skip a shot?

[ppp]

This a.m., Tut's pre-shot # is 194. Until last night, he's always been above 300, so I am thinking of skipping his (lantus) shot (now due), per recommendation quoted below. Does anyone else have experience/advice with a large drop in pre-shot #? Any insight on what this is indicating. He is eating a lot.

I am going to try the every two hour testing that is also recommended here. Data so far is slight. Lowest mid-shots reading I've gotten was 167, yesterday. Near the same time on 11/21, it was 287.



4.4. 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

 

[Djamila]

Another option is to stall for about 20 minutes without feeding, test again, and if the number is rising, give the full dose. That's my preferred option because it's best not to skip if it can be avoided, and 194 is so very close to 200.

 

[ppp]

Thanks. (p.s. cute picture... wonder when I will get around to that)

Too late not to feed (he was sooo hungry). It's not a problem to still shoot if he will eat again, right? Although prob. too late now, anyway. (I was reading up on ketone testing and setting up a separate catbox for him to hopefully get a test.)

Will keep this in mind for future.

It was good to see your spreadsheet; I understand all the cautions about every cat being different but to see the experience of others seems to help. I see that one day while you were on Lantus you went from 275 to 62, with just 1 unit. (Tut's been at 1.5 now for a week.)

 

[ppp]

if this helps anybody help me.
a) tested for ketones: good
b) while I was moving cat boxes around to isolate him from other cats, for this, he got the idea something was up (a vet appointment?!!!) and hid under the treadmill. So, first read since this a.m. a few minutes ago: 334. I Think I will keep testing through today and wait until his regular 8 p.m. time for next shot. (Same 1.5 U??)

Reminder of background. Started insulin 11/18, 3 units [as prescribed by vet, for once per day, since I was going out of town and petsitter could only do once per day]. But cut that to 2 units 11/19, and then 1 unit until 11/21, when I returned home and moved to 1.5 U twice per day, which he's been on since.

Was always above 300 pre-shot until last night, when he tested at 235. Then 194 this a.m. -- skipped shot. Lowest ever mid-shot # was yesterday: 167. s (287 11/21, and 221 11/25).

He ate about 19 oz. of low-carb wet food yesterday, up from last few days. (He's 14 lbs now, having recovered 1 lb. from a 4 lbs loss over the last few months.) Then another 5.5 oz can this a.m. (Woke me up -- very unusual -- he was so hungry, despite 2 feedings overnight)