? 83 @+6, another reduction for Minnie?

[Ale & Bobo & Minnie (GA)]

It seems we were at 3U for almost 4 days and today I got a lower than 90 BG level. Her pattern also seems to be low BG, dose reduction, bounce, rinse lather repeat at this point... I guess I just to want to make sure I’m going down to 2.75 tonight. Also, she never eats before her midday test. Last meal was at 10am and I tested her at 2pm then gave her food after. I just thought I’d mention it.

PS - unrelated question, but the vet put her on b12 injections every other week back when she was diagnosed with diabetes. I’m wondering if you guys all do that or if I can stop given she’s on the b12 methyl daily as well. Those injections can sting

thanks!

 

[jt and trouble (GA)]

We never got B12 injections...hmmm unless shes deficient I dont see why. I guess its not a bad thing. I'm sure someone will have an opinion on this.

 

[Ale & Bobo & Minnie (GA)]

We never got B12 injections...hmmm unless shes deficient I dont see why. I guess its not a bad thing. I'm sure someone will have an opinion on this.

When I was researching neuropathy and b12 methyl, most sites mentioned that the liquid b12 is not the same thing as the methyl version that acts directly into the spinal fluid, but most vets will add the b12 injections once cats get diabetic because they usually are lacking it. Every time I asked my vet about b12 methyl she’d say that cats dont absorb b12 orally as well hence the shots and I think that’s what most vets believe

 

[jt and trouble (GA)]

LOL Sounds like your Vets gots some learnin to do! You needs to edumacate them.

 

[Nan & Amber (GA)]

Yup, another reduction to 2.75!

I'd also get another test or two this afternoon if it's possible, just to make sure she isn't going any lower...

 

[Ale & Bobo & Minnie (GA)]

It seems we were at 3U for almost 4 days and today I got a lower than 90 BG level. Her pattern also seems to be low BG, dose reduction, bounce, rinse lather repeat at this point... I guess I just to want to make sure I’m going down to 2.75 tonight. Also, she never eats before her midday test. Last meal was at 10am and I tested her at 2pm then gave her food after. I just thought I’d mention it.

PS - unrelated question, but the vet put her on b12 injections every other week back when she was diagnosed with diabetes. I’m wondering if you guys all do that or if I can stop given she’s on the b12 methyl daily as well. Those injections can sting

thanks!

Miss @Deb & Wink does your like mean I’m right about the reduction even with no food before the test that read 83BG?

 

[Deb & Wink]

Miss @Deb & Wink does your like mean I’m right about the reduction even with no food before the test that read 83BG?

Yes, that is what my "Like" means. Also, Nan & Amber (GA) had already replied on the dose reduction, so I did not feel I needed to provide any more information.

Your SS link isn't working for me, so I can't open Minnie's spreadsheet. Looks like the permissions have changed.

Doesn't matter when you get that low below 90 mg/dL when you are following SLGS dosing protocol. You reduce.
If Minnie does not hold the reduction, and her numbers start to rise (not a bounce type rise), then you go back to the last good dose.

 

[Nan & Amber (GA)]

Your SS link isn't working for me, so I can't open Minnie's spreadsheet. Looks like the permissions have changed.

That's weird... I still had it open in a tab from earlier, and was able to refresh it and see today's data, no problem.

@Aleluia Grugru & Minnie , did you change anything with the file or the link in your signature?

 

[Ale & Bobo & Minnie (GA)]

Yes, that is what my "Like" means. Also, Nan & Amber (GA) had already replied on the dose reduction, so I did not feel I needed to provide any more information.

Your SS link isn't working for me, so I can't open Minnie's spreadsheet. Looks like the permissions have changed.

Doesn't matter when you get that low below 90 mg/dL when you are following SLGS dosing protocol. You reduce.
If Minnie does not hold the reduction, and her numbers start to rise (not a bounce type rise), then you go back to the last good dose.

