Rapid, steep drop in BG this morning post-shot, anything i need to do or watch out for?

[Amy and Owl]

Gave Owl his .5units this morning at 6:30am, BG was 'HI' on the Libre. Went back to sleep and woke up to a very steep drop. BG hit the 50s at +3. Tested on Relion a few times over the next few hours (the notes icon visible in the screen shot) and he was anywhere from 100 to 80. Fed some wet food at +3 and his usual lunch at +5.5.

I'm happy to see that his high numbers finally broke but that steep drop doesn't seem great, and I'm worrying about this triggering another bounce. Any advice? I am considering setting up his automatic feeder to dispense small wet food snacks at +1 +2 +3 etc to hopefully slow that drop in the future. Looking at past data he does seem to nosedive sharply soon after his shot.

I am at work this afternoon but husband just tested him at +7 and he is 96 on the Relion.

 

[Mary & Jude]

Hi Amy!

Here's your previous post for continuity in following Owl's progress: Owl update and more questions. We post these with each new/daily post.

Some cats onset quickly and strongly after their shot. You're right in your suggestion to test at +1/+2/+3 and feed carbs to flatten or slow the "nose-dive" and keep him in safer numbers. You're also right that these dives can trigger a bounce (which you're likely seeing with today's higher numbers), which is another reason why we try to mitigate those rapid drops in numbers.

Have you decided upon a dosing method yet? If you're following SLGS, a drop below 90 earns a .25 dose reduction; if you're following TR, a drop below 50 for newly diagnosed cats earns a dose reduction.

 

[Mary & Jude]

Also, here is a discussion about a concept we refer to as "feeding the curve," that you might find helpful: 8/10 TASHIE pmps=HIGH! +Questions***

 

[Amy and Owl]

Hi Amy!

Here's your previous post for continuity in following Owl's progress: Owl update and more questions. We post these with each new/daily post.

Some cats onset quickly and strongly after their shot. You're right in your suggestion to test at +1/+2/+3 and feed carbs to flatten or slow the "nose-dive" and keep him in safer numbers. You're also right that these dives can trigger a bounce (which you're likely seeing with today's higher numbers), which is another reason why we try to mitigate those rapid drops in numbers.

Have you decided upon a dosing method yet? If you're following SLGS, a drop below 90 earns a .25 dose reduction; if you're following TR, a drop below 50 for newly diagnosed cats earns a dose reduction.

I am very uncertain which dosing method is best for us but I am leaning toward TR, as I think I should be able to test frequently enough and he is on wet canned food exclusively. Following TR, it looks like he does not need a dose reduction, as the Relion shows he never went lower than 80. Is this correct? I'm assuming I should disregard the Libre lows as they are inaccurate.

I'm hoping he won't shoot back up into high numbers by shot time this evening. I'd love to see his numbers remain a bit more steady. I will get his feeder set up tonight to administer snacks after his AM shot and see if that can slow down the drop. I did read the post about feeding the curve! It makes sense and I'm going to give it a go. Thank you!

 

[Mary & Jude]

I am very uncertain which dosing method is best for us but I am leaning toward TR, as I think I should be able to test frequently enough and he is on wet canned food exclusively. Following TR, it looks like he does not need a dose reduction, as the Relion shows he never went lower than 80. Is this correct? I'm assuming I should disregard the Libre lows as they are inaccurate.

I'm hoping he won't shoot back up into high numbers by shot time this evening. I'd love to see his numbers remain a bit more steady. I will get his feeder set up tonight to administer snacks after his AM shot and see if that can slow down the drop. I did read the post about feeding the curve! It makes sense and I'm going to give it a go. Thank you!

Yes, if you are following TR, a reduction is taken under 50, and since he did not fall below that number, he does not earn a dose reduction. If that is the dosing method you plan to follow, please add that information to your spreadsheet and your signature. If for some reason you find that TR doesn't work for you, you can always switch to SLGS.

His numbers will become more steady. They already are! Look at the increase in greens he's experiencing in the last week or so. It takes some time for kitties to get regulated when they are first diagnosed because they aren't used to those lower numbers and they bounce when hitting them. Overtime, this often gets better (though we have some cats that are just bouncy).

I don't have/use a CGM, so I can't really offer any advice about them. I do hear that the LOs are unreliable, though, and that when people are able to hand test, they do for accuracy on those lower numbers. Let's tag someone who is more experienced with the CGM @Staci & Ivy.

Regarding feeding the curve, I find it really helpful for myself but also for those offering dosing advice to me if they can look at my sheet and see when I've fed carbs to bump up lower numbers. Anything that has an affect on his bg readings should be noted in the remarks

 

[Staci & Ivy]

Yes, if you are following TR, a reduction is taken under 50, and since he did not fall below that number, he does not earn a dose reduction. If that is the dosing method you plan to follow, please add that information to your spreadsheet and your signature. If for some reason you find that TR doesn't work for you, you can always switch to SLGS.

His numbers will become more steady. They already are! Look at the increase in greens he's experiencing in the last week or so. It takes some time for kitties to get regulated when they are first diagnosed because they aren't used to those lower numbers and they bounce when hitting them. Overtime, this often gets better (though we have some cats that are just bouncy).

I don't have/use a CGM, so I can't really offer any advice about them. I do hear that the LOs are unreliable, though, and that when people are able to hand test, they do for accuracy on those lower numbers. Let's tag someone who is more experienced with the CGM @Staci & Ivy.

