Skinny dosing question

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tsteinbarth

tsteinbarth

Member Since 2014
Big siggghhhh . . .
9/12
AMPS @ 6 am: 25
+1 (7:35 am): 396

Gave Skinny some EVO with breakfast this morning . . .

With the HUGE jump, I'm unsure if I just continue with status quo and give him 1u? or reduce?
 
Am I reading that correctly - you got a 25 at AMPS? Did you retest right away at that point? Did you retest again at +1, or just take the one "+1" reading?

If you truly have a reading like 25 (ie, it wasn't a bad test strip or a bad reading from not enough or too much blood on the strip), you don't want to be feeding low carb food like EVO...you want to break out high carb food and/or karo. I can't stress how dangerous a number like 25 is, and you need to get Skinny up and over 50 as quickly as possible - low carb food just isn't going to cut it. With a true 25, you are bordering on seizures, brain damage, and death. Often times, a trip to the vet for a dextrose drip is required when a cat hits numbers like this.

With that said, I wonder if one or both of those numbers are not truly accurate readings. Aside from the fact that 25 is a terrifying number, usually when a cat bounces, they don't jump over 360 points in the course of an hour.

Honestly, I'm not 100% what to tell you to do here. Can you retest and post again? I'd like to see another number to see if we can see a trend.

Did you shoot anything at all? If that 25 was a real number then yes, you would absolutely reduce, regardless of how high the bounce is - Lantus dosing is based on the nadir, not on the preshot value. If that 25 was not a bad strip or bad reading, I would probably take an extra big reduction again - to .5u maybe. At the same time, if that 25 is a an accurate reading, I'm very hesitant to suggest shooting anything at all if you're not able to monitor.
 
I can't give dosing advise, but that 25 is dangerous low, I would guess he may have went lower yet.
It being this early in the game for you, and shooting that 80 last night, a +2 would have been very beneficial. With out any tests prior to the pmps you Dont know if skinny was still dropping from clearing the bounce at pmps or rising. Food intervention in lower numbers is detrimental to keep skinny safe.
Skinny has earned a .25 reduction. That high number at amps is a bounce and can/will affect BG for 3 days.
Did you give dose at the reading of 25? You never want to shoot anything under 50.
Hopefully someone else can advise more.
 
Amy I just looked at her SS, no shot was given, by last nights spot checks I am going with that 25 was a false reading, she had a 455 @+5.
 
I didn't retest him when he got the 25. I did re-test with 396. . . the first number was 411 on the left ear and the 396 was on the right ear. . .

I can't get numbers mid-day most days as I am at work and this week I've been able to take my lunch and come home, most days I actually don't take a real lunch.

I gave him 1u after the high number for 2 reasons: keep him on the 12 hr rotation as much as possible and the 1 seems to be the dose that he responds the most consistently (ha) to. . .
 
Lantus dosing is based on the nadir, not the pre-shots. If that 25 was an accurate reading, you NEED to reduce the dose. As I said, 25 is extremely dangerous - this dose got him there once, and it can do it again. If it happens in the middle of the day when you're not due home for hours, it would be very, very bad news.

Are you able to get in any more tests before you leave for work?

In the future, if you get a number like 25 (or anything below 50), definitely retest right away to make sure it is an accurate reading and not a bad test strip or bad reading in general. Seeing a number like that strikes fear in all of us here, and we worry about each other's cats as much as our own.
 
From Wednesday's condo:
Friday am - shoot reduced dose. Friday pm, shoot 10pm
Saturday - could you shoot just after you teach?
Sunday - sounds like there's no option except to skip, unless son can learn to shoot as well.
Monday - shoot asap
Click to expand...

Amy & Darin are right about immediately retesting any low number.

I think given your erratic schedule over the next 3 days, along with the possible really low numbers, you might want to reduce his next shot to 0.5u, or even 0.25u and then hold it there throughout the weekend, unless someone picks up a low number.

It's hard to believe he could go from 25 to 396 in an hour, but that's not impossible. He went from 133 to 376 in 2 hrs on 9/6. It does look like his spreadsheet is very zig-zag-y, so i think that 25 is a possibility.

Cat's high numbers can be CAUSED by low numbers, which is a hard concept to wrap one's head around. When you see high numbers you automatically think "needs more insulin" but it definitely isn't always the case with cats.

