? 1/28 Noogi AMPS 274, +2 306, +7 128, +11.5 59, PMPS 79

Helen + Noogi

Helen + Noogi

Active Member
Yesterday's post

Thank you for the confirmation to reduce Noogi's dose after his dip below 5 (90) yesterday. This morning we went down from 2u to 1.75u. I was able to check on him at lunchtime and he was sitting at a nice 7.1 (128) at +7. Surprised to find him on the low side when I got home today - got a reading of 3.3 (59) at +11.
He was hungry as he had not eaten his lunch (was using up last of a food he's not keen on and he said no thanks) but ate his normal food now.

Now I'm not sure what to give him tonight - another quarter dose like last night, or skip altogether?
I'll check him again in a a bit ** update: now 4.4 (79), usual PMPS time

And I'm not sure if he needs another dose reduction to 1.5u now, or do I stick to 1.75u for a few more days?

Grateful for some guidance @Wendy&Neko @Staci & Ivy @Chris & China (GA)
 
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Helen + Noogi said:
Yesterday's post

Thank you for the confirmation to reduce Noogi's dose after his dip below 5 (90) yesterday. This morning we went down from 2u to 1.75u. I was able to check on him at lunchtime and he was sitting at a nice 7.1 (128) at +7. Surprised to find him on the low side when I got home today - got a reading of 3.3 (59) at +11.
He was hungry as he had not eaten his lunch (was using up last of a food he's not keen on and he said no thanks) but ate his normal food now.

Now I'm not sure what to give him tonight - another quarter dose like last night, or skip altogether?
I'll check him again in an hour.

And I'm not sure if he needs another dose reduction to 1.5u now, or do I stick to 1.75u for a few more days?

Grateful for some guidance @Wendy&Neko @Staci & Ivy @Chris & China (GA)
Click to expand...
HI Helen, if Noogie is still under 90 when it's time to shoot you can either stall (without feeding) to see if he will come up on his own.
You don't want to shoot if he's under 90 when you need to decide what to do.

It's best to post for help at that time and use the Question Mark in the drop down subject line.
Let me post this then I will post more...
I don't know who is around now to give some guidance
@Wendy&Neko @Angela & Cleo @Suzanne & Darcy @Christie & Maverick
 
You do have a few options when shooting a lower than typical preshot. Here is from the STicky:

How to handle a lower than normal preshot number:
Until you collect enough data to know how your cat will react, we suggest following the guidelines in the
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. 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.

As it says, with experience you'll be able to shoot anything above 90 when following SLGS.

Is there a history of DKA or Ketones?
 
How long until your shot time?

More information:
You hold the syringe and the choice is yours. You can continue to stall without feeding until he is at a number you're comfortable shooting. Although, the numbers may decrease without food making the decision to shoot even harder.
You can give a reduced dose. Keep in mind that the depot from the previous shot will affect the first half of this cycle.
You can also skip!

Can you monitor if you do give a dose? Do you have medium and high carb foods and karo syrup or honey?
Enough testing strips for your meter?

If you stall, can you alter your schedule tomorrow to work your way back so you are shooting 12 hours later?
 
Thanks for that Staci.

Staci & Ivy said:
HI Helen, if Noogie is still under 90 when it's time to shoot you can either stall (without feeding) to see if he will come up on his own. You don't want to shoot if he's under 90 when you need to decide what to do.
Click to expand...

Unfortunately he has been fed already. Very hard to withhold food for an hour when he is used to his supper the moment I get home! :D
He's still under 90 so I guess I skip this evening's dose?
Got about an hour to decide.
As you can see on his spreadsheet he's quite often on the lower side in the evening, and tolerates his dose okay.
Usually higher in the morning. I can't quite figure out why. Could be that he eats more at night (especially now, its hot summer weather where I am).

Staci & Ivy said:
Is there a history of DKA or Ketones?
Click to expand...

Nope <crosses fingers>
 
Staci & Ivy said:
How long until your shot time?

More information:
You hold the syringe and the choice is yours. You can continue to stall without feeding until he is at a number you're comfortable shooting. Although, the numbers may decrease without food making the decision to shoot even harder.
You can give a reduced dose. Keep in mind that the depot from the previous shot will affect the first half of this cycle.
You can also skip!

Can you monitor if you do give a dose? Do you have medium and high carb foods and karo syrup or honey?
Enough testing strips for your meter?

If you stall, can you alter your schedule tomorrow to work your way back so you are shooting 12 hours later?
Click to expand...

I can monitor him this evening and I'm well set up with emergency supplies. I'm not going to give him a full dose but maybe a very reduced dose. Will decide soon. Only limited wriggle room with my schedule tomorrow so we'll see. Not panicking!
Thank you :bighug:
 
** UPDATE**

Decided to skip dose this evening, as he was still 79 an hour after he was meant to have shot and up to 115 two hours - but this was with food.

My question now is what dose does he get tomorrow?
I've just reduced dose to 0.75u. Do I stick with 1.75u for a couple more days and see how it goes ?
Or I drop down another 0.25 to 0.5u right now?
If I have understood the SLGS method every drop below 90 means a dose reduction right away?
And I have cut some high carb food from his diet recently, which might also be why I am seeing the lows. So down to 1.5u tomorrow seems sensible.

Confirmation or advice welcome :)
 
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Helen + Noogi said:
** UPDATE**

Decided to skip dose this evening, as he was still 79 an hour after he was meant to have shot and up to 115 two hours - but this was with food.

My question now is what dose does he get tomorrow?
I've just reduced dose to 0.75u. Do I stick with 1.75u for a couple more days and see how it goes ?
Or I drop down another 0.25 to 0.5u right now?
If I have understood the SLGS method every drop below 90 means a dose reduction right away?
And I have cut some high carb food from his diet recently, which might also be why I am seeing the lows. So down to 1.5u tomorrow seems sensible.

Confirmation or advice welcome :)
Click to expand...
Hi Helen, I’m hoping you get some advice before your morning shot time.
I would think you would reduce The dose again like you mentioned since he dropped again below 90.
It certainly seems that since you have cut out high carb food from his diet that may be making a big difference in his need for insulin.
So you will definitely need to keep close tabs on what he’s doing in response to insulin. I just would like to see you given proper guidance on how much to reduce his dose.

One thing I would do in your title is instead of saying PMPS change it to PMBG which indicates that it was just the glucose measurement, but you skipped the dose.
Great job keeping a close eye on Noogi.
If you don’t get any further direction from anyone post another comment in a little while to see if you can get someone to answer. “
You may want to put a question like “dose help needed.”

Wishing you a very safe evening. :bighug::bighug:
 
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