Dosage Change

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Grandmasterwhiz

Grandmasterwhiz

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Hi Everyone!

Sorry I have been MIA for the past week or so. I was on vacation, and during that time Jelly was staying at the vets where he monitored her and made sure she hate and had her medication daily. When we dropped her off he took her BG and it was at 436. He mentioned he might have to increase her dosage but would keep an eye on her.

I picked her up Monday afternoon. He said she did really well but had to increase her dosage from 1.5 units 2 times daily to 2.0 units twice daily. Told me to keep doing what I was doing as far as her diet and home testing. Jelly has refused to eat dry food and wants solely wet food which is good! I thought I was going to have problems with changing her diet.

I think Jelly is getting use to me checking her BG, however we still have our good times where I feel horrible if I have to prick her more than once :( I hope it gets easier.

The vet wants to see Jelly again on Aug 3rd. I have started home testing her again, especially since they increased her dosage I have updated Jelly's SS. I know it has been only a few days since Jelly has been home, however I am wondering if 2.0 units is kind of high for Jelly. I am not familiar with adjusting what amount of insulin I should give her. This is the first time I have seen her numbers drop so dramatically. I thought maybe the testing strips have gone bad, so I am planning to get some new ones this week. Has this happened to any of you with the significant number drops?
 
Wow! First, yes 2 units is too much. If Jelly was at 227 last night and got 2 units and was at 56 this morning...that's definitely too much. Your goal is to get 2 shootable preshot numbers...and you didn't. And it looks like she surfed most of the day..at least nadir was still green.

I'd say that the high numbers at the vet were due to stress. Being boarded, away from home, etc. can cause major stress which causes BG to go up. This does NOT mean you shouldn't have boarded her. Clearly she needed to be cared for and they were able to do so safely. However, her numbers are bound to be lower being home and with you, where she feels better.

With that being said, I'm not sure what kind of dose you want to go with tomorrow. First, I would not shoot below 200. You did exactly right today. Thank goodness you were home testing! I can't remember...did you start at 1 unit and increase? It's hard to advise you without much data...if she were mine, I might go with 1 unit for a few cycles to see what happens. Will you be around to monitor her tomorrow by chance?
 
I was thinking last night that 2 units was too much, but did not know how much I should have given her, this is all so new to me, that is way this morning I wanted to check her BG before even thinking of giving her her AM dosage. I felt so bad that her BG had gotten so low. Next time I know if its slightly above 200 to reduce the dosage and instead give her like .5 or 1 unit

Yeah, before dropping Jelly off at the vet her readings were in the 400's I was very concerned and you are right I am sure her stay at the vets raised her BG higher. I will definitely monitor Jelly in the morning and see where her BG is before her AM dosage. When Jelly was first diagnosed back on June 25th the vet started her off with 1 unit 2x daily. then he increased 2 weeks later to 1.5 units daily. While under his care he increased to 2 units daily. She is a small cat so I thought 2 units was a lot. I will be able to monitor her tomorrow morning and during my lunch break then before her PM dosage so I should be able to get 3 readings in. I will definitely adjust her dosage depending on the BG readings. :)
 
The diet change can make a big difference and apparently has with JellyBean. The 32 was very low. We don't want them under 40. And the amps of 52 could have meant she was very low overnight. I agree with Rachel.

We suggest not shooting under 200 so I am glad you skipped. If she were mine, I'd restart at one unit if she is over 200 and if you can monitor.
 
Thanks! Yeah when I saw her reading at 32 I was very worried, I kept a close eye on her, made sure she ate something. Being diabetic myself I know how it feels when your sugar crashes. :nailbiting:

I remember reading not to shoot if the numbers are under 200, so today Jelly hasn't had any insulin. I will see where she stands tomorrow, and keep record so when she goes back to the vet, he will know how she is doing. Thanks so much for the advice!
 
I'll be around in the morning...I'm usually here around 5:30ish central time and hang around off and on til 7 central time. Not sure where you're at, or if you'll be up that early, but I'll keep an eye out in the morning to see if you need anything. I think I'm usually the early bird around here due to my time zone. :)
 
Thanks Rachel! I appreciate it! I usually give Jelly her medication around 8am/8pm if anything major or I have any worries I will definitely post. I update Jelly's SS daily. I am from Houston, Texas
 
How is Jelly doing this morning? Did she make it up to 200? You were very smart to skip last night! (Is amazing how much their numbers can spike while at the vet's, isn't it? Same thing happens with Bat-Bat, every time.)
 
