4/28 Shen - PMPS 178

[Nimi S]

Link to previous post : https://felinediabetes.com/FDMB/threads/04-27-shen-amps-207-0-5-229.276902/#post-3067198

Day 2 of 1.25U glargine.
Shen's BG has been dropping and rising very slowly throughout the day today.
Not what I was used to with the 1U and the 350-400s.
Have no idea when to expect the nadirs with this dose - I assume it's too soon to expect?

Do I shoot 1.25U, a little less or 1U?

How long should I stall to check again?

Last snack was at +8.

 

[Nimi S]

Update:
BG at PMPS = 178
stalled and checked BG at +1 = 326
rechecked 7 mins later = 340

Going ahead and shooting 1.25U
Stalled for 1.25 hours.

 

[Bandit's Mom]

Hi Nimi, sorry no one was around to respond to your post. Next time use the "?" prefix in the condo title and put something like "STALLING SHOT! NEED HELP" to catch the attention of more experienced members.

It was safe to shoot the 178 because (a) he was headed higher from a lower nadir in the day and for newly diagnosed and unregulated cats, you can count on a bounce (b) you could monitor.

Did he go up from 178 to 326 without food?

In the SS, please put "178 @+12, 340 @+13" in the PMPS cell?

 

[Nimi S]

Hi Nimi, sorry no one was around to respond to your post. Next time use the "?" prefix in the condo title and put something like "STALLING SHOT! NEED HELP" to catch the attention of more experienced members.

It was safe to shoot the 178 because (a) he was headed higher from a lower nadir in the day and for newly diagnosed and unregulated cats, you can count on a bounce (b) you could monitor.

Did he go up from 178 to 326 without food?

In the SS, please put "178 @+12, 340 @+13" in the PMPS cell?

Hi Bhooma, I edited the post after his 326 reading which was without food. Had mentioned Dosing advice needed in the title along with the PMPS BG.

I was afraid to shoot @178 because I haven’t been able to get up often to check at night since his PM shot has been so delayed and stalling twice pushed it even further, although I tried advancing it twice too. I’m unable to figure out when to expect his nadirs with the new dose, one day it’s at +4, the next at +8.

Is the sudden spike from 178 to 326 to be expected, given that his BG had been dropping and rising slowly the rest of the day?

He has his USG appointment at his +11 mark today, so his PMPS might get pushed slightly further.

Made the edits to the SS. Thank you!

 

[Bandit's Mom]

Had mentioned Dosing advice needed in the title along with the PMPS BG.

I figured you might have!

I’m unable to figure out when to expect his nadirs with the new dose, one day it’s at +4, the next at +8.

Yes, it can be hard to figure out patterns with unregulated cats. Nadirs can and do move around. Nadirs tend to be later in bounce clearing cycles. But his numbers look good. He is responding well to glargine.

Is the sudden spike from 178 to 326 to be expected, given that his BG had been dropping and rising slowly the rest of the day?

Yes, newly dx cats can be pretty bouncy, so it's not unusual for them to bounce 100 points or more in an hour. As he gets used to lower numbers, he will bounce more "slowly", not bounce as high and clear bounces faster. The great thing is that you are seeing blues and greens every day on this dose unlike 1U where we was taking the full 6 cycles to clear bounces.

He has his USG appointment at his +11 mark today, so his PMPS might get pushed slightly further.

What time will you be able to shoot today? USG appointment to get a urine sample by cystocentesis?

Made the edits to the SS. Thank you!

Thanks. Just colour that cell blue with white font?

 

[Nimi S]

What time will you be able to shoot today? USG appointment to get a urine sample by cystocentesis?

His shot time is at 1:30 pm today.
I meant ultrasound (ultra sono graphy, I was confused too) appointment to check his kidneys out - I'm just trying to get all his tests, labs done right now, so that I can stop being worried about things, even after getting normal labs.
The appointment's at 12:30pm, would take about 45 mins. So I should hopefully be back by his shot time.

I checked with the vet if she does cystocentesis and she said yes. So I had wrongly assumed earlier. But no more urine tests right now. Maybe a few days after the antibiotic course for the UTI is completed, we'll check again.

 

[Bandit's Mom]

I meant ultrasound (ultra sono graphy, I was confused too) appointment to check his kidneys out - I'm just trying to get all his tests, labs done right now, so that I can stop being worried about things, even after getting normal labs.
The appointment's at 12:30pm, would take about 45 mins. So I should hopefully be back by his shot time.

Good luck!