Please help ! Dosing/ monitoring of Toby

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My husband just gave Toby 4.5 units of insulin but his number was only 5.6 (101). It was done without him even thinking about it and before I could tell him not to give the dose it was too late. Yes we have a hypo kit on hand but I’m worried that things are going to get bad fast.
 
If you are lucky, he will be bouncing from that 85 today and inflate the numbers artificially. Test him in an hour, it will take 1-2 hours before we start to see what's going to happen.
101 (5.6) isn't too low of a number to shoot but definitely want to be watching closely on this one. Please keep us updated.
 
Phew. Thank you, I feel a bit more relieved now. I’m hoping so since his numbers have been a little all over the place the past couple days.
 
He looks like he may have been bouncing from the lower numbers he's been having and just cleared a bounce this afternoon. He was on his way up though which is good. Normally we recommend lowering the no-shoot number gradually and practice caution when giving full dose at an unusually low number - so while technically his pre-shot isn't too low for full-shot, since it is much lower than usual we mustn't be blasé about it. You have your hypo kit which is good. We can intervene quickly if he starts to dip early. :)
 
So far so good, insulin may not have kicked in yet. Please check again in an hour and post!
 
Hailey K said:
Correct me if I’m wrong but is it below 50 that we need to seek care from a vet ?
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4.6 (83) isn't too low...it's a safe number but we do want to slow down how fast he's dropping. I'd try a teaspoon of his regular food or maybe something a little higher and test again in 30 minutes

If he drops below 50 (2.8), you just need to have some high carb food like Fancy Feast Gravy Lovers and/or some corn syrup, honey or pancake syrup that can be rubbed on the gums (if you can't get them to eat it) to help bring the blood glucose back up above 50.....and of course continue testing. The simple sugars bring them up fast but also wear off quickly so the high carb cat food usually helps hold them up a little better.
 
He has access to his food right now. We just gave him some more and he ate some. I will test again within the hour. I won’t be going to sleep until I know he has gotten to his nadir’s or has started coming back up! These numbers are just new territory for us so we are being very cautious !
 
Okay good, your SS is set up for Alphatrak numbers so I wanted to double-check.

Don't fill him up, we need him to be able to eat later.
 
Hailey K said:
We are using a human meter.
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OK, it's not important right now, but we need to change your spreadsheet so the color coding matches for a human meter instead of the AlphaTrak.

Hailey K said:
We just gave him about 2-3 tbsp of HC wet food
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Good deal...it can take 20-30 minutes for the food to get digested and into the bloodstream so hopefully that will nudge him back up a little.

He's still in a "safe" number but we don't want him dropping much more!
 
Oh I wasn’t aware of that and I’m not sure how to change it the spreadsheet was created for us by someone else, we have been using human meter just after the spreadsheet started, should be somewhere in the notes. He has a big appetite tonight and we took away the remainder, he probably ate only about a tablespoon.
 
Hailey K said:
Oh I wasn’t aware of that and I’m not sure how to change it the spreadsheet was created for us by someone else, we have been using human meter just after the spreadsheet started,
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@Bandit's Mom can help you change the formatting on it so it's correct for human numbers. She's in India so it's earlier in the day there (so it's not important to do it right now....she'll be online for several hours)

For now, our attention is on getting his numbers up, not the spreadsheet
 
Toby is doing good back to his normal high number. Finally after 2:30 AM he had jumped back up to 6.5 at his 7+ so I felt comfortable going to sleep then. He was 20.8 this morning and we did give him his full dose of 4.5. Thank you for everyone’s help last night !
 
Now I’m worried I made a poor judgment. Tonight Toby was 6.9 (124) at PMPS. I gave him full dose of 4.5.
 
What is typically the number I should be looking for to decrease the dose at shot time is it under 150? Also he was at 4.25 before and we had high numbers then, is there a chance that this time will be different and he will be regulated ? And what does being regulated even look like? I was under the impression that regulated numbers where if they were in the blue and green always ?
 
Have you had a chance to read the Prozinc Dosing Methods sticky at the top of the Prozinc ISG?

If following Prozinc SLGS Dosing he earned a dose reduction the other night when he dropped below 90 mg/dl (5.0 mmol/L).

Reductions are based on the nadir or how low a dose takes a kitty - not the pre-shot, unless the preshot is the low number of the cycle.

If your pre-shot is lower than you are used to, you can stall without feeding, re-test in 20 minutes and see if he's rising and decide if the number is safe to shoot. If still on the low side you can stall again, without feeding for up to an hour with Prozinc and still stay on the same shooting schedule if the numbers are high enough to shoot. The other option when you get a low pre-shot is to give a token dose, 10% to 25% of the usual dose. There's some good information in the dosing sticky on how to handle lower than normal pre-shot numbers.
 
