? 9/21 Shelly AMPS 169 Low numbers

[Carina and Shelly]

Shelly's BG has been fluctating between 50-70, and closer to 53 for the past 7 hours. We spot checked two of the lower readings with a Relion and did not get much difference. We are not sure what to make of it. It's the first time we have experienced a prolonged flat curve.
Her current shot time is at +2. We are still a ways off but we are feeling uneasy about shooting at such low numbers even though we are using the TR Method (switched eight days ago from SLGS).

We have been reading the Tight Regulation protocols very carefully and we aren't sure what to do.
We are also wondering if at a 0.5 unit shot, if numbers like these are signs of remission.

Guidance in this moment will be appreciated as we approach our PMPS time.

 

[Staci & Ivy]

Shelly's BG has been fluctating between 50-70, and closer to 53 for the past 7 hours. We spot checked two of the lower readings with a Relion and did not get much difference. We are not sure what to make of it. It's the first time we have experienced a prolonged flat curve.
Her current shot time is at +2. We are still a ways off but we are feeling uneasy about shooting at such low numbers even though we are using the TR Method (switched eight days ago from SLGS).

We have been reading the Tight Regulation protocols very carefully and we aren't sure what to do.
We are also wondering if at a 0.5 unit shot, if numbers like these are signs of remission.

Guidance in this moment will be appreciated as we approach our PMPS time.

View attachment 80399

Hi Carina,
I’m sorry you had the Libre fail today.
I really think when our kitties are in lower BG ranges for several hours it shuts down as a “safety” feature. The sensor must think the person using it isn’t reading correctly, thus it causes a fail.
Since we use it off label, it’s not designed for our cats

It’s wonderful that you are able to blood test her to make sure where her BG is when she is in these low ranges. And it’s good to know that she runs close between your Libre and your handheld meter.
That’s important information to have so whenever she is in these lower numbers, you will want to blood test her

Hopefully this does mean that she is heading for remission. She would need to stay in mostly all green numbers for a week I believe for an OTJ trial without insulin.
Let’s hope that’s where you’re headed

By the way, you can request a free replacement from Abbott for the failed Libre. Just if you contact them, never say it’s for a cat say it’s for yourself or a family member where they won’t even talk to you and they won’t replace it.

It looks like you skipped the dose tonight, so I guess we’ll see how she does without insulin.

I hope you all have a calm night!

 

[Carina and Shelly]

Hi Carina,
I’m sorry you had the Libre fail today.
I really think when our kitties are in lower BG ranges for several hours it shuts down as a “safety” feature. The sensor must think the person using it isn’t reading correctly, thus it causes a fail.
Since we use it off label, it’s not designed for our cats

It’s wonderful that you are able to blood test her to make sure where her BG is when she is in these low ranges. And it’s good to know that she runs close between your Libre and your handheld meter.
That’s important information to have so whenever she is in these lower numbers, you will want to blood test her

Hopefully this does mean that she is heading for remission. She would need to stay in mostly all green numbers for a week I believe for an OTJ trial without insulin.
Let’s hope that’s where you’re headed

By the way, you can request a free replacement from Abbott for the failed Libre. Just if you contact them, never say it’s for a cat say it’s for yourself or a family member where they won’t even talk to you and they won’t replace it.

It looks like you skipped the dose tonight, so I guess we’ll see how she does without insulin.

I hope you all have a calm night!

Thank you so much for the information and support. We are on a later shot schedule so technically we could still shoot. We’ll test her when we get home from picking up a new Libre (you are so right: they fail at the worst times) but we are leaning towards no shot, mostly because this is our first time dealing with a long stretch of low BG numbers and it doesn’t feel safe at this time.

 

[Wendy&Neko]

The way to earn dose reductions is explained here: Reminder: *earning* reductions and starting OTJ trials. It also talks about what we look for before deciding if an OTJ trial should be started. Basically kitty has to earn reductions and get down to even smaller doses. 0.25 units would be next, then 0.1 units. Possibly the drop dose if it looks like she needs a little more insulin support.

It's hard to say whether remission is in the cards, though I hope so. Shelly is in definitely looking like she wants to become regulated, and that is the prerequisite before remission. Your next step would be to stay at this 0.5 unit dose, until she earns a reduction, as per the earning reductions post above. If that 47 tonight was on the Relion, 0.25 units is next.

When you get a lower number than you are used to shooting, try to post here with a subject line like "needing help shooting, lower preshot" or something like that. With Lantus, you do have to eventually get used to shooting lower numbers.