Jelly did great this morning! I checked her BG this morning before her morning dosage and it read 141 so I didn't shoot. I fed her some wet food, and tested her 6 hrs later at 2pm. The first time I tested Jelly it read at 58 however I didn't think I tested correctly so I waited a few minutes and tried again and it read 150. Before her pm dosage I tested Jelly and it was at 253. Instead of giving her 2 units I followed advice and only gave her 1 unit. i will see how 1 unit did for her and continue to monitor her.

It is amazing how stress can spike up their BG. When it was hitting in the upper 400's I was so scared! I know there will be good days and bad days, but I am hoping for more good days!
 
That's great news! Most likely the 58 wasn't right. If you get a weird number like that, always retest like you did. Just to check. Good job with your dosages today! You did exactly the right thing again (you must be a pro!). I like the 1 unit...that yellow number isn't super high, and hopefully it'll give you a shootable AM number. IF not...just means we have to reduce! Can you grab a +2 or 3 before bed just to make sure numbers aren't headed to a weird place? It's a good idea just to check, especially with the low numbers Jelly has been throwing at you!
 
Good for Jelly - sounds like you two did really well today! Yep, sure is amazing how stress and raise BG levels. I would really like to have Bat-Bat's teeth cleaned at the vet's one of these days, but she's teetering on the edge of OTJ-land right now, and since she freaks so intensely any time she's had to go there, I'm putting it off for now (fearful we'd lose the ground we've gained over the past month).

I've no doubt you'll start having more good days!
 
Rachel said:
Can you grab a +2 or 3 before bed just to make sure numbers aren't headed to a weird place? It's a good idea just to check, especially with the low numbers Jelly has been throwing at you!
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That's a really good idea Rachel passed along - and the bonus is that you'll sleep better, 'cause you won't be worrying as much about your kitty. (Which was what I've done more times than I care to count!) Even now, on those cycles when I have to give Bat-Bat a mini-bump of insulin, I check her BG later. She always seems to nadir around +3-3.5 after a dose - and has surprised me every now and then with a really low # then. (If anything has taught me a lesson about not allowing myself to slip into complacency in daily life, it's feline diabetes!)

That's what's so great about testing @ home: You can react more quickly to any plummeting BG to help keep kitty out of the hypo zone.
 
Agree with getting a +2 test. A +2 is a great indicator on how active the cycle is going to be. I try to take one before I go to bed too. If it is about the same as PMPS or slightly higher, Merlin is going to be okay for the night. If it is quite a bit lower, then I need to stay up.
 
I had planned to retest Jelly after her PM dosage but was so exhausted I feel asleep last night. I tested her this morning and her AM BG was 224 so I gave her 1 unit, around 2pm I checked again and it was 99. I checked her BG before her PM dosage and she was at 185 so I didn't shoot tonight.
 
Well! What interesting numbers! I'd say in the future, if you run into a number like that, stall without feeding for 20 minutes and retest. Sometimes, the number will still be rising. If above 200, you could still shoot then.

She may be high in the morning, just a warning. (Though Jelly likes to surprise us!). The next few days should help us see what's going on, I hope.

On a side note, don't feel bad about falling asleep. Happens to us all! You need sleep after all.
 
I will definitely try that next time, stalling without feeding and see what happens when I retest.
I did have a question. Say I test her around before giving her insulin and it is below 200, but test her again a few hours later like 4 or 6 hours and it reads high, when is it too close(in time) to their next dosage to give them insulin? Are you just suppose to wait till its time for the next dosage?
 
You may find you need to develop a sliding scale in dosing the ProZinc. Some cats do well with doses adjusted based on what you know about how much drop you get with a given dose.
 
If you wait 4-6 hours after when you were supposed to shoot, then you start the 12 hour cycle from when you last shot. So, say if you typically shoot at 6pm and he is too low to shoot, you test till 7pm, and he is still too low. Then by that time you probably have a screaming cat that wants food by then so you feed him at 7pm. Remember you only shoot only if they have not eaten for two hours prior to your shot because you do not want your test to be influenced by food. So say you test 4-6 hours afterwards and it is now between 10pm and midnight. You finally get a shootable number and you want to shoot, that will throw off your 12 hour schedule so you will be testing at noon the next day as well as midnight the next night. So most folks will only stall a couple of times (I usually will go about an hour because Merlin would be screaming for his food by then) before calling in a "skip" shot. Does that make sense?
 
