Kaz PMPS 103 / Too low to shoot full dose?

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Claire and Kaz

Claire and Kaz

Member Since 2022
@Suzanne & Darcy
@Bron and Sheba (GA)
@tiffmaxee


Hi not sure if any of you are around right now. I have to give Kaz his insulin in 15 minutes but 103 is too low to give the full dose. I wanted to see what the safest highest dose is that I could give him. I know he was in green earlier today so I know he's supposed to go from 3 units to 2.75. This is still too high.
Would 2 units be safe or should it be lower still?

Claire
 
As I have been unable to find help I have had to decide to reduce the shot to 1.75 which in theory is now 1 unit less than he should be getting.
This is where I feel I am letting Kaz down as I simply do not know what the highest dose is that I could now give him and he still be safe. Take a step forward and a huge jump back.

Maybe for next time I could get some help with this. I know remission is now a very unlikely prognosis but I'd like to give Kaz every best option I can.
 
Hi Claire. I’m sorry I was not on email or ths FDMB until now. When following TR, any number 50 and above is safe to shoot so long as you are able to monitor the cycle.
 
Suzanne & Darcy said:
Hi Claire. I’m sorry I was not on email or this FDMB until now. When following TR, any number 50 and above is safe to shoot so long as you are able to monitor the cycle.
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If I had given him 3 units at 50 he could have gone into a coma. I was told under no circumstance to give insulin if he was at 50. This contradicts everything I have been following?????
I would never have given him the full dose tonight as this would have been dangerous regardless as to whether I could monitor or not. I would then have been scrambling with honey and high carb food.
None of this makes any sense.
 
I've been working on the understanding that if less than 50 NEVER give insulin as its too dangerous, 50-99 give a very small amount of insulin (amt is based off what he's getting at the time).
100-120 - slightly decreased dose and anything above his full dose.

I feel like I am starting again tonight as I simply don't have an understanding on what to do when he starts having low numbers. Now I have given him a lesser dose so he's going to bounce and Kaz and I will have to start all over again.

There needs to be some sort of set plan for people like me that don't know what hey are really doing. There is a plan if there is not enough insulin just keep on increasing by .25 units but in the same way there needs to be a set plan for people like me to follow step by step but there dose not seem to be one it seems like its a guessing game. I've missed my chance with remission I already know this but I would at least like to get him on to a minimal dose. I hate that he has to have this much insulin as I think in the long run its not good for him.

Just really frustrated tonight as I need a plan to follow and I don't have one. Defeated.
 
Okay back now. I so see a couple of 153 preshot numbers where Kaz received his full dose and was fine. The idea then would be to gradually reduce the preshot number where he receives the full dose - allowing you to collect data and also increase your comfort level. It can be very nerve wracking at first as most people on this Board find out. Over on the Lantus Levemir forum you will find people who shoot any number 50 and above (if they are following Tight Regulation protocol.). But they usually worked their way down while gathering data. Shooting lower preshot numbers results in much flatter cycles. But I more than understand your anxiety. Have you gotten a test on him this evening since the pm dose?
 
Claire and Kaz said:
124 is the lowest I have ever been told to give him the full dose.
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Okay so he wasn’t too far off of that mark. I do think that you could have safely given him the full dose this evening. I don’t blame you at all for not wanting to do it though - especially when you did not have support at the time. He will go a bit high, yes, and his next cycle or so will be not as good as they could be because his depot will have been a little depleted which always happens with reduced doses, skipped doses and fur shots. You will not have caused a bounce though. If he has a bounce it will be because he had a low number (green or the mear green) that he’s not completely used to.

Getting a cat better regulated does mean learning to shoot lower preshot numbers- which isn’t always comfortable.
 
I just gave him a test about 5 mins ago his number is 138 which is fine but I'm sure it will be high in the morning.

So as we have had this mishap tonight should I now keep him at the 3 units or decrease to 2.75 due to the green. Giving him a reduced dose kinda screws things up again for him.
 
So my new rule of thumb should be if he's in blue (above 100) give him his full dose.
If he is below 100 then what....

Guessing if the green is a pre shot (80-100) then I don't feed him for another 15 minutes but I need to wait to see if his number comes up or drops. This will then give me an indication as to whether or not the prior insulin is still in his system? Then feed and shoot as normal (even though its below 100)

Next bit confuses me but I will try and have a friend read it and see if they understand it. Really wish someone would write this stuff in very basic English so everyone could understand.

