Low PMPS Number all of a sudden - to shoot or not?

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Kelly & Oscar

Kelly & Oscar

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Oscar had his dose changed to 1 unit twice a day starting this Friday evening. Today he snubbed his FF Ocean whitefish flavor food (my civie did too) so I added a can of Tender Beef Feast to that to get them to eat. They have been munching all day here and there, and his numbers have been in the upper 200's all day. I just tested and at first he was 89, and I thought that just can't be right, so I tested again. Second time he was 96. I thought, can I mess something up 2 times in a row? Tested a third time - he was 106 (different ear)! He gained 5oz of weight for the first time in 4 months last week - could his pancreas already be kicking back in? Should I shoot a negligible amount just to keep it in his system? Should I wait to see if his numbers go up and then shoot? Should I skip it all together?
 
Kelly--
Did Oscar just go on a plane trip this week? How did he do? (I've never been brave enough to try travel with the pets)
I wouldn't even begin to give you advice on a shoot/no shoot for the night, I'm sure someone else will be along soon with better experience.
Can you monitor thru the night if he dips too low? (might be a silly question, but: do you have hc, mc food and karo?)
 
personally i would not shoot and i can't with clear conscience advise you to either. that's just way too low for a pzi insulin in my opinion. and yes, i used to do Dr. Hodgkin's TR protocol so i'm not all that unfamiliar with shooting pzi on lower numbers.
 
FurballLover said:
Kelly--
Did Oscar just go on a plane trip this week? How did he do? (I've never been brave enough to try travel with the pets)
I wouldn't even begin to give you advice on a shoot/no shoot for the night, I'm sure someone else will be along soon with better experience.
Can you monitor thru the night if he dips too low? (might be a silly question, but: do you have hc, mc food and karo?)
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We did have a plane ride this weekend. He did wonderfully - but I am sure it also helped that we have had lots of car rides in a kennel to the vet this past month too. The most important thing they don't tell you on the TSA website is that you have to take your kitty out of his carrier and carry him through the metal detector while the carrier goes through x-ray. I have bloody scratches to show how stressful that situation was. On the way home I gave him 3ml of Children's Benadryl to dope him up enough just to get through security. He was alert and just fine by the second leg of our plane flight.

I am currently on spring break, so I can monitor him all through the night. I do not have karo on hand, but I do have hc dry food and honey.
 
If it were me, I'd shoot at least 0.8 I think you really need to figure out when Oscar is at his low and starts to raise. Looks like somewhere between the +9 and +11, but you need more data. I found with Prudence that if I missed her dose... she would be back into the high numbers again. If you decide to shoot. I'd make sure I'd watch his bg by +6 and on. Again, you need more data on when he's at his low. I had to shoot a 0.4 when Prudy was at ps 124, but that's because I had more data to go by. Every cat is different. You should really keep a tight watch on Oscar if he's getting into the kibble, ok? Sorry if this is coming off strong, but I am trying to type fast since you're wanting to know. My thoughts... he should get something.

Read this too viewtopic.php?f=22&t=9070

Hugs!!!
 
Michelle said:
If it were me, I'd shoot at least 0.8 I think you really need to figure out when Oscar is at his low and starts to raise. Looks like somewhere between the +9 and +11, but you need more data. I found with Prudence that if I missed her dose... she would be back into the high numbers again. If you decide to shoot. I'd make sure I'd watch his bg by +6 and on. Again, you need more data on when he's at his low. I had to shoot a 0.4 when Prudy was at ps 124, but that's because I had more data to go by. Every cat is different. You should really keep a tight watch on Oscar if he's getting into the kibble, ok? Sorry if this is coming off strong, but I am trying to type fast since you're wanting to know. My thoughts... he should get something.

Read this too http://felinediabetes.com/FDMB/viewtopi ... =22&t=9070

Hugs!!!
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Its ok ... I kicked myself this morning for turning my back while the dogs were eating. He hasn't had much of a curve since he has started insulin, so I really have no idea how long it stays in his system. I do know that shooting an hour earlier this Sunday after DLS made him go into the blue.

I just checked his BG again and it is 234 at +2 from his meal. Should I do his regular dose of 1 unit now?
 
i wish i had caught you with that 13? number cause he was definitely on his way up at that point and i would have said shoot then so yes, i'd definitely shoot now
 
Cindy + Mousie said:
i wish i had caught you with that 13? number cause he was definitely on his way up at that point and i would have said shoot then so yes, i'd definitely shoot now
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I just shot a skinny 1 unit (about 0.8),so we'll see how he does. I'll keep everyone updated until I go to bed this evening.
 
I'm late to the party, but generally people set a no-shoot # (150, 180, or 200 are the ones I have seen, depending on your comfort level - sometimes people start with 200 then lower to 180 and then 150 as they get more data and know what doses are safe). If you get a # below that, you retest (every 30 minutes or every hour, depends on your cat's patterns and how low the # is) til you get a shootable #. If you have a clearly rising # that's below the no-shoot but not super low, then if you are shooting late you might go ahead and shoot anyway, since the shot will generally be less effective anyway as the time wears on, so a slightly lower PS is less risky.

