 Max AMPS 118; New to this and only finally getting info by using the Libre sensor.

[Rebecca & Max (GA)]

First time posting to the message board, and looking for some help with Max and his BG numbers. First off, I have to say we have had an extra hard time trying to get blood from Max’s ears to test. More in that later... I finally begged my vet to try the Libre sensor so I could get consistent reads. Max’s first read yesterday was 128 mg/dL, and his PMPS was 229. My vet said to only give Max 0.5U of Lantus is he was around 200, and only give the full 1U dose if he was 300 or higher. I checked Max until 1:30 AM and saw him go up a bit then drop. I didn’t test him again until 5:30, but the graph the Libre shows me showed that Max dropped below 80 at 4:30 AM. I did not give Max his AM shot this morning (but I feel now like I should have given him something!) because he was 118. He hypoed at the Vet last Wednesday during his curve, and dropped to 53 on my on Sunday after blind dosing, so now I’m scared all around. I have watched his BG steadily rise all day,l (photo included) and now it’s time for his PM shot and I don’t know what to dose to give him tonight! I know there isn’t enough info on the spreadsheet to get much info, but anything anyone can suggest would help greatly.

 

[Bron and Sheba (GA)]

Hi Rebecca and Max and welcome,
Some questions first if you don’t mind.
What type of meter were you using when Max dropped to 53 on Sunday and what dose was he getting then?
Do you have high carb food and honey or Karo in the house in case of low numbers?
What type of food are you feeding now?
Has Max ever had ketones in his urine or DKA?
When he hypoed at the vet last Wednesday what dose had he been getting?

 

[Wendy&Neko]

Hello and welcome. On this message board, we find it's best to give the same dose AM and PM with the dosing methods we use, and because of the way the Lantus depot works. The older style insulins used to be dosed based on preshot numbers. Also, are you going to be using the Relion from now on? It's a been confusing for me following the numbers when the type of meter keeps changing. It's best to pick just one type, and stick to it.

The answers to Bron's questions will help us determine how to help you with dosing.

 

[Rebecca & Max (GA)]

Hi Rebecca and Max and welcome,
Some questions first if you don’t mind.
What type of meter were you using when Max dropped to 53 on Sunday and what dose was he getting then?
Do you have high carb food and honey or Karo in the house in case of low numbers?
What type of food are you feeding now?
Has Max ever had ketones in his urine or DKA?
When he hypoed at the vet last Wednesday what dose had he been getting?

Hi Rebecca and Max and welcome,
Some questions first if you don’t mind.
What type of meter were you using when Max dropped to 53 on Sunday and what dose was he getting then?
Do you have high carb food and honey or Karo in the house in case of low numbers?
What type of food are you feeding now?
Has Max ever had ketones in his urine or DKA?
When he hypoed at the vet last Wednesday what dose had he been getting?

I have been using the AlphaTrak 2, but of course ran out of strips before my order arrived (bought the Relion so I had something to test with). The numbers I had 5/31 were all from the AlphaTrak2. He was back down to 1U by then. He hypoed at the vets during his curve on 5/27 (he was 2U then; vet told me to drop him back down to 1U starting Thurs AM).

High carb food (for my CKD cat) and organic corn syrup in the house.

Max has been on Weruva pouches sine before DC- trying time keep him at the same carb % between flavors - current food of choice is 7.1% carbs. He was allowed dry food when we started all this but that has been gone for about two weeks (it was snack food, not his main meals).

I have not tested him for ketones, and I don’t think the vet mentioned them (maybe not tested for them either?).

And again, he was at 2U when he hypoed at the vet.

 

[Rebecca & Max (GA)]

Hello and welcome. On this message board, we find it's best to give the same dose AM and PM with the dosing methods we use, and because of the way the Lantus depot works. The older style insulins used to be dosed based on preshot numbers. Also, are you going to be using the Relion from now on? It's a been confusing for me following the numbers when the type of meter keeps changing. It's best to pick just one type, and stick to it.

The answers to Bron's questions will help us determine how to help you with dosing.

