? 23/02, Maggie, AMPS 345 / +3 223 / +5 124 / +6 126 / +8 151 / +10 187

hellen_maggie

hellen_maggie

Member Since 2025
? - Maggie vomited several times after +6. Should I give the injection?

Hello everyone,

Thankfully, Maggie is doing much better after the difficult episode we went through. On 20/02 she started having repeated vomiting episodes, and we had to visit the vet twice for IV fluids and an anti-nausea injection. No insulin for 2 days. Thankfully, after the second visit to the vet the vomiting stopped, and since yesterday morning we have been back on schedule and resumed her insulin from where we left off.

Today her numbers look quite good for our standards, and we are slowly approaching PMPS. I suspect that tonight’s PMPS may be significantly lower than what we are used to seeing.

I’ve been re-reading the protocol, which says:
  • Below 150 mg/dL (8.3 mmol/L), don’t give insulin.
  • Between 150–200 mg/dL (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 again in a couple of hours, and decide based on that value
  • Above 200 mg/dL but below the cat’s usual pre-shot value, a reduced dose might be wise.

Because I don’t have much time to react between testing and giving the shot, and I still feel quite anxious since all this is still new to me, I would really appreciate some guidance.

If PMPS is between 150–200, which of the three options would you suggest in Maggie’s case? And if it is between 200–250, should I go with a reduced dose according to the protocol, given that her usual preshot numbers are 300+?

I would like to have a clear plan in mind beforehand, so I can feel more confident and prepared at shot time.


Thank you so much for your support. ❤️
 
With the SLGS protocol you don't shoot if it's below 90.
I think the options you are referring to above are in the case you don't feel comfortable to give the whole dose or you don't test enough.
Is Maggie eating? Is she feeling OK? Will u be able to test after the PM shot?
 
Normal BG for a cat is anywhere between 50-120 on a human meter.
222 is a good number to shoot. Later on when you're comfortable you'll be shooting when the numbers are in the normal range.
Question is how well can you monitor tonight?
 
That's ok. Some insulin is better than no insulin.
Keep testing and updating your spreadsheet. It will come in handy later on. We need all that data to know how the kitty reacts. It will be helpful later on when her pre shots number are hopefully lower.
My kitty is in remission right now but you're welcome to look at my SS to see how low i would shoot. As long as he was above 50 he was good to go.
Good luck 👍 🤗
 
hellen_maggie said:
So… I ended up giving 0.50. Maybe I lost my courage at the last minute... I guess I’m still a bit of a chicken when it comes to lower preshots😅Seriously… how do you ever get used to shooting lower numbers without having a mini heart attack first? 😅
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You did well to shoot .5 and not to skip the shot! Back on 18 Feb you shot a yellow that was only a little higher (and definitely in the same ballpark at tonight’s PMPS if you consider meter variance). If you are able to test her and feed her, you are in control of the cycle and can steer her numbers if you need to. Good job. Depending upon tonight’s numbers, you may be able to see that next time she has a similar preshot number you can give .75 units.
 
Karolina & Nestle said:
That's ok. Some insulin is better than no insulin.
Keep testing and updating your spreadsheet. It will come in handy later on. We need all that data to know how the kitty reacts. It will be helpful later on when her pre shots number are hopefully lower.
My kitty is in remission right now but you're welcome to look at my SS to see how low i would shoot. As long as he was above 50 he was good to go.
Good luck 👍 🤗
Click to expand...
Thank you so much Karolina🤗
I’ve looked at many spreadsheets like yours and I can see how low you were able to shoot. It’s really encouraging. I think I may just need more data first (and courage!) I’m still very scared and a bit insecure about shooting lower numbers.
I hope I can overcome this fear soon and that my little girl will do just as well.
Thank you for your advice. The help I’m getting here is truly invaluable. 💕
 
Suzanne & Darcy said:
You did well to shoot .5 and not to skip the shot! Back on 18 Feb you shot a yellow that was only a little higher (and definitely in the same ballpark at tonight’s PMPS if you consider meter variance). If you are able to test her and feed her, you are in control of the cycle and can steer her numbers if you need to. Good job. Depending upon tonight’s numbers, you may be able to see that next time she has a similar preshot number you can give .75 units.
Click to expand...
Thank you so much Suzanne, that really helps my confidence 🤗
You’re right, I did shoot a similar number before (0.50u again, reduced dose). I think I just panic when I see lower preshots!
I’m testing and I’ll keep monitoring closely tonight so I can stay in control of the cycle. Depending on how she does, maybe next time I’ll feel braver about shooting .75!!!
I really appreciate your guidance and support 💕
 
hellen_maggie said:
Thank you so much Karolina🤗
I’ve looked at many spreadsheets like yours and I can see how low you were able to shoot. It’s really encouraging. I think I may just need more data first (and courage!) I’m still very scared and a bit insecure about shooting lower numbers.
I hope I can overcome this fear soon and that my little girl will do just as well.
Thank you for your advice. The help I’m getting here is truly invaluable. 💕
Click to expand...
My pleasure. Glad I could help a bit.
And as Suzanne @Suzanne & Darcy has mentioned above, I was able to shoot at 50 and above since I was following TR. I forgot to mention that detail earlier in my post.
We're all very scared to shoot our first green pre-shot number but with time you'll be yearning for those.
Great job today 👏 🥰
 
