? 6/7 DIFFICULT SITUATION. 6/7 HUMAN METER +7 93, +8 83, +9 LOW, +10 102
- Thread starter Kathy and TiTi
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julie & punkin (ga)
Member Since 2011
Is this +12 for you?
Kathy, I'm wondering if you shoot now at midnight, are you going to be able to monitor this cycle?
Are you wanting to shoot at 12am and 12pm? I thought your shot time had been earlier. What is your preferred shooting time?
Kathy, I'm wondering if you shoot now at midnight, are you going to be able to monitor this cycle?
Are you wanting to shoot at 12am and 12pm? I thought your shot time had been earlier. What is your preferred shooting time?
Kathy and TiTi
Member Since 2016
On 6/6, I had a weird set of numbers, so I waited to shoot and that screwed up my 10am - 10pm shot times. I shot 3 hours late. It's in the comments for 6/6.
Harvey figurd I could safely take the nxt day's shot at 12am - 12 pm. So I did.
Kathy and TiTi
Member Since 2016
How long must I monitor it, and yes, probably. But I need a ball park figure.
If no ball park figure is possible, then ok. I can do it. I'd hate for her to go sky high again.
Was this a bounce?
Or what? I didn't even realize that shooting at 90 on the AT2 was shooting to a low number.
Georgia said it was low because TiTI is on such a high depot. I had no idea.
Yes, 12- -12 is the new shooting time, as per June 6th , when a late shot occurred - like 3 hours late because of fear of falling numbers.
julie & punkin (ga)
Member Since 2011
The reason I'm asking is because one option is to skip the shot now and then get back on track in the morning at the time you want to shoot. If you prefer to shoot at 10, this might be an opportunity to get you to that shot time.
Can you get a new test with the Contour now?
Can you get a new test with the Contour now?
Kathy and TiTi
Member Since 2016
I forgot to mention that I am supposed to walk back the dosage by .25 units. But I've no syringe nor calipers to measure anything other than .5 units. My syringes are in whole units.
However I think I still have some tuberculin syringes.
I'll go check. If you understand those measurements I can probably use them.
Kathy and TiTi
Member Since 2016
yup. On my way to test.
Sandy and Black Kitty
Member Since 2009
The safest way to get back on schedule following a stall is to:
- Either shoot 15 min early each cycle until you are back to your preferred shot time
- Or shoot 30 min early once every 24 hours until you are back to schedule.
julie & punkin (ga)
Member Since 2011
Got a new test yet?
Kathy and TiTi
Member Since 2016
Sorry. I had not done a control test.
this meter has an autolog, meaningI can test BG and indicate if it is for fasting, pre-meal, or post meal, so I tested for post meal and fasting:
107
97
julie & punkin (ga)
Member Since 2011
Kathy and TiTi
Member Since 2016
There's an option to turn off autolog. I don't know if the numbers change depending on whether or not you choose fasting, pre-meal, or post-meal. I think it's just a way to record the conditions .
julie & punkin (ga)
Member Since 2011
Kathy, several of us think you should consider skipping the shot tonight and then you could shoot at 10am (or whatever time you want as your new shot time) in the morning.
Tricia will let you know what to do about the glucometer settings.
For a new dose, let's see what TiTi does between now and morning. Can you get a test about 9:00am your time and post here if you need any help figuring out what to do? We're thinking a reduction to about 13u range, depending on what she does overnight. She may bounce from hitting the LOW/green numbers today, but remember that dose decisions with Lantus are made based upon how LOW the dose can take the cat, not the high numbers that come in a bounce.
I'm not sure what tuberulin syringes are. You need insulin syringes for a u-100 insulin. Specifically (from the sticky about syringes.)
So to summarize our suggestions:
- Tricia will let you know what setting to use on the glucometer
- skip the shot tonight
- test at 9am in the morning and post if you have any questions
- reduce her dose at about 13u
- use appropriate syringes
What do you think about all of that? Questions?
Tricia will let you know what to do about the glucometer settings.
