Kaz AMPS 533/PMPS241

Hi Bron

So Kaz was increased to 2.5 units 4 days ago but his numbers are all over the place. Black first thing and now he's in the blues. Should I stay at the current dose or do you want me to adjust it again?

Claire

 

I would say he is probably dropping lower overnight and that is why you are seeing the black AMPS. Are you able to get any later tests in during the night cycle if the BG is still dropping?
I would stay with the same dose at the moment, seeing you are starting to get blue BGs.
How are the ketones?

 

I try to check Ketones every 2 to three days usually in the evening as they seem to be more accurate when taken then. Today is day 2 he was 0.1 2 days ago.
Its not easy to get up in the middle of the night to check blood as by time set everything up get him ready I'm now wide awake and then I live on 2-3 hours sleep. I was doing this in the beginning and I nearly fell off a 5 story building when I was on site. I need to be fully aware of what I am doing on site or I could kill myself so I really need to get sleep. Since Kaz got sick I am mostly sleep deprived but this would make it worse. If I have to do it now and then I can.
The Libre button is a good option when I need to do this over a few days as I only have to waive it.
I'm going to vet soon (waiting on exact time) as they need to check the Potassium to see if he can come off those tablets so I can get a button put on then if you want me to.

 

I fully understand how hard it is to look after a diabetic kitty on your own and I know how sleep deprived you can get.
I don’t want to put you to the extra expense with a libre. Just make sure he is well fed before you go to sleep.
You are doing a great job with him

 

I may ask for a Libre we'll see I bought two buttons a couple weeks ago. They come in a box of two and I needed one for my trip. I'm worried as his numbers are all over the place and even if it only lasts a couple days I can get a more accurate picture of what's going on. Plus Kaz could do with a break on his poor little ear. He only lets me use one ear and the blood won't come from all spots even with heat when it used to.
I had read that you were not supposed to feed diabetic cats over night? I try to feed him his two big meals before each shot and then 3-4 meals small meals depending on when I get home.

When we do get MeowSpace running (fingers crossed) I can leave him a meal out over night. I can also get a meal ready and cover it and when I go to the loo during the night I can give it to him. My only apprehension with this is that in the morning its the hardest tome to get him to eat. He gets really picky about what he will eat first thing so I worry that if he eats at 3am then he won't eat at 5.30-5.45am when I need him to?

 

Hi Bron
Just went to the Lantus forum and was reading this is a pretty scary area seems if you don't write everything exactly the right way not going to go well. I am becoming very uneasy as I see Kaz's numbers dropping I fed him high carb food to get the number above 200 which I will be checking in about 20-30 minutes. Seems like on the Lantus site its not an emergency unless your into the lime colored green so now not sure I'll get a response quickly if his numbers are lower than 200.

I am assuming that if I can't get his numbers above 200 I skip a dose. I will try asking on the Lantus area but I am expecting this to happen over the next 24-48 hours as he appears to be trending in this direction.

Wondering if I am supposed to decrease his dose?

Fingers crossed he's above 200 although ultimately he needs to be in green.

 

Not sure what you mean?

You can always get help on the Lantus forum if you change you subject line to reflect your problem. If you put HELP in the subject line you should get a response.

If you can’t stall and you need to leave, you can give a token dose such as 1unit and leave some higher carb food out for him.
When does the new feeder arrive.? That should help things.

I would not decrease the dose unless you are giving a one off token dose because of a lower preshot and you can’t stall or monitor the cycle.

 

The new door arrives on Monday per the tracking number but I'm hoping that it will come earlier.

I have stopped all the Tiki right now and am only feeding him foods with carbs (between 3%-9%) to keep the numbers up so I can continue to dose him at the 2.5 level.
If I give him Tiki his numbers will drop again so to keep him safe this was all I could think to do.
Until you tell me otherwise I will keep him at 2.5.

After tomorrow I am home again for three days so I can monitor him a bit closer.

Leaving food out is a problem as Sam will eat it immediately. My other cat has a condition where he forgets he's eaten so he will just eat and eat and eat.

