? - 10/3 Jake NEED ADVICE FOR NEXT SHOT PMPS 86 | Feline Diabetes Message Board - FDMB

? 10/3 Jake NEED ADVICE FOR NEXT SHOT PMPS 86

Cloe & Jake

Cloe & Jake

Member since 2025
Hello,

I’d love some dose advice for tonight. I have been doing a bit of a hybrid TR protocol without success (tried to keep numbers above 60) but I’m now committed to the full TR protocol. I’ve sat on my hands all day with numbers in the 50s. Jake is due for his PM insulin now and only has a PMPS of 86 (compared to his AMPS of 473 this morning). I’m a bit worried about shooting and was thinking of giving a token dose of maybe 1-2 units. What do you think?

Thanks heaps
 
What a gorgeous run of green!

If you're nervous, I'd not feed Jake and stall for 30 min and see what his numbers look like. If they are rising, it's fine to shoot. Frankly, I strongly suspect he's going to bounce back into high numbers. Generally, with TR, you want to work your way down to shooting anything that's over 50. The only reservation is that you don't want to shoot if the numbers are dropping fast and far. Shooting a token dose will also mean that your shot clock starts over -- it's another 6 cycles before you can increase the dose.
 
Sienne and Gabby (GA) said:
What a gorgeous run of green!

If you're nervous, I'd not feed Jake and stall for 30 min and see what his numbers look like. If they are rising, it's fine to shoot. Frankly, I strongly suspect he's going to bounce back into high numbers. Generally, with TR, you want to work your way down to shooting anything that's over 50. The only reservation is that you don't want to shoot if the numbers are dropping fast and far. Shooting a token dose will also mean that your shot clock starts over -- it's another 6 cycles before you can increase the dose.
Click to expand...
We are at about 30 mins post shot time now and it’s up to 100. He’s a grazer so I don’t expect much of a rise with feeding. He generally maintains good levels with skipped doses until about +17 so there is a few hours of overlap to be mindful of.
 
I have ended up giving 2 units at +13 (one hour late) with BGL of 115. I liked the advice on Tilly’s webpage that said “It is likely, because of the way Lantus and Levemir work (they appear to work for >12 hours, therefore producing overlap between doses), you will face the problem of having a low pre-shot BG and wondering what dose you should give. Try reducing the dose the first few times to see what happens - in all likelihood the cat will have higher BGs as a result.” I decided to try a half dose just to learn what is safe for him and slowly work up from there with low pre shot levels.
 
Cloe, We also have this sticky on the forum which discusses shooting lower than normal preshots: Sticky - Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers. These guidelines are based on Tilly's, but they offer a bit more information.

Good luck with this half dose! Not only will the half dose likely cause higher BGs (as mentioned on Tilly's website), but you'll also have the bouncing factor because Jake isn't quite used to those greens yet, and when he experiences them, he'll likely bounce. This is normal; you can look at Jude's SS and see that he bounced quite a bit at the beginning of treatment. He still sees some occasional bouncing, but over time it's not quite as erratic or significant.
 
Last edited:
What they will always ask is if you have all the supplies on hand: MC/HC food, syrup/honey, enough test strips, and can you monitor? Onset is typically at +2/+3, but a +1/+2 test can give an indication of how active the cycle will be, so you'll want to grab those (and you'll have them on the CGM); if his BG at +1/+2 is 20% or so higher than preshot, it can signal that it won't be too active of a cycle; if it is 20% or so lower, you might expect an active cycle, which means his BG could drop. I hope you don't mind, but I'm going to tag @Sienne and Gabby (GA), @Bron and Sheba (GA), and @Bandit's Mom so that they will be on hand should you need some guidance since this will likely be a lower than normal preshot number. Good luck!
 
Last edited:
Mary & Jude said:
What they will always ask is if you have all the supplies on hand: MC/HC food, syrup/honey, enough lancets, and can you monitor? Onset is typically at +2/+3, but a +1/+2 test can give an indication of how active the cycle will be, so you'll want to grab those (and you'll have them on the CGM); if his BG at +1/+2 is 20% or so higher than preshot, it can signal that it won't be too active of a cycle; if it is 20% or so lower, you might expect an active cycle, which means his BG could drop. I hope you don't mind, but I'm going to tag @Sienne and Gabby (GA), @Bron and Sheba (GA), and @Bandit's Mom so that they will be on hand should you need some guidance since this will likely be a lower than normal preshot number. Good luck!
Click to expand...
I will need to leave the house from about +1.5 to +4 but I can watch his BG remotely and I’ll leave out some MC wet food for him. I do also need to leave again around +6 but I can probably take him with me then if he is running low. I have 50% glucose solution, lancets and all the supplies. Would it be better to try 3 units (since he has safely done 1 & 2 units on similar pre shot numbers) or should it be ok to give the full 4 units? Thanks
 
Cloe & Jake said:
I will need to leave the house from about +1.5 to +4 but I can watch his BG remotely and I’ll leave out some MC wet food for him. I do also need to leave again around +6 but I can probably take him with me then if he is running low. I have 50% glucose solution, lancets and all the supplies. Would it be better to try 3 units (since he has safely done 1 & 2 units on similar pre shot numbers) or should it be ok to give the full 4 units? Thanks
Click to expand...
I'm not qualified to offer dosing advice, so I'm hoping one of the more qualified folks will jump in here. It's probably super early for you folks on the other side of the world right now, so I'm not sure if Bron and Bhooma are up yet. How much time until his shot?
 
Mary & Jude said:
I'm not qualified to offer dosing advice, so I'm hoping one of the more qualified folks will jump in here. It's probably super early for you folks on the other side of the world right now, so I'm not sure if Bron and Bhooma are up yet. How much time until his shot?
Click to expand...
No worries. It’s due now so I’ve just given 4u. He looks like he was starting to rise and it was at 126. I keep playing it safe but I have to learn to shoot low, hopefully this will keep him in the green zone 😊
 
It's great that you shot the full dose. Shooting lower numbers can be scary at first, but with time you'll see that you get flatter cycles and better numbers overall when you shoot low.

He'll probably head up in a bounce from those greens you saw earlier, so he might not need MC. But just to be on the safe side, you could feed him some at +1.5 before you leave - if he hasn't zoomed up further by then
 
You must log in or register to reply here.
Back
Top