9/11-+12@167, +13@138, +14@118, STALLING. Please advise.

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blove7

blove7

Member Since 2013
Hi all,

After giving Corduroy .25 units last night at 8:37 pm, his morning AMPS is 167. I am stalling right now. Should I give him another .25? Is this considered shooting low?

Thanks,

Brigitte
 
Re: 9/11, Corduroy, AMPS 167

Good morning!

This isn't considered shooting low. Shooting low is typically numbers below 100 and depending on your experience, it can mean shooting anything above 50. We use numbers below 150 as our "post and ask for input" number when you're starting out. With that in mind, I think you are fine to shoot. If you are concerned, then get early tests to see where Corduroy's numbers are going.

When you have some time, could you complete a Profile for Corduroy? It will give us important background (e.g., date of diagnosis, medical history).
 
Re: 9/11, Corduroy, AMPS 167

Okay, so after stalling for 1/2 hour, I checked his BG levels again before shooting. He is now at 148. Now should I shoot? I'm sorry for so many questions. I just get nervous with these "low" numbers (low for us anyway;))

Thanks again,

Brigitte
 
Re: 9/11, Corduroy, AMPS 167

Hi guys .. I don't think I've stopped into Corduroy's condo before so welcome from us :-D I don't have any dosing advice, but I can say these are some nice numbers, especially for just starting out! Have a great day guys!
 
Re: 9/11, Corduroy, AMPS 167

Hi again,

I apologize for posting so many times today (I hope I'm not already wearing out my welcome), but after stalling for another half hour, his BG levels are now 138. So they're dropping every half hour. Not sure what to do. I haven't fed him yet this morning either. I'm guessing I shouldn't shoot at this point?

Brigitte
 
Re: 9/11, Corduroy, AMPS 167

Hi Brigitte - interesting that the numbers are still dropping a bit. Like Sienne said, anything over 50 is a shootable number WHEN you have the experience - and data - to know how your cat will react. But I can understand your stalling since you haven't shot lower numbers before, and the fact that they are still dropping a little is something else to consider. I'm not sure what to tell you; if you don't shoot his numbers are probably going to be really high by the next shot time. I would suggest you update the subject line of your first post to reflect the new numbers like this:

"+12=167 +13=138 STILL DROPPING, STALL?? HELP PLEASE"

or something along those lines. Sienne probably thinks your question is answered and no one else is checking. Sometimes you need to make it really clear you need some help! How flexible are your shot times? If you check in half an hour and he is not dropping anymore, if you shoot then your next shot time will be out too, can your schedule handle that?
 
Re: 9/11, Corduroy, AMPS 167

Also on your spreadsheet, just to make it clear to others that you didn't shoot yet, you can "stack" the numbers in the usual preshot cell, just type in the numbers "167 @ +12, 148 @ +12.5, 138 @ +13". You will just have to choose the right colour for the cell manually since the spreadsheet won't know what to think of all of those.
 
167 @ +12, 138 @ +13, 118 @ +14, STILL DROPPING, STALL?

Hi there,

He is still dropping, BG at 118 now. This is w/o any insulin last night. I still haven't shot, plus I haven't fed him yet because I have been stalling. Does anyone have some advice as to what I should do at this point?

Thanks so much,

Brigitte
 
Re: 9/11, Corduroy, AMPS 167

Hi Amy and Papaya,

I re-vamped my subject line, so hopefully someone will be able to advise soon. I also typed the numbers in my ss like you mentioned. I hope I did this correctly. When you asked if my schedule can handle it, did you mean tonight, if it's really late? If so, then yes, it can. I don't work until 1 pm tomorrow, but of course, I do need sleep, so the latest I can do is probably around midnight. Is this what you mean?

Thanks so much for your input,

Brigitte
 
Re: 9/11, Corduroy, AMPS 167

Sorry, Brigitte, just to clarify - you said "without any insulin last night" but the spreadsheet shows you shot 0.25 for the PM shot of 9/10, right? So it's just no insulin this morning?

The fact that he is STILL dropping and the fact that you are two three hours past usual shot time might just indicate you should skip this shot and ask for advice about what to do with tonight's shot. He is already on a pretty low dose of insulin and after looking more closely at your spreadsheet I see that he hasn't usually gone terribly high when you've skipped, usually just to around 250, which does show he still needs insulin but isn't too bad.

You do need to find a dose that you can shoot consistently AM and PM while he still needs insulin, but maybe some others can offer advice on shooting very tiny doses less than 0.25 if that is what you need to do. Sorry there aren't more people around at the moment to answer your questions!
 
Re: 9/11, Corduroy, AMPS 167

Oh sorry I cross-posted and didn't see your additional questions.

About the shot times: If you shoot 2 hours late, then the next shot has to be about 12 hours later except you can move each one up by 15 minutes. So if you shot, say at 10 AM today you could shoot the PM shot at 9:45, then tomorrow's at 9:30 etc. until you get back to where you want to be.
 
