Update on Squallie

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Squalliesmom

Squalliesmom

Member Since 2015
Squallie seems to be feeling much more like his usual old self! He ate a great breakfast, has been more active and been purring a lot more this morning. :-) His AMPS was 363. At +3 hrs he was only down to 325, which I thought seemed a little unusual, but at least he's not plummeting 300 or more in the first few hours, like he was before. I will continue to test him throughout the day, obviously; depending on his numbers I may ask again for dosing advice, in case it looks like maybe he needs to move up a little from 2 units. But at the moment we're holding our own and feeling good!
 
I'm really pleased that Squallie's feeling better (and you're sounding better, Lucy!). That BG roller coaster is really tough on their systems.

Definitely post for dosing advice when you're ready. :)


Mogs
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Excellent. Squallie's got his front paws in the lagoon! :joyful:

(Lookin' good in those Patience Pants, Lucy! ;) )
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Squalliesmom said:
At +9hrs Squalie's BG is 136. I will probably be posting again in a couple of hours for dosing advice!
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I think you'll wanna do 2 units again during PM cycle and maybe again for tomorrow's cycle just to see how he's tolerating this 2.0. Maybe the 12th I'd go to 2.5. Slow and steady wins this race :)
 
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That is really good, Lucy. Squallie is getting a really long duration on Vetsulin - unusual for cats. (So glad you've given up on the TID dosing idea.)

Now that you've held this lower dose for a while it's giving Squallie's body a chance to get used to the insulin again and both from his clinical signs and his data today it seems like his response to it is improving. The blues are really encouraging.
 
For all of you who know all the problems I've been having with my vet:
She called me this evening, didn't get me so called back an hour later, then waited for me to call her back. all of this well after office hours. She listened to me, asked for my numbers, and didn't seem to have any problem with me taking him back to 2 units BID. Frankly, I was surprised, but pleasantly so! She wants me to call tomorrow with his AMPS numbers, and by the time they open I'll probably have his first set of "+hrs" numbers for her, as well. Whew, I don't mind telling you guys, her attitude was a huge relief! I just hope it's not the calm before the storm, so to speak, lol!
 
Try not to worry, Lucy. You've got hard evidence of how well the 2 unit dose is starting to work - and for how long!
 
Critter Mom said:
Try not to worry, Lucy. You've got hard evidence of how well the 2 unit dose is starting to work - and for how long!
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I know. She just intimidates me a little bit. I have always gotten along well with her, but I've never crossed her, either, and I've heard from others that she can be very volatile!
 
Wow, just tested Squallie for hisPMPS number - 103? That's almost a full 12 hours from his AM shot, is this unusual? I'm afraid to give him any insulin, and he won't eat, either. Should I be worried?
 
If he hasn't eaten anything I'd stall 20 minutes to see if #'s start coming up (without feeding). Also maybe he'll be more hungry in 20. I wouldn't give him the shot if he doesn't eat.
 
Squalliesmom said:
I finally got him to eat, just waiting for him to finish and then I will test him again.
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Sounds good - typically if the PS is lower then you expect, or declining, you should refrain from feeding to see if he starts to rise back up before you give him the shot - this is known as stalling.
 
Okay, he just finished eating almost a whole can of FF. His BG is up to 187, but it's already a half an hour past his shot time and I'm not sure I want to give him insulin at 187, anyway. Anybody have any suggestions?
 
pevsfreedom said:
Sounds good - typically if the PS is lower then you expect, or declining, you should refrain from feeding to see if he starts to rise back up before you give him the shot - this is known as stalling.
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Sorry I didn't see your message before I fed him!!! What does stalling mean, in the greater picture, and what causes it? Does this mean I should not give him his shot?
 
If you can test at +2 and maybe later if necessary (if you have strips) I'd shoot. Otherwise take the night off. It's up to you. If this is too low to shoot for you - don't shoot! :)

Next time don't feed until after you stall for the shot :) Makes it easier to figure out what to do.
Stalling is to see if the BG's start to rise WITHOUT food so you're more comfortable shooting. It indicates the curve is rising rather than still declining. If the # is food influenced you really can't tell one way or the other.
 
He dropped 227 mg/dL on 2 units today - he can drop from 79.25 to 113 mg/dL per unit.
 
pevsfreedom said:
If you can test at +2 and maybe later if necessary (if you have strips) I'd shoot. Otherwise take the night off. It's up to you. If this is too low to shoot for you - don't shoot! :)

Next time don't feed until after you stall for the shot :) Makes it easier to figure out what to do.
Stalling is to see if the BG's start to rise WITHOUT food so you're more comfortable shooting. It indicates the curve is rising rather than still declining. If the # is food influenced you really can't tell one way or the other.
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Okay. Thank you for the info :-)
 
BJM said:
He dropped 227 mg/dL on 2 units today - he can drop from 79.25 to 113 mg/dL per unit.
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I don't know whether or not to go ahead and give him his shot. His morning shot seemed to kick in a lot later than it has been the past few days, and I don't want him to bottom out in the wee small hours! But I also don't want him to have #s up in the 400s again, either.

