11/23 Putu | AMPS 366 | +2 395 | +6.5 236 | +9 210 | PMPS 153 | +2 251

Putu is still dropping lower at +9 on this new dose. What should be my strategy for dosing tonight?

I'm looking at these guidelines:
"Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise."
This looks like a likely scenario if she stays the same or comes up a bit. What would her dose be then, maybe 50%, so 0.75?

"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"

This could also happen. I don't want to skip or delay, so it looks like a reduced dose might be in our near future. But how much to give?

Following this advice: "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" would mean 0.45 for under 200 and 0.37 for under 150.

I guess I should also see if she's rising, so that means I shouldn't try to give her some food (we're just coming up on within 2 hours of shot time now)?
 
Last edited:
Hi! Putu seems to like Lantus - hurray! I can't speak to dosing but can offer some advice as a lot can change in the remaining hours before your shot.
  • Get a test a little before +10 - if he's still around 200 (or less), you can give a small low carb snack (1-2 teaspoons) if you'd like (remember no food 2-hours before shot time so hopefully Putu eats up his snack :)).
  • Grab a test at +11.5 - do not feed - and post for help here if the number is one you aren't comfortable with. Feel free to tag those that have helped you before - like Elise, Wendy, Chris - just write their screen name with the "@" in front of it. They'll get a notification and they will respond if they are able.
  • Also grab your test at PMPS (+12). Do not feed. Compare it to your +11.5. Is Putus rising or dipping? Don't feed until you know what you're doing about shooting. I know you said you don't want to delay but even a 20 minute delay at PMPS can give you insight to the cycle (and wouldn't put you off schedule in the AM...you can adjust shot time by 30 minutes in a 24 hour period).
Hope that helps some - post updated tests here and it will bump your post up too.
 
Okay, thank you. She flinched and ran away from my +10 test attempt (after I already had a good blood drop too!) so I just fed a spoonful of low-carb food (about 7.5% carbs) and she was done eating before +10.5.

I will post another update at the next test time, but she might not sit for two more consecutive tests tonight. Could I just compare the +12 (or is it +12.5 now due to the snack?) to the +9 I got earlier to see if it's rising?
 
Okay, thank you. She flinched and ran away from my +10 test attempt (after I already had a good blood drop too!) so I just fed a spoonful of low-carb food (about 7.5% carbs) and she was done eating before +10.5.

I will post another update at the next test time, but she might not sit for two more consecutive tests tonight. Could I just compare the +12 (or is it +12.5 now due to the snack?) to the +9 I got earlier to see if it's rising?
Yes you'll want to wait 2 hours for PMPS from food so your PMPS reading isn't food influenced...so in your case that sounds like it will be +12.5 (you can still enter it in your PMPS cell when the time comes.). You can certainly compare the PMPS to the +9 - but the +11.5 will be more meaningful. Whenever I was worried about Jax around shot time, I was always advised to get an +11.5 (and then the experienced folks would say to come back with my PS number :)).
 
Your signature says TR for dosing. The guidelines above you quoted are for people following SLGS. For people following TR, we suggest that if you get a number below 150, you stall, do not feed, and post for help. Above 150 you are good to shoot.

A lot can happen in a couple hours too.
Following this advice: "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" would mean 0.45 for under 200 and 0.37 for under 150.
Where did you find that? It's not standard practice here.
 
It can be crazy how much kitties BG can change in 30 minutes - check our Ruby on 11/13 (here's her SS). At +11.5 before PMPS, Ruby was 94 and then for PMPS she was 172. Just an example of why that 11.5 can be helpful especially as you are gathering data for Putu on Lantus.
 
Your signature says TR for dosing. The guidelines above you quoted are for people following SLGS. For people following TR, we suggest that if you get a number below 150, you stall, do not feed, and post for help.
Ah, okay, I got confused and thought those guidelines applied to both. Are there any rules of thumb for low numbers on TR other than post for help? Just trying to be ready in case no one is available.

Above 150 you are good to shoot.
This was the advice I followed for Putu that led to a no shot and days of high numbers, so I'm hesitant to do this again (see my SS starting 11/18 PM cycle through basically today). Are there any circumstances under which we give a reduced dose on TR for numbers that are lower than normal but above 150?

Where did you find that? It's not standard practice here.
Looks like this was in the PZI forum and I thought it was generally applicable: https://www.felinediabetes.com/FDMB/threads/when-you-get-a-low-pre-shot-number-options.32652/
 
It can be crazy how much kitties BG can change in 30 minutes - check our Ruby on 11/13 (here's her SS). At +11.5 before PMPS, Ruby was 94 and then for PMPS she was 172. Just an example of why that 11.5 can be helpful especially as you are gathering data for Putu on Lantus.
Thank you for pointing this out and providing an example, I had no idea about last-minute swings like this. It's super helpful to see what this can look like.
 
Looks like this was in the PZI forum and I thought it was generally applicable:

ProZinc and PZI are vastly different insulin's than Lantus.

Scroll down to the SLGS section in this thread and re-read it (maybe bookmark or print it out....you'll learn something every time you read it! I still either learn something new or refresh my knowledge by reading this same thread every now and then and I've been at this awhile!)
 
Okay, she's at 153 at +12, but I did feed her a spoonful at +10.5. I can try to get another reading at +12.5 but she is really over it tonight and I don't think she will increase dramatically considering she is down from 210 even with a bit of food in her. @Chris & China (GA) @Wendy&Neko -- any thoughts?
 
I would shoot the full dose as long as you have all the appropriate supplies - HC wet/syrup/strips - I can sit with you through the cycle as long as needed to help you in case of low numbers if that’s what you decide to do.

ETA you kind of had to skip on 11/18 because it was the first day of lantus but you saw what happened after. Now having had her first increase we know that the dose is not significantly too high so the risk is lessened.

And here’s a good post about shooting dropping numbers for your consideration https://www.felinediabetes.com/FDMB...tion-slgs-myths-debunked.111088/#post-1173098
 
Last edited:
I agree with Serryn @Vyktors Mum and I would take her up on her generous offer to be with you tonight. Fortunately, she's on the other side of the world from us.

Lantus cycles are much flatter when you shoot low. It's counter intuitive, but definitely works differently than Prozinc.
 
While I appreciate the very generous offer, TBH I'm not up for shooting a full dose on blue tonight for the first time. I understand the dose is probably not too high because we just increased it. But what I've seen with Putu is, it's not just the dose, it's how we got there. She keeps having these dramatic reactions to any change that I just don't fully understand yet, which is the source of my hesitation.

So I just fed her and gave her a token dose of 0.25 units. I got this "token dose" idea from the SLGS guidelines so maybe I need to rethink whether we're ready for TR yet.

I'm guessing tomorrow we should plan to give her the full 1.5 units again. I was an hour late on her shot tonight, but given that it was a token dose, do I push the cycle back an hour tomorrow or just resume her usual shot time?

Thank you again for jumping in to help.
 
I get it, I know how terrifying it is in the beginning but I would encourage you to read up and study spreadsheets and get comfortable with the idea of shooting lower numbers. The sooner you can make the leap the better for Putu. On the plus side tonight you get some data on what happens on a reduced dose :)

It’s generally not recommended to move shots more than half an hour per day but I think she will be probably be high enough in the morning for you to go straight back to your regular time on this ocassion The depot and ‘smooth action’ have already been interrupted by the late and reduced dose anyway.
 
Back
Top