I know we are all over and not consistent with readings. It has been externally difficult to test Max. I’m sure the high numbers do not help but it has been hard getting blood, and if we do manage to get some, he fights us even when we try to collect the sample. We have been using many suggestions from the Board and the FB group, but it’s still been very challenging. If I don’t know his BG levels, I either blind dose or don’t dose. It’s been frustrating and scary since day 1.
I preferred the AlphaTrac as the sample size seemed to be smaller. I only bought the Relion out of desperation because my order of test strips didn’t arrive before we ran out. I’m failing at every caution that’s here (have test strips on hand, etc.). Our vet sees nothing wrong with blind dosing, but I have not been able to get consistent reads until the Libre sensor, and I’m sure I have messed things up royally.

 

[Chris & China (GA)]

Hi Becky!! I just wanted to say Hello and it's great to see you over here from the Facebook group!

I know the struggles you've had with Max. Hopefully you'll get some useful information in the next couple of weeks and that the Libre will work for the whole time.

Hang in there on the testing with the regular meter, whichever one you decide to use. You've heard all the pro's and con's of the different meters on Facebook as well as the pro's and con's of the Libre!

I promise you that the vast majority of cats will accept testing, but occasionally we run across one that just has to be "different". I know we've discussed trying a cat bag that's used for grooming problem cats and you're concerned he wouldn't be test-able in that either. I was thinking maybe if you have a spare pillowcase, you could cut a hole out of the "sealed" side and see how he reacts to having it slipped over his head. If he doesn't fight it much, getting a heavier material like some of the cat bags are made of may be the answer.

Keep posting and the people here will do everything they can to try to help you!

 

[Bron and Sheba (GA)]

You are wise not to blind dose. I would not do that either.
I see the 80 or below you said he dropped to last night is not on the SS. Can you add that please? Thanks

 

[Rebecca & Max (GA)]

You are wise not to blind dose. I would not do that either.
I see the 80 or below you said he dropped to last night is not on the SS. Can you add that please? Thanks

It was only seen on the graph I got back when I tested him at 5:30. I do not have a accurate number as it wasn’t from a test I did. I saw a drop on the graph at 4:30 AM. I can guess the number (looks to be 70 to 75) and I will add if if need be, but had not because it wasn’t a read I took. If I had been doing ear pricks I would have never seen that, as I was asleep at 4:30 AM.

 

[Rebecca & Max (GA)]

It was only seen on the graph I got back when I tested him at 5:30. I do not have a accurate number as it wasn’t from a test I did. I saw a drop on the graph at 4:30 AM. I can guess the number (looks to be 70 to 75) and I will add if if need be, but had not because it wasn’t a read I took. If I had been doing ear pricks I would have never seen that, as I was asleep at 4:30 AM.

Since I have the graphs to look at, should I attempt to fill in the missing times, or would that make things worse, as they aren’t reads I took? The sensor takes a reading every 15 min, abd that’s what I see in the graph.

 

[Bron and Sheba (GA)]

I think add 75 and put a note in the remarks column that you saw it on the graph.
It does tell us he dropped lower which is the important part.

 

[Rebecca & Max (GA)]

I think add 75 and put a note in the remarks column that you saw it on the graph.
It does tell us he dropped lower which is the important part.

Done, thank you!

 

[Bron and Sheba (GA)]

Let’s see if @Wendy&Neko is still around or @Chris & China (GA).
Are you feeding Max during both cycles as well as preshot? ....giving him a couple of routine snacks?
I think that 0.5U should be ok but let’s see what the others think.

 

[Rebecca & Max (GA)]

Let’s see if @Wendy&Neko is still around or @Chris & China (GA).
Are you feeding Max during both cycles as well as preshot? ....giving him a couple of routine snacks?
I think that 0.5U should be ok but let’s see what the others think.

I hope I understand your question fully... he is fed before each shot (usually between 8-10 AM & PM). I try hard to keep it 12 hrs between. He usually gets a snack (a tsp of wet food) at midnight, and again around 4 AM if he’s up (he got used to my hubby being up for work and feeding him). Every so often he asks for food between 3 and 5, but that not the norm. I’ve been trying to keep his feeding/eating times consistent. I have been adding boiled chicken as rewards/treats for testing him 2x/day, but am not sure if that messing things up.

