Shot lower for first time this PM pls advise

Status
Not open for further replies.

TanyaG

Member Since 2016
Hi all, so today Tinka received her first AM dose of 0.75 as well as a PM dose of 0.75. Her AMPS was a 11.9 which was a little lower than I've shot before but a number I felt very comfortable shooting at. The previous two morning she was too low for me to shoot so she only received an eveing dose of 0.75. Since coming off her steroid we are seeing lower numbers with her. So today as mentioned was first day we shot 0.75 in the AM and then I also adminester a PM shot of 0.75 as her PMPS was 9.2. This is the lowest number we have every shot before at any dose. I just took her +2.5 reading and it is 5.5 mmol/L. So thats a fare drop already from 9.2 mmol/L. It is now +3 and I'm giving her before bed food which is 50g Instinct lamb, low carb, limited ingredient diet. Its 11;30pm here and I'm a little concerned to go to bed with her number being low and only 3 hours into her cycle. She tends to drop low toward ends of her cycle. We dont have that much data as its only day 9, but pls see my SS which is updated thus far. I'm wondering am I going to need to get up in the night to test her or what is best to do? Thank you!

This is my thread from yesterday regarding lower numbers past few days and shooting low today - http://www.felinediabetes.com/FDMB/threads/low-amps-stalling-please-advise.170062/#post-1849828
 
Just having a peak Tanya. Be back in a couple of minutes. Right now I am thinking you are going to have to keep an eye on Tinka tonight. :)
 
The usual nadir for Lantus is between +5 and +8 so Tinka may not have finished dropping as she is obviously having an active cycle tonight. I'd watch her closely right now. Test her again in 30 minutes to see if she is still dropping. If she is, you will need to steer her with some carbs. Do you have any higher carb food she can/will eat or food with gravy in it?
 
The usual nadir for Lantus is between +5 and +8 so Tinka may not have finished dropping as she is obviously having an active cycle tonight. I'd watch her closely right now. Test her again in 30 minutes to see if she is still dropping. If she is, you will need to steer her with some carbs. Do you have any higher carb food she can/will eat or food with gravy in it?
Hi Linda, thanks for your message. Yeah I'm thinking 0.75 twice a day may be too high a dose for Tinka since coming off the steroid. So she just finished eating her low carb food, I will wait 30 mins then, retest and post. If we see a raise in BG could this be from the food though? When you say monitor her closely how often do I need to take her BG? Do you think I can go to sleep in like an hour or two then set my alarm to wake up and check on her. If she is dropping I do have some Natural Balance venision and pea and that I believe is 15% dry carb so I think that is high carb. I also have some freeze dried treats that may be high high carb however they may flare up her skin. Likewise the natural balance venison may also flare her skin. She has allergies hence why she was on steroids which we have managed to bring her off of and she's just eating lamb and rabbit but they are LC. We took her off the steroid past few days as we noticed it was really affecting her BG and likely hugely contributing to the diabetes. But if she really needs the high carb food I can use it. I also have honey but I doubt she'd eat it, I could try rub it on her gums though.
 
Hi Tanya, welcome to LL, haven't visited tinaja condo before. Not familiar with her history, just getting up here and I have dropped dash out.

Looking at the ss, with that drop early in cycle it looks
Ike tonight is going to be an active cycle for Tonka.

You should plan to get another test in now, I'm thinking you !just be at around +3.5 now.

If she is still dropping you it would be wise to stay up and monitor some more.(or set an alarm) at this point hourly or even more frequently if you see a big drop at the next test.

Take a peak at the following link, in it it describes how to handle those lower numbers, frequency of monitoring, when to feed hc LC etc.

http://www.felinediabetes.com/FDMB/...regulation-shooting-handling-low-numbers.147/
 
Cross posted with you.

I would get a test noe, no need to wait 30minures.

As you are following TR I would steer clear of the dry hc, it complicates things as it can take a long time to get out of the system.

For hc just add some honey/syrup to her LC food.