Re: 9/11, Corduroy, AMPS 167

And the spreadsheet: you "stacked" the numbers right, now just delete the ones in the +1 +2 etc columns and save those for after when you actually shoot, if that makes sense.
 
Re: 9/11, Corduroy, AMPS 167

Oh dear I'm starting to feel like Columbo in those old shows with the "one more thing" . . . when you edited your subject line you did it on a new post, not on the original one, so it's still not showing up on the main forum. You need to go back to your very first post of the day and hit "edit" then change that subject line. Then others will be able to immediately see what's going on.
 
Hi Amy and Papaya,

I'm sorry, I DID give .25 last night. I changed the subject line by editing, so hopefully this will work. I will probably have to skip his dose for today as I have an appt. at noon. I have to say, this is all quite stressful, not knowing what to do. :sad:

Thanks again,

Brigitte
 
I think what Amy is saying regarding the spread sheet is with the column before the dose column, remove these 148 @ +13, 138 @ +14, 118 @ +15 but keep the 167 # there only as that's the # you got before you would technically shoot the dose. You've got the 148, 138 and the 118 marked in the correct spots, and that's where they belong. I find it rather interesting and intriguing that he's coming down without this morning's shot. If you shoot at the normal time this evening, please don't be alarmed that his PS # may be high due to not having insulin since last night. This will pass over a day or so, and it's called a bounce. It happens to us all. :lol: You're doing a wonderful job! Please continue to test him throughout the day. You don't want him to drop further, and no worries about constantly asking questions. Ask away! :-D

You need to feed if you haven't done so already. That may help to bring his #s back up.
 
Hi Rhiannon and Shadow,

I just now fed them. I was stalling all morning because I wasn't sure what to do. I just checked again, and his BG is 106 @ 11:18 am, so I guess I am skipping for today. I guess I will check again tonight at the usual time of around 8:30 pm and go from there. Is this correct?

Thanks,

Brigitte
 
Yes, check again at the usual time tonight, and be sure to continue to check him from this point until his next test. The food should help to keep him from falling further... The tests will confirm if he is still falling or not with the food. He seems to be keeping you on your toes today. Good job!
 
Hi Brigitte,

Sorry I can't advise on dosing or skipping, but something you can also do if your question hasn't been answered yet is to go to your original subject line & above the box where you type, there are icons you can add. You'll see a "?" icon that you can highlight - keep that up until your question's answered, so members know to visit your condo. Looks like Corduroy's doing great - even with the skip! Don't be surprised if he bounces, though, like others said, it happens - Tigger does it all the time!
 
I know it's scary not knowing what to do exactly, but I think you handled it well .. fingers crossed Corduroy just surfs the day away and isn't too high when you test tonight .. You're doing a great job!
 
Angela & Blackie & 6 Others said:
I think what Amy is saying regarding the spread sheet is with the column before the dose column, remove these 148 @ +13, 138 @ +14, 118 @ +15 but keep the 167 # there only as that's the # you got before you would technically shoot the dose. You've got the 148, 138 and the 118 marked in the correct spots, and that's where they belong.
Click to expand...

OK Angela I think I do it differently as that is the exact opposite of where I would have put them - I was thinking all those numbers should stay left of the pre-shot since it wasn't clear if she was going to shoot. Anyway whichever way you do it, Brigitte, as long as there are clear notes somewhere explaining when you actually shoot or if you skipped, it will be fine. I hope we're not driving you crazy here :lol: it's just so everyone who is advising can be getting accurate information!
 
Amy & Papaya said:
Angela & Blackie & 6 Others said:
I think what Amy is saying regarding the spread sheet is with the column before the dose column, remove these 148 @ +13, 138 @ +14, 118 @ +15 but keep the 167 # there only as that's the # you got before you would technically shoot the dose. You've got the 148, 138 and the 118 marked in the correct spots, and that's where they belong.
Click to expand...
Click to expand...

-Okay, I removed the #s from the pre-shot column. Thank you.

-And no, you're not driving me crazy at all. I really appreciate the input and help, believe me. I'm nervous about these things :!:

Thanks again,

Brigitte
 
Wendy, I think the main problem this morning was not so much the shooting low but the fact that the number was continuing to drop. What would you have advised this morning given the dropping numbers? I wasn't sure what to suggest.
 
Hi Wendy,

I just read the link that you included in your post. Thank you, it is helpful, but I'm confused by these two paragraphs:

So why the +10's and +11's? Well say you are on day 5 of a dose increase change and your storage shed is now not only full, it is overflowing... and your +10 or +11 was way higher than your preshot. Good way to stay out of trouble cause now you know you would have shot a still dropping number, not a good idea.

Also some Lantus and Levemir users notice a dip at the end of the cycle, meaning that their preshot is always a bit lower than their +10 or +11. It is important to know if your cat is one of those because if you are not raising your dose because your PS doesn't seem to call for it, yet your nadir is not so hot... this could be the reason why.
Click to expand...

- I guess I don't understand what the first paragraph is saying at all. What do they mean by the storage shed being full in correlation to the +10s and 11s being higher that the pre-shot? Also, if the +10s and 11s were way higher, then I do not see how they would be shooting a still-dropping number.