Shooting low is also hard for morning shots as I have to be in the office 4 days a week.
 
Claire and Kaz said:
So my new rule of thumb should be if he's in blue (above 100) give him his full dose.
If he is below 100 then what....

Guessing if the green is a pre shot (80-100) then I don't feed him for another 15 minutes but I need to wait to see if his number comes up or drops. This will then give me an indication as to whether or not the prior insulin is still in his system? Then feed and shoot as normal (even though its below 100)

Next bit confuses me but I will try and have a friend read it and see if they understand it. Really wish someone would write this stuff in very basic English so everyone could understand.

Shooting low is also hard for morning shots as I have to be in the office 4 days a week.
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If you can stall for 20-30 minutes and see if his BG is rising it may help your decision making, although a lot of the time the depot is still carrying them and they are pretty flat (see how Kaz’s depot kept his glucose from rising too much in the early part of the cycle last night). As long as you don’t see dropping numbers, it’s okay. Of course, you do have to give some consideration to the fact that you cannot be home to test on a lot of days- so that makes your dosing decisions more difficult. That’s where I hope he will do this on a day you are home to monitor the cycle so you can gather data on how he responds. You also have the Meowspace, but he has to be feeling well and eating his snacks. You haven’t had trouble with Kaz not eating his snacks lately have you?
 
No Kaz has been eating everything I give him. He does need a Ketone test there just hasn't been enough blood the last couple days. He's generally happy and healthy right now and playing with his brother quite a bit.

I have a vets appointment within the next couple weeks I might ask for a Libre button while I'm there as I can get easier and quicker tests this way.
 
That's good that he's feeling well and eating and playing! Libres are convenient, but just remember that they can read low in the lower end of the scale - but you can always check a low number with an ear prick.
 
No. We find a bit of difference between human blood glucose meters and Libre sensors. The human BG meters measure blood glucose, and the Libre sensors measure glucose in the interstitial fluid that surrounds the cells just below the skin. In practice, the differences are more apparent at the lower numbers- we have seen some really low numbers with the libre that weren’t as low with the human meter. Also, if BG is rising or falling rapidly then the Libre sensor tends to not be as accurate. Let me find an article on this for more information about the differences and the “lag time.”
 
Suzanne & Darcy said:
but just remember that they can read low in the lower end of the scale - but you can always check a low number with an ear prick.
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I have a Libre on my Wiggle. Last evening the Libre read 61 and an ear test with human meter at some time read 63
At higher BGs the meter reads higher like on Saturday the meter read 458 and Libre 360.
 
Larry and Kitties said:
I have a Libre on my Wiggle. Last evening the Libre read 61 and an ear test with human meter at some time read 63
At higher BGs the meter reads higher like on Saturday the meter read 458 and Libre 360.
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Interesting how they’re all different- I wonder if placement has to do with it, or if it’s just sometimes bad sensors (or differences in the sensors.) I have personally experienced a Libre sensor saying that a cat was hypo under 50 and then the Human meter had the number at more like 75 (a good number)
 
Maybe I will just stay with the ear pricks for now if the sensor isn't that accurate. I'll have a think and decide on the day of the appointment.
 
What is your shot time again? Eastern time, I know since you are in Mass., but what is the shot time? From that yellow on the SS, it looks like you will not have to worry about a low preshot number this evening.
 
I just checked his SS and see that he has a pink #. No worries. He will get better preshot numbers soon. I think he was doing a lot better on the 3 unit dose -- if trying to give grey hairs to his mum with lower preshots :-)
 
i do both blood and libre 2 sensors. I'm using the sensor maybe once or twice a month and doing blood in between. I like the libre when I do curves. It's a lot easier especially at 2 am. For the most part I think they are reliable but I did get some lows on the libre and the numbers were fine with blood. I do like the alarm feature especially at night if he's dropping too low. I have problems sometimes getting them to last 14 days. My last one lasted 9 days.
 
