12/30 Abby PMPS <200, Suggested dose?

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megmonger

megmonger

Member Since 2017
Prior thread here: http://www.felinediabetes.com/FDMB/threads/unusually-low-pmps.188725/#post-2099243

Abby had her first solid blue day ever today. Nice gentle curve, and first time ever with nadir <150. PMPS is 188. Based on her historical readings (see ReliOn spreadsheet), should I decrease from her 5.75 units like I did two nights ago? Rather unfortunately hubby fed her before I could stop him so while I am stalling on her insulin I'm not going to be able to get a good read of her BG without the effect of food. Notionally my plan right now is to test her at a half hour and give her some insulin once her reading is >200. But I'm guessing a bit. So, any further insight is appreciated.

Thanks everyone. :)

Also just a note on my spreadsheet - I tried typing in with the alternate format for stalled readings (eg. "174; 214@+13) but it's messing with the charts that I generate from it so temporarily I have my information captured in comment bubbles on the cells and in the notes section.
 
I'd SHOOT!!!

The numbers are coming up so that tells us the last shot is wearing off so it should be fine to shoot the scheduled dose.

Get a +1 and +2 so if you need to intervene, you can do it early

Shooting lower numbers is a gift....take advantage of it!

You don't adjust the dose based on the Pre-shot numbers like you do on Vetsulin....On Lantus, you should be holding the dose unless they drop below 90 (for SLGS)
 
Chris & China said:
I'd SHOOT!!!

The numbers are coming up so that tells us the last shot is wearing off so it should be fine to shoot the scheduled dose.

Get a +1 and +2 so if you need to intervene, you can do it early

Shooting lower numbers is a gift....take advantage of it!

You don't adjust the dose based on the Pre-shot numbers like you do on Vetsulin....On Lantus, you should be holding the dose unless they drop below 90 (for SLGS)
Click to expand...
OK, shot at +0.5.

I'm asking this genuinely and in hopes of returning some of the favor for all of the help I have received here - would FDMB be open to revising the wording in the SLGS protocol if I provided suggested edits? I edit technical documents for a living, and I think some small revisions (not in actual protocol but instead in phrasing) would greatly improve clarity for "newbies."
 
megmonger said:
would FDMB be open to revising the wording in the SLGS protocol if I provided suggested edits? I edit technical documents for a living, and I think some small revisions (not in actual protocol but instead in phrasing) would greatly improve clarity for "newbies."
Click to expand...

The message board is always open to suggestions.

I think the best place to put your suggestions would be the Think Tank Forum
 
megmonger said:
OK, shot at +0.5.

I'm asking this genuinely and in hopes of returning some of the favor for all of the help I have received here - would FDMB be open to revising the wording in the SLGS protocol if I provided suggested edits? I edit technical documents for a living, and I think some small revisions (not in actual protocol but instead in phrasing) would greatly improve clarity for "newbies."
Click to expand...
I’m all for that personally. I’ve found it a little confusing.
 
megmonger said:
I'm asking this genuinely and in hopes of returning some of the favor for all of the help I have received here - would FDMB be open to revising the wording in the SLGS protocol if I provided suggested edits? I edit technical documents for a living, and I think some small revisions (not in actual protocol but instead in phrasing) would greatly improve clarity for "newbies."
Click to expand...
Chris & China said:
I think the best place to put your suggestions would be the Think Tank Forum
Click to expand...
@megmonger
Actually, since you're talking about revising some phrasing, feel free to send me your suggestions. When we're talking about revisions to protocols... well, that's when we prefer discussion in a public forum such as Think Tank.
Thanks! Looking forward to hearing your suggestions.



 
Jill & Alex (GA) said:
@megmonger
Actually, since you're talking about revising some phrasing, feel free to send me your suggestions. When we're talking about revisions to protocols... well, that's when we prefer discussion in a public forum such as Think Tank.
Thanks! Looking forward to hearing your suggestions.
Click to expand...
@megmonger
Sorry, I forgot to come back to this last night...
Parts of the SLGS sticky are intentionally vague. These threads may offer some insight:
Proposed adjustment to Start Low, Go Slow protocol
Protocols: Myths Debunked
 
Jill & Alex (GA) said:
@megmonger
Sorry, I forgot to come back to this last night...
Parts of the SLGS sticky are intentionally vague. These threads may offer some insight:
Proposed adjustment to Start Low, Go Slow protocol
Protocols: Myths Debunked
Click to expand...
These are quite informative, thank you. :) I'm seeing more of the history and nuances now, and they make sense. I will say that those nuances did not come across to me as a "newbie" arriving on the boards here in early 2017. For instance, I see you describe that "SLGS is a thinking man's protocol... not steps to be followed." That context alone has already made it make much more sense to me. Now that I go back and relook at it, I see that the SLGS sticky is called a "Method" rather than a "Protocol." And I see the included caveats such as, "These are 'general' guidelines which have worked for many cats. However, "Every Cat Is Different". Learn how YOUR cat responds to the combination of food and insulin..." (which I read as a boilerplate legal-ish 'we can't promise this will work for everyone' catchall). Without having been here for the history though, the underlying intention was definitely missed by me. My initial experience here at FDMB was that I arrived, introduced myself, received very timely and caring responses, and was directed to the stickies that I read as two alternative step-wise processes to choose from.

Thanks to your links here I've now also read the http://www.tillydiabetes.net/en_6_protocol2.htm protocol. I realize that refers to tight regulation rather than the lay SLGS approach, but I will say that the explanations of "why" on that page have just answered several underlying questions I didn't even realize I had over the last year. Things make more sense now. Very helpful! :)

Probably the longest-running point of confusion for me, exacerbated for sure by my vet (long story for another day!), is that I could never seem to find a simple, succinct statement of what BGs should look like when you finally succeed at getting your cat to a good range (aka "hold the dose" phase). I can discern it immediately on the Tilly page, "Try to keep the cat at a dose where the BGs are in the 50 to 200 mg/dl range for as much of the day as possible." That! A goal to aim for. On the SLGS protocol, the corollary statement is, "Remember that with SLGS, your goal is to achieve flat numbers that are greater than 90." However, it is a bit buried toward the end. It probably took me 3 reads to find it. While it says "remember," unless you are really digging into the weeds it's not clearly stated earlier. And right now this statement is found after a section that I interpreted as only applying if things go wrong. The "Lather, Rinse, and Repeat" seemed to me the end of the overall protocol and I was supposed to do that until we reached remission (if ever). And I saw the bolded "How to handle a lower than normal preshot number" content as just a note in case something went wrong during the lathering rinsing and repeating. I also did not pick up on the "In the beginning" and subsequent "With experience" subsections you see there until after it was explained to me on this thread. I think something as simple as bulleting or labeled/numbered sections would help draw out the intended meanings here.

Anyway, my apologies for rambling. One of these evenings when the kids get to sleep on time I'd like to try putting together a tracked changes version with a few formatting approaches to illustrate my suggestions. All of which will be just that - suggestions - from a long-time "newbie" hoping to help more folks benefit from all of the tremendous knowledge and seasoned experience available from yourself and the rest of the folks on this board. Hope this makes sense.
 
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