? Can somebody advise on Bo’s numbers?

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Jessica + Bo

Jessica + Bo

Member Since 2023
Hi all,

I reduced Bo to .75u the past few days, but I think I need to reduce it more. Or maybe I should not have dosed this morning. The vet advised not to dose under 10 and he was at 10.3 so I dosed. But now at +3 he is already at 3.6. I gave 2 greenies treats to try to slow it from going lower. Should I give more high carb food?

And should I reduce his dose to .5 or .25 going forward?

I want to avoid doing the "low bg -> high carb snack" dance since I'm not always able to wrangle him into allowing me to test it.

He's acting very normal right now at 3.6. So I don't know if he will have obvious symptoms going into mild hypo​
 
Well, right now I’d give him some high carb food to slow down the drop. Do you have any? No more than 1-2 teaspoons. If not you can mix a few drops of honey or karo to low carb food. Then retest in about 20-30 minutes.

I don’t see a dosing method, but if you’re following SLGS, yes, he earned a 1/4 unit reduction by going under 90, so the new dose moving forward will be .5 units. Your meter is human right?
 
Yes it's a human meter. I'm not sure if I'm 100% doing the SLGS method. Just trying to juggle somewhere in between the vets direction and advice from this sub.

This is so nerve-wrecking. Will it always be like this? I normally won't have time to test him so frequently. I just made extra time today due to his lower amps.
 
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Not always, but sometimes. The good news is that he earned a reduction to .5 units so let’s see what the new dose will do. I’d try to stay at that dose for the next 7 days unless he goes under 90 again. Did you give more food and retest yet?
 
Ale & Bobo & Minnie (GA) said:
Not always, but sometimes. The good news is that he earned a reduction to .5 units so let’s see what the new dose will do. I’d try to stay at that dose for the next 7 days unless he goes under 90 again. Did you give more food and retest yet?
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I was going to test again 30 mins after +3 since he is acting very normal. But he's eating now (purina dm canned food that he didn't finish from breakfast) so the 2nd test might be closer to 45 mins after +3 or at +4

Will update soon
 
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It does get easier on your nerves! Consider how far you've come since Bo was diagnosed. The front end of the learning curve is huge and most vets don't have the time to provide you with a great deal of education about feline diabetes. We can help with that!!

You will begin to have a better handle on Bo's patterns as you're collecting data on your spreadsheet. You also have options in terms of what to do if numbers seem lower than you're comfortable with at shot time. Giving your cat the full dose when his pre-shot was 185 is safe. As you get more comfortable with lower numbers, this will get easier. From the Prozinc dosing sticky:

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 once you have data and understand your cat’s cycles. 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 Prozinc users following the Start Low Go Slow approach.
 
Ale & Bobo & Minnie (GA) said:
I’m leaving soon for thanksgiving dinner. I’ll try to check in later. Keep feeding and testing every 30 minutes until he’s above 90
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Just tested again, it was basically at +4. He didn't change, so I'm feeding 1 tsp of friskies gravy food and will try to test again in 30 minutes. He still is behaving very normal so I'm feeling a bit less stressed.

He is definitely getting a reduction to .5 starting tonight. My nerves can't handle seeing him in low numbers :nailbiting:

Thanks all for your help!
 
Sienne and Gabby (GA) said:
It does get easier on your nerves! Consider how far you've come since Bo was diagnosed. The front end of the learning curve is huge and most vets don't have the time to provide you with a great deal of education about feline diabetes. We can help with that!!

You will begin to have a better handle on Bo's patterns as you're collecting data on your spreadsheet. You also have options in terms of what to do if numbers seem lower than you're comfortable with at shot time. Giving your cat the full dose when his pre-shot was 185 is safe. As you get more comfortable with lower numbers, this will get easier. From the Prozinc dosing sticky:

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 once you have data and understand your cat’s cycles. 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 Prozinc users following the Start Low Go Slow approach.
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I remember reading this but I guess I forgot. Thank you for sharing. I'll keep this in mind going forward!
 