Suzanne & Darcy said:
I just checked his SS and see that he has a pink #. No worries. He will get better preshot numbers soon. I think he was doing a lot better on the 3 unit dose -- if trying to give grey hairs to his mum with lower preshots :)
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The pink was exactly where I was expecting it. Every time I've done a reduction it's always the morning test that comes in high. Hoping that by Friday morning we will be back on schedule.
Also need to slightly reduce his food he's been eating way too much and is now 14.6 lbs and he should be 12 lbs.
 
Just read the article on BG and Libre sensor there is quite a difference unless the BG is stable. Bit disheartening.
 
Holtfam6 said:
i do both blood and libre 2 sensors. I'm using the sensor maybe once or twice a month and doing blood in between. I like the libre when I do curves. It's a lot easier especially at 2 am. For the most part I think they are reliable but I did get some lows on the libre and the numbers were fine with blood. I do like the alarm feature especially at night if he's dropping too low. I have problems sometimes getting them to last 14 days. My last one lasted 9 days.
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This was why I wanted to put the button on to get a curve but doesn't seem that its that accurate unless your at a stable level. Sad
 
Claire and Kaz said:
Just read the article on BG and Libre sensor there is quite a difference unless the BG is stable. Bit disheartening.
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It is a little bit, but as long as you kind of understand the differences and what to expect, it can still be a useful tool. You always have the regular ear test as a back up to verify things - but you probably would save that to verify low numbers. It does complicate things on the spreadsheet a bit because you have to note when you are using the human meter.
 
My cat bounces a lot. I don't think we have really stabilized yet. I have found if you scan too much, the sensor will wear out quicker. I was doing some hourly checks when I first started using them (the nurse in me and thought Id have the perfect curve). Mine don't usually last the 14 days. I've come to the conclusion that I'm fine if it doesn't last the 14 days. If I can get a few days of data, I'm happy. If I'm questioning if I need a dose adjustment, I like the libre to get a better picture. I can use the graph screen to get an idea of what he's doing when I didn't scan. Chance gets spunky and physically tries to remove them. I've had to replace the dressing in less than 24 hours of being on. I do like the sensor though. I have it set to alarm when he drops below 60 which is helpful at night. You just have to have the sensor in the room he's in. Plus, I can spot check him at night much easier than blood checking at 2 am. If I remember when I did an active quality control, mine was 30-40 difference at times compared to blood. Blood is always going to be more accurate than interstitial fluid that the libre picks up on. I always double check with the blood meter if I feel or sense something is off. There is a face book group on the libre system for pets. They have lots of helpful advice. Basically, you have to find out and use what's best for you and your cat.
If you've never used the libre, you can get a free one to try. You just can't say your using it for pets.
 
Chrispooky12 said:
I just shot a 67 lowest shoot ever! He gets 2.75 units, I'm scared but I did it.
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Not sure I would have the nerve to give a full dose that low. As I am home I can check Kaz's blood hourly for the next 4-5 hours and then hopefully go to bed or stay up all night.
Give you lot credit

Just looked at your spreadsheet and I see that you are mainly in the green and blue area but you don't seem to reduce your dose? When you get green I thought you reduced by .25. Your cat seems like a perfect candidate for remission?
 
Claire and Kaz said:
Not sure I would have the nerve to give a full dose that low. As I am home I can check Kaz's blood hourly for the next 4-5 hours and then hopefully go to bed or stay up all night.
Give you lot credit

Just looked at your spreadsheet and I see that you are mainly in the green and blue area but you don't seem to reduce your dose? When you get green I thought you reduced by .25. Your cat seems like a perfect candidate for remission?
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I'm following TR & I just posted yesterday to ask about reductions & was told 3xs under 50 or 40 & he gets a reduction. I can only hope for remission as we all do but he has been diabetic for close to 3yrs. He started on Novlin because I didn't know any better. Then he was on prozinc & doing well but was stuck at the same dose, so he's been on Lantus for 4 1/2 mons now. If he's that low at shot time tomorrow I won't be shooting the full dose. TR or not I can't monitor him tomorrow & I hold the syringe.
 