 

[Rebecca & Max (GA)]

I hope I understand your question fully... he is fed before each shot (usually between 8-10 AM & PM). I try hard to keep it 12 hrs between. He usually gets a snack (a tsp of wet food) at midnight, and again around 4 AM if he’s up (he got used to my hubby being up for work and feeding him). Every so often he asks for food between 3 and 5, but that not the norm. I’ve been trying to keep his feeding/eating times consistent. I have been adding boiled chicken as rewards/treats for testing him 2x/day, but am not sure if that messing things up.

He may not be getting food during the first cycle (after his AM shot), as he often goes out to sleep under our kitchen window or on a bed inside.
Max was an outdoor cat when he adopted us 25 yrs ago. He finally spends most of his time inside, but sometimes prefers the outdoors. We live in a dead end street and he stays on our property. No one on our street has dry food out, so he only gets what we feed him...not that you asked, sorry!

 

[Chris & China (GA)]

I agree....let's see how it does over the next few cycles while we get used to the Libre readings.

You don't need to necessarily enter every test the Libre does, but try to add results to your spreadsheet that are at different points in the cycle....like one cycle do +2, +5, +8 and another add the +3, +6, +9...."sprinkle" them around so it shows a good overall sample of what's going on.

Always enter the lowest test result you can estimate (if you didn't actually scan to get a test)....Lantus dosing is based on how low it takes them so that's an important number!

Max shouldn't eat for the 2 hours immediately before Pre-Shot tests, so if you plan on shooting at 9am/9pm for example, he shouldn't eat between 7 and 9 so his number isn't influenced by food

 

[Chris & China (GA)]

Max was an outdoor cat when he adopted us 25 yrs ago.

25 years ago?? Really? Or is that a typo??

 

[Rebecca & Max (GA)]

25 years ago?? Really? Or is that a typo??

OMG, typo!! 14 years ago!! I was one off for each number. Going on about 4 hours of sleep.

 

[Bron and Sheba (GA)]

It is good to keep the feeding consistent. And it’s fine to give a treat when you test.
I would give a good meal before the insulin and then a couple of good snacks at say +3 and + 5 both cycles and if he asks for food later, as long as it’s not for the two hours before the shot, I think he could have a teaspoon food.....all low carb of course.

 

[Bron and Sheba (GA)]

25 years ago?? Really? Or is that a typo??

Hi Chris! my eyes opened wide too when I saw that!

 

[Chris & China (GA)]

We all understand!! Welcome to the wonderful world of sleep deprivation known as "feline diabetes"....we've all been there!!

I figured it had to be a typo. Max is way too young looking to be a quarter of a century old!

 

[Rebecca & Max (GA)]

I agree....let's see how it does over the next few cycles while we get used to the Libre readings.

You don't need to necessarily enter every test the Libre does, but try to add results to your spreadsheet that are at different points in the cycle....like one cycle do +2, +5, +8 and another add the +3, +6, +9...."sprinkle" them around so it shows a good overall sample of what's going on.

Always enter the lowest test result you can estimate (if you didn't actually scan to get a test)....Lantus dosing is based on how low it takes them so that's an important number!

Max shouldn't eat for the 2 hours immediately before Pre-Shot tests, so if you plan on shooting at 9am/9pm for example, he shouldn't eat between 7 and 9 so his number isn't influenced by food

I remembered that from the FB page! He’ll eat between 4 &. 4:45 and then ask to go out. Sometimes he comes right back in, other times he goes to his spot and sleeps until 8. Trying to test him in the AM has been pushing breakfast till much later. I may offer a feed around 3 or 4, but make sure he hadn’t eaten before his 8-10 pm test. Except the times I was desperate to get blood and keot trying even after he was fed.

 

[Rebecca & Max (GA)]

We all understand!! Welcome to the wonderful world of sleep deprivation known as "feline diabetes"....we've all been there!!

I figured it had to be a typo. Max is way too young looking to be a quarter of a century old!

so is it okay to give him 0.5U? He was fed almost two hours ago, so I’m scared I have messed it all up again!
If so, then do I need to wait 12 hrs until I can dose again, or can I dose at say 10 am?? Our times were so good (ugh, blind dosing) until I really tried testing him Am & pm!

