MEME (AT), +6 97, +10 373

Status
Not open for further replies.
rawia

rawia

Member Since 2017
Hi all,

I made a new post to be easier to all of you to look at and give me some help.

Now based on your suggestions i reduced her dose from 1.25 to 1 U.

Her amps today was 224 (alpha track)

I give her 1 U

+3 275

+6 82

+8 59 :nailbiting:

I was scared to death , give her friskes with gravy and some honey.

What is going on, when i used to shoot from Lantus pen 1 U it never dropped to this range, is it the accurancy or what?

Should i reduce it more to 0.5 unit or stay a full day with no insulin to see what is going on?

Please advice?
 
Hi--

I don't know the history here (can you put in a link to your old post? I can't find it), but based on that 59 (and a 53 I see on your spreadsheet-- it doesn't look like the spreadsheet is up to date?) on an AlphaTrak, it does seem like you should reduce again.

Have you tested since the 59? What is her BG like now, and how long before shot time?
 
Her next shoot is after 2 hours and i always get low numbers and do not know to shoot or reduce or not to shoot.
 
OK. That's good that her numbers have come up, but it could be partly due to the honey and gravy. I would hold off on giving her more food unless she drops again-- that way, by the time shot time is here, we'll have a clear picture of where she is on her own.

I think the decision then is going to be between shooting a reduced dose and skipping the shot. You've got a lot of tests and data on your spreadsheet, which is really helpful, but it doesn't look like you've shot a lot of low numbers, so this is somewhat new territory. We'll just have to see where she is at shot time. It would be really helpful if the latest data were entered onto the spreadsheet, too.

A couple of questions about Meme's history: was she previously on dry food before the FF? why was she admitted to hospital on the 13th? any history of ketones/DKA?
 
By the way, it's a good thing that Meme seems to be spending more time in blues and (dark) greens on less insulin! The more time she spends in these numbers, the more chance her pancreas has to heal. The trick with Lantus is to figure out the right dose for her that keeps her in those kinds of numbers a lot of the time, without dipping down into the light greens, but getting down to this level in the first place is half the battle!
 
She was diagnosed on August 4, 2017, before she was on dry food but when vet recommended to do blood test for diabetes i cut her immediatly from dry food because i read somewhere that it is better to detox before starting insulin, then 10 days later when result came we started insulin (Lantus).

she admitted to hospital because she was not eat and dehydrated, vet said she feels nausia and it is common sometimes, put her on IV and run blood works which came all fine. Her history is good nothing from above. Also vet said that her BG was in good range for whole day without insulin at the clinic which was shocked for her, but i think that is because she did not eat anything there, the only thing that she had during her treatment was a minor urion infection which was treated by antibiotics.
 
I updated the log, i skept yesterday second shoot which i did not like but i want to know how much her BG will rise till this morning shoot.

Now she is 100 and only 1 hours and less than 2 hours is her next shoot. Shall i reduce to 0.5 or 0.25??
 
I read in TR protocol that if a new diagnosed cat reached nadir below 100 then should hold the dose for at least 7 days but i am afraid to shoot again if her number does not go more than 200.
 
It's tricky, because the TR protocols assume a human BG meter for their cutoffs. When using an AlphaTrak, my personal opinion is that it is good to be a little more cautious on the cutoffs because the meters tend to run higher. Since she dropped into the 50's on an AT on 1U this morning and a no-shot last night, I'd be extra cautious.

I'm hoping some other people with more experience with both the AT and giving dose advice will weigh in before shot time, but personally, given no history of ketones, I'd be inclined to drop all the way down to 0.25U and see how she does with that. If you can monitor tonight, 100 on an AT is a shootable number, but it's on the edge and a lot lower than you've shot before, so if she isn't higher by shot time, I think a skip is also a possibility.
 
Ok by shoot time if she reached 150 on AT i will shoot .25 and monitor her to see how it works.
 
rawia said:
I read in TR protocol that if a new diagnosed cat reached nadir below 100 then should hold the dose for at least 7 days
Click to expand...
Unless they earn a reduction then you reduce as you have. Today's low may be influenced by the 1.25u depot but I'm not a fan of 50's on AT and think you should reduce to .75u. She'll may bounce tonight because of the drop from 200's to 50's in a short time. Sometimes they bounce worse from big drops rather than lows.

