4PM major dose concern/low glucose

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CORKY

CORKY

Member Since 2023
I've been noticing a pattern on the 1.75 dose, it seem Corky's glucose is best during the day until he feed at 4:PM / dose. please advise
 
Once again, I am dealing with drastic low glucose after 4 PM dose please advise before 4:00 AM dose
 
This is another thread you have just posted. Try and stick to one thread when asking the same question please otherwise it is too confusing for everyone.
https://felinediabetes.com/FDMB/threads/4pm-dose-concern.281032/
I think you need to reduce the dose to 1.5 U at the next dose with those drops of 59 and 69 in the last 2 cycles.
Any drop under 90 warrants a dose reduction.
@Suzanne & Darcy is a prozinc user so I will tag her.
 
just checked glucose low on 105 next dose at 4:00 PM. 1.75 should I dose/not dose/ change dosing
I'm afraid he's glucose will spiral down by dosing quick advise please

4:15 Corky eating his 4:00 pm meal checked glucose again rapidly decreasing it is now 83
do I dose or not
 
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I did read the top post however Corky had 83 glucose at meal time I dose as suggested 1.5 at 5:25 went down more to 66 . So I wont have to ask about dosing that is always on Corky's meal dose when do i not dose even on 1.75, 1.5
Every time is I'm the 100+ it goes down on a spiral gave him a shot of Karo just tested and it went up as fast as it goes down to 130
 
so from 1.5 give him 1.0 ? is after 3 that I feel the danger on dosing him that's when he spirals down from 130 is seconds to 60 - 50 if I dose on the 4: pm aren't I taking a risk even with the meal glucose spirals down from 3:44 - 7:08 my monitor is asking to test it has an hour glass with a drop of blood next to the number
 
mayte said:
so from 1.5 give him 1.0 ? is after 3 that I feel the danger on dosing him that's when he spirals down from 130 is seconds to 60 - 50 if I dose on the 4: pm aren't I taking a risk even with the meal glucose spirals down from 3:44 - 7:08 my monitor is asking to test it has an hour glass with a drop of blood next to the number
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No the new dose would be 1.25 units NOT 1 unit
I'm sorry I really don't understand what you're asking that's why I'm tagging Suzanne for you a prozinc user
@Suzanne & Darcy

Your previous post
https://felinediabetes.com/FDMB/threads/extreme-high-glocose.280986/
 
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Hi Maria,
Remember when Corky drops under 90, anytime, you need to reduce the dose. So with the PMPS of 83 and the subsequent drop to 66 during the cycle...that earned another reduction.
And with prozinc and SLGS you don't give the dose if the preshot is under 90.
If you get a lower preshot, you can stall, don't feed and test again in 20 minutes to see if the BG is rising.
Your new dose is 1.25 U

Maria, can you tell me what you are feeding Corky now please?
Please ask any questions if you are not sure about anything:)
 
Bron and Sheba (GA) said:
That is a lower preshot than you normally shoot so I would get a +2
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several people have been writing to me about +2,. the only +2 I know of is the one on the spreadsheet, which to me is 6:00 AM and those glucose numbers re there, this forum has me feeling so inadequate, even though I've read glossary and how to use it, I'm confuse and I have an A/A:banghead:
 
Bron and Sheba (GA) said:
Hi Maria,
Remember when Corky drops under 90, anytime, you need to reduce the dose. So with the PMPS of 83 and the subsequent drop to 66 during the cycle...that earned another reduction.
And with prozinc and SLGS you don't give the dose if the preshot is under 90.
If you get a lower preshot, you can stall, don't feed and test again in 20 minutes to see if the BG is rising.
Your new dose is 1.25 U

Maria, can you tell me what you are feeding Corky now please?
Please ask any questions if you are not sure about anything:)
Click to expand...

I was feeding him Meau Mix wet food, as of yesterday I bought the Fancy Feast recommended Such as chicken beef turkey 15%
 
mayte said:
several people have been writing to me about +2,. the only +2 I know of is the one on the spreadsheet, which to me is 6:00 AM and those glucose numbers re there, this forum has me feeling so inadequate, even though I've read glossary and how to use it, I'm confuse and I have an A/A:banghead:
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I'm sorry we are making you feel inadequate. That is certainly no our intention. You are doing a very good job. It is hard in the beginning for everyone, so we do understand.
The +2 is always 2 hours after the dose of insulin.
mayte said:
I was feeding him Meau Mix wet food, as of yesterday I bought the Fancy Feast recommended Such as chicken beef turkey 15%
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So it looks like you are feeding an all wet diet now...is that correct?
Is the FF chicken beef turkey 15%?
 
