8/6 Meatball PMPS 364, +3 51, +4 88, +5 163, +6 400

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meatball_mommy

meatball_mommy

Member Since 2013
Well I apparently screwed up royally. More explanation below for how I got here so I can get feedback on where I interpreted wrong, but for right now - here's where I'm at (Please note that I TEST WITH AN ALPHATRAK)

AM + 10 362
PMPS 364
Upped to 2.25 units from 2.00 units (based upon how I thought I was interpreting protocol - more below)
PM + 2 152: knew I was in trouble at this point)
PM +3 51: following hypo guidance. Gave food, ate well.

+3 and 20 minutes: 72 and gave tablespoon of food. ate well.

Will test again in 15 and post.

So, the dose increase (insert "I feel like I royally f*d up" icon here). I have the University of Queensland guidance from AlphaTrak (Table 3B) on my fridge. We'd been reviewing his data since going up to 2.00 units 5.5 days ago. In reviewing his info, we didn't see any < 80s (which would indicate a reduction on AlphaTrak) so we followed the following:

"If nadir blood glucose concentration < 200 mg, but peak is > 200 mg, increase every 5-7 days by .25-.5 U depending on if cat on a low or high dose of insulin)."

What I now suspect is that rhiannan and shadow were exactly right on in this earlier post today(now wish I would have seen that before upping to 2.25 units!). He must have dropped low last night which may have even meant a dose reduction. UGH!! I suck at this.
 
Re: Meatball: PM +3 51 on AlphaTrak. Every 20: 72

We're @ 74. Gave another 1/2 tablespoon of gravy/filet pieces and a drop of honey. Wow do I feel like a total jerk for doing this to him :sad:
 
Re: Meatball: PM +3 51 on AlphaTrak. Every 20: 72/74

While I'm thinking of it - what should this mean for tomorrow's dose?
 
Re: Meatball: PM +3 51 on AlphaTrak. Every 20: 72/74

We've all been there.

If I may make a suggestion. The modified version of the TR protocol that we use here is a whole lot less complicated and much easier to decipher.

You don't suck at this! Reading and interpreting a SS is hard and not everyone gets it. You haven't been doing this very long so you're still learning. With the exception of the AMPS today, I would have been thinking that an increase was on the table. There are two things I'd take away from tonight's numbers. First, that you need to get a before bed test every night and second, never think that when you see a high number that the numbers have been consistently high. Gabby has gone from a pre-shot in the 400s to nadir in the 40s and bounced back to the 400s by the next shot. (See 11-2-2009 on her SS.) Chances are that Meatball was lower than the 120 you saw at your +12.

What you're also seeing is that Meatball can clear a bounce with a vengeance. You got a +10 and there was not a drop between your +10 and PMPS. I certainly would not have expected a drop of 200 points by your +2. The good news is that you tested at +2 and caught the drop. I'm hoping that you gave Meatball some food at +2 to slow things down.

And, congrats on the dose reduction.
 
Re: Meatball: PM +3 51 on AlphaTrak. Every 20: 72/74

Sienne and Gabby said:
We've all been there.

If I may make a suggestion. The modified version of the TR protocol that we use here is a whole lot less complicated and much easier to decipher.

You don't suck at this! Reading and interpreting a SS is hard and not everyone gets it. You haven't been doing this very long so you're still learning. With the exception of the AMPS today, I would have been thinking that an increase was on the table. There are two things I'd take away from tonight's numbers. First, that you need to get a before bed test every night and second, never think that when you see a high number that the numbers have been consistently high. Gabby has gone from a pre-shot in the 400s to nadir in the 40s and bounced back to the 400s by the next shot. (See 11-2-2009 on her SS.) Chances are that Meatball was lower than the 120 you saw at your +12.

What you're also seeing is that Meatball can clear a bounce with a vengeance. You got a +10 and there was not a drop between your +10 and PMPS. I certainly would not have expected a drop of 200 points by your +2. The good news is that you tested at +2 and caught the drop. I'm hoping that you gave Meatball some food at +2 to slow things down.

And, congrats on the dose reduction.
Click to expand...

We're at +4 now and 88. Will do in another 20 to make sure we stay over 80 and then test every 30-40 to make sure we stay in the right direction. Damn, I didn't give him any food at +2, which was stupid in retrospect since that big of a drop was my warning sign - and that's the whole reason I started doing the +2s. Big lesson learned there. And, now that I look at it, I should have figured out he likely dropped below 80 last night with the AMPS. So, really, I should have shot 1.75 this AM (and good grief not 2.25 tonight!).