He’s above 50 so not take action just yet , but he’s close so we want to keep him from going lower and under 50. It will be good to see a slightly bigger increase in his bg
 
It also helps to remember that those green numbers are normal range. They help Bo's pancreas (and liver) get used to being back where they were before the diabetes developed. If you want Bo to go into remission, it's the green numbers that you're looking for. However, almost everyone is panicky when they first start seeing lower numbers. The more you get used to steering your cat's numbers with food, the more confident you will become in dealing with what seems to be a scary range.
 
So true Sienne! The goal as you get more used to all of this is to start to shoot the lower than 200 numbers so he can be in the greens and blues as much as possible - that’s when the pancreas can heal.
 
Ale & Bobo & Minnie (GA) said:
He’s back in the 100s so looking good!
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Yes I'm so relieved!

Ale & Bobo & Minnie (GA) said:
So true Sienne! The goal as you get more used to all of this is to start to shoot the lower than 200 numbers so he can be in the greens and blues as much as possible - that’s when the pancreas can heal.
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I'm guessing that with lower doses, his bg will have less dramatic drops? Seeing it go from 330 to 91 yesterday was nice. But watching the 185 to 65 today was scary.

It might be easier to stay in green if his drops get a little less steep with lower doses
 
Did you skip the shot last night or forgot to record it in the spreadsheet?

shooting at lower numbers as in lower bg, not lower doses. This means learning to shoot the regular dose when you get numbers below 200. I was giving Minnie her regular doses even when I got a preshot around 70. You just have to be able to monitor and to use food to slow down the drop or keep them surfing those lower numbers without much of a drop. When you shoot at lower numbers, you get more of a flat line as opposed to a curve so no big drops.
 
Ale & Bobo & Minnie (GA) said:
Did you skip the shot last night or forgot to record it in the spreadsheet?

shooting at lower numbers as in lower bg, not lower doses. This means learning to shoot the regular dose when you get numbers below 200. I was giving Minnie her regular doses even when I got a preshot around 70. You just have to be able to monitor and to use food to slow down the drop or keep them surfing those lower numbers without much of a drop. When you shoot at lower numbers, you get more of a flat line as opposed to a curve so no big drops.
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I skipped it. I was too nervous about it. Looking back, I should have probably at least given a small dose, but I was still shaken up from the lower numbers earlier in the day.

I won't always be able to test him frequently, so shooting while his PS is green seems pretty intimidating right now, even if his dose is small. With him being a grazer, do you think it's necessary for him? He doesn't eat a whole meal at a time, so it makes me feel like his bg wouldn't have as dramatic of a spike as cats who do eat their whole meal right away. I could be wrong though, I'm still trying to learn how this all works
 
Kind of off topic but I've been noticing "1 drop" in a lot of spreadsheets as the dose. Does this literally mean 1 drop? I can't see how that can be measured but I see it on quite a few spreadsheets
 
What do you mean by it’s necessary? What are you referring to? We like to see 4 tests a day. The preshot tests, a midday and an evening around +2. Can you do those daily? I know folks who don’t work at home and can’t do a midday test will do a test before they leave for work.
 
Jessica + Bo said:
Kind of off topic but I've been noticing "1 drop" in a lot of spreadsheets as the dose. Does this literally mean 1 drop? I can't see how that can be measured but I see it on quite a few spreadsheets
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1 drop is basically for cats that are very close to remission but still need a tiny bit of insulin. You push the syringe plunger all the way in, insert the needle into the insulin bottle/pen and release. The release will “suck up” 1 drop. If you look at Bobo’s spreadsheet, you’ll see I had to do that a few times. Usually you do it for a week before starting OTJ trial for remission.
 
I recommend you try not to skip tonight if you get a number above 200 so we can see what his amps will be on the new dose. He might earn another reduction but we won’t know if you’re not consistent with the dosing and try to hold the dose for at least 7 days. Again, the exception being if he goes under 90 again then he earns an immediate reduction to .25
 
Ale & Bobo & Minnie (GA) said:
What do you mean by it’s necessary? What are you referring to? We like to see 4 tests a day. The preshot tests, a midday and an evening around +2. Can you do those daily? I know folks who don’t work at home and can’t do a midday test will do a test before they leave for work.
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Sorry I wasn't very clear. I was asking if dosing him while his PS is green is necessary.

