"Low" PMPS number for Tigger- help please

Stack the BG readings in the cell, and manually color code it, with the blue color.

We usually stay up with someone, if we tell them to go ahead and shoot. But I'm not able to do that.
You'll want to get at least a +2, and depending on if that number is lower than the pre-shot test, it may be an active cycle and you will want to test every 2 hours or so.

Do you feel ok with shooting the full dose?

So if you need help, please post in the Feline Health forum. OK?
 
Deb & Wink said:
Do you feel ok with shooting the full dose?
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As long as you feel it is okay to give the full dose. I can monitor as often as needed and have various high carb wet food and treats as well as hard food.
I feel he usually doesn't drop more than 100 points from a shot, but I know it could always be different with a number this low, or this low for him, I should say.
I will post there if needed.
 
If Tigger were my cat, I'd give the full dose.
And monitor as much as needed, have my hypo kit standing by and call for help if needed.

This may be low for Tigger, but anything above 150 mg/dL is shootable. Skipping a shot or giving a reduced dose is more for the "convenience" of the caregiver, due to circumstances such as work or other commitments.
 
Good luck! Go Tigger!

If you drop below 70 or so, post for help. That 70 is still plenty of wiggle room for Tigger to drop more. But you aren't used to the low numbers, and it never hurts to get a bit of help. Below 50 mg/dL on a human meter (68 mg/dl pet meter) is where the support with food is needed, bringing up the low numbers with some low carb food first. Just a teaspoon of his regular food to start with, retesting in 20 minutes, posting the new number in your thread.

Medium carb food, 10- 15% or so would be step 2 in bringing the BG numbers back up, if repeated feedings of Tigger's regular low carb food are not doing the trick.

High carb food, >15% carbs is step 3 in bringing the BG numbers back up. Dry food and treats take longer to be digested and have an impact on the BG levels. It's why you want to try the canned food first. Simple sugars like honey or corn syrup act fast, but wear off fast too. So some real food, is needed also.

"Feed the 40's" is an expression we use here.

@Chris & China (GA) is a late night person and lives farther west of where I live, so she may be on later to help.
 
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Chris & China (GA) said:
Looks like Tigger's going to bounce tonight!
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I was fully expecting a number in the high 300s or even 400s..but I got a 204! Not too horrible!

I did have to check him 30 minutes earlier than when his shot was given last night. Since I stalled and delayed shot time. I had to leave for work. Today is my last day of work for 2 weeks (we divided into teams and then self quarantine for 2 weeks before we go back)
But I will have plenty of time to devote to checking on him in the coming days!
 
Breanna H said:
I was fully expecting a number in the high 300s or even 400s..but I got a 204! Not too horrible!

I did have to check him 30 minutes earlier than when his shot was given last night. Since I stalled and delayed shot time. I had to leave for work. Today is my last day of work for 2 weeks (we divided into teams and then self quarantine for 2 weeks before we go back)
But I will have plenty of time to devote to checking on him in the coming days!
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Those are terrific numbers in my eyes, you are doing a great job and you are lucky you have a kitty that is handling the insulin very well....Wish my Brady had those numbers....Im very very happy for you and your little Tigger!!! You got this!!!
 
Breanna H said:
I was fully expecting a number in the high 300s or even 400s..but I got a 204! Not too horrible!

I did have to check him 30 minutes earlier than when his shot was given last night. Since I stalled and delayed shot time. I had to leave for work. Today is my last day of work for 2 weeks (we divided into teams and then self quarantine for 2 weeks before we go back)
But I will have plenty of time to devote to checking on him in the coming days!
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And yes the one comment you made above is so true, Deb is fantastic and we are so lucky to have people devoted to helping us with cats and trying to keep them healthy, cant ask for anything better!!
 
Breanna, looks like the 6.5U dose is finally having an impact on Tigger's BG numbers! That is fantastic!!!!!
A little bounce last night, but still a nice low yellow (200-299) with that 204 BG reading this morning. Way to go Tigger!!!!

Let's see how he does on this dose for a few more cycles.

