Katie's PMPS; dosage?

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Jennifer and Katie

Jennifer and Katie

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Katie is starting to give me AMPS and PMPS that are lower than 200. Is there a "safe" dose for her that I can give, so that she will stay low, but not go hypo? I had dropped her to 1.25 U yesterday morning, but it still seems to be a little too much. She was AMPS 169 this morning, so I didn't want to give her the normal dose. A half hour later, after she ate, she was at 213. I gave her 1 U. Is this okay? Should I have given her less? What should I dose her with tonight if her numbers are shootable, the 1 U, or the 1.25 U?

Also, the story of her life:

Katie is twelve years old today (Happy birthday, Katie!). We have come a long way since I rescued a four week old kitten from a "death row" shelter, where the veterinarian was known as Dr. Death. She turned out to be a sweet, playful little thing who didn't know how to use a litter box. After a few mishaps on my bed, she learned. This little kitten came into my life at a difficult time. I had been in foster care when my grandparents came for me. They lived in an area where I had no friends, and nothing was familiar. Little Katie provided warmth, laughter, and a way for me to get back on my own two feet.
She and I have been through a lot together. From her dealing with the various cats and dogs I rescued, to moving three times already in her lifetime, as well as trips to the vet for a reabsorbing tooth, sprained feet, and declawing (which I will never again do), to now dealing with diabetes. Katie has been an inspiration in my life, demonstrating that you can persevere through most anything. She gives the right amount of affection, while still retaining her dignity as an independent kitty. I know we still have lots of challenges ahead, and hopefully, many years more together.
 
Re: Questions about under 200 dosing, and a story

Happy Birthday Katie!!!

party_cat party_cat

Great Story!

I will look at the SS and give you my toughts--but, rushed right now!

Good on you for giving Katie a GREAT home!
 
Re: Questions about under 200 dosing, and a story

What a beautiful story of you and Katie and she is a beautiful girl. Happy Birthday Katie party_cat !

I think that lowering her dose is a good idea, the 1 unit this morning should be just fine. I think I would stick with 1 unit for a while and see if she evens out her PS's some, unless of course she gets a lower PS again, then reduce more.

You can shoot lower doses into lower PS's but you will need to gather some data to make sure it is safe to do so. Will you be able to get any mid cycle tests in today to see how she does with the 1 unit?

In the future when you wait to retest a lowish PS, don't feed her in between, the higher numbers will be from food spike and you want to see that her true bg is rising on it's own.

Welcome to our group Jennifer, you are doing great and you have great instincts.
 
Re: Questions about under 200 dosing, and a story

Hi Jennifer, and Happy Birthday to Katie!
Good decision this morning, it looks like you're getting the hang of this! I'll 2nd what Robin said - when you are waiting to decide on shooting du to a low PS, you can give it that 1/2 hour but don't feed her. You still want to see a higher reading on the 2nd test, but you want to be sure it is from Katie's system rather than from the food. Then you will know for sure that you are feeding a naturally "rising number". If you get a lower number the 2nd time, then you don't want to shoot into a "falling number", or you want to shoot a dose that is even more reduced.
Katie should do just fine on the 1u today. If you can be around to test her during the day, that information will be very valuable to you the next time questions like today's pop-up because you'll already have evidence on what the reduced dose does for her over the course of a cycle.
As you start seeing a lot of blues and greens, you are going to get a real good feel for this dose adjustment thing. You'll be dealing with smaller doses as well. But as you make adjustments, try to stay with the new dose for a few shots in a row (BG numbers permitting of course) so that you give her a chance to adjust to the new dose. You're trying to gently and gradually allow her body to take over the job of producing insulin so that she won't need your help with that.

And thank you so much for sharing Katie's story. One of the great things about this site is that it allows us to meet so many great people and meet their sugarcats at the same time!

Carl and Bob in SC
 
Re: Questions about under 200 dosing, and a story

Happy birthday sweet Katie!!
and what a wonderful story, thank you so much for
sharing your life with us.

I agree with everything everyone told you this morning
looks like you 2 are coming along great!!!
:mrgreen:

Denise and shakes
 
Re: Questions about under 200 dosing, and a story

Katie's AMPS +2 is 152. We are going to lunch for my great-grandmother's birthday, so I won't be able to test her during nadir time (go figure). I will test right before I leave, and as soon as I get home.
 
