Beau - 7/31 - going to need PM dose advise

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alicia.1771

alicia.1771

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Hey all -- Beau and I will need some PM dose advise after his hypo episode last night and continuous high #'s and very SLOW drop today. I will be testing his BG at 7pm, 7:30pm, and 8pm in case I still don't get a rising # cuz it looks like his BG is just coming down. I've also posted in Health to get more eyes.

7:00am - 303
7:30am - 336 --> fed 1 can FFC
8:00am - gave a skinny 0.8U --> fed 3/4 can FFC
10:00am - 346
1:00pm - 331 --> fed 3/4 can FFC
3:00pm - 314 --> fed 1/4 can FFC
5:00pm - 270
7:00pm - 282 (looking promising...)
7:30pm - 262 / 273 / 287 (3 consecutive readings...not sure about the fluctuation)
8:00pm - 251/ 271/ 277 (what's going on with my cat???)
8:30pm - 263
9:00pm - 236
 
Question for someone who knows a lot more than me (plenty of you out there!).
Would the 3/4 can of FF at +5 have "hidden" Beau's nadir? Was he dropping and then got a sugar boost from eating? If so, then his nadir could still have happened around +6, and he's been climbing since, and without the food boost, it was somewhere lower than 270? Or - was his drop slow and for some reason it took longer than 6 hours to bottom?

Carl in SC
 
I don't think that the food has hidden any great numbers, none of them were that good.

Personally I think he is still coming down off of his low's from last night.

Keep testing for a rising number and we will go from there.
 
7:30pm - 262 / 273 / 287 (3 consecutive readings...not sure why the fluctuation)

This has happened before when I test him and get 3 different #'s on the glucometer. Has this happened to anyone else? I use Relion Micro and the readings were very close to what the vet's machine reads during his BG curve.

Will test again at 8pm to decide whether or not to shoot and his dosage.
 
8:00pm - 251/ 271/ 277 (what's going on with my cat???) I guess I will continue to test every 30min and post.

His AM shot was at 8am, so I still have another hour or 2 to give his PM shot if I see a rising #?
 
I'm in the Midwest so I will be signing off soon.

If you keep getting the same numbers I would stay with a skiny .8u. if he keeps droping but doesn't go below 150 I might go with a .5u but only if his bg is rising.
 
Thanks Robin for your advise.

His 8:30pm is 263. I will test on more time at 9pm and if it's around the same I will go ahead and give a skinny 0.8U.

If I give his shot at 9pm tonight and want to give his shot tomorrow at 8am instead do I need to give a reduced dose?
 
Alicia, I think it is safe to give him a shot now if you want to try to get him back on schedule. A half hour tonight and another tomorrow should do it, but you don't want to make that change all at once. Any early shot = dose increase, so you need to be careful how often you do this and adjust the dose accordingly. A skinny 0.8U sounds like a good plan for tonight.
 
Hi Alicia,
I would stay with the skinny 0.8u .... so you can sleep tonight ......

Can you give him his shot at 8:30 in the AM? If you can stay within 1/2 hour you can usually keep the dose the same, if you can't and need to shoot at 8:00 post in pzi we have some early people.

Why are you testing him 3x at the same time? with the same drop of blood? I got myself with the lancet the other night, I went to get another test strip, and it said 379! I thought I am dead!! You would need a new drop with each test. The meter itself has a 20% variance. BTW I was only 101, blood that is drying which is immediately after, tests off.
 
9:00pm = 236 so looks to be dropping still. I just fed him and he is eating well so do you all think it should be ok to give him the skinny 0.8U now without repeating last night's steep drop?

Wendy - ok, I will slowly move his shot time at 30min at a time so I don't have to adjust the dose.

Nancy - I tested him 3x cuz he was on the rise then I got a lower # so I thought I made a mistake. It was 3 pokes with 3 new blood drops (my poor guy), but it looks his # are still dropping. What should I do???
 
Don't give him any insulin .... better for him to go a little high tonight, than repeat last night.

It doesn't do any good to test 3x at one time ..... now BREATHE but don't give him a shot.
 
