Hello Goeril and Panter!
Nice to see you again!
Ideally no, you wouldn't want to throw off your schedule like that - however skipping doesn't help Panter either, like you said. I think you're skipping a lot when you don't need to. Panter has been diabetic for several months now, you should have been lowering the "no shoot" a long time ago now. Actually it looks like your no shoot number is above 200? I see several times where you skipped over 200 and not sure why.
You want to gradually lower the do not shoot number as you get used to shooting low. For example, originally no-shoot is 200. Then try to shoot at 190. Then move it to 180, etc. You should be giving full dose any time Panter is over 200.
The other thing you need to do - if he is NOT over 200, is stall feeding. If he is below 200, wait for 20 minutes and re-test. Then he may be high enough for full dose. If he is still not high enough, stall another 20. If an hour has passed or you really can't stall anymore, then you can skip or give a token dose. A token dose is 10-25% of Panter's normal dose. So if his full dose is 2.5u, you would give .25 - .62u. Ideally if you do a token dose, I would recommend the higher end. Panter's long overdue for more dosing at "lower" numbers anyway.
I might add, I don't know how easily accessible Lantus is in Norway, but I think Panter would also benefit from switching to it since he's a bouncey fella if you can. My Panic had numbers similar to Panter's before I switched her over to Lantus and it made a big difference.
Here is a refresher on low-preshots and what to do if you get a lower number than you're used to:
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 once you have data and understand your cat’s cycles. 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.
With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Prozinc users following the Start Low Go Slow approach:
If the preshot number is far below usual preshot numbers:
- Do you need to stay on schedule? Then skip the shot.
- Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
- Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:
Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