Suzanne & Darcy said:
The reduction should have been taken when the PMPS blood glucose number was 83, below 90. Reduce from 1.5 to 1.25. Or am I missing something? Be back in a bit.
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correct on the food
Corky started on 2.5 reduced to 2.0 reduced to 1.75 reduce to 1.5 that how we stand tonight, what dose should I give at 4:00 AM ?
right now it's spiraling down 78 I'm giving him a shot of Karo I don't think I'll sleep tonight the monitor's alarm for low glucose will be an all-night thing, it happens every time he's glucose starts declining after 4-5pm
I start a job on Saturday to be able to afford Corky's diabetes, with possible split shifts some nights after 5pm the store closes at 11:00 pm If not home I might find him dead
 
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Okay. I’m looking at the spreadsheet again. I see that Corky had 1.5 units of insulin this morning and he ended up at 83 at PMPS (evening preshot test.). So that means he should have had a new dose given for his evening cycle of 1.25. But he did not. This is okay because you were unsure and were trying to get help. So no criticism is to be found here. I remember what it was like in the beginning!
 
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Those Libre numbers are kind of wacky on your spreadsheet. What have you been feeding him at each hour /test/scan? What percentage of carbs. It’s really helpful to all of us (and will be for you too so you can learn Corky’s response to carbs) if you write in the comments section of your spreadsheet what you feed and when.
 
Suzanne & Darcy said:
Those Libre numbers are kind of wacky on your spreadsheet. What have you been feeding him at each hour /test/scan? What percentage of carbs. It’s really helpful to all of us (and will be for you too so you can learn Corky’s response to carbs) if you write in the comments section of your spreadsheet what you feed and when.
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I was feeding him Meau Mix as of yesterday I purchased as advised the 15% Fancy feast chicken, turkey and beef
always the same routine 4:00 AM feed/dose 4:00 PM feed/dose
the numbers are exactly as posted, that's why I've been so persistent on why this is happening, even reducing the dose the more I reduce the lower his numbers get after after his 4"00 PM feed/dose I need to get this right I start a job Saturday with spilt schedules mornings are good because I'll be home for the 4:00PM feed/dose, but when I get a shift after 5pm I wont be home until 11:30 PM I'm extremely concerned- glucose spiraling down again / shot of Karo and Fancy Feast gravy treat, I can't go to sleep with these low to lower numbers
 
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mayte said:
correct on the food
Corky started on 2.5 reduced to 2.0 reduced to 1.75 reduce to 1.5 that how we stand tonight, what dose should I give at 4:00 AM ?
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Your new dose going forward is 1.25. Do not shoot anything below 90 when following SLGS. I’m questioning the Libre numbers. That is why I asked about what you fed. The numbers are so up and down. I am afraid that I will not be up at 4 am Eastern. I do frequently get up at 4 or 4:30 and definitely will be up by 5, but have to hit the ground running if I get up that late. Have you read this from the sticky note on the ProZinc forum?


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.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Prozinc users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.

We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.
 
mayte said:
yesterday I purchased as advised the 15% Fancy feast chicken, turkey and beef
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That is very high carb food to feed a diabetic cat. Diabetic cats need a low carb diet under ten percent carbs. We save the high carb for when the cat drops below 50. I am sure Missed the explanation/recommendation for this food.
 
Well please take the reduction in the morning to 1.25. If he’s below 150 at preshot you can stall without feeding him anything for 20-30 minutes and retest to see if he’s on his way up. There are some other strategies we could try. We don’t have a lot of data on Corky on the spreadsheet yet, but you are doing such a great job of trying to keep him safe. We will help, and if we need to figure out something with your new job, we will try to do that too.
 
