Blue PMPS 197

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tiffmaxee said:
No. Sorry. I know I keep saying it but shooting so late the feeding schedule is so off. If he eats dinner 2 1/2 hours before PMPS it’s messing with the cycles. It makes him high at night. It’s best for most of his food to be eaten during the first half of the cycle. That’s one reason why his preshots are high. I shot at 6:00. I think most give it at 6 or 7.
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I thought he was supposed to eat right before his shot? I normally feed in the Morning and afternoon but now also feed before shot at night. Is that right? I was on a different injection schedule but have got later and later. I’m trying to get back to maybe 8:30...or 8:00 but will take a few days to get there.”
 
Patty and Blue said:
I thought he was supposed to eat right before his shot? I normally feed in the Morning and afternoon but now also feed before shot at night. Is that right? I was on a different injection schedule but have got later and later. I’m trying to get back to maybe 8:30...or 8:00 but will take a few days to get there.”
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The drill for each Lantus cycle, AM and PM, is as follows:

* Withhold all food for 2 hours before each preshot BG check is due (so PS test won't be food-influenced.

When the dose is due:

* Do preshot BG check.
* If BG is too low for comfort, stall, don't feed and test again in 20 minutes to see if the BG is rising. If it's high enough proceed, else shout out for help.
* Assuming BG high enough to give insulin, feed the kitty.
* Provided that the cat has eaten enough food and you are confident the cat will continue eating enough during the cycle, then administer the insulin dose.

The shorthand, nuance- and complication-free version is: 'Test, Feed, Shoot.' With a bit of practice, provided BG is high enough on the first PS test and appetite is good then the routine can be done within 15 minutes at the beginning of each cycle.

BTW, I'm known as Mogs, or Moglet. :)


Mogs
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Critter Mom said:
The drill for each Lantus cycle, AM and PM, is as follows:

* Withhold all food for 2 hours before each preshot BG check is due (so PS test won't be food-influenced.

When the dose is due:

* Do preshot BG check.
* If BG is too low for comfort, stall, don't feed and test again in 20 minutes to see if the BG is rising. If it's high enough proceed, else shout out for help.
* Assuming BG high enough to give insulin, feed the kitty.
* Provided that the cat has eaten enough food and you are confident the cat will continue eating enough during the cycle, then administer the insulin dose.

The shorthand, nuance- and complication-free version is: 'Test, Feed, Shoot.' With a bit of practice, provided BG is high enough on the first PS test and appetite is good then the routine can be done within 15 minutes at the beginning of each cycle.

BTW, I'm known as Mogs, or Moglet. :)


Mogs
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I wasn't sure if that was your name or not....Mogs.
Ok, since I feed in the afternoon, does that mess up the cycle. I think I'm getting confused by what my vet has told me and what I have learned here. I just want to get this right so Blue can be as healthy as possible. Did you feed only every 12 hours or throughout the day and took up food two hours before PMPS?
My vet even mentioned giving him insulin in afternoon if he ate....does this sound right?
 
jt and trouble (GA) said:
You are MOST welcome. It is my complete pleasure.This is a magical place one I have a hard time leaving every day. I havent had a diabetic cat in many years yet here I am:D and if I can help a stranger feel comfortable enough to stay? I have done my job! ;)
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You are the welcome committee and I appreciate it. I wasn't sure if anyone would notice me with so many Diabetic kitties in need.
Do you still have a cat or cats?
 
Patty and Blue said:
Ok, since I feed in the afternoon, does that mess up the cycle. I think I'm getting confused by what my vet has told me and what I have learned here. I just want to get this right so Blue can be as healthy as possible. Did you feed only every 12 hours or throughout the day and took up food two hours before PMPS?
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You only need to withhold food for the two hour period before each preshot test. At all other times you can make food available and Blue can fill his boots. :)

My vet even mentioned giving him insulin in afternoon if he ate....does this sound right?
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Not in addition to the two scheduled 12/12 doses. Noooooooooo!! (This is a new one on me! ;) )

Technically [*cough*] you could schedule one of the two daily doses in the afternoon, but the other dose - 12 hours later - would have to be given at stupid o'clock every day.


