Help! 11/5 Minner AMPS 236 PMPS 117

[MinnerPip]

Prior Post: https://www.felinediabetes.com/FDMB...5-8-231-pmps-231-4-191-finally-a-blue.295344/

Please help. Increased her dose to 4.25 six cycles ago. Her PMPS is 117, that’s too low to inject for me. I’ve never injected this low. Once it gets below 170ish while she was on dry food I would delay or skip.

I keep repeating this pattern. 4.0 is not enough, but 4.25 gets her to pre shot values that folks doing TR handle but I’m scared. It’s not good to skip doses. I know this.

What do I do? I’ll feed her a little and test again in an hour.

 

[MinnerPip]

I took her BG again, 1.25 hours after PMPS of 117 when no injection given …. It is still dropping

91 now

This happened 10 nights ago when she went off dry food.

Looks like we are skipping this dose and I’ve got a cat that is going to have to be good enough with 4.0 units twice daily and AMPS and PMPS in mid 200 range.

4.25 doesn’t seem to work.

Please please respond if you have better advice or ideas.

 

[Angela & Cleo]

Hi Laura. Was that 91 after stalling without feeding or did you give food when you got the 117?

When following SLGS, you can eventually shoot any number over 90 as long as you can monitor.

I'm going to tag some more experienced members to offer some suggestions @Wendy&Neko @tiffmaxee

Also is it possible to get a couple of tests in the PM cycle? It could help fill in the picture of what Minner is really doing on this dose

 

[Wendy&Neko]

I’ll feed her a little and test again in an hour.

Next time you get a preshot lower than you are comfy with, a stall is OK, but do NOT feed. You want to see if Minner is coming up on her own, without influence of food. And don't wait an hour, try 1/2 hour.

In future, you should start thinking about shooting lower preshots, when you can monitor. Maybe start with a half dose, and see what happens. Eventually, as you gather data, you'll be able to shoot full dose if over 90. When you shoot lower numbers, Lantus gives you nice flat cycles.

I’ve got a cat that is going to have to be good enough with 4.0 units twice daily and AMPS and PMPS in mid 200 range.

Preshot values are not that important. What we want to know is how low the dose is taking the cat, and that is typically somewhere in the middle of the cycle, though today it looks like it was at the end of the cycle. When you can, please try to get those before bed tests and weekend tests if you work during the week, so we can get an idea what is happening on at least some of the cycles.

 

[Wendy&Neko]

Hmm @Angela & Cleo longer post, but I said the same. GMTA.

 

[MinnerPip]

Hi Laura. Was that 91 after stalling without feeding or did you give food when you got the 117?

Hi Angela. I fed her 0% carb pate and tested again 1.25 hours later and it was 91. So I freaked out and fed her 13% fancy feast and some hartz bisque which i think is super low carb but contains some amount of tapioca starch.

So even despite eating … it was still dropping.

And don't wait an hour, try 1/2 hour.

Thank you Wendy. I can for sure do this next time I get a preshot number too low for my nerves

In future, you should start thinking about shooting lower preshots, when you can monitor. Maybe start with a half dose, and see what happens

Wendy, does this mean when I got the 117 pre shot number tonight, an approach could have been to give her 2.0 units and then keep testing ? I assume after giving her the 2.0 units I would not give more insulin for another 12 hours … but learn from what happens with PMPS of 117 and then a half dose.

When you can, please try to get those before bed tests and weekend tests if you work during the week, so we can get an idea what is happening on at least some of the cycles.

Can do. Her poor ear. So try to get +4 or so in PM at least and do more on weekend. I was going to do a full curve this weekend after the increase to 4.25. Now I’ve gone backwards.

I just tested again… at +2.5 she is now 165. So that’s up from 91 an hour ago but also after eating 13% carb.

Should I go ahead and give her 2.0 units now? It scares me but it won’t kick in for 2 hours and I can test then and thru the night if needed.

 

[MinnerPip]

Given it’s +3 now, and I don’t want to get in situation where AM dose has to be during my working business hours, I checked BG again, went from 165 to 202.

So I gave her 2.0 units. Hopefully that will keep her from getting above 300 … I suspect if I totally skipped it would get there or higher.

Boy that 13% carb wet food really makes a difference. I see why its important to keep that on hand for urgent situations. The 0% carb did nothing …

I’ll plan on giving her 4.25 in AM and try to get a few tests in during my working business hours day. Or maybe I should go back to 4 units, sigh.

 

[Angela & Cleo]

You'll have to give insulin 12 hours from when you have it to her tonight. To get back on schedule, you can shoot 30 minutes early once a day or 15 minutes each cycle.
Look at today as a learning experience. Next time you'll know what to do

 

[MinnerPip]

Thanks Angela. Awesome perspective. It was super stressful. I was ready to give up on getting Minner better numbers as the 200s may be good enough. I’m awestruck at how you reach this “magic number” where you suddenly get much lower numbers with just a small increase (scary low for me right now).

we’ll see what happens … and you’ll hear from me soon. Heck it may happen again tomorrow night! Thx again.