I'm afraid Tonka is going to decide when you can go to bed, it's going to depend on her numbers.
 
Cross posted with you.

I would get a test noe, no need to wait 30minures.

As you are following TR I would steer clear of the dry hc, it complicates things as it can take a long time to get out of the system.

For hc just add some honey/syrup to her LC food.

I'm afraid Tonka is going to decide when you can go to bed, it's going to depend on her numbers.
Hi Gill thank you for your message and help. I will test again in 5 mins then, that will be +3 hrs 45 mins, should I just add to her chart as +4? If she is dropping low or not rising much how do you control or help the cycle if you cant use the HC food then? With TR when would I use HC food then?
 
Oh Gill. I am so glad to see you. We are having a very active night here. Poor Tanya with Tinka having an active cycle and there is another kitty named Mittens who has trace ketones, low potassium, a vet fiasco that would stand your hair on end, they are syringe feeding and I'm about ready to drop. I am going to wait and see how Mittens is doing in about 20-30 minutes, and then I really need to hit the sack. So I am wondering if you can take over for me over there shortly. Not much to do except be there for moral support right now.
 
Ok so I just took tinka's BG and it is still 5.5. at almost +4, I did just feed her though so was hoping it would bump up a bit.
 
Hi Gill thank you for your message and help. I will test again in 5 mins then, that will be +3 hrs 45 mins, should I just add to her chart as +4? If she is dropping low or not rising much how do you control or help the cycle if you cant use the HC food then? With TR when would I use HC food then?
Sorry had to restRt pc.

You can use hc but usually with tr we use wet hc.
In the us folks use fancy feast gravy lovers, not sure if they are available in Canada.
But adding honey to the LC food will make it hc,

Oh Gill. I am so glad to see you. We are having a very active night here. Poor Tanya with Tinka having an active cycle and there is another kitty named Mittens who has trace ketones, low potassium, a vet fiasco that would stand your hair on end, they are syringe feeding and I'm about ready to drop. I am going to wait and see how Mittens is doing in about 20-30 minutes, and then I really need to hit the sack. So I am wondering if you can take over for me over there shortly. Not much to do except be there for moral support right now.
Oh c*** I have to go out to the butcher s for our Turkey for the holidays will be out for a couple of hours was just checking in at breakfast, I'll have my phone with me though so will do my best.
 
You can use HC food....just not HC dry food

The Fancy Feast Gravy Lovers or adding a few drops of Karo/honey/syrup is the best
Thanks Chris glad to see you on here too:) So if I can get tinka to eat some of her food with honey I will do that. She's just eaten and had to coax her to finish her food so will be a bit challenging getting her to eat more. Do I need to do this now or do I wait to do that only if it drops more? When should I test again?
 
Do you have any medium carb food? You want to try to find the lowest carb food that will 1. slow down the drop 2. not be so high that it sends them straight back up

Something between 10-15%? (I use the Fancy Feast Florentine in sauce)

We usually save the HC food (or Karo/honey/syrup) until they actually drop below 50
 
Thanks Chris glad to see you on here too:)

Sorry but I can't stay on....I was just doing a last minute look around to see what was going on

Just remember....if she drops below 50, you want to give her something high carb, even if you have to rub some Karo/honey/syrup directly on her gums and then test again in 20-30 minutes

If she's over 50 at that point, you can give a little regular low carb food, but you still want to test again in 30 minutes to make sure she stays up....and then test one more time an hour after that (so you have 2 hours of tests after feeding HC without having her drop back down again)

If she drops down below 50 again during those 2 hours, you start over
 
Do you have any medium carb food? You want to try to find the lowest carb food that will 1. slow down the drop 2. not be so high that it sends them straight back up

Something between 10-15%? (I use the Fancy Feast Florentine in sauce)

We usually save the HC food (or Karo/honey/syrup) until they actually drop below 50
The difficulty is her skin allergies, so I have very low carb like prob only 1-% Wild Calling Rabbit, then I have prob 5% Instinct LID Lamb. Currently since switching to these the itching has reduced a lot and we managed to take her off the steroids. The only other foods I have will likely flare up her skin due to her allergies to chicken, turkey, duck, sardines, pork etc. The venison is probably the only one that "may" not flare her but again i'm not sure and plus it does have salmon oil in. I think it is 15% according to Binky's old spreadsheet list. I could try feed her some more of her Instinct Lamb? Or just risk the natural balnce venison. I do have a Rayne kangaroo but I think its prob too high carb.
 
