Second/Third Set of Eyes Please - Revisiting this morning

I was prepared to increase the dose this morning to 4U. I think she saw my thoughts...Anyway, I am at shot time and getting a reading of 133 after a +8 of 103. Very slow moving up at this point which is unlike her. I am now stalling (no feeding) and will test again in about 10 more minutes.

Trying to get advice in advance. Should this reading remain close (blues) by what % would anyone suggest I reduce the dose, if yellows? Pinks I stay the same I believe. Definitely will not increase obviously. She was probably dangerously low as I slept. She ate a can of mon petite with a lot of water approximately 3 1/2 hours ago. Level still very good for her...

Any suggestions as always very welcome and appreciated. I placed the most recent reading at the +11 from last night. This is a new vial of testing strips I just opened prior to the amps test. Reset meter to 38 and tested twice - 128 and 133 were the readings

 

Maybe 3 u if blues and 3.5 u if yellow?

 

Just retested - Two Readings - 132 and 110.... Actually a 20 minute stall thus far. Still stalling for another 15...

 

OK. I'll revise that. These are PMPS numbers, right? I'd give a token dose of 1 u and test at +2 for sure.

 

No, these are AMPS numbers...It is 9:42am here...

 

This situation always requires guessing - how low to go to be safe but still have insulin doing its thing. You gather data to refer to next time it happens.

 

Oops! The important thing is they're PSs.

 

I've got about 7 minutes left in my second stall. If no change I am considering 2U since her day numbers have routinely been higher than night. I do want to give something, right? However if you are suggesting a token 1U only I will go that route. She's sitting here staring at me and I can tell she is saying just get it over with already and feed me.

UPDATE: End of 2nd Stall - BG 140

 

If it's daytime for you and you can monitor by all means give 2 u. I was being cautious. You know what to do if she gets too low.

 

Okay Thanks so much - Recorded AMPS as 140 and will give 2 units. Will test at +2.
Appreciate your continuous assistance.

 

That is surprisingly low for Goma! Curious to see how she does today...

 

Wow, go Goma! I'm looking forward to seeing how it all ended up!

 

Not well unfortunately. Will update spreadsheet later on when I can get to the computer. She skyrocketed up again.

 

Oh, sweet Goma. I'm so sorry she ended up in the stratosphere. You'll get her back on track tonight.

I have a suggestion if this happens again, but first a big disclaimer:
This could be dangerous for some cats, so if anyone is lurking/reading this please know that this advice is specific to Goma and Greg because he is able to monitor enough, has a large body of data that lets us see how Goma responds to insulin, Goma is consistent in her responses, and because of how the insulin acts for Goma. Applying this to another cat could be dangerous, so please don't. Okay, disclaimer over.

So Goma doesn't usually have 12 hours of duration on Prozinc during the AM cycle, and she runs in very high numbers most of the time. Because of that if she gives a weirdly low PS like that again, you could try stalling like you did yesterday. If that doesn't work you can feed and give her the shot late when she is rising. You already know that part. Here's where it gets tricky: that may mean that you've given the shot at +14 or +14.5 or +15 or whatever it ends up being. Normally you would need to wait another 12 hours before the next shot. However, since typically Goma's duration is less than 12 hours during the AM cycle, you could likely give the PM dose at the regular time (or +10 from the shot time) and be perfectly safe. Don't try this during the PM cycle since she runs lower and has longer duration at night. But during the day my hunch is that shortening the cycle would be just fine. That would allow you to give her the full dose, and still stay on schedule for the following cycle.

The possible hitch in this is if you then test her for the PMPS and she isn't high enough to shoot yet - then you'd have to stall for the PM cycle as well, and then you would be off schedule. So it's a little bit of a gamble and requires you to be willing to be off schedule for a couple of cycles while you walk it back to regular time. However, chances are she'll be plenty high by PMPS and you can just get right back to your typical 12/12 schedule.

And of course this isn't something you would want to do very often. Keeping a consistent schedule is important. But she has only done this a couple of other times, so it might be a strategy you keep in your back pocket if it happens again.

If you really wanted to get fancy, she might be a candidate for 8/8/8 dosing, but that is a big commitment on your part both in terms of being home a lot and also managing your sleep within a rather tight constraint.

 

Thank you. You’ve given me a lot to think about. Have a lot of commitments with many felines at present so the 8/8/8 dosing which is something I had looked into on another site previously may not work well at this time. You obviously gave us a lot of time and thought and I am sincerely grateful. Hope all is well for you and Sam.

 

@Djamila - While I would like to have been able to try your suggestions today, I have to leave the house for an extended period of time. She is once again very low at amps with current readings of 105 (second reading 118). I am stalling without feeding for the moment but must depart within the next hour. This is what I meant by other commitments, I cannot plan anything anymore... What would you or anyone else suggest today as far as dosage goes? Last time we went with 2U. I am stalling for about 10 more minutes for the first stall (no feed). I am also thinking of reducing the night dose amount to 3.5U. Was not able to monitor last night and she probably went very low again. She seems fine.

Any thoughts - I am considering giving 2.5 or 3...

UPDATE: End of first stall - reading is 129. I am now at exactly 12 hours since last injection. These are AMPS numbers.

Beginning 2nd Stall (no feed) - I'm getting that look again...

 

Maybe try 2.5 u - or 3 u if you can monitor? She was safe with 2 u the last time this happened.

 

Thank you - I cannot closely monitor but will probably go with 3 u. She rose dramatically at plus 2 last time so I am hoping she will be safe. The AMPS number I will be using which I just tested for reflects 215 so she is rising. I am guessing she would be okay with the normal dosage but not sure. What do you think? Also, perhaps I need to go back to the lower dose at night (3.5u). Going to feed her now so I can stop getting "the look".

 

I don't think I'd go higher than 3.5 u on a yellow PS. It might be worth trying a small reduction to 3.5 u at night for a few days.

 

Thank you once again! I went with 3.25u this morning. Will see how she does - I will attempt a +2 or +3 if I can get back. I appreciate your time. I tried the lower dose at night once before, and was just considering trying it again. Hope all is well with you.

 

All we can do in these situations is try something - with an eye to safety of course - and log the data we get for next time. All good here in the Great White North.

 

Greg, I think you made a good decision. Onset, as you know, is around +2, so she should be fine until you get home around +3. At that point you can get some data and it will help inform for the next time. As for the night dose, it's worth a try to lower the dose and see how she does. If it doesn't work you can always raise it again, and sometimes they surprise us.