Blue AMPS 81

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If it was my cat, I'd be very nervous about giving 0.75 units Lantus today.

There are a lot of moving parts here:

* Blue's clearing a bounce (and perhaps clearing the carbs from the contraband treats).

* The depot for the 0.75 unit dose is not yet fully established.

* Unfortunately we don't know whether Blue's BG levels were on the way up at AMPS.

I need to check on something in one of the forum stickies and I'll come back to you shortly, Patty.



Mogs
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First up, Patty, under the SLGS protocol any result under 90mg/dL on a human meter earns an IMMEDIATE dose reduction.

Your 81 AMPS meets that criterion, so you now need to give less insulin.

How are you positioned for testing today, Patty (both AM and PM)?


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There'd still be food influence on the reading.

I didn't elaborate much about the reasoning behind my inclination to be uber-cautious because I wanted to leave space for you to give your view first, Patty. Blue is your cat.

Looking at Blue's spreadsheet, bounces and contraband aside, he is very much trending downwards in his insulin requirements. You have also reported his clinical signs and behaviours are getting better every day. He has earned another dose reduction this morning.

This is the first time Blue has been this low at preshot so you have no data at this time to guide you as to what his response could be. Blue has no history of throwing ketones or recent DKA, Even if only giving a reduced dose of 0.5 units, because you're not able to test throughout the full daytime cycle today I think it's safer to skip this morning's dose. If it were me in this situation, I would skip. Also, as Elise says above, it would be better for your schedule. You need to make sure you get sleep too, so that you can look after your beautiful boy.


Mogs
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Critter Mom said:
There'd still be food influence on the reading.

I didn't elaborate much about the reasoning behind my inclination to be uber-cautious because I wanted to leave space for you to give your view first, Patty. Blue is your cat.

Looking at Blue's spreadsheet, bounces and contraband aside, he is very much trending downwards in his insulin requirements. You have also reported his clinical signs and behaviours are getting better every day. He has earned another dose reduction this morning.

This is the first time Blue has been this low at preshot so you have no data at this time to guide you as to what his response could be. Blue has no history of throwing ketones or recent DKA, Even if only giving a reduced dose of 0.5 units, because you're not able to test throughout the full daytime cycle today I think it's safer to skip this morning's dose. If it were me in this situation, I would skip this morning's dose. Also, as Elise says above, it would be better for your schedule. You need to make sure you get sleep too, so that you can look after your beautiful boy.


Mogs
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I don't know about Keytones but do know the vet said he didn't have them. I bought testing strips in case I needed them.
He is feeling good and loving on me in spite of the constant testing. He's the sweetest boy.
 
Normal bg is 50-120. With TR we shoot anything over 50 once we have enough data. With SLGS it’s tricky. They say over 90 but I would never advise you shoot that low and definitely not after eating. Let’s see where we are at +2. How many hours before you leave for PT? You might not need to test until later in the day but I’m planning ahead.
 
To me the +2 is to see if Mr. Pancreas is working. He’s not going to go to hypo range which is under 50. Once we see that test I might even say take a well earned break and don’t rush home. BTW, Max hit the 30’s but never had a symptomatic hypo. Cats usually act normal in the 40’s which is why we need to test. They could be on the brink and we wouldn’t even know it. Then they have a symptomatic hypo and we end up at the ER. That’s why I was so scared when your vet said to give 2 units.
 
Great. I'll check at 12 and post number. I'm so hopeful it will stay low.
If Blue got in the 30s I'd probably take him to the ER.
Absolutely crazy to think of Blue getting 2 units every 12 hours. I'm waiting to send vet the spreadsheet but will when we see where he goes with this.
Okay, be back.
 
I would cancel your next appointment unless you want to go for a reason other than FD.

If you ever see the 30’s I hope you post here first before heading to the ER. Usually some sugar and a little food brings them right up but you would be testing every 20 minutes until into the 60’s and then go to hourly and then until over 50 for two hours without food. We will cross that bridge when and if we get there. It’s why there maybe a few all nighters in the future or at least until +7 or 8.

So if you ever get an AMPS or PMPS that is lower than you have ever seen, stall don’t feed, and retest in 20 minutes. If it’s under 90, test again right away as it could be a bad strip. It happens. Then still stall, Even if higher, don’t feed, and retest in 20 minutes. We definitely need the test at +11-11.5 just in case and to keep you on schedule.

Tonight you can shoot at whatever time you want. The new dose is .50 unless he drops at any point to under 90.
 
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tiffmaxee said:
Gosh I hope not! But being just stupid isn’t much if any better. :banghead::kiss::stop:
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Its my last wish that NO vet would intend harm to collect a fee. But I have seen other wise in how they prescribe that scrip junk food. "Its the best thing on the market for your cat". Riiiight dude. I do realize for some, the script food is NECESSARY but for the majority we even see here? thats just NOT the case.

And youre right stupidity is NOT an excuse.

ok off the soap box.

PLEASE KNOW THESE ARE ENTIRELY MY THOUGHTS . Not endorsed by FDMB.
jeanne
 
jt and trouble (GA) said:
Vet prescribes 2 units...cat hypos ...vet gets more appointments? Sorry but thats the way my mind thinks I'm skeptical that way. :eek::rolleyes::blackeye:
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Feed cat high carb diet, treat with an intermediate-acting, keep cat running artificially high, discourage home testing and promote vet office curves and fructosamine tests. That would be a more lucrative hustle.

(NB: Tongue planted firmly in cheek here. ;) )

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7:00 sound good? I'll probably not last long at that time. Seems like something happens to make it later and later.

I might test when I return and before feeding at 4:00. We can go from there depending on what his test is. If it goes up a lot I might shoot him earlier. What do you think?
 
That’s good for me at night as it’s 4:00 in the afternoon but I won’t be around in the morning. We will cover all possibilities tonight. You can always tag Bron or Sue, if needed but Mogs knows what to do as well. Just remember if ever lower than it should be, stall, don’t feed, and ask for help. I will fill them in to keep a eye out for a tag.
 
When you consider when to shoot remember it’s usually not a one time thing. It also can only be adjusted in 15 minute increments each cycle or 30 each day so if you shoot earlier, that’s you time. I would pick a time that ideally will work for you for the next few weeks. I would not want to get up at 4:00 a.m. to test every morning if I were you.
 
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