? Update on Spy Kitty. BG < 50 today. What dose tonight?

Increased dose two days ago to 2.75u. Last night's numbers were low and this morning PS is 106. What should I do? Skip shot?

 

stalled 30 min. BG 130
edit: stalled another 30 min BG 145
edit: stalled another 30 min BG 165. have to leave house now. will give 0.5U

 

Good job stalling.

Have you transitioned to all wet food yet or is there still some dry in the mix?

Following Prozinc SLGS he earned a reduction last night, back down to 2.5U.

 

I suspect you didn't refresh your browser to see that there was a reply to your question.

Shelley provided good information -- you will need to reduce the dose by 0.25u.

It was fine to give a token dose although I might not have dropped it as low as you did since numbers were rising -- but it also depends on how long you were going to be out of the house..

 

Thank you Shelley and Sienne. I had already given the 0.5U just moments before Shelley's reply came in. And yes, I should not have dropped the dose so much. I was just so concerned about last night's readings, I over-reacted.
I have in my notes from posts at FDMB that if PS is 150-200 the options are to 1) give nothing, 2) give 10-25% of usual dose, or 3) feed, retest in 2 hours and make decision based on that value. That was the basis for my 0.5U which would be in the 10-25% range of 2.75U.

After I returned home I tested at +2.25 relative to the time of the 0.5U dose (which was 1.5 hrs later than usual shot time). BG was 292. At +3 it was 325.

Should tonight's dose be 2.5U regardless of what numbers I get today? His normal shot times are 6:15 am and 6:15 pm. His morning shot today was at 7:45 am. Is it ok to shoot at 6:15 tonight?

edit: Food is approx 70% wet and 30% dry & treats. He is starting to turn his nose up on the DM but I need to get his weight up so it is a challenge. Vet said 250 cal/day.

 

Update:
I did reduce Spy Kitty's dose by 0.25U as recommended (from 2.75U to 2.5U) for his Sat 07/10 PM shot. His numbers yesterday Sun 07/11 were all good, in the 100's. This morning (6:30 a.m. CDT) his AMPS number was 82. I opted to feed him and wait and test again in 2 hours (8:30 a.m.) which I did. His number then was 91. I don't know what to do in terms of what dose to shoot. It seems like 2.5U will send his blood glucose too low? Am I over-reacting again?

He is now at 80% wet and 20% dry + treats. His water intake is down. It had been 11 ounces per day (for 5 days in a row that I measured it) and for the past couple of days it has been 7-8 oz.

 

I think what I have digested from reading SLGS is you hold the reduced dose for at least a few days, preferably one week if the reduction was earned. There is an article about dealing with low numbers. You might read that again to sooth your anxiety as I am certain you have some.
@Sienne and Gabby (GA) Please chime in and correct me if needed.

 

Thanks for replying Ann & Sister. The article about dealing with now numbers..... Is that about what to do if you get low numbers after the normal dose is given (such as feed med or high carb food) or is it about what to do when you get low numbers before you give the shot? I have read a lot on this website. I am just not sure what article you are referring to.

 

You're absolutely not overreacting, you're doing exactly what you should do and keeping Spy safe. You don't have the data yet to support shooting that low and with the food transition caution is warranted.

He earned another 0.25U reduction with that AMPS of 82 this morning, following Prozinc SLGS protocol new dose 2.25U. I recommend keeping a close eye on him in the coming days and keep testing like you have been - it looks like the further food transition is making a difference again and it looks like you might be headed to racing down the dosing scale if you further reduce the dry food.

 

Thank you, Thank you, Thank you. I was so hoping for a reply before time for his evening dose. He has not had any dry food today or no-no treats!

 

If you are stalling, you do not want to feed your cat. The food is likely going to artificially inflate the numbers which would then cause you to shoot. You want to have a pre-shot that is rising independently of food.