Marje asked me to fix my signature because the link should be at the end not where I had it and I couldn’t get the link to work so I recopied and repasted it, maybe that’s it? Sorry, weird I didn’t see the alert for Nam’s reply

 

[Ale & Bobo & Minnie (GA)]

That's weird... I still had it open in a tab from earlier, and was able to refresh it and see today's data, no problem.

@Aleluia Grugru & Minnie , did you change anything with the file or the link in your signature?

Yes, Marje asked me to move it. See my answer to Deb, maybe it screwed it up? Urghhhhh

I also didn’t see your reply never got the alert except for this one. Odd

 

[Ale & Bobo & Minnie (GA)]

Yup, another reduction to 2.75!

I'd also get another test or two this afternoon if it's possible, just to make sure she isn't going any lower...

I’m only 30 minutes away from her PMPS now... I’ll do it now. Thanks!

 

[Ale & Bobo & Minnie (GA)]

Yes, that is what my "Like" means. Also, Nan & Amber (GA) had already replied on the dose reduction, so I did not feel I needed to provide any more information.

Your SS link isn't working for me, so I can't open Minnie's spreadsheet. Looks like the permissions have changed.

Doesn't matter when you get that low below 90 mg/dL when you are following SLGS dosing protocol. You reduce.
If Minnie does not hold the reduction, and her numbers start to rise (not a bounce type rise), then you go back to the last good dose.

I just feel nervous about this consistent decrease. I know I shouldn’t, but urghhhh

 

[Nan & Amber (GA)]

Hmm, my guess is that you put the link to your own access (the "edit" in the address), rather than the sharing link. This is the address I have in the tab that seems to be working, I don't know if it helps:

https://docs.google.com/spreadsheet...UxrERjSwcNrGak9WCttliM8jhn4hJ37a_pnw/pubhtml#

I just feel nervous about this consistent decrease. I know I shouldn’t, but urghhhh

She's doing great! This is a good thing!

The pre-shot is probably enough at this point, you don't need to get another test before that. Next time she goes below 90 during a cycle, though, do try to keep testing if you can. It's very possible she's going lower than that, it might be why she bounces for a while afterwards...

 

[Diane Tyler's Mom GA]

I just feel nervous about this consistent decrease. I know I shouldn’t, but urghhhh

I can't see your spreadsheet either

 

[Ale & Bobo & Minnie (GA)]

I can't see your spreadsheet either

This is all Marje’s fault!!! Lol
I’ll fix it

 

[Diane Tyler's Mom GA]

Lol

 

[Ale & Bobo & Minnie (GA)]

Hmm, my guess is that you put the link to your own access (the "edit" in the address), rather than the sharing link. This is the address I have in the tab that seems to be working, I don't know if it helps:

https://docs.google.com/spreadsheet...UxrERjSwcNrGak9WCttliM8jhn4hJ37a_pnw/pubhtml#



She's doing great! This is a good thing!

The pre-shot is probably enough at this point, you don't need to get another test before that. Next time she goes below 90 during a cycle, though, do try to keep testing if you can. It's very possible she's going lower than that, it might be why she bounces for a while afterwards...

good point. I didn’t think of that because I fed her twice after but you’re totally right. I’ll do a +2 next time I get a lower than 90 BG

Thanks Nan!

 

[Nan & Amber (GA)]

good point. I didn’t think of that because I fed her twice after but you’re totally right. I’ll do a +2 next time I get a lower than 90 BG

Thanks Nan!

Even if you feed her, you want to make sure it's doing the job!

Also, you don't have to have a 2-hr no-food window before testing at any times other than the AMPS and PMPS. Other than that, you can test, feed, or test and feed, any times you want!

 

[Ale & Bobo & Minnie (GA)]

Even if you feed her, you want to make sure it's doing the job!

Also, you don't have to have a 2-hr no-food window before testing at any times other than the AMPS and PMPS. Other than that, you can test, feed, or test and feed, any times you want!

