O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.5 12

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Simke

Member Since 2013
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Not sure what to do 245 had a Hypo event on Sunday appetite poor but did eat to teaspoons this AM
 
Re: Simke is 245 this morning should I give him insulin

He ate well, so I decided to give him is insulin, advice as this is the lowest Am reading I have had, he looks good today.
 
Re: Simke is 245 this morning should I give him insulin

Wow, your lowest preshot. Good job! You gave him the 0.75 dose, right? I think you should start with a +1 this morning just because it's the lowest number you've shot before. Good luck and have a good day.

Surf nicely Simke.
 
Re: Simke is 245 this morning should I give him insulin

You mean give the same amount and blood test in plus one hour
 
Re: Simke is 245 this morning should I give him insulin

I think she was asking that you shot the .75 u dose. It wasn't written in your chart yet.
You will want to get a test one hour after you shoot and probably a +2 too because this is the lowest number you have shot.
 
Re: Simke is 245 this morning should I give him insulin

I think what Dyana means is get a +1 test to see how his # is after he ate and received his shot. Do you have him on a feeding schedule? Congratulations on shooting a 245 # this morning. You'll get more comfortable shooting lower #s as time goes on. Just be sure to test to make sure that he's not diving too quickly. For what it's worth, I've shot a 70's AMPS # a couple of times. :lol: Talk about a bit unnerving, but it was all good. :-D

Also, please input the 0.75u in the SS so that others can take a peek at it, and give you advice if it's needed. Keep the dosing amount consistently the same (unless otherwise told to change it) so that Simke can get adjusted to it, and his shed fills. It'll be interesting to see how he reacts to this amount over the course of a few days.
 
Re: Simke is 245 this morning should I give him insulin

Simone:

We use a peculiar way of expressing time here and it can take some getting used to. If you look across the top of Simke's SS, the hours are expressed in relation to when you've given a shot. Your shot is your AMPS or PMPS. All other times are expressed as the numbers of hours since you gave a shot. Thus, a +1 is one hour after you shot, a +6 is six hours after you shot, etc. We do this because we are all in different time zones so there's less chance of confusion and errors if we use a common way of referencing time.

Whenever you shoot a number that's lower than where you've previously shot, we suggest getting early tests -- a +1 and a +2. You should always have a good supply of strips and high carb/gravy-based food should you need them.

When you have a chance, can you edit the subject line of this thread so it reads: 5/8 Simke AMPS-245

Just an observation... Last night you didn't get any tests due to the high PMPS. Given that Simke's in a much better range this morning, it would have bee very informative if you had gotten a "before bed" test. I'd like to encourage you to always get, at the very least, a test before you turn in for the night.
 
Re: Simke is 245 this morning should I give him insulin

Good morning,

Thanks unfortunately I am not at home, but have organized to get a +2 shot. How do people work and have a diabetic cat????
 
 
Re: O5/08 ams 245 +2 137

If you can, get a +3 test to see what his # is. He dropped 108 points in 2 hours, which isn't uncommon (some drop more than that). Do you know when his nadir is?
 
Re: O5/08 ams 245 +2 137

I won't be around to help. I hope that someone will be here soon to help you further should you need it. You're doing an awesome job. Keep up the excellent work, and be sure to get the +3 test too. It'll tell how much further he's dropping, and if you're going to have a rather busy morning or not (not trying to freak you out here or anything :lol:). Best to be safe than sorry, right? :-D
 
Re: O5/08 ams 245 +2 137

Hi guys .. a pretty big drop for simke at +2, have fingers crossed he just surfs the rest of the day for you .. have a great day guys!
 
Re: O5/08 ams 245 +2 137, +2.5 95

I'd give Simke a teaspoon or two of high carb food and re-test in 30 min.

What you're seeing is the bounce breaking.
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58

Sorry I won't be around for long, but I wanted to reassure you that you're doing the right thing feeding the high carb. Keep checking every half hour and feeding him more if you need to until you get a couple readings in a row that show Simke is going up again. If he does not want to eat more you can try just giving him the gravy off of the food, too, as it won't take up as much space in his tummy as food + gravy. You're doing a really good job by hometesting him so that you can catch these lows! I'll try to check back in later to see how things are going.
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58

Please remove the 911. We reserve that for a life threatening emergency.

Please do exactly what you did the other evening:
  • Test in 30 min.
  • If numbers are in the 50- 60ss or below, feed high carb food.
  • Repeat the process every 30 min. until Simke's numbers level off above 60.
  • Then switch to medium or low carb food.

The step-by-step instructions for Handling Low Numbers are in the post I just linked. Please print this out so you have it handy.
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59

I am here too - will be watching for your +4... we want to keep testing every 30minutes for now.

Have you fed any high carb yet? like a teaspoon of high carb gravy?
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59

Just stopping by to say you're doing a great job! Way to stay on top of it!
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59

To take the 911 off you have to go back to the very first post this morning ... hit the edit option and change the icon... then hit submit.
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70

good so far - another test at + 4.5 please.

when was the last time he got nay high carb food?
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70

very nice.
I hope he will surf for you a little now.
You will still need to check again since this is most likely from the food you gave.

