To shoot or not to shoot?

[Caitlin & Charleston]

Charleston's pmps tonight was 164, which is way lower than normal for him. I fed him as usual, waited 1 hour and checked again. He is now 283. I see from the prozinc dosing protocols that I can now either choose to skip, given him a partial dose, or give him his full dose. Any suggestions of what to do?

Sorry to tag you @Deb & Wink, but I would love your input.

And, what would cause him to be so much lower at pmps than when I checked him roughly at his normal nadir time?

 

[Bear and Julie]

I am having a hard time remembering the acronyms, what is nadir again?

 

[Ale & Bobo & Minnie (GA)]

Charleston's pmps tonight was 164, which is way lower than normal for him. I fed him as usual, waited 1 hour and checked again. He is now 283. I see from the prozinc dosing protocols that I can now either choose to skip, given him a partial dose, or give him his full dose. Any suggestions of what to do?

Sorry to tag you @Deb & Wink, but I would love your input.

And, what would cause him to be so much lower at pmps than when I checked him roughly at his normal nadir time?

I’m sorry I didn’t see this earlier. I’d give him a reduced dose but if you gave him full, can you retest in 2 hours? 283 is a safe number and that went up a lot in one hour you withheld the food right?

 

[Sienne and Gabby (GA)]

I'm sorry no one responded to your question before now.

There are a few additional things to consider when you are trying to decide what to do when you get a lower than expected pre-shot number. First and foremost, how much experience do you have with handling low numbers and how comfortable are you with managing those numbers. It looks like this is the first time you've seen a lower than usual pre-shot reading. While we encourage shooting lower numbers, you want to gain experience with the process. This being the case, stalling was a good option. Generally, you want to test after about 20 min. to see if numbers are on the rise. (Unless you have experience, you probably don't want to shoot a dropping number.)

It's important that you have plenty of test strips and high carb food on hand if you plan to shoot. Getting data is very important. You don't want to shoot a lower number and then go to sleep or leave the house. Cats can be unpredictable so knowing where the numbers are heading is important.

One housekeeping note -- If you waited an hour after your initial (PMPS) test, the number in the pre-shot column was taken at +13.

 

[Caitlin & Charleston]

Thanks @Aleluia Grugru & Minnie and @Sienne and Gabby (GA)! I sometimes forget we are not all in the same time zone. I realized after posting this it was very late in the evening for a lot of people, so no worries.

I probably could have given the full dose after getting the 283 at +13, but I ended up giving him a "token" dose of .5 because I was feeling a little nervous about what was going on and am not experienced at managing low numbers. His numbers continued to rise over the course of the night. I just did his amps and it was 243, which is also lower than normal, but not too low. I fed him and checked again after 20 minutes and it was 414. I think I will go ahead and give him his full dose this time.

I'm going to stay home and keep monitoring him today. I've got plenty of test strips, FF gravy lovers, and some karo syrup in case of low numbers.

 

[Ale & Bobo & Minnie (GA)]

Sienne, please correct me if I’m wrong but I think a number above 200 is safe to shoot even if that’s lower than what you’re used to getting at the amps and pmps because the goal is to get him in those 200 number ranges for the preshots

but yes, the 168 would have made me nervous too and a token dose is always a safe option especially overnight as you won’t be monitoring as closely as during the day. Go Charleston!

 

[Sienne and Gabby (GA)]

@Aleluia Grugru & Minnie - you're correct. We suggest that with Lantus, you post and ask for help if you get a pre-shot number of 150 or below. However, on Health, they tend to use 200 so it gets a bit confusing. Frankly, in the early stages of learning how to manage a cat's diabetes, I'd encourage a new member to ask for help whenever they are uncomfortable with the pre-shot number. Sometimes, it can be an instinct that the kitty is ramping up for lower numbers and it doesn't hurt to have experienced eyes on the thread.