Should I increase dose? PMPS 403

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I’ve only been giving 0.5u. But shouldn’t I increase the dose if my PMPS test is 403?

With Lantus, the dose isn't based on the Pre-Shot....it's based on how low it takes him and since he dropped to 98 today on the .5, you'd hold that dose for now.

The Pre-Shot is important because you always want to make sure he's high enough for insulin at all, but when dealing with dose, we look at the lows
 
With Lantus, the dose isn't based on the Pre-Shot....it's based on how low it takes him and since he dropped to 98 today on the .5, you'd hold that dose for now.

The Pre-Shot is important because you always want to make sure he's high enough for insulin at all, but when dealing with dose, we look at the lows

Well that’s not good. I was anxiously waiting because my time was already getting messed up again (the test just takes forever so it’s unpredictable when I will have my BG number). When no one responded after at least 10 minutes I just made a decision and went with it. I shot somewhere between .5 and 1. So 0.75 or maybe less. It’s impossible to tell without quarter marking lines. Hopefully I didn’t mess up too bad. Clearly, I’m not understanding how this works. I printed it out and read everything so many times that I don’t know why it’s still not clicking. But I’ll keep trying. Thanks again for your help!
 
Also, that 403 is probably a "bounce" number.

Bounces happen when 1. they drop too low, 2. they drop too fast, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3)

With Red dropping to 98 today, while that's not "too low", it's probably a lot lower than his body has been for quite some time. Our cats are so good at hiding that they're sick so by the time we get them diagnosed, they've probably been diabetic for a long time. Their blood glucose has slowly been going up and their body has gotten used to it. Once we start giving insulin, we're forcing the BG down and his body is thinking "Oh no....this doesn't feel right!" and the liver releases stored sugars and hormones to bring it back up. It can take up to 6 cycles for those hormones to clear the bloodstream.
 
Also, that 403 is probably a "bounce" number.

Bounces happen when 1. they drop too low, 2. they drop too fast, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3)

With Red dropping to 98 today, while that's not "too low", it's probably a lot lower than his body has been for quite some time. Our cats are so good at hiding that they're sick so by the time we get them diagnosed, they've probably been diabetic for a long time. Their blood glucose has slowly been going up and their body has gotten used to it. Once we start giving insulin, we're forcing the BG down and his body is thinking "Oh no....this doesn't feel right!" and the liver releases stored sugars and hormones to bring it back up. It can take up to 6 cycles for those hormones to clear the bloodstream.
Ruh-roh! —that’s a Scooby Doo reference

So I dosed too much? You have been so unbelievably helpful! I don’t even know how to thank you. But if I’m being honest, I just read that twice and it’s not really clicking. I’m sure it eventually will and you simplified your explanation nicely. So I’ll keep reading all of your advice and comments until hopefully I get that “ah ha” moment.
Until then, there’s not much more you can do.

thank you again truly! Your time is valuable and it means a lot that that you gave so much of it to me this week.
 
Please go back to the 0.5 unit dose at the next preshot, if the preshot BG is high enough to shoot..
Please give more than 10 minutes for us to answer. Sometimes we are there within 1 minute but at other times we may be helping someone else or not online at the at moment. We are all volunteers here.
 
Please go back to the 0.5 unit dose at the next preshot, if the preshot BG is high enough to shoot..
Please give more than 10 minutes for us to answer. Sometimes we are there within 1 minute but at other times we may be helping someone else or not online at the at moment. We are all volunteers here.
Understood. Thanks
 
Well that’s not good. I was anxiously waiting because my time was already getting messed up again (the test just takes forever so it’s unpredictable when I will have my BG number). When no one responded after at least 10 minutes I just made a decision and went with it. I shot somewhere between .5 and 1. So 0.75 or maybe less. It’s impossible to tell without quarter marking lines. Hopefully I didn’t mess up too bad. Clearly, I’m not understanding how this works. I printed it out and read everything so many times that I don’t know why it’s still not clicking. But I’ll keep trying. Thanks again for your help!
You asked the dosing question in the testing condo after you got the PMPS 403. @Chris & China (GA) responded to you in the same thread 7 minutes later. That is lightening fast for the Main Health Forum. And then you questioned her judgment even though Bron had already told you here to hold the dose and I agreed with her. AND she explained to you why not to increase.

As Bron said in this thread, Chris again responded to the same question that you posed in this thread (were you hoping for a different answer?) in 13 minutes. Again....really fast.

We’ve asked you repeatedly to move your shot time back so you can take the time you need to get the test and not always be lagging behind. It also gives you time to ask your questions and have them answered.

