Zappa PS126 +2 204 +8 519

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Zappa’s mom

Zappa’s mom

Member Since 2022
*Sigh* I was hoping to not see red (519) for a long time. Zappa tested 126 this morning so no shot.

He normally gets his PM shot at 9pm, can I do 8pm or does this mess him up? He has not even eaten yet, I don’t know why the 519. I didn’t give his AM shot because of the 126 after food.

suggestions?
 
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@Zappa’s mom
Hi when you want some advice or suggestions you should put
a ? first in your title then maybe Advice Needed
In your title that you have no you should put AMPS 126 not just PS :cat:
I'm am going to tag a few members for you to take a look at your SS
You need to test at least one more time after your PMPS test say around +5 or +6
I read in your post your vet suggested no shot under 250 I see some members don't agree with that, neither do I
From the SLGS sticky
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
 
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Thank you for the formatting suggestions- noted.

Yes, that’s correct - my vet says no shot if 250 or lower. I did discuss dosing with him a bit. He increased to 2.5 from 2.0 and said that I could adjust down if I wanted to but he does not support dosing if 250 or lower.

In this case however, Zappa was at 126 AMPS so the 250 wasn’t really a question.

I am hoping for feedback on whether or not I can give PM dose one hour earlier than usual. Thoughts?

Thank you so much for replying to my post!
 
Since you didn't give insulin this morning yes you can shoot 1 hour earlier
So do you plan on shooting tomorrow morning at 8 AM?
Will that be you shoot times now 8 AM and 8 PM?
 
Zappa’s mom said:
*Sigh* I was hoping to not see red (519) for a long time. Zappa tested 126 this morning so no shot.

He normally gets his PM shot at 9pm, can I do 8pm or does this mess him up? He has not even eaten yet, I don’t know why the 519. I didn’t give his AM shot because of the 126 after food.

suggestions?
Click to expand...
Next time you get a lower than normal preshot stall, don’t feed and test again in 20 minutes to see if the BG is rising.
Also post and ask for help.
If you skipped this morning you can bring forward the PMPS to an earlier time shot that suits.
 
Diane Tyler's Mom said:
Tyler says thank you :p
Zappa is a handsome boy , I love his mustache :cat:
Click to expand...

I just read all the years on your spreadsheet, you’ve obviously done a great job for your cat. If it were your cat and you got a 126, what would you have done?

I notice sometimes you gave “a drop” when you had a low preshot number. I’m guessing this is to keep things calm so the pancreas doesn’t go into a panic.

If we wait 20 minutes and retest, what number would you be looking for? And would you do a lower dose? Zappa’s getting 2.5.

let me just say I am only asking what would you do in your own situation? I realize you are not telling me what to do, and all my choices are my own.

Thank you Diane.
 
Bron and Sheba (GA) said:
Next time you get a lower than normal preshot stall, don’t feed and test again in 20 minutes to see if the BG is rising.
Also post and ask for help.
If you skipped this morning you can bring forward the PMPS to an earlier time shot that suits.
Click to expand...

Hi Bron, thanks for the message. I had a cat named Sheba too (my moms cat actually but we are all the same family). I’m sorry you lost your sweet girl, she was a beauty. ❤️
 
Diane Tyler's Mom said:
@Zappa’s mom
Hi when you want some advice or suggestions you should put
a ? first in your title then maybe Advice Needed
In your title that you have no you should put AMPS 126 not just PS :cat:
I'm am going to tag a few members for you to take a look at your SS
You need to test at least one more time after your PMPS test say around +5 or +6
I read in your post your vet suggested no shot under 250 I see some members don't agree with that, neither do I
From the SLGS sticky
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Click to expand...

Also about doing a curve…I can do it, but as you can see, his numbers are all over the place. If I do a curve on the 7th day, how can I make a judgement about his nadir from just that one day when things change so much? I’m struggling with this.

I was hoping to have some reasonable consistency before doing a curve.

Am I thinking about this wrong?

oh, I’m Suzanne by the way.
 
Zappa’s mom said:
Hi Bron, thanks for the message. I had a cat named Sheba too (my moms cat actually but we are all the same family). I’m sorry you lost your sweet girl, she was a beauty. ❤️
Click to expand...
Hi Suzanne…Thank you. Yes Sheba was a beauty and had a lovely nature.

