I need help understanding! AMPS 413, PMPS 90

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Lucy and Julian

Lucy and Julian

Member Since 2011
Last night I didn't give Julian his insulin because he was pretty low. This morning, he had climbed to 413 (I was not surprised because I didn't shoot him) and now tonight, he just tested at 90.
I thought he was being a little pushier for food. How can he drop so quickly? This is the biggest drop I've seen him do, and it SCARES ME.
Have people seen this?
His vet had him at a 4unit dose, which I have amended to 2units from all of your concern, support and advice. It seemed like 2 units was working well until last night, and now I'm scared I'm overdosing him again.
I have NOT given him insulin yet, I HAVE fed him. I am going to test him again in 15 min (which will be 30min from the first test.
 
his +12.5 is 80, down 10 points. He is freaking out hungry (he is usually a loud and pushy cat, but this is desperate meowing) so I gave him a TINY amount of dry food. (maybe 7-10 kibbles) Does anyone have any advice?
His +13 is 105, so for now he he holding pretty steady. Im scared to give him insulin, and I'm scared he's going to rebound like he did, and that we are going to continue in this bounce.
 
Julian may be a late nadir cat, or it is possible that today's low is just due to his "shed" refilling after last night's skipped shot. I suspect it is more of the second reason than the first, but as you collect more data things will become more clear.

Are you able to stall tonight? What + hour would you have to shoot tonight to be able to shoot 12 hours after that in the morning?
 
The vet told me that I could shoot him between 6 and 8 am/pm. So that means I have another hour to go. However, I have a store team meeting tomorrow at 6:30-8am, I had been planning on shooting him at the usual 6 o'clock. If I shoot him at 8 tonight, is shooting him at 6am too early? That would be a +10.
 
shooting at +10 is too early until you have gathered more data than you have. You can maybe shoot at +11 if he is bouncing. If you shoot at 8-ish tonight (or earlier, if he rises enough), then would you be able to shoot when you get home tomorrow (8-8:30, I assume), then use the rest of the weekend to work the schedule back to your ideal time?
 
and it does look like he has stopped dropping, according to your spreadsheet. That means he should be shootable soon.

If you want, you can try dropping his dose a little bit until you can become more comfortable shooting lower numbers. Usually it is easier to work UP to a good dose than down to it, the way you are. Just a thought. I think this might be a good dose for him, but I can understand your reluctance to shoot because you haven't had a chance to get that data yet.
 
ok he is at 109, so almost identical to what he tested at 1/2 hour ago. (p.s.- both of us are getting sooooo much better at testing :-D )
 
The 109 that you have right now is a good #. I'm guessing that it's from the kibble that you gave him...? Some dry food is high in carbs (I think). However, the experts would know more about that than I would. The 90 is also a good #, too.

I'm glad that you have found this board. There are many people here who are extremely knowledgeable, and are ready to help. Welcome! :)

Another note, I'm not able to view your spreadsheet as I require permission to do so. It said so when I clicked on your link to the spreadsheet. I would have liked to see how Julian's doing. :)
 
all of a sudden I can't access your spreadsheet anymore. I was just in it a few minutes ago. Weird.

Here is what I just wrote in Tifil's condo, which seems to apply here too:

Libby and Lucy said:
She is no longer dropping, just surfing. Here is where you need to decide - you're an hour and a half later than your usual shot time. Is that ok (will you be able to shoot 12 hours after this for the next dose?). Are you able to monitor and have high carb food and plenty of test strips?

... You can shoot if you feel prepared and have a good stock of supplies, or you can wait another 1/2 hour to see if she goes up a little more, or you can skip it. What do you think?

If you shoot, then our rule is that when you shoot your lowest ever preshot reading, you have to get a +1 and +2. Those numbers will tell you how the cycle will probably go, and will give you plenty of time to intervene with food if she decides to drop.
Click to expand...
 
Ok I'm not shooting tonight. Is it normal/ok to be not shooting as much as I have been? Should his dose go down? I feel like every day there are 1,000 more questions I have!
Try to see his spreadsheet again? I think it should work again.
 
Bud uses Lev and that's what I am familiar with. But Lev and Lantus pretty much have the same protocol. I'm throwing in my 2 cents worth since I originally was following your posts in health and notified the great Lantus folks that you were a newbie in health and to contact you.

Any thoughts I have for you should be thoroughly reviewed by both you and the Lantus folks before you make any decisions regarding dose changes. :smile:

Lucy and Julian said:
How can he drop so quickly? This is the biggest drop I've seen him do, and it SCARES ME.
Click to expand...

Yes, it is scarey. That's why we were concerned about him getting 3.0u and then increasing it to 4.0u. It can drop quickly when the cat is not regulated and/or the dose is too high.

Libby and Lucy said:
Usually it is easier to work UP to a good dose than down to it, the way you are.
Click to expand...
Definitely, Libby! Lucy: I think Julian's dosage is too high, still. There's a bit going on here... since you had to skip a shot, as you suspected, the morning's amps was high. I wouldn't have shot those 2 pmps numbers either. Good call. But here's the problem: If he's too low to shoot, you're going to get a pretty much continuous bouce by skipping the shot.

I'd drop the dose to 1.0u and hold it for a minimum of 8 cycles - 4 days, and then adjust upwards as/if needed. At 1.0u, you will, most likely, not get unshootable low numbers. I'd get as many tests as I could during that period - the more data, the better to make decisions. That's my "better some high numbers than bottoming out in the middle of the night" philosophy . ;-)

But please get opinions from the Lantus folks before you decide what to do.

Congrats on getting the testing thing going good!
 
Thank you for your two cents Beth! I think that is sound advice, as tonight the EXACT same thing happened. He is too low to shoot. So more than likely I'll go to 1 unit tomorrow. That makes me feel better. I DO NOT want to accidentally overdose him!
What do you Lantus folks think?
 
I think there are a couple of issues at hand. First and foremost, you need to get more spot checks during the PM cycle. Even if you don't shoot, you still need to get some tests in. It will help you to understand Lantus' duration of action. You want to be able to see when numbers start to rise.

Ordinarily, if you're not able to shoot twice a day we lower the dose to a level where you can shoot. If you want to lower Julian's dose, that's fine. Just please make sure you can test. It looks like you are not home during the week. Especially if this is the case, you need to be able to collect data in the evenings.

As far as accidentally overdosing, as long as you have a meter, strips, and HC food at home, you can steer the numbers.
 
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