I just re-read your message; I wasn't taking into account that those numbers would potentially be doubled, at two units. I think maybe I'd better not shoot, that could be really scary. He is rising now, but I don't know whether it's because of the food, or not.
 
Well, 187-113 = 74, if he dropped the most you've ever seen.
You could give a token dose, such as 0.5 units.
 
There is much to be said for peace of mind and being able to sleep!

Do you see what I did with the math? for a couple of recent tests, I took the pre-shot and the lowest test you got and found the difference, then divided that difference by the number of units to get an idea of how much she could drop on a unit. This number can vary, and when it happens can vary, but your testing allows you to check that.
 
BJM said:
There is much to be said for peace of mind and being able to sleep!


Do you see what I did with the math? for a couple of recent tests, I took the pre-shot and the lowest test you got and found the difference, then divided that difference by the number of units to get an idea of how much she could drop on a unit. This number can vary, and when it happens can vary, but your testing allows you to check that.
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Yes I do now, thanks for explaining that to me. Suddenly the reasons for all the repeated testing make better sense!

I just checked him again and he's still rising, 229 this time, at +13 hrs.
 
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BJM said:
There is much to be said for peace of mind and being able to sleep!

Do you see what I did with the math? for a couple of recent tests, I took the pre-shot and the lowest test you got and found the difference, then divided that difference by the number of units to get an idea of how much she could drop on a unit. This number can vary, and when it happens can vary, but your testing allows you to check that.
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@BJM - Wow, BJ ... You're a wiz - how cool is that? :cool: I'm in awe!
 
Well, great news Lucy! I think you could skip or give a token dose of .5? I'd say, regardless, you need to drop the dose tomorrow. If the 2 units lasts past +12, a reduction is in order. Maybe 1.5 in the morning, regardless of what you do tonight?
 
You want to be able to answer some basic questions for your cat
- how low is the dose taking him
- when is usually the low point
Then consider how you can use that information.
- how much might 1 unit drop the glucose - look in the recent week or so of data - it won't stay consistent, so you want a range of possibility
- how fast does the drop happen - amount per hour, for example, would be amount of drop to nadir divided by time (hours or minutes)
 
I'm just curious because vetsulin is fast acting and lantus is long so IDK if that way of thinking would work for both (I'm mostly just curious). Like lantus if I shoot at 80 the next thing I know she's at 300, I know with vetsulin you'd probably never shoot at 80 unless you had extreme balls of steel.
 
pevsfreedom said:
I'm just curious because vetsulin is fast acting and lantus is long so IDK if that way of thinking would work for both (I'm mostly just curious). Like lantus if I shoot at 80 the next thing I know she's at 300, I know with vetsulin you'd probably never shoot at 80 unless you had extreme balls of steel.
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Well, you're right about the extreme balls of steel, I may be new to this but even I, in all my inexperience, would not shoot Vetsulin at 80, lol! But I'm curious about the formula, too. Hope someone can answer this question.
 
pevsfreedom said:
I know with vetsulin you'd probably never shoot at 80 unless you had extreme balls of steel.
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I wouldn't give Vetsulin at 80 full stop. Even at a much higher preshot number I would work with the maximum drop seen in recent times and then add a little extra for safety when determining whether or not to give any insulin - even whether or not to give a reduced dose - and if I were not able to monitor her right the way through the cycle I would skip. (When Saoirse got to lower numbers on Caninsulin I used the alarm on my phone to set me to check her clinical signs every 10 minutes after +1, I was that concerned the insulin would take her too low. I supplemented the observations with BG tests. I didn't relax till I knew from testing that she was well and truly past nadir.
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pevsfreedom said:
If you can test at +2 and maybe later if necessary (if you have strips) I'd shoot. Otherwise take the night off. It's up to you. If this is too low to shoot for you - don't shoot! :)

Next time don't feed until after you stall for the shot :) Makes it easier to figure out what to do.
Stalling is to see if the BG's start to rise WITHOUT food so you're more comfortable shooting. It indicates the curve is rising rather than still declining. If the # is food influenced you really can't tell one way or the other.
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It took my over-worked brain a few read-throughs to realize that I was the one who should be STALLING - at first I though it was referring to something to do with part of Squallie's insulin cycle, like bouncing, etc, lol. I can be a real idiot sometimes!
 
Squalliesmom said:
It took my over-worked brain a few read-throughs to realize that I was the one who should be STALLING - at first I though it was referring to something to do with part of Squallie's insulin cycle, like bouncing, etc, lol. I can be a real idiot sometimes!
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Lol. At least you know now! :) Real learning curve with this diabetes thing and I'm far from proficient myself.
 
pevsfreedom said:
Is this only viable info with Vetsulin or all insulins?
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You can calculate those kinds of numbers for any insulin. Do note that Levemir may actually nadir at pre-shot. It is important to have some idea of the drop you can get, as a lower than usual pre-shot may require adjusting timing or dose, or both. Ideally, you want to have a safe number to shoot every 12 hours. And safe gets defined by your mid-cycle testing and tracking the numbers frequently.
 
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