Help with low pre-shot number | Feline Diabetes Management Board

Help with low pre-shot number

Previous Post <---- Phoebe's detailed background info and health history is in this post!

Hello!
It is looking like we are going to have a low PS number and I wanted to see what you all think. We are still 2 hours out from feeding/shot (it is 4:45pm where I am and she gets fed/shot at 6:30pm) and she is at 78. She has the Freestyle Libre. Her typical morning nadir is +3 to +4, but she stayed high all day today and only started dropping around 2pm. She's on a 6:30/6:30 schedule. She is at the tail end of being weaned off of prednisolone, and I've been seeing numbers much lower than I'm used to. That, along with the high dose that she is on make me nervous about shooting low. Any advice would be greatly appreciated! I'm going to cross-check with the ReliOn right now as well and will update when I do.

Update: ReliOn crosscheck at ~AMPS+10.5 was 101. Wondering if this is a false Libre low?
 
@Suzanne and Darcy are you able to help with Prozinc information?

Since you’re going custom dosing, what is your reduction number?

As Wendy mentioned the other day, if Phoebe drops under 50 you reduce immediately by .25 units, if following TR.

If following SLGS, under 90 requires a .25 unit reduction.

So that should give you some ideas on how to handle dosing.
Have you read any of the stickies at the top of
The Prozinc forum page?
Prozinc / PZI
 
I cannot see when you have checked the Libre with the ReliOn. It would be good if you could put the ReliOn numbers into the cell where you’ve checked against the Libre. Put an asterisk or put ReliOn next to the ReliOn number.
 
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Previous Post <---- Phoebe's detailed background info and health history is in this post!

Hello!
It is looking like we are going to have a low PS number and I wanted to see what you all think. We are still 2 hours out from feeding/shot (it is 4:45pm where I am and she gets fed/shot at 6:30pm) and she is at 78. She has the Freestyle Libre. Her typical morning nadir is +3 to +4, but she stayed high all day today and only started dropping around 2pm. She's on a 6:30/6:30 schedule. She is at the tail end of being weaned off of prednisolone, and I've been seeing numbers much lower than I'm used to. That, along with the high dose that she is on make me nervous about shooting low. Any advice would be greatly appreciated! I'm going to cross-check with the ReliOn right now as well and will update when I do.

Update: ReliOn crosscheck at ~AMPS+10.5 was 101. Wondering if this is a false Libre low?
What does this mean?
1755306674678.jpeg
 
If you need to insert a hard return into your spreadsheet to keep numbers together then you hold the alt key and hot the return (enter) key. I can’t tell if that is the problem.
 
Sorry, I saw that format elsewhere on the forum and thought it was the proper way to do it. Also it doesn't look that way on my end. They are all on one line. It means the reading was 70 at +3.5
Okay. Yes. The text is just wrapping on its own. It’s just that you need to insert a hard return in places. The ~ mark means “approximately” so I was confused by that symbol.
 
What was the condition she was receiving the Pred for? I am so sorry for so many questions that I am sure you have answered before. I have had a very difficult week with my cats and I haven’t had a chance to move off of this ProZinc forum all week and that has been very busy too. Please forgive my abruptness!!! This is not my usual self.
 
I am not following a specific one yet, since I'm not sure which is the best for Phoebe's circumstances. I have read through SLGS and Modified Prozinc Method several times though. It seems like Modified Prozinc Method would be best? With the objective of reducing her dose if possible?
Okay. Fair enough. Since she is eating dry food we must stick with SLGS for now. Dry food has impacts upon the cat’s blood glucose that extends quite a bit beyond what wet food does so we have to be more cautious. You must be at about shot time by now.
 
What was the condition she was receiving the Pred for? I am so sorry for so many questions that I am sure you have answered before. I have had a very difficult week with my cats and I haven’t had a chance to move off of this ProZinc forum all week and that has been very busy too. Please forgive my abruptness!!! This is not my usual self.
It is totally ok! The pred was for IBD diagnosed through symptoms, no clinical test. She poops outside the litterbox a lot.
 
What was the condition she was receiving the Pred for? I am so sorry for so many questions that I am sure you have answered before. I have had a very difficult week with my cats and I haven’t had a chance to move off of this ProZinc forum all week and that has been very busy too. Please forgive my abruptness!!! This is not my usual self.
That is totally ok! The pred was for IBD.
 