@Shelley & Jess - With SLGS, you typically hold the dose for a week (providing numbers don't drop into dose reduction territory). You want to then do a curve and make a decision whether the dose needs to be increased. The dose is held more than a few days. If you're referring to the post on dealing with low numbers that's on the Lantus board, it's primarily geared to Lantus/Basaglar/Levemir. The information can be adapted to Prozinc but the depot insulins act differently than Prozinc.

And yes, a dose reduction is warranted with the 82.

 

I think you're looking for @Ann & Sister

 

Thanks Sienne. In your opinion, should I have gone ahead and shot 2.25U this morning when I got the 82?

I am just now reading about the tight regulation protocol. Do you have an opinion on that method?

 

No dry food is allowed when following Prozinc MPM dosing method, so until fully transitioned you'll need to stick with SLGS which means anytime the BG drops below 90, whether it's mid-cycle or at pre-shot Spy Kitty earns a reduction.

MPM allows for faster dose increases and may help kitty get to better numbers sooner. Spy Kitty is already seeing some really good numbers right now. MPM requires more testing than SLGS and reductions are earned when kitty's BG goes below 50 on a human meter or 68 on a pet meter.

 

So the AMPS of 82 yesterday (07/12) warranted a reduction to 2.25U which I did for the PM shot. Several PM tests last night were under 90, the lowest being 60, so I reduced the dose to 2.0U this morning. Was that the right thing to do?
With an AM dose of 2.0U Spy Kitty has several readings under 90 today. Do I reduce again tonight to 1.75U? @Shelly & Jess @Sienne and Gabby (GA)

 

@Shelley & Jess please see above post. I mis-typed your signature.

 

Nice numbers! Yes, with SLGS he would earn another reduction any time he goes below 90. So you have been reducing it correctly and will want to go down to 1.75 tonight.

 

Thanks @Hshray. I am ecstatic about his recent numbers! This will be his fourth reduction in four days. I just wanted to make sure that there was not a "rule" about "no more than so many reductions within a certain time frame". It just seems too good to be true.

 

That’s great! Sometimes once they hit a breakthrough dose they start earning those reductions quite quickly.

 

Did he end up having any dry food yesterday? Any today? Depending on the status of the dry transition and what the PMPS number is we might look at a little larger reduction.

 

No, he did not have any dry food yesterday or today.

 

**Anti-Jinx** Anti-Jinx**Anti-Jinx**

No, no rule, take those reductions, the numbers will tell us if he doesn't hold the reduction and you can increase again if needed.

You're doing an awesome job getting those tests in! Earlier I was looking at that 35% drop from AMPS to +2. Doesn't look like he got any food bump and we 'usually' don't see that much of a drop at +2 during a 'normal' cycle with Prozinc, but ECID (every cat is different) - with the food transition just something to keep an eye on.

 

Yes that was an unusual drop when there should have been a food bump!
The run on green numbers is over tonight with the reduction to 1.75U. I will hold at that dose now and see where we go from here on this roller coaster ride!

 

This morning's AMPS is 69. I triple checked it as the second check was the last strip in the bottle so I also checked with a strip from the new bottle. Second number 70, third number 67.
Is that too low to shoot or do I reduce by 0.25U to 1.5U and shoot? @Shelley & Jess

 

Did you stall without feeding?

 

yes

 

Post the next test, we'll see what kind of rise he's got going and decide if/what to shoot from there.

The blues last night were probably a bounce from that run of greens.

 

Do you want to see a test at +1? That will be in 10 min.

 

Yes please. Still no food? If he's green I'd skip.

 

Yes, still no food. Thanks for the help.

 

+1 is 86

 

Not much of a rise in an hour. I'm not comfortable telling you to shoot anything because of the rapid changes in his numbers since removing the dry.

 

Yes, I am not comfortable with shooting at that number either. Will try to stall for another hour. He is being patient but obviously he is ready for breakfast!

