Re: Boomer PMPS 178 he cont to drop should I shoot??
i want to talk a little more about his dosing. just some thoughts rolling around in my head that might help you sort through what direction you want to go.
if your goal is to get him off of insulin and becoming diet-controlled, getting his blood sugar under 120 as much as possible is part of the package. It's when his blood sugar is in the normal range that his pancreas can heal. Cats are unique in their ability to have the beta cells regenerate and begin to produce insulin again. So as that happens, we see the dose going down as the cat's pancreas is sputtering back to life and producing some supplementary insulin. That process can be fast or slow - just depends on the cat.
It's something you're going to want to talk with your husband about - because often, as you've seen, the blood sugar isn't completely predictable. We can follow the protocol, or suggest a reduced dose and try to keep boomer out of the 20's, but really it's going to be your testing that catches where Boomer's BGs are going and brings him up, even when it takes a while. That experience you had yesterday with so many hours wasn't typical, but when a cat's pancreas is sputtering back to life, sometimes things are hard to predict!
We do know that shooting low helps a cat's blood sugar even out and stay low (low meaning in normal numbers, 50-120). Backing away from a low preshot by reducing the dose or skipping, doesn't help in moving towards going off of insulin.
Last night when I was suggesting shooting even less if this morning's preshot was lower, i was really addressing the needs that i was hearing you express about being exhausted and needing to go to work, rather than what was best for Boomer. That's a valid thing to do, but i thought perhaps i should explain why i was offering that as an option. If the world was ideal, taking that reduction of 0.25u and continuing to shoot that 2.25 until he goes below 50 again is the preferred route. The protocol is tried and proven, so as much as we're able to stick to it, especially for newly diagnosed cats, that's what i'd rather do.
Often a cat shot from a higher number (say 350) can dive in an unnerving way even more than a cat shot at 85 that will then stay flat for the next 12 hours. that higher number can be just as risky as shooting low, sometimes i think even more so. The only way to prevent that risk is to reduce the dose enough that the cat just stays relatively high. For whatever reason, cats will hover flat in the less-than-100 numbers, but it's often difficult to get them to stay flat at 150 or 200. as their numbers are higher, the range experienced in the cycle is often (not always, but often) a larger range.
that said, it's a balancing act. So . . . he does have to be monitored when he's low or looks to be heading low. You're doing a fantastic job of doing that. Still, people have lives and can't drop everything to take care of their diabetic cats. it's just reality and no one faults a person for doing what they need to do - we'll support you in whatever you decide.
there's no perfect way to do this. I just want to make sure you understand the pros and cons of aiming for a particular blood sugar range or shooting the lower preshots without reducing.
Does that make sense? Does it raise any questions? Maybe others can contribute ideas too.