Need Advice...PMPS 149..+1 ~ 223 already

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Meadow

Meadow

Member Since 2010
Hello LL!

Yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=21561

We're having an interesting number day here today. WCR is good....Meadow seems to feel good, is eating very well and having normal LB deposits. She seems bright eyed and happy and is enjoying her naptime on the carpet bed in front of the a/c. It's stinking hot here again today! :cool:

We're doing a bit of a curve today so here's the deal so far:
7am AMPS 161... had breakfast of 3/4 can FF
+2 ~ 174..breffis # 2...1/2 can FF
+4 ~ 59...ate 1/2 can med carb food
+6 ~ 63....ate a few pieces of freezed dried chicken treats
+ 8 ~ 55....ate another 1/2 can med carb food.

Interesting day, wouldn't you say? Curious to see what her PMPS is going to be. Now I have to tell you...the internist said not to shoot under 200 and just wait until her bg was above 250 and then give her the insulin. But if I do that, it throws her entire schedule off again and screws me up royally timewise. So I decided to just bite the bullet and shoot. I am not sure why her bg's were so darn high yesterday and today they are so much lower. Shall we take bets on how high her bounce is after this?? :roll: :lol:
 
Re: 8/4 Meadow's AMPS 161 + 8~55 Hmmm.....

Interesting day, wouldn't you say? Curious to see what her PMPS is going to be. Now I have to tell you...the internist said not to shoot under 200 and just wait until her bg was above 250 and then give her the insulin. But if I do that, it throws her entire schedule off again and screws me up royally timewise. So I decided to just bite the bullet and shoot. I am not sure why her bg's were so darn high yesterday and today they are so much lower. Shall we take bets on how high her bounce is after this??
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not to mention it will deplete the shed and you'll lose even more momentum. There are other options, like BCS or stalling.


Will you be home tonight to monitor? Have plenty of strips and foods?

Please get a +11 or +11.5 and post for help - this will give others a heads up in advance.

Just remember, when you reach your PMPS, and if it's lower than usual, don't feed yet - post for help.
 
Re: Need Advice...PMPS 149..what to do??

Okay....we had a +10:45 of 128 and now a PMPS of 149(+12)....what do I do? Her numbers have been so low today. I have plenty of test strips and the required foods, but I know I won't be able to stay up much past midnight due to my current health status...even that will be hard. Not sure what to do.
Maybe just give her .25u??
 
Re: Need Advice...PMPS 149..what to do??

.

Doesn't neccessarily mean you have to be late.

I would suggest at least 2 spot checks tonight thou.



That info will help a lot for her progress.
 
Re: Need Advice...PMPS 149..what to do??

It looks to me like Meadow's BG is on the rise.... (pls update your SS when you have a minute)

128 @ +10.45
149 @ +12

You haven't fed Meadow since +10, correct?

I'm not up to date with Meadow's medical status, so I'm a little hesitant to guide you.
Normally i would say shoot (rising number and home to monitor) but you have to do whatever you are comfortable in doing.... and don't forget about the shed.

A BCS would be 0.75U or 0.5U...
Do you want to wait another 15 mins and see what the number is?
 
Re: Need Advice...PMPS 149..what to do??

Since you are using the alphatrak meter and not a human one, I believe the low number to adjust the dose is 80 and not below 50 like it is with human meters. If you were testing with the relion, that 55 would probably be in the 30s at least. Someone please correct me if I am wrong here, but I personally would take down the dose by 0.25u.
 
Re: Need Advice...PMPS 149..what to do??

She's had no food since 3:30pm (+ 8 and 1/2) actually. Just took another reading and it is only 150. She was in the hospital for pancreatitis on the 19th-21st. I definitely don't want to give her a full dose since she is even lower now that her AMPS and that dose sent her down into the 50's.
 
Re: Need Advice...PMPS 149..what to do??

The alphatrack is a good point... I didn't think her numbers today were with the alphatrack - was watching her SS for that.