Oh c*** I have to go out to the butcher s for our Turkey for the holidays will be out for a couple of hours was just checking in at breakfast, I'll have my phone with me though so will do my best
Thanks Gill. I think Tanya is going to be fine and I am setting an alarm to check on things here a bit later anyway. All seems quiet on the Mittens front right now. I think the bean is catching a few much needed winks and I think I will do the same. :)
 
The venison is probably the only one that "may" not flare her but again i'm not sure and plus it does have salmon oil in. I think it is 15% according to Binky's old spreadsheet list. I could try feed her some more of her Instinct Lamb? Or just risk the natural balnce venison.

You're not going to feed her a lot of it....we're talking a teaspoon or two.....Hopefully that wouldn't cause her any problems, but if you think it might, just use the Karo/honey/syrup and add it to a little of her low carb food
 
With the food allergies, adding honey to her LC and documenting how much may be the easiest way to prevent a flare up of her skin problems.



Over time you will learn how much you need to give, and when.

If you find yourself in a pickle and absolutely have to use the dry tonight then use it. But in order to follow TR you will need to figure out a different solution, personally I would head down the honey route, less likely to cause allergy problems.
Thanks Gill. I think Tanya is going to be fine and I am setting an alarm to check on things here a bit later anyway. All seems quiet on the Mittens front right now. I think the bean is catching a few much needed winks and I think I will do the same. :)
Dh is driving, and I can check in as I have my phone, I'll be waiting in line at the butchers no doubt so it'll give me something to do lol.

Glad mittens is quiet.
 
Thanks everyone! Gill I'm going to take her BG in 5 mins and see where she is at and will post back.
 
With the food allergies, adding honey to her LC and documenting how much may be the easiest way to prevent a flare up of her skin problems.



Over time you will learn how much you need to give, and when.

If you find yourself in a pickle and absolutely have to use the dry tonight then use it. But in order to follow TR you will need to figure out a different solution, personally I would head down the honey route, less likely to cause allergy problems.

Dh is driving, and I can check in as I have my phone, I'll be waiting in line at the butchers no doubt so it'll give me something to do lol.

Glad mittens is quiet.
Hi Gill Tinka has dropped to 5.1 at +4.5. Should I feed her a tsp of her Instinct LC wet lamb and add like a 1.4 tsp of honey? Really hope she will eat it.
 
Ok so update is that at +4.5 she dropped to 5.1 that was at 1am. I fed her just over a tsp of her Instinct lamb LC wet food and added 1/4 tsp honey which she finished at 1:15am with a little coaxing. Going to test again in 5-10 mins as that will be +5 and report back. Lets hope she has increased!
 
Hi Tanya, Just doing a final check before I go cuddle my pillow and furballs. I'm gonna go test my sweetie and will check back one more time in a few minutes.
 
Hi Tanya, Just doing a final check before I go cuddle my pillow and furballs. I'm gonna go test my sweetie and will check back one more time in a few minutes.
Thanks Linda, so Tinka's BG is now 6.8 at +5. So that went up from 5.1 to 6.8 in 20mins following feeding her the honey. I hope I didn't feed to much? How many more tests should I do before its safe to go to sleep? When should I set an alarm to check her again then do you think? thanks!!
 
At 5.1/91 20 min ago she is staying about the same from her earlier tests. I probably

The honey seems to have bumped her up.
If it were me, as you don't have much data yet, I would set the alarm and test in a couple of hours, the honey is influencing the number you just got, but as that wears off she might drop. So to be safe, I would test 2hrs after the food.
 
