? Shoot or no shoot? Mimi 9/23 PMPS 37.

I know in the past they’ve said to wait to feed ans see if it goes up on its own but what does that tell me - the depot will be enough to keep her BG down during her cycle? Why hasn’t the insulin worn off yet. She’s meowing at me cause she’s hungry. She also just puked a hair ball.
 
Don't feed, stall, and test again 20 minutes later and see where she is at. Do not shoot any number below 50.

From the Tight Regulation sticky:

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
 
My 2 cents :

37 is a no shot. Mimi likely will not go up enough or soon enough to shoot.

Occasionally, a cat will have a longer than 12 hour cycle.

Also, there is something called a double dip where a cat will take a second dip (though usually not nearly as deep as the nadir) near the end of a cycle.
 
Waiting and testing tells you if the BG is rising or falling. In general, you would not shoot a number that is falling without food.

I don’t think I would shoot with that PS, but since she has had DKA before, I’m not sure what her risk is for missing a dose.
 
PerfumedCatMom said:
Don't feed, stall, and test again 20 minutes later and see where she is at. Do not shoot any number below 50.

From the Tight Regulation sticky:

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
Click to expand...
Dammit I shot her a reduced dose and fed her. I brought her down to 2.5
 
Librarianista said:
Waiting and testing tells you if the BG is rising or falling. In general, you would not shoot a number that is falling without food.

I don’t think I would shoot with that PS, but since she has had DKA before, I’m not sure what her risk is for missing a dose.
Click to expand...
I got a fur shot yesterday morning and she still dropped.
 
Christie & Maverick said:
Rosa, it is very important to know what her BG test is right now. We don't shoot numbers under 50.
Click to expand...
I shot her because I didn’t get a response in time and I didn’t realize that part of TR. she just ate her LC. She’s been shot a reduced dose. Instead of 2.75 it’s 2.5


I had to run to the market quick I’ll be back in 20 minutes.
She’s been fed.
 
Rosa, what did you feed? If it were my cat, I'd want to be sure number was above 50 before giving insulin, and certainly a 37 warrants a follow up test regardless of where it occurs in the cycle. I wouldn't be leaving without knowing she is safe. Even with a reduced dose, you may have to deal with frequent testing tonight, and intervening with high carb and/or syrup. Post when you can get another test please.
 
Mimis mom said:
I shot her because I didn’t get a response in time and I didn’t realize that part of TR. she just ate her LC. She’s been shot a reduced dose. Instead of 2.75 it’s 2.5

I had to run to the market quick I’ll be back in 20 minutes.
She’s been fed.
Click to expand...
Rosa…..really? You’ve been here well long enough to know we don’t shoot below 50. Period. Even with a reduced dose.

You absolutely know this about TR and you also know where to find the info. And if you don’t get a response, be conservative! And leaving? Since you did shoot (which you shouldn’t have), you should have stayed right there and tested her,

I hope you don’t end up at the ER with her because her BG is too low.

Librarianista said:
In general, you would not shoot a number that is falling without food.
Click to expand...
This is not correct. First, we never feed to be able to shoot. Second, many experienced members shoot dropping numbers as long as the PS is above 50 as long as they are able and available to test and have supplies. It’s a great way to take advantage of carryover and overlap.

Librarianista said:
I’m not sure what her risk is for missing a dose.
Click to expand...
Of course you are correct, with DKA in the past, we have to be careful but Rosa could have fed LC, waited two hours, and shot the full dose…or, in this case where the BG dropped below 40, Rosa would have taken a 0.25u reduction and shot after two hours if the BG was above 50.
 
Last edited:
I’ve always been told to shoot low to stay low? I didn’t know a number mattered? I thought when it was below 40 it was just a reduced shot. I’ve asked about it being the nadir and I didn’t get a direct response.

No I did not know or at least remember or know where to find the information. I just recall shoot low to stay low, not to ever skip a shot because she was DKA before.


I also don’t need to feel like I’m ignoring directions - I asked I didn’t get a response and I went off what I know and thought I understood. Does my heart need to race right now? Is that fair to me to freak out?

I haven’t been on this group in months because I following a less strict more convenient group on Facebook (mostly for the convenience) and they would instruct people to not sure below 150!? Mimi didn’t see green for a long time so I came back here ans have finally been seeing good numbers .I did not know there was NO shot below 50 otherwise I would never have done thst to her or myself…
 
Mimis mom said:
I’ve always been told to shoot low to stay low? I didn’t know a number mattered? I thought when it was below 40 it was just a reduced shot. I’ve asked about it being the nadir and I didn’t get a direct response.