Dottie, if you have officially switch to alphatrack, I believe you need an 80 for a dosecrease. And if you have switched, please make a note to that effect in your signature.
 
Re: Need Advice...PMPS 149..what to do??

And if you are using an AlphaTrack, Meadow earned a dose reduction so it's important to know what meter you're using. Your Profile says you're you're using a Relion.
 
Re: Need Advice...PMPS 149..what to do??

Am currently using the AlphaTrak, but will go back to Reli-On next week. Can't afford the strips. But for now we are using the Alpha since last week. I did put that in my notations on the spreadsheet and added it to my signature for now.

Sienne and Gabby said:
And if you are using an AlphaTrack, Meadow earned a dose reduction so it's important to know what meter you're using. Your Profile says you're you're using a Relion.
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Re: Need Advice...PMPS 149..what to do??

I don't want to get too far off schedule here, so I am going with .50u tonight. Will monitor her to see what happens. Any quick input??
 
Re: Need Advice...PMPS 149..what to do??

That helps. Thanks!

I'm not sure what you're nervous about. These were GREAT numbers today! I strongly suspect that the reds from yesterday were a high before a break. It also suggests that Meadow is feeling better.

You have the option of stalling if you are not comfortable with shooting. If that will put your schedule too far off for tomorrow, you can shoot a BCS (big chicken sh*t) dose. You would already be reducing the dose by 0.25. So your "new" dose would be 0.75. If you are nervous about giving that amount, you can always reduce to 0.5u. That way you will not be depleting the shed too much.

I want to encourage you to think about the idea of shooting numbers below 200. I realize you're not there yet, but many of us will shoot number above 50. It does not mean that Meadow will crash. You also know how to manage low numbers with food and if you're nervous about it, we're all here to help.
 
Re: Need Advice...PMPS 149..what to do??

I second what Sienne says. Do not be afraid of the greens. Go have a look at Trouble/Carrie - see all greens! You are there to monitor and you control the numbers with food. You can always abort a cycle with gravy if you need to go to sleep (although apparently sleep is over-rated... ). You do what you can and that's OK.

So the 50s were alphatrack readings and therefore they are totally dosecreases! LIke Sienne said your dose tonight should have been 0.75U, but if you are comfortable with 0.5U, so be it. A little somethin is better than nothing. Please do not forget about the shed, keep an eye on the number and get a +1.
 
Re: Need Advice...PMPS 149..what to do??

Sienne and Gabby said:
That helps. Thanks!

I'm not sure what you're nervous about. These were GREAT numbers today! I strongly suspect that the reds from yesterday were a high before a break. It also suggests that Meadow is feeling better.
Click to expand...

Sienne, I guess I am still unsure of what will happen with her. I am just so petrified of sending her into a severe hypo episode and me not being here to deal with it.

Sienne and Gabby said:
You have the option of stalling if you are not comfortable with shooting. If that will put your schedule too far off for tomorrow, you can shoot a BCS (big chicken sh*t) dose. You would already be reducing the dose by 0.25. So your "new" dose would be 0.75. If you are nervous about giving that amount, you can always reduce to 0.5u. That way you will not be depleting the shed too much.
Click to expand...

It's so difficult to judge the .75 on the syringes, so I gave her what looks like .5 to me but could in fact be a fat .5. Hard to tell where to place the rubber. I guess I am a BCS myself! nailbite_smile

Sienne and Gabby said:
I want to encourage you to think about the idea of shooting numbers below 200. I realize you're not there yet, but many of us will shoot number above 50. It does not mean that Meadow will crash. You also know how to manage low numbers with food and if you're nervous about it, we're all here to help.
Click to expand...

