7/7 Scamper PMPS 80 +1 122 +2 97 +3 50 +3.75 56 +4.5 67

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GatorsRBst

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So for the last few days, I haven't been giving Scamper insulin shots because he's been maintaining a pretty low BG level without it. Please check out Scamper's spreadsheet - I'd appreciate your input. I didn't really intend to start an OTJ trial, but it looks like that's what has happened... It just started out with skipping a shot b/c of lowish BG, then continued the same way.

The vet visit last Monday went well & the doc told me that a BG level between 120-180 is good/normal. Wendy has told me that for an OTJ trial to be good, it needs to be 14 days with BG quite a bit lower than that. Is the doc wrong? Scamp's had a couple BG tests with his BG levels in the high 100s, so I guess those days don't count as good for the OTJ trial?

Thanks for he tips and advice!

Most recent Previous condo 6-28-13
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

It looks to me like he's not quite there, yet.

Usually we see a lot more greens and more normal numbers between 50 to 120 before we advise a trial.
I think you could 0.10 and see how it goes.
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

hello janet. scamper's doing very well! :mrgreen:

kirsten from tillydiabetes probably says it best,

"Try to go from 0.25 IU to a drop before stopping the insulin completely. Reducing the dose too quickly generally does not work: most cats do not go into remission with fast reductions.

and

"Phase 5: Remission: 14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs."
http://www.tillydiabetes.net/en_6_protocol2.htm



i agree with dyana. i think scamper is very, very close, but not quite there yet.
our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

I agree with Dyana and Jill.

In case you were unsure what a dose of 0.1u looks like, here's a photo:
01unit-1.jpg
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

Thanks for the advice. It is too late for the AM shot at this point, but I am considering giving a PM shot of 0.1 unit (as long as his BG isn't below 100).

The vet told me something quite different from you all and I'm wondering why he would tell me that between 120-180 was what I was shooting for when you all are telling me much lower than that? I don't like to have Scamper drop so close to 50 BG - I can't always be home to monitor his BG every 30 min to an hour (plus the strips are expensive) to administer HC food if needed, so I really didn't want to have him hover around that 50 area. But now you are telling me the normal area is between 50-80... I'm very confused about this difference in BG level advice! Can someone explain to me why the vet's advice would differ so much from yours?

If you look closely at the spreadsheet on 7/3/13, both times when I gave Scamper a very small dose of insulin (I put 0.25 on the spreadsheet, but looking at the pic of 0.1, I really think it was closer to that, but it was hard for me to control) he dropped low & it caused a high bounce once as well. In the last 4 days with no insulin shots, Scamper has been in the range you say he should be aiming for in 6 out of the 9 BG tests I did and hasn't bounced or dropped below 50. This is why I was feeling that it was the right thing to do.

Of course you all are so knowledgeable & haven't steered me wrong even once, I'm going to listen to you! I can only attribute Scamper's improvement to the help I've gotten here! Thank you so much for your continued advice and input. I definitely don't want a remission for Scamper to fail!
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

The difference could be that the vets are used to seeing cats that are stressed to be at the vet's office, so their numbers are higher when there, and come home to more normal levels once they're home. Also, the vets are probably used to measuring BGs using an AlphaTrak meter which tends measure about 30 points higher than a human meter, which we use. Vets are not used to people being as proactive as we are testing our cats at home, so they are used to people bringing their cats into the office once a week or every two weeks for a stress filled BG vet test.

When I measure 0.25 there is a bit of light showing between the plunger and the zero mark. When I measure 0.10 the plunger is just touching the bottom of the zero line with no light showing.

I hope that helps.
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

Thanks, Dyana, helps a lot & seems reasonable. I appreciate the input with that as well as the needle explanation!
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

In addition to Dyana's information, vets typically like to run cats in higher numbers than we do. Usually, the rationale is that most of their clients don't home test. If you don't home test, you need a much wider margin of safety. As a result, what most vets will consider as "normal" is a higher range than we use.
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

Since we are home testing, we like to see out cats in normal non-diabetic numbers, 40-130. We know that with home testing, we can keep them safe. We know that while they are in these lower numbers, there is more time for healing the pancreas and less organ and nerve damage going on.
 
Re: Scamper 7/7/13 OTJ trial? Advice requested!