However I have found a way to bypass the security on the MeowSpace so that its open both ways no magnet required to get in. This means that both cats can access it however Kaz is the only one who really understands it. So i was going to leave food in there but I think he may eat it immediately.
Currently trying to teach him what a automatic feeder is. I may leave a meal in the automatic feeder as well and hope he notices it.

 

I would hold the dose of 2.5U for 10 cycles after you first saw the blue BGs as long as there are no ketones.

 

I think there are a lot of cats that forget they have eaten and will just keep eating!

 

Ok thanks

So if above 200 give dose as usual but if below 200 reduce to 1 unit for 1 cycle and then as long as his numbers have increased again go back to the 2.5 and remain there for 10 days in total (5 days in at 2.5 units).

Again thanks for your help. Going to try get some sleep. Have the alarm set for 1 pm to give him a small meal then.

 

Hold the dose at the moment because you are just seeing blue BGs.
If you get a BG preshot under 200 and you have to go to work and can’t stall, then give the token dose and feed some higher carb food before you leave .
If you are staying at home and the preshot is under 200 …you can stall, dont feed and see if the BG is rising…the you can give the normal dose and monitor the cycle as normal.

 

10 cycles not 10 days.

 

If that's the case then I am already on cycle 11.
I tried leaving food out in a timer in the MeowSpace but I will never know which cat eats it (if it gets eaten) as its accessible to both of them right now? One small can of 3% carb food broken into two meals.
Kaz is now overweight which is going to come with its own health issues.
At least tomorrow I can try and test a bit more. I could not get any blood out of one ear it was weird. I had to force him to let me use the other ear but he protested this quite a bit.

 

It is 8 to 10 cycles from when you start seeing the blue BGs

 

Sorry I misunderstood. Ok so it restarted yesterday PMPS shot. Got it.
Thank you for clarifying.

 

I am excited to see some blue on his spreadsheet. This is good!

 

I am too but I am the one probably keeping him in the higher bracket now as I have been feeding higher carb food. Scared to let it drop as then I can't dose properly and then have to go to work and leave him and I am scared something bad will happen.

I am not a fan of zoom calls but I wish that this site held once a week/biweekly/monthly meeting on line where you could call in and ask questions from the experts (that's all of you).
I feel like I am picking it up but still don't understand fully where I go from here and I feel I ask too many questions.
Guess I would just like a definitive plan mapped out ahead of me so I can see where I am going instead of day by day.

 

By the way I think it was you that sent this to me I've been watching Clyde's spreadsheet daily he's doing really well looks good for remission for him.

 

You don’t ask too many questions.

 

Hi Bron

This mornings shot marks the 10th cycle. Should I stay as is or change the dose again?
Thanks for your help.

Claire

 

I think you can go up to 2.75 units Claire. Will be interested to see the blood results. Get a copy of them if you can.
What is the date of your vacation?.

 

I fly on the 16th of June and return on the 5th July.

Besides adjusting the shot for my trip I also need to adjust the time of the shots to coincide with when this lady will be visiting. Right now I give him his shot at 6.15am and 6.15pm but I need to adjust this to either 8am/8pm or 8.30am/8.30pm.
(forget which time she said but think it's the later). This means adjusting everything by 2 hours. I think I read I can adjust by 30 mins each day but obviously wanted to check that this is the case as I need to figure out when I need to start making this adjustment.

I will adjust Kaz's evening dose to 2.75.

I'll also send email now asking for the blood results which I was supposed to get yesterday as they keep telling me the Potassium is important.

Thanks

Clair

 

Yes you can adjust the time by 30 minutes a day or 15 minutes each cycle whichever is better for you.

 

Good luck with the increase, Claire. His spreadsheet definitely looks like he needs that increase. I am happy that you saw some yellow on 5/8 though.

 

Hi Bron

Dr Brum sent me an email which I find a bit bizarre.


