AMPS under 200 after HIGHs - How much to shoot?

Kathy4Skipper

Kathy4Skipper

Member Since 2021
I may have given a fur shot yesterday, but I was confident that I hadn't so I was confused by yesterday's values being HIGH all day.

This morning he is at 191 which is too low to shoot. I had been giving his shots around 9:00 am/pm but since I thought I gave a fur shot yesterday, I shot at 7 pm last night... two hours earlier.

Will you please look at Skipper's spreadsheet and let me know how much I should shoot this morning? We are new to this and Skipper is just all over the place.
 
Are you withholding food 2 hrs before the AMPS and PMPS testing? Can you stay around to monitor? Have you fed him yet? Do you have hypo kit?

If you haven't fed, test again 20 minutes after your first test. If he's above 200 and you can stay around to monitor, go ahead and shoot. But keep an eye on him during the day.

If you fed, if he's not above 200 upon retest I mentioned above, no hypo kit, and/or you can't stay around to monitor, I'd shoot what we call a token dose. In this case, around 0.25U-0.5U.
 
Thank you so much for your quick reply!

Yes, I withhold food 2 hrs before AMPS and PMPS testing.
Yes, I feed him this morning after testing at 7:11am Central Time... 45 minutes ago.

How long should I wait before retesting since I already fed him?
 
Kathy4Skipper said:
Thank you so much for your quick reply!

Yes, I withhold food 2 hrs before AMPS and PMPS testing.
Yes, I feed him this morning after testing at 7:11am Central Time... 45 minutes ago.

How long should I wait before retesting since I already fed him?
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When you get a lower than usual preshot, it's best to stall without feeding to see if he's still falling (in which case usually no shot or another no-feed stall), or flat/rising (in which case give a shot, possibly adjusted dose).

Usually I'd say don't retest because it's influenced by food, but in this case it's an extra data point.

If you can stay around to monitor and have a hypo kit, I'd say try 1U. If not, 0.25-0.5U, whoever you're comfortable with.
 
FrostD said:
When you get a lower than usual preshot, it's best to stall without feeding to see if he's still falling (in which case usually no shot or another no-feed stall), or flat/rising (in which case give a shot, possibly adjusted dose).

Usually I'd say don't retest because it's influenced by food, but in this case it's an extra data point.

If you can stay around to monitor and have a hypo kit, I'd say try 1U. If not, 0.25-0.5U, whoever you're comfortable with.
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Since I'm going to test for a data point and then give a shot, how long do I wait before testing and shot?
 
Kathy4Skipper said:
Since I'm going to test for a data point and then give a shot, how long do I wait before testing and shot?
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Oh sorry, go ahead and test now. If he's higher than this morning, ok to give shot (dose based on what I said in previous posts). If he's flat or dropping post again
 
I feed Skipper and his brother the same food. When I went to check on him, Skipper was eating the rest of his brother's food so I waited until he was done eating to re-test.

So, at 1-hour after AMPS, he is now at 244. I guess I should still probably wait to shoot? Test in another hour? [Skipper had a bad infection and has been on antibiotics. The vet said he could go into remission... could these number mean he might be going into remission already, or just a fluke thing?]

What do you... wait an hour to retest and then shoot since the little bump is because of his breakfast? The value is higher than this morning, but I was expecting it to be MUCH higher after eating... that's why I'm unsure.
 
N
Kathy4Skipper said:
I feed Skipper and his brother the same food. When I went to check on him, Skipper was eating the rest of his brother's food so I waited until he was done eating to re-test.

So, at 1-hour after AMPS, he is now at 244. I guess I should still probably wait to shoot? Test in another hour? [Skipper had a bad infection and has been on antibiotics. The vet said he could go into remission... could these number mean he might be going into remission already, or just a fluke thing?]

What do you... wait an hour to retest and then shoot since the little bump is because of his breakfast?
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I would shoot now. I asked about food because if he was still falling or flat with food, we'd want to stall again.