I really think she earned a reduction last night and should have been reduced today to 4.75 with the ReliOn reading of 83. So with tonight’s lower reading which we don’t have previous data for — I would recommend a reduction for tonight to 4.5 units of you can get a few tests at least earlier in the cycle.
 
I really think she earned a reduction last night and should have been reduced today to 4.75 with the ReliOn reading of 83. So with tonight’s lower reading which we don’t have previous data for — I would recommend a reduction for tonight to 4.5 units of you can get a few tests at least earlier in the cycle.
Ok, that sounds good! I had thought the same thing about reducing yesterday, but wasn't sure. I will go ahead with the 4.5 units now. And so going forward, do you recommend using the SLGS guidelines? Thank you so much for this!!!
 
It is totally ok! The pred was for IBD diagnosed through symptoms, no clinical test. She poops outside the litterbox a lot.
I have an IBD cat (diagnosed via surgical biopsy) so I understand. Is she doing okay without the Pred? My poor boy is not doing well and won’t eat tonight at all. His liver enzymes are very high and I am worried. He had been doing great and now has taken a turn for the worse. I have two other sick cats right now too. They’re ganging up on me.
 
Ok, that sounds good! I had thought the same thing about reducing yesterday, but wasn't sure. I will go ahead with the 4.5 units now. And so going forward, do you recommend using the SLGS guidelines? Thank you so much for this!!!
A reduction to 4.5 tonight. Tomorrow if her AMPS is back up to about normal then I would shoot 4.75 (just going with the .25 reduction). If she’s lower than normal then continue with the 4.5 unit dose.
 
I have an IBD cat (diagnosed via surgical biopsy) so I understand. Is she doing okay without the Pred? My poor boy is not doing well and won’t eat tonight at all. His liver enzymes are very high and I am worried. He had been doing great and now has taken a turn for the worse. I have two other sick cats right now too. They’re ganging up on me.
That sounds really rough, I am so sorry. I really appreciate you taking the time to help me and Phoebe. She is definitely doing worse without the pred. (the second tab Phoebe's SS is Poop tracking and that sort of tells the story) She hasn't pooped in the litter box since Tuesday D:
 
First order of business would be to try a single protein that Phoebe has not eaten before. Then if she still is not doing well, you can give Pred. @Lane&Biddy you can speak to this. Hannah, look at Biddy’s spreadsheet. Lane had been getting a lot of harassment from other groups for giving a diabetic cat Prednisolone— but Biddy actually needs the Prednisolone because of Triaditis. Lane and I have worked together for some months now, and Biddy has excellent BG numbers and is a very well-regulated diabetic despite the pretty significant dose of Pred. It can be done. Yes, the dose is higher than an average cat, but it is possible.
 
First order of business would be to try a single protein that Phoebe has not eaten before. Then if she still is not doing well, you can give Pred. @Lane&Biddy you can speak to this. Hannah, look at Biddy’s spreadsheet. Lane had been getting a lot of harassment from other groups for giving a diabetic cat Prednisolone— but Biddy actually needs the Prednisolone because of Triaditis. Lane and I have worked together for some months now, and Biddy has excellent BG numbers and is a very well-regulated diabetic despite the pretty significant dose of Pred. It can be done. Yes, the dose is higher than an average cat, but it is possible.
Thank you for this advice! We had reached the max dose of the pred and she was still not doing well. The vet suggested that her unregulated diabetes could be contributing to or exacerbating the GI issues. So we're kind of doing an elimination method. I'd like to explore some other treatments and root causes for her gut issues as well, since I don't think we really did that properly initially. I need to look back at her records but I think she has been on budesonide before. But all that said, it's very possible that nothing I try will really help her little gut, and she'll end up back on the steroid. Thank you so much again for helping us in starting this journey! I'm sending good thoughts for your IBD kitty cat too.
 
I very highly recommend the Visbiome Vet probiotic. For my other IBD cat (I have 2) it has made a huge difference. He was never able to get down to 2.5 mg. Pred every other day until we started Visbiome. Asy your vet about it. It’s the most well-researched probiotic out there.
 
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