Monster AMPS 184 safe to shoot?

I realized my last thread was getting a bit long to read so I decided to post a new one. I am trying to move her shot up to an hour earlier so her AMPS is early. I am going to dose 1.5 and will be able to get +2 and possibly +4 levels before I leave for work today. Is that safe? I'm afraid of her dipping low while I'm at work.
 
Yes she did! She got a little higher right before bed but, even with eating through the night, she looked good this morning. When do you think we might see another depot? What should I do when that happens
 
Hi Regan!

I'm attaching the links to your previous posts. We ask that people include the link to their previous post when they start a new one, so that helpers will have access to Monster's progress and won't need to search for it.:cat:

It looks like she is seeing some nicer numbers here lately (those blues yesterday 😻)! Good luck as you continue her treatment!!

Help! Bg so low with no shot
Diagnosed one week ago
 
Here is some reading on the depot: What is the Insulin Depot? When you change the dose it can take 6 cycles to see the full effect of that dose and depot.

What you are likely seeing now is a bounce, due to the lovely string of blues she's not used to (yet). Here is the definition of what we call a bounce:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
It is annoying to us, but perfectly normal, especially more so in recently diagnosed cats. Although longer term diabetics can also bounce.
 
Thank you. It does seem that she is bouncing being that she is higher today already. I plan on another curve Wed or Thurs. Her ears are also hitting a point where they don't want to bleed as easily now. It was going great for testing a few days ago and now I'm having to pick her multiple times and she's mostly pretty good with it, but she let's me know when she's getting irritated with me. Luckily enough, she doesn't really feel the shot. Thank you again for all your help!
 
Bouncing days are a good day to test less. For example, you could probably ease off the rest of today until PMPS.
 
AMPS 66 she got some treat and I fed her breakfast. I realized I didn't leave out food to last all night and she was waking me up to tell me she was hungry. I didn't think she would get so low. Is this the low end of a bounce for her? I'm going to test again in just a few minutes to make sure she's coming up, but for now I'm holding off her AM dose.
 
Testing at + .5 and +1 were 77 and 89. So she's coming up slowly. I don't feel comfortable shooting and having to leave her all day while I'm at work. I hope that's the right decision and she doesn't get too high.
 
Hi Regan,

Monster is seeing some nice greens!

Here is the information from the dosing sticky for SLGS (Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)):
------------------------
"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."
---------------------------------------

Important note: On the sticky (linked above), just below the info that I posted above, there is some detail that discusses the protocol for lowering the above thresholds,
after you've gathered enough data.

Also, on SLGS, a number below 90 earns a dose reduction.
 
Thank you, yes it's a bit shocking to see such low numbers when I'm not used to it, lol. I did a bit of reading on that while I was waiting to get more levels on her. I feel alright about not shooting this am. I'd rather her have a bit higher numbers than fall too low when I'm not home.
 
I work full time too, and I don't like to worry about Jude going too low when I'm at work either. Fingers crossed that, overtime, as Monster spends more time in the greens, she will grow more accustomed to lower numbers and her numbers will (hopefully) flatten and not be so bouncy. Not every cat finds that level of regulation, but for those of us that work outside the home, it's sure nice when/if they do and when there is a little bit of predictability in their response to the insulin.
 
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Oh I can't wait until she's a bit more predictable. I'm guessing it's maybe the depot again?.... it's been about 3 days. I should have the syringes delivered tomorrow (hopefully) so I can be more accurate with her dose.
 
Hi Regan,

Monster is seeing some nice greens!

Here is the information from the dosing sticky for SLGS (Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)):
------------------------
"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."
---------------------------------------

Important note: On the sticky (linked above), just below the info that I posted above, there is some detail that discusses the protocol for lowering the above thresholds,
after you've gathered enough data.

Also, on SLGS, a number below 90 earns a dose reduction.
I was planning on lowering her dose to 1 unit tonight since she was so low this morning. That's based on what I'm reading in the protocol. I hope I have interpreted that correctly?
 
Better safe then. Her dose will be 1.25 going forward. Any drop under 90 means you reduce by ,25 when following SLGS. Your spreadsheet says SLGS. If correct please add that to your signature too.
 
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