So, I was planning to give a PM insulin shot of 0.1 unit tonight, but Scamper's PMPS number is 80, which is already in the normal range without any insulin shots over the last few days. I won't be able to stay up all night with him testing to be sure he doesn't drop low, so I'm feeling unsure, but think that I should NOT give him the shot. Would you all advise to still give the shot?
 
Re: Scamper 7/7/13 New question - Advice requested!

If he were mine, I'd shoot the .1u because he does not look like he's quite into remission but there is no telling if he will come back down tonight, Janet.

His BG is flat; but he could have gone up a bit after the 77 and this is a second dip. If it is, he might go up; but he might not. It's your call but if you shoot, you would need to get a +1 and a +2 and then go from there.
 
Re: Scamper 7/7/13 New question - Advice requested!

ok. giving the 0.1 unit shot & will test at +1 and +2. Stay tuned...
 
Re: Scamper 7/7/13 New question - Advice requested!

Janet

Good shooting! I'll be up and on tonight so I can help you. You've got all the supplies I"m assuming since he's been coming down on you......strips, HC, karo, etc. Oh yes...and chocolate for you?

 
Re: Scamper 7/7/13 New question - Advice requested!

Janet

I have to T/F/S Gracie. Sorry I couldn't wait longer. I let Sienne know you were going to post a +1. I will be back in 15 minutes and will be here for your +2.
 
Re: Scamper 7/7/13 New question - Advice requested!

Yes, I have all the needed supplies. +1 and +2 done. Not sure what those numbers mean, though... Advice?
 
Re: Scamper 7/7/13 New question - Advice requested!

Janet

Can you please go to the first post of the day, click on "edit" and then in the subject line type:

7/7 Scamper PMPS 80 +1 122 +2 97

Then click "submit". You add each test result that same way. There are some of us scanning the subject lines to check the numbers and that way we can watch you.

Thanks!

And maybe grab a +3 test and post it? Looks like he onset and I just want to see what he has in mind for tonight.
 
Re: Scamper 7/7/13 New question - Advice requested!

What we meant was to update your subject line with the +1 and +2 test results so we could follow along. Otherwise, we don't know if you saw the post and tested. Can you test at +3 and post the numbers?

You need to edit the subject line in the first post in this thread for it to appear on the Board.

Sorry for the confusion. We're so used to talking in LantusLand-speak that we forget that what we're saying isn't completely obvious!
 
Re: 7/7 Scamper PMPS 80 +1 122 +2 97 +3 50

+3 BG reading 50...

Also, I read your link & understand everything except the 'condo' information. How do I link a previous day's thread to a new one?
 
Re: 7/7 Scamper PMPS 80 +1 122 +2 97 +3 50

How about giving Scamper a bit of higher carb food -- a teaspoon or two -- and re-testing in 30 min?
 
Re: 7/7 Scamper PMPS 80 +1 122 +2 97 +3 50

To link your condos:
  • Go to the condo from the previous day.
  • Copy the location info (the http:// etc) at the top of your browser.
  • Then, open a new condo for the current day.
  • In the text box, you'll want to insert the code for an internet link. Click on the URL button that's above the text box. This will insert the following code:
  • In between the two sets of brackets, paste the location inform that you copied earlier.
  • You'll have something that looks like http information goes here

If you want to make a fancier link, you can name the link -- for example, Yesterday's Condo
 
Re: 7/7 Scamper PMPS 80 +1 122 +2 97 +3 50 +3.75 56

Thanks for the info on linking condos. Technically, where I am it is now after midnight, but I'm assuming I should keep adding here until morning? I'll be sure to link today's condo to the next one.

Scamp's reading went up a tiny bit - 56 now and +3.75.
 
Re: 7/7 Scamper PMPS 80 +1 122 +2 97 +3 50 +3.75 56

How about lather rinse repeat...in other words since you tested, feed a tsp gravy since it is early, test in 30.

Yes...you will start a new condo with his AMPS on 7/8.

Great job!
 
Up to 67 mg at +4.5. It is now after 1am... hope it is ok for me to get some sleep soon.

I don't think I'm going to do PM shots anymore when Scamper's BG is below 100 at pre-shot time. I know this goes against your advice, but every time I do, he seems to go into a low drop & I can't stay up this late on a usual basis. Plus I am happy to home test, but have got to keep costs down, including strips! Hopefully I can get him into a full remission without causing these low drops on a regular basis...
 