I'm really concerned about how low he appears to be getting. Twenties are very dangerous - we're lucky he's surviving these. I'd encourage you to reduce his dose to either the 0.5u or 0.25u for the weekend, and don't raise it back up until one of us can look and confirm that he actually needs more insulin. There are pictures of these tiny doses in the New to the Group sticky. First and foremost is his safety. I hope your son is going to be able to test him this weekend. Skinny may be trying to go off of insulin - let's keep him safe!

From the TR Protocol guidelines:
Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
Please ask for advice.

If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.
Click to expand...
 
Julie, seeing that you think the 25 is a possibility, then would you think that the 455 @pm+5 is influenced from the evo dry given at pmps?(I just noticed the feeding of evo dry in the SS remarks)
 
i don't know what the carb content of the EVO dry is. I'm not sure if that is the Young Again that some people talk about, which is supposedly 5% carbs. Most dry food is too high in carbs for diabetic cats, but in skinny's case, it might be ok for the moment, because we don't have a good picture of his dosing needs yet. Typically, dry food will stay in the system for at least a day.

I don't know if the 25 is accurate or not. But in the absence of knowing, I'd rather assume that it is and reduce his dose accordingly.

Toni, while you are gone, I'd err on the side of a possibly too-low dose in order to keep him safe. Hopefully when you get back, we can help you get a better picture of what he needs.
 
julie & punkin (ga) said:
From Wednesday's condo:
Friday am - shoot reduced dose. Friday pm, shoot 10pm
Saturday - could you shoot just after you teach?
Sunday - sounds like there's no option except to skip, unless son can learn to shoot as well.
Monday - shoot asap
Click to expand...
I think given your erratic schedule over the next 3 days, along with the possible really low numbers, you might want to reduce his next shot to 0.5u, or even 0.25u and then hold it there throughout the weekend, unless someone picks up a low number.
Click to expand...

I completely agree with this...shooting a lowered dose over the weekend is the best way to try and keep Skinny safe while you are not available for testing. Given what we've seen Skinny can do, I would be very, very cautious and would not shoot more than .5U this weekend. If you get any readings that are even remotely questionably low - like, say, 150 - I'd go with .25U for the weekend. This is very much a "better safe than sorry" situation.
 
The Evo and Young Again are actually different. YA is supposed to be 5-6% carbs. Evo cat & kitten formula is supposed to be around 12%, I think.
 
I appreciate the feedback on this week. I never got a chance to show my son how to obtain BGL. He is fine with feeding and shots and the importance of 12 hrs feeding and insulin.

I'm going to go with .5u for the weekend if he has an OK number tomorrow morning before I leave. If it's low I'll do the .25u and have my son do the same for the weekend just to be safe. I'll be able to check numbers mid-afternoon on Saturday but not again until Monday. There will be no numbers for Sunday.
 
Detailed plans for this weekend . . .

today: shot @ 4:30 pm
Saturday AM: shot @ 5:30 am
Saturday PM: shot between 5p-6p (son is aware of the need to stay within this timeframe)
Sunday AM: shot between 6a-7a
Sunday PM: shot between 6p-7p
MOnday AM: shot between 6a-7a


Numbers will be obtained: today @ 10 pm; Saturday at 5:30 am & Saturday @ 3:30 pm; Monday @ 11 am

I will have access to the message boards during the weekend if anyone has feedback.
 
my only thought is to take 2 syringes and draw up a 0.5u dose in one and a 0.25u dose in the other. Label them clearly. Use something colored like tea or coffee so your son can see clearly what the dose is. Those are such tiny doses that it might be easy for him to get mixed up.

I'd also add that if your son has any doubt about the blood sugar being too low, he should just skip the shot. it's better for Skinny to be too high while you're gone than go too low unmonitored.

enjoy your time away. when we traveled, my son texted or called with the preshot before every shot so i could give my 2 cents worth. i just felt better with it. :-D
 
SOOOOOOO . . . I think there is a high possibility that the recent low number was an error. . .

Just now when I did the first reading I got a 23 and then did 2 more readings which were 279 & 270. . .
 
Well, that is a HUGE relief!!! So now you know to ALWAYS retest if you get a number that seems odd! I learned that the hard way, too! Nice job!

I hope all goes well while you're gone. You're fortunate to have a family member willing to care for Skinny while you're gone. It's so much easier on them to be at home than boarded.
 
before you touch the bead of blood with the test strip, make sure you have an adequate amount of blood to test accurately. a too-small blood drop can cause a wonky test like that.
 
Skinny doesn't seem any worse than before . . . . Plan on continuing with the .5u for a few days and see how his numbers are.
 
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