Low numbers

Hala

Hala

Member Since 2023
https://felinediabetes.com/FDMB/threads/7-5-pre-shot-what-do-i-do.275977/#post-3060724


#Admin
Today my sugar cat’s numbers were beautiful for the first time since his diagnosis back in August. Please take a look at his spreadsheet and give me your advice. I am thinking of reducing the shot again eventhough I reduced it last night? It is it safer to skip? I skipped shooting 2 days ago and the numbers were more elevated.
I have to mention as well that when I skipped the shot 2 days ago, the morning after I had to shoot him 2 hours earlier than his usual shot time but I kept the 12 hours cycle and I am moving forward in 15 mn increments to be back in the old schedule.
https://docs.google.com/spreadsheets/d/10Qgx5tX91g7TG1XC0p1-SL4vOnLWhsbV4580nDYCK24/edit
 
With SLGS reductions are earned if under 90. That’s not the case. When lower than usual stall, do not feed, and recheck in 30 minutes. Then you have choices based upon the new bg. Did you test again? Did you feed?
 
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.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus, Levemir, and Biosimilars users following the Start Low Go Slow approach:
 
From the sticky on helping us to help you:
  • Your thread title should conform to the following format:
Date (mo/day) Kitty’s Name AMPS or AMBG subsequent test numbers PMPS or PMBG subsequent test numbers (AMBG and PMBG are used if you don’t shoot or gave an accidental fur shot).

As an example: 06/26 Fluffy AMPS 220 +2 160 +3 120 +5 100 +8 132 PMPS 200 +2 287 +5 300

Also add a question mark prefix to call attention to your thread.
 
tiffmaxee said:
With SLGS reductions are earned if under 90. That’s not the case. When lower than usual stall, do not feed, and recheck in 30 minutes. Then you have choices based upon the new bg. Did you test again? Did you feed?
Click to expand...
I just saw your reply. Actually he did drop below 90 today If you take a look at the spreadsheet at +6 he was at 4.7 (84.6) that’s why I thought he earned a reduction. I have already read the enclosed info about dosing ( thank you for the screenshot by the way) and therefore I assumed that a token dose is the right thing to do and that was based on the fact that I tested him again half an hour later and his BG was up to 8.6 from 7.5. I gave him 0.5u
Do you agree that I should reduce the dose tomorrow to 2:25? He is on 2.50u since yesterday.
 
tiffmaxee said:
From the sticky on helping us to help you:
  • Your thread title should conform to the following format:
Date (mo/day) Kitty’s Name AMPS or AMBG subsequent test numbers PMPS or PMBG subsequent test numbers (AMBG and PMBG are used if you don’t shoot or gave an accidental fur shot).

As an example: 06/26 Fluffy AMPS 220 +2 160 +3 120 +5 100 +8 132 PMPS 200 +2 287 +5 300

Also add a question mark prefix to call attention to your thread.
Click to expand...
 
I am still figuring out how to post correctly in the forum. I will do that next time. Thank you
 
Yes, definitely reduce the dose. Whenever the BG is under 90 during a cycle a reduction is taken the next cycle even if it’s the first cycle on a reduced dose. Congrats.
Your ss is a little weird. The last reading says 3/8 so I thought it was not up to date.
 
tiffmaxee said:
Yes, definitely reduce the dose. Whenever the BG is under 90 during a cycle a reduction is taken the next cycle even if it’s the first cycle on a reduced dose. Congrats.
Your ss is a little weird. The last reading says 3/8 so I thought it was not up to date.
Click to expand...
 
tiffmaxee said:
Yes, definitely reduce the dose. Whenever the BG is under 90 during a cycle a reduction is taken the next cycle even if it’s the first cycle on a reduced dose. Congrats.
Your ss is a little weird. The last reading says 3/8 so I thought it was not up to date.
Click to expand...
The spreadsheet should be on World mmol. Maybe you see it converted to US? I checked it on my signature and it’s normal! ( a member in this group pointed it out a few days ago as well and then I thought it may have been converted to US)
 
Good luck with the new dose.

The World version of the spreadsheet looks fine, but there is an extra line underneath today's entry on the US version. It's a good idea to double check the US tab of the spreadsheet, as that's what most people here look at to help with dosing.

A request, when you skip a shot, could you please put wither "skip" or "NS" for no shot, in the units cell. That way we know at a glance that you skipped the shot instead of that you just forgot to enter the data. Skipping can impact Lantus dosing, so it's good for us to know if that's what you did.
 
Wendy&Neko said:
Good luck with the new dose.

The World version of the spreadsheet looks fine, but there is an extra line underneath today's entry on the US version. It's a good idea to double check the US tab of the spreadsheet, as that's what most people here look at to help with dosing.

A request, when you skip a shot, could you please put wither "skip" or "NS" for no shot, in the units cell. That way we know at a glance that you skipped the shot instead of that you just forgot to enter the data. Skipping can impact Lantus dosing, so it's good for us to know if that's what you did.
Click to expand...
 
Oh I see I thought not filling the cell indicates no shot so that’s clear now. And I have no idea why these numbers are appearing in the US version but I will check again. Thank you for your feedback.
 
Wendy&Neko said:
Good luck with the new dose.

The World version of the spreadsheet looks fine, but there is an extra line underneath today's entry on the US version. It's a good idea to double check the US tab of the spreadsheet, as that's what most people here look at to help with dosing.

A request, when you skip a shot, could you please put wither "skip" or "NS" for no shot, in the units cell. That way we know at a glance that you skipped the shot instead of that you just forgot to enter the data. Skipping can impact Lantus dosing, so it's good for us to know if that's what you did.
Click to expand...
Again thank you for the clarification
Last question for this thread because it’s related to low numbers and I got a bit anxious after I gave the token dose. The numbers I have are in pet metre so they are lower if converted to human metre ( I use the formula) so my question is can I still follow the dosing and instructions on FDMB OR should I convert the number to a human metre and act accordingly?
 
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