So....tough love here. There is so much info on this board that it’s beyond amazing and incredible. Members are willing to put down whatever they are doing, and most of them have their own diabetic cats, to respond to someone in need. But you need to have patience. Look at this forum alone and see how many new, frightened members there are. Then go to the LBL forum, the PZ forum, the Vetsulin forum, the acro forum. Look how many people need help and there are only a few that have the experience with every insulin. Patience, Grasshopper!

If you don’t get a response right away, read back through what has already been given to you in the thread and if you still don’t understand whether to increase the dose, then tag an experienced member or send one a PM and ask them to go to your thread. But don’t just arbitrarily and on your own increase the dose because you don’t have the data right now. The saying here is "don’t increase the dose unless you know how low the current dose is taking the kitty". And you don’t know. He could easily have gotten a BG somewhere below 98.

Caveat for anyone reading: if your cat has ketones or a history of DKA and you want to raise the dose but are unsure, put up a 911 to get the attention if you must shoot right away (most times, you can stall until you get help). Just be sure you take the 911 down as soon as someone helps you.

It’s easy enough for you to say if something happens it’s your responsibility. Yes, that is true, but don’t you think we all feel it when something happens to a cat here regardless of whether the CG was being careless or not? We do. We take every single cat here seriously and the loss or irreparable insult to even one of them from a symptomatic hypo devastates the entire group.

Many members have made many good suggestions but have you tried them? Did you try to burrito him and put him in a chair next to you where he can’t move and his paws are covered? Did you look into toe pad testing? Unfortunately, I have not heard back from the member who, for a short time, did urine glucose testing but, honestly, it’s not something I’d have ever done and now you see why. Now you understand why it is imperative that he learn to be tested.

Have you ever tried a thunder shirt for cats? They work well for most.

I know you will likely be upset when you read this. We understand you are trying. But you can’t be cavalier ("Ruh-roh! —that’s a Scooby Doo reference”) because his life is in your hands and this is not funny or anything to be taken lightly.

Final word: please have respect for our members here and how they are trying to help you. Don’t give them 10 minutes to respond and do what you want without even understanding the repercussions.

Ok...off my soapbox.
 
You asked the dosing question in the testing condo after you got the PMPS 403. @Chris & China (GA) responded to you in the same thread 7 minutes later. That is lightening fast for the Main Health Forum. And then you questioned her judgment even though Bron had already told you here to hold the dose and I agreed with her. AND she explained to you why not to increase.

As Bron said in this thread, Chris again responded to the same question that you posed in this thread (were you hoping for a different answer?) in 13 minutes. Again....really fast.

We’ve asked you repeatedly to move your shot time back so you can take the time you need to get the test and not always be lagging behind. It also gives you time to ask your questions and have them answered.

So....tough love here. There is so much info on this board that it’s beyond amazing and incredible. Members are willing to put down whatever they are doing, and most of them have their own diabetic cats, to respond to someone in need. But you need to have patience. Look at this forum alone and see how many new, frightened members there are. Then go to the LBL forum, the PZ forum, the Vetsulin forum, the acro forum. Look how many people need help and there are only a few that have the experience with every insulin. Patience, Grasshopper!

If you don’t get a response right away, read back through what has already been given to you in the thread and if you still don’t understand whether to increase the dose, then tag an experienced member or send one a PM and ask them to go to your thread. But don’t just arbitrarily and on your own increase the dose because you don’t have the data right now. The saying here is "don’t increase the dose unless you know how low the current dose is taking the kitty". And you don’t know. He could easily have gotten a BG somewhere below 98.

Caveat for anyone reading: if your cat has ketones or a history of DKA and you want to raise the dose but are unsure, put up a 911 to get the attention if you must shoot right away (most times, you can stall until you get help). Just be sure you take the 911 down as soon as someone helps you.

It’s easy enough for you to say if something happens it’s your responsibility. Yes, that is true, but don’t you think we all feel it when something happens to a cat here regardless of whether the CG was being careless or not? We do. We take every single cat here seriously and the loss or irreparable insult to even one of them from a symptomatic hypo devastates the entire group.

Many members have made many good suggestions but have you tried them? Did you try to burrito him and put him in a chair next to you where he can’t move and his paws are covered? Did you look into toe pad testing? Unfortunately, I have not heard back from the member who, for a short time, did urine glucose testing but, honestly, it’s not something I’d have ever done and now you see why. Now you understand why it is imperative that he learn to be tested.

Have you ever tried a thunder shirt for cats? They work well for most.

I know you will likely be upset when you read this. We understand you are trying. But you can’t be cavalier ("Ruh-roh! —that’s a Scooby Doo reference”) because his life is in your hands and this is not funny or anything to be taken lightly.

Final word: please have respect for our members here and how they are trying to help you. Don’t give them 10 minutes to respond and do what you want without even understanding the repercussions.

Ok...off my soapbox.
I actually asked for a clarification on the comment from her on the 0.5. I wasn’t sure if she meant that it was OK in general to be giving insulin and not understanding that I asked if I could increase it or not in the other thread.