We say shoot low to stay low. Think about how close he is to remission. If you could just continue this path, he would likely be in remission sooner rather than later and you wouldn't have to deal with it at all. If you never shoot under 100, I have no idea what would happen in terms of remission.

I would get one more test in 30 minutes to be sure he is still headed up. Then I would leave LC him.
 
I'm exhausted & working from my iPad in bed. Can't get the technology to let me enter any more info into subject line... Scamper's BG at +5.4 is now 62... Not continuing to go up & I'm extremely frustrated. Don't see how getting so close to hypoglycemia is helping his health & I KNOW this frustration & lack of sleep isn't helping mine.

Sorry - just needed to vent. I knew this would happen if I gave him a shot & I'm kicking myself now. I love my cat dearly, but these kind of close calls with the low readings drive me crazy! And I'm low on funds & can't keep burning through strips at this rate.

Will need to think over what I plan to do in the future. The advice you are giving me is the opposite of what the vet told me just a few days ago, so I need to research & think it over, see what my finances and my own health can handle, etc., before I make a decision. Some sleep before I do so will probably help...
 
He's no where near hypoglycemia. He is in very safe, normal numbers. We have some cats in this forum that like to surf along in the 40s. He's actually having a very lovely cycle.

My vet had nothing to do with my Gracie getting regulated. The people in this forum did. Vets are always going to be uber conservative because they can't have you calling their office every time he dips into the 70s.
 
You are totally right on all counts. I was just exhausted & worried. It was very late at night for me, and to be honest I'm worried about $$ at this point. Testing and using up so many strips on a daily basis just really isn't something my finances can handle at this point. I apologize if you were insulted. You all have done nothing but help me!

I thought anything near or under 50mg was a warning of nearing hypo. It isn't? If not, then perhaps I can go longer between BG tests to save on strips?
 
Janet --

There's a difference between low numbers and symptomatic hypoglycemia. The dosing protocol we use is based on research that was published in a top tier veterinary journal. This protocol would never have been approved by the animal protection committee at the university where the study was conducted nor would it have been published it it put a cat at risk. With this protocol, a drop below 50 warrants a dose reduction. The bottom line is that because you're testing and able to use food to steer the curve, what you're doing is safe. A kitty that's dipping it's toes briefly into low numbers is fine. Humans are just as susceptible to low BG and don't become severely ill if they are a bit lightheaded from not having eaten. It's the same for our kitties. We don't want to see a cat sitting in the 20s for any length of time -- but numbers that low are very uncommon. We rarely see a cat here experience symptoms of hypoglycemia. We do, however, want to see kitties get back into normal BG numbers (i.e., 50 - 120).
 
Janet

:-D :-D you didn't insult me! :-D I just wanted you to know he was safe. Safety is of primary importance here and I would have let you know if I was worried about his numbers. Many, if not most, of the cats in this forum will dip into the 40s and maybe the 30s at some time. We are here to help you if that happens. If we feel the kitty isn't responding like he/she should, we will suggest a visit to the ER or vet.

I can't remember a time that has happened here in Lantus ISG because we do teach members how to control the number with food. When Scamper is dropping, you need to test. If he flattens out or trends up, you can take a break but sometimes they come back down. It's important for you to study his SS and see if you can pick out his patterns. One other saying we have around here is "know thy cat".

You did great!
 
Sienne - thanks so much for the clear explanation - it makes me feel better about having Scamper get in the 50s with his BG readings. The vet had seemed very worried about those, and then needing to feed him the HC food was making me think it was quite dangerous. I want Scamper to reach remission so much, so thanks for explaining. It makes me feel much, much better about the dosing protocol.

Marje - thank YOU so much for the help & understanding. I can't thank you enough for your support, advice, etc. I'm feeling pretty confident that with your help Scamper is going to reach remission sooner, rather than later, and that hopefully it will be long-lasting remission!! Again, thanks. (I'm getting to "know my cat" much more than I ever thought I would, but it's clear I still don't know him well enough!!)
 
You are very welcome, Janet.

I think the reason Sienne had you give HC to start with is because he was low early in the cycle. If he had given you a 50 later in the cycle, we would have gone with LC. It's kind of an art to learn what % carb to give when based on the BG, the cat, and the caregiver.

I'm very happy to see him doing so well!
 
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