Sometimes when I shot late I would raise the dose a bit - like you said where you got blues after a +11 shot, I found it would work the other way on a +13, and the dose that normally gave me a good nadir would just hold things from going high, rather than giving a nice drop. ECID though, so I'd view all of this as good data collection, now you have a sense of his response in this set of conditions.

The 89 or 106 PS in and of itself is interesting... not sure what it means. Sometimes a late drop like that (and you have a bit of an inverse curve too on that cycle - did you say he got into dog food this morning?) can mean the dose is too high, but I wouldn't have thought that at all except for that one cycle. Everything else I see looks like the dose is a bit low. When you get better results on a +11 shot like that, it tells me that a slightly higher dose might work better at a +12. But that 106 and the inverse curve really throws me off. Maybe others will have insight...
 
Joanna & Bix said:
The 89 or 106 PS in and of itself is interesting... not sure what it means. Sometimes a late drop like that (and you have a bit of an inverse curve too on that cycle - did you say he got into dog food this morning?) can mean the dose is too high, but I wouldn't have thought that at all except for that one cycle. Everything else I see looks like the dose is a bit low. When you get better results on a +11 shot like that, it tells me that a slightly higher dose might work better at a +12. But that 106 and the inverse curve really throws me off. Maybe others will have insight...
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I was thinking the exact same thing about the +11 shot: all of his numbers so far indicate that I should raise the dose, but those low numbers last night are proverbial wildcards. I might let this dose settle in for a few more days to see what happens before I raise it again

Michelle said:
Kelly & Oscar said:
293 now at 1 hour after shot, 3 hours since the 106 number
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Just keep in mind that if you shot at 234. adjust your 12 hours.
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:YMSIGH: I shot 30 min late this morning thinking that would help and because he was already at 317. I hope I didn't mess things up further! nailbite_smile
 
Joanna & Bix said:
The 89 or 106 PS in and of itself is interesting... not sure what it means. Sometimes a late drop like that (and you have a bit of an inverse curve too on that cycle - did you say he got into dog food this morning?) can mean the dose is too high, but I wouldn't have thought that at all except for that one cycle. Everything else I see looks like the dose is a bit low. When you get better results on a +11 shot like that, it tells me that a slightly higher dose might work better at a +12. But that 106 and the inverse curve really throws me off. Maybe others will have insight...
Click to expand...

I agree with Joanna about a slightly higher dose might work better at a +12.
 
Michelle said:
Joanna & Bix said:
The 89 or 106 PS in and of itself is interesting... not sure what it means. Sometimes a late drop like that (and you have a bit of an inverse curve too on that cycle - did you say he got into dog food this morning?) can mean the dose is too high, but I wouldn't have thought that at all except for that one cycle. Everything else I see looks like the dose is a bit low. When you get better results on a +11 shot like that, it tells me that a slightly higher dose might work better at a +12. But that 106 and the inverse curve really throws me off. Maybe others will have insight...
Click to expand...

I agree with Joanna about a slightly higher dose might work better at a +12.
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I will be contacting the vet today about a dose change. Should we go up to 1.5, or go small - 1.2?
 
I like the 0.2u increases personally, but don't think there would be anything wrong with going 0.5 right now, since you are home testing and can do some mid-cycle checks to be sure the #s aren't getting low. I probably wouldn't do any steps that big once you are at 1.5 though. Since you have already seen some occasional blues, I think good #s are on the horizon! :)
 
An update for those that did not see my post in the general discussion FD part - we have a check up appointment at the vet tomorrow because he has a small amount of ketones in his blood (0.3mmol/L), puked this afternoon, and his appetite is diminished. Sounds like we definitely need a dose increase here!
 
Oooh, with ketones yeah, probably you'll want to jump up by 0.5u I would think. Glad you are going to the vets - if you can get any food or fluids in him that is good, if he will keep stuff down. Hope he is feeling better soon.

Ketones .... be gone!!!! cat(2)_steam
 
Right before his PM shot he started begging for food flip_cat I gave him his favorite - FF Flaked Fish and Shrimp, and he gobbled it all up and still wants more. YAY! I just got an email back from my vet to approve a dose increase to 1.5 units twice a day. I will check his ketone level again tomorrow to see if we are any different. I am so very glad that I purchased the Precision xtra meter and ketone strips. I would have never known he had ketones because he hasn't visited the litter box (that I have seen lol) since he puked.
 
Kelly & Oscar said:
Right before his PM shot he started begging for food flip_cat I gave him his favorite - FF Flaked Fish and Shrimp, and he gobbled it all up and still wants more. YAY! I just got an email back from my vet to approve a dose increase to 1.5 units twice a day. I will check his ketone level again tomorrow to see if we are any different. I am so very glad that I purchased the Precision xtra meter and ketone strips. I would have never known he had ketones because he hasn't visited the litter box (that I have seen lol) since he puked.
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That's GREAT he wanted to eat!!!!! Sending prayers that the Ketones go away!!!!!!
 
Kelly-
Great news!! Hope he continues to eat and do better-tell him not to scare his momma like that ok!? Keeping paws crossed for no more ketones =^^=
 
We started with the 1.5 units this morning and he is already back in the 300's as of an hour ago. The ketone level is still at 0.3. We have a vet appointment in an hour to check on things, but he seems to be holding steady with no more puking. I really hope this new dose settles in soon! I don't like to see those 300's!
 
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