8/5 Punkin PMPS 163, +1 156, +2 164, +3 183, +4 218

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Punkincat

Member Since 2011
Punkin's coming up on her 8;45 1unit and she just tested 163.
Lantus 1 unit bd Anybody on board to look at her SS real quick for me
 
Re: Should I shoot

here's your guidance:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?

A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise. In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine. Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.

Keep in mind that these are general guidelines, and they should be personalized to your own cat's reactions to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then your experience should be your guide.
Click to expand...


so the standard questions are - do you have plenty of test strips? are you going to be home tonight and able to monitor and test? and what's your comfort zone? the 3 choices above are skip, give a token dose, or wait a couple of hours and see how punkin is then.

you have to be ok with your decision - you are just getting started, but this isn't especially low . . . what are you thinking?
 
Re: Should I shoot

I've read that over and over. YES I'll be home all night so I can test. She sleeps on my head so I know if anythings wrong
 
Re: Should I shoot

welllllll the only way you'll know if she's low is by testing. you can't depend on behavior - lantus is slow acting and often cats on lantus don't exhibit signs of hypo until they are below 30. so this is a great opportunity for you to gather some info. test her every couple of hours until you see a clear rise in her numbers and it's past the middle of the cycle.

glad you made it over here! welcome!
 
Re: Should I shoot

This just happened to me two days ago (look at Stella's SS). Keep in mind I know NOTHING... I had a mini heart attack because I didn't know what to do and nobody responded. I have been MIA since trying to figure out what I would do differently. I spoke to my vet today asking what she would have done. I told her I shot .8U which is 25% of her regular dose. My vet said she would have told me not to shoot. If I wasn't testing like most don't because they don't home-test I feel it still would have ended ok. I have been upset because I feel like I am in this on my own. If I would just grow up...I guess I would realize we are, and we all do the best we can each shot. Here is a link (somebody?) sent after the fact, but maybe it will help you now.

Low shot numbers

I am with you out here. Best of luck. *hugs
 
Re: Should I shoot

I think the time the Lantus takes I'll go ahead and give her her 1 unit. The ketones scare me.
 
Re: Should I shoot

julie1220 said:
welllllll the only way you'll know if she's low is by testing. you can't depend on behavior - lantus is slow acting and often cats on lantus don't exhibit signs of hypo until they are below 30. so this is a great opportunity for you to gather some info. test her every couple of hours until you see a clear rise in her numbers and it's past the middle of the cycle.

glad you made it over here! welcome!
Click to expand...

So shoot and watch or watch and shoot?
 
Re: Should I shoot

heehee, i want you to make the call - i don't think that's a low number, but you are new to this, and i also would understand if it makes you nervous and you want to wait to have it rise. what i was saying is that if you shoot you have to test and not rely on behavior to know what her blood sugar is doing.

so are you ok shooting and then testing tonight?

if you wait, then the time you give your shot becomes your new shot time and you have to be ok giving the shot 12 hours from tonight's shot. does that make sense?
 
Re: Should I shoot

good job! you have to do it at some point. i'd suggest you check her in 2-3 hours and post the number you get in the subject line like this:

8/5 punkin (hmmm, there will be 2 of our punkins!) pmps 163 +3/BG #

i'll make sure and check back tonight & i'm sure others will be on to advise you also. we can let you know when to give the next test and if the number is significant or not.
 
Re: Should I shoot

oh, and you edit the subject line of your first post here and just keep editing & resaving that subject line as the day goes by.
 
Re: Should I shoot

OK, 2 hrs, OK i'll do that and be back in 2hrs.

Thanks, I mean that, Thanks.

It's spooky
 
Re: Should I shoot

Good job but the only thing I would change in Julie's suggestion is that you most definitely get a +2.

I'm gonna just throw this out for you to think about:

Looking at your SS, it "appears" that Punkin may have been dropping and clearing a bounce. I say "appears" because he started at a higher 200 number at AMPS, came down to 209 mid cycle, and is now 163 at PMPS. If so, then he "might" (or might not) keep dropping for a little bit and then his lantus will kick in....so he "might" drop more. I sure wish I had a crystal ball :lol: :lol:

If he doesn't mind the pokes, I would even suggest that you get a +1 because it will tell you if, when he's dropping at PS, if he continues or he comes up before onset. The reason I know alot about this is because I have a kitty who does it but she isn't the only one. It's not that huge of an issue when he's at this high of a number, but as you learn to shoot lower and lower numbers, it can become one.

