AMPS 159 (low for her) dose reduced, PMPS 349

Butterscotch's Pawrents

Butterscotch's Pawrents

Member Since 2019
AMPS 159, repeated right after on opposite ear with large blood sample was 161. She has never had a BG this low. Please advise. Super new here and I've never delt with a number this good!
Using PetTest meter.

Since we're new to the message board, here's a link to a previous thread in case you want to know more about Butterscotch.
http://www.felinediabetes.com/FDMB/...ooking-for-dosing-advice.218765/#post-2434490
 
When you stall you should not feed. You did the right thing. Then you get another test in 20 to 30 minutes to see if you can give insulin. Can you get another test now?
 
Are you able to monitor all day? Do you have plenty of testing supplies and some karo or honey in case you need it to help get Butterscotch's numbers up? I was just reading you have trouble getting her to eat sometimes. Do you feel comfortable having to possibly try and get her to eat if her numbers go lower today?
 
carfurby said:
Are you able to monitor all day? Do you have plenty of testing supplies and some karo or honey in case you need it to help get Butterscotch's numbers up? I was just reading you have trouble getting her to eat sometimes. Do you feel comfortable having to possibly try and get her to eat if her numbers go lower today?
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We had plans but we can cancel and stay home. We do have supplies and her appetite has been a little better.
 
carfurby said:
If you're up for it, you can shoot her 3 unit dose and then test at +1 to see where she is going to go today. I'll watch for you to post your +1 test.
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I think I'm too nervous to do the whole 3 units. She seems to have had a sudden drop in numbers over the last couple days where she previously had been maintaining high. I'm worried she'll continue the trend and drop too low. Would you recommend a partial dose?
 
carfurby said:
Would you feel comfortable trying 2 units? There is a chance she will bounce today, but we can't know for sure.
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I'm reading the SLGS protocol and it suggests a token dose if BG is 150-200 (I presume using a human meter, and since I'm using a pet meter I know her reading would look lower on a human meter). Should I maybe just give 0.75units (or I'd be comfortable with 1unit because my syringes are marked in 1unit increments and I'd have trouble measuring less than 1unit)?
I'm just worried with the lack of data I have yet to collect on her and this seemingly sudden trend downward.
 
carfurby said:
It's probably from the numbers that are lower than she is used to. Did you give insulin?
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Haven't injected yet. Wanted to make sure she was eating due to her pickiness. Also contemplating the Insulin dose. I definitely don't want to see her numbers spike today because I'm just so happy she's finally seeing better numbers. But I'm also an anxious person and worried about dropping her. I think I'll meet you in the middle and give her 1.5units.
 
Wondering if it'd be more helpful to retest at +2? Given the food and insulin were done at the same time the food spike will take at least 2 hours to clear and the onset of Lantus is generally 2-4 hours. We will be keeping a close eye on her and would certainly retest sooner if she was showing any signs of hypo. Does this sound reasonable?
 
This could be the day of her turning point - please try not to panic...these lower numbers are what we all dream of. You've gotten some great advice - test hourly and you'll start to see which direction she's headed...if she starts to drop too fast - you can add a bit of MC or HC to her food to slow the drop.

I know the first time is 'heart in your throat' time...but you'll get used to it. You've got lots of help and support here. :)
 
carfurby said:
It looks like he may bounce today. The +2 test will help let you now for sure.
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Thank you for standing by this morning, it was very comforting. Hopefully the bounce isn't too bad. I'll definitely need advice later this evening regarding what to do with her PM insulin once I see what her numbers are today.
Many thanks :D
 
That's okay. For future reference, when someone says +whatever number, we mean from the time you gave insulin. You'll want to at least get a +10 or +11 test in so we can see if she's going up or down by PMPS time.
 
carfurby said:
That's okay. For future reference, when someone says +whatever number, we mean from the time you gave insulin. You'll want to at least get a +10 or +11 test in so we can see if she's going up or down by PMPS time.
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Just did a +8.5 test and it was 223
From the two other complete curves we did at home her nadir was at +8 and +10 so I think this looks good given her results this morning. If I'm going to see a bounce, when would you expect that to happen?
I know we haven't done the PMPS yet but given our results so far, any thoughts on how much insulin we should give tonight?
Also, what time should I give insulin tonight (on schedule or delay a while)?
~ normal dose time is 6am/6pm, gave half the usual insulin this morning at 7:15am.
 
Bouncing is not always the same. I thought she might have bounced during the day today. She could also bounce this evening or tomorrow. Some cats have a delayed bounces. Sorry there is not clear answer.

When you delay a shot, you're technically supposed to shoot 12 hours from the time you eventually gave the shot. Then you're supposed to work your way back to your normal shot time in one 30 minute increment per day or two 15 minute increments per day. Really you should shoot at 7:15 tonight and then work your way back starting tomorrow.