Re: Questions about under 200 dosing, and a story

Agree, agree. You are doing a great job with your Katie. The nadir numbers will really fill out the picture for you.

Here is some info on micro dosing:

Micro Dosing headed to remission
When your cat is consistently in numbers too low to shoot at shot time and in numbers in the 100 range and below during the cycle, you can consider micro dosing. This process should be guided on the forum by experienced members and will require more frequent testing.

You may be shooting at times other than the 12/12 schedule, when the blood glucose levels rise enough to require a small dose of insulin. You will need to pick a number somewhere near the 150 range at which you will plan to shoot, being sure that the number is indeed rising. The dose at these low numbers will vary with each cat and its patterns, so advice should be solicited. But you may be considering doses below .25 and even considering a “drop” of insulin. At this point, U100 needles and the conversion chart will be necessary.

It is important during this period to offer small frequent meals. You may want to experiment with the lowest carb foods to help bring down the numbers, staying away from seafood more than once or twice a week.'

BUT you don't want to try these methods until you have some more information about her numbers at nadir and maybe have done a curve?

Thanks for such a sweet story. Sounds like you and Katie are a real team. cat_pet_icon
 
Re: Questions about under 200 dosing, and a story

Happy Birthday, Katie. And yes, Jennifer, you're doing a great job.
 
Re: Questions about under 200 dosing, and a story

I was so nervous while I was at the luncheon! I was afraid I was going to come home to a hypo kitty. Instead, she greeted me with her normal affection. Her +5.5= 62.
 
Re: Questions about under 200 dosing, and a story

Still good. A small snack would be ok but not required.
carl
 
Re: Questions about under 200 dosing, and a story

Her +6 is 53!! I made her eat some wet food, but how worried do I have to be about this number? Does this mean the 1 U of insulin is still too much??
 
Re: Questions about under 200 dosing, and a story

These are very nice numbers, but they don't leave you alot of wiggle room - particularly early on when you aren't sure what her patterns are. A nadir of 53 is wonderful. Sometimes kitties have a later nadir than +6, so I would suggest feeding her a little lo carb food and taking another test in 15 - 20 minutes. You just want to be sure she is headed up, not down.

I would think lowering the dose by a little would be wise, but let's see what you get for a pm preshot number.

Okay to be nervous, but this is GOOD news! These are lovely numbers for so early in the sugar dance. They just mean more testing for Katie and monitoring for you.
 
Re: Questions about under 200 dosing, and a story

We are not worried, but just like to be prepared. Do you have some higher carb food around if you need it? Something wet, maybe with that forbidden gravy?
 
Re: Questions about under 200 dosing, and a story

No. 53 is just where you want her. If she ate a liile she'll start back up.
if she keeps acting normal just test her in 30 minutes and at +1 and post her #'s
Carl
 
Re: Questions about under 200 dosing, and a story

I am on my phone so i can't be my normally wordy self! Thanks for also being here Sue
Carl
 
Re: Questions about under 200 dosing, and a story

AMPS +6.5= 59. She's gone up a little bit, but that could just be from the food, right? If 53 is a good number, when do I have to start worrying? Below 50?
And yes, I have some wet food that has 16% carbs. Is that enough? At what number do I feed the high carb food? I've read the hypo sticky, but hearing things from people reiterates what I've read.
 
Re: Questions about under 200 dosing, and a story

She is a new diabetic so you can be cautious. I would consider the gravy off the higher carb food if she heads down below 50. You don't have to feed the can, just some of the gravy.

Yes, the food may be bringing her up, but that is good. That is what you want and is good information for you - to know that food brings her numbers up.

Maybe another test in 15-20 minutes? I know you are also probably watching her like a hawk. You normally wouldn't see any unusual behaviors in the 50s but there is that "Every Cat is Different" thing. If she would howl or hide or twitch, it is time to break out the honey.

I am just being cautious since she is so new to insulin. 50s are lovely numbers. We just wouldn't want to go into the 40s but she probably will start heading up.
 