For a new dose, let's see what TiTi does between now and morning. Can you get a test about 9:00am your time and post here if you need any help figuring out what to do? We're thinking a reduction to about 13u range, depending on what she does overnight. She may bounce from hitting the LOW/green numbers today, but remember that dose decisions with Lantus are made based upon how LOW the dose can take the cat, not the high numbers that come in a bounce.
I'm not sure what tuberulin syringes are. You need insulin syringes for a u-100 insulin. Specifically (from the sticky about syringes.)
SYRINGES:
- U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus or Levemir from vials, cartridges, and pens. BD, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings. Needle gauge and length is your preference Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
So to summarize our suggestions:
- Tricia will let you know what setting to use on the glucometer
- skip the shot tonight
- test at 9am in the morning and post if you have any questions
- reduce her dose at about 13u
- use appropriate syringes
What do you think about all of that? Questions?
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Kathy and TiTi
Member Since 2016
yes.Kathy, several of us think you should consider skipping the shot tonight and then you could shoot at 10am (or whatever time you want as your new shot time) in the morning.
Tricia will let you know what to do about the glucometer settings.
For a new dose, let's see what TiTi does between now and morning. Can you get a test about 9:00am your time and post here if you need any help figuring out what to do? We're thinking a reduction to about 13u range, depending on what she does overnight. She may bounce from hitting the LOW/green numbers today, but remember that dose decisions with Lantus are made based upon how LOW the dose can take the cat, not the high numbers that come in a bounce.
I'm not sure what tuberulin syringes are. You need insulin syringes for a u-100 insulin. Specifically (from the sticky about syringes
SYRINGES:
- U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus or Levemir from vials, cartridges, and pens. BD, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings. Needle gauge and length is your preference Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
So to summarize our suggestions:
- Tricia will let you know what setting to use on the glucometer
- skip the shot tonight
- test at 9am in the morning and post if you have any questions
- reduce her dose at about 13u
- use appropriate syringes
What do you think about all of that? Questions?
-Why 13? Tell me, please, precisely why. I need to know, so I can feel safe. My concern is that the combined factors of very tardy shooting, and a 2 unit drop, will cause her numbers to soar again.
-I only have whole number syringes. I was going to get some today, but between work, and TiTi's fall downward. That did not happen.
Kathy and TiTi
Member Since 2016
testing tomorrow sounds good. 9am, and figure it out from there. But is it safe to go to sleep?
julie & punkin (ga)
Member Since 2011
Tricia says she doesn't know much about it but she sent the instructions with it.
She "earned" a reduction today. We don't know for certain that the LOW was good, but clearly things have changed with your correction of the meter coding and your removal of the dry food she was eating. I think we should assume the LOW was accurate.
Cats on 1u get dose increases and decreases of 0.25u most of the time. That's a 25% change in dose. If we reduced TiTi's dose by 25%, that would be to a new dose of 11.25u per shot. The 13u is more than a 10% reduction but less than the 25% reduction. The most important numbers you get are the low numbers, not the high numbers.
It's very important not to give a dose again that can get a cat into LOW numbers.
Does that make sense?
As far as syringes, do you have more of what you have been using? If you have at least 1 more, hopefully you can get more of what you need tomorrow morning.
I would NOT use the Tuberculin syringes.
She "earned" a reduction today. We don't know for certain that the LOW was good, but clearly things have changed with your correction of the meter coding and your removal of the dry food she was eating. I think we should assume the LOW was accurate.
Cats on 1u get dose increases and decreases of 0.25u most of the time. That's a 25% change in dose. If we reduced TiTi's dose by 25%, that would be to a new dose of 11.25u per shot. The 13u is more than a 10% reduction but less than the 25% reduction. The most important numbers you get are the low numbers, not the high numbers.
It's very important not to give a dose again that can get a cat into LOW numbers.
Does that make sense?
As far as syringes, do you have more of what you have been using? If you have at least 1 more, hopefully you can get more of what you need tomorrow morning.
I would NOT use the Tuberculin syringes.
Most of the cats around here are getting fairly small doses and so the depot is small. The depot with a 15u dose is quite large.
If a cat is on, for example, 1.25u and they take the normal 0.25u reduction that is a 20% reduction. Reducing from 15u to 13u is only a 13% reduction.