No need for potassium tabs. The blood glucose was great at 180-

So if I gave him a pre ear prick at 6am and the reading was 425 for BG. Then as soon as I got back from the hospital it was 218 (around 10am) does it make sense that his BG dropped that low after 3 hours and he had food.
Seems a bit odd. I would have expected pink numbers not blue. What does this now mean for Kaz's cycle. I personally did not see blue but if the test results say he was in the blue then do I hold for another 8-10 cycles or do I still adjust to the 2.75.

Full results are below which I don't fully understand will start looking things up but everything appears in the acceptable range except BG and BUN?

 

Is that all the bloodwork that they did on that day? The BUN is marginally elevated but many factors can influence BUN. Could he have been a little dehydrated on that day? Without a urinalysis to go along with this chem screen, it’s hard to interpret the BUN. A urine specific gravity reading would be helpful.

 

There’s not a whole lot of difference between 187 and 218. If you got those readings yourself on your own meter, I would say that they were within the +/- twenty percent meter variance.

 

It’s probable that he is bouncing again from the 187/218 on that day

It’s excellent that his potassium is back up, by the way! I hope it will stay that way. Will you take him back for a recheck before your trip to make sure it’s still okay? I am sure if you notice anything unusual like lethargy, you will take him back anyway.

 

You would expect the BG to drop as he had had an insulin dose 4 hours earlier and as Suzanne said with the meter variance there is not a lot of difference.
Yes I would still do the increase tomorrow.

 

The libre you are going to put on when you go away, is going to give human meter BG numbers, so it might be an idea for you to buy a ReliOn premier meter now, which is only $9 at Walmart and 100 test strips are $17.88, so that when you put on the libre when you go away, the BG numbers will be similar. At the moment because you are using an alphatrak meter, they are higher. What do you think?

 

Thanks will increase tomorrow.

 

I already own this blood meter (think its this one I got it at CVS or its really similar it was cheap) I bought it when the first Alpha Track broke as I needed a device to use in between.
I was using the other as it was specifically for animals and the people one seems to give lower readings and the fact that the Alpha has him in black so much and the other device simply said HI so I had no idea what the actual reading was and it worried me.?

I can switch to the human one while I travel which I will do towards the end of the week I don't think I have many test strips left so need to go buy some more.

 

I would think that the BUN number is elevated in part due to the Prazosin he takes I think it can elevate kidney. Not really good drug to keep a cat on but sadly he blocks as soon as you take him off. I was going to do an experiment of weening him off due to the diabetes as diabetic cats drink a lot more and this actually might help with his condition. With all this cat has had to suffer over the past couple months I was waiting and now don't want to do it till after I get back from the UK.

 

Sorry the only reason they did bloodwork was to see if he could come off the Potassium but based on the results from the prior two dates it would appear that this is all they test for. Is there something specific your looking for? I can always add it to my list and then next time they draw blood ask them to test for it?

 

I was just thinking that they should have gone ahead and done a CBC along with the chem panel and a urinalysis. But that's for a full checkup. They were only checking for potassium -- so it makes sense they just looked at electrolytes.

I know that Prazosin can lower BP, so it can then, in theory, reduce GFR in the kidneys, which could elevate BUN. Does he have a history of having an elevated BUN? I am wondering if he only started having an elevated BUN after he started the Prazosin.

 

I would have thought that when he was diagnosed on March 5 they would have done both panels of blood work and a urinalysis.

 

To be very honest I am not sure as they never did bloodwork till he got the masses on his liver and kidneys a couple years ago(once every 5 years the doctor would say why don't we check but more rabbis and distemper and a yearly check). Till then he went to a small vet but after Kaz got sick I moved him to Angel under Dr. Brums care as I trusted him plus I wanted Kaz somewhere he could be helped quickly if something was wrong. Dr Brums attitude is to let a cat be a cat and once a year he will do blood work on Kaz but don't think they are full screens. Technically he is due for his annual in August but as he's in and out not sure if this will be kept?
Kaz also goes to cardiology once a year to have his heart looked at. This is more of a precautionary thing than anything else and is linked to the masses.