No I did not know or at least remember or know where to find the information. I just recall shoot low to stay low, not to ever skip a shot because she was DKA before.


I also don’t need to feel like I’m ignoring directions - I asked I didn’t get a response and I went off what I know and thought I understood. Does my heart need to race right now? Is that fair to me to freak out?

I haven’t been on this group in months because I following a less strict more convenient group on Facebook (mostly for the convenience) and they would instruct people to not sure below 150!? Mimi didn’t see green for a long time so I came back here ans have finally been seeing good numbers .I did not know there was NO shot below 50 otherwise I would never have done thst to her or myself…
Click to expand...
I’ve always been told “never skip a shot if she was DKA”. And reduce the shot if below 40.
 
Marje and Gracie said:
Rosa…..really? You’ve been here well long enough to know we don’t shoot below 50. Period. Even with a reduced dose.

You absolutely know this about TR and you also know where to find the info. And if you don’t get a response, be conservative! And leaving? Sorry nice you did shoot, you should have stayed right there and tested her,

I hope you don’t end up at the ER with her because her BG is too low.


This is not correct. First, we never feed to be able to shoot. Second, many experienced members shoot dropping numbers as long as the PS is above 50 as long as they are able and available to test and have supplies. It’s a great way to take advantage of carryover and overlap.


Of course you are correct, with DKA in the past, we have to be careful but Rosa could have fed LC, waited two hours, and shot the full dose…or, in this case where the BG dropped below 40, Rosa would have taken a 0.25u reduction and shot after two hours if the BG was above 50.
Click to expand...
I didn’t know this.

I know this now.

I still don’t know how to find stuff other than on the sticky notes and I don’t remember reading in the sticky notes what to so PS. If it’s something I missed then I am sorry.

I didn’t want to mess her shot time up because of my work schedule- I would rather have just skipped- not shoot two hours later? Howwill I ever scale that back in time. I’ve also never heard of doing that until now: I’m not saying anything is wrong I’m just saying I’m learning this right now.
If I knew it once before it was months ans months ago and must have forgotten.
 
One thing I will say about Mimi is i inject her every day, twice a day- and never fur shot. She always gets her dose which means she might have a few “fur shot” times in there to make up for the fact she’s a really good patient and never once fights me. She’s like a doll and let’s me do anything:

the fur shot was on purpose because I was too nervous of her low numbers ans I thought it would be a great time to finally move her shot time to what I want it to be- almost 2 hours earlier than it is now so I can hire a care taker once in a while because right now her shot time is too late for anyone. I am even changing my work schedule so I can do everything earlier and saw an opportunity to do that- which is why she didn’t get insulin yesterday morning. What’s crazy is how her depot must have drained but still the reduced dose was too much for her. I should have skipped but I honestly thought I would be hearing a lot of pushback for skipping so either way I was wrong tonight
 
Marje and Gracie said:
I hope you don’t end up at the ER with her because her BG is too low.
Click to expand...


are you saying that with HC or even corn syrup she could still end up in the ER?? can someone tell me or explain to me why she would have such a low PS number and or why she would continue to drop if the insulin is wearing off? I need to make sense of why that could happen? is it the depot?
 
Christie & Maverick said:
Thanks, with all the other posts I didn't see it and it isn't on your SS. What % carb did you feed when you shot?
Click to expand...
I haven't updated the SS since then I posted here first, and I have some issues going on with my immediate family so I am also dealing with that,
I fed her LC, her regular raw formula.

Should I test again?
 
Mimis mom said:
are you saying that with HC or even corn syrup she could still end up in the ER??
Click to expand...
Yes. If she drops back down and doesn’t start a bounce when she onsets, you could be in for a long night.

Mimis mom said:
can someone tell me or explain to me why she would have such a low PS number and or why she would continue to drop if the insulin is wearing off? I need to make sense of why that could happen? is it the depot?
Click to expand...
Yes. She dropped to 23 on 3u. That dose could affect her depot up to six subsequent cycles. She was headed down today.

When members are new here, we help them find info, etc. You’ve been here two years and many of us experienced members have helped you repeatedly, giving you links, etc. It’s your responsibility to continue to read the stickys and all the other info on this board.
 
Marje and Gracie said:
Yes. If she drops back down and doesn’t start a bounce when she onsets, you could be in for a long night.


Yes. She dropped to 23 on 3u. That dose could affect her depot up to six subsequent cycles. She was headed down today.

When members are new here, we help them find info, etc. You’ve been here two years and many of us experienced members have helped you repeatedly, giving you links, etc. It’s your responsibility to continue to read the stickys and all the other info on this board.
Click to expand...