I have read the the sticky. Still doesn’t tell me the number that is considered too low for a full dose. I’ve seen some people say token dose if it’s under 200, some say under 150 even some posts I’ve seen saying under 250. I know Toby would be way to high for days if I didn’t give him a full dose if he was around 200-250. And the sticky still isn’t explaining what is considered a normal range for AMPS nadir or PMPS. Toby constantly runs high so there really is no number that I even consider normal for him when it’s clearly still way to high, he’s always in the purples and yellows with an occasional blue number around nadirs. I was under the impression that between 4-9 would be considered great numbers regardless if it’s AMPS or PMPS or anything in between. I thought the whole point of trying to get him regulated was having lower numbers without going too low obviously. I don’t recall anyone mentioning a dose decrease the other night and I don’t disagree that he may need to decrease to 4.25 but that dose wasn’t successful before, is there a chance it will be successful this time. I worry he will continually just stay in the purples and yellows if we decreasing the dose or always having to give token doses.
 
I find that information a little all over the place at first it says decrease if it’s below 150 but later on it says is they are between 3-6 months then to only decrease if you see a BG number below 50, which we haven’t. So what guideline am I supposed to be following if it says multiple different things ?
 
I know it's confusing (and I hope I don't make it worse!)

An earned dose reduction is different than giving a token dose because of a lower than normal pre-shot number.

Hailey K said:
first it says decrease if it’s below 150
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This section is Under the "How to handle lower than normal pre-shot numbers"

Hailey K said:
it says is they are between 3-6 months then to only decrease if you see a BG number below 50,
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This quote is under the MPM (Modified Prozinc Dosing Method) on when to take a dose reduction.

The two most followed dosing methods for Prozinc are SLGS (Start Low Go Slow) and MPM (Modified Dosing Method)

SLGS - kitty earns a reduction anytime his BG drops below 90
MPM - kitty earns a reduction when the BG drops below 50

SLGS is recommended in the beginning and as you gather more data and more experience you may want to try the MPM dosing method.
 
That’s makes more sense thank you. It is tempting to want to follow the MPM since we haven’t had much luck trying to regulate Toby as his numbers have been consistently high, yet at the same time these low numbers for us were scary yet exciting at first because we have never experienced them before. We will decrease for a few cycles and see what happens ! Fingers crossed tonight won’t be as challenging as the other night, but I think he’s handling it a bit better tonight based on his numbers so far.
 
Hailey K said:
I’ve seen some people say token dose if it’s under 200, some say under 150 even some posts I’ve seen saying under 250.
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In the Main Forum and for new members without data we recommend a no shoot or token dose at 200 on a human meter.

In the Prozinc ISG and/or if you have collected more data, have more experience and have a better idea how the insulin works for your kitty the no shoot or token dose number is lowered to 150 on a human meter.

The 250 number may have been for a new member with no data using a pet meter (Alphatrak) or a different faster/harsher acting insulin like Vetsulin.

The goal is to gather data, learn how your kitty responds and gradually lower your 'no shoot' number.
 
Perfect ! Thank you so much for your help and helping to make sense of things. It is frustrating to say the least trying to figure all of this out ! I appreciate it !
 
I can try to get one more number out of Toby in an hour before I have to go to bed for work in the AM. Does it look like he will be okay without any need for HC food intervention ?
 
It looks like the start of a 'typical' cycle. Prozinc usually onsets at +2. The drop from +2 to +3 is about 10%. If he keeps up this pace it'll be a good cycle but we don't really have have much data to compare to when shooting this low, so yeah, get another test in an hour if you can.
 
Okay so I think I already know the answer and should be giving Toby a token dose tonight based on his data, or is it possible since we have been monitoring closely and I’ve had someone home with him during the day that we can keep this good thing rolling by giving him his new lesser dose of 4.25 ?
 
Correction. He crept back up to 9.5 for his PMPS so I’m comfortable going ahead with his full dose. But in regards to a token dose if he’s lower can the maximum amount I give him only by 25% or is it possible to give something like half of his normal dose or say 3/4 of it? Or should I always be just a token dose ?
 
Following Prozinc SLGS Dosing Toby earned another dose reduction down to 4.0U yesterday with that BG reading of 52.

He was pretty close to earning a reduction if you've decided to follow MPM dosing instead. Keep a close eye on him in the coming days - sometimes something just clicks and they can start coming down the dosing scale pretty quick. If back to back reductions are earned they should always be taken to keep Toby safe.

Looks like at +2 last night he might have been headed towards a bounce (won't know for sure until we see some more numbers though). If he is bouncing, be patient, don't get discouraged and give it time to clear. It can take 3 to 6 cycles for a bounce clear.
 
I just updated his spread sheet he was 17.2 this morning so we held the 4.25 dose. I’ll see what he is tonight and if he’s still low I will decrease again.
 
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