 

I think they may have done the tests your talking about when he was hospitalized with DKA as i got an itemized invoice and remember these being on there. They never shared these results with me.

 

Hi Bron

I am going to try to start using the people monitor this weekend (going to have to try and run both so I can understand it)
I have not asked about upping the dose again as Kaz's numbers are all over the place and as he's getting blues and now today greens (may be getting these while I'm at work) I assumed you wanted me to hold at the dose I was at.

When should I ask you about the plan to put in place while I am gone? I need to try and make sure I have enough time to educate Laurie. I'm hoping she will want to come around a couple times and watch me give the insulin and then try herself in front of me.

MeowSpace is now fully functioning and Kaz gets an additional 2 meals during the day when I'm at work. Also means I can now leave the house a bit more.

Thanks Claire

 

Sorry one other thing he's currently at 98. I gave him some higher carb food to bring the numbers up slightly. As long as he's 150 or above I give him the full dose. If below 150 give him only 1 unit. What is the number when I should be holding the insulin please.

 

Still unable to tag anyone tried putting the @then persons name but nothing happens. Guessing not doing it in the right place. Tried looking on this website for instructions but can not find. Sorry such IT idiot but I wanted to make sure I could get hold of the other members you had mentioned in case of emergency.

 

it sounds like you are on the right track, using the @ sign then as you type the persons name like bron, a little box appears with multiple choices and you click on the one you want

it looks like this:

 

Sorry nobody was around but he answered the question for you!

See what Bron thinks about a no shoot number. Technically with TR it is 68 on alphatrak, but you work your way down to that slowly. Since he is post DKA and fairly unregulated we really don't want to skip if we can avoid it.

@Bron and Sheba (GA)

 

Do you mean you are going to start using a human glucose meter? If so you will need to note it in the SS so we know which one you are using. If you are going to swap over to the human meter fully, I will ask @Bandit's Mom to change the SS for you. You will find it confusing if you are going to test with both meters. The Human meter runs a bit lower than the pet meter.

Now that you are seeing green BG you need to stay with the same dose (2.75 units) for now.

We won’t be able to tell you the dose until just before you leave as we will need to be able to see how low the dose it taking Taz each cycle.
You can start to tell Laurie when and what to feed Kaz. I would write it down in dot form so it is easy for her to see. and I take it she will fill the auto feeder up each cycle? I would write on the top of all the cans the carb % and tell Laurie what to do if the BG is lower etc and when to feed what %.
Make sure you have the hypo kit set up for her with instructions on what to do if she finds Kaz is having a hypo or is in very low numbers.
And are you still going to have a libre freestyle fitted before you go?
We will tell you the no shoot number and the dose probably the day before. I know it isn’t long before but that is the best way of doing it.
How does that sound?

That is really good news

If you are using the alphatrak meter 68 is the BG where you have to take action to bring the BG up higher with high carb food or honey/Karo. If it is the human meter the BG take action number is 50.
As Kaz has not had any preshot numbers under 225, I would start off with 200 then lower it down to 150 over a period of time (and assuming you will be around to monitor the cycle. If you get a number under the preshot you have set, you can either stall and test again in 20 minutes if that is possible and see if the BG is rising or you can give a lower dose. If this happens post and hopefully someone will answer.
We need you to practise tagging someone. So hit the @ then start typing in the username of the person you want to tag. A box like Kyle posted will look up. You need to click on the person you want to tag. Try it now and see if it works.

 

@Hendrick Cuddleclaw

Stupid me I think I finally got it. Not sure why it was not working before

 

Sorry probably another stupid question but on the SS and I was going to ask this as soon as I switched to the human meter are those numbers at the top designed for a human vs a cat?
I thought these were cat readings and was going to ask for the equivalent of a human but if these are indeed human readings then Kaz's numbers have actually been a lot worse than I realized.

 

@Bandit's Mom (testing this works)

Hi Bron - yes I switched to the human meter this morning per your recommendation. I inserted a line on the SS showing this and then also recorded the Alpha number in the comment section.

