Dandy Boy! Too low to shoot?

Status
Not open for further replies.
theruss

theruss

Member
Hi all,

Instead of piggy-backing on Robbie the kitty's post from earlier, I decided to start a new thread. I'm running into a similar situation.

It's been exactly 7 days since I started home testing. Dandy was on 6u of Prozinc BID. At this time, I completely dropped dry food from his diet, and dropped his dose to 1u BID. I have been taking a bit of an aggressive approach by moving up his dose .5 every two to three days until it appears that it's having an effect. Since all of these changes, his BG has been pretty flat in the upper mid 200s to lower 300s.

Today is his second day at 2u BID.

I got readings of:
AMPS +10 of 178,
AMPS +11.5 208,
AMPS + 12 (usual PMPS) 176

He was getting very hungry, so I fed him 3oz of low carb, wet food for dinner.

To be safe, I withheld insulin. I'll check BG again in two hours. Does that sound right?

If I check again later and he's still hovering in the high 100s / mid-low 200s, do I just wait until morning, usual time? Do I give him a decreased dose? How about if he skyrockets (not thinking this will happen, but who knows)?

I'm home for the rest of the night, so I could check every couple hours...

Thanks!
R
 
I'll withhold advising to shoot or not till we see that next number. One way to handle this (do I shoot or not shoot???) at the normal PMPS time, is to hold off on feeding until he comes up to a number you feel comfortable shooting, and when he crosses that line, go ahead and feed and give him the shot. That meal he ate should raise his BG within an hour. If you check in two hours, you might be surprised that he hasn't really changed much from that 176. That would be awesome to see, really, because it would indicate there's some insulin coming from his pancreas.

If you see a number you feel good about shooting, you can shoot a reduced dose if your plan is to go back to his normal shot time tomorrow morning.
I was thinking maybe 1u? Just so there is some insulin helping till tomorrow morning, which is a better option (in my opinion) than having him go 24 hours with no shot. Especially since his numbers are looking really nice the past couple of days.
Carl
 
Thanks Carl and Sue!

Well, I fell asleep at 7pm like an 5 year old, so I missed the opportunity to get reads :(. I did get one just now at PMPS+7 (no shot, so AMPS +19...so confusing when you miss a shot) of 233, so still not terrible (but also not green!).

I'm going to give him a late night snack because he's asking for one. I'll give him .5u to tide him over for now (since it's late and getting pretty close to normal AMPS time)...and then dial back to 1.5u tomorrow morning at regular time (which is in 5 hours or so, assuming his numbers seem safe to shoot) and see what kind of numbers we get for the next couple days.

Next time this happens, I'll maintain an adult-like sleep schedule and follow as suggested. I'll also try and hold out a little longer before I decide to feed/shoot. You gotta understand...this puss is demanding and wanted his supper. Now hopefully I'll be able to get back to sleep :). If not, I guess I'll be doing some additional late night testing...

My other thought is, maybe I should have shot at 176? I sort of arbitrarily picked 200 as my 'no-shoot' zone, based on reading posts. Since I've been home testing, I haven't seen anything near green, definitely not near hypo. My daily curves seem to be pretty flat from pre-shot to where I would expect nadir to be, percentage-wise, so maybe this would have been fine, and I should lower my 'no-shoot zone' to 175? Maybe I need some more data before I do that...

Any additional thoughts would be appreciated. Thanks so much for your time.

Good night!!

R

EDIT: 291 + 2hrs after feeding / .5 shot ZZZZzzzzZZ
 
Watch him today. In most cats, the insulin lasts At least 8 hours, so giving another shot at +6 can cause an overlap and mean lower numbers.
 
Will do. I'll be going home around lunch time and should be able to get two good reads then (AMPS+6,+7).

His numbers definitely weren't in hypo territory yesterday (or the day before) @ 2u, so I figured even if there was overlap, it would at most reproduce the same results as the sum of it's parts (1.5u + .5u overlap = 2u)(although I'm no math expert hehe). This was what I administered yesterday morning, so the worst case would be a repeat of yesterday's numbers. Just offering my thought process there. Whether any of that's true, who knows...

Either way, I'll stay at 1.5u for the next few days and see how the numbers look.

I'll look into converting and using the U100 syringes. Judging a half unit on the U40 needles is a daunting task at 6am....

My last question (not EVER, just for now) is in terms of 'shoot or don't shoot'. Is there a general consensus? Or does it vary greatly by sugarpuss?

Thanks for the responses!

R
 
When giving min doses in the under .25 range, people do shoot under 200 - often at 170 or so. But only after they have a couple weeks of data that gives them some idea how the cat might react. IMHO, it's a little early for you. You just switched to wet and he is responding well, and much differently than he did to the 6 units.

Once you have some data and at least some general ideas of how he reacts when you shoot X into 200, you can be more aggressive with the dosing. Another factor is whether you can monitor. Shooting below 200 is one thing if you will around to test and intervene if he drops into the 40 range. Much scarier to shoot and leave.
 
My last question (not EVER, just for now) is in terms of 'shoot or don't shoot'. Is there a general consensus? Or does it vary greatly by sugarpuss?
Click to expand...

Yes, it varies - just like everything else - by sugarpuss. But, IMO just as importantly, it varies by every shooter. It comes down to two things. How much data you have collected, and how will you be able to manage the "monitoring" of the cycle. With Prozinc, even more so.

If you look at enough Lantus/Lev spreadsheets, you'll see many people with mucho experience, regularly dose a full amount on a green preshot number. Newbies don't, nor are they advised to. I used to see that, and it scared the crap out of me. BUT, that's the way the "L's" work and if you eventually do switch, it's something you'll learn and understand better. However, Prozinc is much more of a "if this, then that" insulin. If you shoot, it's going to follow the pattern of the insulin. It's going to push the BGs down, then it's going to wear out, and the numbers will come back up. With data, you at least have a fairly good idea how much a given dose is going to do because you've seen it happen pretty consistently.

At some point, you'll know, or at least confidently believe, that 1u is going to do "this much". If you know 1u regularly pushed his BG down 100 points, and you've seen it happen lots of times, then you might get a preshot of 150 and say "ok, that leaves me at 50? I'll be around to test, I think it's good". Or if you aren't around to test, you can either skinny up the dose, or halve it or whatever. I'm a big believer is shooting a token (some folks call the "big chicken ****") dose rather than skipping completely. It seems like if kitty goes 24 hours with no juice, it can set you back. Something, even a little bit, is better than nothing. But ONLY if you feel comfortable doing so.

You will know how sensitive Dandy is to insulin. Bob was a gulper. A couple of times, I shot 1u into a green preshot (don't try this at home!). Not because I was stupid, but because I had seen 1u drop him 50 points or less. He surprised me once and gave me a 42. That was a day I was around to watch.

The key is "know thy cat". And know what to do if you see a low number. Use food to feed the drop so it doesn't go too low. Only shoot a dose you wouldn't shoot normally IF you are going to watch him like a hawk.

Carl
 
Hey Carl,

Thanks for the awesome response! Makes total sense, and I think will ultimately be very helpful.

Russ
 
Status
Not open for further replies.
Back
Top