8/6 Smores; PMPS 176;+2-97;+3.6-48;+4.2-70;+4.8-75

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Sam and S'mores

Member Since 2011
Yesterday's Condo

Edited to include all readings here in the first message:
AMPS 245
Shot 1.25
+4-50
+5-54
+6-45 (!) (gave 1TB HC wet, ate all immediately)
+6.8-50
+7.6-43 (!) (Ate ~2TB HC wet immediately)
+8.5-63 (yay!)
+9.6-91
+11-126
PMPS 176
Shot 0.75
+2-97
+3.6-48 (!) (ate ~1.5oz LC just before measurement, ate 1tsp HC wet after)
+4.2-70
+4.8-75
--
Original post below:

We skipped last night b/c of a low reading, but I went back to the normal shot this morning. He is now down at 50!

Every measurement is a struggle still (we're only on day 5 of hmoe testing), so I was planning to check in an hour.

If anyone is around with a lot of experience, I'd love some advice on how worried to be, and what levels I should start to go into the hypo kit! I'd really like to let him level out on his own if he can...
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50

ok, dont panic...

from the How to Handle Low Numbers sticky:

viewtopic.php?f=9&t=46003

If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of food with high carb (HC) gravy or HC food only. (If you have a cat with GI issues, using syrup plus LC food is an alternative.)

Test again in 15 – 20 min. Depending on the numbers, give more HC food.

Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.

Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.

DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.



so yes, feed a bit now, and get the retest, preferably in 1/2 hour rather than waiting for an hour, give it a try, I know you are new to hometesting, but try your best to retest in about 1/2 hour after that 50 and some food.
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50

50 isn't a panic number. Take a deep breath. Take a look at the link that Ronnie posted. It's what you need if there's low traffic on the board.

You do want to feed a little bit of food with higher carb than usual. You can mix HC + LC. The idea is that you want Smores to surf in the above 50 BG range. Those are numbers which promote pancreatic healing. (In other words, this is a good thing!)

Can you get another test at +4.5 and post the results in your subject line?
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50; +5 54

I was able to get another reading at +5, and he has drifted up slightly to 54. I have not yet given him any HC food (he is still grazing on this morning's Friskies can).

I will try to get another test in half an hour, but definately get another one in an hour. Since I have not had to "spike" him with carbs, I'm hoping this will be a more gradual response.

So, assuming he continues to drift back up, what do I shoot tonight? I.25 seems like it is too much, certainly for a PM shot when I will not be able to monitor him all night. But he missed last night's shot too, and I don't want to have his storage shed completely empty out either... I know it will depend on the rest of his curve, but I'm not confident what to do in any of the scenarios.
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50; +5 54

It's too early to decide what to do about tonight. There's no way to know where Smores' numbers will be.

You can give him more LC food. LC may have the same effect of getting him to surf. That's fine. Right now, you don't know exactly how he'll respond to which kind of food at what point in the cycle. Testing every 30 min. until you know you have rising numbers or there is a steady surf is the plan for the moment.

At some point, you really need to get a curve. There's no way to tell based on your SS where Smores' nadir is. Knowing when Lantus onset and nadir both occur is important information.
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50; +5 54; +6 4

Uh-oh! He dropped below 50.

It's taking me too long to get each of these measurements. Most of the pricks don't bleed at all... I wonder if I need better lancets. I sit down to get the 30min measurement, but when I finally get it, it's been 1hr!

I've given him a tablespoon of HC wet food and he wolfed it down. He still has ~2oz left of his 5oz can from this morning. We was eating that regularly, but it's getting to the warm part of the day, and I think he's been just hiding in the cool parts of the house. Maybe I'll move his food to him for now.

Time to try to take another measurement... Wish me luck.
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50; +5 54; +6 4

Now you want to give some HC and please test every 30 min. Numbers will wobble as food wears off. The only way you can control the numbers is by testing and with food. If you don't test when numbers are in this range, numbers could drop further unbeknownst to you and it will be hard work to get them back up.

Smores earned a dose reduction for tonight based on the 45.

I'm not going to be able to keep following. Please read the link that Ronnie attached on managing low numbers. I'm not sure who's around right now if you need a hand.
 
Re: 8/6 Smores !!NEED ADVICE!!; AMPS 245; +4 50; +5 54; +6 4

Good luck.
A lot of times, I have to do several (or more than one) pokes right next to each other to get enough blood for a test.
Are you warming his ear, first?
 
Re: 8/6 Smores !!ADVICE!!; AMPS 245,+4-50;+5-54;+6-45;+6.8-5

I did a little better than 1hr... :? I'm going to get new lancets. I've felt these, and I think they are dull.

In any case. He is back up to 50, so he's not crashing (at least not yet). I'll retest as soon as I get back.

Hopefully this is some good healing going on. I'm still astounded by the drop over the last day. Did his pancreas suddenly decide to wake up and take over?
 
Re: 8/6 Smores !!ADVICE!!; AMPS 245,+4-50;+5-54;+6-45;+6.8-5

Leave a little low carb food out, if you're going to run to the store, just in case, k?
 
Re: 8/6 Smores !!ADVICE!!; AMPS 245,+4-50;+5-54;+6-45;+6.8-5

You'll be back in less than 30 minutes, right?
 
Re: 8/6 Smores !!ADVICE!!; AMPS 245,+4-50;+5-54;+6-45;+6.8-5

You are doing great Sam.

Test again in 15 – 20 min. Depending on the numbers, give more HC food.

Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.

Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.

Remember, the numbers may bobble.
 
