? 7/20/16 Petey amps 190 +2 89 +3 82 +5 82 +9 52 +9.20 55 +10 58 pmps 45 +.5 165 +1 284

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Hi - Looks like Petey may be sliding down and I'm supposed to be somewhere in 3o min. I gave him a few Tbl LC food. Any advice appreciated!
 
Good plan with the LC, it's late in the cycle so hopefully that will keep him ticking over.

Petey, surf safely for you bean.
 
THanks Gill - So Petey decided to keep sliding down, crazy guy. I gave him his usual LC dinner + approx. 1 Tbl HC gravy. No shot tonight, obviously. And another reduction (woohoo!) I'm assuming I just shoot tomorrow am at usual time?
 
Congrats on the reduction. That was quite the slide today! :D:eek: I'd keep monitoring for a bit yet tonight to make sure he comes up.

You can shoot tomorrow at your usual time. Even a bit earlier if it suits you.
 
If in future Petey gives you a low number at preshot, there are other options than skipping. Obviously you wouldn't shoot under 50. Stalling is one option. When Neko gives me a low number (usually in the morning when I'm half awake :rolleyes:) I usually wait 15-20 minutes without feeding and test again, and she's usually on her way up by then so it's safe to shoot. Here is the part from the Sticky Note on Shooting Low Numbers:

Some general rules when stalling (ECID):

** 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
** 40s or lower – you have a couple of choices.
  • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
  • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
    • --- Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
** 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.

Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.

Using the overlap by shooting low is a great way to take advantage of Lantus/Levemir’s long, flat cycles, once you have learned to do so safely.
 
Wendy&Neko said:
If in future Petey gives you a low number at preshot, there are other options than skipping. Obviously you wouldn't shoot under 50. Stalling is one option. When Neko gives me a low number (usually in the morning when I'm half awake :rolleyes:) I usually wait 15-20 minutes without feeding and test again, and she's usually on her way up by then so it's safe to shoot. Here is the part from the Sticky Note on Shooting Low Numbers:

Some general rules when stalling (ECID):

** 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
** 40s or lower – you have a couple of choices.
  • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
  • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
    • --- Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
** 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.

Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.

Using the overlap by shooting low is a great way to take advantage of Lantus/Levemir’s long, flat cycles, once you have learned to do so safely.
Click to expand...


Thanks Wendy. So I did feed him his usual meal + some gravy. I tested 25 min later and he's at 165, so big food spike! I shouldn't shoot now, right? Also, what does "Using the overlap by shooting low" mean?

Thanks!
E
 
Since you fed HC, that removes the option of stalling without feeding. All good, just an option for next time. :)

A couple of useful concept in understanding your kitty's response to insulin are the carryover and overlap.
  • Carryover - insulin effects lasting past the insulin's official duration
  • Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect
If your cat is at a good Lantus dose, you'll see some carryover, meaning the insulin keeps working into the beginning of the next cycle and past your shot time, potentially up to the time of the onset of that shot. So the carryover is your previous shot insulin effect reducing and the next shot's effect starting up. That means you get a steady amount of insulin and you end up with those nice flat cycle that Lantus (and Lemevir) can produce when shooting low. If you delay the shot until the numbers rise up too much, then you are losing the overlap.
 
Hi Wendy, thanks for explaining.

For future, would it be advisable to stall in the situation I had tonight: I came home a little late -- a half hour past his regular pmps, and he was hungry. That's when I tested and he was gone from the 50s (where he'd been since +9) down to 45 (so basically flat I guess). Should I still have stalled at that point, even though I was already late for his shot?

Also, do I need to test again in an hour or so, i.e. is it likely he's gong to crash after this crazy food spike he's having?

Thanks!
E
 
Just saw that 284, I think you are good for the night. Looks like a bounce in the making. You could get a before bed test for data gathering purposes, but I don't think he's in any danger tonight. :rolleyes:

As for whether stalling when you are already late, that depends how flexible your schedule is. If you can't delay much and need to be on time the next day due to work, then stalling won't work.
 
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