I not only read all of the advice but I look at people’s spreadsheets and try to understand the numbers. It seems like most people increase the insulin when the number is higher. Which is why I thought I was supposed to be doing it that way and why I asked. I’m sorry that I’m having a hard time understanding and not doing it at a fast enough pace for you.

If you read any of my previous messages you would see that I have tried ALL the suggestions. Including the ones you just repeated.

I looked into paw testing but learned it’s a bad idea because of possible infection.

You seem very unable or unwilling to relate to someone who’s new to this and is not only feeling drowned by new and confusing information, but is having a really hard time with everything. It’s overwhelming. I DO read everything but its hard to remember sometimes.
From the numbers to even the words people use are all so unfamiliar. Have you ever read something and not understood a word of it because it’s all brand new? Because it is for me.

Last night, I was scared by the number and clearly still haven’t grasped the concept of interpreting numbers and dosing. It’s rude to say something like, “were you expecting a different answer”. Because I don’t remember getting an answer. I’m not saying that I didn’t. But it’s really hard to retain the endless amount of information being thrown at me. And in the moment I was also scared.

If I wasn’t taking this seriously I wouldn’t be here. Sometimes I use humor to deflect when I’m upset. That part of your response I agree with and apologize for.

As for the rest of it, I will stop asking questions since I keep getting these type of response from you. Perhaps it’s best if I find a different support system so I don’t have to feel attacked by asking questions or making mistakes. I thought that was the whole point of this forum.

Thank you to everyone for the help! I am more than grateful for your time and advice! Sorry to anyone that I made feel this way, since all the “likes” says that you agree. I won’t bother anyone anymore.
 
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I could have sworn Lauren had a SS set up, now it's gone?
I removed it. I don’t think this is the right place for me. I am apparently upsetting people. Which was never my intention. I don’t need any more stress or negativity when I’m already having such a hard time. I have printed out all the information, including your wonderful advice and will use it as a reference. Thank you for all of your help!
 
I actually asked for a clarification on the comment from her on the 0.5.
Chris said this:
403 is more than high enough for insulin so go ahead and give the .5 unit dose again.
I don’t understand what about that needs any clarification.

It seems like most people increase the insulin when the number is higher.
They follow a protocol or method of regulation. Those methods are on the board for anyone to read. Yes, looking at other SSs is a great idea as long as you understand what you are looking at or ask questions when you don’t.
If you read any of my previous messages you would see that I have tried ALL the suggestions. Including the ones you just repeated.

I looked into paw testing but learned it’s a bad idea because of possible infection.
I did read all of your previous posts and you didn’t address that you tried “ALL” the suggestions. If paw testing can result in infections, I wouldn’t have suggested it.

You seem very unable or unwilling to relate to someone who’s new to this and is not only feeling drowned by new and confusing information, but is having a really hard time with everything.
You might want to recall all the time I’ve patiently spent helping and supporting you, how many times I’ve assured you you were not bothering me and I was happy to help, how many links and other info I’ve provided for you. Every, single new member here feels drowned by all of this.

Have you ever read something and not understood a word of it because it’s all brand new?
Of course I have. We all have. Members have been very patient and helpful to you in answering your questions in straightforward answers.

Perhaps it’s best if I find a different support system so I don’t have to feel attacked by asking questions or making mistakes. I thought that was the whole point of this forum.
No one has attacked you. There is a difference between what I said to you and “attacking you” which no one here has done. Everyone has tried to answer your questions and have been quite patient and supportive.

I’ve been on every FD website forum and am familiar with the FB ones. We get many, many, many members from all of them because they don’t get the support we give here, and quite frankly, some of them are downright dangerous. While it’s up to you, I’d just suggest you put Red first and stay where you will get the best advice.

It’s your choice and we all wish you the best of luck.
 
Lauren:

It's been very clear to me from your first post that you are letting your anxiety get in the way of your ability to process the information that's being provided. No one faults that. In fact, we've all been there and empathize. However, it's in both your and Red's best interest if you can stop, take a few breaths, and relax or go back and read over the posts and sticky notes and try to understand what members are communicating. Yes, you may get different or even conflicting information and not everyone's posting style will be your cup of tea. People are doing their best to help. Marje's point is that you have to do your part, as well. Read through the sticky notes. I still read them over and it's been over 10 years since I've been here. In cases of dosing, the answers you're looking for are likely in the dosing method sticky. That doesn't mean you shouldn't ask questions. The dosing methods can need additional interpretation based Red's data. Looking at other cat's spreadsheets can be helpful; but, you need to know what you're looking at. It took me quite some time (many months) to be able to interpret spreadsheets.

