?17/3 PMPS 14.3 Djoko - reduced dose?

Marj & Djoko

Marj & Djoko

Member Since 2020
Hello,
I skipped Djoko's insulin dose yesterday night (6 at PS) and gave him his insulin this morning. I wanted to give his ears a break so I did not test him this morning. I was expecting him to be in the 20s and he is very low. He received 1.25U this morning. What do I do? Is 1.25U too much now? Not a long time ago, he was around 25 at PS.
Please help.
Merci
Marj & DJ
 
No I did not. As mentioned above, I wanted to give his ears a break. I skipped yesterday night shot and gave him 1.25 this morning.
 
OK. I understand wanting to give his ears a break, but you shouldn't give a shot without at least a pre-shot test. As you can see from tonight's numbers, they can always surprise you with a low number!

I think Djoko is giving some signs that he's needing a little less insulin these days. If his ears are hurting, I'd recommend another skip tonight (hate to do it, but we still don't really have enough data to shoot a number like this), and maybe even trying a lower dose, such as 1.0U, tomorrow. We need to find a dose that allows you to shoot twice a day, comfortably.

@Bron and Sheba (GA) , your thoughts?
 
Nan & Amber (GA) said:
OK. I understand wanting to give his ears a break, but you shouldn't give a shot without at least a pre-shot test. As you can see from tonight's numbers, they can always surprise you with a low number!
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Duly noted. No more assumptions. We skipped a dose less than a week ago and he was at 27 PS but will ALWAYS pre-shot even when I skip...
 
What about now. Should I retest or feed him?
He is very hungry and meowing for food.

Have you ever seen a pattern like that? I do think 1U would be better yes.
 
If you've decided to skip, you can give that poor starving boy his meal :).

You will want at least one more test later tonight, just to see how he's doing and to make sure he isn't going any lower. The only reason to test right now would be to help make the shoot/don't shoot decision.
 
Bron and Sheba (GA) said:
Yes I would skip the dose as well. He does look as if he’s needing less insulin. I would also test again during this cycle to see how he is going.

yes feed now.
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OK merci! I will skip and give him 1U and do random tests. I think his nadir is after +6.
Thank you very much. It is encouraging to see that he seems to need less. Maybe his pancreas is waking up.
 
Bron and Sheba (GA) said:
Yes I would skip the dose as well. He does look as if he’s needing less insulin. I would also test again during this cycle to see how he is going.

yes feed now.
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Djoko ate and I just tested him and he is already at 14.3 I am a bit disappointed because he will spend the night high. Would it be possible to give him 0.5? I am on schedule.
 
Marj & Djoko said:
Djoko ate and I just tested him and he is already at 14.3 I am a bit disappointed because he will spend the night high.
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Don't worry. He'll come back down! We have a saying here, "better a day too high than a moment too low." Besides, lately it seems like his bounces have been pretty short-- he'll be back down before you know it!
 
Marj & Djoko said:
Djoko ate and I just tested him and he is already at 14.3 I am a bit disappointed because he will spend the night high. Would it be possible to give him 0.5? I am on schedule.
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I don't know if you saw but edited my post while you liked the post. Should I still skip or dive a reduced dose (for tonight)? Normally, what is the impact of a meal on BG level? Is it that instantaneous?
 
Well, it usually takes about 30mins for a meal to hit and start to affect BG numbers.

If you were to shoot late, it would affect your schedule going forward. How late is it now?
 
Sorry, just saw the "I am on schedule" note. If so, I think you could give a dose tonight if you want to give some insulin. You'll still want to get at least one more test tonight.
 
