? Misty got her first blue today!! Should I increase the dose or hold?

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Bree & Misty

Bree & Misty

Member Since 2021
Curving today and Misty got a 158 at +8 :joyful:. It's her first blue ever! Should I increase the dose or hold a bit longer? Really excited that we're seeing better numbers.
Thanks!
 
Lovely to see a green BG!
Did you give a snack at +10? It might help the BG to rise a bit before the next preshot but is within the ‘no food for the 2 hours before the next preshot’
Test again at +11 to see if the BG is dropping or going up.
Hold the dose, do not increase. Even if you had just got the blue BG you would hold the dose longer with the appearance of the first blue BG.:)
 
Bron and Sheba (GA) said:
Lovely to see a green BG!
Test again at +11 to see if the BG is dropping or going up.
Hold the dose, do not increase. Even if you had just got the blue BG you would hold the dose longer with the appearance of the first blue BG.:)
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Will test again in an hour and update!
Any reason why the nadir is so late? Should I change anything based on that?
Thanks :)
 
Bron and Sheba (GA) said:
Bree I added a bit about feeding at +10 just now. Did you see it?
It may be too late now to feed with the 2 hour window of no food
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We're at +10.5 right now. Should I give a snack and stall the PM test feed shoot 30 minutes? Also what kind of carb content should the snack be?
 
Bree & Misty said:
Any reason why the nadir is so late? Should I change anything based on that?
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I’m not a Prozinc user so I’m probably not the best person to answer that. I’m sure @JanetNJ or @Panic can. But I would imagine that dose of 1.25 is beginning to work well and the duration of the shot is longer. Just keep doing what you are doing . It’s progress!
Bree & Misty said:
We're at +10.5 right now. Should I give a snack and stall the PM test feed shoot 30 minutes? Also what kind of carb content should the snack be?
Click to expand...
Probably best to just leave it now and keep on track.
At the next dose, you may need to stall, dont feed and test again in 20 minutes if the BG does not rise high enough. Post and ask for help.

Next time this happens, give a small low carb snack at +10. It’s all a learning experience :)
 
Bron and Sheba (GA) said:
I’m not a Prozinc user so I’m probably not the best person to answer that. I’m sure @JanetNJ or @Panic can. But I would imagine that dose of 1.25 is beginning to work well and the duration of the shot is longer. Just keep doing what you are doing . It’s progress!

Probably best to just leave it now and keep on track.
At the next dose, you may need to stall, dont feed and test again in 20 minutes if the BG does not rise high enough. Post and ask for help.

Next time this happens, give a small low carb snack at +10. It’s all a learning experience :)
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Great, thanks Bron! I'll probably end up making a new thread for pmps as I doubt it'll go to above 200 in less than 2 hours.

Would love some input from prozinc users as well if any see this :)
 
Bree & Misty said:
@Bron and Sheba (GA)
She is still dropping. +11 is 84. Bring up with food or wait?
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As you have dropped under 90 on the SLGS method, I would feed a low carb snack now and test again 30 mins to see if she is rising.
That means the preshot BG is going to be influenced. Can you push it out an hour without stuffing up your schedule too much?

She has earned a reduction down to 1 unit at the next shot….let’s see if she is high enough to shoot.
 
Bron and Sheba (GA) said:
As you have dropped under 90 on the SLGS method, I would feed a low carb snack now and test again 30 mins to see if she is rising.
That means the preshot BG is going to be influenced. Can you push it out an hour without stuffing up your schedule too much?

She has earned a reduction down to 1 unit at the next shot….let’s see if she is high enough to shoot.
Click to expand...
I fed a low carb snack, but right before I did she vomited up the treat I gave her at the last test and a little bile. Does that change anything?
Yes I can push it out an hour no problem
Her numbers were absolutely horrible on 1 unit, I was getting black numbers almost every day. Still reduce to 1 unit?
 