You did a great job bringing her back up. This is the way you work down the dosing scale and possibly get them into remission. Hopefully you didn't need to give more food 2 hours prior to PMPS. Before shooting post her PMPS, don't feed. Can you monitor tonight?
 
Yes i am able to monitor overnight, so you tell me to shoot 0.75 and not less!!

I will post up her PMPS which is in 45 minutes and hopfully that anyone will be around to help dosing by that time.

Thank you all and will re post shortly.
 
fyi, @rawia , Karen has a lot more experience than I do-- if she thinks 0.75U is safe to shoot, it is!

My lower recommendation was due to 1) putting more emphasis on the no-shot last night to have drained the depot more (so that 1.0U this morning would have been acting on its own), and 2) I am a total chicken.

We'll see what the pre-shot looks like!
 
I am chicken my self but last time i told my self that i have to shoot and deal with low numbers any way or i will never know what is the best dose for her.

Can i ask what does bouncing mean :oops:

It might be selly question but really i hear that word but do not know what is the meaning!!
 
rawia said:
Yes i am able to monitor overnight, so you tell me to shoot 0.75 and not less!!

I will post up her PMPS which is in 45 minutes
Click to expand...
I'll be sure to look for her PMPS. Don't feed (unless she dropped below 68 again) and wait for a response..OK? You want green but safe green and by working down in the .25u increments is the best chance for not missing a good dose. If you're tired and don't feel up to monitoring like you have been then that'll change the recommendation. Also be sure you have more high carb food and strips.

Below is a short explaination of bouncing which is found in the The Basics New To the Group Sticky
Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Thank you for the information.

No i am not tired and i really want to reach the good dose ASAP even if i have to monitor all the night.

I have one more bottle of strips but got also the one touch meter incase of any surprise and did a test with it, the diffrence is only 18 points in low numbers which is ok. (Incase i ran out of AT strips).
 
She is now 101 on AT, have to shoot after 5 minutes.

What to do now feed her and shoot 0.75?
 
It's a little hard to see what Meme's dose should be. We find it's best if you can consistently shoot the same dose AM and PM. For her new dose, I would try 0.75 units as Karen suggested, even though it may be the 1.25 units dosing that is impacting the cycle. Better to deplete the 1.25 depot for a while and see where things are.

For tonight, can you monitor Meme? It's hard to say what will happen. She could bounce in which case tonight will be a non event. Or the depot could still be in charge and give you lower numbers. Cats do like to be unpredictable.
 
It's pretty much the same with meter variance. Like Wendy said, it could be a non event or you may have to steer. Are you up for feeding and shooting .75u? Get a +1 and a +2.
 
Yes sure.

Ok now i will feed her and give her 0.75 , feel scared but will do it better than not shooting
 
Shooting the first green is always scary. Often times when you shoot low they just surf. I'll check in an hour to see how Meme's doing. Remember, you have the tools to keep her safe. These are for you
BOS.png
 
It is also because the no half unit syringe( my syringes will arrived tomorrow and will be able to shoot on PM ).

That is why i am afraid that the dose is not accurate with this syringe but i did my best.
 
rawia said:
It is also because the no half unit syringe( my syringes will arrived tomorrow and will be able to shoot on PM ).
Click to expand...
That does make it a bit more difficult. Glad you're getting new syringes. See what the +2 is, right now, no food spike but staying kind of flat. How is her appetite? You may need to start steering at +2 if needed.
 
She will never say no for gravy meal at anytime but can honey or karo syrup do the job if she refuse to eat.

I usually feed her and give some honey because she always eat small amounts.
 
The honey gets numbers up quickly. It's a great tool to have ready, especially with a cat that isn't super food-motivated. The only thing is that it wears off quickly (plus you don't want to give too much, because they can throw up).
 
I don't know that you need to bring the high carb out just yet-- you can wait to see where she is at +2, and then as long as she isn't too low, just her regular low-carb food might work to keep her "surfing" along in these good numbers.
 
rawia said:
Ok

In this range i am afraid that she will drop very low on +6
Click to expand...

Maybe, but then again maybe not-- that's one of the things about Lantus, it's actually better at keeping BG level in this range than it is at pulling numbers way down. And like Karen says, giving them a little bit of food early in the cycle can help keep them flat and keep them from diving.

We'll just have to see what Meme has in mind today, but so far she's doing great!
 
Status
Not open for further replies.
Back
Top