Good luck!!!
 
Re: Should I shoot

good catch, marjorie - that didn't occur to me. thanks!

see you in 2 hours - and if you get that +1 that's awesome. these can tell you what direction punkin's going and how fast.
 
Re: Should I shoot

OMG............ +1, okie dokie. Punkin has no say in it, I'll have new numbers in an hour
 
Re: Should I shoot

What a trooper you are. Oh...I forgot to tell you....I'm a testaholic :lol: :lol: :lol:

Did you give us your name?
 
Re: Should I shoot

You have got to, gottogottogottogottogottogotto, start testing during the PM cycle. If that wasn't perfectly clear, please start testing at night. Many of our cats run lower numbers at night. Testing and food are your biggest and most important tools when it comes to controlling your cat's numbers.

Personally, I would not have suggested you shoot unless you swore on a stack of Bibles that you would test tonight. If I am not convinced someone will act on the safety of their cat I will not make a recommendation. So, please, for all of our sakes get a +1 and a +2 and we will be able to help you figure out what to do from there.
 
Re: Should I shoot

nice to meet you jerry!

marjorie held my hand through my punkin's first low numbers episode. we'll all help you through the learning curve, then you'll get to help other newbies!
 
Re: Should I shoot

Jerry....good, thanks!!

Sienne is right and I thought you shot because you agreed to test tonight and you could stay up and test....so we're counting on you!!! If you get into any low numbers, we'll stay up and walk you through it. Take a look in my signature box...there's a link for "handling low numbers". All you ever wanted to know but we'll still check in through the night.
 
Re: Should I shoot

Oh don't worry I'll test in an hour or every hour if need be.

As far as not testing at night, my vet only started me testing this week, and I'm just doing what he said to do. All the dry food has been gone, weined off slowly and I have the low carb wet food list and I shop hard for FF below 8 carbs, try for lower.

So the food deal I DO DO! The testing, I was doing what I was told, but trust me I'll test PM from now on,
 
Re: Should I shoot

And one more task when you have some time.... Could you complete a profile on Punkin and attach it to your signature. The Profile gives us background -- date of diagnosis, what you're feeding, any health issues, etc.
 
Re: Should I shoot

There are lots of things vets know really well. Hang around here long enough and you'll realize that diabetes tends to be low on the list of what most vets are knowledgeable about. I'm not trying to throw a brick at vets in general or yours in particular. It's just that diabetes (in every species) is probably one lecture in one class in all of their training. On top of that, most caregivers don't home test so vets will discourage shooting in ranges where we routinely shoot. Cats do very well here because we follow a specific dosing protocol that has been well researched and published in reputable veterinary journals.

As far as testing at night, next time you're feeling feisty or if your vet tells you your testing too much if you test at night, I'd ask him if he wouldn't test if this were his/her child. I suspect after a big gulp, your vet will simply say, "Nevermind."
 
Re: Should I shoot

awesome. good job getting another test.

do you also have high carb canned cat food? something other than low carb? if not the honey will work, but we like to use the gravy from high carb canned cat food to steer numbers.

see you in an hour at :45!
 
Re: Should I shoot

Ya know, I'm freaken out over here and you're asking if I have ice cream,,,,,,,,,,,,, Yes Rocky Road!
 
Re: Should I shoot

It's helpful to post your test info in the subject line. That way, if you're running into low numbers, it's easy to scan the board and look in. To edit your subject line so it's visible, open your first post in the thread, click the "edit" button, change the subject line and click the "submit" button.

Just as an FYI, usually, your +1 is higher than your pre-shot since it often reflects a food spike. Your +2 (in a perfect curve) is the same as your pre-shot. That your +1 is the same may indicate this could be a busy cycle. (The breakdown of what a "perfect" curve looks like is in the New to the Group sticky.)
 
Re: Should I shoot

We just like to be prepared ;-) ;-)

So here is a lesson right off the bat. The +1 "should" be a little higher than your PMPS. Your +2 should be about the same. If it's not, then you can expect that Punkin might have some lower numbers tonight.

Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...

Last thing before I go eat dinner: could you please be sure and edit your subject line? I think Julie put the info in earlier. Now it should state:
8/5 Punkin PMPS 183 +1 156

This allows us to see at a glance where PUnkin is and whether we need to pop into your condo or not. Thank you, Jerry. You're doing GREAT!!

See you at 45 after the hour.
 
Re: 8/5 Punkin PMPS 163 +1 156

I changed the subject line, yes she told me but I forgot. I'll change it on her pmps+2 to reflect that number too.

