Okay what is the protocol for dosing under 200? Mini dose? If so, How mini? Normal dose and watch? Skip? Etc??? Thelma is at 146, (would prefer not to test every 2 hours all night because I have narcolepsy and a kid in virtual school . ) thinking I should scale back to .50 or .75 and check her at 2/3 am?? https://docs.google.com/spreadsheets/d/1YI8RJr7d3bp233wsuutZrVH_26t30bT4QCWuLFTciG8/edit
Someone with more experience may weigh in but if you are following SLGS, the guidelines say the following (here's the link for you to read when you can (I re-read the guidelines alllll the time )): How to handle a lower than normal preshot number: 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.
Sorry you didn't get a quicker reply Katrina! I think you did the right thing.....but reducing the dose doesn't necessarily mean you won't have a long night. The depot is still releasing the .75 dose until it drains Looks like the +1 was about the same as the PMPS? I'd plan on getting a +2 and let's see what's going on then. Did she eat well at PMPS?
Nice job dosing. You've shot blue before. I've always felt some insulin is better than none.I'm not sure at what +# you'd be at at 2-3 am., but it's probably a good idea. (and a snack too, if she goes lower than you'd like) It looks like Thelma is a bit on the bouncy side these days, that fact she's staying in the blues, and rather steady, is a good thing.
Yes, usually she has 2 cans in the evening, I do have higher carb food ready to give her as well if she’s still dropping
No, she doesn't need anything medium or high carb now....if it's a usual time for food, just a couple teaspoons of her regular food. She's looking good! I'd try to get a +5
Skip. It looks like 1 unit is too high for her, from my understanding. What's going on with her bowels? Is there any pattern to when she poops outside the box?
I'm sorry you didn't get a response to your dosing question. It looks as if you are commenting on yesterday's post. I don't think I would have skipped. Maybe reduced again, but not skipped. From my experience it only causes their depot to become unstable & the BG to rise back into the clouds. Sometimes our sweet go a bit lower than, say +6. My Nova is a classic example. You shot a reduced dose last night at what was relatively was same pmps as today (by just a few points), and Thelma pulled a beautiful blue pm cycle--most likely due to the depot from the 1 unit dose given previously. I DO understand why you did tho, you are early in the journey & according to SLGS a no-shoot is under 200/150 and you want to keep her safe. I have done the same thing. In time, with more data, you will get used to those blue #s and Thelma will tell you when to reduce by going below 90 for a reduction. You will now see her BG rising back into the yellows and pinks. The ultimate goal is to get her into those blues & greens and get her pancreas healing. Read & re-read the SLGS & TR protocols---they are there to guide you as well. You will also want to start a new thread every day, and reference the previous post as well for history's sake. Re-read the PSA sticky, and ask questions if you don't understand. There are a lot of caring people here with loads of more experience than me to help & guide you though this--at first--scary diagnosis.
