? Coco AMPS today is 87...her numbers have really taken a change!! Advice welcome!

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Anna123

Anna123

Member Since 2016
Although I have been told it's not good to skip a dose, I'm pretty sure that I shouldn't dose Coco at 87....I'm happy about her new adventure with lower numbers, but it does confuse me on dosing her. Before, she was very consistently in the 300's for AMPS & PMPS...now it's a little crazy..she was in the 40's the other day preshot. What to do about dosing?!!!! She has been on 8 units recently & I did a curve on the day when she was super low, without giving a dose...I sent the numbers to my vet & she said to give the full 8 unit dose if she is in the 100's and if she's under 100 to cut the dose in half (so 4 units) I think that's pretty darn aggressive...but I'd like to hear other advice.
 
Looking at Coco's ss I do think that you should have taken the reduction, holding on to a dose when a reduction is earned, can result in a depot that is overfull and an overdosed kitty. I am wondering with this mornings ambg if Coco went lower last night and she is already on her way up, or if indeed she is still heading down, FWIW seeing as you didn't take the reduction the other day I think skipping this morning was a sensible choice, but I might suggest you get a +1 even though you haven't given insulin, the depot could still see her drop some especially if it is overfull (with a high dose kitty it can impact the cycle considerably).

There are cases where on TR you might wait for 3 drops under 50 before taking a reduction, but that's usually for a longterm diabetic (over a year from diagnosis) or for a cat that doesn't hold reductions, so far Coco hasn't shown that she doesn't hold reductions and is not quite over a year since diagnosis. It does seem like something has changed for Coco given the colour change in her ss, so it might be sensible to take those reductions as she earns them to avoid getting into deep water.
 
Gill & George said:
Looking at Coco's ss I do think that you should have taken the reduction, holding on to a dose when a reduction is earned, can result in a depot that is overfull and an overdosed kitty. I am wondering with this mornings ambg if Coco went lower last night and she is already on her way up, or if indeed she is still heading down, FWIW seeing as you didn't take the reduction the other day I think skipping this morning was a sensible choice, but I might suggest you get a +1 even though you haven't given insulin, the depot could still see her drop some especially if it is overfull (with a high dose kitty it can impact the cycle considerably).

There are cases where on TR you might wait for 3 drops under 50 before taking a reduction, but that's usually for a longterm diabetic (over a year from diagnosis) or for a cat that doesn't hold reductions, so far Coco hasn't shown that she doesn't hold reductions and is not quite over a year since diagnosis. It does seem like something has changed for Coco given the colour change in her ss, so it might be sensible to take those reductions as she earns them to avoid getting into deep water.
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I tested Coco an hour after her morning 87 and she was at a 96...then at +6 she's at 164 (around nadir). As for why I didn't reduce her...good question. My vet wanted me to stop skipping doses & give the 8 U a chance...I agree that she seems to need a reduction...but to what ? 7? 7.5? I am getting a little confused, being that I'm having to skip doses..It's new territory for me. (and Coco)
 
Hi Anna - it's great to see Coco showing some better numbers now. :) With that 43, I would have lowered the dose to 7.5 units. 8 units is taking her too low - we determine what dose to give based on how low it takes kitty. It's much better to have a slighly lower dose and not have to skip the shot. And yes, it's much more fun going down the dosing scale. :D

By the way, if you were home to monitor, it would have been perfectly fine to shoot that 87 this morning. Cats cycles are a lot flatter when you shoot low. Shoot low to stay low is the TR saying.
 
Wendy&Neko said:
Hi Anna - it's great to see Coco showing some better numbers now. :) With that 43, I would have lowered the dose to 7.5 units. 8 units is taking her too low - we determine what dose to give based on how low it takes kitty. It's much better to have a slighly lower dose and not have to skip the shot. And yes, it's much more fun going down the dosing scale. :D

By the way, if you were home to monitor, it would have been perfectly fine to shoot that 87 this morning. Cats cycles are a lot flatter when you shoot low. Shoot low to stay low is the TR saying.
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I will start 7.5 tonight....It's so hard for me to "get" shooting that low. At what number would you say not to shoot at all? and would I give the entire 7.5 units at 87? Do you ever give partial? I actually could not stay home today, so I couldn't have done that anyways, but it's interesting to know that I should actually dose at 87...What's confusing to me is the fact that 87 is actually a very good, normal number..so why do I need to bring her down further? Sorry for all the questions, but going backwards is new to both Coco & I ;)
 
Sooo...my vet just called me (after I emailed Coco's SS to her).. She wants me to drop her to 6 units 2X a day...what to do??
 
It's your call what you want to do, follow the vet or follow TR. You hold the syringe. We've seen people drop the cats dose and end up in pinks and reds. How much experience does your vet have with high dose cats and people who test? If you do drop the dose, please be vigalent and test for ketones daily.

As far as shooting low - experienced people will shoot anything over 50. The lowest I ever shot was 51. I loved giving Neko insulin in the 80's, cause for her, it often meant she didn't move more than 10 points the entire cycle. Shooting low really does flatten out the numbers for that cycle, unless they bounce of course. The first few times I shot green, I held my breathe and Neko bounced. :rolleyes: Take a look at some of the other subject headings here, especially those that start the cycle green.

You can give partial doses if you are nervous, but a better strategy might be to wait 20-30 minutes without feeding, and retest to see if the number is rising. There is a sticky note on shooting low numbers which describes the options. The issue with shooting a partial dose, is that the depot will usually influence at least the first part of the cycle. Anytime you get a low number, don't feed, and post here for advice. What we suggest may depend on the situation. And the fact that you could not monitor today would play into it, especially since you don't have experience with green preshots yet.
 
Wendy&Neko said:
It's your call what you want to do, follow the vet or follow TR. You hold the syringe. We've seen people drop the cats dose and end up in pinks and reds. How much experience does your vet have with high dose cats and people who test? If you do drop the dose, please be vigalent and test for ketones daily.

As far as shooting low - experienced people will shoot anything over 50. The lowest I ever shot was 51. I loved giving Neko insulin in the 80's, cause for her, it often meant she didn't move more than 10 points the entire cycle. Shooting low really does flatten out the numbers for that cycle, unless they bounce of course. The first few times I shot green, I held my breathe and Neko bounced. :rolleyes: Take a look at some of the other subject headings here, especially those that start the cycle green.

You can give partial doses if you are nervous, but a better strategy might be to wait 20-30 minutes without feeding, and retest to see if the number is rising. There is a sticky note on shooting low numbers which describes the options. The issue with shooting a partial dose, is that the depot will usually influence at least the first part of the cycle. Anytime you get a low number, don't feed, and post here for advice. What we suggest may depend on the situation. And the fact that you could not monitor today would play into it, especially since you don't have experience with green preshots yet.
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I do feel a bit pulled between TR, which makes sense to me and this vet. She is a specialist & diabetes is one of her 3 specialties. I was surprised that she just wanted me to skip the "7's"...she doesn't think it's good that I am skipping doses lately (although she too believes in shooting low). I guess I have a little over an hour to figure out what dose to give Coco. lol. How do ketones come into play?
 
The recipe for DKA is not enough insulin, inappetence and infection/inflammation. Ketones is a warning signal. Every time you reduce to not enough insulin, that is the first of the three in the recipe and ketone testing is a precaution.
 
I shot 7.5...it just makes sense to me to follow a system, rather than jump around with dosing. My vet will hate me. lol! If she needs another decrease, we'll get there...
 
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