Are you able to get some tests in during the PM cycles..?
A lot can happen in that cycle and unless you are testing you won’t know. Even a before bed test is a good idea. And if the before bed test is lower than the pre shot BG, that can be a sign that it will be an active cycle and I would get another test in later to see if the BG has continued to drop.
Also I can see you are following SLGS and you were doing quite well but once you got to 2 units you skipped a dose when the preshot was 240. ,Why was that? Was it because you had to go to work? And you skipped again at 231.
I would shoot any number over 200 while you are on the main health page.
Do you leave food out for him when you are at work?
And with SLGS you increase in 0.25 unit increments not 0.5 unit increments.
 
Bron and Sheba (GA) said:
Hi Suzanne…Thank you. Yes Sheba was a beauty and had a lovely nature.

Are you able to get some tests in during the PM cycles..?
A lot can happen in that cycle and unless you are testing you won’t know. Even a before bed test is a good idea. And if the before bed test is lower than the pre shot BG, that can be a sign that it will be an active cycle and I would get another test in later to see if the BG has continued to drop.
Also I can see you are following SLGS and you were doing quite well but once you got to 2 units you skipped a dose when the preshot was 240. ,Why was that? Was it because you had to go to work? And you skipped again at 231.
I would shoot any number over 200 while you are on the main health page.
Do you leave food out for him when you are at work?
And with SLGS you increase in 0.25 unit increments not 0.5 unit increments.
Click to expand...
 
Bron and Sheba (GA) said:
Hi Suzanne…Thank you. Yes Sheba was a beauty and had a lovely nature.

Are you able to get some tests in during the PM cycles..?
A lot can happen in that cycle and unless you are testing you won’t know. Even a before bed test is a good idea. And if the before bed test is lower than the pre shot BG, that can be a sign that it will be an active cycle and I would get another test in later to see if the BG has continued to drop.
Also I can see you are following SLGS and you were doing quite well but once you got to 2 units you skipped a dose when the preshot was 240. ,Why was that? Was it because you had to go to work? And you skipped again at 231.
I would shoot any number over 200 while you are on the main health page.
Do you leave food out for him when you are at work?
And with SLGS you increase in 0.25 unit increments not 0.5 unit increments.
Click to expand...

Hi Bron,

Our Sheba was all black and she was a sweet little cat. Sheba is such a good name for a cat.

Here’s the hard part - my vet set my guideline at no shot if we are at 250 or lower, that’s why I didn’t give the injection. Others on the website have told me they think the 200 rule is better. I’m really struggling with the idea of not following my vets guidelines.

We have a real shortage of vets where I live, and mine is awesome. It took me years to find him. I’m afraid if I do shoot lower and something happens, he will drop me as a client. But I am considering giving Zappa a small dose if under 250 based on what I’m seeing with his numbers, and everyone else’s numbers on their spreadsheets.

I work from home, so fortunately that’s not an issue for me.
There are a few tests after the pm shot on my spreadsheet. I’ve been giving his pm dose at 9pm and the latest I can stay up is midnight. His numbers are always lower at the +3 at midnight.

I gave his pm shot at 8pm tonight so I’ll do midnight again, and that will be +4. I feed him 4 times a day.

I will say his personality picked up considerably after the first week of insulin. Far more animated, walking around much more and is interested in his surroundings - he seems happier. He is also drinking a lot less water.
 
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Hi, Suzanne. I don't think I've stopped by previously.

First, what you tell your vet is entirely up to you. You do not have to share Zappa's spreadsheet or tell the vet if you've given a shot if Zappa is at a lower point than what the vet has suggested. You're at home with Zappa -- you're vet isn't! I truly suspect that those of us who use Lantus have more experience with the insulin than most vets. It has been popular here for almost as long as I've been a member of FDMB (I joined in 2009) and that's when the research on Lantus for cats was first being published.