The honey part of the concoction will wear off pretty quickly. How much actual food did you give her?
At +4.5 I gave her about 1 and a half tsp Instict wet LC food with 1/4 tsp honey. Earlier in the eve I fed her at PMPS 50g Instinct LC food and then at +3 again 50g LW food those are her usual feed times. Did I not feed enough at +4.5? I thought it was just to get the honey in? When should I feed her again and how much do you think? Thanks!
 
At 5.1/91 20 min ago she is staying about the same from her earlier tests. I probably

The honey seems to have bumped her up.
If it were me, as you don't have much data yet, I would set the alarm and test in a couple of hours, the honey is influencing the number you just got, but as that wears off she might drop. So to be safe, I would test 2hrs after the food.
Thank-you Gill:) is it worth testing again now? Or I'll be up for another 30 mins so I can test again then. Will set alarm for a few hours time. If she drops again should I feed her some more LC with honey again?
 
With regards to her AMPS tomorrow morning if she's above 8.4 I was thinking it would be best to reduce her shoot to 0.5 after tonights situation. I have chronic health issues myself and plus its a crazy busy time and I think the two doses of 0.75 are proving to be too much for Tinka with her coming off steroids. Before when she was on 0.5 twice daily we weren't seeing that much change or any blue numbers but that was when she was on steroids. We then upped it to 0.75 but then she came off her steroids and we started to see her numbers drop a lot, which is why she had to have two morning skipped. I'm pleased to see blue and even green its just quite stressful having to monitor like this and not get much sleep. I'm thinking 0.5 twice daily will be safer and hopefully effective enough. What are your thoughts?
 
Ok so her +6 at 2:30am is now 8.9, this is 1 hour and 15 mins since the tsp of LC food with the 1/4 tsp lamb. I will try test again at 2 hours after food or else set an alarm for 2 hours time from now. If when I test she is dropping again should I feed her a tsp or two of LC food with 1/4 or 1/8 honey? Thanks!
 
Just seeing this. Glad you had some great help last night with the dropping numbers. Just to throw my 2 cents in...I would be more conservative with the dosing because of stopping the steroids. Steroids such as prednisolone (not sure if that is what you were using ) can take up to a week to completely clear the system. Steroids such as injected depomedrol can take a bit longer. With the removal of steroids from the picture that can certainly affect the glucose levels.

My thought is that lowering the dose to 0.50 unit might be a safe approach. Even though according to the TR protocol you did not earn a reduction, when removing steroids from the mix it changes the approach. I have seen a couple of people whose kitties have gone off steroids, have their insulin needs drop fast and in a couple of cases go off insulin fairly quickly. You can post a new thread in the morning with the preshot number and see what others have to say.

You did a great job last night. :bighug:
 
Just seeing this. Glad you had some great help last night with the dropping numbers. Just to throw my 2 cents in...I would be more conservative with the dosing because of stopping the steroids. Steroids such as prednisolone (not sure if that is what you were using ) can take up to a week to completely clear the system. Steroids such as injected depomedrol can take a bit longer. With the removal of steroids from the picture that can certainly affect the glucose levels.

My thought is that lowering the dose to 0.50 unit might be a safe approach. Even though according to the TR protocol you did not earn a reduction, when removing steroids from the mix it changes the approach. I have seen a couple of people whose kitties have gone off steroids, have their insulin needs drop fast and in a couple of cases go off insulin fairly quickly. You can post a new thread in the morning with the preshot number and see what others have to say.

You did a great job last night. :bighug:
Thank you Mary Ann it's been quite the night! After 4:30am and I'm finally heading to bed as her numbers are going up. Hubby will be up at 7:30am to take her AMPS etc. Grateful for everyones helping here tonight thanks ladies! Thanks for weighing in too, I very much agree with you about the steroids and reducing to 0.5 from tmrw AM. That is interesting to hear the effects can be up to a week after coming off and we've already seen some big changes. Yes she was on Prednisolone for past 2.5 months consistently for skin allergies likely from foods (and off and on for past 6 years) and I now believe that's what has really affected/caused the diabetes. So for tmrw then if she's above 8.4 I will feed and shoot 0.5 instead of 0.75, but if she's below 8.4 I'll stall and post for help on a new condo/thread. Thanks so much!
 