Use the remarks column in SS to tell us what food you are feeding during the cycles and when Misty drops low. That helps us and will help you looking back at it at a later date.
She may bounce after dropping into greens so don’t be surprised if she does!
I suggested feeding the low carb now as it is the end of the cycle and the Prozinc will start to wear off soon, so we don’t want to feed her high carb and send the BG too high. Does that make sense.?
 
Bron and Sheba (GA) said:
Use the remarks column in SS to tell us what food you are feeding during the cycles and when Misty drops low. That helps us and will help you looking back at it at a later date.
She may bounce after dropping into greens so don’t be surprised if she does!
I suggested feeding the low carb now as it is the end of the cycle and the Prozinc will start to wear off soon, so we don’t want to feed her high carb and send the BG too high. Does that make sense.?
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Yes that makes perfect sense. I'll add the food now
Did you see my last post?
 
Bree & Misty said:
I fed a low carb snack, but right before I did she vomited up the treat I gave her at the last test and a little bile. Does that change anything?
Yes I can push it out an hour no problem
Her numbers were absolutely horrible on 1 unit, I was getting black numbers almost every day. Still reduce to 1 unit?
Click to expand...
Hopefully she keeps down the low carb snack. Let me know if she vomits again. Otherwise no change moving forward.
Misty has told us she needs a reduction in dose so you need to take it.
Is there any reason you are not following TR? If you can get tests in every cycle you could do it.
I have to go out for 20 minutes but will be back
 
Bron and Sheba (GA) said:
Hopefully she keeps down the low carb snack. Let me know if she vomits again. Otherwise no change moving forward.
Misty has told us she needs a reduction in dose so you need to take it.
Is there any reason you are not following TR? If you can get tests in every cycle you could do it.
I have to go out for 20 minutes but will be back
Click to expand...
Mostly because I can't get am cycle tests regularly Mon-Thu. I can come home at lunchtime in an emergency but it's not feasible every day since I have to extend my lunch to do so. Adding in commute I couldn't get anything other than a +11. If TR is still possible with those limitations I'd love to try it.
Thanks for all your help
 
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Bron and Sheba (GA) said:
Hopefully she keeps down the low carb snack. Let me know if she vomits again. Otherwise no change moving forward.
Misty has told us she needs a reduction in dose so you need to take it.
Is there any reason you are not following TR? If you can get tests in every cycle you could do it.
I have to go out for 20 minutes but will be back
Click to expand...
107 @11.5ish
 
Bree & Misty said:
107 @11.5ish
Click to expand...
That is just 30 minutes after the food though isn’t it? So it’s food influenced but good she’s on the way up
So you still have 1 1/2 hours to the new preshot time….is that correct?

I’m going to tag @JanetNJ and @Panic to see if they are around to help with the PMPS

I can see you have limitations on the mornings. How long after the shot do you have to leave for work?
 
Bron and Sheba (GA) said:
That is just 30 minutes after the food though isn’t it? So it’s food influenced but good she’s on the way up
So you still have 1 1/2 hours to the new preshot time….is that correct?

I’m going to tag @JanetNJ and @Panic to see if they are around to help with the PMPS

I can see you have limitations on the mornings. How long after the shot do you have to leave for work?
Click to expand...
Yes all correct.
Thanks for the tags
My work schedule is really wonky right now, Monday and Wednesday I leave at +30, Tuesday I leave at +1, and Thursday I shoot right before I walk out of the door. Trying to get a new job with more consistent hours but until then I'm kind of stuck with the current shot schedule. Can't really shoot any earlier because if I do I won't be home in time for the pm shot on Tuesdays :(
 
Bree & Misty said:
Yes all correct.
Thanks for the tags
My work schedule is really wonky right now, Monday and Wednesday I leave at +30, Tuesday I leave at +1, and Thursday I shoot right before I walk out of the door. Trying to get a new job with more consistent hours but until then I'm kind of stuck with the current shot schedule. Can't really shoot any earlier because if I do I won't be home in time for the pm shot on Tuesdays :(
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I’d stick with SLGS for now until things start to settle down at work I think. You can always swap over later if things improve with work.
She is starting to respond well to the insulin. Looks like the 1.25 dose has made a bit of a break through. Just because she wasn’t doing well on the 1 unit before, doesn’t mean she won’t now. Earning a reduction in dose is progress!
Do you have an automatic timed feeder for her to use when you are at work? They are a lifesaver for people who have to work.
You can get more tests in during the PM cycle if that is feasible. Cats often go lower at night.
 
