Low PS Advice

[KyraCat]

Hi all!

Long time no post - we have just been doing our own thing seeing how we get along and I think we are doing OK (please excuse the current bounce we appear to be in). Kyra is looking and acting great - he seems to be his old self again and it makes us so happy to see how well he is doing. Clinical signs-wise he is great.

Disclaimer: When you look at our chart and think 'What on earth has she been playing at?!?!?' - We don't lower Kyra's dose every time he gets a forest green as we have found, in Kyra's case, that the reduction doesn't help out. We do try now and again to lower it if we have had a really long run low PS scores but have found we end up having to up the dose again..3.5 does appear to be our unit (despite the current bounce)
Also - we have stuck with Caninsulin as we are getting good numbers, no he isn't regulated but I am happy with how we are getting on at the moment

I was after advise on what to do when you get a low PS score, after a bewildering conversation with the vet. Why do they do this, we have been happily going along for weeks and then boom they blow us up!

So the vet has told me that we should not be testing Kyra everyday and we should just give him his 3.5 units regardless. I whole heartedly told her that I would not be happy giving him a full 3.5 dose when his PS was 4.3 (as per December 1st and 5.5 on December 2nd PMPS). However she said that despite these scores we should still be giving him the full dose otherwise his body will never get used to what we are giving him if we keep altering the dose based on the PS score.

I know when you are new you are told not to shoot anything below 11mmol, due to in experience, but have I gotten too stuck in that pattern (though I am now more confident in altering a little here and there if we do get a low number) and should, for how long we have been doing, I be giving a full dose regardless of his score? I feel I will get a resounding NO! but I just need to check for my own sanity really!

As ever thank you for being here to help and guide! I am currently waiting for my mom to get home so I can have a rant at her about all of this over the phone

 

[FrostD]

I have never been comfortable giving a full dose (or even close to it) with a low PS number. BUT it's up to you to decide what that number is, based on data you get over time. But I personally would not be shooting a cat that low with a full dose; technically by forum recommendation, that earns a .25U reduction I believe.

Back when Mr Kitty was regulated, that number for me was about 115 (about 6.4). If he was around that number, I'd give a token dose, about 1/2 or 1/4 his normal dose. If he was closer to 100 (5.6) or lower I just skipped altogether. But I had a fair amount of data and a good "feel" at that point for how he reacted to insulin.

Your vet perhaps does not want you to go crazy with adjusting dosages based on every PS, which I can understand to a point.

Curious why you think 3.5 is "your dose?" Looking at the last few weeks his numbers are high, and his nadir's don't seem to be getting low enough. The tricky thing here is that it could go either way...he could need a larger dose, OR he could need a reduction because too much insulin has him in a kind of perpetual bounce (see my SS as an example...better numbers from lower dose, although we still haven't solved the problem)

Edit: I think you did the right thing Jan 2nd with that half dose and saved him from dropping too low. I probably would have done the same with the other two low PMPS this past week.

You know your cat better than anyone, and I certainly am not a vet, but I'd suggest dropping to 3U immediately. I'd continue to drop the dose by 0.25U every 5 days to see if, in fact, the dose may be too high. If you get to 2U or lower and numbers aren't slightly better, then you can at least rule that out.

 

[KyraCat]

Knowing you felt comfortable at 6.4 for a full dose does make me feel better - of course I will do everything at Kyra pace and see how we move along. Thanks for your input - that's really good to know! At the moment anything under 10 we have reduced the dose in some way. I am using our spreadsheet a lot to base my 'guestimations' on when he does hit a 10 or below and I do admit I am not 100% consistent as I'm trying to find the right low dosage - as we know this is no sprint to the finish line.

Also yes you are correct any thing in forest green or below does earn a reduction by forum standards, however as I mentioned we don't like to drop him as soon as we see one of these numbers as we have found, from our own experience, we then just plateau. So we give a few days (maybe longer) to see if we are getting some form of consistent low numbers then we reduce.