 

You could feed and test in an hour see what kind of food bump he gets. He handled the last NS really well - got back on track the next cycle.

 

I just had to go take care of my neighbor's pets so now we are at +1.5. I can get to +2 without feeding.
I will test again then. If in the blue, I was thinking to dose at 1.5U. Does that sound reasonable?

 

Post the number, we'll see where he's at.

 

+2 is only 94

 

I'd skip, get back on track and schedule tonight if needed.

 

Ok. Will do. Many thanks.

 

Feed him (he's probably 'starving'!) and grab a test in 3 to 4 hours, might give us an idea if/how much his pancreas is kicking in. If the number is lower his pancreas is working.

 

Yes, I fed him as soon as I did the "+2" test. He only ate 1/2 oz then, and just now an hour later he ate another 1/2 oz. This is how the day goes. I have to prompt him every hour or two to eat.

 

I have updated Spy Kitty's spreadsheet with today's test numbers. He is up to 178 at +10. Do I shoot 1.5U for his PM shot?

 

Yes, let's keep stepping down the dose if he's high enough to shoot and you're around and can stay up to test. (I know some nights I just couldn't do it and reduced the dose a bit more because I needed sleep).

He hasn't shown you any lime greens yet, close, but not quite. Do you have your hypo kit stocked? Want to make sure you're ready for them if he does decide to go there. I've seen the full effect of removing all dry take anywhere from a few days to a week or more. We don't know where he's finally going to land with the food transition yet. It's a balancing act for you right now, and it doesn't make it easy, keeping him in good numbers while waiting to see what the full effect of removing the dry does.

 

Ok, I will dose 1.5U and test until he passes his nadir. Yes I have a hypo kit stocked.

Every day has its surprises, but mostly all good at the moment. Weighing everything he eats to try and make sure he gets enough calories, measuring how much water he drinks to monitor how that is dropping, counting how many time he pees to see if that is dropping, testing every two or three hours....... Whew, it is a full time job!

His peeing on the floor instead of in his box was the only unpleasant issue today. Fortuantely it was on tile and not carpet. And considering he has only been an indoor cat for two weeks and that is the first time, I could not be upset.

Thank you

 

Got a 56 at +2 this morning on 1.5U dose. Should I go ahead and give him some LC wet at this point? @Shelley & Jess

Edit - He went to his food bowl at +2.5. Very hungry which is unusual and good. Will test again at +3.

 

Just seeing this. He's probably going low and why he's seeking food. Get a test now please. You might need to give him some higher carbs.

 

44 at about +3

 

Tsp of HC food. and test again in 20 minutes

 

59

He is still hungry. Can I give him more LC now?

 

No more food right now and test again in 30 minutes to make sure he doesn't start dropping again. You've got a bit to go before nadir and we want to keep him hungry in case you need to prop him up again.

 

BG up to 68 and we are at +4

 

Perfect! Surfing along in the greens. Can you test in an hour?

 

Yes. I can't thank you enough!

When can I feed him?

 

A little LC now won't hurt, it's what he's used to.

We should look at a larger reduction this time - looks like he wants off the juice in a hurry!

 

Ok, will feed a little LC now.

The possibility of "off the juice" is very good news! +5 is in 10 min. I will test then and then every 2 hrs after that unless you tell me to get more frequent data.

 

Need help knowing what to dose tonight after going below 50 today. PM shot in 45 min. @Shelley & Jess

 

How did you feel about that lime today?

I’m thinking 0.75U tonight if he keeps rising and if under 150 I think we should try a lower dose at 0.5U for a couple of cycles - his numbers might wobble a bit but we can see how he handles it.

My concern, he’s not bouncing high from the lows and no shots, he’s clearing them fast and we’re a few more days in with the food transition.

 

I messed up my when doing my reply. It is within your reply above.

 

You’re having great numbers! Good job you and Spy Kitty!

 

Good luck with your decision about Lantus for your handsome George.