- And in the second paragraph, to me, a dip at the end of the cycle would mean that the pre-shot would be higher, so I do not understand when they say it would be lower.

Also, how can I find the nadir? Do I need to test every two hours or even more? I guess that's what I'm afraid of the most. Even tonight, with his pre-shot being 289 and giving him .25 units, I'm afraid that he will go hypo in the middle of the night.

Again, thanks for all your help,

Brigitte
 
9/11: PMPS=289, +2=246. When to stop worrying about hypo?

Hi all,

Corduroy's PMPS was 289. At +2, it was 246. I plan to stay up for awhile longer to check it again before I go to sleep, but is there a time when I can stop worrying? Say for instance, at +3? I was sleep-deprived last week, and although I'll do anything for my kitty, I hope to get a little sleep this week ;-)

Thanks,

Brigitte
 
Do a "before bed" test...if he's dropping a lot lower, you can set your alarm to check later. That's what most of us do.

"Generally", if the +2 is about the same as the PS number, it SHOULD be a "Quiet cycle", so you wouldn't need to test more often. You can also always leave a little LC food out. Most cats will get hungry if their BG drops
 
I will try and answer but I hope the others chip in too.

Firstly a normal cycle is for example:
AMPS 300 +3 200 +6 100 +9 200 PMPS 300
This is a curve with the nadir at +6.

However the first paragraph you asked about - its like this example:
AMPS 300 .... +10 400 + 11 250 PMPS 150.
Then the number is successively dropping from the +10 and +11 to PMPS . The paragraph is referring to the preshot test that occurs after your +10 and +11 - not the previous one. So you know the number is dropping and whether you are safe to shoot. If you didnt get the +10 or +11 you wouldnt know that.

Also, how can I find the nadir? Do I need to test every two hours or even more? I guess that's what I'm afraid of the most. Even tonight, with his pre-shot being 289 and giving him .25 units, I'm afraid that he will go hypo in the middle of the night.
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The nadir wanders between cats and on different days. You dont need to test every 2 hours unless you think he could be dropping a lot..We recommend a before bed test every night because if your +2 or +3 is more than 20% lower than PMPS then you may have an active cycle. And you might want to set the alarm for a later test just to check.

For example on these nights:
- tonite I would get a PMPS+5 since he doesnt seem to be dropping that fast. Or even later ie +6 or +7.
- on the 2nd he dropped a lot to PMPS +2 so the +3 was a good idea.
- on the 8th you were ok to go to bed because the PMPS+2 was higher than PMPS.

Generally you only have one nadir in a cycle too so if he drops down and starts to rise again over an hour or two you are also safe to go back to bed. (but the drop or rise has to be more than 20%)

Make sense?

Wendy
 
Hi Brigitte

Welcome to Lantus Land!

I'd like to put a different spin on things ....I find there's always a lesson and something for members to learn for the next time because there will be.

Corduroys +12 was 167. Sienne said she thought you were safe to shoot....and you were. Also as she said, we encourage you to shoot above 150 and if you get a PS below 150, post for help. If you had shot the 167, you could have fed and numbers would have come up. By stalling and not feeding, the numbers continued to drop until you had to skip.

If you get a 150 or below and post for help, then a member can walk you through safely shooting and we teach you to gradually shoot lower and lower. Our commitment to you is if someone helps you shoot your lowest number, they stay with you as long as necessary until Corduroy is coming up.

Let me answer your other questions.

In a normal cycle (unless your kitty has a late nadir), the +10 and +11 should be rising numbers. If you have gotten one of those tests then you can tell if your PS is a dropping number or a second dip. Lantus is known for second dips. You can identify a second dip because there would have been a nadir, numbers come up, then at PS, numbers drop. Second dips are safe to shoot because the dip is never lower than the nadir.

Contrast that with a dropping number. A dropping number is where the BG slides down all cycle and the lowest number is the PS. Shooting forgoing numbers can allow you to take advantage of the overlap and carryover between two cycles. However, you need data to shoot lower dropping numbers (below 150). You need to know if your cat gets a food spike or not at +1. You need to know exactly how your cat responds to food management.

Lantus and Levemir are depot insulins. Their action is different and since you use Lantus, I'll explain that one. When you start giving shots, the kitty doesn't generally use the insulin of those shots off the bat. Instead, the insulin is deposited as a precipitate in the subcutaneous layers and when the depot (formally called storage shed) is full at the current dose, then the cat starts to use the Insulin that you shoot. Here is a great post on the Insulin Depot.

The nadir can change from cycle to cycle and the depot can affect up to 6 subsequent cycles although in most cats it's usually 3-4 cycles.

One hint on how a cycle might evolve is in the +2 test. We urge you to get a +2 as many cycles as you can.
If the +2 is much higher than the PS, it's likely to be a slow cycle.
If the +2 is similar to or same as PS, you should be prepared for an active, Lantus cycllr.
If the +2 is much lower than the PS, you could expect a very active cycle.

I hope I've answered some questions.
 
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