Insulin or not?

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For the past two weeks, We have been treating Max, 1st with 1unit PZI, then 1.5 units this past week. His bg has always been bt 315 and 385. Last night I increased to 2 units (vet had wanted me to dot his last week but I was afraid to). His bg was 217 this a.m. Do I need to give him insulin this morning? If so, please advise on dosage. I know it is still high, but just scares me that it fell so quickly after dosage increase.
 
Hi
can you test it again? You need to make sure it is rising before you shoot
Carl
 
Do you have any mid-cycle numbers from the last week when you were doing 1.5?
 
I'm on my phone so can't be real detailed... I would shoot 1.0 this morning. Can you get a test at +3?
Carl
 
The only way to really tell if the dose is "right" is to try to get tests when possible between shots. The more data you have, the more you'll know the dose is safe. I'll write more later.
Carl
 
I agree with Carl's advice on amount. I think what got you into the lower preshot number is that you increased by a whole unit. We advocate increasing by .25 if the numbers are in the lower ranges and .50 if in the higher ranges. If you get a preshot under 200, it is possible that he went quite low overnight. You may see a bounce from those numbers in the next cycle. It is important to try to get some midcycle numbers so you can see how the dose is really working - any place in the 4-6 hours after the shot is very useful.

Here is a document on PZI: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799 Too much for one reading but lots of good info. We also have a forum for PZI users; everyone there uses or has used your insulin and can help with dosing. http://www.felinediabetes.com/FDMB/viewforum.php?f=24
 
Welcome!

Agree with Sue.

If you get home tonight and get a high number, even a 400 or 500, do not increase the dose back to 2u. If a cat gets low one cycle, their body can freak out and send them high the next cycle. This is temporary, so if you give more insulin and the high numbers drop out on their own you then have a kitty with much more insulin onboard than needed and possibly some scary low numbers coming.

It takes a bit to get used to all this, but you're in a good place here.

Cathy
 
I'm going home to retest now.

Just to clarify, we started out at 1 unit PZI after initial diagnosis of DB and he was on that 2x a day for a week.

Last Monday (4/23/12), the vet did a BG curve at his office every 2 hrs from 8am to 5pm. I tested at 6pm and 8pm that night, too. The numbers on the curve ranged from 318-387 all day. My vet told me to increase dosage from 1 to 2 units 2x per day, but after visiting here, I decided against that and went up to 1.5 units instead.

I tested every evening from last Tuesday (4/24/12) to last night (4/29/12) and got the same ~315-385 bgl range every time. Because of this, last night I decided to increase from 1.5 units to 2 units, so 1/2 unit, not a whole unit at once.

This morning I got the low number. I am trying to test more often, but it is difficult with working and taking care of my 3 year old (getting her ready in the mornings is my least favorite part of parenthood).

On top of that, my husband owns his own business and has been slammed. I help him with accounting in the evenings. And one last thing, the other cats are not taking well to the change in diet from dry to wet food and they sense something is going on with Max b/c they have been peeing all over my house. Not a good excuse, but I'm so stressed.
 
Sounds like things are your house are a little stressed. nailbite_smile Good info to have that you didn't move up really fast in dosage. We tend to post the optimum care at first; then we try to help you adapt to what is possible at your house.

Preshot numbers are vital but midcycle numbers really help you adjust the dose. A cat can bounce from low numbers to high. If he is going low at midcycle, then he could be higher at preshot. Giving more insulin can just increase that problem. It's a hard thing to get your head around - the body panics at the lower number than it is used to and dumps glucose: http://petdiabetes.wikia.com/wiki/Somogyi_rebound Not sure what will happen today. Since you were a little late with the preshot and he might have gone low last night, you may see the high cycle again. It can take a while for a rebound to clear. If you and when you can, get a number around +5-6 hours after the shot. My idea is that the dose was too high and that is why you got a low preshot. I would not shoot the 2 again and might stick with the one unit until any possible rebound clears. Once you get a good picture of how the one unit works, you might go up by .25 to see if that makes the difference.

All numbers help, but you get what you can. Once you can see how the insulin works, the easier it is to adjust the dose and do the most good.

Is he on a wet low carb diet with low carb treats? Any dry kibble or high carb treats can really impact blood glucose levels up.
 
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