I tried tagging Bandit's Mom more to see if I could get it to work than anything else. Also interested in those coloured bands above. I always thought they related to cats but is there a different color band for cats as these two meter read differently. A 68 on a human meter would appear to be really low on a human meter based on the readings I am getting now?

EG Pre Shot AT2=548 Human Meter=441 (100 points in difference) Just worried as if I get a 200 on the human then that would technically be a 100 and blue and then I am not supposed to be giving insulin as below the threshold number of 150? Just want to make sure I don't hurt Kaz accidently.

Yes the MeowSpace is the best thing I have ever bought for Kaz and is a life saver. He will not leave the front door as soon as the cat feeder goes in as he thinks his brother can get in even though I keep telling him otherwise but he's a pro at getting in and out and I even left him a small meal last night as his numbers were low.

Think this is last answer. I cut out small squares about 3 weeks ago and stuck carb % on all food and one can (marked one) is never used its left out so I can quickly see what % I am giving each time. Quite frankly it makes it easier for me although at this point I know what most of the usual food is. Plus I printed the food chart and have that on the kitchen counter too with all foods in stock highlighted for easy view.

Thanks for your reply

 

As Kaz has not had any preshot numbers under 225, I would start off with 200 then lower it down to 150 over a period of time

Sorry I don't understand this please. I know I am keeping the insulin at 2.75 per your answer above but not sure what this means. Written down in my book about the 68 vs 50 numbers for taking action.
Thanks Claire

 

it would be great to be able to tag you Claire, I wonder if you are amenable to changing your username, and removing the @

yes you did! You're not stupid -- after all you made it here and you're still here. Which is incredibly smart!

 

Did not realize my user name was non taggable just assumed it was @Claire? Go look now see if I can figure it out.

 

There is no # before my name just the @ sign wondering if that's not supposed to be there as I see no @ sign in front of any other names let me try removing that?

 

The only thing
@Bandit's Mom will have to change for you on your spreadsheet when using a human meter for the color coding is the last 2
Instead of 68-99 dark green it would be 50-99
Instead of BG<68 lime green it would be BG<50
Everything else stays the same

 

@Hendrick Cuddleclaw

I can't change it twice did not realize I now have to wait 89 days to change it again per the system sorry.

 

Take away the @ sign and just leave Claire and Kaz

 

Thank you this is really helpful to know. In my book for quick reference.

 

Have to wait 89 days to make changes again

 

Maybe one of the administrators can take away the @ for you
@Wendy&Neko

@Sienne and Gabby (GA)
We weren't able to tag Claire at all first she had the @ sign the Claire tried to change it just now and put the @ sign Claire and Kaz she wasn't aware to take away the @ sign, now she has to wait 89 days to fix it, so we are unable to tag her

 

Hi Claire, the tag worked. Are you switching to a human meter temporarily and will you be switching back to the AT2 on your return? Or will you stay with the human meter? Will make changes to the SS accordingly.

 

Bron had suggested that I switch to make it easier for Laurie (she's not testing but Libre button will be on). Hoping she will text me the numbers so I can keep the spreadsheet up-to-date and still monitor for as long as button works. Don't want to push her too far and lose her.

The human test strips are definitely cheaper unless you buy in bulk which is an expensive option upfront (50 tubes at 50 if bought separately for AT2 cost $2.500 or $50 a tube but if bought in bulk cost $750 of $15 a tube). I was contemplating doing this as they work out to be the same cost as human strips and I thought cat strips were better. However I am happy to stay on the human strips permanently if it makes it easier for helping me which I think it does as so most people are on human ones.

Basically I will do what ever you or Bron tell me to do as I can't do this without all of your help.

Claire

 

I would stay with the human meter since our numbers are based on human meters and Bhooma @Bandit's Mom will also fix it up top on your SS where you have the Alpha Trak and put now using human meter

 

Hi Claire. I believe that Bron is suggesting that you adopt a “no shoot” number of 200 initially (where if Kaz’s pre-shot tests - morning or evening- are below 200 then you would not shoot) and that later you can gradually lower that “no shoot” number to 150.