Yeap, got it. She was at 139 at the PMPS I gave her a token shot. I didn’t want to skip a dose again because it throws her numbers too high the next day and she was drinking lots of water the next day. I’ll test again in 2 hours to make sure she’s not going down

btw, I think I fixed the ss you guys let me know

 

[Diane Tyler's Mom GA]

Spreadsheet is good, I can see it now

 

[Ale & Bobo & Minnie (GA)]

Even if you feed her, you want to make sure it's doing the job!

Also, you don't have to have a 2-hr no-food window before testing at any times other than the AMPS and PMPS. Other than that, you can test, feed, or test and feed, any times you want!

happy Saturday!

I tested her at +2 last night and she was already up above 200. I left some food out by her bed and it was gone this morning. Of course I can never tell if she or Bobo ate it or even what time. This am she was at 314. So, let me know if you agree but I’m thinking that if I get a PMPS that is between 100-200 next time, I’ll give her 1/2 her dose. Last night I gave her a third and she was above 300 this am. I’d like to see if 1/2 a dose will keep her in the 200s. If she’s under 100, I’ll retest and if she’s going up then 1/3 dose. If she’s going down like the other day, then I’ll skip. Sounds like a good plan to you?

 

[jt and trouble (GA)]

happy Saturday!

I tested her at +2 last night and she was already up above 200. I left some food out by her bed and it was gone this morning. Of course I can never tell if she or Bobo ate it or even what time. This am she was at 314. So, let me know if you agree but I’m thinking that if I get a PMPS that is between 100-200 next time, I’ll give her 1/2 her dose. Last night I gave her a third and she was above 300 this am. I’d like to see if 1/2 a dose will keep her in the 200s. If she’s under 100, I’ll retest and if she’s going up then 1/3 dose. If she’s going down like the other day, then I’ll skip. Sounds like a good plan to you?

No advice here but ...I SURE wish my husband would take as much care with his diabetes as some of you are!

 

[Deb & Wink]

I just feel nervous about this consistent decrease. I know I shouldn’t, but urghhhh

Decreases are good! It means that Minnie's body is healing, and she is getting better.

btw, I think I fixed the ss you guys let me know

Me too. Access is back. Yeah!

I tested her at +2 last night and she was already up above 200. I left some food out by her bed and it was gone this morning. Of course I can never tell if she or Bobo ate it or even what time. This am she was at 314. So, let me know if you agree but I’m thinking that if I get a PMPS that is between 100-200 next time, I’ll give her 1/2 her dose. Last night I gave her a third and she was above 300 this am. I’d like to see if 1/2 a dose will keep her in the 200s. If she’s under 100, I’ll retest and if she’s going up then 1/3 dose. If she’s going down like the other day, then I’ll skip. Sounds like a good plan to you?

Let me think about this for a minute. And look at Minnie's SS first.

It's the nadirs you want to look at, to base dose changes on.
Although, I think your questions may be more geared to what do you do if you get a low pre-shot?

I suppose you want an answer that says more than "punt"?

Ok, Stall. Seriously, stall without feeding Minnie for 20 minutes, retest and see if the BG is rising.
If it is rising, and it's at your target threshold, give Minnie your suggested dose, the 1/2 or the 1/3. She does tend to bounce if you do that, so be prepared.

Truly, with Lantus anything above 150 mg/dL is a shootable number. If you were over in the lantus ISG forum, people would be wondering why you are concerned with giving Minnie a reduced dose of insulin if her BG is > 150 but < 200.

I'd suggest you modify your strategy, so you give Minnie her full dose if the BG is >150.
Give a reduced dose if the BG is > 100 and <= 150. Your 1/2 a dose sounds ok, but I think she will bounce like crazy the next cycle, due to the "depot" draining and not enough insulin. Plus low numbers make cats bounce like crazy anyway.

