12/13 Indy AMPS -123 (skipped am)

Libre? Or meter? He's still in good numbers right now. Unfortunately I can't give dosing advice but anything above 50 is good. Hopefully someone can help you with dosing soon.
 
I see that Christie is on the board--thought she might weigh in--perhaps she's looking at Indy's spreadsheet. She is far more experienced in giving dosing advice. Here is the blurb from the SLGS dosing method. I know that you haven't chosen a dosing method, but this one is the less aggressive of the two. I'm here to talk it through with you if you want. I asked about ketones because we don't like for kitties with ketones to skip doses, so it's good Indy doesn't have that issue in play.

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 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. When you have reached that stage, the following guidelines are suggested for Lantus, Levemir, and Biosimilars users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.
 
Yeah, I emailed my vet to ask if she wanted me to follow one of the dosing methods and I haven't heard back from her.

We aren't going anywhere today, so monitoring will be happening for sure. He is currently nomming happily on his lunch and I gave him his turkey tax for being good for the ear prick.

Would it be ridiculous to give him 1u so we don't skip completely but lower the risk of hypo?
 
Jessica & Indy said:
Yeah, I emailed my vet to ask if she wanted me to follow one of the dosing methods and I haven't heard back from her.

We aren't going anywhere today, so monitoring will be happening for sure. He is currently nomming happily on his lunch and I gave him his turkey tax for being good for the ear prick.

Would it be ridiculous to give him 1u so we don't skip completely but lower the risk of hypo?
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What is his bg now?
 
Sorry, I just got home and was trying to gauge info here and SS. If no ketones, I’d skip. I think you noted you are following vet advice, which is fine; however, you’ve already stalled for an hour and it will likely be difficult to adjust shot time now. If we want to apply the SLGS method, you’d need his number to be above 90 before shooting.
 
Aannndd he went right back to his food bowl. *Face palm*

And promptly regurgitated again.

(He hasn't had this problem in months....why today buddy. Why today?)
 
Poor fella!!!

Jessica, I know you've got your hands full right now, but when you get a chance, two things: first, when we are testing more than once in a time-slot, we stack those numbers in that time-slot on our sheets. It looks like this:

Screenshot 2025-12-13 at 2.07.34 PM.png


Second, the SLGS blurb that I posted mentions this: "With experience, you may find that lowering these thresholds may work well for your cat." What that essentially means is that, overtime, as Indy starts spending more and more time in the greens, you're going to start shooting in the greens (well below 150), and you won't necessarily need to adhere to the guideline of not shooting under a certain number that is outlined in the SLGS method (posted above). I mention this because it was confusing to me to begin with when Jude was following SLGS and when I had green preshots. I kept thinking that I shouldn't shoot if he was below 150, but "with experience," and data you will be shooting those lower numbers. Always feel free to check here, though, any time. And I hope the vet decides to approve a dosing method for you--it's so much easier when you have a method/guidelines to follow.
 
I hope he keeps a little food down. Once you have some time, can you please stack some of the BG readings in the +11 column.
Here’s an example:


In your case if I understand correctly I’d put Libre tests 123 @ +12, 101/91 @ +12.75, then I’d use the 66 @ +13.
 
I will do my best with the spreadsheet. :-). We have an abundance of data with the libre. I understand we will shoot below 150...but I guess I was concerned about the fact he was still going lower than his +10 and +11. Then waited a few minutes and it was even lower. Where do I put +13?

Picking up some fancy feast gravy lovers today, so we have some higher carb wet food in the house for him.

He kept the first bit of freeze dried salmon down and just gave him a bit more.
 
Jessica & Indy said:
I will do my best with the spreadsheet. :-). We have an abundance of data with the libre. I understand we will shoot below 150...but I guess I was concerned about the fact he was still going lower than his +10 and +11. Then waited a few minutes and it was even lower. Where do I put +13?

Picking up some fancy feast gravy lovers today, so we have some higher carb wet food in the house for him.
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You did the right thing today!! And you were right to be concerned with decreasing numbers at the preshot. He had a very late double nadir from that last cycle.
 
That is correct. Again, because we don't know the dosing method you are following, we can't make a recommendation about dosing decreases. And, again, as a reminder, if you were following SLGS, a decrease is earned when he drops below 90; that number is 50 when following TR.
 
And vet replied. She wants us to do 1u. Said it could have been a pancreatitis flare up and he still has some pancreas function.
 
Spoke to my mom today and something in the conversation got to me. I was explaining that we are having a rough time finding the right dose for Indy. And she said something along the lines of "maybe this is just his body shutting down". I know she didn't intend for it to be mean....but it hurt. Like overall he is still enjoying his life. He is still Indy, he wants his loves, his snacks, he is using litter boxes okay, eats food, drinks water...like his quality of life is pretty good. But when people say something like that, it makes me doubt that i am doing the right thing. He is not the first cat I have had that has gotten to 17 years old....but Louie has cancer and Skyla had stage 4 CKD and a mass in her bladder (pretty sure that was cancer too). In comparison, Indy is doing great! But the doubts are still there.

And then when I am typing this and crying...of course my Indy boy gets up out of his bed and gives me love.
 
I'm so sorry about your conversation with your mom. :bighug: Cat's out of remission are just harder to regulate the second time as the first time. We see it time and time again. But it looks like Indy is trying really hard, and his pancreas is healing some. You are doing a great job with him. Cats are so much more than their blood sugar numbers and it sounds like Indy is doing pretty well overall.

Reducing by 0.25 units sounds like a good option for tonight.
 
Wendy&Neko said:
I'm so sorry about your conversation with your mom. :bighug: Cat's out of remission are just harder to regulate the second time as the first time. We see it time and time again. But it looks like Indy is trying really hard, and his pancreas is healing some. You are doing a great job with him. Cats are so much more than their blood sugar numbers and it sounds like Indy is doing pretty well overall.

Reducing by 0.25 units sounds like a good option for tonight.
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I thought that reduction was good too. Vet wants 1u. She didn't even say anything about the different types of dosing.

Edit to add: I also have 14 other animals this vet sees, so I don't want to piss her off.
 
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