Alicia,
Sorry, I was distracted by a hypo in health. It looks like you've gotten plenty of good advice on this.
I have usually subscribed to the "when in doubt shoot low" theory. It looks like his numbers have kept dropping.
My gut says shoot a little less than the .8. The dose is "late", and if you want to try to get him back on schedule by the end of the day tomorrow, then you will need to do in incrementally, so the AM dose would be later than normal, but less than 12 hours, right?
I would go with .6 perhaps. The worst thing that will happen is that you get a higher AMPS than you want. That beats having to deal with low numbers over this cycle, especially after last night's episode.
If you can afford to wait a few more minutes, maybe someone else will advise, but that' my thoughts.

Carl in SC
 
or like nancy says, you could skip the dose.... ultimately it's your call.
carl
 
My feeling on just skipping tonight and get him back on schedule in the AM ..... is because he likes to go low and if she wanted to sleep tonight without worrying. That would be what I would do.
 
Uh-oh...I had given him the skinny 0.8 around 9:15pm...Man, why is this so complicated??? Looks like I will be setting my alarm throughout the night again...

Ok, help me understand how to handle this situation a little better next time:
-- if he had stayed around 250's it's ok to give the skinny 0.8U?
-- if he had continued to drop like he did to 236, I can:
a) give the shot but risk him going low again
b) give a smaller dose say 0.5U to have a less risk of hypo but still get insulin in him
c) skip the shot and let his # go high tomorrow AM and restart the cycle

Looking back now a) was probably not a wise choice, which sadly I made.... :cry: My brain is not working properly being so tired...

Between b) and c), which would be a better choice?
 
Well, my brain is not working well now but you have to remember YOUR kitty .... he goes low and you will need to keep that in what you do, here out. I would not have shot but he will probably be fine, we're just gun shy from last night ....

Now my Payne, she NEVER goes low, so I can shoot lower numbers and not worry. Get in a couple of tests before bed, which is sounding good right now :)
 
Nancy,
I understand your logic completely. If she wants no worries tonight, especially after not much if any sleep last night, skipping the dose is a logical step. Alicia can get a good night's rest, and maybe Beau is higher than "normal" in the morning. Better safe than hypo-ing.
I've just not been a fan of skipping doses, but that's with my cat, not someone elses'. I'm not the one who'd have to worry all night long. I just thought even a token dose would still allow for a safe night for Beau (.5, .25?) and a peaceful night for mom, but would keep Beau closer to "normal" AMPS so she didn't have to try to bring him way down tomorrow.

bridge
=======
water

Alicia,
Keep checking on him, and we'll keep checking on you!

1 -regardless of the number, if you had seen a rise in BG over the say +8, 10 and 11 tests, you would have known his BG was moving in the right direction, making shooting "safer" because you knew he was on the way up. If the number at PMPS had been 250, and had been rising for 4-6 hours, then yes, .8 should have been okay.
2- all 3 choices, a b and c are valid. At .8 his numbers may drop low. Bright side - after last night, you know what to do.
OR, you could lower his dose, lowering the risk of going low, and probably have seen a number you expected at AMPS. OR, you could have skipped dosing, and probably seen a higher, but not drastically higher AMPS.

between b and c, I don't know if there's a right choice. I would have went with B, others with C. Neither option would have drastic consequences. I don't think A will either. It's just that you'll have to monitor Beau for a bit. Take cat naps....they work for our sugarcats!

Carl
 
Thanks Carl for checking in on me & Beau. At +2 he is 162 so much better than yesterday's 55. Will be taking cat naps tonight and check him again at +4, +6, etc.
 
Hi Nancy - looks like you and I posted around the same time! So far so good, his +2 is at 162 so I'm hoping his drop will be much slower and much less than last night. I will continue to check up on him every 2 hours and hope to see a rise after the +6.
 
Okay, we cross posted, he sounds good .... my reasoning for skipping his shot tonight leaned towards the time, you were almost 2 hrs. past shot time and starting over tomorrow seemed a good choice.

But you need to remember that there are many choices, none is absolute. You will learn Beau's interpretation
of this sugar dance we all do and it will get easier. The beginning is hard but you are doing really well!

When Payne was first Dx. she went straight into DKA and we rode that train for quite awhile until my learning curve caught up .... and then you start to understand your kitty, and can finally keep them healthy. Payne is doing great! and she lives up to her name on a daily basis! Good job!
 
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