Re: Questions about under 200 dosing, and a story

so I looked at your SS and it appears that her nadir is normally at +6 and you fed her
and her number went up some so I think she is fine.
Normally I panick when I see 50 and under, especially if the very low number is at a +4 or+5
but +6 when her nadir is your fine.

I am so curious as to what her pmps will be.....
If possible tonight, if she is low at +12, can you not feed and wait 20 minutes and test again
would love to see how she is surfin...
she might bounce, I know I just looked at her ss but cant remember the last time she saw green...

keep us posted
 
Re: Questions about under 200 dosing, and a story

AMPS +7= 74. I would be posting this in Katie's SS as well, but google doesn't want to load it right now.
 
Re: Questions about under 200 dosing, and a story

That is looking fine, Jennifer. Good to know that her nadir is generally around +6 and that food will bring her up. You did great - survived your first adventure with lower numbers. Be sure to post her pm preshot number and get some advice on dose. She is reacting very well to the insulin and food change.
 
Re: Questions about under 200 dosing, and a story

Awesome job Jennifer!
Carl
 
Re: Questions about under 200 dosing, and a story

Welcome to our group! What a great story! Looks like you & Katie are doing wonderful.
 
I tend to be conservative so take my advice in that context. It's overnight - she probably won't be eating and you probably won't test. It can be a bounce from her 50s today. I would go with a little less than one unit. Are you using U100 needles? Could you eyeball like a .75? I think it is easier to be more aggressive with dosing when you are with her and she is active and eating. You can leave out some low carb overnight in case she dips a little low and she can bring herself up.

What do you think?
 
There's not a lot of traffic on here late at night but hopefully someone will be along before then. Hang on.
 
I'm using u-40 syringes, actually, but I think I could still eyeball 0.75. Don't you think that will make her numbers shoot back up, though, and we'll be back at square one?
 
I don't know, Katie. That is why we call this thing a sugar "dance". You just can't be sure - she is reacting well to the insulin and the food change may still be kicking in. Or she may be already settling in to both. At some point, you go with what you feel best about. Your gut is a pretty good gauge and you know your cat better than I do.

One unit will most probably be safe. If I were you, if I gave that dose, I would set the alarm for +6 and get a test and I would leave food out overnight.

It's too bad the board is so quiet. It would be nice if you could get another opinion as I know I am more conservative than some.
 
Jennifer,
I missed this till just now. I think the 1u is fine. Like Sue, I tend to be conservative with dosing advice, since it isn't "my" kitty. I was pretty agressive with Bob, but I knew him, and had a good feel for how he'd react, plus I was "right here" if things went bad. But Bob never had a hypo. He dropped into the 40s a couple times and that scared me (more than him I think). If try to forget Bob's dance when trying to help others with their's, well, because ECID and Bob was very "D".

I might have went along with the .75, but definitely not more than 1. If you shoot a high number with a higher dose to try to bring it down (I think that is called "chasing" the high), you'd most likely end up with bounces, or you might push too much and go way low. .75 would have been conservative, and 1u is agressive, but not too agressive I think.

Carl
 
Yikes, I missed all the excitement.

I'm pretty sure that your PMPS is panicky liver from those beautiful greens today and it will clear in a few cycles by itself. We usually say "don't shoot extra insulin into a bounce" because it will clear on it's own and if you have raised the dose you might be shooting too much insulin when the bounce clears.

I'm with Sue, I would lower your dose to .75u going forward so you can avoid getting on the high/low roller coaster.

Good job today.
 
Her PMPS +5 was 164. AMPS=274. Also, she had loose stool this morning, which worries me, since she very, very rarely (almost never) has loose stool. Gave 0.75 U for AM.
 
I like your plan. It may be a little lower than she needs, but the numbers will tell you that. My theory is that you can always raise the dose the next time around, but there is no way to get the insulin out of the kitty once it is shot. :mrgreen: You are doing a great job, Jennifer.
 
Wanted to wish Katie a Happy Birthday!
It sounds like you and Katie have been through a lot together, your story was very nice.
She seems to be getting a very good response to 1U, that is very good early on in the sugar dance, theres hope she may be one of the lucky kitties that can go off the juice.
Have you changed her food at all? Maybe that is what is causing her to have a loose stool.
 
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