? No shot this morning

Hi Becki. I'm sorry no one was able to reply to you when you posted. Did you give a shot? It looks like you did according to your spreadsheet. Have you tested Sox again since?
 
No shot Becki! We normally say don't shoot at a number of 11 or lower unless you have loads of data and know in advance what a dose at a number like that is likely to do.

Your best bet is to wait for half an hour, don't feed, and test again to see if bg has risen. If it is clearly rising, you could give a dose - how much does depend again on your previous data and what that tells you. If you're concerned, you could give just a token dose, say half the usual dose, but keep monitoring. If the number hasn't risen, still don't shoot but again keep monitoring - bg can be very unpredictable as you know. The problem of course with not giving a shot at usual shot time is that it throws the cycle out - then it's more or less a matter of tweaking the next shot times as appropriate, something you can only decide at the time.

In an instance like this I'd suggest posting on the main forum as well as this one, as you'd probably get more eyes. I only saw this thread myself as I was looking at the forum lists and happened to see this. And there aren't many of us in the UK to see an early morning thread, let alone rest of the world members who are either fast asleep or getting ready for bed!
 
@Crista & Ming I did give him the 1u. I was due to do a curve today so will be keeping a close eye on him now. And test every 2 hours. I have my high carb food on hand if I need it.

Diana&Tom said:
In an instance like this I'd suggest posting on the main forum as well as this one
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I did wonder about if I should do that. And with the time I have to give the insulin I know lots of people will be asleep.
Would there be anything particular that made his preshot today do different to other mornings?
 
Could you do a test now just to see where Sox is at?

Becki and sox said:
Would there be anything particular that made his preshot today do different to other mornings?
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From my experience and understanding, sometimes cats are just being cats. A good dose won't stay good all the time and you either have to dial back or up again. Sometimes they're starting to get used to being low and won't bounce as quickly or at all. The more data you gather, the more you'll be able to understand your cat's patterns.

If you look at my SS, you'll see that on 11/9/18, Ming suddenly had a low PS. But I still held the dose and still increased eventually. I don't know why he did that but he did it and hasn't done it since. But keep in mind, I'm using lantus and there are different rules and results with it compared to ProZinc. I'm just showing you an example and you definitely shouldn't try to analyze Ming's SS. It's all over the place :rolleyes:

Edit: Hopefully someone with PZI expertise can answer your question better. I'm just giving you an example. If they tell you to change the dose, I'd listen. Again, Lantus is different. When I was on PZI, I also suddenly got a low PS number and I skipped the dose. The next dose, I reduced. But eventually increased again.
 
Becki and sox said:
@Crista & Ming I did give him the 1u. I was due to do a curve today so will be keeping a close eye on him now. I have my high carb food on hand if I need it.


I did wonder about if I should do that. And with the time I have to give the insulin I know lots of people will be asleep.
Would there be anything particular that made his preshot today do different to other mornings?
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All sorts of things can make pre shot numbers different to what you expect, bg is never really fixed and you're likely to get a few surprises along the way. This is partly what makes treating FD such a potentially complicated process, as you have to be on the ball all the time.

So you gave him 1u at a PS of 10.6 - yes, monitor very carefully now and have your hypo kit ready just in case. You may be just fine and he was planning in shooting up again just after you tested - anything can happen, these are very early stages of treatment so you can't even guess really. If you do see a steep drop in the next hour or so though, do post on Main Health as this is a one-off situation.
 
Crista & Ming said:
From my experience and understanding, sometimes cats are just being cats.
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Yes definitely I totally believe that. Sox has always been one for keeping me on my toes.

Diana&Tom said:
If you do see a steep drop in the next hour or so though, do post on Main Health as this is a one-off situation.
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I will do indeed. And will definitely keep a close eye on him today.
I've never had this situation in the mornings yet so really wasn't sure what to do. Just knew I wasn't going to be increasing the dose today.
 
I’m tempted to say continue to test since you were going to do a curve today anyway. Were you going to test ever two hours or every hour? Maybe Diana will have something better to suggest :)

It looks like Sox drops starting around +5 so I would definitely do hourly tests once that time rolls around like you did a few cycles ago.
 
Ok so 9.9 at +2 is pretty much the same as the ps number so no immediate need for concern but it's when the insulin starts to kick in ("onset") that you'll need to be specially vigilant to make sure the drop doesn't happen too fast/steeply. Keep those hypo supplies to hand just in case - and have a read again of the beginner's guide so you'll know the theory of what to do if it starts to look worrying.

This is also a time when you can post on the Facebook group as well - we always direct Facebook people over here for a full explanation of FD and how to manage it, but the FB group tends to be busier as many people find it easier to use on their phones, so you'll sometimes find that you get more replies there.