It's true you don't have much PM test data. So until you are able to test and get that data, your plan sounds ok with the modifications suggested. It could be very good to get a +2 every cycle, especially the PM cycles where you have little test data. That test often tells you what direction the BG's are headed.

Fill in some more pieces of the puzzle on the SS, not just the "bookends" (the pre-shot tests) and the "middle shelf of the library" (the nadir).

With Lantus, every time you skip the dose or give a reduced dose, you are letting the "depot" drain. So better to avoid that "draining of the depot" as much as possible, and learn to shoot at lower numbers.

 

[Ale & Bobo & Minnie (GA)]

Decreases are good! It means that Minnie's body is healing, and she is getting better.

Me too. Access is back. Yeah!


Let me think about this for a minute. And look at Minnie's SS first.

It's the nadirs you want to look at, to base dose changes on.
Although, I think your questions may be more geared to what do you do if you get a low pre-shot?

I suppose you want an answer that says more than "punt"?

Ok, Stall. Seriously, stall without feeding Minnie for 20 minutes, retest and see if the BG is rising.
If it is rising, and it's at your target threshold, give Minnie your suggested dose, the 1/2 or the 1/3. She does tend to bounce if you do that, so be prepared.

Truly, with Lantus anything above 150 mg/dL is a shootable number. If you were over in the lantus ISG forum, people would be wondering why you are concerned with giving Minnie a reduced dose of insulin if her BG is > 150 but < 200.

I'd suggest you modify your strategy, so you give Minnie her full dose if the BG is >150.
Give a reduced dose if the BG is > 100 and <= 150. Your 1/2 a dose sounds ok, but I think she will bounce like crazy the next cycle, due to the "depot" draining and not enough insulin. Plus low numbers make cats bounce like crazy anyway.

It's true you don't have much PM test data. So until you are able to test and get that data, your plan sounds ok with the modifications suggested. It could be very good to get a +2 every cycle, especially the PM cycles where you have little test data. That test often tells you what direction the BG's are headed.

Fill in some more pieces of the puzzle on the SS, not just the "bookends" (the pre-shot tests) and the "middle shelf of the library" (the nadir).

With Lantus, every time you skip the dose or give a reduced dose, you are letting the "depot" drain. So better to avoid that "draining of the depot" as much as possible, and learn to shoot at lower numbers.

That all sounds great. I agree 100% I’d rather not reduce or skip shots so will do! Thanks Deb!!!

 

[jt and trouble (GA)]

 

[Ale & Bobo & Minnie (GA)]

Decreases are good! It means that Minnie's body is healing, and she is getting better.

Me too. Access is back. Yeah!


Let me think about this for a minute. And look at Minnie's SS first.

It's the nadirs you want to look at, to base dose changes on.
Although, I think your questions may be more geared to what do you do if you get a low pre-shot?

I suppose you want an answer that says more than "punt"?

Ok, Stall. Seriously, stall without feeding Minnie for 20 minutes, retest and see if the BG is rising.
If it is rising, and it's at your target threshold, give Minnie your suggested dose, the 1/2 or the 1/3. She does tend to bounce if you do that, so be prepared.

Truly, with Lantus anything above 150 mg/dL is a shootable number. If you were over in the lantus ISG forum, people would be wondering why you are concerned with giving Minnie a reduced dose of insulin if her BG is > 150 but < 200.

I'd suggest you modify your strategy, so you give Minnie her full dose if the BG is >150.
Give a reduced dose if the BG is > 100 and <= 150. Your 1/2 a dose sounds ok, but I think she will bounce like crazy the next cycle, due to the "depot" draining and not enough insulin. Plus low numbers make cats bounce like crazy anyway.

It's true you don't have much PM test data. So until you are able to test and get that data, your plan sounds ok with the modifications suggested. It could be very good to get a +2 every cycle, especially the PM cycles where you have little test data. That test often tells you what direction the BG's are headed.