It will be good to have a relatively high no shoot number at this point- with your trip coming up and all. @Bron and Sheba (GA)

 

Claire if you can add to your signature what you are feeding Kaz that would be great. Such as LC Wet or Combo (LC /Dry)
To do this tap on your name up top , a drop down will appear , tap on signature and add it, then tap save. If you can do this then Bhooma won't have to ask you

 

Ok thanks

So if I am now understanding this correctly the new no shoot number (NO INSULIN SHOT) is at 200 on a human meter which based on numbers so far will happen now?
Then I wait till the next shot (12 HOUR WAIT) and if then above 200 give the usual 2.75.

And this is safe for Kaz to go from insulin to no insulin as my gut says with human meter he's going to be closer to the 200 mark most of the time. Its now three hours before his next shot and the number is 202 on human meter.

Going to feed him some high carb food to get his numbers back up as I don't really understand this. I can see missing insulin every now and then but not on a regular basis if he needs it.

Can you please explain.

 

I'll tag @Suzanne & Darcy about this
I can try tagging @Wendy&Neko
@tiffmaxee also

 

Thanks

I changed the signature to add Kaz's food

 

Personal opinion: I do not see how skipping the shot if he is less than 200 on a human meter at pre-shot time will help Kaz. I think he may shoot off to the moon. If it were my cat, I would give at least some insulin- a half dose or something less (depending on number.). But it’s standard advice when you are new and you get a number below 200 to post for advice/help on the Board.
Bron will probably be along before your pm shot time to clarify. It’s very early morning for her now, I believe.

 

Here are some guidelines on how to handle lower than expected pre-shot numbers:

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 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.

 

Claire I remember you saying you feel more comfortable posting on the Main Forum rather than the Lantus Forum . If you start posting on the Lantus there are more eyes on that forum. Think about
You would post like this
Date Kaz AMPS # and any other tests after that them PMPS# then any other tests after that.
We like to do a new post everyday and you would also link the previous days post to the new day. It makes it easier if a member has to take a look at your previous days post


This is your previous post
https://felinediabetes.com/FDMB/threads/amps-588-pmps-534-kaz.262165/

 

And here’s what you really should read to help prepare you for the lower than expected pre-shot numbers. I could paraphrase it, but there’s no point. This just explains things so well.
https://felinediabetes.com/FDMB/thr...y-to-shoot-handle-lower-pre-shot-numbers.147/

 

Anyway… let’s see where he is at pre-shot time tonight. He may be above 200 anyway and the point will be moot… at least for tonight.

 

1) Ok think I got this if below 150 NO INSULIN - post to board (NEW POST) asking for help (NEW POST SHOULD BE ON OTHER BOARD TO GET QUICK RESPONSE (TODAYS DATE/KAZ/AMPS#/HELP) I usually do the ear prick and feed 30 mins prior to shot so i have enough time to react to an issue.

2) Between 150-200 then reduce shot by up to 25% (so at 2.75 now basically give him 2.00 units).

The feed and wait a couple hours and then make decision ..........this is bit confusing as I was told that if I missed giving a dose not to give one 2 hours later but to wait till the next dose 12 hours later. This would break that rule?

 

Sorry, that's beyond my pay grade. I'll see if I can get in touch with the site admin. It's not such a bad thing to not have someone tag you all the time.

When switching from the AT to a human meter, remember than the differences in numbers are higher in the high numbers, and much closer as you get down to lower numbers.

 

Yes that is how to post on the Lantus Board so if you need help with dosing
Date /Kaz/ AMPS # you can then put Help Stalling Do I Shoot
If you do decide to start posting on the Lantus Board Tomorrow morning you can say you have been posting on the Main Forum before

 

Tried reading this twice and find it a bit confusing. I'll try reading it again in a bit to see if a break and coming back helps but honestly now feeling a bit panicky again.

 

Next insulin is 2 hours from now.