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Bron and Sheba (GA) said:
I’d stick with SLGS for now until things start to settle down at work I think. You can always swap over later if things improve with work.
She is starting to respond well to the insulin. Looks like the 1.25 dose has made a bit of a break through. Just because she wasn’t doing well on the 1 unit before, doesn’t mean she won’t now. Earning a reduction in dose is progress!
Do you have an automatic timed feeder for her to use when you are at work? They are a lifesaver for people who have to work.
You can get more tests in during the PM cycle if that is feasible. Cats often go lower at night.

Have you thought about posting over on the Lantus forum? You can post there daily and get lots of advice.
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Oh that's great news! I do have an automatic feeder and set it to give her a meal at +6 every cycle. I can get 2 tests in every night and more if she's dropping and needs to be monitored. Fingers crossed on work calming down soon.l
I haven't thought about posting on Lantus since I'm using Prozinc, but if it's allowed I'm happy to do so. Thanks again!
 
Bree & Misty said:
I haven't thought about posting on Lantus since I'm using Prozinc, but if it's allowed I'm happy to do so. Thanks again!
Click to expand...
Oh my mistake! I know you are using Prozinc but forgot for a minute you were using Prozinc when I made that suggestion!! :banghead: I’ll change the above post so don’t confuse anyone else!
No ….continue to either post here on the main forum or the Prozinc page, although I don’t know how busy that is.
 
Bron and Sheba (GA) said:
Oh my mistake! I know you are using Prozinc but forgot for a minute you were using Prozinc when I made that suggestion!! :banghead: I’ll change the above post so don’t confuse anyone else!
No ….continue to either post here on the main forum or the Prozinc page, although I don’t know how busy that is.
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Haha no worries! Prozinc has lighter traffic than here I believe, I might try posting there for PZ specific advice too. Thanks!
 
Bron and Sheba (GA) said:
What do you think about giving a snack at +2 or +3 and +6 each cycle? That would give her a snack around the onset of the insulin and again at the nadir.

Misty is a beauty! What type of kitty is she?
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Yeah that's just fine! I'll split her mid cycle meal.

Thank you! She's my pride and joy :cat: she's a rescue kitty and was listed as domestic shorthair, I suspect a little Russian blue genes but not sure
 
How to handle a lower than normal preshot number when following SLGS:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • 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
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin once you have data and understand your cat’s cycles. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

This above information is from the SLGS Prozinc method.

These are guidelines so we can be slightly flexible as 145 is close to 150.
I think you can either skip the dose and give nothing, OR you could give a token dose of 0.25 units IF you can monitor all this cycle and have plenty of test strips and higher carb food.
What so you think?
 
Bron and Sheba (GA) said:
How to handle a lower than normal preshot number when following SLGS:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • 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
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin once you have data and understand your cat’s cycles. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

This above information is from the SLGS Prozinc method.

These are guidelines so we can be slightly flexible as 145 is close to 150.
I think you can either skip the dose and give nothing, OR you could give a token dose of 0.25 units IF you can monitor all this cycle and have plenty of test strips and higher carb food.
What so you think?
Click to expand...
I have plenty of test strips and some FF beef in gravy. I can monitor all night if I absolutely need to, but I'm not crazy about being a zombie in the morning... what will happen if I skip?
 
Bree & Misty said:
I have plenty of test strips and some FF beef in gravy. I can monitor all night if I absolutely need to, but I'm not crazy about being a zombie in the morning... what will happen if I skip?
Click to expand...
The BG will probably rise ….have no idea how much.
If you do skip she will settle down again. And you can choose the time for the AMPS to suit you.
Remember you will have a new dose of 1 unit.
 
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