You mentioned giving Minnie her regular dose even if her PS was 70. I'm saying that seems too intimidating for me as I won't always be able to monitor Bo to make sure he won't go hypo with getting insulin while his numbers were already so low.

I don't fully understand how it all works, but I'm assuming he would get a bigger jump in bg if he ate his whole meal at once, so his bg wouldn't drop to dangerous numbers.

But since he grazes on the same meal for hours, I assume that means his bg doesn't have a big jump right around shot time. This part is what makes me extra nervous about dosing him if his numbers are already a bit lower than normal
 
Jessica -
I agree with your observation about having given Bo insulin last night. My thinking is based on what is on your spreadsheet. Bo dropped into dose reduction territory during the AM cycle. By +6, his numbers were heading up. That's no surprise given that he's just getting used to green numbers (and so are you!!). If you look at the trend, his numbers kept rising. There's a good chance his PM cycle was in the 200s.

It may be helpful since you're not home during the work week, if you can try to get a few extra tests in when you're home. I think this will help you to get more comfortable so you can see how Bo's cycles proceed. Likewise, last night, it may have been helpful to get another test in after the +2.

The simple answer to your question about whether giving a shot with a green pre-shot is maybe. It all depends on what your goals are. If your goal is for Bo to have a chance at remission then the answer is yes. Remission means he's in normal numbers (50 - 120). If your goal is that he's tightly regulated, it means he will need to be on insulin but the numbers need to be below renal threshold but it's better if he's closer to normal range. I know that shooting low numbers sounds terrifying right now. It does get easier as you become more confident when it comes to directing the cycle with food.

It also sounds entirely counterintuitive that if you shoot a low number that your cat's BG level doesn't crash. While it's possible, ultimately, you're progressively lowering the dose because your cat's pancreas is starting to work and needs less and less insulin. The cycles flatten out and are generally, mostly green.

In response to Bo's grazing, if his numbers were dropping into a low range, most cats look for food. They seem to intuitively know that they need to eat. I had a timed feeder. If Gabby's numbers were running lower than I liked, I left food in the feeder for her to ensure she was in a safe range.
 
Sienne and Gabby (GA) said:
Jessica -
I agree with your observation about having given Bo insulin last night. My thinking is based on what is on your spreadsheet. Bo dropped into dose reduction territory during the AM cycle. By +6, his numbers were heading up. That's no surprise given that he's just getting used to green numbers (and so are you!!). If you look at the trend, his numbers kept rising. There's a good chance his PM cycle was in the 200s.

It may be helpful since you're not home during the work week, if you can try to get a few extra tests in when you're home. I think this will help you to get more comfortable so you can see how Bo's cycles proceed. Likewise, last night, it may have been helpful to get another test in after the +2.

The simple answer to your question about whether giving a shot with a green pre-shot is maybe. It all depends on what your goals are. If your goal is for Bo to have a chance at remission then the answer is yes. Remission means he's in normal numbers (50 - 120). If your goal is that he's tightly regulated, it means he will need to be on insulin but the numbers need to be below renal threshold but it's better if he's closer to normal range. I know that shooting low numbers sounds terrifying right now. It does get easier as you become more confident when it comes to directing the cycle with food.

It also sounds entirely counterintuitive that if you shoot a low number that your cat's BG level doesn't crash. While it's possible, ultimately, you're progressively lowering the dose because your cat's pancreas is starting to work and needs less and less insulin. The cycles flatten out and are generally, mostly green.

In response to Bo's grazing, if his numbers were dropping into a low range, most cats look for food. They seem to intuitively know that they need to eat. I had a timed feeder. If Gabby's numbers were running lower than I liked, I left food in the feeder for her to ensure she was in a safe range.
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Hi Sienne,

Yes my goal is for him to go into remission. I'm willing to give him the insulin as long as he needs it but he really hates the BG testing and only tolerates the insulin injection, so the sooner he goes into remission, the sooner I can reduce the amount of times I have to poke him in a day.

I am curious about his numbers though but I'm not sure I have enough data to make any assumptions yet. But he is consistently back in yellow by the PMPS, no matter how low his AM cycle drops. Is this something to worry about?

