**help** pierre is at 101 AMPS

Hello!

I believe this is yesterday's post. We always link these on each daily post for continuity: Pierre *dx 19 aug 2025* thread 2

I'm not qualified to give dosing advice, so I'm going to tag @tiffmaxee, @Marje and Gracie, and @Sienne and Gabby (GA); we'll see if one of these good folks are around for guidance.

The dosing protocol for SLGS's lower than normal preshot numbers is below. According to it, you would not shoot under 200, BUT Pierre has a history of ketones, so we need to be super careful with that.

Hopefully, someone with experience will weigh in soon.

How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. 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.
 
ok. its been moved. no need to comment here..

i just did it again, its been an hour and its 158. not sure where to put that in the ss since i didnt give injection.

i ordered the ketone strips but they didnt have any. (tried to replace with lancets :rolleyes: )... ill attempt to get those today.
thank you
 
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With a history of ketones it’s not good to skip. Lantus is dosed based upon how low it takes a day, the nadir. We don’t know that because you have not tested beyond preshot except for once. The depot builds over the first 5-7 days. Will you be home today to test until +6 and fo you gave high carb food or Karo? Can you be off schedule as you can’t shoot less than 11 1/2 or 12 hours after giving insulin. If you can shoot we need to figure out how much to give.
 
PierreW said:
ok. i can move it. i just rename it to get assistance more quickly?

i just did it again, its been an hour and its 158. not sure where to put that in the ss since i didnt give injection.

i ordered the ketone strips but they didnt have any. (tried to replace with lancets :rolleyes: )... ill attempt to get those today.
thank you
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You can post on the main forum or on the Lantus forum. In either place, however, only post once per day and start a new post daily with the date at the top, so people don't get confused and have to track down multiple posts.

Also, under your original post here, you can select edit and then select "no prefix" on the left and you'll have some options: select the "?" That often helps to get eyes on the post. Be sure to remove the prefix when you get an answer to your question.

When we have multiple tests in one time block, we stack them. If you'll look at my sheet, on 7/5/25 I've done this with Jude's PMPS shot. You'll need to manually change the color. If you're not sure how to do any of this, just let us know.
 
tiffmaxee said:
With a history of ketones it’s not good to skip. Lantus is dosed based upon how low it takes a day, the nadir. We don’t know that because you have not tested beyond preshot except for once. The depot builds over the first 5-7 days. Will you be home today to test until +6 and fo you gave high carb food or Karo? Can you be off schedule as you can’t shoot less than 11 1/2 or 12 hours after giving insulin. If you can shoot we need to figure out how much to give.
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ok. yes i can be home. hes genuinely not doing super great with the testing so im not pushing it because i know its a lot. hes starting to dart even if im just walking into the same room as him. i tested him last night and then had to track him down to get him to eat.

i just need to know if i can give him his shot. last one was given at 10pm due to the vet appt yesterday morning.
 
Last shot was how many hours ago? We talk in terns if hours past insulin due to different time zones. It sounds like it could be less the. 12 hours.
 
12 hrs in 15 minutes

this is why i dont think i can do this im going to kill this cat because im only just learning things and the vet appt messed me up. i cant work on getting back on schedule when i dont even know what im doing to begin with and the vet office isnt helpful but im being told the literal exact opposite on here of what i should be doing.

apparently i cant even count. its already been 12 hours. which is why i frantically posted. he was due 2 hours ago for the shot. his bg was 101 (10:06), i fed him. then i tested again 11:15 (158)... hes past due by 2 hrs and 5 minutes right now.
@tiffmaxee
 
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101 is a nice AM number :) You can add the 158 either in the same block or make a note in the comments section that is way at the end of the row. Normal blood glucose levels is roughly 60 to 150 or so. Newbies are generally advised not to give any insulin if the PS is in the normal range. A skipped shot is fine.

Your cat's history of ketones makes things a bit complicated. I don't have any experience with ketones so I'll leave the question of whether to give insulin now, either the full dose or a reduced dose, to those who have experience.
 
tiffmaxee said:
Last shot was how many hours ago? We talk in terns if hours past insulin due to different time zones. It sounds like it could be less the. 12 hours.
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squeem3 said:
101 is a nice AM number :) You can add the 158 either in the same block or make a note in the comments section that is way at the end of the row. Normal blood glucose levels is roughly 60 to 150 or so. Newbies are generally advised not to give any insulin if the PS is in the normal range. A skipped shot is fine.

