? Need help low numbers then high

[Scdal]

Yesterday morning, Phoenix's preshot number was 188. This is low for him. I fed him and waited an hour before giving him his 6 units of insulin. The reading then was 220.
+5 253

Preshot in evening 401 + 3 268

This morning his preshot was 151
I again fed him and am waiting for his numbers to rise to 200 before I give his injection.

Am I doing the right thing?

 

[Sienne and Gabby (GA)]

If you're kitty's pre-shot number is lower than your comfort zone, please do NOT feed your cat. You want to stall but not feed. The food will raise the numbers versus waiting to see if the numbers are rising on their own.

When you see lower numbers and then a spike into high numbers, this is what we refer to as a bounce. Phoenix isn't used to spending time in lower numbers. As a result, your cat's liver and pancreas "panic" and dump a stored form of glucose along with counterregulatory hormones into his system. This causes the rise in numbers. It's actually a protective mechanism, albeit one that the caregiver finds to be rather annoying!

Susan -- have you looked over the sticky notes at the top of the board? I'd encourage. you to select a dosing method. Looking at Phoenix's spreadsheet, you're holding doses longer than what we suggest. If you hold doses overly long, it's likely that glucose toxicity develops. The name sounds worse than what it is. This is when your cat's body treats the higher numbers as the new "normal" making it harder to get the numbers to come down into a better range and can contribute to bouncing.

 

[Scdal]

Oh Gosh, I read the sticky notes wrong. It said to hold the INITIAL dose 5-7 days. I have been holding every dose for 7 days.
I have already fed him and I need to recheck his blood glucose. If his glucose has risen above 200, should I go ahead and give his injection? This is what I did yesterday.

I am a stupid newbie to this and I am still learning a lot. My vet has been almost useless. He only responds to an email every two weeks even when I send him the spreadsheets. I rely on all of you.

From now on, I know not to feed him if his numbers are low and keep checking.

 

[Scdal]

I just did a recheck since it has been 1 hour. His glucose is 177 and that is after eating. I am still going to hold off on his injection until it reaches 200 or should I skip his morning shot?

I hate to skip a shot altogether since his evening preshot is always high. I have errands that I was supposed to run this afternoon, but they can wait. Phoenix is more important.

 

[Sienne and Gabby (GA)]

Susan --

You may be a newbie but you're not stupid! The instructions are initially overwhelming until it become routine!

Given that Phoenix is on a raw low carb diet, you can choose between Tight Regulation or Start Low Go Slow as a dosing method. With TR, you hold the initial dose and subsequent doses are evaluated after 3 days (unless a reduction is indicated or if the nadirs are mostly less than 200, and then the dose is held for 5 days). Dose reductions are given if the numbers drop below 50. You post and ask for help if the pre-shot is below 150.

With SLGS, doses are held for a week unless a reduction is indicated. You post and ask for help if the pre-shot is under 200 and dose reductions are given is the numbers drop below 90.

With either approach, you want to eventually be shooting progressively lower numbers. For example, I followed TR with Gabby and would shoot any number over 50. You have to have the data to support shooting low, though.

Depending how far off schedule you are at this point, you may need to skip. If you were to shoot now, the next shot would be due in 12 hours. The most you can shift the shot schedule is by 30 min. If you skip, you'll be back on schedule at PMPS.

 

[Scdal]

Thanks for replying. I had just posted another thread before you responded. I will skip his shot this morning even though I know his numbers are getting high.

This cycle has lasted 2 days now. Very low before morning shot and very high before evening shot. This is throwing me for a loop. I don't know how to handle the morning situation. If it happens again tomorrow morning, should I consider a reduced dose in the morning to keep him on schedule?