Suzanne & Darcy said:
Well please take the reduction in the morning to 1.25. If he’s below 150 at preshot you can stall without feeding him anything for 20-30 minutes and retest to see if he’s on his way up. There are some other strategies we could try. We don’t have a lot of data on Corky on the spreadsheet yet, but you are doing such a great job of trying to keep him safe. We will help, and if we need to figure out something with your new job, we will try to do that too.
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the night readings are the concern, not the mornings, I will wait 20-30 minutes as suggested and do 1.25 during the day is in the 200-300 range even with 1.75 it's been after the 4PM that the dramatic decrease begins, I was send a list of these foods to get better than Meau Mix I bought a 3 week supply should I go back to Meu Mix ? The data on the spreadsheet is all the data It was started the minute I received it the numbers not shown ed on certain dates is because of glitches with the sensor. I'm on it ever hour on the hour since this sudden decreases in glucose. I want to thank you so much for everything you've done if his glucose reads or stays low under 6-70's I should not dose correct.
 
mayte said:
e if his glucose reads or stays low under 6-70's I should not dose correct.
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That is correct but remember what Suzanne posted about this if
the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
 
mayte said:
I was feeding him Meau Mix as of yesterday I purchased as advised the 15% Fancy feast chicken, turkey and beef
Click to expand...
If these are the ones you are talking about they are medium and high carb foods for you hypo, when Corky's BG drops too low and you need to bring it up
For your Hypo kit
Med and High Carb food and some honey/karo



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

Between 11% and 17% is medium carbs.

18% and over is high carb.
 
Suzanne & Darcy said:
That is very high carb food to feed a diabetic cat. Diabetic cats need a low carb diet under ten percent carbs. We save the high carb for when the cat drops below 50. I am sure Missed the explanation/recommendation for this food.
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@mayte

The Fancy Feast Classic Pates are the low carb foods that are under 10%
Some are 2% and some are 3 %

I'm going to give you the food link so you can see that
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
When you look at the food chart go to where it says
Fancy Feast Classic , you will see the first one listed is Chicken Feast

You can even feed the Fancy Feast Roasted/Flaked/Chunky
The are either 4%, 5% , and 6% which are also ok to feed if you need a higher
low carb food

These are listed right under the Fancy Feast Classics
 
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good morning I- read Dr Pierce article very informative, when I got tis food chart, I understood that this is what I should be feeding, Corky. I purchased the cans,
they have the small 1 feed container.
What brans of food should Purchase going to Walmart this morning, I have the PRN prescription for the Royal Canin
glycemic wet foo, but i cannot order that until 2m week from today, that the insulin syringes is my reason to get a p/t job, would it cause too much damage giving the Fancy Feast for two more weeks or
is there an over the counter food i can but if you have a list please send
 
Suzanne & Darcy said:
The reduction should have been taken when the PMPS blood glucose number was 83, below 90. Reduce from 1.5 to 1.25. Or am I missing something? Be back in a bit.[/QU
Diane Tyler's Mom said:
If these are the ones you are talking about they are medium and high carb foods for you hypo, when Corky's BG drops too low and you need to bring it up
For your Hypo kit
Med and High Carb food and some honey/karo



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

Between 11% and 17% is medium carbs.

18% and over is high carb.
Click to expand...
Click to expand...
 
gave the dose recommended 1.25 , seeing the chart we can clearly see that he doses even with reduction and feeding , after the first hour of that his glucose start to spiral down. I'm not an expert but if we reduce the 4 PM dose
will keep his glucose in check
 
Bron and Sheba (GA) said:
You should be able to buy the fancy feast pates at Walmart without any trouble I would think.
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them will get them they come in individual portions, there's a difference in the Fancy Fest pate I got the classic collection with 3 flavors it's a soft pste
 
Bron and Sheba (GA) said:
Let’s see what the BGs are for this cycle.
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Bron and Sheba (GA) said:
You

we can’t really make a decision about the next dose until we see what happens this cycle.
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will you be able to make that decision before his 4:00 pm dose . i will continue to give data hourly even though I check every 1/2 hours concern of the rapid decrease, after the decrease it increases but never over 120+ 200's

you have bee the contact that has giving me precise and understanding instructions that I can understand immediately I appreciate it very much ;););)
 