His +3 was 81 today so that means I should reduce from .5u to .25u for tonight's dose correct? But if he is back in yellow by PMPS, my instincts are telling me that the AM dose was not high enough to keep him in blue/green all day. Or am I just looking at it wrong? I might be too anxious to see his numbers get back to normal.

I'd also like to tag @Suzanne & Darcy since she's been so helpful under my post in the ProZinc forum.
 
When you follow SLGS, you reduce when he goes under 90, so yes tonight’s dose should be .25. It’s a normal reaction to want to dose by the high numbers, but we don’t do that. We dose by how low the bg goes. You had a blue amps today so he’s getting in the lower range numbers which is great. I have a feeling you’ll see a lower yellow or maybe even a blue again at pmps today.
 
I’m not sure about the modified TR. with Lantus the difference is that on SLGS you hold a dose for 5-7 days and with TR you only hold for 3 days. You also only decrease with TR when the bg goes under 50 as opposed to 90 with SLGS. So TR is a bit more aggressive because you’re increasing faster
 
We recommend new members using Prozinc follow SLGS for at least a month before trying MPM (Modified Prozinc Method). Also, if you're feeding any amount of dry (like your signature & spreadsheet says) you'll need to stick with SLGS.
 
Shelley & Jess said:
We recommend new members using Prozinc follow SLGS for at least a month before trying MPM (Modified Prozinc Method). Also, if you're feeding any amount of dry (like your signature & spreadsheet says) you'll need to stick with SLGS.
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Yes, he won't eat the wet food out of the auto-feeder. So if I want to continue providing food between PM +3 and AMPS, it has to be the dry. I'm mixing in the freeze-dried treats with hopes that he will begin to like them, and I can provide them as his nighttime snack instead of the kibble.

I'm not confident enough to switch to the more advanced method, but just out of curiosity. Why can't I do it if he has any dry food?
 
@Ale & Bobo & Minnie (GA) @Sienne and Gabby (GA)

Another nadir below 90 today. I've been reducing his dose by .25 any time that happened according to SLGS. But his current dose is .25. I'm not 100% sure what to do here.

His needles only go in .5 unit increments, so the .25 shots were just estimates. Should I try to aim for somewhere around .1 now?

I skipped the pm shot last night since he was already in blue and I couldn't monitor him overnight. The only reason I felt confident enough to give .25 this morning is because I'm doing a curve today, so I knew Id catch it if he dipped too low. Not sure what to do for tonight especially if he doesn't go back up to yellow by PMPS.
 
Ale & Bobo & Minnie (GA) said:
He still needs a little bit of insulin. Do you know how to measure .1?
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I was planning to make a mark on his syringe with a sharpie so that I have a line to aim for. Is there a better way?

I have a followup call with his vet today. Previously she advised me not to dose him if he was under 10 (180) at preshot. This morning and last night he was around 7.8 (140) so I skipped them. I plan to ask her if she believes it is safe for him to get a small dose at these numbers.

Assuming he continues to trend downward, what kind of numbers am I looking for to start an OTJ trial? Are there instructions somewhere in the forum for that?

The vet previously told me that under 9 (160) is normal for a cat. But most OTJ sheets I've seen have the cats under 100 the majority of the time. I don't want to stop too soon and prevent him from healing.
 
Do that, take a pic and post it here so we can check. .1 is the very first line in the syringe.

take a look at Bobo’s spreadsheet and his OTJ trial period. You want numbers below 100 to consider a cat is in remission. Right now you’re still getting above 100 numbers. Has @Suzanne & Darcy replied at all?
 
Let me find the info. It’s here somewhere. And yes, he’s still outside the normal 50-120 range so he still needs a bit of insulin. You wouldn’t stop until you’re seeing consistently green numbers.
 
Ale & Bobo & Minnie (GA) said:
Let me find the info. It’s here somewhere. And yes, he’s still outside the normal 50-120 range so he still needs a bit of insulin. You wouldn’t stop until you’re seeing consistently green numbers.
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OTJ Trial
  • Start the trial on the next green pre shot.
  • If he is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his number is lower 3-4 hours after a meal, then the pancreas is working!
  • Post every day so we can monitor your progress and see if any tweaks are needed. He may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
  • After 14 days of no insulin, we have a party!!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Once he is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him monthly. Weight should remain stable. If he seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
 
I think folks are getting ahead of what the numbers are saying.

