Stalling, help choosing dose?

[Joy W]

Hi folk. I usually look after our diabetic cat Minerva, but my partner does sometimes if I'm away. I was out tonight and he did Minerva's ear test, which was a) a bit late as he didn't get home quite on time, and b) lower than we usually see! He didn't know about stalling without food and so he stalled/skipped, but then he also fed her. I have since got home and checked it a couple more times, and it's gone up, to a level that is fine to shoot. But it's really late and although it's now been at least 90 minutes since she did eat properly she did get a small treat each test. We've just put up her dose in the last couple of days. I think she's probably safe to shoot but I'm not sure how much because it's so late now (+14), the fact she has had some food, and as she's just had an increase. Any advice appreciated.

 

[Bandit's Mom]

She's safe to shoot at 15.9 mmol / 286 mg/dl. The only question is whether your schedule can accommodate the 2 hour delay? If you can, please go ahead and shoot the full dose.

Next time you get a low number, stall without feeding and test after 20 mins to see if the number is rising.

 

[Bandit's Mom]

Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/stalling-please-help.248591/

Getting back on a 12/12 shot schedule - suggestions for newer caregivers

 

[Sue and Luci]

Hi Joy, I'm not sure what the issue is - the pre-shot number you have in your column for 7/18 looks safe to shoot. Are you questioning the timing or the dose itself? Has it been at least 12 hours since the last injection?

Good to see you here Bhooma, I'm just getting ready to leave to do some other things...

I hope Joy/Minerva can get things straightened out.

Joy, if you do decide to shoot, you'll need to adjust your schedule by 15 minute increments to get back on track...if not, skip and start again at the next shot time.

 

[Joy W]

Thanks Bandit's Mum. Apologies if I wasnt clear. Yes I already know to stall without feeding. Garth did not. He wasn't sure what to do at the 10 as he hadn't seen that number before and didn't know the lower limit, so he just skipped and fed her. So I got home later to a fed, un-shot cat. The later readings I took, including the 15.9, are with food on-board, and I don't know what to do if the reading is after food, I don't know whether to treat it normal, or to somehow adjust it?

Unfortunately our schedule can handle NO delay. We shoot and walk out the door basically. Based on that, should we just roll with the skip? Thank you for your help, it's so kind.

She's safe to shoot at 15.9 mmol / 286 mg/dl. The only question is whether your schedule can accommodate the 2 hour delay? If you can, please go ahead and shoot the full dose.

Next time you get a low number, stall without feeding and test after 20 mins to see if the number is rising.

 

[Joy W]

Thanks Sue, appreciated. My question is if and how to adjust the dose given how late it is combined with less valuable data. I can't adjust tomorrow morning's dose time at all. All I can do right now is skip, shoot it all, or adjust the dose. I was thinking adjust the dose would be preferable to a skip so that there was something, but I don't know how to work out how much it should be. I do know that normally on a stall you'd factor in how glucose is trending without food, but we don't have that data as she ate, so I would be adjusting based on time and somewhat tainted data (ie I don't know if she was already trending upwards or if the food is what did the increase).

Given its even later now I'm just going to roll with the skip, thank you.

Hi Joy, I'm not sure what the issue is - the pre-shot number you have in your column for 7/18 looks safe to shoot. Are you questioning the timing or the dose itself? Has it been at least 12 hours since the last injection?

Good to see you here Bhooma, I'm just getting ready to leave to do some other things...

I hope Joy/Minerva can get things straightened out.

Joy, if you do decide to shoot, you'll need to adjust your schedule by 15 minute increments to get back on track...if not, skip and start again at the next shot time.

Timing

 

[Bandit's Mom]

Unfortunately our schedule can handle NO delay. We shoot and walk out the door basically. Based on that, should we just roll with the skip?

Sorry, but I'm just seeing this. Yes, just skip and shoot at your usual time tomorrow morning.

 

[Librarianista]

Thanks Sue, appreciated. My question is if and how to adjust the dose given how late it is combined with less valuable data. I can't adjust tomorrow morning's dose time at all. All I can do right now is skip, shoot it all, or adjust the dose. I was thinking adjust the dose would be preferable to a skip so that there was something, but I don't know how to work out how much it should be. I do know that normally on a stall you'd factor in how glucose is trending without food, but we don't have that data as she ate, so I would be adjusting based on time and somewhat tainted data (ie I don't know if she was already trending upwards or if the food is what did the increase).

Given its even later now I'm just going to roll with the skip, thank you.


Timing

I’m not a dosing advisor, but everything I’ve read and been advised to do lines up with skipping. Since you cannot adjust your schedule and adjust dosage based on late/early shooting is for people with lots of data and experience, skipping is the safe option.