PMPS 96 for Io is that too low to shoot?

Jazmin

Jazmin

Member Since 2015
Io’s PMPS is 96, is that too low to shoot or should I wait an hour and try again? His numbers have been pretty low lately with no change in dosing. Should I be doing anything differently?
 
Do you know which dosing method you are following...TR or SLGS...?

Usually, if you are stalling- it's no food and you wait 20 mins or so -recheck and see if the numbers are coming up on their own. You don't have to wait an hour first
 
Si am cat mom said:
Do you know which dosing method you are following...TR or SLGS...?

Usually, if you are stalling- it's no food and you wait 20 mins or so -recheck and see if the numbers are coming up on their own. You don't have to wait an hour first
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We haven’t picked a method yet, due to my schedule and then I had to order different syringes to do the TR. I want to do TR but now that his numbers are getting lower I’m scared to increase the dose. He’s just been doing his one unit 2x per day this whole time
 
Jazmin said:
I don’t have the regulation filled out because we haven’t started one or the other yet.
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It makes a difference on the dosing advice...TR would say one number is okay to shoot while SLGS says another and would have had you reduce the dose already....

I think that post about missing info meant the missing values in your SS. It doesn't say some of the preshot numbers or how much insulin was given yesterday after the PS test
 
Under SLGS


Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

For today's PMPS bg under SLGS
How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.
 
Si am cat mom said:
It makes a difference on the dosing advice...TR would say one number is okay to shoot while SLGS says another and would have had you reduce the dose already....

I think that post about missing info meant the missing values in your SS. It doesn't say some of the preshot numbers or how much insulin was given yesterday after the PS test
Click to expand...
I put in the notes of some that I was out of town and had people giving Io his shots but not testing.

I just don’t know which to pick, should I be doing SLGS since his numbers are low?
 
Jazmin said:
I put in the notes of some that I was out of town and had people giving Io his shots but not testing.

I just don’t know which to pick, should I be doing SLGS since his numbers are low?
Click to expand...


I only mentioned SLGS because you seemed apprehensive about shooting lower numbers and because you didn't always have mid cycle test during the day or overnight.
SLGS doesn't recommend shooting under 90 - and if you shoot under 150, they recommended having enough information to know what your cat does after their insulin kicks in/ how low the current dose is taking them. You would have earned a reduction to 0.75 for those BGs that were under 90 already.
TR has caregivers shoot low to stay in lower numbers.....you can shoot as low as 50, but would need to monitor closely overnight and have low, medium, high carb food to intervene if the BG starts to fall...
 
82 and 107 are the lowest numbers you have recorded over the last few days, but we don't know if that's the lowest your kitty has gone. Those are decent, safe numbers though.

Do you have supplies to test and monitor overnight?
Even if you followed SLGS and shot the reduced dose, you would still want to monitor and test +1, +2 to see where your cat's BG is heading since the depot from the previous dose will be influencing these numbers.
Sorry to throw so much information at you....

You should grab another test....enough time has gone by....you would be shooting an hour late by now
 
I did a +2 and that’s at 109. I ended up giving his full dose at his dose time. I’ll keep an eye on him and keep testing tonight
 
It looks like she can do the necessary tests. Just a few missed, one when wasn’t home and one day she tested late in A.M. cycle and it was pretty high and didn’t get a PMPS.
 
The decision on which dosing method is up to the caregiver. TR requires all low carb wet or raw with a minimum number of tests. By the way, it doesn't require a certain type of syringes, the same are used for SLGS too.
 
Wendy&Neko said:
The decision on which dosing method is up to the caregiver. TR requires all low carb wet or raw with a minimum number of tests. By the way, it doesn't require a certain type of syringes, the same are used for SLGS too.
Click to expand...
I didn’t have ones with half unit markings so I wasn’t comfortable trying to figure out the micro doses with it
 
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