Love your new avatar, with Tigger taking a nap on and above your head. Does he do that often?
Breanna H said:
I did have to check him 30 minutes earlier than when his shot was given last night. Since I stalled and delayed shot time. I had to leave for work. Today is my last day of work for 2 weeks (we divided into teams and then self quarantine for 2 weeks before we go back)
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No worries on having to check him 30 minutes earlier than usual. Prozinc is nice and flexible that way, allowing more leeway in the timing of the dose than the longer lasting insulins like lantus.

Yes, it's best to keep to a 12/12 dosing schedule when you can, but Tigger had other ideas last night, and we asked you to stall so that threw you off a bit this morning. Up to 1 hour of leeway is ok with Prozinc. Not every day of course, not every cycle, but now and again, it's perfectly fine.

What do you do for work, that you are on for 2 weeks and then off for two weeks? If you are willing to share that information of course.

You are always welcome. Thank Wink over there in my avatar. He was a true character, in absolutely horrible shape when I first fostered him from the shelter. Needless to say, he ended up being a "foster fail." Best thing that could have happened for him, and me. ;) I miss him.

p.s. @Irish Pat is partially color blind, so I've been trying to remember to include the number ranges whenever I talk about the colors on the SS.

p.p.s. Thanks @Chris & China (GA) for checking on Breanna and Tigger. Deb up at midnight? You've got to be kidding. Past 11 pm or 10 pm? Not likely. I turn into a pumpkin about 8:30 - 9 pm most nights. Like Cinderella's coach did when midnight struck after taking her to the fancy dress ball at the palace.
 
Deb & Wink said:
Breanna, looks like the 6.5U dose is finally having an impact on Tigger's BG numbers! That is fantastic!!!!!
A little bounce last night, but still a nice low yellow (200-299) with that 204 BG reading this morning. Way to go Tigger!!!!
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I am so excited! I hope we keep going forward and not backwards.

Deb & Wink said:
Love your new avatar, with Tigger taking a nap on and above your head. Does he do that often?
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He sleeps on my head quite often. It seems to be his favorite spot. I usually end up being kicked completely off of my pillow but I can't bare to disturb him so I let him keep it, haha. I just took this one the other day.

Deb & Wink said:
What do you do for work, that you are on for 2 weeks and then off for two weeks? If you are willing to share that information of course.
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I am a Registered Nurse in an Endoscopy Clinic. We do all kinds of scopes. Usually I do work every week, Monday through Friday. We divided into teams so if anyone gets sick, the other team can come in and we can continue doing procedures. So far, our hospital has not been hit very hard. Hopefully it stays that way. It is a larger hospital but we are in a more rural area.

Deb & Wink said:
p.p.s. Thanks @Chris & China (GA) for checking on Breanna and Tigger. Deb up at midnight? You've got to be kidding.
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Thank you so much @Chris & China (GA) for checking on us! And I am quite the night owl when I don't have to work. Even when I do, I stay up way too late. Looking forward to these next two weeks of staying up and sleeping in, minus getting out of bed to tend to Tigger, of course.


Keep your fingers crossed for us that this trend of lower numbers continues!!
 
@Chris & China (GA)
@Deb & Wink

Not sure if I should post here or on my main thread so just let me know but we are having a great night! But I need some advice for morning.

Tigger was just 91 at his bedtime +5.5 check. I plan on staying up and rechecking as needed and I have my hypo kit available as well. He is also getting some of his usual wet food now.
I did raise him up .25u this AM as he was still having nadirs greater than 150. I probably should have held the 6.5 longer, but I was half asleep this morning and it was kind of an impulse decision and I did it.
However, now I'm not sure what do now for morning, depending on his number. The modified method says to hold a dose as long as nadirs do not drop below 50. As long as he is >200 in the AM, should I hold?
What if he is less? How much should I drop the dose? (I'm sure he will bounce and be more than high enough but I was hoping to catch someone tonight, just in case).
After loosing all hope, I am finally seeing some light with Tigger!
Thank you!
 
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Breanna H said:
As long as he is >200 in the AM, should I hold?
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If he's above 200 in the AM, I'd go with the 6.75 again as long as you're home and able to test.

