Too low for *my* comfort... Dosing Advice Needed

[Kathy4Skipper]

Skipper's feeling better, but I'm not after pulling an all-nighter.

We're finally in the greens with yesterday afternoon being a little scary with an AM+6 of 60. I had to stall one hour last night before giving his shot at PM+1. Last night PM+6 was 85.

Dose history: On July 27, I went up to 1.8ish, which resulted in a PMPS of 185 on July 28, so I went back down to 1.75u.

My question for you: Is his body still reacting to the 1.8ish on the 27th and 28th?
Do I continue with the 1.75u? or does he now need less?

 

[Shelley & Jess]

Somebody's looking good lately!

Following SLGS dosing he earned a reduction when he went below 90 yesterday, so yes, reduce to 1.5U if he's high enough to shoot.

 

[Shelley & Jess]

My question for you: Is his body still reacting to the 1.8ish on the 27th and 28th?
Do I continue with the 1.75u? or does he now need less?

Prozinc is an in-and-out insulin, no depot to influence the next cycles. Any influence you might see with Prozinc would be the bit of overlap you might get from one cycle to the immediately following cycle.

Dose reductions are done with Prozinc based on the most recent dose, which was the 1.75U. So, the earned dose reduction following Prozinc SLGS would bring the dose down to 1.5U

 

[Kathy4Skipper]

Somebody's looking good lately!

Following SLGS dosing he earned a reduction when he went below 90 yesterday, so yes, reduce to 1.5U if he's high enough to shoot.

Thanks for pointing out the below 90 rule that I missed yesterday. Much appreciated!
His AMPS is 180... if I'm using the regular AMPS time... I did have to stall one hour last night so maybe AMPS is really in one hour? I don't want to stall so I think I'll go ahead and feed him and give the 1.5u.

 

[Shelley & Jess]

Sounds good! Prozinc does have a bit of wiggle room, within an hour window if he's high enough to shoot.

Any time you decide to stall it's important not to feed first. We stall to make sure they're rising on their own without food influence.

 

[Kathy4Skipper]

Sounds good! Prozinc does have a bit of wiggle room, within an hour window if he's high enough to shoot.

Any time you decide to stall it's important not to feed first. We stall to make sure they're rising on their own without food influence.

Thanks for the clarification on the stall. I've added notes to his spreadsheet.

When there are several data points, is it sufficient to look at the trend of the cycle to know that they are rising on their own without food influence? Or can they stop rising and go flat?

 

[Shelley & Jess]

When there are several data points, is it sufficient to look at the trend of the cycle to know that they are rising on their own without food influence? Or can they stop rising and go flat?

Good question. Last night you have great data to show the pattern of the cycle and that he was rising at the end and high enough to shoot this morning.

When testing is limited for a cycle and he's lower than normal at preshot I would most definitely stall and make sure he's rising on his own. They can and do go flat. And when you get a lower than normal preshot and stall you want to see a rise on his own that's more than meter variance, that 15% to 20% difference that your handheld meter is allowed to have from test to test.

Until you really know how much of a food bump your cat gets from their meals it's best to not feed 2 hours before preshot and best not to feed if stalling. If his numbers are low the food might be inflating his numbers above what might otherwise be to low to shoot.

 

[Kathy4Skipper]

Good question. Last night you have great data to show the pattern of the cycle and that he was rising at the end and high enough to shoot this morning.

When testing is limited for a cycle and he's lower than normal at preshot I would most definitely stall and make sure he's rising on his own. They can and do go flat. And when you get a lower than normal preshot and stall you want to see a rise on his own that's more than meter variance, that 15% to 20% difference that your handheld meter is allowed to have from test to test.

Until you really know how much of a food bump your cat gets from their meals it's best to not feed 2 hours before preshot and best not to feed if stalling. If his numbers are low the food might be inflating his numbers above what might otherwise be too low to shoot.

Great info! Thanks!

So, with the meter variance, if I had stalled, I would have wanted to see a value of 216? Is this correct if his preshot was 180?
180 * 1.2 = 216

 

[Shelley & Jess]

So, with the meter variance, if I had stalled, I would have wanted to see a value of 216? Is this correct if his preshot was 180?
180 * 1.2 = 216

Using 180 as an example for a stall number, yes, I'd want to see him a bit over 200.

Using 157 as an example, I'd want to see something above 180.

If he stays flat through a couple of 20 minute stalls, (I wouldn't stall any longer than an hour if needed) and he's still lower than you've shot before, this is when you decide if you should skip, give a token dose or reduced dose and get tests in if you can to see how he handles it.

Skipper's looking good and you're doing great!!

 

[Kathy4Skipper]

Using 180 as an example for a stall number, yes, I'd want to see him a bit over 200.

Using 157 as an example, I'd want to see something above 180.

If he stays flat through a couple of 20 minute stalls, (I wouldn't stall any longer than an hour if needed) and he's still lower than you've shot before, this is when you decide if you should skip, give a token dose or reduced dose and get tests in if you can to see how he handles it.

Skipper's looking good and you're doing great!!

Thank you so much for your help. I learned a LOT today!