Chrispooky12 said:
I'm following TR & I just posted yesterday to ask about reductions & was told 3xs under 50 or 40 & he gets a reduction. I can only hope for remission as we all do but he has been diabetic for close to 3yrs. He started on Novlin because I didn't know any better. Then he was on prozinc & doing well but was stuck at the same dose, so he's been on Lantus for 4 1/2 mons now. If he's that low at shot time tomorrow I won't be shooting the full dose. TR or not I can't monitor him tomorrow & I hold the syringe.
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It's strange as I think we are both following the same procedure but I have been told by at least 4 long time member that if he goes into green he automatically earns a reduction. Only reason I did not reduce this time was because I reduced the insulin and I felt due to this he had no longer earned the reduction due to my cowardice.
 
Claire and Kaz said:
It's strange as I think we are both following the same procedure but I have been told by at least 4 long time member that if he goes into green he automatically earns a reduction. Only reason I did not reduce this time was because I reduced the insulin and I felt due to this he had no longer earned the reduction due to my cowardice.
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I've gotten different replies from different long time members.I think it all depends on really what your comfortable with & if you can monitor.

Your boy looks alot like my daughter's boy. He's a handsome boy. I think Kaz has a great chance at remission, just keep doing what your doing. :bighug:
 
Claire and Kaz said:
It's strange as I think we are both following the same procedure but I have been told by at least 4 long time member that if he goes into green he automatically earns a reduction. Only reason I did not reduce this time was because I reduced the insulin and I felt due to this he had no longer earned the reduction due to my cowardice.
Click to expand...
I just looked at my last thread & it says reduction if he drops below 50 3xs reduction if he goes below 40 once, just wanted to clarify that.
 
Chrispooky12 said:
I just looked at my last thread & it says reduction if he drops below 50 3xs reduction if he goes below 40 once, just wanted to clarify that.
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Interesting. Based on what I was told Kaz should have a reduction tomorrow as he is green. 40 is below where he should ever be that's the danger zone. Do find this a bit odd?
 
Claire and Kaz said:
Interesting. Based on what I was told Kaz should have a reduction tomorrow as he is green. 40 is below where he should ever be that's the danger zone. Do find this a bit odd?
Click to expand...
Yes I saw that, I was looking at his spreadsheet when you added the 78 he just hit! Go Taz go just let your momma get some sleep later, hopefully my boy let's me get some sleep too!
Yes I agree 40 is dangerously low...I may just have to set an alarm & test him @+9 tonight, just depends what he's @ when it's bedtime I guess.
 
Holtfam6 said:
My cat bounces a lot. I don't think we have really stabilized yet. I have found if you scan too much, the sensor will wear out quicker. I was doing some hourly checks when I first started using them (the nurse in me and thought Id have the perfect curve). Mine don't usually last the 14 days. I've come to the conclusion that I'm fine if it doesn't last the 14 days. If I can get a few days of data, I'm happy. If I'm questioning if I need a dose adjustment, I like the libre to get a better picture. I can use the graph screen to get an idea of what he's doing when I didn't scan. Chance gets spunky and physically tries to remove them. I've had to replace the dressing in less than 24 hours of being on. I do like the sensor though. I have it set to alarm when he drops below 60 which is helpful at night. You just have to have the sensor in the room he's in. Plus, I can spot check him at night much easier than blood checking at 2 am. If I remember when I did an active quality control, mine was 30-40 difference at times compared to blood. Blood is always going to be more accurate than interstitial fluid that the libre picks up on. I always double check with the blood meter if I feel or sense something is off. There is a face book group on the libre system for pets. They have lots of helpful advice. Basically, you have to find out and use what's best for you and your cat.
If you've never used the libre, you can get a free one to try. You just can't say your using it for pets.
Click to expand...

Sadly they don't hand out free sensors in Massachusetts pretty much the only state that they don't. I like the button as it's easier at night but I did not realize the difference was this much. Bit worrying knowing this as next time I travel I will now be more worried than normal.
 
Chrispooky12 said:
Yes I saw that, I was looking at his spreadsheet when you added the 78 he just hit! Go Taz go just let your momma get some sleep later, hopefully my boy let's me get some sleep too!
Yes I agree 40 is dangerously low...I may just have to set an alarm & test him @+9 tonight, just depends what he's @ when it's bedtime I guess.
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I believe that +6 is when the insulin really kicks in so I will be up till midnight tonight just to make sure. He usually only eats 0% carb food but I gave Kaz some 4% about 5 mins ago. I know that anything under 10% is considered low carb but I don't agree so i hate going over 5% and prefer to stay at zero.
 
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