The basic principle that makes Lantus such a good insulin for cats is, "shoot low to stay low." Lantus is a long acting, gentle insulin. It is unlike some of the shorter acting insulin that hit hard and drop numbers quite fast. Most vets have considerable experience using the older varieties of insulin such as Novolin or Vetsulin. With those insulins, especially early in a caregiver's experience, we would coach you to use a higher pre-shot number as a "no shot" point since the insulin can have an abrupt effect on numbers.

In practical terms, what that means is that in general, Lantus isn't as good as other insulin at bringing numbers down from higher ranges. (This is not to say that Lantus will not drag numbers down. It's just not the way it typically works. It's also why home testing is so important since cats don't like to be predictable.) So, if you're shooting lower numbers, you tend to see a flatter curve. If you take a look at Herman's spreadsheet -- he recently went into remission on Lantus -- you can see that Amy was shooting low pre-shot numbers. When I was treating my cat's diabetes, I would routinely shoot any number over 50.

The headache with seeing a lower pre-shot number and skipping the shot means you're likely to see a big jump in numbers by your next shot time. Because you skip the shot, numbers will be high. In addition, if the numbers are lower at pre-shot time, there may be a "bounce" because your cat isn't used to being in low numbers. If your goal is to get Zappa regulated, you'll want to think about getting comfortable with shooting progressively lower numbers so you can ultimately keep Zappa in normal range blood glucose numbers. You do have other options besides skipping. You can not feed and stall to see if numbers are rising or you can shoot a reduced dose. It also helps to remember that any adjustment to the dose has an effect on the Lantus depot. If. you skip or adjust the dose, your cycle count for the dose starts over. There's more information on how Lantus works in the sticky notes at the top of the Lantus board if you want to do some additional reading.
 
Thank you Sienna,

I am seeing a pattern the past two days which fits with your description. Again this morning, I had a low number, so didn’t shoot in keeping with my vets direction. But I think you’re right. I just gave him his PM dose. Here are the numbers for today:

AMPS 167 (NS) +1 173 +6 371 PMPS 434 (gave shot 2.5)

This is a similar scenario as yesterday. My question is this - if tomorrow morning he is the mid 100’s again, what dose should I give? I’m nervous about giving 2.5.

I understand we should look at the nadir to determine dosage, but his is all over the place. What if I give 1.0 and see how it goes? Or will that mess him up even more?

awk! Don’t know what to do. What do you think?

Thank you!!!!

suzanne
 
A couple of thoughts...

If you're responding to someone's question/post, you may want to tag them. You type the "@" sign and start to type out their user name. FDMB will supply a list of members whose names begin to match. Click on the person. The board will then let the person you're tagging know there is someone trying to contact them. If you look at the top right side of the page, there's an "Alerts" link that will list out who's responding to a message and provide a link. It's helpful since I would not have known you were responding to my post if I hadn't stopped by your thread. (I'm tagging you so you can see the alert: @Zappa’s mom)

How you deal with the lower numbers may be a bit of a practical issue. My first thought was that you might want to stall. That's a good approach providing your schedule is flexible. When I was managing my cat's diabetes, I had to leave the house for work so stalling wasn't a good option. When you stall, you do NOT feed your cat. You retest in 20 min or so and repeat the process until you see numbers that are rising. The idea here is that you are at the end of the cycle. Typically, numbers start to rise. In addition, you'll be feeding Zappa which would also cause numbers to rise. Where the flex in schedule happens is that if you've stalled for an hour, your next shot is due 12 hours later. You then have to walk the shot time back (either by 15 min every shot time or by 30 min once a day). That may not be feasible for everyone.

Shooting a reduced dose like you've suggested is another possibility. One thing to consider is you still have the depot in play. You don't always see a lessened response during the cycle wherein you reduced the dose. However, given the frequency with which you're skipping shots, I suspect Zappa's depot is not full. The other headache with a reduced dose is that you're "shot clock" has to reset -- your count for the number of cycles at a given dose restarts every time you either skip a shot or change the dose.

