STALLING I need help!!!!

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Yvonne & Freddie

Member Since 2014
3-17-14 PSAM 339 +3 204 +6 76 +7 87 +9 121 PMPS 105

Testing 1/2 hour after shot was due and his BG number is 121

I gave him 1 unit this morning and his numbers are all on top and on his SS.

Fred threw up when I gave him a nugget of Stella and Chewy's but has held down his wet food before AMPS. only about 3 teaspoons. I have taken him off W/D cat food and his numbers have gotten real low.
I have only given him a very few EVO kibbles today after his 1:00 testesting. He hasn't eaten much all day... he has slept all day only moving to go potty and to take a couple of drinks.

I am not giving him his shot tonight as I don't know what to do.
I will wait a few minutes and I do have to feed him.

Yvonne and Freddie

I don't know what I should do now...Freddie's numbers are too low to shoot arn't they I have not fed him yet hope to hear from someone as to what to do now....PLease
He hasn't eaten much today...
Yvonne

HI
Can I get your advice! Would you please take a look at Freddie's SS number's that I took in a 24 hour period. I need some guidance
When I tested at 1:00 am his number went down to 98 I didn't know what to do at the time I was in a panic so I gave him some W/D food and he was acted strange his eyes looked strange so I gave him some corn syrup...(now I don't think that was the thing to do) I was so afraid that I would fall asleep and my alarm was not working. I did wake up 2 hours later tested and it was up to 146.

What should I have done?
Also he was stressed when I took his PMPS last night because a dog was in our yard just prior to the shot is all I can think of why his numbers went up from running around 190 to 194 all day and then 348.
 
He may be doing what we call a double dip, when they have their lowest number at nadir, and then go down a little again, but not quite as low as the nadir at close to the end of the cycle. You are smart not to feed him while you stall. I would do another test 30 minutes after the +12 and post the number. Hopefully, he will be on the rise.
 
you're doing fine Yvonne

Just retest as Dyana suggested, and let us know what the number is

If it's going up, you probably should go ahead and give him the 1 unit dose. His numbers today were excellent!

As long as you have plenty of test strips, High carb food and can test tonight, you don't want to lose the momentum you're starting to get going.

If you're really concerned, you can give a smaller dose, but if it doesn't keep him in those good numbers, you might end up going right back up again

We had discussed "Stalling"...You don't feed, post for help, and retest every 20 mins or so. If he goes up, you go ahead and shoot the scheduled dose if you have all the supplies you need

If you've already fed him, make sure to say so when you let us know his next test number
 
3/17/14 PMPS was 105

Tested again 1/2 later and it is 121 now just tested again and Freddies BG is 118.
He has not eaten yet.
Yvonne
 
If it were me, I'd go ahead and shoot the scheduled dose, as long as you have the supplies you need in case you need to steer him with food later on

121 and 118 are the same number, but they're both up some from the 105 so he's coming up

If you stall too much longer, he could go back down (it's hard to explain why) and you might not get a chance to shoot at all

You could also continue to stall another 15-20 minutes and test one more time if it would make you feel better, but once you feed him, that food should bring him up some and the shot won't start "kicking in" for at least a couple of hours yet. (actually, with Levemir, it's more like 3-4 hours

It's got to be your final decision though. If you just can't bring yourself to shoot the same dose, you can shoot a smaller dose, or skip the shot tonight, but then you have to start over
 
Hi Chris, since you asked me to come here, here I am :). Now I got confused with your last comments. Are you talking about Juno's or Freddie's? I gave Juno's shot when he was 189, and one hour after the shot he was 238. This should be okay. What do you think? How many more times should I test him? I also should get a bit of sleep too.
 
OK...yeah, I was looking at Juno's spreadsheet, but talking to Yvonne about Freddie at the same time..sorry about that!

I'd get a +2 on Juno, and if it's still rising, he's probably going to keep going up in a bounce tonight, so it'll be a good chance for you to get some sleep and not worry about him

I'll remove the link sending people here on your post. Trying to deal with both of you at the same time was a little too much. Go on back to your post :)

You're doing great!
 
Yvonne, if it were me, I'd go ahead and shoot the 1 unit as long as I had the supplies to test later, high carb food in case I needed it, and could test if I needed to. He didn't drop that low today, and is just starting to show improvements in his numbers.

