? 6/24 Bella AMPS/16, +6/8.1, +8/6.3, +10/7.1, PMPS/10.6, +2/13.3

Tara and Bella

Member Since 2023
Hi all,

I have been willing these blue numbers to come but now they are here I’m scared about our PMPS at 7pm tonight!

I’ve reviewed the numbers for shooting, stalling and not shooting!
( for my reference later!!
  • 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.)

I’m just doing a pre-emptive strike here ahead of time. Also today I did some mid to afternoon curve checks… can I call this my curve day or should I do it tomorrow as well? I feel this is enough of curve evidence of the nadir. Going by these curve numbers I am maintain 1.75U.
 
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Hi Tara sorry no one got back to you sooner. It's good that you gave something.
I see that you're following the SLGS dosing method. It's really good that you referred to the sticky for guidance.
I think you have enough data that next time you can shoot the full dose if the BG is 150 (8.3) as long as you can monitor and have food and supplies to steer the numbers and keep kitty safe :cat:. And
With more time you'll be able to lower that to 90.

It looks like Bella was heading up anyway since her am+10 was 128 and the PMPS was 191.

She'll recover. :) It looks to me that she is heading up and if you want get another test at +3 just to be sure before calling it a night.
 
Hi Tara sorry no one got back to you sooner. It's good that you gave something.
I see that you're following the SLGS dosing method. It's really good that you referred to the sticky for guidance.
I think you have enough data that next time you can shoot the full dose if the BG is 150 (8.3) as long as you can monitor and have food and supplies to steer the numbers and keep kitty safe :cat:. And
With more time you'll be able to lower that to 90.

It looks like Bella was heading up anyway since her am+10 was 128 and the PMPS was 191.

She'll recover. :) It looks to me that she is heading up and if you want get another test at +3 just to be sure before calling it a night.
+3/11.4 So she dropped back down
 
Yep I’ll stay up.

It’s so strange because I have been wanting these healthy number but seeing the numbers are here they are scary!

Regarding next time, or this time I could have shot full dose or should I have done a half. Honestly I don’t know how to work out 25% of 1.75U so I went with my gut on 0.5U.
 
It’s so strange because I have been wanting these healthy number but seeing the numbers are here they are scary!
Not strange at all! Very normal. We've all been there. My first green I reached for HC :oops:

Regarding next time, or this time I could have shot full dose or should I have done a half.
If it were me, I would have shot the full dose because the +10 number was 70points lower than PMPS. This means to me that the insulin shot is waning, numbers increasing ...ok to shoot the full dose.
BTW just because I say this doesn't mean I wouldn't be nervous as all heck shooting :bighug:. I would be very nervous! Sometimes I still am :oops:
When I am, I remind myself that the stickies here provide us with the tools necessary to keep kitty safe. As long as you can monitor, have testing supplies and HC food/syrup, the caregiver is in control.
:bighug:
 
That makes sense. I was tossing between 0.5-1U tonight but I didn’t want to send her into hypo then be bouncing and starting all over again!

Can you give any advice on what you would do tomorrow morning regarding shot?

Should I…
If above 11.1 return to 1.75U
If between 11.1-8.3 give 1U

Not sure?
 
Can you give any advice on what you would do tomorrow morning regarding shot?

Whenever I'm concerned about the next morning's shot, I set an alarm to get a PM+10 or +11, then at AMPS I will be able to see what the BG is doing on its own. If the number is the same or higher I shoot the full dose as long as I am home to monitor and have the supplies etc etc etc.

You have a lot of data for a little less than a month so that is GREAT!
Looking at your spreadsheet, I think you can shoot the full dose with any BG over 150 mg/dl (8.3 mmol/L) provided you can monitor.
If under 150 mg/dl (8.3 mmol/L), then I would stall without feeding, post and ask for assistance, and test again in 20-30 minutes to see if the BG is rising. Sometimes, the BG can go down without food, so posting for help and put something like “BG level xxx, stalling, please HELP” in your thread title.
 
Thanks for that positive enforcement about my data, it’s hard to know if we are doing ok but I’m learning so much! Thanks for the guidance on shooting above 8.3 and stalling if bellow, then I can ask for “help” or make an informed judgement call on a reduced or skipped dose.

These lower numbers are really scary but I’m going to embrace them because I want them to be our new normal!!! For Bella’s sake.

Question—— shooting her full dose above 8.3 is about helping earn reductions when she can be monitored?
 
shooting her full dose above 8.3 is about helping earn reductions when she can be monitored?
Yes and No. The goal should be Regulation not necessarily earning reductions. From the Sticky -The Basics:

'What is Regulation?':
There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":​
    • Not treated - blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs
    • Treated, but not regulated - often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs
    • Regulated - generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia
    • Well regulated - generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia
    • Tightly regulated - generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin
    • Normalized - 60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin

A cat needs as much insulin as she needs. The Tightly Regulated number range is what's referred to here as the "healing" greens and blues. They are indeed scary but like you said:
but I’m going to embrace them because I want them to be our new normal!!! For Bella’s sake.
That's a GREAT ATTITUDE!!
 
Feeling a little disappointed ☹️ Bellas bounced to 28.8, very clear I should have been more bold last night with a higher dose! I suppose I wasn’t ready to push my limits on Shooting higher in the 8.3 to 11.1 zone!

I gave her full dose this morning and I’m treating yesterday’s curve as a maintain dose result.

Should I try get some tests in today?
 
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