Ty 6/19 - AMPS 187 - should I give full dose (1 U)???

CCG

CCG

Member Since 2019
Ty's BG was 187 this morning, which is surprisingly low to me (the blue days on his spreadsheet are the only consistent blue #s we've seen since we started testing at home).

His sugar levels were low (for him) all night. I wish I had woken up to test between +5 and +7 PMPS to see if he dropped below 100, but I missed my alarm :(

Now I'm worried about giving him a full unit because I can't be home today to monitor. Suggestions? He has been improving so much so I don't want to throw him off. But don't want to risk hypo. Wish I could stay home today.

Complications:
Ty has been eating less than usual, but the food he IS eating is higher carb than usual. The only thing he will eat right now is deli turkey and high carb Friskies food (shredded chicken w/gravy). I've also still been syringe-feeding him a bit of his regular food (FF pate) to supplement his calories.
 
Morning! I think 187 is a safe number to shoot :)

I'm not sure if anyone gave you this bit of information yet, but exactly as you observed... cats typically have lower BG levels at night, what you're seeing in Ty is normal. Also, it is ok for Ty to drop below 100 :) You want his numbers to start getting lower over time.

I can understand your concern though... you have to do what is best for you and Ty, you also should do what you feel most comfortable with. Your comfort level and confidence will build over time as you gather more data. In the end it is always better safe than sorry, If you don't feel comfortable to give the full dose maybe try a reduced dose and make sure there is food out for him. Better to spend a day too high than a minute too low --- as members around here say.

Here's what the TR and SLGS sticky says around reduced dosages:

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.
Also here is a document about how to become comfortable shooting lower numbers :)
 
AmandaE said:
Morning! I think 187 is a safe number to shoot :)

I'm not sure if anyone gave you this bit of information yet, but exactly as you observed... cats typically have lower BG levels at night, what you're seeing in Ty is normal. Also, it is ok for Ty to drop below 100 :) You want his numbers to start getting lower over time.

I can understand your concern though... you have to do what is best for you and Ty, you also should do what you feel most comfortable with. Your comfort level and confidence will build over time as you gather more data. In the end it is always better safe than sorry, If you don't feel comfortable to give the full dose maybe try a reduced dose and make sure there is food out for him. Better to spend a day too high than a minute too low --- as members around here say.

Here's what the TR and SLGS sticky says around reduced dosages:

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.
Also here is a document about how to become comfortable shooting lower numbers :)
Click to expand...

Thank you :)
To be on the safe side and to give me peace of mind, I gave a token dose (~.25U) and left some food out.
It is very helpful to have other people to talk to about this, especially in moments of doubt!
 
CCG said:
Thank you :)
To be on the safe side and to give me peace of mind, I gave a token dose (~.25U) and left some food out.
It is very helpful to have other people to talk to about this, especially in moments of doubt!
Click to expand...
I think you can leave the house now without having to worry that Ty is at risk :) Next time maybe you can try giving a bigger reduced dose, No pressure though :P

I agree, this forum really helps when you're trying to make a tough decision, even something as small as someone reading an article that you haven't come across yet. Sharing is caring :D

Have a nice day :)
 
Wow. I just posted this on another thread but Ty is full of surprises for me.

So glad to have had your help, and also very glad that I was conservative with his dosing. I just got home and took a reading (+7 AMPS). Even after such a small dose this morning + HC food left out (that he ate), his BG is 94. That is a crazy number for me to see because we have never seen it that low since he was Dx in February! Almost a little scary to see, but this is around his nadir and his is totally fine. I am home now and can monitor. It is also exciting because we have barely been able to get him below 200s ever and he is definitely trending in the right direction :)
 
CCG said:
Wow. I just posted this on another thread but Ty is full of surprises for me.

So glad to have had your help, and also very glad that I was conservative with his dosing. I just got home and took a reading (+7 AMPS). Even after such a small dose this morning + HC food left out (that he ate), his BG is 94. That is a crazy number for me to see because we have never seen it that low since he was Dx in February! Almost a little scary to see, but this is around his nadir and his is totally fine. I am home now and can monitor. It is also exciting because we have barely been able to get him below 200s ever and he is definitely trending in the right direction :)
Click to expand...
That's great! There is a chance that there is some of his 1u depot is remaining and giving you those lower numbers. Good thing you were conservative this morning! good instincts :D

I wonder what his PMPS will be?
 
AmandaE said:
That's great! There is a chance that there is some of his 1u depot is remaining and giving you those lower numbers. Good thing you were conservative this morning! good instincts :D

I wonder what his PMPS will be?
Click to expand...

Very true! I'll take it though, as its the lowest we've seen! He has had so many issues lately and we thought we'd never be able to get his sugars down into a better range.
 
CCG said:
Very true! I'll take it though, as its the lowest we've seen! He has had so many issues lately and we thought we'd never be able to get his sugars down into a better range.
Click to expand...
You've come so far in such a short amount of time! Ty is lucky to have such a caring Kitty parent :)
 
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He is still low!
+9 AMPS 120
+10 AMPS 115
even while I have been letting him munch on food to get calories.

It's like his pancreas decided it wanted to start working today...
 
Wow! Another low pre shot! These are good numbers and so far Ty is still safe! I think based on your comfort level and the data that you have so far you might want to do another token dose :)
 
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AmandaE said:
Wow! Another low pre shot! These are good numbers and so far Ty is still safe! I think based on your comfort level and the data that you have so far you might want to do another token dose :)
Click to expand...
I agree - that is what I did. Gave the same dose as this AM (or roughly... it is such a small amount!). I feel better this time because I am home tonight to monitor.
 
Sharon14 said:
How’s Ty doing? Is he eating better?
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Ty is doing OK today. I was at work all day so could not get much data, but not surprisingly (after such a little amount of insulin yesterday) his numbers have been high today.

His eating is good and bad. Good in that his appetite is definitely back... bad in that he is still being very picky about what he eats. They didn't have Tiki Cat food at the Petsmart that I visited (it was a small store), so I will have to order on Chewy or try another store tonight. He is really only going for the high carb Friskies food -- either shredded or chunky. Refuses pate and everything else I have put in front of him even though he used to love it.

This is also odd, but part of me thinks he sort of likes the syringe feedings. His energy has returned and he hasn't been shy about telling me if he doesn't like something I'm doing. With feeding, he just sits there and lets me do it with very little - if any - restraint. I didn't syringe yesterday, but this morning I did because I did not want to continue to give him the HC food with his numbers being high.

Will keep trying lots of different options. For now I am just glad that he is eating on his own and showing clear signs of hunger (coming out at feeding time for other pets, meowing for food -- all of the old habits). It makes me feel confident that we can find something better for him that he will like. He is also still ketone negative as of this evening :cat:
 
Petco carries Tiki. Maybe try mixing the gravy food he loves with a small amount of pate. If he goes for it, you can gradually increase the pate and decrease the gravy.
 
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