? Day 2 - Need Advice again

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Kris & Teasel

Kris & Teasel

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Hi fellow PZIers,

Yesterday my cat, Teasel, had a low AMPS of 6.9 (124) so I withheld his insulin. Sue suggested that I try a dose of 2.6 units in the evening. His PMPS was high, of course, at 24.7 (445). I gave him 2.6 units at his usual time after his evening meal. I didn't do any more testing during the evening because I was battling a raging headache and went to bed.

This morning, his AMPS was 16.9 (304) - not too bad considering he'd had only one lower dose the day before. I've tested today at +5 (11.3), +8 (9.4) and a short while ago, his PMPS (at about +11.5) was 7.9. It's in his SS. I know this is too low to shoot but I don't want to have too many missed shots. He's been fed and is just finishing. Should I wait an hour? two hours?, test again and try giving only 1.0 unit as a "token dose"? I'm unsure of how to proceed. Hoping some expert eyes are on the forum.
 
Whoops. Looks like you fed him already. You can wait two hours and shoot a smaller dose, but it will throw off your schedule. The next shot would have to be 12 hours since the delayed one.

It is good news that 2.6 is too much. He is needing less insulin every few cycles. But I know it is scary to see those low numbers.
 
Hi Sue,

Should have tried that but he's already finished his evening meal. The three of them were demanding I feed them. I need to be more on the ball. He's had very late nadirs the last few days that I've tested - not usual for him historically.
 
Our messages just crossed. I was going to try giving only 1.0 unit this evening. I can wait 2 hours if need be and test again. That means a mid-morning shot tomorrow and then I'd have to back up my timing over several days to get back on track. Are half hour increments too much for that?
 
krisu said:
Our messages just crossed. I was going to try giving only 1.0 unit this evening. I can wait 2 hours if need be and test again. That means a mid-morning shot tomorrow and then I'd have to back up my timing over several days to get back on track. Are half hour increments too much for that?
Click to expand...

That plan sounds doable. Yes, you can move it by 30 minutes at a time.
 
Thanks, Sue. That's what I'll do. I see the link to your protocol and I've actually read it multiple times but these low numbers are spooking me and clouding my brain.
 
Hi Carol,

Yes, very stressful. So many things to think about - not wanting to skip a shot, how to adjust dosage, wait to shoot later after food raises BG and there goes your daily injection schedule down the drain, and testing and testing and testing and more testing. A strong response to the insulin is what we're after but it's scary when it happens!
 
Stressful, but also good news! We all feel the same way...we wish and hope for good numbers then when they come, we panic! I remember the first time I got a green preshot...I completely lost my head and came on here begging for help even though I KNEW those were good numbers and I shouldn't shoot. Thank goodness for Sue being here and calmly reminding me not to shoot. :)
 
Here's where I am this morning after giving a token dose of 1.0 unit last night 2 hours later than normal. He'd had his evening meal at his regular time (2 hours before last night's dose):
  • his AMPS today was 21.8 - as if he'd missed his PM shot last night - so I treated this as a missed shot.
  • I'm going back to my regular dosing schedule this morning because of this. I would back up the timing from last night by half hour increments if he'd had an effective dose that was still affecting his BG. Doesn't seem to be the case.
  • I've given him a dose of 2.0 units this morning because 2.6 units yesterday morning gave me a +11.5 of 7.9, ie., long duration and a PMPS too low to shoot at his regular time. Two units seems a reasonable reduced dose with (maybe) some wiggle room.
  • I'll be able to test at +2 but then have to be out until mid-afternoon and will test again then, say around +8.
I hope I've made a good call on this. I really appreciate the guidance and support I've received on this board but I know there'll be times when I have to rely on my own judgment. Any/all feedback is welcome.
 
Very nice job figuring this out! I think your dose reduction is a good idea. It'll be interesting to see his numbers today.

If you ever need to shoot early again, and his numbers are in lower ranges, try to get two tests within 10/20 minutes of each other. You want to be sure the number is rising, not falling. You can easily shoot 30 minutes early with Pro
Zinc in any situation - once you know the number is sure rising. Your thinking today is grand because he is high. Just something to have in your kit for the future.

Also, use the stall whenever it will work. If the preshot number is too low, wait 20 minutes without feeding and retest. You want a rising number and one over your no shoot target number.
 
The other thing to remember is, now that you can test, you can always catch a number that is falling and steer with food.

So you know - not that you are likely to need it today. Generally, if they fall into the low 50s, we give a little regular low carb and retest in 20 minutes. If the number is rising, just keep an eye on it. If still falling, give a teaspoon or so of the gravy off high carb food (small amount so he will still eat later if you need him to). Retest in 20 minutes. If still falling, rub some honey on his gums. You want three rising tests before you relax. Also, if you ever get a number in that low range, post here and on Health for help. (On Health because there are usually more eyes there)
 
Home a bit later than planned. Just tested at +8.75 and BG is 15.8. Fed about 2 T of usual wet food right after testing as a snack because he missed his usual small mid-day meal. Must be feeling OK because he's chasing his sister. Will do PMPS test in about 2.75 hours and if it's shootable, I'm contemplating raising his PM dose to 2.2 units. Yesterday, 2.6 units given in AM was too much (PMPS too low to shoot). Can always try 2.4 units tomorrow if necessary. Opinions anyone?
 
Last BG at +3 before going to bed was 20.4. Will assess whether 2.2 units is enough when I see his AMPS tomorrow. Maybe it would be a good idea to stay at 2.2 units for tomorrow? I'm not sure because there has been lots of dose hopping the last 48 hours.
 
BIG EXCITEMENT!!! I saw Teasel go into the litter box to pee and had a long handled spoon ready. I was able to put it under his backside and catch some urine to test for ketones with a Keto-Diastix strip. It came up negative - hurray! I think I surprised him this time but I hope he'll tolerate this method going forward. This is a first for me!
 
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