When you get a low pre shot number options

There are several options one has when they get a low pre shot ["PS"] number where low is a value below their set "no shot" value. The most important thing in this scenario is to be safe. In many scenarios just not shooting any insulin that cycle or "no shoot " may be fairly safe. But for many cats, and especially those with a history of ketones, no shoot may not be the best or even safest option. Below are your options:

Option 1) Wait and test.
When you get a Pre-Shot ["PS"] number under your no shoot of say 200 and you have very little data to support shooting at that number, you can "wait and test" instead of giving the usual dose or simply no shooting. Wait 30 minutes and test again. If the cat is over your chosen no shoot, 200 in this case, representing a rise in blood sugar values, you can shoot. It is best to avoid feeding during this wait time, so you do not get a rise in values due to the food. This will be a cycle when you do want to get some extra tests in to see if the low number is part of a pattern of lower BG values. Be sure to get a mid cycle test/number at your cat’s nadir if known. If not known, around 6 hours after the shot was given. If you get a low number at the preshot (80-150), you would follow the same procedure, but you would want to reduce the dose of insulin by as much as one half when the number has risen to 200. Also, if you are consistently needing to wait and test you may be time for a dose reduction. If you shoot late or early one cycle then likely you will be shooting early or late respectively the next cycle. Waiting and testing is a good compromise in safety and utility.

Option 2) No shoot.
This is just like it sounds. Don't shoot any insulin that cycle. The advantages of this is that it is simple and normally a pretty safe thing one can do [but is your cat "normal?"]. The disadvantages are that without insulin that cycle the kitty's blood glucose ["BG"] values will likely zoom up for the next cycle. This may slightly slow the regulation process by a few cycles as you try to bring the numbers back down from where they zoomed off too the next few cycles. Also, if one has a kitty with a history of ketones it can be important to keep at least some insulin going in their system. In the beginning this tactic can also lead to seesaw effects between cycles were they go to high then too low then to high etc. For more thoughts on not shooting any insulin read here.

Option 3) Shoot a reduced dose.
In the beginning this is the most "risky" option. Risky because you may not really have the data to know what your cat will do at any dose. Roughly conservative guidelines for this would be to shoot at least 1/3 your previous dose with a BG reading under 200 and at least 1/4 your previous dose with BG reading under 150. And by all means, as a beginner, do not shoot any insulin below a BG value of 100. There is no empirical evidence for these rough guidelines. It is best to consult with someone first though before you do this just to make sure this tactic would be right for your situation. If you choose this option it would be good to get at least a +3 test and a +6 test so you can watch for any dangerous lows) you know if your kitty will not be going too low that cycle and b) that you can use that data for later and maybe increase the guidelines the next time. Especially as a beginner it is important to try to shoot on a rising number, and with this strategy it can be sometimes difficult to tell if the number is really rising if you have not gotten any previous tests that cycle. This tactic is meant to reduce the amount seesaw effect of no shooting and slow any zooming up in BG values the next cycle. Using U100 syringes with U40 insulin and doing the conversion can assist with finding more consistent dose reduction increments.

You, the owner, is the one holding the syringe. Regardless of these approximate guidelines, the the choice of dose is your choice - you need to make sure you are making safe decisions for you kitty.

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Note: do not post into this topic if you do not have to. If you have comments please post then into the Newbie checklist draft topic. This post compiled from many sourced. Thank you.