Since he went up with food, that means he was either flat or rising to begin with at AMPS. So ok to shoot. As we say "you hold the syringe", so choose the dose you're comfortable with.
 
Note this also means your shot schedule will be a little off. The earliest you can shoot tonight is 11 hours from now.
 
Ok. I think I'll shoot 0.5u now since I don't know how Skipper will react. I'm home today so I can test a couple of extra times throughout the day. Noted on the time to shoot tonight... earliest is 11 hours from now. Thanks for that tip!
 
@FrostD I shot 0.5U at 10:20am Central this morning. Skipper's +6 value was 398, not much different than his AMPS post feeding of 369.
So, this means that the earliest I can shoot is 9:20pm, or I can wait until 10:20pm, which is fine with me. I'd like to try to get back on track of shooting at 7am or 8am within a couple of days.
Please take a look at his spreadsheet?
How much insulin do you think I should give tonight? And at what time?
 
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Kathy4Skipper said:
@FrostD I shot 0.5U at 10:20am Central this morning. Skipper's +6 value was 398, not much different than his AMPS post feeding of 369.
So, this means that the earliest I can shoot is 9:20pm, or I can wait until 10:20pm, which is fine with me. I'd like to try to get back on track of shooting at 7am or 8am within a couple of days.
How much insulin do you think I should give tonight? And at what time?
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I would go back to your normal dose, provided he's above 200. And yes you can do an hour earlier tonight, and again in the morning if he's above 200.

Given his numbers today you probably could have given full dose this morning, but always better safe than sorry! Now you have an extra data point
 
FrostD said:
I would go back to your normal dose, provided he's above 200. And yes you can do an hour earlier tonight, and again in the morning if he's above 200.

Given his numbers today you probably could have given full dose this morning, but always better safe than sorry! Now you have an extra data point
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I honestly don't know what his normal dose is since we just started. I'm so careful when I shoot I really didn't think I did a fur shot yesterday but the numbers probably don't lie. And to stay in the Pinks all day today without going HIGH on only 0.5U makes me wonder what's going on.
Thoughts?
 
Kathy4Skipper said:
I honestly don't know what his normal dose is since we just started. I'm so careful when I shoot I really didn't think I did a fur shot yesterday but the numbers probably don't lie. And to stay in the Pinks all day today without going HIGH on only 0.5U makes me wonder what's going on.
Thoughts?
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You may want to try 1.25 since you’re doing SLGS. With the .25 unit increases you have a better chance of not missing his ideal dose, especially since you’re just starting out.
 
I was actually thinking stick with the 1.5U for a few more days, again provided its safe to shoot (above 200, flat or rising). He's likely going to bounce from the blues and yellows today and be pretty high in the morning again.

What we ultimately want is nadirs in the low blues/high greens (until you get comfortable enough to decide on a dosing method, in which case we want him down around 50s/60s, but that can make people nervous). Over time we'll reduce that 200 threshold bit by bit, but need more data.

It will take some time for him to stop bouncing. I'm glad Hilary commented, if you look at George's spreadsheet you'll see what I mean. He bounced and bounced then started to settle down (now he's creeping up a bit, but that's just all part of the fun of diabetes :cool:), and she also got comfortable lowering her shooting threshold.

My cat has two underlying high dose conditions, so don't let my spreadsheet scare you!
 
Since I had two-plus hours before his PMPS, I went ahead and fed him at his regular dinner time. I should have just given him a snack because he didn't want to eat at shot time. So I only gave 1U. He ate about 1/4 of his food so I left it out for him to eat overnight if he wants. I'll make sure there isn't any food out two hours before tomorrow morning's shot.

I'll re-read both replies in the morning so I'll be on top of things and starting fresh in the morning!

Thanks you both,
Kathy
 
[My cat has two underlying high dose conditions, so don't let my spreadsheet scare you![/QUOTE]
I took a peek at your spreadsheet anyway and I laughed when your kitty's adorable picture popped up at the end. Thanks for including it! :woot:
 
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