? Tiny dosing, sub-200 AMPS/PMPS assistance needed

[stacia]

Hello, it's been awhile. I'll do my best to keep it brief but comprehensive enough.

My Tasha, who just had her first sugarversary, has never been high-dose (she's on Prozinc), but in the past month, she's been giving us lower and lower pre-shot numbers. Often we delay an hour just to get something high enough that we're confident shooting. As you can see from her spreadsheet (here - scroll way down), there are many lovely yellows and blues.

In the last 30 days, we've gone from 0.6u (using u100 needle), briefly to 0.4u, to we're just dropping like crazy. We can't settle anywhere for long. We were at 246 yesterday morning and wondered if 0.2u would be enough but held there, she was only 149 last night so we gave 0.1u. This morning, 151. I gave her literally a drop.

She acts great. She's not over drinking, she's eating well, she's purring, she sleeps a lot but she's 15 and that's just her. Her litter box activities suck but they always have - she poos outside the box at least 50% of the time, almost always pees in the box.

Questions - Are we doing ok? At what point do I skip insulin altogether? I'm terrified about overdosing her but also afraid to get too optimistic about not giving her insulin.

I would appreciate some guidance. Am I missing anything?

 

[Larry and Kitties]

You have very few BGs reading between shots. Without more BG readings at about 5-7 hours it is hard to tell what the dose should be

 

[stacia]

I'll grab one at +6, about half an hour from now. The vet we've been seeing favors fructosamine checks over curves and over-checking (though she likes that we're home testing) and unless she's acting weird (like last night she didn't wake up for the automatic feeder at 4am), I'm generally immersed in the work day. But if those will help, I'm happy to collect that data and report back.

 

[Sue and Oliver (GA)]

Hurray for Tasha! Here is a paragraph from the PZI forum on micro dosing

When your cat is consistently in numbers too low to shoot at shot time and in numbers in the 100 range and below during the cycle, you can consider micro dosing. This process should be guided on the forum by experienced members and will require more frequent testing.

You may be shooting at times other than the 12/12 schedule, when the blood glucose levels rise enough to require a small dose of insulin. You will need to pick a number somewhere near the 150 range at which you will plan to shoot, being sure that the number is indeed rising. The dose at these low numbers will vary with each cat and its patterns, so advice should be solicited. But you may be considering doses below .25 and even considering a “drop” of insulin. At this point, U100 needles and the conversion chart will be necessary.

It is important during this period to offer small frequent meals. You may want to experiment with the lowest carb foods to help bring down the numbers, staying away from seafood more than once or twice a week.

Also, you might post on the PZI forum and get daily advice there. The Remission thread on the forum could also be interesting - if you look at the spreadsheets on that thread, you'll see how others did this OTJ (anti jinx) thing.

 

[stacia]

Larry - Tasha thanks you for the brilliant idea of mid-afternoon chicky treats. Purr purr!

151 AMPS, +6 after 1 drop of insulin is 142. Spreadsheet updated. Unfortunately, going to be leaving in about an hour and probably won't be back until around her +10. Tomorrow, I should be home the entire afternoon. (The human needs a tooth drilled.)

Sue - I'll check out that forum, see what I can find there. Thanks for the resource. We have an automatic feeder that goes off 3 times between insulin doses (wet food at roughly +3 and +8, some bonito flakes at +9) so she gets in-between meals. I think it could be a recent food change of sorts making a difference? We took a 3rd food out of the rotation. I'm not sure because they've only been getting low-carb Friskies cans - but I can't think of a single other thing.