I’m just checking in on Corky’s spreadsheet. So far so good this morning. Last night he actually had a really great cycle (just talking about the numbers here). He never dropped into lime green so he was safe the whole time. Those green numbers, while safe, are a little lower than the target range for BG when following SLGS (start low go slow) dosing method. Although I believe he is eating medium to high carb food that should be saved for times when you need to raise his blood glucose up. I am very sorry if there’s been confusion about what to feed him. I’m sure that Meow Mix is also high in carbs because I believe it’s full of grains and is a dry food. He could be slowly transitioned to any of the Fancy Feast Classic pates (no gravy). I say slowly transitioned because feeding lower carb food will result in lower BG numbers. There are other low carb and affordable pates that can be fed, including some of the Friskies pates. But I understand if you bought a three week supply and need to feed that. A lot of stores will allow you to return unopened cat food. You should keep some of those cans in reserve for your hypo kit. As Diane suggested, it’s a good idea to write the number of carbs on each can in the hypo kit with a Sharpie permanent marker.

On your spreadsheet, I see a lot of Karo syrup being used also at times. Karo syrup shbe reserved for times when your cat drops below 50 (human meter). That isn’t a criticism. I understand the fear of hypo especially when everything is so new. We can help you with what to feed and when also.
 
Suzanne & Darcy said:
I believe Corky had his morning shot three hours ago (since she shoots at 4 am and 4 pm Eastern - and that’s my same time zone and it’s 7 a.m. here now.). I have to leave to take a cat to the vet for a dental soon so I won’t be around.
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Will you be around for the 4pm shot Suzanne? Ill be an bed fast asleep in a couple of hours but Im sure @Bandit's Mom could be around if necessary for the 4 pm dose.
 
mayte said:
will you be able to make that decision before his 4:00 pm dose . i will continue to give data hourly even though I check every 1/2 hours concern of the rapid decrease, after the decrease it increases but never over 120+ 200's

you have bee the contact that has giving me precise and understanding instructions that I can understand immediately I appreciate it very much ;););)
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checking 1/ hour later 7:AM he is spiraling again glucose at 81 and dropping when at 7 was 124 and is decreasing very rapidly I can see it on the monito graph. I really feel that leaving him in the afternoons going to in this condition It's not going to be feasible, I don't want to get home to a unconscious or dead Corky I tested again now is 78 @7:38
something has to be very wrong with his dosing
still spiraling down will post 8AM numbers I checked 10 minutes after I posted the 78 7:38 now @ 7:48 went down to 75 and decreasing gave shot of Karo right now
 
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Maria, remember that if the BG drops under 90 you need to reduce the dose at the next insulin shot.
If you are ever unsure, always post and ask us
 
Bron and Sheba (GA) said:
Maria, remember that if the BG drops under 90 you need to reduce the dose at the next insulin shot.
If you are ever unsure, always post and ask us
Click to expand...

when I dose at 4:AM his glucose is good is the 4 PM I keep saying his glucose decreases by the minute and when the time comes to feed/dose is when I am petrified to dose most of the time have to give him a shot of Karo and wait till his glucose rises. I did this just at 7:48 AM now is when it went up at 240 so now instead of 1.25 ap PM dose decrease to 1.0 what happens if it's at 2 digits the
glucose
 
very well it will be only 1.0 stepping out for an errand now that he is gone from the danger zone thank you
 
Maria, I would continue with the 1.25 Unit dose unless he drops under 90.
And it doesn’t look like he will. It looks like he is on the way back up now.
 
mayte said:
I've been noticing a pattern on the 1.75 dose, it seem Corky's glucose is best during the day until he feed at 4:pM / dose. please advise
Click to expand...

that has been my point all along you are absolutely correct I went on an errand got home and now his glucose is rocket high see spread sheet he's never had this high glucose back-to-back for a while, his glucose decreases is a usually after 2:PM or right before feeding and dosing, I find these numbers are so random, and crazy I haven't given him the in between meal since yesterday
 
Bron and Sheba (GA) said:
Maria, I would continue with the 1.25 Unit dose unless he drops under 90.
And it doesn’t look like he will. It looks like he is on the way back up now.
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right now his glucose has been to very high since 9:AM (see spreadsheet I need to be advised on the 4PM feed/ dose if his glucose remain with these numbers please
 
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