I'm not sure about tonight's dose. It depends on what her PMPS is. Are you able to stay up tonight and monitor if you need to?
 
carfurby said:
Bouncing is not always the same. I thought she might have bounced during the day today. She could also bounce this evening or tomorrow. Some cats have a delayed bounces. Sorry there is not clear answer.

When you delay a shot, you're technically supposed to shoot 12 hours from the time you eventually gave the shot. Then you're supposed to work your way back to your normal shot time in one 30 minute increment per day or two 15 minute increments per day. Really you should shoot at 7:15 tonight and then work your way back starting tomorrow.

I'm not sure about tonight's dose. It depends on what her PMPS is. Are you able to stay up tonight and monitor if you need to?
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We prefer not to stay up too late as we've been up late with her the last few days and have to work early in the morning. But her safety of course comes first. We could reasonably stay up to do a +4 test.
 
carfurby said:
I won't be on the board that late. Can you test now and see where she is?
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We are actually starting to run down on strips and only can get them online. (I guess until you're actually doing it you don't realize how much extra testing you'll need to do!) Need to conserve the strips a tad in case I need to do extra tests while waiting for the new ones to arrive. Don't want to get myself in a bind.
I completely understand that you have to sign off. I'm very greatful you stuck with us throughout the day. :) Maybe someone else will pick up where you left off.
Any general guidelines you can recommend for dosing tonight? I know you can't guess what the PMPS will be but any insight will help.
She has perked up so much today, it has been a joy to see a bit more of our sweet kitty coming back. <3 These new numbers caught me off guard this morning but it has given me hope that we can help her.
 
Update your subject line if you need help tonight. If the PMPS is lower than the +8.5 test or about the same, he may go down tonight and you may need to do more testing. If the PMPS is higher, he may not. I'm not sure about the dose tonight. Today's numbers are most likely influenced by the depot from the 3 unit dose, meaning if you shoot 1.5 units tonight you probably won't have the same numbers. If you need to conserve strips and not test a lot tonight, you may not want to go back to 3 units. Maybe try 2 units unless his PMPS is lower than the +8.5. Than you may want to stay with 1.5 units. Good luck.
 
PMPS 349
Fed 3 oz FF
Need advice on what dose of Insulin to give. Insulin dose due now.

~BG readings started in Blue this morning and she's never had a Blue reading. Gave half dose (1.5units lantus) this AM.
BG readings during the day are comparable to yesterday when the full dose (3units lantus) had been given.

We are new and need recommendation, thank you so much in advance
 
Sorry no one was able to give you dosing advice-- it's unusually slow around here due to the holiday weekend. I think the 2.5U was a good decision. Hopefully Butterscotch will give you a number that lets you go to bed at the +3!
 
Nan & Amber said:
Sorry no one was able to give you dosing advice-- it's unusually slow around here due to the holiday weekend. I think the 2.5U was a good decision. Hopefully Butterscotch will give you a number that lets you go to bed at the +3!
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Thank you for reassuring my decision to dose 2.5. I was worried someone would be like, Omg what did you do lol :D

I figured the holiday has people busy. I feel good about the decision.
Thinking I'll do 2.5 units in AM if numbers are 200's to low 300's and hold there for a while. Unless numbers are in the mid 100's again then maybe 2 units or if numbers are high in the 400's then maybe go to her original 3 units?

I know it's hard to really say before the PS test but it's hard having to stall and wait for advice when her insulin is already over an hour behind schedule. Luckily my husband has tomorrow off but we both work all day on Tue and need to try to get the dose back on sched as much as possible.
 
I think the idea to make a lower dose the new dose is reasonable. I still worry that the 3U was too much, too fast, although until this morning she didn't have any non-high numbers to support that impression, lol.

We don't really do sliding-scale dosing with Lantus here (it's hard with the "depot" insulins-- making immediate changes doesn't give you immediate results, so you are always chasing a moving target). It's better to settle on a dose, see what it does for a few days (giving the depot a chance to develop), and then make any changes in very small (0.25U, usually) increments. Now that you're testing more regularly, Butterscotch will lead the way and tell you what to do!
 
Nan & Amber said:
I think the idea to make a lower dose the new dose is reasonable. I still worry that the 3U was too much, too fast, although until this morning she didn't have any non-high numbers to support that impression, lol.

We don't really do sliding-scale dosing with Lantus here (it's hard with the "depot" insulins-- making immediate changes doesn't give you immediate results, so you are always chasing a moving target). It's better to settle on a dose, see what it does for a few days (giving the depot a chance to develop), and then make any changes in very small (0.25U, usually) increments. Now that you're testing more regularly, Butterscotch will lead the way and tell you what to do!
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I think if she does well with the 2.5u tonight then I'll hold at that dose for some time unless the AMPS is drastically different. What you said about the Depot completely makes sense. :)
 
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