Also consider that she is just getting wet food now so that will drop the BG and we don't know to what extent the incorrect coding on the AT affected the accuracy of the tests. Also, reducing by 2u will make it easier if you only have syringes with unit markings.
Please do not use tuberculin syringes. They are not the same as insulin syringes and, I believe, they read in mls, not units. At least the tuberculin syringes I have read in mls.
I have a Bayer Contour and never set it on any specific setting. I used control solution to code it and used it.
If a cat is on, for example, 1.25u and they take the normal 0.25u reduction that is a 20% reduction. Reducing from 15u to 13u is only a 13% reduction.
Also consider that she is just getting wet food now so that will drop the BG and we don't know to what extent the incorrect coding on the AT affected the accuracy of the tests. Also, reducing by 2u will make it easier if you only have syringes with unit markings.
Please do not use tuberculin syringes. They are not the same as insulin syringes and, I believe, they read in mls, not units. At least the tuberculin syringes I have read in mls.
I have a Bayer Contour and never set it on any specific setting. I used control solution to code it and used it.
Gill & George
Member Since 2015
Morning Kathy
When did you last give HC?
From what I gather from the thread it seems that was at +10, two hours ago, If that's the case, I might be tempted to get one more test done but don't feed in the meanwhile, just to be on the safe side. If she remains the same or higher without food, then I think it would be ok to give her her bedtime snack and go to bed.
Just want to make sure that those carbs aren't going to suddenly wear off and her BG go to low while you sleep.
julie & punkin (ga)
Member Since 2011
Also Kathy, I would expect her numbers to zoom up by morning. She got into lower numbers than she's been in & her body isn't used to them, plus she stayed in normal range for the entire cycle. Even if you'd shot on time tonight I think it would be likely for you to see high numbers by tomorrow. Maybe not, but it would be typical if she went high tonight.
Even with that, I would reduce the dose in the morning because my focus would be on how low she got today.
I'm going to bed - long day and I have to work tomorrow. Hopefully someone will be online in the morning if you need help, but I think we've gone over it all tonight as much as possible.
The scenario where I'm envisioning you might need help is if you are still seeing green numbers in the morning. That would make me reconsider shooting 13u even. If she stays green all night and you still have green in the morning, I would definitely post for help and rethink what dose to shoot. Please do post if you still have green numbers in the morning.
Kitties getting higher doses can often even skip shots without having their blood sugar rise. The large depot continues to give out and control blood sugar.
Even with that, I would reduce the dose in the morning because my focus would be on how low she got today.
I'm going to bed - long day and I have to work tomorrow. Hopefully someone will be online in the morning if you need help, but I think we've gone over it all tonight as much as possible.
The scenario where I'm envisioning you might need help is if you are still seeing green numbers in the morning. That would make me reconsider shooting 13u even. If she stays green all night and you still have green in the morning, I would definitely post for help and rethink what dose to shoot. Please do post if you still have green numbers in the morning.
Kitties getting higher doses can often even skip shots without having their blood sugar rise. The large depot continues to give out and control blood sugar.
Sandy and Black Kitty
Member Since 2009
Ditching the dry is one reason to be very careful - it is a huge game changer.
This is an example of reasons to reduce - having to work hard propping up numbers.
Another reason to reduce is that under the SLGS guidelines an 83 earns a reduction.
And no matter which guidelines or protocol you use, if that LO was real then the dose needs serious re-evaluation.
There is a saying around here (there are many actually
) - Better a day too high than an hour too low.
Kathy and TiTi
Member Since 2016
Ok, on tuberculin. I only mentioned it, in case one of you would know the conversions.
She adores her new food. I think she's a gourmet eater. But I think it changed things dramatically. I've had enough drama for quite a long time.
Ahh. Those percentiles do clear things up for me. The low was definitely scary. I do, yes understand that lows are very dangerous.
I guess my concern is that she not speed into highs that cause that ketoacidosis. I've nothing here to counteract that. I've no short acting insulin to help her, nor would I know how to safely administer it.
julie & punkin (ga)
Member Since 2011
With a lot of factors changing, it's better to be conservative and keep her safe. Unless ketones are present, there is no urgency that would prevent us from taking a conservative course here with her.
