Concerned a little to shoot tonight

Laurie&Petey

Laurie&Petey

Very Active Member
Been using the Libre 3 for 3 days. Trip to the vet really stressed him out, but we got back in the two's today with 2.5u. I did some spot checks and the libre is atleast 50 points higher than the AlphaTrak -so he is lower than this graph.

I'm concerned to shoot tonight cause he has not gone back up today like he usually does, so will he continue to go down rapidly with tonights shot?

https://drive.google.com/file/d/1CtY0ofBA6jA84tKG-x4PnQIK3MVfkQWW/view?usp=drivesdk
view
 
Last edited:
How long before the PM shot? It looks like Petey is having an active cycle and that the 2.5 units is working :)
Since you are very new to this, I think that as long as you can monitor, you can shoot if over 200. I would also get a +1- or +11 to see if he's heading up or still going down in BGs.
If at PMPS he is below that threshold, I would first double check with the handheld meter, then I would stall without feeding and test again in 20-30 minutes and post here for help with the thread title "HELP STALLING" to grab attention.
 
Angela & Cleo said:
How long before the PM shot? It looks like Petey is having an active cycle and that the 2.5 units is working :)
Since you are very new to this, I think that as long as you can monitor, you can shoot if over 200. I would also get a +1- or +11 to see if he's heading up or still going down in BGs.
If at PMPS he is below that threshold, I would first double check with the handheld meter, then I would stall without feeding and test again in 20-30 minutes and post here for help with the thread title "HELP STALLING" to grab attention.
Click to expand...

2 hours till PMPS. So if he tests below 200, stall without food?
 
LaurieB said:
2 hours till PMPS. So if he tests below 200, stall without food?
Click to expand...
Can you get a test now since its +10? Lets see where he'll be at PMPS. No need to get nervous until reason to be nervous :bighug:
I can be around in 2 hours for your PMPS. If you shoot tonight, can you monitor? Do you have plenty of testing supplies and medium carb/high carb food, karo or syrup in the event he goes super low?
 
Angela & Cleo said:
Can you get a test now since its +10? Lets see where he'll be at PMPS. No need to get nervous until reason to be nervous :bighug:
I can be around in 2 hours for your PMPS. If you shoot tonight, can you monitor? Do you have plenty of testing supplies and medium carb/high carb food, karo or syrup in the event he goes super low?
Click to expand...

217 on AT3, 287 on Libre

Yes, just not sure I can monitor alllll night. Plenty of supplies.
 
LaurieB said:
217 on AT3, 287 on Libre

Yes, just not sure I can monitor alllll night. Plenty of supplies.
Click to expand...
Thats great! Hopefully, it won't be an all night monitoring event. You do have a few options when shooting a lower than typical preshot. Here is from the STicky:

How to handle a lower than normal preshot number:​
Until you collect enough data to know how your cat will react, we suggest following the guidelines in the
Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.​
      • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
      • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
        • a.) give nothing
        • b.) give a token dose (10-25% of the usual dose)
        • c.) feed as usual, test in a couple of hours, and make a decision based on that value
      • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
      • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
      • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.
With experience, you may find that lowering these thresholds may work well for your cat.

​
As it says, with experience you'll be able to shoot anything above 90 when following SLGS.

Is there a history of DKA or Ketones?
 
Angela & Cleo said:
Thats great! Hopefully, it won't be an all night monitoring event. You do have a few options when shooting a lower than typical preshot. Here is from the STicky:

How to handle a lower than normal preshot number:​
Until you collect enough data to know how your cat will react, we suggest following the guidelines in the
Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.​
      • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
      • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
        • a.) give nothing
        • b.) give a token dose (10-25% of the usual dose)
        • c.) feed as usual, test in a couple of hours, and make a decision based on that value
      • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
      • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
      • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.
With experience, you may find that lowering these thresholds may work well for your cat.

​
As it says, with experience you'll be able to shoot anything above 90 when following SLGS.

Is there a history of DKA or Ketones?
Click to expand...

He had ketones 5.x at diagnosis, no acidosis. Follow up three weeks later had trace amounts. I have not tested for ketones.
 
Angela & Cleo said:
How long before the PM shot? It looks like Petey is having an active cycle and that the 2.5 units is working :)
Since you are very new to this, I think that as long as you can monitor, you can shoot if over 200. I would also get a +1- or +11 to see if he's heading up or still going down in BGs.
If at PMPS he is below that threshold, I would first double check with the handheld meter, then I would stall without feeding and test again in 20-30 minutes and post here for help with the thread title "HELP STALLING" to grab attention.
Click to expand...

And what does an "active cycle" mean? I was surprised his snacks (tbsp of wet food) didn't do much today, it went up a little then came back down nicely.
 
Good Question! Here is the excerpt from the Sticky - The Basics explaining an active cycle:

Example of an ACTIVE, but NOT necessarily typical Lantus and glargine biosimilars cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar/Semglee cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir/Biosimilars: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
 
You must log in or register to reply here.
Back
Top