Your cat's history of ketones makes things a bit complicated. I don't have any experience with ketones so I'll leave the question of whether to give insulin now, either the full dose or a reduced dose, to those who have experience.
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so i did another bg +1 after the AMPS bg and its up a bit to 158 after eating.
i dont have those ketone strips.
 
I know it’s hard but you need to wait another 15 minutes and test. When you give insulin later than normal the next shot needs to be 12 hours after that. Sometimes if high enough you can shoot 30 minutes early. I think the BG might rise more and it will be okay to shoot if you wait and test.
 
are you speaking about yesterdays morning shot after the vet appt? is that where im off schedule? i have given him 9 shots total since dx. they have all been 9a and 9p. his vet appt was at 8:30 yesterday morning, i brought in my bgm and his insulin. i thought they would want to watch me etc... the vet said "hell be fine until hes home".. were home and at 10a (1 hour later than normal) he gets his shot. then the next shot was 12 hrs later at 10p... i was going to work on the walking it back to 9a over the next day, but i figured giving him todays shot 12 hours after last nights would be fine since its keeping with the 12 hrs..

its already been over 12 hours since his last shot. 12 hrs plus a few minutes. i guess i need to start marking the exact time since it doesnt align perfectly with anything else.
 
Grab another test. If riding you can shoot the full dose if 3 units. Post your results. I get it will be higher. Do you give a treat after each test? The depot fills for the first 5-7 days so it gas formed. While that was an ok amps it’s low for a newly diagnosed cat which is why we stall.
 
tiffmaxee said:
Grab another test. If riding you can shoot the full dose if 3 units. Post your results. I get it will be higher. Do you give a treat after each test? The depot fills for the first 5-7 days so it gas formed. While that was an ok amps it’s low for a newly diagnosed cat which is why we stall.
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ill go test now.
he gets 2 units, so youre thinking i need to add an additional unit?
 
tiffmaxee said:
if possible get a test later in the day around +5-7. You won’t be able to shoot less than 11 1/2 hours from this shot.
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+5 (6p) and were at 61
hell have access to his food until 10:30 (2 hrs before PMPS)
next shot at 12:30p (11.5 hrs since last shot)

should i test at all between the +5 and the PMPS?

i do have this marked on my SS in todays comment section, still working through where to put each number within the blocks.
 
I just got this notification. Test again please at +6. We need to make sure he doesn’t drop under 50 and if he does he earns a reduction to 1.75. If going up I would test at +10 or 11 so there is time to strategize. If he’s under 90 at +6 I would test again in an hour at +7. He’s responding well to insulin.
 
he is extremely difficult to get a read from. so 6.5+ he's at 74

my main question is, I'll test again at +10, what should I be looking for in order to know whether or not I should change anything?
 
He’s having a nice cycle. The 70’s are great. You want him to be at least 150 to shoot any insulin. If around 200 shoot his dose. If lower post for help.

Please update your spreadsheet with BG results.
 
PierreW said:
I have the info in today’s comment section. I’m working through how to put in the info due to shooting at a different time today. I’ll put it in how I think it should be and leave the comments in case it’s wrong.
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No worries!! I just wondered if there was something wrong on my end that I couldn't see the numbers.:)
 
ok. this was the worst yet i think. truly. 30 minutes trying to get him without causing stress. well.. were both stressed so who knows if that will influence things.
228 at 10.5+
 
Try and find special treat to give after every test. Max was not a foodie but I found one. He was easy to test but fluids were difficult. His piece of shrimp or lamb treat was a life saver. It gets easier. Testing keeps him safe. I thought Max would hide from me and didn’t test at first. I had to go to my vet a couple times a week for nadir tests and when I saw a 60 I started testing. No more finding a way to get him out from under my bed to get to the vet so often. You will develop@ routine that works for you.
 
I think what's confusing you about the timing is that you're basing everything on your preferred/typical shot time. Whenever you give a shot, that is your AMPS or PMPS time. So, if your usual shot time was 9:00 and you missed that shot due to the vet appointment and shot 2 hours later (i.e., 11:00), then 11:00 was your AMPS. All of the other tests are then based on the number of hours past the time you actually shot.

To adjust your shot time, you can move the time by 15 min twice a day (each shot time) or by 30 min once a day. If you opt for the 30 min adjustment, be consistent with either your AM or PM shot until your at your preferred time.

Also, you really need to get at least one PM test. We encourage members to get a "before bed" test so you can do to sleep without worrying if Pierre's numbers are plummeting. The minimum number of tests per day is four -- your two pre-shot test and at least one additional test during both the AM and PM cycles.
 
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