Just checking in and glad to see all is well other than Mama Bean being sleep deprived. :D You handled that very well Tanya. Good Job!
Thanks so much Linda I appreciate the support it was quite the night:) Stayed with Tinks for several hours after I gave her the honey till 4:30am and her BG kept rising more in the blues and so finally went to sleep. Hubby checked on her few hours later at 7:30am and then took her AMPS which was around 16.9 which is pretty high for her esp in the AM so I think the 1/4 tsp honey and maybe the extra LC food really raised her BG a lot. Next time I'll start with less honey like an 1/8 but it's reassuring to know she responds well to the honey if we are ever seeing low dropping numbers early on or too low at any time. We decided to administer 0.5u this morning as st this point I haven't even put up our Christmas tree or gone to the grocery store to finish getting food for Christmas as been focusing so much on Tinka and making sure she's ok so amd with all the food changes, coming off steroids, extra BG testing, adjusting insulin etc it's been pretty busy, I need to work with a more steady unit and as Mary Ann mentioned the steroid can lower BGs for up to a week after stopping still so after last nights situation I'd rather see how she does on 0.5 twice daily. Maybe I can get a bit more done then and some more sleep too;) Hopefully 0.5 twice daily will be an effective amount for her. If I don't see any blue on that over the next week then I'll look to increase again. What do you think? Thanks so much for all your help!
 
so I think the 1/4 tsp honey and maybe the extra LC food really raised her BG a lot.

Actually this has nothing to do with the higher pre-shot readings Tanya so no you didn't overdo it. It's Tinka's body fighting back against the lower numbers she reached last night. It's called a bounce. The body of a diabetic becomes use to having their BG elevated. The body also has a defense system that goes into action when the body senses the BG is going too low. In a diabetic the defence works but the on/off switch timing is off kilter so the defences click into action at higher BG levels than they do in a non0-diabetic. So when Tinka got to those lower numbers last night, her defences clicked in which helps keep the BG from going to low along with the food, honey you used to prop her up temporarily. The food and honey (especially the honey) wear off pretty quickly but the glucagon (stored sugar) that got pushed into the bloodstream doesn't dissipate quite so fast. Sort of like the defence mechanism goes into overdrive. Those higher numbers can last for up to 3 days (6 cycles) and you just have to wait it out as difficult as that is to do.

I agree with reducing the dose to 0.5u completely. My rule of thumb is that I have to be in good shape to look after my girl the best I can. If I try to be too aggressive and end up with multiple sleepless nights, I may not react properly when really necessary. So your needs and Tinka's needs must be met by compromises whether permanent or temporary. You may need to take things a bit slower because of your needs but that's ok! Tinka needs you!

If I were you, based on last night's cycle, I would save trying to shoot any lower BG numbers on a day rather than night cycle because many if not most cats go lower at night. Or be more aggressive on your days off. Just figure out where that median line is that meets Tinka's needs but doesn't overly impact yours.

Have a very Merry Christmas. I hope Tinka behaves so you can enjoy your holiday without any major drama! :bighug::bighug::bighug::bighug::bighug:
 
Actually this has nothing to do with the higher pre-shot readings Tanya so no you didn't overdo it. It's Tinka's body fighting back against the lower numbers she reached last night. It's called a bounce. The body of a diabetic becomes use to having their BG elevated. The body also has a defense system that goes into action when the body senses the BG is going too low. In a diabetic the defence works but the on/off switch timing is off kilter so the defences click into action at higher BG levels than they do in a non0-diabetic. So when Tinka got to those lower numbers last night, her defences clicked in which helps keep the BG from going to low along with the food, honey you used to prop her up temporarily. The food and honey (especially the honey) wear off pretty quickly but the glucagon (stored sugar) that got pushed into the bloodstream doesn't dissipate quite so fast. Sort of like the defence mechanism goes into overdrive. Those higher numbers can last for up to 3 days (6 cycles) and you just have to wait it out as difficult as that is to do.