Nan & Amber (GA) said:
Sorry, just saw the "I am on schedule" note. If so, I think you could give a dose tonight if you want to give some insulin. You'll still want to get at least one more test tonight.
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Hello, I gave him insulin this morning at 6h15 because he has not receied his insulin yesterday night and did not want him to be hyper for too long. I am flexible given that I am working from home (COVID 19) but I understand it is important for diabetic cats to have a routine.
I normally shoot him betweeh 7h45-8h15/19h45/20-15. It is now close to 20h20. What would make more sense: skip or reduced dose?
And by reduced dose, 1U or 0.5U? When should I retest - before shooting or later tonight? I
 
I think it is up to you. If shooting now doesn't move you off your preferred shot schedule too much, he's high enough to shoot. You could even do a full 1.0U if you wanted (0.5U is also an option if you wish).

For reference, here's how we move dose times in a planned way to get back "on schedule" once its shifted off: 15mins per shot, or else 30mins per day.

Marj & Djoko said:
When? After the test I suppose?
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Yes; I'd suggest a test between +2 and +4 (whatever is convenient for you).
 
Nan & Amber (GA) said:
I think it is up to you. If shooting now doesn't move you off your preferred shot schedule too much, he's high enough to shoot. You could even do a full 1.0U if you wanted (0.5U is also an option if you wish).

For reference, here's how we move dose times in a planned way to get back "on schedule" once its shifted off: 15mins per shot, or else 30mins per day.



Yes; I'd suggest a test between +2 and +4 (whatever is convenient for you).
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Ok. Is he high enough because of the food? Should I retest him and we base the dosage on the result?
 
Nan & Amber (GA) said:
I think it is up to you. If shooting now doesn't move you off your preferred shot schedule too much, he's high enough to shoot. You could even do a full 1.0U if you wanted (0.5U is also an option if you wish).

For reference, here's how we move dose times in a planned way to get back "on schedule" once its shifted off: 15mins per shot, or else 30mins per day.



Yes; I'd suggest a test between +2 and +4 (whatever is convenient for you).
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I do not understand "or 30mins per day". Does it mean if I normally shoot at 7Am, either 6h30 or 7H30 would work but ideally 7h15 or 6h45?
 
Marj & Djoko said:
I do not understand "or 30mins per day". Does it mean if I normally shoot at 7Am, either 6h30 or 7H30 would work but ideally 7h15 or 6h45?
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It means (for example), if you would prefer to shoot at 7am-7pm, but got off schedule so that you shot at 8pm one night, you have two options for getting back on schedule:

shoot (day 1) 7:30am-7:30pm, (day 2) 7:00am, 7:00pm or
shoot (day 1) 7:45am, 7:30pm, (day 2) 7:15am, 7:00pm

with of course a longer time of shifting schedules if you are more than an hour off.
 
Marj & Djoko said:
Ok. Is he high enough because of the food? Should I retest him and we base the dosage on the result?
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Well, only guessing here, but I think that going from 5.7-14.3 is pretty clearly more than just food-- he's going up all on his own (plus food). So that's why I say it's probably safe to shoot (if you'd prefer to keep him on some insulin).

As for dose, for the same reason it's probably safe to shoot his new full dose, 1.0U. We don't base the dose amount on pre-shot values, the goal is to find a consistent dose that you can shoot twice a day. That said, if you are feeling nervous about shooting and are looking for an in-between option with not shooting, a half-dose of 0.5U is also an option.
 
Nan & Amber (GA) said:
Well, only guessing here, but I think that going from 5.7-14.3 is pretty clearly more than just food-- he's going up all on his own (plus food). So that's why I say it's probably safe to shoot (if you'd prefer to keep him on some insulin).

As for dose, for the same reason it's probably safe to shoot his new full dose, 1.0U. We don't base the dose amount on pre-shot values, the goal is to find a consistent dose that you can shoot twice a day. That said, if you are feeling nervous about shooting and are looking for an in-between option with not shooting, a half-dose of 0.5U is also an option.
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Yes it may well be that his insulin was wearing off. I could give him a skinny 1 and retest before I go to bed. I am starting to believe that it all happens at the end of the cycle for him (see last BG curve). I will give him snack during the night.
Thank you!
 
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