It may be that Jelly needs some time to settle into the 1.o unit, too. Keep in mind that he went from 2 units to zero units to 1 unit in just the past few days, so his body may just need to adjust to the reduced dosage ... Is there any way you can do a mini-curve over the weekend? Or maybe at least get a couple of #s during his night cycle, say a +2 & +4 or a +3 & +5? I know it's kind of a drag to stay up or set the alarm a couple of times during the night, but those extra #s can be helpful in getting a better feel for his pattern.
 
Merlin said:
If you wait 4-6 hours after when you were supposed to shoot, then you start the 12 hour cycle from when you last shot. So, say if you typically shoot at 6pm and he is too low to shoot, you test till 7pm, and he is still too low. Then by that time you probably have a screaming cat that wants food by then so you feed him at 7pm. Remember you only shoot only if they have not eaten for two hours prior to your shot because you do not want your test to be influenced by food. So say you test 4-6 hours afterwards and it is now between 10pm and midnight. You finally get a shootable number and you want to shoot, that will throw off your 12 hour schedule so you will be testing at noon the next day as well as midnight the next night. So most folks will only stall a couple of times (I usually will go about an hour because Merlin would be screaming for his food by then) before calling in a "skip" shot. Does that make sense?
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Yes, that makes perfect sense! Thank you for clarifying it for me!
 
Robin&BB said:
It may be that Jelly needs some time to settle into the 1.o unit, too. Keep in mind that he went from 2 units to zero units to 1 unit in just the past few days, so his body may just need to adjust to the reduced dosage ... Is there any way you can do a mini-curve over the weekend? Or maybe at least get a couple of #s during his night cycle, say a +2 & +4 or a +3 & +5? I know it's kind of a drag to stay up or set the alarm a couple of times during the night, but those extra #s can be helpful in getting a better feel for his pattern.
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Thanks! That is a good idea, I have a better chance over the weekend to test Jelly more often. I will go out to the store and by some more testing strips (running low) I am more of a night owl so staying up at night is easier for me, rather than early morning I am always dragging. lol It will be interesting how Jelly does at night.
 
Good evening. I am having a late night because Merlin decided to go low on me tonight (at +2), so I thought I would check out some spreadsheets while waiting between tests. Looks like Jelly is going low on you some more too. Just checking to see if you have any questions. Where you able to increase his numbers with some medium or high carb food? I saw that he had a BG# 20 today. If I could make a suggestion, you should test a few times after you receive a low number i.e. anything under 40-50. The suggestions it to get three rising numbers after a low number and the tests should be done every 20-30 minutes. We consider 20 as being hypo even though he may not have had any symptoms. Let us know if you have any questions.
 
Wow, good eye, Cindi. GrandmasterWhiz (what's your name?), Jelly Bean is all over the place. Could I suggest that you restart at one unit, get those nadir numbers and see how that dose works. She is bouncing all over from highs to lows. Not only does it not feel good, it has taken her into some dangerously low numbers.
 
Oh my! Yep, Cindi is right!!! I would go with what Sue said. It's really important that you don't get such low numbers...it's very very dangerous.
 
Merlin said:
Good evening. I am having a late night because Merlin decided to go low on me tonight (at +2), so I thought I would check out some spreadsheets while waiting between tests. Looks like Jelly is going low on you some more too. Just checking to see if you have any questions. Where you able to increase his numbers with some medium or high carb food? I saw that he had a BG# 20 today. If I could make a suggestion, you should test a few times after you receive a low number i.e. anything under 40-50. The suggestions it to get three rising numbers after a low number and the tests should be done every 20-30 minutes. We consider 20 as being hypo even though he may not have had any symptoms. Let us know if you have any questions.
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Hi Cindi, thank you so much for getting back with me. I appreciate it. Oh yes, these lows numbers have been scaring me. I know something is wrong when Jelly comes up to me and starts to sit by me, that is when I check her BG and it is usually low, so I try and give her some food with a little bit of dry. I know she must feel horrible and scared, makes me feel so bad. Next time (which I hope doesn't happen again) I get a low number I will definitely do retest.
 
Sue and Oliver (GA) said:
Wow, good eye, Cindi. GrandmasterWhiz (what's your name?), Jelly Bean is all over the place. Could I suggest that you restart at one unit, get those nadir numbers and see how that dose works. She is bouncing all over from highs to lows. Not only does it not feel good, it has taken her into some dangerously low numbers.
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Thank you Sue, yes Jelly is all over the place, makes me so sorry. I feel like maybe I am not doing enough. I hate seeing those super low numbers, I start to panic, because I can't begin to imagine how she must feel. She has a vet appointment on monday, unfortunately I can't go but I am going to give my mom her spread sheet so the vet can see. However I will start her back at 1.0 units and only shoot if she is over 200.