I would expect him to bounce at some point too, since those greens are new to him, but nobody can guarantee what will happen in the future.

You have to do what's comfortable for you though, so if it'll really worry you to shoot the 1 unit, you can shoot a reduced dose, and go ahead and feed Freddie.

Either way, you'll want to get a +1 and +2 just to make sure he's heading up and let us know what you get then.

Again, I'd suggest shooting the 1 unit, but in the end, it has to be your decision. You'd be the one staying up with him if he did continue down (although I'm sure someone here would sit up with you if it became necessary)
 
Chris

I ended up giving Freddie just a drop or 2 of insulin he just will not eat and his number was 101 so it is going down.
10:30 it was 101.

Why is it going down without the insulin. I will be testing in another half hour
 
Hi Yvonne,

Chris asked me to come explain about stalling. the idea with stalling is that you're waiting to see what will happen the first few times you're faced with a number that is lower than you've shot before.

Most of the time, if a person is monitoring (and hey - you are testing more than enough to be following the Tight Reg Protocol!) you can shoot any number over about 50ish. but . . . you want to become data ready to do that.

that means that you want to gradually shoot numbers lower and lower until you get to the 50's. what you see tonight is that Freddie dropped after +12. He's most likely dropping because he hasn't been fed.

Since you've decided to shoot a token dose tonight, just record it in his spreadsheet with the best estimate you can give of the dose, and you can get back on track tomorrow. i'd go back to the 1u dose in the morning.

Here's a good link for you to read about what to do when you're faced with Low Numbers. It explains about becoming data-ready so you can shoot lower numbers with confidence.

i'd invite you to post over on the Tight Regulation Insulin Support Group. People will teach you what you need to know to follow that protocol - you are on your way already, but it will be safer if you learn the quirks of how to do it.

julie
 
Thank you I will go over to the tight regulation support group tomorrow..
I probably gave Freddie a dose of .5 or lower I sure didn't want to pose a problem tonight. and I did feed him the EVO he absolutely would not touch his wet food no matter WHAT i did to it.
Going to test again.
Yvonne and Freddie
 
Hi Yvonne

Chris asked me to pop over and try explain a few things regarding the numbers dropping.

First, I agree with Dyana that he got a second dip when he came back down to 105 after going up to 121 at +9. Lantus is known for its second dips. But, in reality, 121 to 101 is all within meter variance and you could say he's just fairly flat.

However, if you were to take the numbers at face value, it's possible he's dropping again because he hasn't eaten. Just because you haven't shot doesn't mean he has no insulin on board. Lantus is a depot insulin and a dose can affect several subsequent cycles. That's why I don't usually suggest a reduced dose if current numbers are flat because the early part of the cycle, at the least, is going to play out the same as if you had shot the full dose. The larger effect will occur later in the cycle or, more likely, next cycle.

The other scenario for a cat to keep dropping as you are stalling is if they are clearing a bounce. As the counterregulatory hormones and glucagon clear, the numbers might just keep coming down as cycles tend to be more active if they are bounce clearing. When my Gracie was on Lantus, she did this to me very frequently and I had to get really good at shooting dropping numbers safely or I would have had to skip a lot of shots.

If it's the end of a cycle and they are flat or just get a second dip, it's best to shoot and then feed. That will help the numbers come up a bit. BUT...if the depot is really full, they might come right back down.

Does that help?
 
I think it may sink in when I reread when I am not so tired. I was up most of the night last night testing..
I just tested him and he was 146 at 11:30 so at least he is not going down and I will be safe for tonight he also ate Evo food. so he has something in him...
TY I will try and figure this all out in the morning..
Yvonne

Thank You Chris!!!! and Julie
 
Thank You Marje will try and understand all this in the morning I think he is ok for tonight ...poor little guy....this is so hard for me to understand..
Yvonne
 
Don't worry now, Yvonne. Try to get some rest. The depot is a difficult concept to grasp. But we are here to answer your questions. :-D
 
it's hard for everyone at the beginning. you don't have to absorb it all at once. we tell people over and over again because we all get it that it takes a while to understand. It's like a college crash course of Feline Diabetes 101 - there's a steep learning curve at the beginning but it gets infinitely easier before long. you also will get it - don't worry!

sleep well.
 
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