Regarding feeding the curve, I find it really helpful for myself but also for those offering dosing advice to me if they can look at my sheet and see when I've fed carbs to bump up lower numbers. Anything that has an affect on his bg readings should be noted in the remarks

Hi Amy, I’m so glad you can test the Libre LO’s.
While it’s true Libre lows “can” actually be higher on a handheld meter with a blood test, it’s not true for everyone.
So best to double check if possible.
For me, Ivy usually has to be in Lo range for her to be around 60-80 on a handheld with a blood test.
However, Monster @Monster's Mom had found the comparison to be very similar with both meters.

So it seems every cat is different, once again.

And yes, the feeder is a great idea to help slow the drops, especially if Owl is responsive to carbs!

You’re doing so great. Give him lots of kisses from us

 

[Amy and Owl]

Thank you both so much!

I just got home from work and I am so happy to see that Owl is not skyrocketing up high after being in good numbers all day. We have 1 hour until shot time and he looks to be climbing.

The last time he was this low preshot his vet wanted me to skip, but then he went super high for two days. I don't want to make that same mistake twice.

 

[Staci & Ivy]

Thank you both so much!

I just got home from work and I am so happy to see that Owl is not skyrocketing up high after being in good numbers all day. We have 1 hour until shot time and he looks to be climbing.

The last time he was this low preshot his vet wanted me to skip, but then he went super high for two days. I don't want to make that same mistake twice. View attachment 76544

Safe surfing Owl, nice and steady please

 

[Monster's Mom]

Hi, Amy & Owl

I find the Libre sometimes is very close to what Monster's BG is. Sometimes it even reads the same. When it reads LO, such as the other night, she was 55 by the meter. I know if she's down in the 50s on the Libre, she's likely in the 60s. Monster BG is lower than the average diabetic right now so the sensor sometimes seems to get wonky after a few days. I like to use it as a guide to see how she's doing. When she eats I can see her little "food bump" that she going up for a bit, then that wears off and she comes down again. So it's nice to have those numbers and you can tell how carb sensitive your kitty is and about how long food can raise them.

You'll just have to get to know Owl and his numbers, and by hand testing you can compare the readings and see how different they are. For Monster, she is usually within 10 points of the Libre reading.

 

[Amy and Owl]

Hi, Amy & Owl

I find the Libre sometimes is very close to what Monster's BG is. Sometimes it even reads the same. When it reads LO, such as the other night, she was 55 by the meter. I know if she's down in the 50s on the Libre, she's likely in the 60s. Monster BG is lower than the average diabetic right now so the sensor sometimes seems to get wonky after a few days. I like to use it as a guide to see how she's doing. When she eats I can see her little "food bump" that she going up for a bit, then that wears off and she comes down again. So it's nice to have those numbers and you can tell how carb sensitive your kitty is and about how long food can raise them.

You'll just have to get to know Owl and his numbers, and by hand testing you can compare the readings and see how different they are. For Monster, she is usually within 10 points of the Libre reading.

When doublechecking the Libre with my Relion, I have found the difference to be fairly significant. I've made sure to note it in my spreadsheet, but usually the Relion is anywhere from 30-50 points higher. For example, when the Libre low glucose alarm went off last night at +3 it said Owl was at 49. Relion said 80. That's a pretty big difference!

Hi Amy, I’m so glad you can test the Libre LO’s.
While it’s true Libre lows “can” actually be higher on a handheld meter with a blood test, it’s not true for everyone.
So best to double check if possible.
For me, Ivy usually has to be in Lo range for her to be around 60-80 on a handheld with a blood test.
However, Monster @Monster's Mom had found the comparison to be very similar with both meters.

So it seems every cat is different, once again.

And yes, the feeder is a great idea to help slow the drops, especially if Owl is responsive to carbs!

You’re doing so great. Give him lots of kisses from us

Last night and this morning I fed small amounts of his usual Fancy Feast pate at +1 +2 and +3 to see if it would slow that rapid nosedive after his shot, and it doesn't seem to have done anything. Both times he dropped sharply, stayed nice and low for a few hours, then shot back up. He is ending up higher and higher each time at PMPS. Not sure if I should try a slightly higher carb food. He seems to be bouncing a bit (I think?) so I will give it a few days and see how it goes.

 

[Mary & Jude]

Last night and this morning I fed small amounts of his usual Fancy Feast pate at +1 +2 and +3 to see if it would slow that rapid nosedive after his shot, and it doesn't seem to have done anything. Both times he dropped sharply, stayed nice and low for a few hours, then shot back up. He is ending up higher and higher each time at PMPS. Not sure if I should try a slightly higher carb food. He seems to be bouncing a bit (I think?) so I will give it a few days and see how it goes.

I would try a higher carb food. There is a note in the discussion I posted earlier about feeding the curve where she mentions that some cats might even need a higher carb food (likely MC) at their shot to stave off the dive.

 

[Staci & Ivy]

When doublechecking the Libre with my Relion, I have found the difference to be fairly significant. I've made sure to note it in my spreadsheet, but usually the Relion is anywhere from 30-50 points higher. For example, when the Libre low glucose alarm went off last night at +3 it said Owl was at 49. Relion said 80. That's a pretty big difference!

That’s like the difference I see with Ivy as well.

Sometimes if I see a 50 Libre it can be 120-150 on the handheld.
But there is also a time delay (the Libre lags 15 minutes, so it’s said.)
So they may never be in complete sync anyway.

It’s a bit tricky trying to compare. But when you get familiar, you can “guesstimate” to some degree.
But as long as you can blood test, then you know pressure sure where you are