A third option that may make more sense is to reduce Zappa's dose. In many cases, if a caregiver is having to skip doses, it may mean that the dose is a bit too high. What's happening now is that you're giving a shot only once a day. You might want to consider dropping the dose back to either 2.0u or 2.25u and see if you are able to get pre-shot numbers you're more comfortable with. We also make dose changes in 0.25u increments. You've been increasing by 0.5u. (We do increase by 0.5u if nadirs are consistently above 300.) You may also want to try to get at least one test in before you head off to bed every night. Many cats experience lower numbers at night. Without more PM tests, you're missing half of your cat's data. Having that before bed test also means you can go to sleep with some assurance that Zappa is in safe numbers.
 
Zappa’s mom said:
I notice sometimes you gave “a drop” when you had a low preshot number. I’m guessing this is to keep things calm so the pancreas doesn’t go into a panic.
Click to expand...
Hi Suzanne
Only just seeing this now, you need to tag members when you have a question :cat:
The reason he was getting a drop dose and as because he was going into remission. When you see all green for 7 days you start to decrease the dose.
Since you were looking at my SS did you see before I started to give a drop dose I was giving 0.10 units , before that was 0.25
@Zappa’s mom
 
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Diane Tyler's Mom said:
Only just seeing this now, you need to tag members when you have a question :cat:
The reason he was getting a drop dose and as because he was going into remission. When you see all green for 7 days you start to decrease the dose.
Since you were looking at my SS did you see before I started to give a drop dose I was giving 0.10 units , before that was 0.25
Click to expand...

@Diane Tyler's Mom - yes I studied your chart and Herman’s chart too. We have had progress! Tonight I was faced with shooting below 250, I decided to do it. I decided on 1.0 - his normal dose is 2.5 but I just can’t do 2.5. I will test at +3.

Now I’m worrying about food, he eats Stella and Chewy wet and Stella and Chewey freeze dried raw. I’m concerned about phosphorus. Everything else he throws up and has diarrhea- I’ve tried lots of other food, always a fail.

My other cat - his brother - has crystals so he is on SO diet from Royal Canin. It stopped his crystals but I would prefer a healthier food for him too.

I found Dr Lisa years ago online and transitioned ALL my cats from dry food to wet food. It was brutal, they loved their dry food.

I honestly feel like I could’ve done better.
 
Bron and Sheba (GA) said:
Well done shooting the 221. Because it is the lowest you have shot, I would get a +2 to see how he’s going . Then go from there.
Click to expand...
Hi Bron, I know her vet has told her not to shoot anything under 250 , that's what she's been doing. She gave 1 unit tonight , wouldn't it have been better to give at least 2 or 1.75 units. Of course you know I have no idea when it comes to giving advice on doses :cat:
@Bron and Sheba (GA)
 
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Bron and Sheba (GA) said:
Also I can see you are following SLGS and you were doing quite well but once you got to 2 units you skipped a dose when the preshot was 240. ,Why was that? Was it because you had to go to work? And you skipped again at 231.
I would shoot any number over 200 while you are on the main health page.
Do you leave food out for him when you are at work?
And with SLGS you increase in 0.25 unit increments not 0.5 unit increments
Click to expand...
Me again, her vet told her not to shoot anything under 250 so that's what Suzanne has been doing
@Bron and Sheba (GA)
 
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Zappa’s mom said:
@Diane Tyler's Mom

245
Click to expand...
OK I guess you can call it a night since the +3 is higher than the pre shot.
If you want to can you leave him some low carb wet food out after you go to bed
Just be sure to pick it up 2 hours before you test tomorrow morning

Suzanne if I were you I would do a new post , we call it threads everyday start with the
Date. Zappa AMPS # and any other tests after that, continue on the same thread with his PMPS # and any additional tests after that
Much easier for us to follow along
Also link your previous days post to your new one every day
 
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Diane Tyler's Mom said:
OK I guess you can call it a night since the +3 is higher than the pre shot.
If you want to can you leave him some low carb wet food out after you go to bed
Just be sure to pick it up 2 hours before you test tomorrow morning
Click to expand...

@Diane Tyler's Mom
@Bron and Sheba (GA)

Thank you!
I don’t leave his food out - they eat before we go to bed and they’re pretty good about sleeping through the night. But I feel good about 245. It will be interesting to see what happens on the AMPS. It would be great if I can keep him in the blue and yellow zones consistently, for now.
I hope you both have a lovely evening ❤️
 
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