10/26 Zeke AMPS=89, +1=114;+4=172 Darn, looks like a Bounce

Zeke had a record low +9.5 (73) this morning. I feed him his usual meal at 4:30 AM and expected his BG to go up. It has not moved much - +10.75 = 75. I might need some advice if it stays low come AMPS. Looking at the protocol, if his BG is between 50-100, I have 3 options. I'm leaning towards option 1 - feed (as usual at PS) and reduce the dose 0.25u. He's been on 1.25u so we'll go to 1u. Does that sound like a good plan?

Last night I didn't get a reading after +5.5 (135) until the +9.5 = 73. So it's very possible he earned a reduction anyway as his nadir can be anywhere between +6 & +7. Because of this, that's why I'm leaning towards just giving him the reduction at AMPS. However, if he's over 100, then should I give him the 1.25u as I don't know for sure he earned a reduction last night, correct?

Here's a recap of yesterday:
AMPS 406
+3 374
+6 318
PMPS 333
+4 206
+5.5 135
+9.5 73
+9.75 71
10.75 75

Zeke's previous condo

Re: 10/26 Zeke +10.75=75 Need AM DOSING Advice

I think the options are to do a temporary reduced dose, or stall and wait for a higher number without feeding, or skip.

I'm going to go find the exact wording.

Re: 10/26 Zeke +10.75=75 Need AM DOSING Advice

These are healthy numbers. They're not too low; they're ideal. Just feed and shoot as normal, and get a reading every 2 hours.
And don't hurry to or assume a reduction. He wasn't that close to it, and you should genuinely see a need for a reduction. I know the low #s are making you nervous, however you are well within the margin of safety, and these are in fact the numbers you want. In other words, he's doing well!

Re: 10/26 Zeke +10.75=75 Need AM DOSING Advice

He's 89. I'm not comfortable giving the whole 1.25u. I'm gonna do 1u but really I'm not that comfortable with that either but I'll be home so we'll see how it goes.

Re: 10/26 Zeke +10.75=75. AMPS=89 Need AM DOSING Advice

FWIW... f your not comfortable with the normal dose, then shoot reduced. I would. The safety of your kitty comes first. The numbers are great, but one does need to feel good with what one is doing. I'd get a test at +1, then +2: it should give you an indication on where numbers are headed this morning. Good luck!

Re: 10/26 Zeke +10.75=75. AMPS=89 Need AM DOSING Advice

I just did a Search on the board for BCS Stall Skip and got lots of matches. You might want to do the same and review them. It's your choice on whether you want to reduce the dose or call it a BCS and go back to his regular dose tonight.

Re: 10/26 Zeke +10.75=75. AMPS=89 Need AM DOSING Advice

I gave Zeke the 1U. When I stated that I wasn't comfortable even with that, I meant because I've not ever shot him so low. It's just unchartered waters for me so consequently, I'm not comfortable. Looking at the protocol, if <100 then shooting a reduced dose is acceptable. I want to do what's best for Zeke so, if I need to shoot a 89 then so be it!

Fortunately, I'll be home all day so I can keep a close eye on Zeke. I'm just hoping we're not gonna be fighting the numbers all day. Zeke will only put up with so much ear pricking in a day and then it gets ugly which only adds to the stress level - no fun for anyone.

Re: 10/26 Zeke +10.75=75. AMPS=89 Need AM DOSING Advice

Laura --

It's fine to reduce the dose for this one shot. You've not shot this low before so I can understand why you may not be comfortable. We encourage caregivers to work their way down the ladder when it comes to shooting lower numbers. What I would encourage you to do is give some thought to how low you are comfortable shooting. It looks like the lowest pre-shot Zeke has had is in the 150 range. Maybe shooting closer to 100 is he next step?

Re: 10/26 Zeke +10.75=75. AMPS=89 Need AM DOSING Advice

I shot a PMPS of 112 so I'd easily be comfortable with 100. How today goes will help me decide what my threshold is. However, whether or not I would be available to test after shooting low would also dictate my cutoff. That one's tough. I'd probably be inclinded to go with a BCS.

I was wondering if I should have feed Zeke a higher carb food this morning to prevent a dangerous slide. I opted to just give the usual 4%. Seems it would be best to hold off with MC until # drops below 50 or even 40. Was that the right call?

Re: 10/26 Zeke +10.75=75. AMPS=89 Need AM DOSING Advice

Whenever you are shooting lower than usual, you will want to get a +1 and +2 test. The early tests will help to guide you with respect to whether you need to start steering the numbers with higher carb food. I would have done exactly what you did -- fed LC. If you see numbers are dropping at +1, they you may want to add some higher carb food to slow things down. Typically, there is a food spike at +1 and your +2 is at about the same as your pre-shot number unless it's going to be an active cycle. Should it be an active cycle, you will want to test more often so you can decide when to intervene with higher carb food. There's a balance between waiting to see numbers drop into dose reduction range and then using HC to bring them up vs. using food to slow the process down before numbers get into that range. In most cases, the latter approach is what I use with Gabby because she has a tendency to dive. The strategy you use depends on your cat and how your cat responds to insulin.

Just in case you should need it, these are the instructions for handling low numbers. It's useful to have on hand!

Re: 10/26 Zeke AMPS=89, +1=114

Hi - nice job! Another fwiw, as I'm not really an advisor, but dealt with a diving cat for close to five years. I so agree with all that Sienne said, and is how I fed Mannie. One gets very good at "steering" numbers with food. It is always so great when you can just keep the LC going. Good job! Enjoy your day today.