146 @ +10...Advice Requested for PM Shot Options

Hi All,

Yesterday Rewster was lower at her PM shot time than she typically has ever been, and its was under 200. I followed the sticky advice and stalled without food and posted to the forum. I ended up doing a half dose (.5 unit, U40) at +13, and it caused her to steeply (and scarily) drop which had to be mitigated with MC fancy feast. Here is that thread. Thankfully @Chris & China (GA) helped me out!

It seems like we may be on track for a similar situation tonight. What is your insight on how to handle tonight? I'd like to stick with the 5:30 am/pm shot times, so should I simply plan to skip the dose if she is under 200?

Also--she didn't eat all of her food this AM, I think because of feeling full from the fancy feast carbparty last night.

Today is the 18th day since diagnosis. Thank you in advance!

 

PMPS was 189. I skipped the dose for fear of a plunge and I don't have flexibility tomorrow for AM shot time.

 

I don't usually spend much time in this forum but wanted to see how Rewster was doing today. Looks like she didn't bounce too high after that fast drop last night and was clearing it fast!

Next time, since you had the 146 at +10 and 189 at PMPS, that's a pretty good sign that she's probably going to go higher, so if you can, stall without feeding and check again in 20-30. If the number went even higher, you could either give the scheduled dose or if you were concerned about another dive, just give a token dose like 0.25.

Stalling for 20-30 minutes doesn't necessarily mean you wouldn't be able to shoot at the regular time tomorrow, but since you did skip, IF you wanted to change her shot times, you could shoot anytime in the AM tomorrow. Looks like you shoot pretty early already though (5am?)

Anyway, at least you'll get to see what happens when you skip a shot. Every piece of data is good data!

 

Thank you so much for checking in on us! I was surprised at the lack of bounce this morning, too.

In retrospect I agree that the climb from 146 to 189 was quite a clear harbinger a token shot would be well tolerated. We do 5:30am/pm shot times so my partner has enough time to measure her at +2 reliably for each shot time, and so she isn't a menace waking us up in the middle of the night asking for food. Previous to our sugar journey, she had been asking for a 2:40am snack for 10 years so we're also breaking her of a night-food/free feeding habit.

I'm looking forward to seeing the story the data tells over the next cycle! I'm sure she'll be high in the morning but we shall see.

Thanks again for all you help! We need it! Have a great night.

 

Hi there. I’m sorry I was not around in the afternoon and evening yesterday and didn’t see your post until it was way after your shot time. Your kitty had earned a reduction down to .75 units on Sunday night with that drop below 90 (per SLGS). So going forward the new dose should be .75 units. None of the numbers in green were dangerous, but I certainly can see how they would be scary. I hope Rewster won’t be too high as a result of the skip last night. It looks like a token dose of perhaps .25 units would have been a better course of action. But no worries, you hopefully got some sleep. I will check in with you in the morning, okay?

 

I’m usually over on this ProZinc forum helping people. Can you post in the morning here?

 

Morning! I agree, thank you! @Chris & China (GA) also advised me in the main forum from my post on Sunday to go down to .75 units as a new dose thankfully I had planned to do that this morning.

I'm actually surprised she was at 320 this morning at her AMPS (I thought maybe she'd be in the low 400s). I gave .75 units. We'll be testing throughout the day and her 20cal snack and next test will happen at 7:30am.

220 cal/day is likely enough for her, yes? She has always been a smaller cat, but she's been anywhere from 9 to 12 pounds in her life so I figured to feed 220 based on the 20cal per pound for ideal weight. Thanks again!

 

Good about the AMPS. I think that already your spreadsheet shows some really good progress. I would like to help you. I will check in on her spreadsheet later at around +2.

 

Just checking in. I don’t see a +2 on her spreadsheet. I’m hoping for a nice cycle today!

 

Sorry about that, I think my partner updated the sheet after arriving to work. Doing well so far at 100 BG at +7!

 

@Suzanne & Darcy Checking in--her PMPS was 212. Judging on her nadir this morning I did .5 unit. I'll obviously monitor throughout the next few hours. Not sure if I should have stuck with the .75 unit dose but I was nervous.

 

Okay. This will hopefully give us some good data. What a nice cycle today!

 

Hi there. Things went okay last night. It sounds like Rewster is eating well today. Is everything else okay? Just checking in.

 

Hi! Thank you for checking in!! Everything seems to be going well so far today..especially that she’s eating heartily.

Running a little high BG-wise but at least will be very clear for the full .75 dose at her PM shot time.

 

Yes. I also hope that you can get some sleep tonight. A few of us on this ProZinc forum were just congratulating ourselves on being able to sleep tonight. I hope you will join us!