Karolina & Nestle said:
My pleasure. Glad I could help a bit.
And as Suzanne @Suzanne & Darcy has mentioned above, I was able to shoot at 50 and above since I was following TR. I forgot to mention that detail earlier in my post.
We're all very scared to shoot our first green pre-shot number but with time you'll be yearning for those.
Great job today 👏 🥰
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Ι really hope so!!!!!! Thank you again for everything Karolina ❤️ 🙏 💖
 
Maggie says thank you all for your support ❤️
As you can see, she can sleep peacefully knowing she has the best team watching over her 😴🐾
 

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hellen_maggie said:
how do you ever get used to shooting lower numbers without having a mini heart attack first?
Click to expand...
You gradually lower the number where you shoot the full dose and gather data when you either shoot full dose, part dose, or skip. Have plenty of test strips and high carb food around. Also, look at spreadsheets of other people's cats, and see what happens when they shoot lower. Lantus is great at keeping low preshots flat and low.

Did you change anything about the spreadsheet? I can't open it. I'm not at home, so it could also be my setup though I'm able to open others.
 
Wendy&Neko said:
You gradually lower the number where you shoot the full dose and gather data when you either shoot full dose, part dose, or skip. Have plenty of test strips and high carb food around. Also, look at spreadsheets of other people's cats, and see what happens when they shoot lower. Lantus is great at keeping low preshots flat and low.

Did you change anything about the spreadsheet? I can't open it. I'm not at home, so it could also be my setup though I'm able to open others.
Click to expand...
Hi Wendy,
I haven’t changed anything on my spreadsheet. I double-checked the settings and it should be visible to everyone on the forum. I hope you’re able to open it now, maybe it was just a temporary issue?

Looking back, I think I made a mistake by reducing the dose last night. Her numbers went up quite high and fast later in the cycle. This morning we had an AMPS of 373. Trial and error, right?

I suspect this morning’s cycle may look similar to yesterday’s. If we end up with a yellow AMPS again, I’ll take a deep breath and shoot the full dose. I’m trying to gather data and build confidence.

I honestly would be completely lost without you all. Maggie and I can’t thank you enough for your patience and support. 💕
 
Wendy&Neko said:
You gradually lower the number where you shoot the full dose and gather data when you either shoot full dose, part dose, or skip. Have plenty of test strips and high carb food around. Also, look at spreadsheets of other people's cats, and see what happens when they shoot lower. Lantus is great at keeping low preshots flat and low.

Did you change anything about the spreadsheet? I can't open it. I'm not at home, so it could also be my setup though I'm able to open others.
Click to expand...
I tried to check the spreadsheet last night, too, to see how the cycle had gone… and I also could not open it.
 
Sienne and Gabby (GA) said:
Hellen --

I just wanted to check in to see if you were aware that the Royal Canin dry diabetic food is really high in carbs.
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Hi Sienne 🌹
Unfortunately, that's the food my vet recommended as soon as Maggie was diagnosed. I had no idea it was so high in carbs until I found this forum and got informed. I'm now trying to very slowly and gradually transition her to air-dried food (Ziwi Peak), which only has 3% carbs. I hope we can manage it soon and eventually get rid of the kibble entirely! Unfortunately, all my attempts to switch to wet food failed; no matter how gradually I did it, her stomach would react after a few days...hope we have better luck with ziwi..
 
You might want to pass the carb info along to your vet. Many vets make the incorrect assumption that the "prescription" foods are manufactured to be appropriate to whatever the problem is the food is supposed to address. The companies lost a class action suit a few years ago for calling their food "prescription." In fact, several of the diabetic foods are now labeled as "dietetic". Vets get so little training in nutrition that they tend to rely on the food companies' sales reps. You might consider sending your vet the link to Dr. Lisa's feline nutrition website.
 
Sienne and Gabby (GA) said:
You might want to pass the carb info along to your vet. Many vets make the incorrect assumption that the "prescription" foods are manufactured to be appropriate to whatever the problem is the food is supposed to address. The companies lost a class action suit a few years ago for calling their food "prescription." In fact, several of the diabetic foods are now labeled as "dietetic". Vets get so little training in nutrition that they tend to rely on the food companies' sales reps. You might consider sending your vet the link to Dr. Lisa's feline nutrition website.
Click to expand...
I actually already did 😊
I was honestly afraid he might misunderstand my intentions, but I approached the subject very diplomatically. In the end, he was more open than I expected. At first he was supporting the exact opposite view, but he did listen.
He is a good vet in general, but he doesn’t have much experience with feline diabetes. (I had to insist quite a bit about switching from Caninsulin to Lantus. Initially he was completely against it, but eventually he agreed to prescribe it and at the same time admitted that he isn’t familiar with it).
I could never imagined that at least 90% of vets here in Greece recommend Royal Canin Diabetic dry food for diabetic cats. It feels a bit like trying to put out a fire with a glass of water....
 
It's not just in Greece! Many vets in the US listen to what the food manufacturers sales representative tells them. Not who I would consider a reliable source of information especially if they work on commission.
 
Sienne and Gabby (GA) said:
It's not just in Greece! Many vets in the US listen to what the food manufacturers sales representative tells them. Not who I would consider a reliable source of information especially if they work on commission.
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My vet does not work on commission, I believe it is purely a matter of lack of time to look into the issue further. He is a highly sought-after doctor in Athens and works six days a week/12 hours a day, his clinic is always full... So he simply prefers the solutions recommended by the large pet food companies. I hope he has read the documents I gave him and that he will suggest the right solutions for the next diabetic cats that come into his clinic.....
 
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