? 3/5 Lila AMPS 248; +11 99; PMPS (+12.5) 102; +1 124; +2 146; +4 220

Amanda Wenger

Amanda Wenger

Member Since 2020
Question of to shoot or not to shoot (the full dose)? (I feel like I know the answer to this until if affects my cat) If you've followed Lila's story, you know getting her numbers down has been difficult. She seems to be doing well on 1.5u but now I have a good problem. She is 99 (checked with ReliOn meter) at +11 and is due for her PM injection in about 30 minutes.

Obviously, I will check her again PMPS but can someone please direct me to the protocol for when to give full dose vs reduced dose. I can hold for additional time if needed as well, although she might bite my head off for not letting her eat on time! I'm reluctant to entirely withhold insulin due to her recent DKA.

ETA: +11.5 reading is 84 on Libre so she may still be dropping?

Thanks so much!
Amanda and Lila
 
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With TR you can shoot anything above 50, provided you can monitor and have syrup/HC if you need to intervene. Are you still using the Freestyle Libre? Here is your last post for continuity:

Last Post

I'm not sure I would have increased to 1.5u as quickly as you did, you only held 1u for 4 cycles. That said, Lila may bounce from the 99, so why don't you see where you are at by PMPS. With recent DKA, you do not want to skip.
 
Thanks! She was at 82 PMPS and was 79 just now (30 mins after PMPS). I'll keep checking every 15 minutes and withhold food for a bit and see if she starts going back up. Yes, we still have the Libre and it works most of the time.

She was previously on 1 unit prior to going into the hospital and I was told I held the dose too long so I was trying to go by the tight regulation guidelines relative to her high numbers.
 
Numbers have flattened out now, while you haven't shot green before, let's see next test. If you shoot, you'll need to continue to monitor, starting with +1 and +2. Are you able to monitor tonight? I will stay with you and help you along.
 
I just checked and she was 102 so I fed her. Should I keep her 1.5 dose? I can monitor her tonight as much as needed. Thank you so much for your help!
 
Yes, let's do 1.5U now that that's where you are at - the jump up might have been a bit too quick, so if you can monitor, we'll see if she earns a reduction. You're welcome - See you at +1 :)
 
And just a quick housekeeping note, if you could keep your title updated with latest numbers as well as you SS, that would be great. For the numbers earlier you can stack them in the +11 cell, although I see them in the remarks. It just helps keep things squared up so we can see that you shot a little late.

Here's an explanation of stacking numbers:

Sometimes it is necessary to stall at PS if the BG is too low to shoot and tests are taken every 20-30 minutes apart and must be recorded. The BGs are then “stacked” as shown below and, in this case, recorded in the +11 column so the PMPS, which was at +14 can be recorded in the PMPS column:


The above tells anyone looking at the SS that testing for PMPS began at +11.75 but the BG was too low; subsequent testing every 15 minutes occurred until the Caregiver felt the BG was safe enough to shoot at +14.

In your case, you stalled until +13 I believe. That is important, since tomorrow you will need to adjust your shot time, otherwise you'll be shooting 1 hour early. Since you stalled to +13, you can either shoot 15 minutes early each cycle starting tomorrow morning until you get back on schedule, or 1/2 hour once a day until you get back to original shot time.
 
With the +2 still higher again than preshot, you can feed a little snack, and get a before bed test, maybe +4 or +5 just to see how the cycle is going. Usually the +2 is a good indication for most cats of how the cycle will go, if higher than preshot, likely not much action. Getting a follow up test would be good if you can just in case she decides to pull some shenanigans.
 
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