In the green for the 1st time! Need advice

Holly and Sunny Bear

Holly and Sunny Bear

Active Member
I upped Sunny's dose this morning to a fat 2U and am keeping a close eye on him. His BG just read as 89 at +5 and his lowest numbers historically are at +5 +6 and +7 so I'm nervous about it going lower.

I'm checking every hour - but wondering if i should give him a meal or just watch now. At what number do i worry about going hypo?
 
Hey Holly, some really good numbers!

I would say if he came up from that 76 without food, and you're able to keep an eye on his BG numbers over the next few days, then try and stick at that dose. The longer he can stay in the low blues/dark greens the more chance his pancreas will have to heal.
 
That is great that Sunny had his first greens! :cat: It is good that you were able to test him so often.

If he were my cat, I had hypo supplies on hand, and I knew I was able to stay with him to test him often, then I would feel comfortable with just watching him (no emergency high-carb foods) and seeing what he does, which is what you did! Another thing to note is that the ProZinc Forum isn't as active as the Main Forum, so if you are ever worried about him going low and want some time-sensitive advice then you can get quicker answers there.

You don't have enough days of data to give a good prediction about what will happen if you keep him on that fat 2u. Since you just started him on insulin, are following Start Low, Go Slow method, and he dropped below 90, he has earned a dose reduction of 0.25u according to SLGS. See how he does on that, then adjust accordingly. When you get more data on SLGS (at least a month), and are able to continue getting mid-cycle tests day and night, then you could consider switching from SLGS to the Modified ProZinc Method which allows for lower nadirs and lower preshot values. But for this first month, it is best to play it safe and follow the dosing protocol.

If you want to improve the data you collect, try to get a +2 each morning and night (especially the night one). Then, you can look back on this data and see what is number was at +2, and compare it to the current PMPS +2 to see if you can sleep soundly :) It's a great way to help predict if he will have an "active cycle" where his BG drops.

Holly and Sunny Bear said:
At what number do i worry about going hypo?
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Refer to the hypo emergency page for information about hypo. You will be concerned about both the BG number and any symptoms he is displaying.

Do you have a hypo-kit set up yet?
 
FarmKitty said:
That is great that Sunny had his first greens! :cat: It is good that you were able to test him so often.

If he were my cat, I had hypo supplies on hand, and I knew I was able to stay with him to test him often, then I would feel comfortable with just watching him (no emergency high-carb foods) and seeing what he does, which is what you did! Another thing to note is that the ProZinc Forum isn't as active as the Main Forum, so if you are ever worried about him going low and want some time-sensitive advice then you can get quicker answers there.

You don't have enough days of data to give a good prediction about what will happen if you keep him on that fat 2u. Since you just started him on insulin, are following Start Low, Go Slow method, and he dropped below 90, he has earned a dose reduction of 0.25u according to SLGS. See how he does on that, then adjust accordingly. When you get more data on SLGS (at least a month), and are able to continue getting mid-cycle tests day and night, then you could consider switching from SLGS to the Modified ProZinc Method which allows for lower nadirs and lower preshot values. But for this first month, it is best to play it safe and follow the dosing protocol.

If you want to improve the data you collect, try to get a +2 each morning and night (especially the night one). Then, you can look back on this data and see what is number was at +2, and compare it to the current PMPS +2 to see if you can sleep soundly :) It's a great way to help predict if he will have an "active cycle" where his BG drops.


Refer to the hypo emergency page for information about hypo. You will be concerned about both the BG number and any symptoms he is displaying.

Do you have a hypo-kit set up yet?
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Thank you for this guidance! Soaking it all in.
 
Holly and Sunny Bear said:
I'm scared he's going to go hypo while I'm sleeping after his PM dose.
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I think this is more evidence that you should follow the SLGS dosing protocol and do a dose reduction. The more data you collect, the more knowledgeable and confident you will feel when dosing the insulin.

Just to put numbers into perspective a bit: my Dixie's nadirs where in the 70's a few weeks in a row (near the top of my 2021 spreadsheet), and I have given her insulin shots when her pre-shot has been in the 90's. That isn't hypo range. When they get to that <60 range (as mentioned on the hypo emergency page), then you want start monitoring them closely and think about bringing their levels up with food or syrup, making a post, etc. But even then, that doesn't guarantee a hypo happening. It really depends on the cat.

Check out the 'What is Regulation?' section in this stickied post. I suppose the ideal situation would be 'tight regulation', where the numbers are usually in the range 60-120. So in this case, the numbers can acceptably go even lower than what you saw in Sunny today without any issue. But this will require more data, testing, and experience, so don't expect this right off the bat. Start with SLGS and see how far you get with it. You will know when you feel comfortable to move to more custom dosing.

Basically, be alert when Sunny goes low unexpectedly, gather data, and try to be relatively prepared. But don't worry about hypo at every turn since that is just unneeded stress on your life!

Holly and Sunny Bear said:
I will reduce his dose by .25 tonight and check him at +2
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That sounds good. Will be interesting to see how his next few cycles are.
 
It's not under 200 (which is the recommended number to skip if you have < 3 months of data), so you could still give 1.75u, but this will depend on a couple of things...

Are you able get midcycle tests? Looks like +5 to +7 is the nadir time. Can you set an alarm and wake up around then? Do you have work tomorrow and need a good night's rest? Can you leave some food out?

If you are really worried and want a good nights sleep, then you can reduce it by 50% and see how he does.

Whenever you see a "new" low PS number like this, you look at previous cycles (which is hard to do here), and decide what you wanna shoot. It is totally fine if you want to do temporary reduction just for this cycle to see how he reacts with this low PS number. Then next time you a similar PS number, you give more insulin (closer or equal to his usual dose).
 
Not sure if you gave insulin yet or not, but looks like his numbers are rising, so it would be suitable to give some insulin. Even a small amount of insulin (aka a token dose) is better than no insulin in this case.
 
Thanks @FarmKitty! I just gave him 1.75and will get up tonight and check on him. :) thanks for your advice!
He just tested at 311 -- but i did feed him an hour ago. Didn't realize I needed to stall on feeding him to see where his BG was going without food. :banghead:
 
Holly and Sunny Bear said:
Didn't realize I needed to stall on feeding him to see where his BG was going without food
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Haha, yeah that is necessary for stalling. Otherwise the BG will be temporarily high just from the food, so the number isn't useful in determining if you can safely give insulin. It's good that you are learning about this now vs in the future when Sunny gets a lot lower though :D. Hope he has a nice cycle!
 
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