09/22 Billo +5 147, AMPS 106, +2 93

This girl is on a march! Amazing what the right insulin and right dosage can do!

Yep keep an eye on her! I will be checking in to see how she is doing!
 
I've been trying to get her over 50 for about two hours now, she's rising but slowly! I'm going to feed her again shortly, but I think a dose reduction is called for tonight.
 
Abdullah said:
I've been trying to get her over 50 for about two hours now, she's rising but slowly! I'm going to feed her again shortly, but I think a dose reduction is called for tonight.
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Your spreadsheet shows a 57, 55 & 61 for today. Beautiful numbers. She went below 50? I'm not seeing the below 50 yet (maybe you haven't entered it). I see she has had a couple of other drops below 50 so you're probably comfortable dealing with them, but if you aren't or just want some backup, just ask. :)

Are you still doing SLGS? If so, you would take a reduction if she goes below 90, unless you are on a modified SLGS of some kind? Looks like your new dose would be 1.25u, for this evening but I'll ask @tiffmaxee who I believe is around, to confirm that please.

I'd suggest you remove your dosing amount from your signature. It still says you are at 2.25u. BID. :) You've stepped down the dosing ladder quite a bit since then! Better to remove it entirely from your signature. Nobody will get confused that way and they'll look for your dosing on your spreadsheet.

Congrats on the reduction!
 
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Sorry!!! My apologies guys, that was a typo on my end, Billo didn't drop below 50 at all today, the lowest was 55.


Butters & Lyla said:
Your spreadsheet shows a 57, 55 & 61 for today. Beautiful numbers. She went below 50? I'm not seeing the below 50 yet (maybe you haven't entered it). I see she has had a couple of other drops below 50 so you're probably comfortable dealing with them, but if you aren't or just want some backup, just ask. :)

Are you still doing SLGS? If so, you would take a reduction if she goes below 90, unless you are on a modified SLGS of some kind? Looks like your new dose would be 1.25u, for this evening but I'll ask @tiffmaxee who I believe is around, to confirm that please.

I'd suggest you remove your dosing amount from your signature. It still says you are at 2.25u. BID. :) You've stepped down the dosing ladder quite a bit since then! Better to remove it entirely from your signature. Nobody will get confused that way and they'll look for your dosing on your spreadsheet.

Congrats on the reduction!
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thank you so much for checking up! You're right, I was much more comfortable today dealing with her low numbers, I didn't need to spam you guys with questions all day long lol. I'm starting to become more confident now, thankfully.

Still doing SLGS. I will give her 1.25u tonight.

Thank you for bringing that to my attention, and my apologies for not changing it earlier, I forgot to. I'll make the change now.

Thank you once again! :)


tiffmaxee said:
Yes. I don’t see the under 50’s but I’m sure you haven’t put them in yet. Under 90 is a reduction with SLGS. Your dose is 1.25 if he comes up enough.
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Thank you! Billo's PMPS was 88, so I'm going to reduce her dose to 1.25u this evening.
 
It will be fine. With TR we shoot as low as 50. Get a +1 and +2 to start. If the +2 is lower than the PMPS, you will need to keep testing and feeding small amounts.
 
Abdullah said:
That was my mistake.
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How to handle a lower than normal preshot number:

For your reference.

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus, Basaglar, and Levemir users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.


 
With Billow being a long term diabetic and following SLGS, I would have stalled, not fed. and retested in 20 minutes.You definitely test enough to do TR if you want.
 
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