4/1/20 - PMPS=99; +1=<40; +2=80;+3=41; +4=<40 - 2nd below 40 in 1 day

Mnm

Mnm

Member Since 2020
Hi. Marco's really dropping below 40 a lot these days. I just changed his dose from 1.5 to 1.25. he's already going to low again. I'm tempted to drop to 0.75 for tomorrow. Thought's ideas? I realize you don't want to drop insulin that quickly. All the same, he keeps dropping below 40.

I would love some experienced recommendations.

Feeding him snacks now to get his BG up. Again, I'm thinking of going down 0.5 units of insulin for tomorrow (from 1.25 to 0.75) given he keeps dropping so quickly. Thoughts?

Thank you-

Wendy and Marco
 
Let me qualify that question.... That assumes he's high enough to give insulin for his next shot. Again, just looking at reducing by 0.5 instead of 0.25 as he's really getting low after having a decent starting number.

Again, thank you.

Wendy and Marco
 
A couple questions. First, did you ever decide between following Tight Regulation or Start Low Go Slow as your dosing method? So far it looks like TR but I wanted to confirm. If you put either TR or SLGS in your signature, it'll help us help you. Second question, you gave the shot 1 hour and 55 minutes late last night. Was your shot this morning also 1 hours and 55 minutes late?

Moving up the shot too much can act like a dose increase. The other consideration on a reduction is that the larger depot can influence 4-6 cycles after a reduction. Meaning that the 1.5 unit dose can still be influencing tonight's cycle. Given the struggle you are having to get him up, I would still reduce to 1.0 units, in spite of the larger depot influencing the cycle.

The link to your previous post here. http://www.felinediabetes.com/FDMB/threads/previous-condo.227723/
 
Wendy&Neko said:
A couple questions. First, did you ever decide between following Tight Regulation or Start Low Go Slow as your dosing method? So far it looks like TR but I wanted to confirm. If you put either TR or SLGS in your signature, it'll help us help you. Second question, you gave the shot 1 hour and 55 minutes late last night. Was your shot this morning also 1 hours and 55 minutes late?

Moving up the shot too much can act like a dose increase. The other consideration on a reduction is that the larger depot can influence 4-6 cycles after a reduction. Meaning that the 1.5 unit dose can still be influencing tonight's cycle. Given the struggle you are having to get him up, I would still reduce to 1.0 units, in spite of the larger depot influencing the cycle.

The link to your previous post here. http://www.felinediabetes.com/FDMB/threads/previous-condo.227723/
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Hi Wendy. I'm doing TR. I shot at 1 hour 55 minutes late last night. I shot 1 hour 10 minutes late this morning. And I shot 35 minutes late this evening.
 
Mnm said:
Hi Wendy. I'm doing TR. I shot at 1 hour 55 minutes late last night. I shot 1 hour 10 minutes late this morning. And I shot 35 minutes late this evening.
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And thank you for your input.
 
Mnm said:
I shot at 1 hour 55 minutes late last night. I shot 1 hour 10 minutes late this morning. And I shot 35 minutes late this evening.
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OK, that explains the low numbers. You move the shot either 15 minutes per cycle or 1/2 hour once per day. This morning should have been no earlier than 1 hour 25 minutes late and the same time tonight. Or 1 hour 40 minutes later this morning and 1 hour 25 minutes late tonight. Shooting early like you did acts like a dose increase, which he doesn't need.

Getting Back on Schedule: http://felinediabetes.com/FDMB/threads/getting-back-on-schedule.101059/

Could you update the spreadsheet to show how much earlier you shot today. Tomorrow morning, shoot the same time you did tonight.
 
Thank you!

With that, would you still shoot 1 unit (assuming he's in range) tomorrow, or would you go with 1.25?

Thanks again
 
I assume it is better to shoot insulin late than to skip a shot all together. Is that true? I was under the impression that if you don't give insulin within two hours of "typical time", wait and shoot in the next cycle. Is that the best? With the way his numbers are now, it's doubtful he's going to be very high at 6:30 AM.
 
Mnm said:
I assume it is better to shoot insulin late than to skip a shot all together. Is that true? I was under the impression that if you don't give insulin within two hours of "typical time", wait and shoot in the next cycle. Is that the best? With the way his numbers are now, it's doubtful he's going to be very high at 6:30 AM.
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If you get a lower than normal BG, stall, don't feed and test again in 20 minutes to see if the BG is rising.
Post and ask for help.
You don't want to stall for too long as it will throw your schedule out too much.
Is it better to shoot the insulin late then to skip the shot all together?........well it depends. ECID ( every cat is different). If you leave it too long with stalling and are not feeding, the BG will start dropping because the cat is hungry and needs food. It also depends on the BG, if the cat is eating well, if the cat has had ketones in the past and if the CG can monitor the whole cycle if needed. But generally if you get to 2 hours past shot time I would skip the shot (providing the cat had no history of ketones.)
 
Thank you for the input. Yes, saw post 3 from Wendy. Wasn't sure if that was still applicable given the "new information". Sound like it is. Again, thank you!
 
Marco is now at BG = 174. I assume this changes giving 1 unit to 1.25 units. With this new information, do you concur?
 
Wendy&Neko said:
A couple questions. First, did you ever decide between following Tight Regulation or Start Low Go Slow as your dosing method? So far it looks like TR but I wanted to confirm. If you put either TR or SLGS in your signature, it'll help us help you. Second question, you gave the shot 1 hour and 55 minutes late last night. Was your shot this morning also 1 hours and 55 minutes late?

Moving up the shot too much can act like a dose increase. The other consideration on a reduction is that the larger depot can influence 4-6 cycles after a reduction. Meaning that the 1.5 unit dose can still be influencing tonight's cycle. Given the struggle you are having to get him up, I would still reduce to 1.0 units, in spite of the larger depot influencing the cycle.

Hi Wendy-

You mentioned that "moving up the shot too much can act like a does increase". Also, that the "depot can influence 4-6 cycles". Does the "moving the shot up to much" also act like a "depot" that takes 4-6 cycles? I ask as Marco's numbers keep dropping below 40. I started a new string: http://www.felinediabetes.com/FDMB/threads/4-2-marco-amps-174-6-40-he-keeps-dropping-40.227846/ Very interested in your input.

Thanks-
Wendy and Marco


The link to your previous post here. http://www.felinediabetes.com/FDMB/threads/previous-condo.227723/
Click to expand...
 
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