Just seen what Crista has written above - yes, hourly tests at expected onset time definitely, but I'd test hourly before then too, just in case the dose at a lower ps number will cause a faster than usual drop. In a situation like this it is always best to be extra careful.
 
Also I would read up on how to deal with hypo.

I’ll type out what I’ve done the two times it has happened to me:

When I saw a number around 3.8, I retested in 30 minutes. If it continued to lower, I gave a tsp of high carb food and retested in 30 minutes. I repeated this until I saw that Ming was rising again. Sometimes I tested every 15 minutes just because he was REALLY low. He was at 1!

If they get really low, you can either rub honey on their gums or add it to their food. When Ming was at 2.8 and 1.6, I added honey to his food. I melted honey in hot water and mixed it with his wet food.

Don’t feed too much at first because you don’t want Sox not to eat if he goes lower. If he doesn’t eat, then you’ll have to rub honey or syrup on his gums.

High carb foods can be anything around 15-20% carbs. Fancy feast gravy flavoured cans are a good option as well as any dry food or treat you have.
 
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Thanks guys I've got my gravy food, high carb treats and honey on hand.
I'll keep my spreadsheet up dates as I go.
Should I do a +3 or wait till +4 do that one and then test hourly from there?
 
It wouldn’t hurt to do a +3 test :)

Paws crossed Sox just floats nicely this cycle! I’ll check in later if I can. It’s 2 AM here and while I don’t feel like sleepy right now, I know I might randomly pass out. But from experience, I know @Rachel may be online in 2-3 hours.

Again, post in the Main Health forum if you don’t get a response fast enough!
 
You made a wise decision to stay at 1 u and look at the beautiful curve you have! :smuggrin: I'm glad others were here to help. It's difficult when you're in a very different time zone ...
 
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@Kris & Teasel thank you. It is... I don't think there's many of us uk'ers here.
Do you think with +5 reading I'm ok to wait and test him at +6 then feed him his mid day snack.
The +6 test is due in 15 mins?
 
Just got home after a few hours out and yes - lovely curve so far. Will be interesting to see how the rest of the day pans out.
Just shows how ECID - every cat is different - as you could have been looking at a different scenario! Always best to err on tje side of caution.
 
Okie dokie just was a bit scared if he might have dropped to much between the +5 and +6 but he seems ok at the moment.
 
Kris & Teasel said:
Absolutely textbook beautiful curve!!
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I've just fed him his mid day snack. It usually varies between half 12 and half 2 for him.
Say today he wasn't going to have got his mid day snack till half 2. Would his BG likely to carry on dropping (past 3.8) untill he got the food?
 
Becki - lovely curve today, and really great decision going with the 1u this morning! It's really just a guess when you get an unusual number like that, but you guessed well! Hopefully Sox will have lots more blues and green in his future!

It's good that you were vigilant today since this was his first day showing you numbers like this. That being said, in a healthy cat who is getting species appropriate food (low carb wet food), their bodies have a built in way to keep themselves from going too low. The liver simply dumps glucose into the blood stream to bring them back up. Now that is assuming a reasonable amount of insulin, of course. And you know from previous cycles that the amount of insulin you're giving is reasonable. So if the snack was delayed, he might have gone a little lower, but it's very unlikely that he would have gone into dangerous territory unless there was some other health issue interfering.

How many hours past his shot time are half 12 and half 2? I do recommend giving snacks before typical nadir, and again around typical nadir, just to make sure he has some extra fuel available if he starts to drop. Many cats will seek out food if they are dropping too quickly or too low. Just like for us humans, when our BG goes low we feel hungry and seek out a snack.

Again, really great job today with your dosing decision and your testing. I imagine it was a bit of a stressful day for you, but you did great!
 
The half 12 shot was +5 and I'm just waiting on the half 2 shot (+7) that is due in 25 mins.

Djamila said:
Again, really great job today with your dosing decision and your testing. I imagine it was a bit of a stressful day for you, but you did great!
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Thank you... I was a little stressed with it pre shot this morning as I didn't know what to do for best... Knew I didn't want to give 1.25u but thought if I stuck with 1u I could at least keep a close eye on him.

I do worry if I get a number like that pre shot and I'm due to go to work and not observe... Maybe then would you drop to 0.75 just to be on the safe side.

I just wonder about the food as Sox does not get a meal through the night he normally just gets a meal before we go up to bed... Is that pre bed meal ok or should he have a meal through the night?
 
