Jul 27 - Monkey - AMPS 167, +1 184, +2 157 +6 85 PMPS 293- first time shooting on blue NERVOUS

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Mel & Monkey

Member Since 2017
Yesterday: http://www.felinediabetes.com/FDMB/...-amps-151-stalling-shoot.181287/#post-2008791

This is our third post in the support group. It's the third day in a row Monkey has been blue around the time of her shot in the morning and the last 2 days because I'm very new to this and it seemed unusual, I skipped her shot out of fear of her going hypo. Since she's above 150 though, today I am going to shoot her usual 0.5U, though we could really use some hand holding if folks are around. Should I do extra testing, and when? Anything else I should do? I'm really, really nervous about this!
 
The more information you have on shooting a blue will help you be more comfortable shooting blues in the future.
You could get a +1 (it may be food influenced), and definitely get a +2 to get an idea of what the drop is (which will give you some idea of how the cycle is going to play out).
You can do this.
 
Good job shooting a blue today! As Red and Rover said, start with getting a +1 since this is the lowest you've shot; it could be food influenced. A +2 could be more telling if it is the same number as the AMBG or lower then it's going to be an active cycle and some more testing will be required to keep Monkey safe.

If you need more assistance, post and someone will be able to hang with you.
 
Good job shooting.

Looking at yesterday's pm number midcycle 15.1(270) makes me wonder if monkey will still be dropping by the time you get the +1.

Often at +1 we may see numbers come up a bit from ps, due to food, and the fact that the shot won't have onset yet. If you find that the +1 is dropping, or flat, then I would recommend giving him a snack at +1, to try to encourage him to surf and not drop too much.

If he's about the same as ps then a teaspoon or two of low carb would be fine, if you see a significant drop at +1(in the region of 50pts or so) then something with wet food with some higher carbs to slow monkey down.

Looking forward to seeing that +1.
 
+2 was 8.7 (157) and she's having another snack (she is underweight so we free feed as much low carb wet as she wants) .. is this looking good so far for not having to check her every hour? When should I test next and what am I looking for?

Thanks everyone in advance :)
 
+2 was 8.7 (157) and she's having another snack (she is underweight so we free feed as much low carb wet as she wants) .. is this looking good so far for not having to check her every hour? When should I test next and what am I looking for?

Thanks everyone in advance :)
If it was me, I'd check at +4 to see if she's staying in safe numbers or if you need to take action.
 
What helps you understand what numbers at what times mean that they'll have a good cycle? When I look at her spreadsheet, I can't decipher when I should be checking or how I would know it's dropped too low for a certain part of the cycle, for example.

Maybe I can squeeze in a quick nap before her +4 because I haven't slept yet from the stress.
 
What helps you understand what numbers at what times mean that they'll have a good cycle?

This is what a "typical" Lantus cycle should look like....of course our kitties don't read the handbook so they don't always follow the rules!!

+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: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

Now with Lantus, there's another "rule" that we find can almost predict what the cycle is going to be like. It involves the +2 reading (in some cats, the +3 is a better indicator)

If the +2 is about the same as the PS, it's usually a pretty "normal" cycle.....with the blood glucose going down gradually to nadir and then climbing again by the next PS

If the +2 is higher than the PS, that usually signals the beginning of a bounce.....those are the cycles where you can usually take a break from testing so much

If the +2 is lower than the PS, that's your "early warning" that they might be going much lower later in the cycle and it's important to get more tests in to keep them safe

Monkey's +2 is "about the same" as the PS, so hopefully he'll just gradually go down to nadir (around +5 to +8) and then start to come up again and end up in a nice blue number for PMPS
 
6.9 = 124. It's best to use the US numbers, and update your subject line (and spreadsheet) with the latest numbers when asking for suggestions. He's's only gone down about 30 points in two hours. I might wait another two hours. When would you typically feed her again?
 
Congratulations for shooting a blue! Superwoman! You definitely deserve these! ;);)
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I would feed a couple of tsps of her regular low carb food, to see if you can get her to surf or hold steady in these nice pancreas healing numbers. On SLGS, this does mean a reduction to 0.25 units has been earned.:D Test again in an hour to make sure she's no longer dropping.
 
If I were to try to switch to the TR protocol - would I keep Monkey at this dose instead of a reduction because it didn't drop below 50?
 
Would it be safe given the amount I'm testing her to switch to TR and continue giving 0.5U BID for the next few cycles?
 
Would it be safe given the amount I'm testing her to switch to TR and continue giving 0.5U BID for the next few cycles?
Yes, TR just requires that there's no dry food given to the diabetic cat. You can change doses every 3 days instead of every 7 days. It's probably better you do TR because she has many blues and greens are what you want for the pancreas to have healing time.
 
Ok I'm just getting ready to do her evening shot so I'll keep on with 0.5U - would I count the 3 days dose starting tomorrow morning since I skipped the 2 mornings before today? What am I looking for in the meantime in case it needs to be lowered or raised? I've been poring over all the Lantus and TR stickies in the forum which are great, it's just still information overload for me so any pointers are more than welcome! :)
 
would I count the 3 days dose starting tomorrow morning since I skipped the 2 mornings before today?

This morning would be cycle 1....tonight would be cycle 2.....you want to hold the dose for at least 8-10 cycles before deciding to increase unless he drops below 50 on a human meter....you want to hold it longer than 6 cycles because his nadir is below 100 on this dose

If he drops below 50, you'd reduce to .25

As far as increasing, this is what we go by:

INCREASING THE DOSE:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit
 
This morning would be cycle 1....tonight would be cycle 2.....you want to hold the dose for at least 8-10 cycles before deciding to increase unless he drops below 50 on a human meter....you want to hold it longer than 6 cycles because his nadir is below 100 on this dose

If he drops below 50, you'd reduce to .25

As far as increasing, this is what we go by:

INCREASING THE DOSE:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit

Thank you :bighug:
 
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