Sandy's got some very wise words above.
Sandy's got some very wise words above.
Kathy and TiTi
Member Since 2016
That makes sense. When first dosing TiTi, 2 years ago, she was on 10 units (my mistake), and she acted cured. But her numbers were getting really low. 40,50.Ditching the dry is one reason to be very careful - it is a huge game changer.
This is an example of reasons to reduce - having to work hard propping up numbers.
Another reason to reduce is that under the SLGS guidelines an 83 earns a reduction.
And no matter which guidelines or protocol you use, if that LO was real then the dose needs serious re-evaluation.
There is a saying around here (there are many actually
Bottom line - 15u is a lot of insulin. Being that we don't know the reason Titi is such a 'big gulper' best to err on the side of caution.
- Better a day too high than an hour too low.
Now based on that, I am wondering if something round 10 units is optimal.
I remember early today Georgia said, to keep very close track of TiTi, immediately correcting her glucose, because if it got to low, it would be like trying to stop a train. That phrase has guided me all this long day.
I think the low was real, too. Right before the human meter, max, read LOW, Titi was getting a bit sluggish, and that raised a red flag.
Kathy and TiTi
Member Since 2016
Yes, and helpful. Good thing I get sort of calm and solid in emergencies. I think I'll go to bed now , with a light margarita, and quietly, just for a few minutes, mind you, fall apart.
That is unless she needs another test?
julie & punkin (ga)
Member Since 2011
With a diabetic cat, 2 years ago is an eternity. I don't think we can know anything from what happened 2 years ago - fortunately you're testing now and monitoring enough that we'll be able to untangle the situation and see what she needs to move forward.
By the way, it's Gill that was helping you today. George is her cat - and lucky for them both, George went OTJ (off the juice) and became diet-controlled a month or so ago.
It's good that you were noticing the behavior changes - typically LO means that the blood sugar is too low to measure. I don't know if that varies from meter to meter, but my glucometer only showed LO if it was under 20. That's a crisis, so it's good you were testing and took action. Just an fyi, when I had a test number under 50, I never let it go more than 30 minutes without retesting after I'd given glucose. You want to make sure it's coming up and see if you need to give more. For a cat under 30 I wouldn't go more than 15 minutes without retesting again.
About going to bed now - did you see Gill's comment above? She addressed the question above.
By the way, it's Gill that was helping you today. George is her cat - and lucky for them both, George went OTJ (off the juice) and became diet-controlled a month or so ago.
It's good that you were noticing the behavior changes - typically LO means that the blood sugar is too low to measure. I don't know if that varies from meter to meter, but my glucometer only showed LO if it was under 20. That's a crisis, so it's good you were testing and took action. Just an fyi, when I had a test number under 50, I never let it go more than 30 minutes without retesting after I'd given glucose. You want to make sure it's coming up and see if you need to give more. For a cat under 30 I wouldn't go more than 15 minutes without retesting again.
About going to bed now - did you see Gill's comment above? She addressed the question above.
Sandy and Black Kitty
Member Since 2009
High BGs alone do not cause ketoacidosis. DKA is caused by the combined effects of :
- not enough food energy (calories) making it into the cells
- not enough insulin
- infection, inflammation and/or stress of some kind
Tricia Cinco(GA) & Harvey
Member Since 2011
Kathy, I don't think those settings are useful for the way we monitor cats. I would turn the autolog off.
Also, when you get a number that really surprises you, like that Lo, ALWAYS retest immediately to confirm it was a good test. You'll save yourself a lot of stress that way.
Also, when you get a number that really surprises you, like that Lo, ALWAYS retest immediately to confirm it was a good test. You'll save yourself a lot of stress that way.
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Sandy and Black Kitty
Member Since 2009
One last thing before I too turn in (I'm on the east coast and it's getting early). . .
The fewer variables the better. Work on developing consistency - it will be your best friend.
The fewer variables the better. Work on developing consistency - it will be your best friend.
- shot times
- dose
- type/timing and amount of food
- meter used
- syringes used
Kathy and TiTi
Member Since 2016
Kathy and TiTi
Member Since 2016
One last thing before I too turn in (I'm on the east coast and it's getting early). . .