For a cat to be approaching OTJ, the majority of test data should be numbers in the greens and almost all of the numbers should be normal range. Bo has not even seen a green pre-shot number. IMHO, this is NOT a cat that is ready for an OTJ trial.

Jessica - I think your anxiety regarding "low" numbers is pushing you to skip shots. Even having skipped shots last evening and this morning, while Bo is in very good numbers, they are not normal range numbers. You can shoot numbers that are 90 and above. It's fine to work your way down to that point but to get Bo into a solid remission that will stick, he needs to spend considerable time in normal range numbers.
 
I have to agree 100% with Sienne. Bo is not ready for an OTJ trial yet. These blue AMPS are very shootable and I’d try the 0.1u dose. If he drops below 90, then we can talk about some other ways to hold the dose longer. A cat should be churning out BGs mostly below 100 before attempting a trial if you want him to have any chance in staying in remission.
 
Ale & Bobo & Minnie (GA) said:
Do that, take a pic and post it here so we can check. .1 is the very first line in the syringe.

take a look at Bobo’s spreadsheet and his OTJ trial period. You want numbers below 100 to consider a cat is in remission. Right now you’re still getting above 100 numbers. Has @Suzanne & Darcy replied at all?
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I haven't heard from Suzanne in a few days, I hope everything is okay with her.

The very first line of my syringe is just empty. This is my syringe with the plunger fully pressed:
Plunger fully pressed.jpeg


The lines I marked to estimate .25 (bottom line), then .1 (top line)
Lines at my guess for .25 and .1.jpeg


My guess at what .1 dose would be:
Guess at 0.1.jpeg
Guess at 0.1(2).jpeg




Sienne and Gabby (GA) said:
I think folks are getting ahead of what the numbers are saying.

For a cat to be approaching OTJ, the majority of test data should be numbers in the greens and almost all of the numbers should be normal range. Bo has not even seen a green pre-shot number. IMHO, this is NOT a cat that is ready for an OTJ trial.

Jessica - I think your anxiety regarding "low" numbers is pushing you to skip shots. Even having skipped shots last evening and this morning, while Bo is in very good numbers, they are not normal range numbers. You can shoot numbers that are 90 and above. It's fine to work your way down to that point but to get Bo into a solid remission that will stick, he needs to spend considerable time in normal range numbers.
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Marje and Gracie said:
I have to agree 100% with Sienne. Bo is not ready for an OTJ trial yet. These blue AMPS are very shootable and I’d try the 0.1u dose. If he drops below 90, then we can talk about some other ways to hold the dose longer. A cat should be churning out BGs mostly below 100 before attempting a trial if you want him to have any chance in staying in remission.
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Sorry I didn't mean to create panic. I'm not planning to start OTJ trail just yet, I'm just trying to collect information to be as informed as possible in the event his number keep trending down. Especially if there are other signs that I need to be looking out for (eg: if artificially low numbers are a concern like artificially high numbers can be).

It is true that I'm still nervous about shooting at low numbers, but I'm getting less nervous as his insulin dosage decreases (from 1.5 to 0.1 in 11 days!). I'm just trying to gain more insight since this forum is saying that under 100 is normal, but my vet is saying that under 160 is normal. So I want to make sure I have all the right information before choosing to ignore the advice of his vet and trying to get his BG even lower.

In the end my goal is for Bo to go into remission. But being that I've trusted the vet 100% for the past 5 years, I just want to be extra certain before ignoring her advice to hold insulin at the numbers he's at now.

Thanks to everybody for being so patient with me. I'm sure its frustrating to see me keep skipping/reducing doses when to your eyes, I should not have. I hope that I'm at least getting a bit better as I go. I definitely owe you all so much thanks for giving me the assurance I need to keep going. I don't know how many doses I would have skipped if you folks weren't here to encourage me :bighug:

PS: I have a call with Bo's vet today to go over his numbers. But at this point, my current plan is to inject 0.1 whenever his PS is in blue, even if it is below 10 (180).
 

