pmps +4 87.

this is pretty low for squishy at +4. suggestions on what to do now????

 

I wouldn't give high carb just yet. IMO, I'd get +6 & +7 numbers tonight. He may even go or ride low around +9. If you can not get these numbers. Leave out some canned food for him. But try to get at least +6. Definitely reduce dose AMPS. I do not know what type of syringe you're using. Try and go a tad under 1 unit. Its about 0.8 units. if he goes pretty low tonight. You may even consider 0.5 tomorrow morning even if his PS is mid yellows/pink. If no one will be around to test tomorrow... If it were me, I'd go 0.5 units and leave out some canned food during the day.

 

I just read your other post about not leaving food out. He will need some food if he goes low. You do not want him going hypo without being able to have access to food. Hopefully, if you leave food out... he'll eat enough til he's full confused_cat I just bought this auto pet feeder. you can get it at Wal-mart http://www.walmart.com/ip/6-Day-Automatic-Pet-Feeder-Cats-Dogs/5969455

Hope this helps!

 

That is a little low for a +4, but hopefully nothing to worry about. By now you have probably already gotten past nadir and any real danger of low #s, so I hope it all went well! It's always good to have the Hypo post from Health handy somewhere for reference - it has good info on what #s to worry about, and what to do if you see different #s, symptoms, etc. I have found it invaluable in a crisis (or perceived crisis, not sure I've ever really had a true crisis - Bix has been in hypo #s before, but his body has taken care of it better than I have!).

I would probably go back to the skinny 1U I guess. Sometimes a lower +4 like that can be a good sign that their body is kicking in and getting them to good #s, but it can also be the dose too high, and if you aren't around to monitor, probably safer to shoot on the light side. *sigh* because I didn't like those yellow nadirs the past couple cycles, but what can you do. I'm not usually a big fan of letting the dose "settle" as that wasn't my experience, but I haven't used ProZinc so perhaps my POV would be different if I had. Since others are getting good results with it, I'd go with what they are recommending.

As far as shooting a different dose AM vs. PM yes it can be done, but I agree I would hold off on that at this point. I think it makes it more confusing to know what is going on with a dose, and it can cause more problems than it solves. It seems most useful to me for a cat that has clear & predictable patterns, and is expected to be on insulin for a while (lifers, that is). If the cat's response is variable like Squishy's is, and there's reasonable hope of things improving quite a bit in the near future :mrgreen: then it seems to me it would just confuse things (compounded by responses like tonights, which leave one wondering what dose would be the right one to shoot).

If you did want to pursue it, I would try a slightly higher dose in the AM than in the PM, counter to what would be intuitive from shooting just based on PSs (i.e. higher dose at night for the higher PS). Higher dose in the AM might lead to better duration, and lower PS at night, lower dose in the PM might even out things by letting the AM PS equalize a bit more with the PM one. Short version then is I wouldn't recommend it, since shooting a higher dose in the AM seems a little scary with the lower PS, and shooting a lower dose at night to let the AM PS get a little higher seem counter-productive. Anyhow, it's probably all an aside for now.

Hope the rest of your night is going well and you are able to get some sleep. If you get into any real crisis & no one is here, be sure to post on Health to get faster responses.

 

well hubby kinda freaked out and gave him another whole can while i was on here typing we checked him again at +5 and it was up to 141. i have an early morning today i actually am going to be a little late getting to work. so we went to bed after that. i did update his ss. and his amps was 303, i stuck with the skinny unit because both hubby and i have a long work day today. wont get home till around 8 tonight. i am going to try and come home for lunch again, and so is the hubby. he should be here anywhere from 10:00 to 12:00 to get a reading then i should be able to get home around 2:00. hoping they numbers are good and we can stick with the reduced does! thank you again for all the advice i would be lost without all of you!

sorry didnt make myself clear on why hubby freaked out. while i was on here hubby checked him again about 20 to 30 mins after we got the +4 reading and squishy had already eaten a can a ff and his bg dropped to 77. this is when the hubby gave him another can a ff. then we did the +5 and it was at 141.

 

I'm sorry I missed this last night! When you have a lowish # before the nadir like that, you can give him a snack to cushion his drop if you are worried. That's what I would have done. You did fine, I understand why hubby freaked out, it is scary in the beginning to see low #s! Try to remember that those #s are what you want. :smile:

Yes, there is your cue to lower the dose! I wouldn't go any lower than a skinny 1.0u or 0.8u, small decreases are best IMO. Stick to it for a few days, keep an eye on the nadir. Don't worry if you get some higher mid cycle #s in the beginning, that can happen when you change doses. If you see another low nadir, it's time for another small step down. Squishy is doing great and so are you!

BTW, I was going to say that you are more likely to see that low nadir at night, because even though his pmps is higher, he seems to drop more at night (no food?), giving you the lower amps.

 

Also, if his body isn't used to the low #'s, you can get some panicky liver #'s as well. He may go slightly higher than usual, but that'll settle down as his body gets used to nice normal green #'s again. So don't panic if you see a slightly higher PS and hold the lower dose to see if his body is just adjusting. When lowering the dose, tiny changes are best (and ProZinc seems to work really well in those tiny changes.) So lower, hold for a few cycles before you lower again. The only time to lower immediately - on the next shot - is if you get a nadir reading in the 40's or if you notice hypo symptoms.

Oh and the first time I got a really low # (because the Vet had us up the Prozinc by a whole unit!) I ended up surrounding the cat with plates of food. Dumped a whole can of tuna on one side, canned chicken on the other and lunchmeat in the middle. We've all done it! When we were lowering our dose because Mr. P started kicking in, I used to follow the cat around the house with food. She'd wake up and there would be a plate of food in front of her.

 

Yay, glad things went ok last night, I was a teesy bit worried nailbite_smile though not expecting anything really awful, but you just never know. The good news too is that now you know what that food can do! Looks like he is a spiker if a can put him that much higher. It's good to know b/c if you ever get to #s much lower than that, the trick is to give just enough food to keep them in good #s, and sometimes you can convert a scary bit into a sweet ride in perfect #s.

Of course that doesn't apply on a true hypo (not just lower-ish #s, but the really scary stuff), or a serious overdose that might require vet intervention or at least Karo, etc. But when the drop is just a little more than you wanted, you can often balance it with 2 or 3 bites of HC given every 30 minutes or so, depending on how the #s are going, and keep them in really good #s for hours. Once I let Bix eat all the HC he wanted rather than rationing it like that, and he was up in the 300s shortly. So don't do that, lol, unless it's a true crisis!

But since you now know the LC will give him some spike, that should help you know better what to do in new situations, and also get a better understanding of the how the food is affecting him normally.

 

Squishy's pmps looks good, below 300! :smile: Don't worry about that 175 around nadir today, I think you're on the right track.

 

i sure hope we are on the right track. the hubby and i finally got to get out of the house for a little and went for dinner. it was so nice. i was still worried, but it was good. and my sugar baby was waiting at the door for us when we got home. he is such a good kitty.

 

Good for you, getting out of the house with hubby! It does get better, the worrying...although I was worried yesterday when I was delayed getting home to test Tinkles at nadir. Of course, he was just fine and sound asleep! ;-)