10/21 Simon AMPS 134

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Simon'sMommy

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Still not giving him any insulin but this was the highest reading he has had in a while (on 10/16 he was 131 which was the only other reading over 130 since his last shot on 10/15) so we are keeping an eye on it. Although he is OTJ right now, he is still not giving us numbers we would like to see consistently. He is over 100 at all pre shot tests and although he is almost always between 70 and 90 at what would be at +6 if he was getting a shot, we are unsure if this is low enough to warrant keeping him off insulin altogether. Should we be giving him say 1/4 unit with numbers like he has been showing us (averaging between 115-128 most of the time) or should we keep him OTJ for the two week trial period? He has not had any insulin at all since 10/15 when he had a 1/2u only.

I am confused as to what I should do. I am worried that giving him insulin with these reasonably low numbers (all under 135 all week long) would crash him and give him a hypo but still am not happy that he is often over 120 either.

Any advice would be greatly appreciated. Please take a look at his spreadsheet and tell me what you think. Does he get a small dose (no one would be home most of the day to monitor) or should I keep him OTJ and see what happens in the two week trial. Thanks in advance.
 
Difficult question, Joyce. The usual "wisdom" is that you want kitties going off the juice in double digits most of the time, with a downward trend. Most remission cats run in double digits in the 70-90 range, but some are always in the 40s and 50s.

But it is hard to be agressive and give insulin when you are so close to those lower ranges. There is a way to give a "drop" of insulin. (i'll find it and post it). Could you give a drop at pmps and plan to observe a little overnight (maybe a before bed test and an alarm to catch nadir?). If you get lucky, the drop might last through the pm and daytime cycle and then dose again at night.

Also, check through the ss of cats in the Remission thread above. People used different methods when they got numbers in the lower ranges. Lots had to chase the number (shooting when the kitty got to their chosen number - usually in the 120 range.)
 
Sue, thanks so much for your response and the link. The problem is I am using U40 syringes and do not have any U100 syringes to micro-dose with that accuracy. I could eyeball it and expel drops until I get to what would be about .1u I guess and then use something to gauge it. I am unsure if .25 would be too much for him and that is the worry. I can easily eyeball .25ish (never perfect with these syringes) but since we will not be home to monitor, that could be waaaay too much with his recent numbers. So, tonight I will try giving him a tiny bit if he is over 100 at PMPS test and see what happens as I can stay up to get a nadir reading and see where he is (and a few before that even as I know I will be worried shooting if he is in the 120's) This is a hairy time for sure! But, I don't want him in the 120's consistently. I want him under 100 for remission. Thanks again for the response. Will see what happens tonight.
 
One thing that worries me about dosing Simon at all though is that he is consistently in the 70's to 90's at what would be +6 if he were having insulin. Does this not mean that giving him a dose would bring him down too low at that time? I am worried about this as he seems to spend the day in green numbers but is a little higher before his breakfast and his dinner as evidenced by the 115-135 readings I am getting at that hour. What about the lower numbers mid-day? Do they count?
 
Yes, they do. And you don't want them below 40. The way to manage them is to feed him and bring them back up if they head down lower than you would like.

It also could be that offering him some food about 4 hours before each shot might bring those preshot numbers down. You might try that before you try a little more insulin. (If his pancreas is working, food should lower his numbers. The preshots could be higher because he hasn't had anything to eat in a few hours?)
 
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