6/23 Scully Earned a Reduction

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Tara and Scully

Tara and Scully

Member Since 2014
Scully has been at 1.5 units for the last 20 cycles. We continue to see a mix of AMPS and PMPS numbers ranging from all over the 300s to the high 100s, but last night she had her first green PMPS at 79. Armed with a healthy stock of test strips and HC food/treats, we decided to go for it. When she hit 28 at +5, I panicked. She was showing no visible signs of hypo thankfully, but I didn't follow protocol for dealing with low numbers. At +5, she's normally ready to eat another small meal (we leave lc canned food down all the time and she free feeds). Last night instead of letting her eat her normal FF Classic Chicken, I gave her the entire can of FF Gravy Lovers Chicken, which she scarfed down like there was no tomorrow. I know I should have given just a teaspoon of gravy at a time and retested every 15-20 minutes, but I was afraid. I also let her have about 15 Party Mix treats, which she is no longer allowed to eat since her FD diagnosis. So, of course, instead of raising her BG up a little and encouraging a green surf, I carbed her up so much that her BG went through the roof. At +5.5 she tested at 99 and at +6 159. I was rewarded this morning with an AMPS of 479. Ouch!

Since this is the third time she has dropped below 50 on this dose (that I have been able to document), I think a dose reduction back down to 1.25 units is warranted. I was reluctant to reduce the dose before because she has been getting into those nice green numbers fairly regularly, but I don't want to endanger her. I did give her usual 1.5 units this morning because her AMPS was so high, but I'll reduce to 1.25 units tonight.
 
Congrats on the reduction Tara. For kitties that are newly diagnosed (less than one year), we suggest trying .25U reductions the first times kitty goes below 50 as there is no way of knowing how well they'll handle the reduction. Once you've done a few reductions and seen how Scully handles them, and you gain experience in handling low numbers, we can decide if you need to modify that approach to reductions. Safety first. From the protocol:
Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
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A number in the 20's is very scary. I think the majority of us have overcarbed the first time our cat went low and you don't want a cat in the 20's. That's another sign to try the .25U reduction after the first below 50. Next time you hit a low number, feel free to post here and ask for help to walk you through. I know I appreciated help the first few times. :YMHUG:
 
Thanks Wendy! Just got home from work (got out early today) and Scully is at 351 at almost +9. Her PMPS will definitely be high. Should I wait until tomorrow morning to reduce the dose?
 
I would reduce tonight. We only do the old dose once to help with the bounce. Cats can still go low from high numbers if they are on too much juice. Neko earned her first reduction from a 430 PS. :roll:
 
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