I'm using both meters right now and I think a lot more confusion is happening because the human meter says 202 but the Alpha says 308 which is way in the acceptable range for giving a shot. Find this really confusing just because I changed meters surely on a people meter 100 would be the time to stall and not dose as this would be around 200 on the animal meter??? Very confusing.

 

The numbers on the document I attached about becoming data ready to shoot lower numbers are all based on human meters.

I do understand the confusion with the meter switch. I am having it too.

 

Don’t panic. Kaz is okay and he’s in safe numbers now.

 

It is confusing because these are just guidelines and are helpful but each individual cat has to be taken into consideration. Also, you are following TR now and not SLGS. My advice to people with a lower than normal pre-shot number is almost always to stall for 30 minutes, do not feed any food and then retest after 30 minutes. You will then see if the number is rising on its own at the end of the cycle (with no influence from food) and will then be able to make a dosing decision on that number. So, at that point options are usually: skip, shoot a reduced dose, shoot full dose.

The thing about waiting up to two hours is that your whole schedule is thrown off. It will take 4 days to get back to your usual shot times (since shot times should only be adjusted by 30 minutes each day).

 

This would not work with my work schedule so this is extremely scary.
I could never do this as it would put Kaz in danger.
Half hour and I will know if I have an issue

Still don't agree/understand about the 200 number on the human meter to stop a shot as this is 300 on the AT and that's an acceptable shoot number.

 

I probably just didn’t understand Bron correctly perhaps?

 

Maybe she was talking about a 200 on the AT? It seems likely since all you have tested with in the past was AT. I hope I haven’t just come along and confused everything even worse. I didn’t even know until this morning that you had switched to doing a human meter.

 

@Bron and Sheba (GA)

So as expected the number on the human chart is 177 which is below 200 threshold however if this had been on the AT2 it would have been 270 which is well within the acceptable range to shoot. I am very confused as to what I am now supposed to do.
I am going to feed Kaz as normal and then check back to see if I have advice from others.

 

Your pmps is 177 on human meter and 270 on the AT? If that’s the case, if it were my cat and I was able to monitor the cycle and feed and test and I had plenty of supplies for hypos —- I would shoot.

 

You shot a 225 once but that was at a lesser dose. Do you want to shoot the whole dose. If you had never gotten the human meter and got the 270, you would have shot the full dose, right? I would think of it like that.

 

i 100% agree and I was going to shoot him as for the past 3 days it was acceptable to shoot at this number. I don't understand why its not acceptable anymore. Have I put Kaz in danger over the past three days for giving him a shot when he should not have had one. I simply don't understand and I don't want to kill my cat.

 

It was at exactly the same dose it was yesterday. I have been on the 2.75 units for a number cycles as I was told to hold there due to the blue numbers.

 

Yes. Exactly right. Hold for approximately 8-10 cycles with blue nadirs is the general rule - depending on if they are lower blues or higher blues.

 

No. I do not think you have put Kaz in any danger. You can see this by your spreadsheet. He has been in safe numbers.

 

If you are uncomfortable and want to wait for further clarification, do you want to reduce his dose for tonight?

 

I do have a question though. I’m scrolling back through this thread and you said something about feeding him high carb food? Was this 177 a fasting number? Two hours without food prior to the test?

 

No I feel comfortable giving him his normal dose which he’s getting now.
I still need to understand what I am doing. I don’t want to be someone that does a task but doesn’t actually understand what they are doing. This is why I ask so many annoying questions. I want to understand exactly what it is I am doing and until the switch to the human meter I was getting a handle on everything but now I feel like I did when I first came to this site. Clueless and huge fear for Kazs safety which means more to me than anything.
I’m scared I’m doing something wrong which will ultimately hurt my precious cargo.

 

I understand. I am sorry you are so stressed like in the beginning. It’s important for you to understand.
I do not believe you will put Kaz in danger if you shoot the full dose. I am not saying that based on an opinion but I am basing this on his spreadsheet. I do, however, have a question about your reduction point. Had you and Bron established a reduction point? He had that 98 on the Alpha Trak yesterday and I am wondering if that was below his reduction point and if his dose should have been reduced by .25.