The fewer variables the better. Work on developing consistency - it will be your best friend.
Hang in there and hang in here. It gets easier
- shot times
- dose
- type/timing and amount of food
- meter used
- syringes used
ok thanks. TiTi is now at 74. Is that ok?
Kathy and TiTi
Member Since 2016
ok. I will.
TiTi is at 74 now. Is that ok?
Can I feed her and go to sleep?
Kathy and TiTi
Member Since 2016
Oh. I didn;t know that. Thanks. Clarifies things.
Gill & George
Member Since 2015
Hi Kathy,
Two choices:
The reason she is still dropping in spite of skipping that shot is the depot is still affecting the BG and you may still get some significant downward momentum.
Sorry I know you must be exhausted, I would hold of that margarita for now.
Two choices:
- she's 30 points lower than an hour ago, I think you I would give her some of her regular food with some honey in it. (A couple of teaspoons of food with a bit of honey) and then test in 30 min (she has dropped 30pts in an hour so at that rate in an hour she would be under 50 and we want to avoid that) but then you are going to need to stay up for a few more hours yet.
- An alternative would be to retest again in 20min without feeding and see if she is still dropping or if she is staying the same. If you find she is still dropping then you are going to need to carb her up and continue montitoring. My worry about doing it this way is that the BG could get ahead of us and it might be an upward struggle to get her back up, but if she stays the same then you know that she is surfing and you can get some sleep.
The reason she is still dropping in spite of skipping that shot is the depot is still affecting the BG and you may still get some significant downward momentum.
Sorry I know you must be exhausted, I would hold of that margarita for now.
Gill & George
Member Since 2015
Sorry my internet kept dropping out was struggling to get that message posted, if you havent fed test her again now it's been 15min since you posted so it should give you some idea if TiTi is still dropping or if she has leveled out
Kathy and TiTi
Member Since 2016
It's been 38 minutes since that test, so I can check it now, and I will.
Gill & George
Member Since 2015
OK let me know what it is, Did you feed at that 74??
Gill & George
Member Since 2015
How you doing Kathy?
Kathy and TiTi
Member Since 2016
72, and 50 minutes earlier, it was 74
Kathy and TiTi
Member Since 2016
I'm a bit tired, but I can keep going.
Kathy and TiTi
Member Since 2016
I think she had been eating an hour before the test, but has had nothing for about 2 hours now.
Kathy and TiTi
Member Since 2016
I'm not entirely surprised. The sticky on managing low numbers mentioned several days, possibly, of increased caution.
Gill & George
Member Since 2015
So you are at about +4 now???
and the last time she ate HC/honey was at +10??
and the last time she ate HC/honey was at +10??
Kathy and TiTi
Member Since 2016
I think it was after she dropped from 221 to 102, within an hour. That would have been PMPS.
Kathy and TiTi
Member Since 2016
Yes, +4. was the 72 reading, actually about 29 minutes before +4
Kathy and TiTi
Member Since 2016
No, wanted to see if the number would hold, so I didn't feed her.
Kathy and TiTi
Member Since 2016
I may be contradicting myself. I should have charted the feeding times. I will from now on.
Gill & George
Member Since 2015
I think she seems to be done with sliding since its been 3-4hrs since HC that shouldn't be in the picture, and she is holding flat in the last 30 min (good call on not feeding)
I would give her her bedtime snack and get yourself off to bed.
Remember
13u in the morning regardless if she is very high (dose is based on how low it takes them not the pre shot)
if she is in green hold fire and post for help. I'll be watching for you.
I would give her her bedtime snack and get yourself off to bed.
Remember
13u in the morning regardless if she is very high (dose is based on how low it takes them not the pre shot)
if she is in green hold fire and post for help. I'll be watching for you.
Gill & George
Member Since 2015
Sorry having trouble with internet again.
Good idea to chart the foods, when BFG dropped I used to make notes as I fed and keep updating the ss as I went along with them.
Kathy and TiTi
Member Since 2016
I never say stuff like this, but , Bless you.
Gill & George
Member Since 2015
Your welcome, Someone was there for me when I needed it so it's only right to give something back, it's my pleasure.
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