Question about pre-shot numbers

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EmmasMom

EmmasMom

Member Since 2012
Hi all,

I can't tell you how helpful reading this forum has been to me in the past few weeks since Emma's diagnosis. Thanks to all the caring beans out there willing to share your knowledge and experience!!

There is one thing I've read a few times here that I don't understand, and that is: If a pre-shot number is low, wait a while without feeding and then retest to see if the numbers are going up before giving insulin. The "without feeding" part confuses me.

My understanding is this...Food causes the BS to rise, insulin (either made my kitty's pancreas or injected by us) is needed to get the sugar into cells and reduce the BS. If I don't inject because the pre-shot number is not high enough before eating, won't she not have enough insulin to deal with the rise in BS after she does eat? Please let me know what I'm missing!

Thanks!!
Jen
 
The reason to wait is to check and make sure you are shooting into a rising number and not a falling number (too little food, for instance) so that when you do shoot the insulin your cat won't continue to go down and into hypo territory.

If you keep testing and she is going down (never had this happen so I may be wrong) you eventually just feed her and not shoot. Or shoot a reduced dose based on your knowledge of her normal BG level activity through the day on the data you have gotten.
 
Ditto on the not feeding if under 200 at preshot, but retesting in 20 minutes. We want a "real" number, not one inflated by food.

It looks like you have skipped a few preshot tests and given one unit? With a food change and some lovely numbers, it would be a good idea to get a number before you ever give a shot. She could surprise you some morning with a low number and then the one unit would be too high.

Just for reference: We consider a cat regulated if, on insulin, they run around 200 at preshot and in double digits at nadir, but not below 40. (Below 40 is getting too low and you want to intervene with food or syrup if the numbers continue to fall) A cat is considered in remission if they range from 40-120 without insulin for 2 weeks or longer.
 
Thanks! I'm giving her ears a little break since I have a couple days off and can be at home with her to keep watch. I'm still getting her used to the tests and we're getting better at them!

I asked this question because of 8/24-25. Her PMPS on 8/24 was 171, so I reduced her dose from 1 to 0.5. That night she spilled sugar into her urine. Maybe I should have reduced by less. I need to switch from U40 to U100 syringes so I can make finer changes more easily (I know I need to convert with the U100s). I think also I'm also figuring out that her renal threshold might be on the low side.
 
I think her numbers are looking great. The range from pmps on the 24th to amps on the 25th is not much. We figure every meter can be +/-20% on any reading. So your 171 and 215 are basically the same number. On the 26th, she may have gone up a little (probably after eating?) but she went right back down again for pmps. That was a cycle where finding out what her +12 was and making sure it was rising, not falling, would have been a good idea. It turned out okay, but one of these cycles, it might not.

I am just nervous because the food change is recent and may still be bringing her numbers down along with the insulin. For us, Oliver went down 100 points overnight with the change from dry to wet, but some cats take a week or so to slowly go down. Also, some cats take several weeks to settle into the insulin and gradually go down in numbers. If she is one of those cats, you want to be on top of the numbers because she could gradually need less and less insulin.

Be sure you hold the spot where you poked for a few seconds afterwards to help with bruising. You can alternate ears and use a tiny smear of neosporin with pain relief also.
 
Thanks Sue. I was doing tests but not keeping good track of them her first week on insulin (not on her SS - I just updated it with some notes). The vet sent me home with wet and dry DM and said to free feed both. No info on different carb levels between the wet and dry (!!). I left both the wet and dry out for her, and Emma favored the wet food at first but then started eating more of the dry. Her numbers were all over the place the first week, and in retrospect I am sure now it was the inconsistency in food, with her numbers being higher when she was eating more of the dry. I think she is immediately affected by the higher carb food. Good to know there can be a longer term effect too though, so I will keep an eye on that!!
So thankful to have found all this info through this site!!
 
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