Dosing advice for Nigel ASAP!

Feed Nigel some LC food now and then test him 30 minutes later. Hopefully that will prop him up a bit. Many cats tend to go lower at night so it's better to deal with the dropping numbers earlier in the cycle.
Tomorrow, assuming you will again be out all day, do not give Nigel any insulin until you get a confirmation of what dose to give. It may be that the 0.5u is fine but it may also be that for safety purposes right now, a quarter unit would be better. I'm saying this because of the significant difference in the FL and Prime readings we got tonight. Needless to say, this discovery is warping the picture yet again. If per chance the PMPS from the FL tonight was an inflated reading, then his PMPS may not have warranted a dose of 0.5u. We just don't know and it's all a guessing game right now.

Dose is not based on how high the pre-shot reading is. The dose is based on how low it is taking the BG at peak action. The pre-shot tells you if it's safe to give insulin and gives you a starting BG to gauge the drops the dose causes for Nigel. The insulin works best if we find a consistent dose you can give both day and night rather than changing it every cycle.
 
I'm floored by the difference in those readings. Both are safe but they are 2 different animals especially at this hour of the night. 65 is low enough to warrant either higher carb food to prop him up a bit or keeping an eye on things for awhile but with 105 a little more LC and off to bed with a test at bathroom break would suffice. The strange thing is that Nigel seems to be hitting peak action early and he really drops quickly.
Curiosity, which way was the arrow pointing on the FL display with that 105 reading?
 
I wish I knew. He hasn't seemed to be very carb sensitive up to now. Check his BG with the FL and see which way the arrow is pointing now.
 
Test him again now with the PRIME.....sorry, but those FL numbers are totally bizarre. He's dropped 10 points by its measure yet it seems to think he's steady.
 
I think if you leave some LC food with ONE drop of karo down for him to munch on if and when he needs it and then test again just for safety sake at a bathroom break tonight he should be fine.
Off to bed we all go!:)
 
I checked with the FL in the middle of the night at +9 and it was 180 then 124 just now. Will test with the Prime, but is it looking like no shot this morning?
 
The routine here in Lantus forum is to start a new thread (known as condo) every day. For a title, you can use "Date, Nigel AMPS #" we also put a link to the past thread (this one) in the today's new condo for history like you did when you came over to Lantus from Health.
 
Yup, Feed Nigel and have a worry free day. Going forward I think we are going to have to look at lowering the dose to 0.25u. It would be really helpful if you could pick up some syringes with half unit markings.
 
Can you post a pic of the graph off the FL for us to look at when you can spare a minute please? I'm really curious to see last night's graph and whether that will shed any light on what's going on when compared to the Prime readings last night.

Just to be clear on moving forward..........

Add some high carb gravy food (FF with gravy is fine) to your shopping list.

Test Nigel with the Prime (you can take FL reading too for curiosity sake if you want) when you get home (assuming that will be roughly an hour or 2 before normal shot time). Post that number so we can see if it looks like Nigel might need insulin.

Do not feed Nigel for 2 hours before his normal shot time.

Get a pre-shot test with the Prime and post for advice. You can take an FL reading for curiosity sake only. Remember we dose based on more than the pre-shot number and right now there is a lot to take into consideration so let's discuss before giving any insulin tonight. I'm sure after 3 nights of monitoring intensely for several hours, you don't want to be in that boat again tonight if at all possible.

The substantial difference between the FL and Prime readings as well as Nigel's reactions is making dosing decisions more difficult than would normally be the case.
 
Well, I just tested him with the FL and it showed him at 87. Put some Karo in his food and made him eat more. He tested 69 on the Prime. I have to go to work as it’s my busiest day. Hope he’s ok. I bought some gravy food yesterday.
 

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Good morning Grant, You didn't shoot this morning so not reason to worry he would be ok

It's been quite an ordeal for you, and things have been more complicated than usual, and it appears that Niegel is a diver (likes to go down a lot and fast ) does make me go back to when Babu and me started he was also a bit complicated but really I does get easier down the row. (A message from Babu to Niegel, he does say Nigel better start behaving because Babu doesn't want to lose his diving championship)

On more serious matters after you get the pre shoot reading and we see how he's doing (and if he needs insulin at all) I would still consider to start with a very conservative dose 0.25 u and start monitoring, let's see what others think

I do remember that at least the brochure and instructions that I got when I bought the FL did mentioned that one should be careful on low numbers and "maybe" double check :confused: later on I did find some information pointing to the fact that the FL was not very accurate in low numbers which are usually when we need more readings and more precision
 
Grant, if there is no insulin given there is no need to give him karo. Karo is used as a rescue tool ONLY when you have give an insulin injection and numbers are low.
 
