? LETO AMPS 75/am shot skipped / +9 115 / PMPS 151 / +2 49...how can i avoid hypo event?

http://www.felinediabetes.com/FDMB/threads/9-6leto-amps131-pmps186-3-113.202624/

Took his dose down yesterday to 1.5, but I'd been skipping shots for numbers like this but I know the goal is to get more consistent in giving 2 shots/day


Update,
Gave his pm shot, and he's at 49 +2 hours later. I gave him a few tablespoons of gravy lovers fancy feast to try and bring that up. Should I be feeding him the whole can, or just a few bites?

 

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. 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.

But this is from SLGS - not sure if it is the same if you are using TR protocol

 

Don't shoot because this number is too low given where you are. 75 is shootable with more data, but with recent diet change and being new, it is better to be safe.

Consistency is a goal, but it looks like you are going to get to learn about small doses quickly.

 

responding to this thread hoping it bumps it back to the top - as this evening I'm heading into hypo territory...

 

With a low number you will want to feed a small amount of high carb food. If you have something with gravy, use a spoon to get just the gravy and give a spoonful. If you don't have gravy food, add a few drops of honey or Kato to a teaspoon of low carb food. Feed, retest and post you result.

You want to stop the drop and bring him back up.

Please post next number.

 

Ok - just reviewed the edited post and understand gravy is already on board. Do not feed whole can. You want to use the least amount of food/gravy you can to get him up.
Please test and post number. Indicate how long ago he had food and or gravy.

 

Been giving him a tablespoon of the gravy lovers fancy feast at a time...I'm testing every half hour and i'm reading 69 at the last one, which was just about 5 min ago. I'm just going to keep watching him and testing every half hour till those numbers start coming up. His spreadsheet has been updated.

 

OK - good. 69 is better! Good job!

Next step is to see if he can stay up without the food. Record the last time he was fed and keep testing to see that the numbers don't drop. Don't worry about small differences in numbers (meter variance), but do focus on overall higher / lower to keep him safe.

 

Will do. We know what to watch for in general (seizures, odd walking, twitching) but how about being sleepy? Full disclosure, it is 10pm where we are, so he is probably just tired and wanting us to stop poking at his ears, but thought I'd ask if sleepiness was a bad sign I just hadn't read about...

 

You will want to watch the numbers because not all hypo events have symptoms. This why home testing is so important. It is very good that you caught this early. I haven't seen sleepiness as a sign either - actually the opposite (restlessness). So - watch the numbers to confirm OK for 2 hours since last food. I know it is late so I want to make sure you are OK to monitor.

Also - need to revisit dose because even with the skips 1.5 is taking him too low. Reduction is earned because of the 49, but I think I would be more comfortable starting even lower (and letting him tell you if he needs more juice). Depending on how things go tonight, I would want to try 1U.

 

@Bobbie And Bubba - Looking for input here because of the recent change in diet - should the dose be .5U because of recent change to only canned food? We now know that 1.5U is too high, I initially thought it should go down to 1U, but now I'm thinking he should be re-started at .5U. Would that make sense for SLGS?

 

We are okay to monitor all night if need be. My husband and I are taking shifts. The dosage issue is on my mind too. I lowered it to 1.5 against the advice of the vet (who wanted to keep it at 2), but convinced her just this afternoon after going to her armed with his BG chart and her own numbers from the blood and urine they drew that he really was at too high a dose. Anyway, long story we will definitely be bringing it back down to 1u or lower asap.

 

OK good - glad you have a team approach! I'm up for about 1 more hour watching numbers in my own house, so let me check on you again before I turn in.

Let's see if we can get some other inputs on dose. I'm no expert and I don't use SLGS, so I hope some others will have some good inputs for you.

I wouldn't bother fighting with the vet. To be very honest, I love my vet and consider him to be part of my family but we rarely even discuss FD anymore. My Rosie has other health problems and he is very helpful with those, but for insulin dose help I come here. Some vets are going to be offended that you are getting advice from "the internet". However, I didn't realize routine vet training doesn't really cover diabetes in detail let alone some of the differences between cats and dogs. Perhaps most problematic is even if a vet practice is up to speed on the latest standards, these standards don't encourage home testing. I would really like to see that changed because so many come here reporting that their vet doesn't encourage home testing or is hostile to it when that is what they are taught.

Your decision on how to best work with your vet because you will need ongoing support - even if he has no other health problems, the stupid prescriptions can be a pain if the vet is not on board.

 

I would go to 1.0 unit next. Both dosing methods say he's earned a 0.25 unit reduction, but so soon after the skip and with a food change, I would be more conservative. Could you put either SLGS or TR in your subject line, so we know at a glance what dosing method you are using?

Your vet doesn't hold the syringe, you do. I printed off a copy of the dosing method I was using and gave it to my vet, plus weekly copies of the spreadsheet for the first few weeks. After that, I got asked what the current dose was when I saw my vet, but that was the only discussion,

 

I'm about ready to sign off for the night. I'm checking on you to make sure you are OK. From the SS looks like you are doing all the right things and all is well.

 

Yes, I think we are okay keeping him in the 50's/60's until we are through the cycle. I am grateful you were there to talk me through this. While this wasn't fun, and I wouldn't choose having my kitty in danger, I am glad for what I learned through the experience...next time (if there is one which I hope there won't be) I'll be much less scared, and much more prepared. I hope your own numbers were all good tonight!