? 2/27 Toulouse PMPS 86

Toulouse’s Mom

Toulouse’s Mom

Member
Toulouse was 122 two hours before preshot. His preshot is 86. We are going to stall another 30 minutes to see, but I could use some advice on what to do in these situations. Thank you!

Also could anyone help me understand why we’ve been seeing the lowest numbers right at preshot? Is it normal for his nadir to have moved like that?
 
First of all, congratulations on the reduction earned with the bg falling under 90. If the bg rises over 150 and you can monitor and have supplies, you could shoot a token dose. Are you following your vet’s advice because I see different dosing during the day than at night. Your ss says SLGS but it’s not in the signature. I think 2.5 has been too high a dose. I would try 2.0 both cycles if my cat. If the next test is not over 150 I would shoot 1.0. Almost everyone here finds it best to shoot the same dose both cycles unless you need to shoot a token dose. If you shoot a token dose you would go back to 2.0 in the morning.
 
tiffmaxee said:
First of all, congratulations on the reduction earned with the bg falling under 90. If the bg rises over 150 and you can monitor and have supplies, you could shoot a token dose. Are you following your vet’s advice because I see different dosing during the day than at night. Your ss says SLGS but it’s not in the signature. I think 2.5 has been too high a dose. I would try 2.0 both cycles if my cat. If the next test is not over 150 I would shoot 1.0. Almost everyone here finds it best to shoot the same dose both cycles unless you need to shoot a token dose. If you shoot a token dose you would go back to 2.0 in the morning.
Click to expand...
Thank you for your help! When you say token dose is that 1.0 or something else?
 
Did you get another test? It’s not on your ss. A token dose would be a reduced dose. You have been shooting 1.0 if too low. What is the BG now?
 
tiffmaxee said:
Did you get another test? It’s not on your ss. A token dose would be a reduced dose. You have been shooting 1.0 if too low. What is the BG now?
Click to expand...
The next test was 86 still. We are going to do a reduced dose at 1.25 I think based off of how he responded earlier this week. Hopefully the right decision and I’ll be up monitoring him.
 
How to handle lower than normal preshot BG:
number:

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
 
tiffmaxee said:
With SLGS you don’t shoot if under 90
Click to expand...
Apologies, I will be completely honest I have not updated that part of my spreadsheet mostly because I do not know which method I’m really doing or understand the difference.
We got to the 2.5 and 2 based off what our vet has told us to do after a long time of SLGS it feels like.
 
No apology necessary. It’s hard for us to give solid dosing advice if not following one of our methods. Since you feel comfortable shooting under 90 I wonder if TR would be something you would consider? Have you looked at the dosing method directions? With TR you need at least 2 tests each cycle which you do and need to feed a wet or raw diet, no dry. You shoot if over 50 if you can monitor. Reductions are earned if under 50 . With SLGS reductions are earned if under 90 and you hold doses a week and then evaluate the dose, With TR doses are held a minimum of 3-5 days depending on how low a dose takes your cat. I’m over symplifying this. Look at the methods again. We can help you if you follow one of them.
 
tiffmaxee said:
No apology necessary. It’s hard for us to give solid dosing advice if not following one of our methods. Since you feel comfortable shooting under 90 I wonder if TR would be something you would consider? Have you looked at the dosing method directions? With TR you need at least 2 tests each cycle which you do and need to feed a wet or raw diet, no dry. You shoot if over 50 if you can monitor. Reductions are earned if under 50 . With SLGS reductions are earned if under 90 and you hold doses a week and then evaluate the dose, With TR doses are held a minimum of 3-5 days depending on how low a dose takes your cat. I’m over symplifying this. Look at the methods again. We can help you if you follow one of them.
Click to expand...

I have looked over the two methods a few times since diagnosis but for some reason can’t really wrap my head around them. Which is why it seems as though I’ve been doing a mix of both methods. I think maybe starting with SLGS and now moving into more a TR space. TR does scare me a bit and gives me pause only because I’m not able to monitor him 24/7.

He’s my best friend though so I really want to get this right. He is on an all wet food diet and I try to at least do 3 or 4 tests a day. So do I need to think about sticking to TR? I definitely want to avoid skipping doses (unless necessary) as i hated seeming him bounce so much and he’s finally been starting to be more like himself. He also has neuropathy from how long it took us to get him moving towards blues and greens.

I really appreciate you taking the time to help!
 
Toulouse’s Mom said:
I have looked over the two methods a few times since diagnosis but for some reason can’t really wrap my head around them. Which is why it seems as though I’ve been doing a mix of both methods. I think maybe starting with SLGS and now moving into more a TR space. TR does scare me a bit and gives me pause only because I’m not able to monitor him 24/7.

He’s my best friend though so I really want to get this right. He is on an all wet food diet and I try to at least do 3 or 4 tests a day. So do I need to think about sticking to TR? I definitely want to avoid skipping doses (unless necessary) as i hated seeming him bounce so much and he’s finally been starting to be more like himself. He also has neuropathy from how long it took us to get him moving towards blues and greens.

I really appreciate you taking the time to help!
Click to expand...

You don’t need to follow TR IFit makes you uncomfortable. How about following SLGS strictly and see how that goes? That means you dint shoot if under 90 and takes reductions if the bg falls under 90. If you take earned reductions you likely won’t need to give reduced doses or skip. You most likely will be able to give the same dose both cycles. If you try that and don’t get the results you like, you could then try TR. What do you think?
 
tiffmaxee said:
You don’t need to follow TR IFit makes you uncomfortable. How about following SLGS strictly and see how that goes? That means you dint shoot if under 90 and takes reductions if the bg falls under 90. If you take earned reductions you likely won’t need to give reduced doses or skip. You most likely will be able to give the same dose both cycles. If you try that and don’t get the results you like, you could then try TR. What do you think?
Click to expand...
Apologies for the delay in response! I was up all night trying to monitor and not spiral, just some feline diabetes fun!

I am still a little confused on the SLGS. What's the difference between taking under reductions and reducing doses? Also, is there a lower chance of remission with SLGS? Thank you for your help!
 
With TR you reduce if the BG falls under 68 with the AT meter and 50 if using a human meter. With SLGS reductions under 90.
With TR you would not normally take back to valve reductions. With SLGS any time then falls under 90 a reduction is earned, you reduce the dose the next cycle. That becomes the new dose until the BG falls under 90 on the new dose. If it happens the next cycle you reduce. So reductions can come quickly. You hold doses longer with SLGS unless a reduction is earned.

If you follow either of our methods the goal is to find a dose you can shoot every cycle. Lantus is a depot insulin so shooting lots of different doses doesn’t really take advantage of the depot. So shooting 2.5 in the morning and 2.0 at night doesn’t work well normally.
Have you read the sticky on depot?
 
Last edited:
With TR you reduce if the BG falls under 68 with the AT meter and 50 if using a human meter. With SLGS reductions under 90.
With TR you would not normally take back to back reductions. With SLGS any time the BG falls under 90 a reduction is earned, you reduce the dose the next cycle. That becomes the new dose until the BG falls under 90 on the new dose. If it happens the next cycle you reduce. So reductions can come quickly. If it doesn’t fall under 90 for 7 days you decide then whether to increase, decrease, or keep the dose the same. Either way TR you hold at least doses 5 days once you see blue or green.

It’s hard to explain but we can help you learn what to do if you pick a method.
https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
 
You must log in or register to reply here.
Back
Top