Thanks
 
Re: 8/5 Punkin PMPS 163 +1 156

rocky road should be fine.

:lol:

no worries, if you were in a crisis we'd tell you. ;-)

it's all a piece of cake. you're gonna test punkin every hour til we tell you differently. if you need to do something besides show up and test, we'll tell you.

it's just good to make sure you've got what you need before you need it.

and just to help you be ready ahead of time, i'll tell you the process. if punkin goes low (low = lower than 50) we're going to tell you to pop open a can of that slurpy gravy high carb canned food, press out about a teaspoonful of gravy and give it to sweet little punkin. then you wait 15 minutes, test and tell us what it is. if it's still below 50, you're going to repeat the process until it's up. then we'll see where we're at and what you need to do to maintain it.

so it's really not hard, it's just a matter of keeping track of your little girl and feeding her. cats mostly like that gravy so she's not going to complain about it.

on second thought perhaps you should crack open a bowl of rocky road now to prime yourself for the evening. :-D
 
Re: 8/5 Punkin PMPS 163 +2 164

looking great on the +2. very nice. you might not need that rocky road after all. :lol: pass me the spoon.
 
Re: 8/5 Punkin PMPS 163 +2 164

And....almost as important as the ice cream is to B-R-E-A-T-H-E ;-) ;-)

Nice +2. Still could be a little food spike. See you at +3. Julie and I might tag team you :lol: :lol:
 
Re: 8/5 Punkin PMPS 163 +2 164

Thanks guys, my freak level is coming down some. See ya at +3 and thanks for staying up with Punkin and me, this is wayyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy spooky
 
Re: 8/5 Punkin PMPS 163 +3 183

you're doing great jerry. no news is good news. see ya in an hour. you can sleep in between if you want. sometimes people set their cell phone alarms.
 
Re: 8/5 Punkin PMPS 163 +3 183

Nice +3, Jerry!! And look at all the info you are gathering.

It's important to learn whether your kitty gets a food spike at +1 or +2. You'll need it later as you move towards shooting lower numbers. Of course, hopefully Punkin will not be like Gracie and change frequently :lol: :lol: :lol:
 
Re: 8/5 Punkin PMPS 163 +3 183

hang on jerry - i sent a message to marjorie to consult on how long you should keep it up. i don't know . . .
 
Re: 8/5 Punkin PMPS 163 +3 183

Jerry: I like to get two rising numbers if kitty is so close in numbers. With meter variance (20%), then the 183 is about the same as the +2 so it looks to me like Punkin is surfing. I know it's late there, but I think it's not a bad idea to get a +4 and see what Punkin is doing.

Can you sleep/test? That's what I do on late nights. Thankful for my smart phone :lol: :lol:
 
Re: 8/5 Punkin PMPS 163 +3 183

ok - so we're both going to be up still, but we're both also aware that it must be about midnight in arkansas.

marjorie's cat is a zoomer that drops with great flair and drama and i have mr. flat cat who moves all of 50 points in an entire cycle most of the time. we don't know how your punkin is because there isn't data yet. it's a good sign that he's up at +3, but even so, it doesn't tell us what's coming next.

so we're putting the call in your court. if you are still going strong and want to get another test, that's super. i think both of us would feel better with at least one more test between now and +6, just for insurance. if you are dying to go to sleep, then how do you feel about setting an alarm and getting up in the next couple of hours to test? if your punkin follows the text book the lowest points would be somewhere between +5 and +8ish, but of course, we just don't know. some cats do, some cats don't. no crystal ball - which is why we test.

so . . . what would you like to do.
 
Re: 8/5 Punkin PMPS 163 +3 183

Sure, you're the boss. I was kinda wonering why by now she hadn't started dropping rather than rising. Looks to me, as a novice but from the chart you posted, that she would be heading toward her low peak of the cycle rather than going up so high. Does that make any sense?
 
Re: 8/5 Punkin PMPS 163 +3 183

I think she is "surfing" and is relatively flat since PMPS. Julie is correct that you can elect to sleep until +5 and just get a number there if you want.

Cats have different onsets and different nadirs....AND it can move. Sometimes my girl peaks around +4 and other times, much later. Sometimes she onsets at +1.5, sometimes at +3. She likes to keep it real :lol: :lol: :lol:

I will definitely be up until your +4....don't know if I'll make it to +5 but it looks like tonight might be a nonevent. Just be sure you have the info on dealing with low numbers printed out.
 
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