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Jessica + Bo said:
But being that I've trusted the vet 100% for the past 5 years, I just want to be extra certain before ignoring her advice to hold insulin at the numbers he's at now.
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We all get this. I’d had a very trusted vet for ten years but she didn’t know squat about treating FD because none of her clients, until me, questioned the “no testing” and the 1u dose increases.
 
Hello. I've been away and am trying to catch up with what's going on with you and Bo. I see Bo has been doing well on that .25 unit dose. Why the skipped shots recently? Was it just nerves. There's a lot of blue on the spreadsheet. I don't think the .25 dose was given a very fair chance yet. We know that with a preshot of 184, he did great with the .25 dose. Now with a lower preshot, we don't know yet. You can try the .25 when he's at a little bit lower preshot (lower than the 184, I mean) and see how he does -- because you do plenty of testing and will catch him if he were to drop below 50. If he's below 150 at AMPS or PMPS, I would try the .1 unit dose and see how it goes. Again, you test plenty and will catch him if he drops below 50 and you will be able to intervene with carbs. We need some more data. You're doing great!
 
I think you should follow the MPM protocol, if your goal is remission. Then you can let him go into more normal numbers above 50 and try to keep him between 50 and 120 (max.) What do you think?

ETA: I see he's still eating dry food, so I guess it's SLGS. Perhaps we could customize his reduction point though? I don't think it will help him to keep dropping his dose every time he drops below 90.
 
If you were to Google something like 'normal blood glucose range for cats' you'll see some variability in the range that's provided. There are a few considerations.
  • It can depend on what kind of meter you're using -- human vs pet-specific. They are calibrated a little differently. As an example, 50 on a human meter is the equivalent of a 68 on a pet meter. The pet meters run higher.
  • It may depend on the insulin. I've seen much higher "normal" range numbers quoted for the faster acting insulin like Vetsulin.
  • And what is more likely the biggest factor is that most vets are not used to having their clients home test. In addition, vets are not typically available 24/7. As a result, they want a wider margin of error to prevent hypoglycemic events. They prefer to have a cat in higher numbers so the cat is in safe numbers and you're not calling in a panic. Even if the vet is in the office, it's unlikely you're going to get an immediate call back. Home testing allows you to monitor what's going on with your cat in real time and steer the curve if necessary.
It wasn't until Roomp & Rand published their paper on tight regulation that they documented having cats' blood glucose in the lower end of the normal range helped to get cats into remission and there weren't adverse effects.
 
Suzanne & Darcy said:
Hello. I've been away and am trying to catch up with what's going on with you and Bo. I see Bo has been doing well on that .25 unit dose. Why the skipped shots recently? Was it just nerves. There's a lot of blue on the spreadsheet. I don't think the .25 dose was given a very fair chance yet. We know that with a preshot of 184, he did great with the .25 dose. Now with a lower preshot, we don't know yet. You can try the .25 when he's at a little bit lower preshot (lower than the 184, I mean) and see how he does -- because you do plenty of testing and will catch him if he were to drop below 50. If he's below 150 at AMPS or PMPS, I would try the .1 unit dose and see how it goes. Again, you test plenty and will catch him if he drops below 50 and you will be able to intervene with carbs. We need some more data. You're doing great!
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I think the issue was that he went under 90 on the .25 units so what kind of reduction would that mean?
 
Hi Everybody,

I had a call with Bo's vet today and she is advising I stop insulin. I am still on the fence about whether or not this is the right call. I do believe that looking at Bos numbers, his pancreas is kicking back into gear. But after doing some research, I also believe he has a better chance of staying in remission if his average BG is below 6.

Bo is no longer on the purina dry and I'm working to transition him to FF pate exclusively, (for now he is getting purina canned for breakfast and FF pate for dinner). I have not found a low carb snack/food that he likes yet that can be left out overnight without him eating it all in one go. So for now, I have no overnight snacks to leave out for him incase of an overnight hypo. That's one of the reasons for most of the recent night time skips.

I know this forum would advise against it, but I am going to give him 1 more night to see if his numbers keep decreasing without insulin. If they do, I am inclined to listen to the vet. If he doesn't naturally go down to 6 or below then I'm inclined to continue insulin in very small doses (0.1) to try to encourage his average to settle in a more optimal range.
 
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