Can you leave food out for him? Or do his siblings eat it all? I feed my kitties dinner, and then leave out food when I go to bed. Occasionally Sam will wake me up in the night asking for food. When he does that I'll usually sit up and grab a quick test to make sure he's okay, and then give him a bit more food if he's run out. Over time I've learned to trust him - he usually lets me know what he needs. So all that to say that if you can't leave food out at night, just pay attention if Sox is fussing. Ideally it's good to give him access to some food at night as well - especially if he's active at night like my cats are!
 
Becki and sox said:
The half 12 shot was +5 and I'm just waiting on the half 2 shot (+7) that is due in 25 mins.


Thank you... I was a little stressed with it pre shot this morning as I didn't know what to do for best... Knew I didn't want to give 1.25u but thought if I stuck with 1u I could at least keep a close eye on him.

I do worry if I get a number like that pre shot and I'm due to go to work and not observe... Maybe then would you drop to 0.75 just to be on the safe side.

I just wonder about the food as Sox does not get a meal through the night he normally just gets a meal before we go up to bed... Is that pre bed meal ok or should he have a meal through the night?
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I can only manage a bed time meal for Teasel because his siblings eat different food (by necessity). It seems to be OK for him *most* of the time.
 
Yeah I struggle leave food out as Sox just eats everything all in one go.
And the others would eat it too. The cats also sleep down stairs seperate to us due to house alarms.

Half 2 shot (+7) 4.8 would I be ok to go back to 2 hour testing now?
 
WoW! What a nice cycle Sox is having. :D Great decision making on the dose Becki!
Multiple cat households are a bit of a pain when it comes to food particularly when there is a diabetic or other special diets in the mix. :rolleyes:
Becki and sox said:
I do worry if I get a number like that pre shot and I'm due to go to work and not observe... Maybe then would you drop to 0.75 just to be on the safe side.
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Dropping the dose is always an option you can use to keep Sox safe and your sanity intact. You could also try feeding food that is a bit higher in carbs to slow down his drops but that is something you'd be best to experiment with when you are home to see how that works for Sox.
 
MrWorfMen's Mom said:
Multiple cat households are a bit of a pain when it comes to food
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Yeah they do seem to be... They have never been fed in the night so that's something different for me too. Maybe a small about if dry food mixed in at night to make the affects of the food last longer?

I think dropping the dose would work easier for my sanity yes so I know he's ok while we're out.
MrWorfMen's Mom said:
WoW! What a nice cycle Sox is having. :D Great decision making on the dose Becki!
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Yes he's been a very good boy today. I did panic abit this morning but just thought I'm here all day so can keep an eye on him.
 
Looking at your ss, the nighttime data doesn't seem all that differernt from the daytime data so far. So based on that, i don't think you need to change up what you're doing at this point as far as the nighttime feedings. Sox seems to be managing fine at this point.
 
Yes, he may well be rather high and flat tonight. Time will tell though - he didn't do too badly the last time you had a green.
 
Becki and sox said:
Yeah they do seem to be... They have never been fed in the night so that's something different for me too. Maybe a small about if dry food mixed in at night to make the affects of the food last longer?

I think dropping the dose would work easier for my sanity yes so I know he's ok while we're out.

Yes he's been a very good boy today. I did panic abit this morning but just thought I'm here all day so can keep an eye on him.
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Dropping the dose is always better for your sanity, Becki... you and Sox have done really well today, especially considering that we'd normally advise not shooting at a bg of lower than 11. You've certainly got a nice curve going on, just always bear in mind that Sox might not respond in exactly the same way another time... I'm sorry to be the one urging caution and far be it from me not to celebrate with you, but your nadir isn't actually far off what we would be worried about and you just never know what's going on inside a cat! So again, think carefully when you get an unexpectedly low PS number and make sure you'll be around all day if you're going to dose. And as I said early on, you can always stall (without feeding) and test again to see what direction the bg is going in.

I think you and Sox both need some nice treats today!
 
Becki and sox said:
If I get that again then and im not able to stall due to work would you either drop dose or not give insulin?
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For peace of mind, in that instance, I would skip the dose. You can't leave the house and be at work for hours worrying about whether Sox is going too low or not. It's better to be highish for a few hours than low for an unknown length of time. As time goes on and you get more data, you'll be able to judge with more confidence what number is ok to shoot and what is probably not - the trouble is, even then a cat can throw you a curve ball at any time so it's really a matter of using your best judgement. A lower or token dose is often a good compromise so there is at least some insulin in his system.
These are still early days, remember - as time goes on you will get a better feel for what to do for the best.
 
Ok thank you. Im hoping it does get to a point where it gets easier to know what I'm doing. If he still below 11 tonight I'm best to go no shot? If he's 11 or above should I give the 1u again or give 0.75u. I wouldn't be able to stall tonight as I need times to be 7 and half 7 in the morning due to work.
 