 

[Bron and Sheba (GA)]

What time is it now and what time would you like to have the insulin doses given?
I wouldn’t skip for a second time in a row with a high BG

 

[Rebecca & Max (GA)]

so is it okay to give him 0.5U? He was fed almost two hours ago, so I’m scared I have messed it all up again!
If so, then do I need to wait 12 hrs until I can dose again, or can I dose at say 10 am?? Our times were so good (ugh, blind dosing) until I really tried testing him Am & pm!

What time is it now and what time would you like to have the insulin doses given?
I wouldn’t skip for a second time in a row with a high BG

its 11:35 pm here. I don’t want to skip it either, and will adjust tomorrow as needed. I prefer between 8 & 10, but am willing to shoot whenever I need to

 

[Bron and Sheba (GA)]

Ok shoot now and then you can go back either 1/4 hour per cycle OR 1/2 hour once a day until you get to the time you want to shoot. It will take a few days but you will get there

 

[Bron and Sheba (GA)]

I’d feed him another good snack now though as you said you fed 2 hours ago

 

[Rebecca & Max (GA)]

I’d feed him another good snack now though as you said you fed 2 hours ago

THANK YOU!!

 

[Bron and Sheba (GA)]

THANK YOU!!

You are very welcome!
Try and get a couple of tests in a during the first half of the cycle if you can. I know it’s the middle of the night. It looks like around +6 is his nadir but of course that can move around too.

 

[Chris & China (GA)]

Try and get a couple of tests in a during the first half of the cycle if you can. I know it’s the middle of the night.

Since she's got the Libre on, I'd suggest she just get a good night's sleep, especially since he's over 500.

It will continue taking readings all night....she'll just have to estimate the exact number when he drops overnight (like we're guesstimating the 75)

You can leave a little food out for him if you want to too. Just remember to pick it up in the morning by 9:00am …...Then do your AM test reading at 11:00 (to work your way back to the time you choose to shoot), then feed his morning meal and shoot. With Lantus, you don't have to wait between feeding and shooting. Most of us test/feed/shoot all in about 5-10 minutes and do the shot while their head is in the bowl. As long as he's willing to eat, he's got usually 2-3 hours before the shot starts to "kick in"

 

[Rebecca & Max (GA)]

You are very welcome!
Try and get a couple of tests in a during the first half of the cycle if you can. I know it’s the middle of the night. It looks like around +6 is his nadir but of course that can move around too.

It’s now 1 AM, but I took a read. It’s still reads “HI”, but I did see his BG dip on the graph a bit after he got some food and his insulin. Will try and make it another hour (drinking my strongest tea). If Max or the dog with dementia wakes me after I finally get to sleep I’ll test him then as well.

 

[Bron and Sheba (GA)]

It’s now 1 AM, but I took a read. It’s still reads “HI”, but I did see his BG dip on the graph a bit after he got some food and his insulin. Will try and make it another hour (drinking my strongest tea). If Max or the dog with dementia wakes me after I finally get to sleep I’ll test him then as well.

I think you could safely go to sleep now.

 

[Rebecca & Max (GA)]

I think you could safely go to sleep now.

I made it to 2AM and he read 470 mg/dL. Made going to sleep easier. My husband so kindly woke me a bit after 3 am as he was getting ready to go deep sea fishing, tested Max (+4) and saw 396 and a dropping arrow (a trend the sensor picks up I assume...it’s either angled 45 degrees up, down, or it’s flat). Crashed hard asleep until the CDK kitty wanted food at 5:52. Max read 376 (+6). He wanted food too as he’d usually eat in the early AM, I offered him the 4.6% carb I fed him before him PM shot. My daughter woke me with her testing him at 8:39 (+9, back up to 395, but expected with the food) and offered him a teaspoon of the 4.6% food as it’s usually his test time window. Planning on AMPS at 11:15 (will have a 2 hr fasting window) and shooting the 0.5U recommended last night. Interesting trend, he dipped the lowest on the graph at 4:30 am again (+5 this time) so it’s something I will make a point to look for this afternoon and tomorrow morning!