It would be helpful for you to start getting some tests in at different times too if you can. Most of them are at or very close to +6....it's helpful to get tests at different points in the cycle.

Think of your spreadsheet like it's a puzzle...if the only pieces you have filled in are along the edges and one strip up the middle, it's hard to know what the picture is. If you sprinkle pieces all over, it's easier to see the whole picture!
 
Breanna H said:
As long as he is >200 in the AM, should I hold?
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As long as Tigger is >200 at pre-shots, you should hold the dose.

You've shot the high blue range (170-178) before, so even a number that is a bit lower than 200, like those 170's, you should be able to shoot as long as you are around to monitor.

Since you have already shot below that 200 threshold, you might want to consider 175 as your new threshold, instead of using 200 mg/dL as the threshold/decision point/shoot or no-shoot number.

As Chris said, sprinkle those tests around a bit. A +2 is always a good test to get. But a +5 or a +7 could help to "fill in the blanks" on the SS.

Your crystal ball agrees with mine, betting that Tigger will bounce after those low greens last night, 4/26/20.

I know your "two weeks on, two weeks off" schedule must make it very difficult to take care of yourself and Tigger. Hope you are managing all the responsibilities in your life right now.

From the MPM protocol, for reference:
How to handle a low pre-shot number:
  • Sometimes your kitty will surprise you with a lower than normal PS number (but above 50). When that happens you have four choices:
    • Skip the dose: If the number is below 200, and your kitty is newly diagnosed (less than three months), your best option is to skip unless your kitty has ketones or is post-DKA (see below) and you should post here or in the Health Forum for help.
    • As you gain more experience and data, your goal is to gradually learn to shoot lower and lower numbers (never below 50). You can use other options below as you are learning to shoot below 200. Ultimately, with data, experience, and knowing your cat, you should be able to shoot PSs above 50 provided you are available and able to monitor.
      • If your cat has been diabetic for awhile and the PS is much lower than normal, you may still need to skip if you have to leave the house for many hours and can’t monitor, but in general we don’t recommend skipping if your cat has a good body of data, so see the other options.
    • Stall: Do not feed your kitty but wait 30 minutes and test again. (Note: we generally stall without feeding because food will falsely cause the BG to rise. It’s important to not shoot a food spike
    • If after stalling the number is rising into safer ranges, you can then give the full-dose shot. You can stall as long as you need to (in 30 minute increments), but keep in mind that the next shot needs to be 12 hours later, so be mindful of your new shot time. If it’s getting too late, try the next option.
    • Reduce the dose: How much to reduce can be a tough decision. Some of it will depend on how well you know your cat, how confident you are in testing, if you’ll be around to monitor, etc. This is a good time to ask for advice. If no one is around and it’s your first time, reduce the dose by 50%. If you have been at this awhile and know your cat’s reactions well, you can do a smaller reduction. If your cat is below 150, do not give a dose at all unless you can get regular BG tests throughout the cycle.
    • Give the regular dose: this is recommended if you are able to monitor closely and/or if your cat is a long-term diabetic (more than a year) and you have a lot of data to know it’s safe. Long-term diabetics with solid data can often safely shoot below 150 (and should if possible to do so safely).
Tigger is 4 months plus into his diabetes diagnosis. Time to gather a bit more data and learn to shoot some lower numbers.
 
Deb & Wink said:
As long as Tigger is >200 at pre-shots, you should hold the dose.
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Tigger definitely decided to bounce. 423 this morning. So no need to worry about being too low. :(:blackeye: I guess the universe thought I was too excited over my green numbers last night, haha.

Hopefully, the bouncing will calm down a bit after a few more doses.

Deb & Wink said:
As Chris said, sprinkle those tests around a bit. A +2 is always a good test to get. But a +5 or a +7 could help to "fill in the blanks" on the SS.
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Not a problem. I can start doing that.
Hopefully, over the next two weeks I can get some good data. It sounds like this will be our last round of weeks off and on, as our state is planning on beginning to reopen some things here soon. So we will see.

Thanks for all your help!
 
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