Kaz AMPS 533/PMPS241

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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?
 
[USER=10387]@Claire[/USER] said:
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.

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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
 
[USER=10387]@Claire[/USER] and Kaz said:
@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.
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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
 
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[USER=10387]@Claire[/USER] and Kaz said:
@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.
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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.
 
Bandit's Mom said:
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.
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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
 
[USER=10387]@Claire[/USER] and Kaz said:
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
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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 :cat:
 
Suzanne & Darcy said:
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)
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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.
 
[USER=10387]@Claire[/USER] and Kaz said:
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.
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I'll tag @Suzanne & Darcy about this
I can try tagging @Wendy&Neko
@tiffmaxee also
 
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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 :cat:
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/
 
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.
 
Suzanne & Darcy said:
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.
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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?
 
Diane Tyler's Mom said:
Maybe one of the administrators can take away the @ for you
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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.
 
Diane Tyler's Mom said:
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
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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.
 
[USER=10387]@Claire[/USER] and Kaz said:
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?
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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).
 
Suzanne & Darcy said:
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).
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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.
 
[USER=10387]@Claire[/USER] and Kaz said:
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.
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I probably just didn’t understand Bron correctly perhaps?
 
[USER=10387]@Claire[/USER] and Kaz said:
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.
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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.


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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.
 
Suzanne & Darcy said:
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.
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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.
 
Suzanne & Darcy said:
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.
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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.
 
[USER=10387]@Claire[/USER] and Kaz said:
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.
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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.
 
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?
 
Suzanne & Darcy said:
If you are uncomfortable and want to wait for further clarification, do you want to reduce his dose for tonight?
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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.
 
[USER=10387]@Claire[/USER] and Kaz said:
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.
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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.
 
Suzanne & Darcy said:
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.
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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.
 
Suzanne & Darcy said:
Also, can you please put what you shot in your spreadsheet and the time that you shot?
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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?
 
[USER=10387]@Claire[/USER] and Kaz said:
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?
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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.

[USER=10387]@Claire[/USER] and Kaz said:
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.
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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.

[USER=10387]@Claire[/USER] and Kaz said:
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
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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.

[USER=10387]@Claire[/USER] and Kaz said:
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.
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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!

Suzanne & Darcy said:
Had you and Bron established a reduction point? He
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She is following TR so the reduction point is 68 on the alphatrak meter and 50 on the human meter.




[USER=10387]@Claire[/USER] and Kaz said:
his insulin is adjusted down by .25 will this stabilize his numbers again?
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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!:bighug:
 
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?
 
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