Marje is incredibly patient and truly understands (and I should know since I'm one of the people who was here when she arrived with Gracie). The message isn't to leave FDMB. Your feelings may be hurt but take the message in the spirit of its intent. If a Moderator is explaining how your posts are coming across, it's not being said to drive you off the board. In fact, it's just the opposite. If the people who are responding to your questions are getting the impression that you aren't paying attention or that you are expecting an instantaneous reply and you're annoyed when that doesn't happen, they will stop posting to your thread.

It is entirely your choice if you stay or if you go. I loosely monitor the FB group of FDMB. There are lots of people who comment and provide a substantial amount of misinformation. In addition, dosing advice is not permitted on the FB group. Several of our experienced members keep an eye on other of the feline diabetes groups. I was a member one as well. I was appalled at the amount of poor, if not downright dangerous information that was provided (e.g., to not give a cat that's in quite low numbers any high carb food). I've seen cats die from symptomatic hypoglycemic events on some of those boards. I stopped monitoring because it broke my heart. In addition, if you suggested a different course of action, you were kicked off of the site.
 
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Ruh-roh! —that’s a Scooby Doo reference

So I dosed too much? You have been so unbelievably helpful! I don’t even know how to thank you. But if I’m being honest, I just read that twice and it’s not really clicking. I’m sure it eventually will and you simplified your explanation nicely. So I’ll keep reading all of your advice and comments until hopefully I get that “ah ha” moment.
Until then, there’s not much more you can do.

thank you again truly! Your time is valuable and it means a lot that that you gave so much of it to me this week.
Lauren, My cat is not on Lantus but on ProZinc. I also heard but did not GRASP what the wonderful helpful people here told me. I made a WORD doc on my computer and copy and paste all pertinent tidbits of info into that word doc. Save it but leave it up. Then read it daily. I did all of this. Just the main point is what needs to sink in. Also read others' troubles and the answers they get (how I found out about your situation today) I am a newbie too!
In reading the help you got, I would copy:
With Lantus, the dose isn't based on the Pre-Shot....it's based on how low it takes him and since he dropped to 98 today on the .5, you'd hold that dose for now.
High jumps (bounces) are cats system adjusting, no cause for concern
Don't increase until an experienced member suggests it, might be some wait time and you can stall
 
I looked into paw testing but learned it’s a bad idea because of possible infection.
I was doing paw testing but felt it hurt my cat more so learned ear testing. PM me for help with getting ear testing down, if you choose
You seem very unable or unwilling to relate to someone who’s new to this and is not only feeling drowned by new and confusing information, but is having a really hard time with everything. It’s overwhelming. I DO read everything but its hard to remember sometimes.
So not true. The peeps here are so helpful, I know because I am new and struggling. It is important to learn everything you can, make bullet points
As for the rest of it, I will stop asking questions since I keep getting these type of response from you. Perhaps it’s best if I find a different support system so I don’t have to feel attacked by asking questions or making mistakes. I thought that was the whole point of this forum.
I do not think you should stop asking questions, just make copies of the question and answer on a bullet point page so you can refer to it

The SS? I hoped and wished and prayed peeps here would stop asking for it "How can it be that important" I would ask myself. I bucked it as long as I could. Chris helped me set it up and all of the sudden I became aware of how important it is.
Please do not leave, for your cat's sake.
I am amazed daily that there is this much help available to me right here at my computer and I feel like I am the most informed person there is now regarding my Joe and his condition and I have only been doing this with the forum for about a month. I know more than my vet could have ever told me, about my Joe and how he is doing
 
Hi. You may not believe it but everyone here truly cares about all the cats here. You may not know it but some of us were trying to find someone that could help you work out a testing arrangement that works for you and Red. I for one asked a former member but she lives too far away from you. Written comments can come across as negative when they aren’t meant to be. People disagree at times. FD is not an exact science but our cats are in control and often throw us the unexpected. Often folks like you are scared. I get that. I burst into tears after coming to this site and I’ve nursed cats with lymphoma and kidney disease. We all understand the fear and the big learning curve. But we are either volunteering after having lost a diabetic cat or people dealing with their own diabetic cats and hectic lives. I hope you can get past your hurt feelings and realize that what matters most at this time is helping Red. :bighug:
 
Hi Lauren,
I do hope you will think about staying on the forum as we all only want what is best for you and Red.
You don’t need to learn it all at once. That is why we are here. To help you through it until you learn more about FD and you are confident enough to do it on your own. And that won’t happen in a few short weeks. I am still learning new things.
Keeping in touch with the people who are helping you is really important as they don’t know what is happening and they really care what happens to you and Red. Just posting and saying you are running late but will be back on 30 minutes would be a huge help to us when we are waiting for you at preshot time.
It’s wonderful you love Red so much and want what is best for him.
I hope we see you back here soon :):bighug:
Bron
 
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