 

[Carina and Shelly]

The way to earn dose reductions is explained here: Reminder: *earning* reductions and starting OTJ trials. It also talks about what we look for before deciding if an OTJ trial should be started. Basically kitty has to earn reductions and get down to even smaller doses. 0.25 units would be next, then 0.1 units. Possibly the drop dose if it looks like she needs a little more insulin support.

It's hard to say whether remission is in the cards, though I hope so. Shelly is in definitely looking like she wants to become regulated, and that is the prerequisite before remission. Your next step would be to stay at this 0.5 unit dose, until she earns a reduction, as per the earning reductions post above. If that 47 tonight was on the Relion, 0.25 units is next.

When you get a lower number than you are used to shooting, try to post here with a subject line like "needing help shooting, lower preshot" or something like that. With Lantus, you do have to eventually get used to shooting lower numbers.

Thank you. Super helpful and thank you for the reminder about the earned dose reduction due to the 47 BG (on the ReliOn, yes). I will test her again at +4.
Is there any reason to worry tonight if her behavior seems normal?

 

[Wendy&Neko]

As long as you can get her up above 50 - I presume you gave her some higher carb food - she should still be OK at 47 temporarily. We don't want cats on insulin that low. I did once test a non diabetic of mine at 49. I'd test again in 30 minutes after feeding, to make sure she's come up. More details on what to do in this post:
Don't Panic! or How to Handle Low Numbers

 

[Clarice & Mami Cat]

Shelly's BG has been fluctating between 50-70, and closer to 53 for the past 7 hours.

View attachment 80399

Hi Carina, I’m not that experienced, but I just wanted to share that it was very much the same here. Every time Mami Cat’s numbers looked like this on Libre 1 - staying flat around 53 for many hours - it showed me (and taught me) that it was time to reduce her dose.

Whenever I insisted on keeping the same dose, she would go “low” during the next cycle, below 40, and she would clearly feel uncomfortable - quiet, sleepy, low on energy and just not quite herself.

If that 47 tonight was on the Relion, 0.25 units is next.

We spot checked two of the lower readings with a Relion and did not get much difference.

Glad you can also cross-check it with the human meter. Each cat is different, but this was something I was able to “learn” from Libre 1. It became kind of a "valuable" sign for me to pay attention to.

Wishing all the best to Shelly and her new dose

 

[Wendy&Neko]

Every time Mami Cat’s numbers looked like this on Libre 1 - staying flat around 53 for many hours - it showed me (and taught me) that it was time to reduce her dose.

Every cat is different and so is their blood glucose patterns. Flat green on Neko just meant flat green and telling me how low that dose was taking her. I not so fondly remember one night she was 53 for hours.

 

[Carina and Shelly]

As long as you can get her up above 50 - I presume you gave her some higher carb food - she should still be OK at 47 temporarily. We don't want cats on insulin that low. I did once test a non diabetic of mine at 49. I'd test again in 30 minutes after feeding, to make sure she's come up. More details on what to do in this post:
Don't Panic! or How to Handle Low Numbers

Food has been such a challenge. We have been relying on her HC treats that are from her hydrolyzed protein diet.
Do you have any suggestions for a good HC novel protein option that could work with IBD?

 

[Carina and Shelly]

Hi Carina, I’m not that experienced, but I just wanted to share that it was very much the same here. Every time Mami Cat’s numbers looked like this on Libre 1 - staying flat around 53 for many hours - it showed me (and taught me) that it was time to reduce her dose.

Whenever I insisted on keeping the same dose, she would go “low” during the next cycle, below 40, and she would clearly feel uncomfortable - quiet, sleepy, low on energy and just not quite herself.




Glad you can also cross-check it with the human meter. Each cat is different, but this was something I was able to “learn” from Libre 1. It became kind of a "valuable" sign for me to pay attention to.

Wishing all the best to Shelly and her new dose

Thank you for sharing

 

[Clarice & Mami Cat]

Every cat is different and so is their blood glucose patterns. Flat green on Neko just meant flat green and telling me how low that dose was taking her. I not so fondly remember one night she was 53 for hours.

Agree. Sure. Sorry. I can't generalize.
Is 53 a classic, though? (Just kidding.)
Here, it would stay there for quite a while on one drop — or go up a little and then come back down there.

 

[Wendy&Neko]

We have been relying on her HC treats that are from her hydrolyzed protein diet.
Do you have any suggestions for a good HC novel protein option that could work with IBD?

I don't see a post yet for today so replying here instead. The suggestions will depend on which proteins she can eat. For rabbit eaters, the Nature's Variety Instinct single ingredient rabbit is a good medium carb. Typically people will give low carb treats, but higher carb food, You can just add a drop of karo or honey to a spoonful of good.