I agree with reducing the dose to 0.5u completely. My rule of thumb is that I have to be in good shape to look after my girl the best I can. If I try to be too aggressive and end up with multiple sleepless nights, I may not react properly when really necessary. So your needs and Tinka's needs must be met by compromises whether permanent or temporary. You may need to take things a bit slower because of your needs but that's ok! Tinka needs you!

If I were you, based on last night's cycle, I would save trying to shoot any lower BG numbers on a day rather than night cycle because many if not most cats go lower at night. Or be more aggressive on your days off. Just figure out where that median line is that meets Tinka's needs but doesn't overly impact yours.

Have a very Merry Christmas. I hope Tinka behaves so you can enjoy your holiday without any major drama! :bighug::bighug::bighug::bighug::bighug:
Thanks so much for this info Linda it's really helpful to know:) She was still on 16 when I tested her +6 so I guess that makes sense then why her numbers aren't lower today plus we reduced the dose this morning. I'll test out the 0.5u for the next 5 days or so and see how we get on. Hopefully numbers will come down over time but not too low. It's very true a balance is definitely needed, I need to be well to look after Tinka too.

So is it possible to shoot say 0.75 in the AM and 0.5 in the eve for future reference? For now I'll stick with 0.5 twice daily so we can both find a balance of recouping but it's good to know options for next few weeks after the Christmas period. I hope you have a very Merry Christmas too and thanks again for all your help:)
 
Tanya, Lantus works better with consistency. Because it is a depot insulin, it is much better to give the same dose day and night. That way the depot of insulin (like a little gas tank) is constant. Giving one dose AM and a different dose at PM makes the predictability (which isn't perfect at any time) even more difficult to deal with. I'd stick with 0.5 for the moment, get through the holidays, so you can enjoy them, get enough sleep and stay healthy, and then forge ahead with a dose increase if need be. If however Tinka throws you another curve, you can always reduce again and there will be some folks around over the holidays to help although response time may be a bit slower than usual. Just watch the pre-shots and don't shoot any reading any lower for now. Having just come off steroids, she may drop more so monitor carefully and don't be afraid to skip a dose if you really need to. It happens but you need a life too! :bighug::bighug:
 
Tanya, Lantus works better with consistency. Because it is a depot insulin, it is much better to give the same dose day and night. That way the depot of insulin (like a little gas tank) is constant. Giving one dose AM and a different dose at PM makes the predictability (which isn't perfect at any time) even more difficult to deal with. I'd stick with 0.5 for the moment, get through the holidays, so you can enjoy them, get enough sleep and stay healthy, and then forge ahead with a dose increase if need be. If however Tinka throws you another curve, you can always reduce again and there will be some folks around over the holidays to help although response time may be a bit slower than usual. Just watch the pre-shots and don't shoot any reading any lower for now. Having just come off steroids, she may drop more so monitor carefully and don't be afraid to skip a dose if you really need to. It happens but you need a life too! :bighug::bighug:
Thanks so much! :) So don't shoot 0.5 lower than 8.4 or 9.2?
 
Oh I'd stick with 9 for now if not a bit higher like 10 or 11, just in case, especially if you will be out partying or socializing over the holiday. I do tend to be a bit over conservative sometimes but better safe than sorry:).
 
Oh I'd stick with 9 for now if not a bit higher like 10 or 11, just in case, especially if you will be out partying or socializing over the holiday. I do tend to be a bit over conservative sometimes but better safe than sorry:).
Thanks so much Linda yeah I think it's best to be safe too especially if I'm not around :) Have a wonderful Christmas!!
 
Status
Not open for further replies.
Back
Top