Becki and sox said:
Ok thank you. Im hoping it does get to a point where it gets easier to know what I'm doing. If he still below 11 tonight I'm best to go no shot? If he's 11 or above should I give the 1u again or give 0.75u. I wouldn't be able to stall tonight as I need times to be 7 and half 7 in the morning due to work.
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I think you already have a very good handle on what you're doing, Becki, as I said on your Facebook post last week. You understand the basics and the theory, it's now a question of collecting data and applying what you've learnt to your own cat! As far as dosing tonight goes, see what the experienced Prozinc people here suggest. I may be in the minority in being reluctant to shoot. Really, that's what these forums are all about, asking questions and getting different members' replies so you cam weigh things up and make a decision. Some questions will elicit a definite "do this or that", others are more borderline.
 
Diana&Tom said:
Really, that's what these forums are all about, asking questions and getting different members' replies
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Yeah it really has been a good help. I didn't really get much other information off the vet.
Should I wait and see if I get any other reply on what to do tonight in this post or ask a new question on the forum? I have 2 and a half hours before my PMPS.
 
Becki and sox said:
Yeah it really has been a good help. I didn't really get much other information off the vet.
Should I wait and see if I get any other reply on what to do tonight in this post or ask a new question on the forum? I have 2 and a half hours before my PMPS.
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Still time for people like @Kris & Teasel , @Rachel and @Djamila to get back to you - I'm sure they'll all have good suggestions. You could also post on the main forum and link this thread so you're not starting too many new ones.
 
Becki and sox said:
Ok thank you. Im hoping it does get to a point where it gets easier to know what I'm doing. If he still below 11 tonight I'm best to go no shot? If he's 11 or above should I give the 1u again or give 0.75u. I wouldn't be able to stall tonight as I need times to be 7 and half 7 in the morning due to work.
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If he's around 11 tonight you can try 1 u again. Get a +2 after that. If you see similar tomorrow AM you can try 0.75 u for your peace of mind. Another thing to try would be 0.75 u tonight to see what sort of AMPS that gives you.
 
Yes hopefully I'll post on once I've took tonight's pre shot BG.

@Kris & Teasel think I'd be happier with 0.75 tonight just as I won't be up to watch him through the night. If you think that's ok.
If he's 11 and below maybe not give a shot?
 
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Becki and sox said:
Yes hopefully I'll post on once I've took tonight's pre shot BG.

@Kris & Teasel think I'd be happier with 0.75 tonight just as I won't be up to watch him through the night. If you think that's ok.
If he's 11 and below maybe not give a shot?
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Yes to sleep on the night before going back to work! Your peace of mind is paramount and it's early days so using 11 as your no shot boundary is fine. :)
 
My hubby is also off tomorrow so if Sox is around the same pre shot as he was this morning I'm happy to give him .75 and my hubby can keep a watch on him.
If I'd have give him 0.75 this morning he still probably would have had decent green numbers wouldn't he. But maybe just not as low.
 
I am in the camp of being more aggressive with dosing. There are a couple of reasons for that. First of all, while I have seen many many cats on here die from ketones (too little insulin is a key factor there), I've never seen a healthy, reasonably dosed cat even get into danger from dropping a little low. I know it's possible, because anything is possible. But it hasn't happened over here in prozinc-land during my time here. I've seen a cat with a secondary health issue get into trouble on another forum, and a cat that was receiving ridiculous levels of insulin without monitoring. But a cat who is being monitored and dosed well? It's just never been a problem here. But too little insulin? that has taken many of our kitties. So personally I'm more afraid of under-dosing.

Second, the window to get a cat into remission is fairly short. A cat that is on a low carb wet diet, and is dosed well, has a 60-70% chance of remission within six months. After six months, the odds go down to about 20%, and after a year, it's a long shot. (I'm sorry I'm having trouble finding the article that cited that right now). So my tendency is to recommend careful monitoring (which you're doing) and a more aggressive stance on dosing to take advantage of the early days of a diagnosis.

I'm not talking about going crazy here. I think aiming for low blues and high greens is good - I'm not suggesting aiming for 50, and certainly not suggesting being reckless in any way. But I think what you did today, and the numbers you got, were good. Ideal really. And I think it shows that she can handle 1u at a number like that. At least for today. When a cat decides to go into remission, they usually do it fairly quickly (at the beginning), so it does require care and wisdom.

All that being said, if you feel more comfortable with 0.75u, go for it. I do believe that sometimes the caretaker has a sense about things, and if you're feeling like a reduction is needed, do it. Trust yourself. If the cycle ends up too high, you can go back up in dose tomorrow. But your mama-sense might know what your kitty needs better than anything/anyone else.
 
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