 

Hi! We're at 159 at PMPS. I'm going to stall for 30 minutes and then measure again to see if we're on the upswing or not.

 

She was on her way up so I did a token dose of .25 rather than skipping the dose like last time.

 

Very good! I hope it goes well. I know you will be monitoring the cycle.

 

Hi @Suzanne & Darcy. I have a question for you about dosing.

I'm finding it tricky to hold a dose for 7 days. She has shown a pattern for a bit and then either drops below 90 (which would mean a dose reduction with SLGS) or has a lower PMPS which causes me to token dose. How do I know when/if to switch to TR, and how do know when to transition to "full dose shoot" lower PS numbers?

 

Is the 146 after a stall without food? If so, what was the first number?

 

The 146 was without food. She had last eaten anything at around 10am. We're currently stalling and measuring again at 6pm.

 

Oh. Okay. I understand. She did earn a reduction down to .5 units on the night before last when she hit 65. I would start testing her at +2 to see if it looks like her +2 snack should be a few more carbs (8-10 percent maybe.)

 

Okay, will do. Thanks!

 

Did she go up, down, or stay flat with the stall?

 

159 at 6pm, so we gave .5 units with food and will monitor again at +2.

 

When following SLGS, a token dose, fur shot or skipped shot doesn’t restart the 7 day cycle count. 14 cycles gives us enough time to see what the dose is doing. Now, having said that, if in that seven days you have a whole bunch of times when the full dose wasn’t given, we would consider all the data carefully. Good luck with the reduction. You can always go back up in due time. I hope Rewster will start to smooth out a little bit.

 

Understood, thank you as always for the advice!! It helps us so much.

 

Wow. You’re already down to79. Did you try some MC because it’s so early in the cycle?

 

And I would test again in 30 minutes after giving the higher carbs to see if your numbers are stable, rising or going down.

 

Yes we gave her 1/2 tsp of 10% carb fancy feast on top of her typical snack at +2, and she floated nicely this past hour. We’re going to measure hourly until +6 and give her more snack as needed.

 

She’s doing well. Keep up the good work!

 

Thank you!! 93 @+5. We're going to get some sleep now. Have a great evening and thanks again!

 

@Suzanne & Darcy
Has Rewster earned another reduction tomorrow morning since she dropped under 90 again tonight following SLGS?

 

Hi Renee just a reminder don't forget to add that 93 @+5 , glad she came up for you

 

Yep. Rewster did earn another reduction. I don’t know if it will hold so close to the other reduction, but you can always go back up again if the numbers warrant it.

 

Gotcha. So we’ll do .25 for a week and then reassess. Thank you!

 

Yes. And depending on how things go, you may want to consider switching to MPM since you have been doing SLGS for about a month now.

 

Could you please give me some details on MPM? I'm unfamiliar.

 

Hi Renee did you reduce to 0.25 units this morning as advised since he earned the reduction. If it doesn't hold you can always go back up if the numbers warrant it like Suzanne said

 

Hi @Diane Tyler's Mom--This morning I did .5 units. This evening we'll do .25 units and continue that way for a week.

 

Great good luck

 

Thanks!

 

@Suzanne & Darcy

 

Yes. I am at the vet with my cat now and will get back with you on it later. MPM will allow you to change the dose more frequently (i.e. not hold the dose for a full 7 days) if the numbers warrant it. You can increase every 6 cycles if needed. Target nadirs are 50-120 (so the “healing greens.”)

 

Hoping all went well at the vet!

 

I’m not liking the higher numbers that I am seeing since the most recent reduction. If you want to hold for 6 cycles and switch to MPM (if you have had a chance to read over the sticky) we can raise her back to .5 units if it still looks like she needs a little more support after those 6 cycles. Did I send you the sticky? Anyway, it is pinned at the top of this ProZinc forum in the sticky entitled ProZinc Dosing Methods.

 

And yes, thank you. My sweet Ginger was dubbed a “little miracle” because she’s doing so well with her heart disease. The vet never thought she’d make it this long. She was just in for some bloodwork and a BP check. Will get bloodwork back on Monday so I’m hoping it’s okay. She takes Lasix so I always am worried about her kidneys. Today though she’s not wanting to eat for some reason. Hopefully it’s just stress from yesterday and she hasn’t picked up a virus or anything. I may break out the Fancy Feast soon — usually she gets the lower phosphorus Weruva foods.

 

I like the idea of monitoring the .25 for 6 cycles then switching to MPM after collecting the data. I did just read the sticky fully so now I know what to expect. Thank you!

Hoping Ginger starts snacking soon! I know it can take a while to bounce back fully from a vet visit!