@Veronica & Babu-chiri I found some info yesterday that suggested the FL is not to be used as a replacement for blood testing. I also found numerous reviews suggesting it's not only low numbers where the FL seems to be off compared to blood testing. It seems some find it reads high, some low and some folks complained about both problems and it didn't seem to be consistently with either low or high numbers. Last night we got a 60 point difference on one reading, 40 on another, and in both cases the Prime reading was lower. When dealing with dropping numbers, I'll go with the lower readings anyday. Not really sure the FL is quite the amazing technology it's being marketed as. :nailbiting:
 
Well under normal circumstances I would say no ( it's certainly not going to hurt him), however, it will raise his BG temporarily which means that when we (or the vet) look at the graphs or BG history on the FL, there will be an artificially elevated BG there when no insulin was given. This could give the impression his BG is running higher than it actually is and we don't want to do anything to artificially raise his BG right now when the ? of diagnosis and need for insulin is on the table. If he had had insulin this morning and his numbers were dropping, then you do what you have to bring numbers up, otherwise let nature take its course. He will not go hypo if he didn't get insulin.
 
I’m still wondering if he was misdiagnosed or if he is prediabetic. Like I said in my first post, the diagnosis was based on heavy drinking/peeing after a diet change that stopped shortly after changing his food back, the vet wasn’t convinced of diabetes until a blood/urine test (no fructosamine test) and he’s never lost any weight or showed any changes in behavior.
 
Your suspicion is IMHO totally warranted and Nigel is certainly not responding as expected in many ways which is why we have been taking this a step at a time and being cautious. When there has been no insulin given, feed Nigel as you normally would (lower carb food is fine and a good idea) so we can see what he does without insulin in the picture. The only caveat to this right now, is that there is still a depot of insulin in his system which is playing into the picture too. With the suspicion of diabetes, you don't want to withhold insulin if needed however if he isn't diabetic, you don't want to be dosing him either. And right now, with the readings we've seen, the picture is still a blurry.
 
The fact that something and stress did raised his numbers over normal numbers and it did took a few hours to go down does put him at least as borderline diabetic ( or prediabetic) it also could be that he's diabetic but since you caught it early his pancreas is not totally broken but working a bit hence this abrupt changes which will mean that he may benefit from getting some insulin to help his pancreas heal and go into remission , in any case feeding him only low carb food from now on is going to help him even if it turns out he doesn't need insulin (fingers crossed), actually it even helps non diabetic cats, mine became more active and even their coats improved.
 
Are the measurements of the ones at Walmart the same otherwise? Do I just ask for syringes with half unit increments it are there any other specs that would differ from these?
 

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ADWdiabetes.com has a variety and are used frequently here but ordering that way will take time. Walmart staff do not know they have syringes with half unit markings. Ask to see what they have. It should say on the box or you should be able to look at them. They are also 3/10ml. syringes not .5ml. Perhaps that might be the reason they said they didn't have any? :rolleyes:
 
Alright, got the syringes.

And here is the graph from the FL (got home a litttle late so there’s a small gap in the data. Do you think Nigel’s gonna need insulin today? Could test with the Prime now as well or wait until closer to shot time.
 

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Tested with the Prime and just updated. So his ears are getting pretty scabby. Do you prick the same spots over and over or should I not prick a scab?
 
AmericanTemplar said:
Tested with the Prime and just updated. So his ears are getting pretty scabby. Do you prick the same spots over and over or should I not prick a scab?
Click to expand...

If you don't have to poke scabs, then don't, but not a big deal if you do. He will be less scabby soon, once his ears get used to it. He's likely scratching a bit too.
 
Perfect!
So far, I'm leaning towards skipping tonight. He is in normal range right now, and didn't get overly high even after Karo with his breakfast.
Let's see what he is at closer to shot time.
 
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