help - PMPS too low to shoot, vet said to keep at 1 unit and shoot?

jud and corv

jud and corv

Member
My cat just started insulin on Friday and he's been responding pretty well to it. I've found lately that his PMPS numbers are too low to shoot (170-180). I called the vet this morning and she said to go ahead and give him his 1 unit of Lantus. Just want to make sure this is okay? I'm worried I don't know how he's responding to the insulin entirely yet and that he's going to go hypo while I'm sleeping.

I'm about to give him his AM shot and didn't know if I should decrease unit or not. SS below.
 
JL and Chip said:
Per yesterday’s thread …
8/20 Corv, AMPS 283 +6 123 PMPS 173
I believe you were going to reduce to 0.75u for the AM shot in the hopes that you would have a shootable PM number.

Vets often think in whole numbers. I would take Wendy’s suggestion.
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I was going to, I shouldn't have called vet and just did it. Now the vet has me confused. She said to go ahead and give him his 1u if he was at his previous PMPS numbers
 
The 1 unit today will probably be OK for today, though I would like you to get a later test than +6 today. Maybe +7 to +8? Looks like Corv might be nadiring later in the cycle when you only get one shot in per day.

The reason I suggested a reduced dose overall is that you are skipping frequently and it's easier to start at a dose where you can shoot twice a day and gather data, then work your way up in dose if you need to. When people have more data, shooting below 200 is commonly done. Can you stay up as late as +4 to night?
 
jud and corv said:
My cat just started insulin on Friday and he's been responding pretty well to it. I've found lately that his PMPS numbers are too low to shoot (170-180). I called the vet this morning and she said to go ahead and give him his 1 unit of Lantus. Just want to make sure this is okay? I'm worried I don't know how he's responding to the insulin entirely yet and that he's going to go hypo while I'm sleeping.

I'm about to give him his AM shot and didn't know if I should decrease unit or not. SS below.
Click to expand...

When I started my journey, the vet recommended I increase his dose from 2 units to 3 units based on a single fructosamine test. I was also in the process of switching to wet food from dry high carb food. My vet did not recommend home glucose testing, but I began to take some measurements prior to increasing his dosage and noticed that his pre shot values were coming up lower than 200 and dropping day by day. I called the vet to explain this and he insisted to continue with the dosage but not give insulin below 200, which made no sense to me.

I was angry at first that his recommendation to increase dosage without regular testing could have caused a severe hypo event but I have begun to realize that it really is too much for your average vet to keep up with, and understand that his recommendation was just using the limited data on my cat available to him. Every cat is different and home glucose testing gives you the data needed to adjust dosage and give insulin safely. I was hesitant to make any changes without the guidance from my vet, but these frequent dosage decisions are needed to keep your cat safe and it would not be feasible to check in with them daily for guidance. The great people here are always willing to offer guidance and support!
 
Honestly, in my vet experience; I trust and rely on this Forum 100% blindly, As you say there are many well knowledgeable members that are exceptional in getting our fur babies more stable, quicker than a Vet would, not all vets have experience or advanced on Feline Diabetes, so they treat as they would a dog, I was told by the vet that cared for my Corky hospitalized 8 days when diagnosed, that the normal range glucose should be between 200-300! I came home almost at the point of a nervous breakdown when his glucose would reach 150 and it was dosing time, today by the amazing coaching I get here I shoot in the 70’s if need to, but never skip a dose, then again Corky is on ProZinc different protocol from Lantus, there are knowledgeable members that can guide you with Lantus 😸😸
 
Wendy&Neko said:
The 1 unit today will probably be OK for today, though I would like you to get a later test than +6 today. Maybe +7 to +8? Looks like Corv might be nadiring later in the cycle when you only get one shot in per day.

The reason I suggested a reduced dose overall is that you are skipping frequently and it's easier to start at a dose where you can shoot twice a day and gather data, then work your way up in dose if you need to. When people have more data, shooting below 200 is commonly done. Can you stay up as late as +4 to night?
Click to expand...
Yes I've updated his SS today, did a +4 and +7, +7 was around 124. I can stay up to +4 tonight to keep an eye on him and I got my hypo kit ready just in case! I'm feeling confident. Gonna grab a +8.5 quick before I leave the house to run errands!
 
Thank you Albert and Corky's Mom for the kind words! I'm very lucky to have a vet that only treats cats. She's very knowledgable and trusted in the community. I know the people on here are very experienced, as well so I feel lucky to have so many people to help me!
 
Good to see he's on his way up. Now you have to decide how comfortable you are shooting if he's not over 200. I'd still suggest a reduced dose tonight if you do shoot. No need to repeat the last few days. Your call if you want to go with 0.5 units or 0.75 units. You are the one who will have to monitor. You might also consider how much he feels like eating.

Lantus is a depot style insulin, meaning shots are cumulative and he might go lower with back to back shots. It does take 5-7 days of regular shots in the beginning to build that depot though.
 
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