2/13 Susie AMPS 186

Summer and Susie (GA)

Summer and Susie (GA)

Very Active Member
Susie had a 186 AMPS this morning. I "stalled" for 25 minutes and retested twice. The first was 231 and the second reading was 240. I fed and then gave her a reduced shot of Vetsulin of 1 unit. I am confused about something. I have read not to fed and shoot if AMPS/PMPS are under 200 but I also read that if numbers continue to go down I should have some high carb food available. Luckily, her numbers went up but what is the procedure if her numbers were continuing to go down? Shouldn't I feed to stop the drop? Did I do the right thing by stalling and then reducing her shot from 1.25 to 1 unit?
 
You shot a regular 1.25 dose on the 9th and 12th with a preshot around 240, both ended up ok. You did the right thing by stalking, but today you probably would have been ok with full 1.25U once you saw the 240. The 85 on the 9th doesn't really concern me, that's a good nadir even if it's a tiny bit below the reduction threshold.

As for the drop - as far as I know, we only feed to stop the drop when the insulin is active. This is because the drop in BG is practically impossible for the cat's body to regulate on its own, so we have to intervene. A natural drop in blood sugar is ok.

The caveat - some insulins have a longer duration, meaning the prior dose may still be working when you go to give the next shot. Some cats even nadir around the +10 to +12 range on some insulins. This is very rarely the case with Vetsulin though. We stall because:
  • If the prior insulin is working, and we add more to it, it can result in an even bigger drop.
  • If the cat is experiencing a natural drop, we don't want to add too much insulin to it. However, there's a fine line for stalling too long - if you just never give a cat food, the numbers will drop because of it. Two to three half hour stalls is the max I'l personally will do
 
FrostD said:
You shot a regular 1.25 dose on the 9th and 12th with a preshot around 240, both ended up ok. You did the right thing by stalking, but today you probably would have been ok with full 1.25U once you saw the 240. The 85 on the 9th doesn't really concern me, that's a good nadir even if it's a tiny bit below the reduction threshold.

As for the drop - as far as I know, we only feed to stop the drop when the insulin is active. This is because the drop in BG is practically impossible for the cat's body to regulate on its own, so we have to intervene. A natural drop in blood sugar is ok.

The caveat - some insulins have a longer duration, meaning the prior dose may still be working when you go to give the next shot. Some cats even nadir around the +10 to +12 range on some insulins. This is very rarely the case with Vetsulin though. We stall because:
  • If the prior insulin is working, and we add more to it, it can result in an even bigger drop.
  • If the cat is experiencing a natural drop, we don't want to add too much insulin to it. However, there's a fine line for stalling too long - if you just never give a cat food, the numbers will drop because of it. Two to three half hour stalls is the max I'l personally will do
Click to expand...
I totally understand why you don't shoot when AMPS/PMSP are low. I don't understand why you don't feed. My example: I got a 186 AMPS. She was hungry and wanted her breakfast. I stalled doing the shot but why did I have to stall to feed her? Also, if she had continued to drop then I would have been instructed to feed high carbs. Just a little confusing for me. Thanks for getting back with me.
 
Summer and Susie said:
I totally understand why you don't shoot when AMPS/PMSP are low. I don't understand why you don't feed. My example: I got a 186 AMPS. She was hungry and wanted her breakfast. I stalled doing the shot but why did I have to stall to feed her?
Click to expand...
We stall 'without feeding' just so that the preshot number isn't temporarily elevated by food (tricking us into thinking that it's OK to give the shot when it may not be). We want that preshot number to be as 'true' as possible.

Summer and Susie said:
Also, if she had continued to drop then I would have been instructed to feed high carbs
Click to expand...
She could have continued to drop more at that point (12 hours+ after a Vetsulin shot) - and without insulin on board that would have been just fine. No insulin, no risk.
It is only when a cat is in hypo numbers, or is in low numbers - and has insulin active in its system continuing to lower the numbers - that it can become necessary to feed a higher carb food.

Context is really important.
It's not just 'what the number is', but also, 'where that number occurs in the cycle'.
For example: A relatively low number at the peak/nadir of the cycle (as long as that is a safe number) may be a nice thing to see.
A relatively low number - when there is still some time to go to the peak of the insulin cycle - may require action to stop the blood glucose dropping too low.

Eliz
 
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Elizabeth and Bertie said:
We stall 'without feeding' just so that the preshot number isn't temporarily elevated by food (tricking us into thinking that it's OK to give the shot when it may not be). We want that preshot number to be as 'true' as possible.


She could have continued to drop more at that point (12 hours+ after a Vetsulin shot) - and without insulin on board that would have been just fine. No insulin, no risk.
It is only when a cat is in hypo numbers, or is in low numbers - and has insulin active in its system continuing to lower the numbers - that it can become necessary to feed a higher carb food.

Context is really important.
It's not just 'what the number is', but also, 'where that number occurs in the cycle'.
For example: A relatively low number at the peak/nadir of the cycle (as long as that is a safe number) may be a nice thing to see.
A relatively low number - when there is still some time to go to the peak of the insulin cycle - may require action to stop the blood glucose dropping too low.

Eliz
Click to expand...
 
FrostD said:
if you just never give a cat food, the numbers will drop because of it.
Click to expand...
Not necessarily. In some circumstances. BG levels can rise the longer a diabetic goes without food if the amount of insulin circulating in the cat's system doesn't keep pace with the glucose released from the liver. At mealtimes, the pancreas is supposed to produce bolus pulses of insulin. Even in a diabetic cat, those pulses can help to tamp down BG levels a little. If the cat doesn't eat, those pulses, such as they might be, don't get triggered.


Mogs
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