??? New Lows What to do? SLGS

[Scdal]

This morning, Phoenix's preshot number was 114 so I held off and did not shoot. I did not feed him. An hour later, his numbers have dropped to 79.

What would you advise that I do? Should I wait another hour before making a decision? Or, should I go ahead and feed and skip his morning shot?

I had a conference with his vet on Friday. He would like to keep Phoenix's numbers around 150. This is because of his age. He is 16. He does well in this range. All the excessive peeing and drinking stops. He is also more active and alert. He acts like he feels good. He doesn't want to take a chance on his numbers dropping too low. He says based on his age, even in older humans, you shouldn't expect perfect numbers.

Based on this information, what do you think I should do this morning? If his numbers rise to 200, I am unsure if I should give a full dose or a partial one.

 

[Scdal]

It has been 2 hours and his BG is now 59. I am starting to get scared !! Is anyone out there to answer? I am going to skip and feed. Hopefully, his numbers will start to rise.

 

[Nan & Amber (GA)]

Whoa!

Definitely skip this morning. He may be continuing to drop because he's missing breakfast; hopefully he'll come right up after he eats, but I'd test again in an hour just to be sure. 59 is still safe, but too close for comfort!

 

[Nan & Amber (GA)]

Did you shoot last night? There's a blank on the spreadsheet. If he's this low after a skipped shot, that's very interesting. Either way, though, you'll want to keep testing today-- even without shooting, 7U makes for a large depot, and you could still see some action today.

I think I may have asked this before, I'm sorry, but was the prednisone in your signature a one-time shot, or is it ongoing?

Phoenix has earned a reduction, I think of 0.5U down to 6.5U. I'm also going to tag @Wendy&Neko for help on dosing strategies going forward, as she is most familiar with procedures at higher doses and the kinds of things that can happen.

Has Phoenix ever been tested for high-dose conditions like acromegaly or IAA?

 

[Sienne and Gabby (GA)]

Here's the link to your last thread. We link our posts together since it makes it easier to back track for information.

Just to put Nan's comments in a bigger picture, unless you have collected a good deal of data and are comfortable steering lower numbers with food, you want to avoid shooting a dropping number. You have to know your cat's patterns well and be confident in your ability to to manage numbers if you shoot numbers that are dropping at shot time. You don't have any way of knowing how much influence the meal will have on bringing the numbers up and, you'll be giving a shot which will start to act in about 2 hours. If you know your cat is carb sensitive and that numbers will level off, it may be fine. Having been one of those people who shot a dropping number without realizing that's what I was doing, it's not for the faint of heart!

I'd also like to make a housekeeping suggestion. Marje posted an announcement at the top of the board. In all likelihood, you're not getting quite the response you need because Phoenix's test numbers aren't in your subject line. In many cases, the experienced members scan the subject lines looking for numbers that indicate if help is needed. By all means, include your comment but also include the numbers. I had a few extra minutes and opened your condo (aka thread). So, include the numbers in the subject line and link your previous post to the current day. Thanks.

 

[Scdal]

+3 hours now without morning shot and he has risen to 98 after eating. I did give him 7 units last night. I believe I am going to drop his dose down to 6.5 units. These low numbers are getting too scary for me.

I did ask the vet about acromegaly. He isn't concerned at this point. From now on, I will include the numbers in my subject line. I am going to monitor his BG every hour for a while until I am sure he is safe. Tonight, I am dropping his dose to 6.5. I am going to set my alarm every hour this evening to check his BG if it starts dropping low.

I will admit that the 59 reading really scared me !!

 

[Wendy&Neko]

Could you remind me again if you are following TR or SLGS for dosing? And then put TR or SLGS in your signature so we can stop asking.

I had a conference with his vet on Friday. He would like to keep Phoenix's numbers around 150. This is because of his age. He is 16. He does well in this range

It's really hard, impossible actually, to keep a cat in a flat line with numbers around 150. Did your vet mean that nadirs should be 150? If so, I really disagree because with nadirs that high, you'll be seeing a lot of pink and high yellow numbers. Ideally you want Phoenix to spend time under renal threshold (the point where he has so much glucose it spills into the urine), because it makes the kidneys work harder and he pees more. Kidney disease is common enough in older cats, so it's a good idea to try to keep their job as easy as possible by keeping numbers under renal threshold as much as safely possible. SLGS has a goal of nadirs in the 90-149 range, so a little lower than what I think your vet is suggesting.

I did ask the vet about acromegaly. He isn't concerned at this point.

Most vets of "a certain age" were taught - "this is acromegaly, you'll never see it". My vet was in that camp. She thought we needed to get above 10 unit before you needed to consider it. Not true, Neko never got that high. One in four diabetic cats has it - there have been cats on doses as low as 1 unit with acromegaly. Once cats get over 6 units, it's much more likely.