I do. I read them. I have read them. I didn't know or perhaps have forgotten because its been 2 years, about the PS rules. I have only been told repeatedly that I need to shoot low to stay low, LT diabetic cats have to drop below 40 and or 3 times below 50 in order to earn a full reduction. I am also constantly reminded of her DKA from 2 years ago, which wouldn't that be too long of a time now for me to be worried about it? I always saw the word "recent DKA kitty" and its been 2 years.
 
Marje and Gracie said:
when she onsets,
Click to expand...
when she onsets- you mean when the insulin kicks in at +2? or, I don't understand what you mean by doesn't bounce. I don't understand how to find stuff- I go to the search and type in something I might want to find and it sends me to every post ever mentioning that but not like a direct post. I can't explain it. Im not searching right. I see the stickies but was that info above about PS numbers in them?
 
PerfumedCatMom said:
Don't feed, stall, and test again 20 minutes later and see where she is at. Do not shoot any number below 50.

From the Tight Regulation sticky:

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
Click to expand...
Where did you get this from- the sticky?
 
@Marje and Gracie why would I have shot if I knew that already. It’s as though you’re saying I knew I shouldn’t have shot and did it anyway. Why on earth would I do that to my cat or myself?
tiffmaxee said:
https://www.felinediabetes.com/FDMB/threads/dont-panic-or-how-to-handle-low-numbers.210109/
Click to expand...
darn it - I thought that sticky was only for nadirs. I didn't know it had PS info in it. I also thought below 40 was just reduced.. I should have opened that..
well right now mimi is rising on her own and hasn't had for in an hour
 
Rosa, the only rule you really need to know on the FDMB is never shoot a cat when their preshot number is a lime green one, and that is any number below 50. You stall, don't feed, test in 20 minute increments. Once she starts rising, then you can shoot. I understand you can't be off schedule, so since DKA is long ago, you can skip or give a reduced dose, but that reduced dose should be 25% of what her usual dose is. Even if you don't shoot, the depot is in play and you have to keep testing Mimi if she is at 37.

Write this stuff down on a post-it note or print it out and put it on your fridge. I read and re-read the stickies constantly as I need the reminder of what to do. It's never something that sinks in after one reading. Look at other people's spreadsheets, learn from how they do things. Then it won't seem as baffling every single day.
 
From the New to the Group sticky: Where Can I Find. There are many, many other links on the New to the Group Sticky.

This sticky, at the top of this ISG actually has, in its title, how to handle low Preshots.

Mimis mom said:
It’s as though you’re saying I knew I shouldn’t have shot and did it anyway.
Click to expand...
No, I’m not saying that. I’m saying that after one month max, members know not to shoot below 50. You’ve been doing this two years. This is not information you should have forgotten. It’s so much more important than remembering “shoot low to stay low”. How low would you have shot using that justification? 20? 15?
 
Last edited:
Rosa - TEST AGAIN NOW!! I think it's been about an hour since your last test, she will have onset since then.
 
Sorry to worry every body. Mimi is doing good atm she seems normal, is cleaning herself and sitting up observing the ghosts in the room lol
 
Mimi +4 121

only fed at PS and +2.5


Now can someone explain to me why she was so low at PS!?? Was it the depot? What could have been some possible causes?
 
There are a couple of basics you need to be attentive to.
  • You need to give members more than 20 min to respond to a request for help. We are all volunteers. We all have lives outside of FDMB. Christie responded to your tag within 16 min. Katherine and Red & Rover also responded within a few minutes. I wasn't online.
    • Basic rule: do not shoot below 50
    • Basic rule: feed the 40s (and below)
  • Unless your cat is very carb sensitive, you need to feed medium or high carb when numbers are low. 37 is a low number. See the sticky on Handling Low Numbers. I have no clue why you didn't refer to the sticky. Low numbers are low numbers, regardless of when in the cycle they occur. Of course, there's the sticky note right above it that has handling low pre-shot numbers in its title. The sticky states,
    The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if a cat is lower then usually the best option is to wait until they are at a shootable number to shoot.
    Click to expand...
  • If you are asking for help, it is your responsibility to read ALL of the replies and respond in a timely way, especially if the response is from someone you tagged, a moderator, or other very experienced members. Once someone with experience responds, they will feel obligated to be there throughout the emergency (and this was an emergency) with you or arrange for someone else to stay up with you. If you are not responding to what people are asking for, they are likely to to get frustrated and not stick around. Again, in the Handling Low Numbers sticky, we note,
    Please post your numbers. Those people who are helping you will not abandon you. In fact, they are staying up with you. The experienced people will even work in shifts to make sure your cat is safe and you have the support you need. Remember to refresh your browser to see new posts and keep posting so we know all is well.
    Click to expand...
  • Do not clog your thread with miscellaneous questions until after your cat is safe.
  • Keep your spreadsheet current especially in an emergency. I know I do not want to wade through chatter to find the most recent numbers. The numbers are all I care about in a situation like you encountered last evening. It's the safety of your cat that is of paramount concern. Likewise, when Christie asked for test data, you did not initially respond.
  • Do NOT leave. I was appalled that you were going to go out of the house with Mimi in low numbers. If you re-read the How to Handle Low Numbers sticky, it states,
    DO NOT become complacent. If numbers have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
    Click to expand...
"Shoot low to stay low" does NOT mean shoot any number you get. Safety is and will always be the basic premise of how we approach dosing. As Marje said, you have been here for over 2 years and by now, you should know what you're doing and not go into a tailspin if Mimi's numbers drop low. It's happened a fair amount and frankly, your response last night was not markedly different than when you first joined.