Re: 8/6 Smores, AMPS 245,+4to+7.6 43-54, +8.5-63, +9.6-91

I'm still here. I also have a sick 9 month old, so I am walking arround bouncing her b/w fighting for blood...

I took a reading at 7.6 of 43(!), so I gave a bunch more HC food.
S'mores took a 30min nap while I dealt with the screeming baby, and then I just got a shot at ~8.5 of 63. (yay)

I should probably mention that he does not seem symptomatic of hypo at all.

I'll go update the SS now.

UPDATED:
+9.6 shot of 91, so I think we are spiking back up. I'll get some more of the curve and then post for advice on the PM shot...
 
Re: 8/6 Smores; AMPS 245,+4to+7.6 43-54, +8.5-63, 9.6-91

These really aren't hypo numbers for most cats. You don't really want to find out where that is, though. I do suspect if a cat sat in the 40s for hours you might see symptoms but a quick dip into those lower ranges, well, most cats are not symptomatic.

It sounds like you've got your hands full!
 
Re: 8/6 Smores; AMPS 245,+4to+7.6 43-54, 8.5-63, 9.6-91, 11-

OK, now what should I be planning to shoot?

+11 is 126
I'm guessing PMPS will be 150-200

This morning's dose was 1.25, but we skipped last night's dose completely.

I'm thinking a ~half dose of 0.5. Thoughts?
 
Re: 8/6 Smores; !!DOSING!! AMPS 245,+4to8.5 43-63;9.6-91;11-

My thoughts FWIW: Smores earned a dose decrease with the 43 today, from 1.25 to 1.00. I would go with the 1.00 tonight, depending on the +12 number. Let's see what others have to say. You are going to be around tonight, correct?
 
Re: 8/6 Smores; !!DOSING!! AMPS 245,+4to8.5 43-63;9.6-91;11-

In the Tight Regulation Protocol, the guidance for reductions is:

Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
so I would reduce by 0.25, to 1 unit BID.
 
Re: 8/6 Smores; !!DOSING!! AMPS 245,+4to8.5 43-63;9.6-91;11-

PMPS was 176

Your suggestions are 1u. My reading and sense of S'mores says 0.5. So I'm splitting the difference: 0.75

Let's see how late I have to stay up ~O)
 
Re: 8/6 Smores; AMPS 245,+4to8.5 43-63; PMPS 176

What a day you have had!

It is important that you be comfortable with what you are shooting.
Sam and S'mores said:
Let's see how late I have to stay up ~O)
(hope you can get some rest!)
 
Re: 8/6 Smores; (long night ahead) PMPS 176; +2-97

Hi towards those to my west!

+2 is 97... he has dropped very fast. It's probably going to be a long night.
 
Re: 8/6 Smores; (long night ahead) PMPS 176; +2-97

I would feed a little something to see if you can get him to surf. Then test in 30 minutes.
 
Re: 8/6 Smores; (Very long night ahead) PMPS 176; +2-97; +3.

He's a grazer, so he has food for most of his cycle (he finishes a 5.5oz can around +10 in each cycle). He ate some around the +2 measurement, and then took a long nap.

He woke up and had a big meal at +3.6. I measured as soon as he walked away from the bowl and got a BG of 48.

I gave him some HC (~1 tablespoon). He licked the gravy off, but didn't eat much. I'll recheck in 30min or so. I'm hoping the big meal bumped him back up.
 
Re: 8/6 Smores; (Very long night ahead) PMPS 176; +2-97; +3.

get him to eat a couple tsp of gravy and test in 30 minutes please.
 
Re: 8/6 Smores; (Very long night ahead) PMPS 176; +2-97; +3.

Right back up to 70 after to big meal (+4.2)!

I took the rest of the HC away. I think he ate ~1tsp.

I woke him up for the shot, and now he's chowing down again.
 
Re: 8/6 Smores; (long night) PMPS 176;+2-97;+3.6-48;+4.2-70

Numbers may wobble around as the HC begins to wear off. You'll need to get another test in 30 min. to make sure you know where the numbers are going.
 
Re: 8/6 Smores; (long night) PMPS 176;+2-97;+3.6-48;+4.2-70

I don't think it was the HC. He really did not eat enough to make a difference (based on his reactions from earlier today). I think it was just the big LC meal. I don't have enough data on S'mores yet to know if this is "normal". (and he's never been in this BG range since DX anyway)
 
+4.8 came in at 75. I think it's time for me to go to sleep so we can do it all again tomorrow.

Thanks for all the help!
 
If you're still around, please get one more BG test. It should be about 30 min since the last one.
Want to be more certain he's still surfing in a safe range and not dropping again after the food wears off.

MJ&Donovan
 
I was still around, trying to give back what I can at this point with some vary basic advice elsewhere, so I took another shot:
+5.4-73

I think we're OK.

And I finally had a run of good measurements! It takes a few pricks each time before one of them bleeds. It's odd. Most of the time I just get NADA from the prick, as if it never happened, and then I'll get one that pops a nice blood drop. I've learned to just keep pricking quickly, and not try to find or wait for the failed pokes to bleed.
 
Here's hoping you don't have many of these drama-filled evenings in your future.
Congrats on the dose reduction. Now Smores, please don't bounce after this.

MJ&Donovan
 
Sam,

I know I had not respond earlier as you were going through your rough patch with S'mores' BG dropping, I didn't want there to be too many cooks in the kitchen, but my thoughts and prayers were with you, S'mores, and your family. It is hard enough going through our kitty's BG dropping like that, but to have a sick baby on top of that.

I peaked at S'mores SS today and was glad to see a smoother BG day! Hope you baby is feeling better too.

Roberta
and Casey
 
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