Fill in some more pieces of the puzzle on the SS, not just the "bookends" (the pre-shot tests) and the "middle shelf of the library" (the nadir).

With Lantus, every time you skip the dose or give a reduced dose, you are letting the "depot" drain. So better to avoid that "draining of the depot" as much as possible, and learn to shoot at lower numbers.

I actually copied and pasted your entire reply so I can reread over and over again. Getting your super calm detailed explanations is like meditating or having a warm glass of milk when your stomach is in knots. You have the teacher’s touch Or is it librarian’s? They’re also known to be calm

the only other thing I also need to figure out is how the nausea/vomit affects her numbers, which may have nothing to do with the dose she’s on. Like this morning again more vomit and not wanting to eat, so I gave her baby food to be able to shot. That’s a different food and when all she eats is that and tuna for a day, I’m sure it affects her levels. I’m just not sure if it sends it up or down. Baby food only has 2% carbs so I guess that’s a good thing and it makes me think it would send her numbers down having less carbs that would require less insulin, right? I don’t think I should change her dose based on those days because I feel like that’s almost a false reading. Anyway, I’ll see where she’ll be midday. I added the +2 shot from last night, but disclaimer she hadn't eaten since the shot so it was pretty much on an empty stomach and I think it would have been higher had she had food in her. Btw, I was wondering how long it takes for the food to make her BG go up. Like if she eats 5 minutes before I test her, is that going to influence the numbers or it takes more time than time.

As always, thank you

 

[Deb & Wink]

Btw, I was wondering how long it takes for the food to make her BG go up. Like if she eats 5 minutes before I test her, is that going to influence the numbers or it takes more time than time.

Ale, it takes more than 5 minutes, for food to have an effect on the BG readings. Karo syrup or honey on the other hand, can be very fast to act. Not much to digest there, so faster into the bloodstream. Doesn't keep the BG levels up for long, but gets them up fast.

When we are helping people with a low numbers situation, we ask them to retest in 15-20 minutes. That is partially to see if the BG levels are rising on their own, but also to see if the food (grab for the low carb food first) is having an effect.

the only other thing I also need to figure out is how the nausea/vomit affects her numbers, which may have nothing to do with the dose she’s on. Like this morning again more vomit and not wanting to eat, so I gave her baby food to be able to shot.

Less food on board, will often cause the BG numbers to be lower. So vomiting, or a cat that is not eating well can lead to a cat having lower BG levels. Not necessarily hypoglycemic territory low. But lower than normal.

Since lantus onsets in about 2 hours, it's ok to still give your cat the shot, as long as you know you can get your cat to eat something before that insulin onset. By either a) eating on their own, something yummy like the baby food or b) hand feed or syringe feed. Also, it doesn't hurt to leave a little bit of their regular low carb food for them to snack on between the insulin dose and about mid-cycle.

Once a cat reaches the middle of the cycle, most of the insulin will have been used up by that point, to digest the food a cat did eat earlier.

I gave her baby food to be able to shot. That’s a different food and when all she eats is that and tuna for a day, I’m sure it affects her levels. I’m just not sure if it sends it up or down.

So test to find out, if it sends Minnie's BG's up or down. Not just on one cycle where you need to give her the special baby food and tuna to get her to eat anything. But whenever that happens. Because, on one cycle Minnie may be in the middle of a bounce, and you won't see the same picture you would if her numbers are lower at pre-shot and the BG's are on a more even keel.

Baby food only has 2% carbs so I guess that’s a good thing and it makes me think it would send her numbers down having less carbs that would require less insulin, right?

Not necessarily that less insulin would be needed. Some cats do better on less carbs, some do better on around 5-6% carbs, some do better on 10% carbs or even 12%. It's that dang ECID (Every Cat is Different). Gets you every time.

So learn more about how Minnie is reacting to the food and insulin, by testing a bit more.
As we also say "Know Thy Cat."
Then you will know when to adjust the insulin dose.