Mogs
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No you can feed several small meals and pick up food until you have enough data two hours before shots. It’s best to feed the majority of the food in the first half of the cycle though as the insulin starts to wear off later. At first Blue was dropping late so I wasn’t thinking about when you fed. I fed Max before insulin and then at +2, +3 or 4 and +6-7. It’s fine to free feed too. I don’t want to confuse you. If you start to see the PMPS high it’s worth trying to not feed late in the cycle. By shooting at 9:30 I was wondering if he ate a lot earlier in the evening. Does this make sense?
 
tiffmaxee said:
No you can feed several small meals and pick up food until you have enough data two hours before shots. It’s best to feed the majority of the food in the first half of the cycle though as the insulin starts to wear off later. At first Blue was dropping late so I wasn’t thinking about when you fed. I fed Max before insulin and then at +2, +3 or 4 and +6-7. It’s fine to free feed too. I don’t want to confuse you. If you start to see the PMPS high it’s worth trying to not feed late in the cycle. By shooting at 9:30 I was wondering if he ate a lot earlier in the evening. Does this make sense?
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He ate at 4 with the others. I have one baby that cries for wet food everyday at the same time. OMG it will drive you crazy, but that's what started the afternoon feeding. When I worked we didn't have a problem because I wasn't here to hear Bella.

Blue doesn't normally eat at night but recently he has been hungry. I just fed and shot at 9:15 so I'm easing back to earlier. I feed in the morning of course so that works fine to test, feed and shoot. It's the night I have more problems with. I'll get it.

What's the plan for tonight?
 
tiffmaxee said:
Right now he’s all over the place because he’s had so many different doses. Give it a week ay .75 unless he drops under 90 and see what happens. With all your testing I don’t know why you need to go back to the vet so soon.
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She wanted a follow up to see how he was doing and also his sister Layla, who was constipated. I agree, I might cancel. Maybe I'll just send her the SS to show her what I'm doing.
 
Critter Mom said:
Glad you restated this, Elise. I should have included that in my response above. (Too used to the need to feed small meals every 3 hours. :rolleyes: )


Mogs
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The problem with me feeding so many small meals is he just doesn't eat very much. He ate about a quarter of a can of wet and I gave him some freeze dried chicken treats because he wasn't eating much. I hope that's enough for the shot?
 
Patty and Blue said:
I don't really understand why Blue gets high BG in the middle of the night and early a.m. He doesn't eat.
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Even if a cat doesn't eat for many hours the liver still keeps releasing sugars from its stores throughout that time. (If it didn't do that we'd all completely shut down between meals!)

For general information, in addition to food rises and bounces, two other things of note may markedly elevate BG levels: dawn phenomenon (affects morning blood glucose levels), and impaired fasting glucose (BG goes higher at the end of a longer period without eating anything). Often the AMPS is the last number to come into range when a cat is heading for remission.


Mogs
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Mogs made some good points. That’s why when you were seeing the numbers going down at the end I suggested a +11. If it were lower than you have shot but the +12 was going up it would be okay to shoot provided you were able to stay up and monitor possibly for several hours. Stalling too long sometimes the bg goes down and you can’t shoot. Tiger times the insulin is wearing off and the bg rises. Often shooting low gives a nice flat cycle.
 
tiffmaxee said:
Mogs made some good points. That’s why when you were seeing the numbers going down at the end I suggested a +11. If it were lower than you have shot but the +12 was going up it would be okay to shoot provided you were able to stay up and monitor possibly for several hours. Stalling too long sometimes the bg goes down and you can’t shoot. Tiger times the insulin is wearing off and the bg rises. Often shooting low gives a nice flat cycle.
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I think I understand what you're saying. So test tonight same as last night okay?
 
You might not need to set the alarm. Get a +2 for sure. If it’s higher or about like last night just get some sleep and test when you wake up. How does that sound?
 
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That’s more than a food bump. What did he eat? I dint think he onsets yet. Probably a +3 tomorrow night instead of +2. Ma. Onset between 2-3 .
 
M not familiar with those. Seems he’s just being a cat. Max had a nickname around here, Mr,Unpredictable. Let’s see where he is in the morning.
 
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