04/10/14 Jose AMPS 196 +4/56 PMPS 184 +4/196???

previously

Jose was doing so well and now tonight's nadir is higher than his PMPS. After this reading I asked my brother and his girl friend if he got to any of the dry food and sure enough he did. They said it was just a few bites before the noticed but those few bites clearly affected him.

I'm wondering if it would be ok to give Jose a mini dose of insulin to keep him from going up too high. I want to keep him below the renal threshold but I'm afraid that by the time his AMPS comes he will be well above it. Has anyone ever given a "booster" of insulin when they know their numbers are on the rise?

Hi Rebecca,

I would recommend against a mini-dose in the middle of the cycle. You never know for sure when the initial dose is going to onset, and a booster dose can onset at the same time as the initial dose, resulting in a crash. The 196 at +4 really isn't that much higher than the PMPS - it's within meter variance. I wouldn't sweat a little contraband. He'll work it out of his system in a cycle or two.

I'm with Jen. Possibly dangerous, Rebecca. While it's rare, sometimes a bounce or a reaction to contraband means a high number , and then a lower one before the cycle is over. I wouldn't shoot any earlier than +10, and then only as long as he is rising. And then you have the dilemna of shooting at the regular time (which would be +14) or earlier (+12 which messes up your schedule?)

It's the old adage - better too high for a day than too low for a minute.

This is not a situation in which to do that.

Under very specific conditions, with very rigorous monitoring, some individuals may add a short-acting insulin dose as a supplement to a long acting insulin. These are usually in cats with other medical conditions such as high insulin doses (acromegaly, insulin auto-antibodies, or Cushings) or in a medically supervised situation when treating diabetic ketoacidosis in a vet hospital.

The 'oops' situations are not emergencies and most cats can tolerate a day or so of higher than desirable glucose levels with minimal harm. We do suggest testing for ketones, as those are a medical emergency. My signature link Secondary Monitoring Tools has some tips on how to do that, as well as other assessments which can be used to evaluate your cat's health.

Thanks for replying with all that information. His AMPS is normal this morning so it does look like he was able to work out the HC food.