You want him to be 70 or higher without the influence of high carb ...
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70

You did the right thing posting and asking for help. Don't feel bad that you were asked to remove the 911 - people who have been doing this for a lot longer see low numbers all the time and know better how their cats will react to them. Considering how low Simke dropped three days ago, you were right to be concerned about the early drop you got this morning. You're doing well in handling the lower numbers and pretty soon you will actually be happy to see them instead of scared :mrgreen:

One thing you might want to do so the Americans can figure things out . . . if you enter more than a single number on your spreadsheet, you'll notice an error on the American version because it can't convert it. So when you put something like "5.3 at +2.5" you actually need to click over to the US mg/dL sheet and manually enter the 95 in the right square. If you want the spreadsheet to do the calculating for you, you could first just put 5.3 in the right spot, check what it converts to on the US sheet, then go back and put in the "at +2.5" part on both the US and World sheet. Hope that makes sense, if not please ask!

Don't get discouraged! It can be stressful at first but Simke is doing really well today!
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

Still not sure what I am looking for and what my goal is? Did I need to be worried today? Whenn should I be worried? What is ideal?
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70

don't worry about the 911 thing....

you needed attention right then... that was correct.

they always ask for it to come down after you have attention and there is someone helping/staying with you and helping.
The crisis part is over... and one of us helps you ride it out from there.
Your in good numbers now but you did have a low at +7 recently so we need to keep testing....
make sure Simke doesn't drop again .
If he does you will want to give him a small amount of medium carb gravy...

We are learning how he reacts to various carb values and keeping him in safe numbers.
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

Thanks,
Really finding it hard, I hope it gets easier
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

Ideally, Simke would have earned a dose decrease if he had gotten under 50 ( all he needs is a 49 to earn a decrease) but that hasn't happened so far.

I'd say the food got him up there. Which food did you give him so we can footnote it so you know it did a decent job rising the numbers?

The goal is to have numbers between 50 and 120. That would be remission numbers...
you can look at my spreadsheet and see it's blue and green.... used to be more green but I have numbers that are desireable.

So you will continue having days like this but you will get more comfortable over time as you learn how to deal with it and steer with food when Simke
is having the lower number days.
It's a very quick learning process and all the testing you are doing is keeping him safe.
And the data you are collecting by doing it teaches you his pattern, his way of responding to the insulin.

It does get easier.
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

Simke said:
Still not sure what I am looking for and what my goal is? Did I need to be worried today? Whenn should I be worried? What is ideal?
Click to expand...

The "blue" and "greens" are where you want to be, just not below 2.8 mmol/L (50 mg/dL). The protocol people on this board are following says: "Try to keep the cat at a dose where the BGs are in the 50 to 200 mg/dl (2.8-11.1 mmol/L) range for as much of the day as possible." Being in that range should help his body heal and will keep the kidneys from having to try to get rid of all the extra glucose in the bloodstream. You were fine to be concerned, though, because Simke dropped quickly and you don't have a lot of information yet on how low he might go! It's all part of the learning process.

Here's a link to the Lantus Tight Regulation Protocol, if you haven't seen it before, that explains in detail what range you want to see in the BG and how you will adjust his dose. When others here advise you to decrease or increase the dose, these are the "rules" they are going by. It takes a while to get familiar with all the details so don't worry, there are always lots of people around who can help you figure out what to do, but at least if you look over it you'll understand where they're coming from!

It's very helpful that you have the spreadsheet set up so everyone can see exactly how Simke is doing :thumbup
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

It does get easier as you get used to it. You did a great job today ( although its not over - I would get another test at 5.5 ). And we are here to help!

Also these low numbers are great news! If he had dropped under 50 you would have been able to drop the dose again! Plus you really want low numbers like Rhiannon and Amy said, because these are normal and will help him heal! However until we have more data about how he is going to behave on a certain dose, we need to be more careful like you were today.

Another test at 5.5? The thing we are checking for is that his high carb food doesnt wear off and suddenly he takes a down turn.

Wendy
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

You are doing a great job! The first time Zener got in greens on Lantus I was terrified. We had a hypo episode on Humulin before I was home testing and I never forgot how frightening that was. Once we found the FDMB and the Lantus group, it got a little bit easier. You will get more accustomed to low numbers with practice and more knowledge and there are wonderful people here to help keep Simke safe and someone will stay with you when things get difficult. So lovely to see these healing numbers! :YMHUG:
 
Re: O5/08 ams 245 +2 137, +2.5 95 + 3 58, +3.5 59 +4 70 +4.

Very nice job handling Simke's numbers.

The version of the protocol that Amy linked is the one used by the Lantus forum in Germany. They've modified it, somewhat, as have we. Personally, I find their version a little harder to understand. I think, for now, if you used the version of Tight Regulation we use here, it will be clearer for you.

The numbers you are looking for really depend on what your goals are. As a general rule, we all want to keep our kitties below renal threshold (i.e., BG numbers that minimize the risk or kidney or other organ damage) which is somewhere around 200. However, if your goal is for Simke to go into remission, you want him to spend as much time as is possible in normal BG range (50 - 120).
 
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