So, for the morning, since I did 2.25 tonight (and only tonight), would you recommend going to 2.0 or 1.75? I'd be reluctant to drop .5u. I think I would go to 2.0, get more PM tests, and watch for more data indicating a reduction to 1.75? Thoughts/feedback?
 
Re: Meatball: PM +3 51, +4 88, +4 and 20min 96

If this were my cat, I would not have dropped the dose this morning. I tend to not reduce the dose unless I see the number indicating a reduction is needed. My crystal ball doesn't let me see the numbers in between the tests I get!!

I think it's your call whether to go back to the 2.0 or reduce to the 1.75u dose. It's a hard call. Chances are that the 2.25u hasn't had an effect on the depot yet and you're seeing the effect of the 2.0 dose. As I'm thinking about this, I'd be inclined to go to the 1.75u dose. That 51 meant business. I suspect that if you went back to the 2.0u, you'd be chasing after Meatball's numbers.
 
Re: Meatball: PM +3 51, +4 88, +4 and 20min 96

Ok, you don't suck at this. ;-) And don't do the "if only" thing or you'll drive yourself insane. Like "if only I had tested last night I might have caught a lower number...." You aren't going to catch every low number. Nobody does.

So, for the morning, since I did 2.25 tonight (and only tonight), would you recommend going to 2.0 or 1.75? I'd be reluctant to drop .5u. I think I would go to 2.0, get more PM tests, and watch for more data indicating a reduction to 1.75? Thoughts/feedback?
Click to expand...

That's a really great question that I don't know the answer to. ;-)

You're right, Meatball might have dropped under 80 overnight based on your AMPS, but no way to know for sure. If so, that would have meant a reduction this morning to 1.75u. So, that leaves the question you asked.... 1.75u, or 2.0u tomorrow?

Personally, I like your logic with going with 2.0u. The way I figure, when kitties are "done with a dose", they make that clear to you. If Meatball is "done" with 2.0, and wants a reduction to 1.75u, then I think he'll let you know that soon if you stick with 2.0 for the time being. It might be better to wait for conclusive results and continue to climb down the dose ladder, than to go with 1.75u, see "not so great" results, and have to go back up to 2.0?
Does that make sense?

Wait for other input from people who have "been there, done that" though. I didn't use Lantus with Bob, so my suggestions are based on what I've learned here and not from 1st hand experience.
 
Re: Meatball: PM +3 51, +4 88, +4 and 20min 96

See? One of those people I was talking about beat me to the post! I'd follow Sienne's suggestions before I'd follow mine.
 
Re: Meatball: PM +3 51, +4 88, +4 and 20min 96

Thanks so much to all. The posts kept me from the fetal position, and mostly stopped the tears for feeling like I failed the little guy. But I'll take the lessons learned that I need and do better next time! We're at 96. I'm waiting another 40 for another test. Then another hour before sleep.

I will go to 1.75u tomorrow. We'll hold there for 3-7 days and see what transpires. I am also going to aim for always a before bed shot (between +2 and +4 most likely), and likely a +10 since my boyfriend is up early. And we'll go from there. Thanks again!
 
Re: Meatball: PM +3 51, +4 88, +4 and 20min 96

You most certainly did not fail lil Meatball! For some perspective...when I started this whole ordeal I wasn't testing and one day I came home for lunch to a cat in a full hypoglycemic seizure - I nearly lost him. You are testing and watching out for Meatball's well-being. You caught this before it got out of hand and took corrective actions. I applaud you and you are doing great!! Meatball is in good hands! Grats on the reducie!
 
Re: Meatball: PM +3 51, +4 88, +5 163

We're at +5 and 163. Phew. Feeling like we're on the upswing. I removed the "911" from the post. Just gave another bit of food. Will retest in an hour and go to bed. Back to 1.75u tomorrow. Thanks again all.
 
Re: Meatball: PM +3 51, +4 88, +4 and 20min 96

Tara & Buster said:
You most certainly did not fail lil Meatball! For some perspective...when I started this whole ordeal I wasn't testing and one day I came home for lunch to a cat in a full hypoglycemic seizure - I nearly lost him. You are testing and watching out for Meatball's well-being. You caught this before it got out of hand and took corrective actions. I applaud you and you are doing great!! Meatball is in good hands! Grats on the reducie!
Click to expand...
Thanks for that. Tomorrow is a new day, right?
 
Re: Meatball: PM +3 51, +4 88, +5 163

Every day is a new day! ;-)

Here's my general philosophy on life. (I'm no Plato!)

Forget yesterday. Screw it, it's over.
Live for today. A lifetime can be lived in moments.
Do not fear tomorrow. Anticipate it.

You did great with this today. :-D
 
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