As far as DKA, if Mimi has had no recurrence since 2019, it's not relevant. Frankly, you're not testing for ketones so why are you getting frantic with stalling or skipping a shot?

You may want to give serious consideration to using SLGS. TR is much more aggressive and it doesn't seem well suited to your level of anxiety. SLGS will give you a greater margin for when to shoot although the other basic issues are still in play.
 
Last edited:
Sienne and Gabby (GA) said:
There are a couple of basics you need to be attentive to.
  • You need to give members more than 20 min to respond to a request for help. We are all volunteers. We all have lives outside of FDMB. Christie responded to your tag within 16 min. Katherine and Red & Rover also responded within a few minutes. I wasn't online.
    • Basic rule: do not shoot below 50
    • Basic rule: feed the 40s (and below)
  • Unless your cat is very carb sensitive, you need to feed medium or high carb when numbers are low. 37 is a low number. See the sticky on Handling Low Numbers. I have no clue why you didn't refer to the sticky. Low numbers are low numbers, regardless of when in the cycle they occur. Of course, there's the sticky note right above it that has handling low pre-shot numbers in its title. The sticky states,
  • If you are asking for help, it is your responsibility to read ALL of the replies and respond in a timely way, especially if the response is from someone you tagged, a moderator, or other very experienced members. Once someone with experience responds, they will feel obligated to be there throughout the emergency (and this was an emergency) with you or arrange for someone else to stay up with you. If you are not responding to what people are asking for, they are likely to to get frustrated and not stick around. Again, in the Handling Low Numbers sticky, we note,
  • Do not clog your thread with miscellaneous questions until after your cat is safe.
  • Keep your spreadsheet current especially in an emergency. I know I do not want to wade through chatter to find the most recent numbers. The numbers are all I care about in a situation like you encountered last evening. It's the safety of your cat that is of paramount concern. Likewise, when Christie asked for test data, you did not initially respond.
  • Do NOT leave. I was appalled that you were going to go out of the house with Mimi in low numbers. If you re-read the How to Handle Low Numbers sticky, it states,
"Shoot low to stay low" does NOT mean shoot any number you get. Safety is and will always be the basic premise of how we approach dosing. As Marje said, you have been here for over 2 years and by now, you should know what you're doing and not go into a tailspin if Mimi's numbers drop low. It's happened a fair amount and frankly, your response last night was not markedly different than when you first joined.

As far as DKA, if Mimi has had no recurrence since 2019, it's not relevant. Frankly, you're not testing for ketones so why are you getting frantic with stalling or skipping a shot?

You may want to give serious consideration to using SLGS. TR is much more aggressive and it doesn't seem well suited to your level of anxiety. SLGS will give you a greater margin for when to shoot although the other basic issues are still in play.
Click to expand...


I understand Sienne, thank you for your response. I think I should stick with TR because it seems to be working (her shes been earning reductions instead of increases.
When you say my level of anxiety do you mean if I were to leave her home and go away? I think that's the only anxiety I have over her now compared to the past is just being too scared to leave her.
 
The frantic nature of your posts, not paying attention to the information that's being provided, getting flustered until someone points out you're not paying attention, not recalling basic information that's been reiterated for you on several occasions, and asking less than relevant questions all suggest you are in a tizzy in situations like the other night. It doesn't help your cat if you are anxiety ridden. Granted, it's my impression of what's going on but it certainly reads like you are scattered all over the place. And no, I was not referring to your reticence about leaving the house. I was pointing to your response to a 37.
 
You must log in or register to reply here.
Back
Top