Thanks for the help. I actually did go against the internist advice and shoot the 1u this morning even though her number was only 161. My vet wasn't open yet to call him and ask....and frankly, he would have said to do what I feel comfortable doing because he says I know more than him about this. He told me last week that he never thought about home testing before, but now because of what I showed him, he tells his clients to home test if they are comfortable doing it. And it's all because of what I learned here. But I am still not confident enough yet to have faith that what I am doing won't harm her I guess.
So now we shall see what her bg's do the rest of the night until bedtime. I think her ears are tired though. I am having a hard time getting them to bleed now.
 
Re: Need Advice...PMPS 149..what to do??

Helene & Tizon said:
Please do not forget about the shed, keep an eye on the number and get a +1.
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Ok, will do. But I am 1/2 hour off schedule now, so the +1 won't be until 8:30pm.

Thanks to everyone for their help with this!
 
At the +1 hour we have a bg of 223. Can anyone figure out when her nadir is from my spreadsheet? Or do I not have enough readings to tell? To me it looks like around +7 or +8, but who knows with her bg's being so up and down.
 
First off, take a deep breath.

We all get nervous about not being home if our kitty's numbers are low. One of he advantages of having a lot of data is that you have a better chance of making an educated guess about where numbers are headed. There have been a lot of days that I have rushed home at lunch time and found Gabby's numbers were just fine.

Get a +2. You don't know how much of your +1 is a food spike. Go back and take a look at what the "ideal" curve looks like. It's in the New to Lantus sticky. Unless Meadow's numbers are heading up, your +2 should be close to your PMPS.

As far as nadir, it looks like it's generally in the middle of the cycle. However, nadir is not a permanently fixed point. It can, and does, change. There are days when Gabby's nadir has been at +6 and days when it's at +10 and days when it's been at +2. If you think about nadir as always being at the same time, you'll drive yourself crazy. Remember, we're dealing with cats and they like to mess with us. Nothing is completely predictable.

I have to say that I like the fact that your vet is willing to learn. He's seen what you're doing and how it's working and encouraging others to do the same. Remember, most vets aren't used to people who home test. They live a very large margin of error around pre-shot numbers because they don't realize that we know how to manage those numbers. Most people never find FDMB and they just do what their vet says.
 
Sienne and Gabby said:
First off, take a deep breath.
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Ok, deep breath taken. :-D It's all good. +2 and she's 181.

Sienne and Gabby said:
As far as nadir, it looks like it's generally in the middle of the cycle. However, nadir is not a permanently fixed point. It can, and does, change. There are days when Gabby's nadir has been at +6 and days when it's at +10 and days when it's been at +2. If you think about nadir as always being at the same time, you'll drive yourself crazy. Remember, we're dealing with cats and they like to mess with us. Nothing is completely predictable.
Click to expand...
Ahhh....now that explains my confusion! Here I was thinking all along that nadir is at a certain time during each cycle....like always at +4 or always +7. :oops: Maybe now I won't drive myself crazy! :lol: Thanks for that clarification.

Sienne and Gabby said:
I have to say that I like the fact that your vet is willing to learn. He's seen what you're doing and how it's working and encouraging others to do the same. Remember, most vets aren't used to people who home test. They live a very large margin of error around pre-shot numbers because they don't realize that we know how to manage those numbers. Most people never find FDMB and they just do what their vet says.
Click to expand...
This is one reason I like my regular vet so much. He's so open to learning from me because he knows how much research I do. When we went through the whole VAS experience with Munchkin, he had only had one cat in his years of practice that had VAS, so he wasn't too versed in it. I brought him a lot of info that I learned from the VAS group which he now incorporates into his practice....and it also got him to change his vaccination protocols and sites. Of course I still go to him for guidance and if I bring him something he isn't sure of, he will call on other vets who specialize in that particular issue. He wasn't exactly thrilled when the internist said not to shoot under 200, but figured that guy was more experienced at this considering her pancreas problem and all, but when I spoke to him earlier this afternoon, he was glad I went with my instincts and shot. :smile:
 
Congratulations on winning your vet over, that's tremendous. Nice to see Meadow getting some lower numbers, too.
 
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