04/02 Bambi AMPS 422, +1 329, +2 303, +6.5 115, +8 123, PMPS 149, NS +1 142 +1.5 186

Caglar and Bambi

Caglar and Bambi

Member Since 2023
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As you may have followed earlier, Bambi fell to low BG levels of 28/30 at +3, 2 days ago evening from PMPS 248 and I lowered her dose by 2 steps from 1.75u to 1.25u right after that incident. Her BG rose the following days as expected to 400s and high 300s but today her PMPS is again unexpectedly low at 149/144. Her recorded nadir was around 120 yesterday and 115 today, but these figures and the ups and downs no longer make sense to me and I am having difficulty deciding what dose to give. Would you suggest the same dose, a step lower at 1.0u or a token dose at 0.5u?
 
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With SLGS you increase and decrease by .25. You decided to take a .50 reduction. Another reduction has nit been earned. You have shot similar bg before. I’d give a full dose of your 1.25 and get a +1 and +2. I’d feed lc then as well. If either bg is lower feed mc.
 
tiffmaxee said:
With SLGS you increase and decrease by .25. You decided to take a .50 reduction. Another reduction has nit been earned. You have shot similar bg before. I’d give a full dose of your 1.25 and get a +1 and +2. I’d feed lc then as well. If either bg is lower feed mc.
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True, but the levels don't seem to be behaving as they did previously. I had shot at levels between 150-200 with much higher insulin levels the past few weeks but nadirs fell max to around 70. Now even with a lowered dose the PS seems too low to me at below 150. The other day it was around 250 and it fell to 30 so I'm not confident with the current dose.

She's still feeding primarily on diabetic dry food (16% carbs) so her normal feeding is medium carbs I guess. I haven't made the transition to low carb wet food yet, waiting for the levels to stabilize
 
tiffmaxee said:
With SLGS you increase and decrease by .25. You decided to take a .50 reduction. Another reduction has nit been earned. You have shot similar bg before. I’d give a full dose of your 1.25 and get a +1 and +2. I’d feed lc then as well. If either bg is lower feed mc.
Click to expand...

Also, my logic for the 0.5u is from the guide:

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.
 
While dose adjustments are indeed made by 0.25u, the reduction previously was due to the fact that the pm dose should have already been reduced to 1.5u due to her getting in the 70s during the am cycle then seeing that pm cycle numbers again quite significantly under 90 earned another reduction, hence 1.25u was suggested :).

Numbers are on their way up from the 115 earlier today. Had she been continuing to drop through to PMPS I would have said a stall (no feed) and retest in 20 minutes to see if numbers are rising on their own would have been wise, but you have shot similar numbers, and have the ability to monitor. I would shoot 1.25u.
 
Caglar and Bambi said:
Also, my logic for the 0.5u is from the guide:

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.
Click to expand...
Yes, I’m glad you are familiar with the sticky, and in your case I think you do have good data on how your cat responds to insulin, so these general guidelines like not shooting or giving a token dose may not be necessary for you.
 
Christie & Maverick said:
While dose adjustments are indeed made by 0.25u, the reduction previously was due to the fact that the pm dose should have already been reduced to 1.5u due to her getting in the 70s during the am cycle then seeing that pm cycle numbers again quite significantly under 90 earned another reduction, hence 1.25u was suggested :).

Numbers are on their way up from the 115 earlier today. Had she been continuing to drop through to PMPS I would have said a stall (no feed) and retest in 20 minutes to see if numbers are rising on their own would have been wise, but you have shot similar numbers, and have the ability to monitor. I would shoot 1.25u.
Click to expand...

Thanks Christie, they have been rising but very slowly, +6.5 115, +8 123, PMPS 149, +1 142 and readings do vary quite a bit hence I'm hesitant. I also made the mistake of feeding her before deciding to stall and not giving a shot so the current readings will be because of the food I guess. :(

It's +1.5 right now so I guess I will test again and give her the delayed 1.25u shot and keep monitoring for 2-3 hours each hour. Hope everything goes well. I know the major effect of insulin comes hours later and I was pretty confident with similar cases but the incident the other day is making me a bit too paranoid. :(
 
It might be a wee bit late to shoot, unless you can adjust your shot time tomorrow. Of course, I completely understand, I don’t mess with the 30s ;) and I certainly didn’t see them so quickly in my journey with Mav, so your sense of cautiousness is understandable. You can always no shoot and pick things back up again tomorrow, Bambi will likely be unphased :bighug:
 
You’re welcome :), I’ll watch for updates.

Just a quick comment, since you shot late, you’ll need to capture the details to show the timeframe, by “stacking” the earlier numbers, and record them in the +11 column. Your shot at +13.5 then goes in the PMPS column. Here’s an example,


In your case I’d put 149 @ +12, 142@ +13 in the +11 column then 186 @ +13.5 in the PMPS.

No shenanigans tonight, Bambi, let’s see a nice flat cycle.
 
Christie & Maverick said:
You’re welcome :), I’ll watch for updates.

Just a quick comment, since you shot late, you’ll need to capture the details to show the timeframe, by “stacking” the earlier numbers, and record them in the +11 column. Your shot at +13.5 then goes in the PMPS column. Here’s an example,


In your case I’d put 149 @ +12, 142@ +13 in the +11 column then 186 @ +13.5 in the PMPS.

No shenanigans tonight, Bambi, let’s see a nice flat cycle.
Click to expand...

Thanks, I was stacking in the PMPS column, I will fix those tomorrow and move them to +11 column.

Fingers crossed.
 
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