6/25 Pudge AMPS 274 +5 149 +6 155 +9/10 169 +11 248 PMPS 264

[kitten68]

https://www.felinediabetes.com/FDMB...168-6-209-9-326-pmps-350.291390/#post-3188438

well.

geez.

all blues today... and at hours apart too.. (???) +9/10 is like 169.

uh. since am currently on SLGS.. understand nadirs of 150 or less, keep dose.. but PMPS is supposed to be in the 300s and mid-high 200s right? anyway... am guessing if it stays below 200 at PMPS.. give half or less?... the depot isn't even full yet (if I'm understanding). IF below 200, again contemplating a dose of 1 U. maybe .5 U. just to see how he fares.. before I decide to shoot numbers like that. thing is.. with Lantus, understand dose should be even AM/PM but on SLGS.. you reduce dose.

if was TR.. would shoot at 2 U anyway right?

any advice appreciated.

thanksss.

@Wendy&Neko @Diane Tyler's Mom @Suzanne & Darcy @tiffmaxee @Marje and Gracie @Shell

 

[JL & Cooper]

Looking good today, Pudge! Nice blues!! Hope he’s coming up a bit more now to make tonight’s decision easier for you!

 

[kitten68]

Looking good today, Pudge! Nice blues!! Hope he’s coming up a bit more now to make tonight’s decision easier for you!

what a ride!!!! he did!.. came up to 248! then 264 for PS.. YAYY. lol.... looks like regulating. thank uuu!!!! so happy.

just glad it went up.. I HATE that decision crap when its under or around 200... lol.. its a very necessary guideline it just gives me a hard time cause it's a guess right. to shoot, not shoot.. how much.know w time will get even easier. but UGH. especially since im thinking of TR.. im like ughh. but doing SLGS.. so yeah. I will be reading on the methods more and trying to commit better to memory. haha.

 

[Alicia & Kit cat (GA)]

what a ride!!!! he did!.. came up to 248! then 264 for PS.. YAYY. lol.... looks like regulating. thank uuu!!!! so happy.

just glad it went up.. I HATE that decision crap when its under or around 200... lol.. its a very necessary guideline it just gives me a hard time cause it's a guess right. to shoot, not shoot.. how much.know w time will get even easier. but UGH. especially since im thinking of TR.. im like ughh. but doing SLGS.. so yeah. I will be reading on the methods more and trying to commit better to memory. haha.

As you get more data, you'll be able to have a better idea of what is safe to shoot. Since you're on SLGS, once you have that better idea, you can shoot as long as you're above 90. And if you switch to TR, eventually your no shoot numbers gets to be 50. But that's a number you work towards. And just remember that you're not shooting the preshot, you're shooting based on the nadirs.
If you decide to switch to TR, don't hesitate to ask questions as well. We're on our second go round, and have been back at it for over a year, and I still have questions and refresh my memory with the stickies.
I know the lower numbers can be scary until you get used to them, but it's good to see them. Most of us start to crave seeing those dark greens.

 

[kitten68]

As you get more data, you'll be able to have a better idea of what is safe to shoot. Since you're on SLGS, once you have that better idea, you can shoot as long as you're above 90. And if you switch to TR, eventually your no shoot numbers gets to be 50. But that's a number you work towards. And just remember that you're not shooting the preshot, you're shooting based on the nadirs.
If you decide to switch to TR, don't hesitate to ask questions as well. We're on our second go round, and have been back at it for over a year, and I still have questions and refresh my memory with the stickies.
I know the lower numbers can be scary until you get used to them, but it's good to see them. Most of us start to crave seeing those dark greens.

is that true for SLGS?.. cuz thats what we’re doing currently and is news to me. the stickies always say below a certain number not to shoot, based off the PS… (???)… dont recall any mention about supposed to really be shooting nadirs.. :/ (thanks for lmk.. ugh.. idk what. this info is overwhelming again. feel like im hearing stuff/things changing from what thought how it was from time to time now…. will do best to do some reading this weekend..)

 

[Alicia & Kit cat (GA)]

Apologies - dosage is based on nadirs, but see below for what I meant in regards to shooting lowers numbers.

Bold will be something I bolded for emphasis. Until you are more comfortable and have adequate data, yes, there are guidelines. But someone who has the experience and data, on SLGS, could shoot anything above a 90.

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.

• Below 150 mg/dl (8.3 mmol/L), don't give insulin.
• Between 150 and 200 (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 in a couple of hours, and make a decision based on that value
• Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
• In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
• Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.

Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus, Levemir, and Biosimilars users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:

• Do you need to stay on schedule? Then skip the shot.
• Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
• Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.

If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.


Let me know if that brings up more questions. I know it's a lot of information.

 

[kitten68]

Apologies - dosage is based on nadirs, but see below for what I meant in regards to shooting lowers numbers.

Bold will be something I bolded for emphasis. Until you are more comfortable and have adequate data, yes, there are guidelines. But someone who has the experience and data, on SLGS, could shoot anything above a 90.

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.

• Below 150 mg/dl (8.3 mmol/L), don't give insulin.
• Between 150 and 200 (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 in a couple of hours, and make a decision based on that value
• Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
• In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
• Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.

Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus, Levemir, and Biosimilars users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:

• Do you need to stay on schedule? Then skip the shot.
• Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
• Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.

If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.


Let me know if that brings up more questions. I know it's a lot of information.

ohhhhh if you DONT HAVE DATA follow this….. hm! right, so for beginners.. what im saying. right. thanks! well… its really good to know. ok to shoot 90 and above.. right cuz the goal is to have even numbers and the dose keeps them at those values.. right? might be good to know/have it put where info on that is.. cuz otherwise would have been treating things that way forever. and his numbers look like definitely need it.. thanks again.. tbh i was doing that anyway.. lol tho tonite was 219 , definitely still got his meds. eh. want things good, maintained.. and after a day of not lookin like anything either.. night 7.. thinking of holding dose based on what i see tonite, and just think i should. and going to try best to test now. really tired ….