ETA:Bron said to hold the 2.75 with the green nadir.

 

No I was under the impression that as long as the number was above 200 on the AT2 to shoot as normal. If he went under 200 and I could stall to wait 20-30 minutes and retest if then above 200 to give shot as normal if not then ask for help.
If I had to go to work and could not stall then to give a token dose of 1 unit and feed him higher carb food which I now understand to be above 10%.

I believe I was told as it's in my book that if under 150 I was not to give any dose (again AT2 meter) and post on the board for help.

Again this was all with AT2.

Based on today I will continue with both meters until I have a better understanding of the human meter.

My gut says that a 200 on AT is actually 100 on the human meter but I also read on one of the posts that the lower readings were closer together. Hoping that as long as I still have the AT2 I can keep going without hurting Kaz which is my main concern.

Thanks ever so much for talking to me as been bit out of my mind today with worry.

 

You’re very welcome. I remember what it was like. Continuing with the human and AT meters will give you a good idea of the variance between the two. Just put the AT numbers over in the comments section as you have been doing. The variance between the two meters apparently does get closer as the numbers get lower. For example, the “take action” number for a human meter is 50 and on the AT it’s 68. So that is only an 18 point difference. But today in Kaz’s numbers you have been getting about a 100 point difference.

 

Also, can you please put what you shot in your spreadsheet and the time that you shot?

 

Not sure what you mean about what time I shot. Kaz's shots since day 1 (2 exceptions for evening shots when I had to adjust slightly for work functions) have always been at 6.15am and 6.15pm. Am I supposed to put these somewhere? No one has ever asked me to do that before.

Kaz's numbers are coming down weird all of a sudden over last three days his numbers have started coming down. My gut says that while I am at work they have been in the blue's. Not sure why this has happened so suddenly. Anyway I fed him 1/2 pouch of high carb food tonight and will recheck in couple hours.

If his insulin is adjusted down by .25 will this stabilize his numbers again?

 

Hi Claire, I’m so glad @Suzanne & Darcy was able to help you earlier. I am just going to read through the thread to come up to speed and get back to you. I’m really glad you gave the full dose at the pm shot.

 

The no shoot number is where you stall, don’t feed and test 20 minutes later to see if the BG is rising. And you post and ask for help on the forum. I know that might be hard when you have to go straight out to work so on those occasions a reduced dose may be best. We want to avoid skipping insulin altogether as he needs some insulin, especially after DKA.
You just gave insulin with a preshot of 177 (when you could monitor) which is great! And now we can get some data on how he goes with that preshot and the full dose.

this is why I wanted you to swap to the human meter now and not get a fright when you put on the libre the day before you left for your trip.
The human meter runs lower than the pet meter so we expect lower numbers. Normally as the numbers get lower, the difference gets smaller. Because you have shot a 177 we can now lower the no shoot number to that…..that means that is when you will stall, dont feed and retest 20 or 30 minutes. If it is a day that you have to work, we can sort out a reduced dose.
It is great you have the auto feeder set up and Kaz likes it. This will make things easier all round.

I completely understand your concerns. This is why I wanted you to swap to the human meter before you put on the libre to travel. ….getting used to the lower numbers of the human meter will just take a few days. The human meter BGs are showing as lower but Kaz still has the same numbers on the pet meter…..it’s just the human meter runs lower.

Absolutely you need to understand what you are doing….that is our aim here….to help you learn how to manage your Kaz and to understand why you are doing what you are doing. Keep asking questions!

She is following TR so the reduction point is 68 on the alphatrak meter and 50 on the human meter.

His numbers have not become unstable, you have just swapped to the human meter where they are lower…..this is normal.
Let’s see how he goes over the next few days. When do you work over the next few days?
Remember we will be recommending the dose be reduced for when you are on vacation. We call it a vacation dose.
You are doing an excellent job looking after your beautiful boy!

 

I see you are giving 15% carbs Claire. I think it would be better to give some lower carb food instead so that we can see how the dose goes with that preshot. I know you are anxious but do you think you could do that?