12/19 Kitty Cat AMPS 47/63, +.5 69, +1.5 44, +2.5 76, +3.5 59, +5 85, +10 97, PMPS 117, +2 156

Definitely I think safety is the priority so get him above 50...but I don't know about shooting once he's above 50 or if you just skip because he's so low. I know nothing how all this plays in with DKA.
 
Here's what the sticky says:

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.

Using the overlap by shooting low is a great way to take advantage of Lantus/Levemir’s long, flat cycles, once you have learned to do so safely.
 
I would stall and see if she would come up. 47 is pretty close to 50. Oh good, Bhooma is here! I've skipped shots with Ruby who also had DKA. I think it's a problem when the DKA is recent and there are still ketones, but Kitty Cat's episode was a while ago and her ketones are negative, right?
 
PerfumedCatMom said:
I think it's a problem when the DKA is recent and there are still ketones, but Kitty Cat's episode was a while ago and her ketones are negative, right?
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on 9/13 I skipped a shot because he was vomiting and couldn't keep food down. then he was small for ketones, but hasn't had them again.
tiffmaxee said:
Can you monitor as long as needed? What % carbs did you feed?
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yes, not a problem. I fed 1tsp FF gravy turkey 15%
He's playing with his toys right now, behavior is nothing out of the ordinary
 
I would feed some more 15% and shoot your new reduced dose. The depot is pretty full so it will be good to feed more mc at the beginning.
 
tiffmaxee said:
I would feed some more 15% and shoot your new reduced dose. The depot is pretty full so it will be good to feed more mc at the beginning.
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How much MC? He usually gets 6tsp LC breakfast.
Edit: I gave 3tsp MC since that's what was left in the can. Shot 3u. will test again in 30.
 
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We want her to stay above 50 as the depot is in play so if in doubt feed extra mc. If she starts to drop don’t hesitate to add a little hc.
Last night I would have not fed at +4 and tested at +5. Then I would have fed and set the auto feeder. I saw the test late in the cycle in the 80’s though so this morning must have been quite a surprise.
 
tiffmaxee said:
Last night I would have not fed at +4 and tested at +5. Then I would have fed and set the auto feeder. I saw the test late in the cycle in the 80’s though so this morning must have been quite a surprise.
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noted for next time! and yes, I thought we'd be okay when the +10 was 83
 
The basic rule is to feed the 40s (or any number below 50). It's trickier at shot time. If it were me, I would have retested because it looks like you had a dropping number at shot time. Unless you are confident with regard to managing low numbers, I generally don't recommend shooting a dropping number. A different approach would have been to have waited 30 min without feeding and see if numbers were heading up, providing the retested number was above 50.

That said, please monitor VERY carefully. You shot a food inflated number with not much time to see if the HC was going to wear off and just where the numbers would land. It's possible that numbers might drop back down. If they are dropping again, intervene early. In other words, if you test at +1 and numbers are in the 50s or even low 60s, prop them up with a bit of MC.
 
Sienne and Gabby (GA) said:
The basic rule is to feed the 40s (or any number below 50). It's trickier at shot time. If it were me, I would have retested because it looks like you had a dropping number at shot time. Unless you are confident with regard to managing low numbers, I generally don't recommend shooting a dropping number. A different approach would have been to have waited 30 min without feeding and see if numbers were heading up, providing the retested number was above 50.

That said, please monitor VERY carefully. You shot a food inflated number with not much time to see if the HC was going to wear off and just where the numbers would land. It's possible that numbers might drop back down. If they are dropping again, intervene early. In other words, if you test at +1 and numbers are in the 50s or even low 60s, prop them up with a bit of MC.
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ahhh i just read this, noted for next time. I'm definitely not comfortable managing low numbers yet.
 
What does this mean for his PM dose?Does he get another reduction on top of the one earned last night? Also since I delayed his shot by 30 mins, can I shoot 15 mins early tonight and 15 mins early tomorrow morning?
 
Tge higher depot is in play so a second reduction is not earned. Given how active this cycle is unless she’s bouncing I don’t think I would shoot early tonight. If still low post for help. It might require a skip or token dose. I hate skipping with a possible DKA or ketones. Whether to shoot early would depend on how high or low the bg is at preshot.
 
Sorry, just catching up on updating my post and SS. Very exhausting day. It's +10 now and I fed him again just for extra extra extra measure leading up to PM shot.

+6.5 fed (88), +7.5 held (81), +8.5 fed (80), +10 fed (97)
 
He's at 117 now, 15 mins before +12 so I think it's okay to shoot early to get closer to original shot time?
Edit: Okay I shot 3u 15 mins early and depending on how he is tomorrow, I'll try to shoot 15 mins early again to get back to our original shot time. Fed 4tsp LC and will get a +1
 
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