Oh by the way, my name is Elizabeth :)
 
I'm so glad to hear this Elizabeth! Yes, all the highs and lows could make her feel bad. I know the feeling of not doing enough...but trust me when I say you ARE. You're doing a fantastic job of testing and getting those mid cycle numbers that helped alert us to the fact that she was going so low. You're here, which is where you can gain some great information to take care of Jelly. You're getting her to the vet to get checked out. You've put her on a low carb diet. You've done a lot...some people never do this (they don't all know they need to!).

I definitely think that the not shooting under 200 is good. Do you know how to deal with low numbers?
 
Hi Elizabeth. This is how I handle low numbers. Once he hit 50 and sometimes a little higher, I start trying to increase the BG number by low carb food. I only give about a teaspoon as it really doesn't take much to increase their number plus you don't want them to get full just in case you need to keep giving them food. I start off with low carb but if Merlin gets to 40 or below, I give him a little bit of gravy from a medium or higher carb food. Again, just a little bit still. I usually test 20-30 minutes again after a low number. I also typically feed shortly after the test. Last night I was testing every 30 minutes. Since I was not near the 40's, I was testing and then feeding low carb food 15 minutes after each test. Even though I had decent numbers, it was too low a number, way too early in the cycle and he was heading towards a crash.

I see that you offered dry food probably along with higher carb wet food. You do not need to give Jellybean dry food at all. Dry food takes awhile for the cat to absorb it into their system so it is not a fast action resolution; wet food is. So I would only stick to wet food while steering Jellybean from lower numbers.

Since he is bouncing all over the place, I agree with Sue that trying a consistent dose for a while (if the number is safe), may help determine his nadir and settle him down a little. Go low and start slow is the slogan here. Thanks for checking back here and if you have any questions, just holler.
 
Rachel said:
I'm so glad to hear this Elizabeth! Yes, all the highs and lows could make her feel bad. I know the feeling of not doing enough...but trust me when I say you ARE. You're doing a fantastic job of testing and getting those mid cycle numbers that helped alert us to the fact that she was going so low. You're here, which is where you can gain some great information to take care of Jelly. You're getting her to the vet to get checked out. You've put her on a low carb diet. You've done a lot...some people never do this (they don't all know they need to!).

I definitely think that the not shooting under 200 is good. Do you know how to deal with low numbers?
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Thank you so much Rachel, I know all you guys love your sugar kitties. So it is refreshing knowing I am not alone and I have people to talk too and are going through the same thing.

When Jelly hits the low numbers its all new to me I really don't know what to do, or how to raise them gradually and safely. I have read on several post that some give a higher carb wet food with gravy. I have read some people rubbing honey on the gums. (is that when they are super hypo?)
 
Merlin said:
Hi Elizabeth. This is how I handle low numbers. Once he hit 50 and sometimes a little higher, I start trying to increase the BG number by low carb food. I only give about a teaspoon as it really doesn't take much to increase their number plus you don't want them to get full just in case you need to keep giving them food. I start off with low carb but if Merlin gets to 40 or below, I give him a little bit of gravy from a medium or higher carb food. Again, just a little bit still. I usually test 20-30 minutes again after a low number. I also typically feed shortly after the test. Last night I was testing every 30 minutes. Since I was not near the 40's, I was testing and then feeding low carb food 15 minutes after each test. Even though I had decent numbers, it was too low a number, way too early in the cycle and he was heading towards a crash.

I see that you offered dry food probably along with higher carb wet food. You do not need to give Jellybean dry food at all. Dry food takes awhile for the cat to absorb it into their system so it is not a fast action resolution; wet food is. So I would only stick to wet food while steering Jellybean from lower numbers.

Since he is bouncing all over the place, I agree with Sue that trying a consistent dose for a while (if the number is safe), may help determine his nadir and settle him down a little. Go low and start slow is the slogan here. Thanks for checking back here and if you have any questions, just holler.
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Thank you! I will definitely keep that in mind I pretty much got rid of all the higher carb (wet) food I will keep a couple of cans handy just incase. When her numbers would go below 70 I would give her low carb wet food with a little bit of dry food. However I will stay clear away. My question is do you only feed your kitties when its testing time? My vet originally had said to leave food out for Jelly throughout the day so she could nibble on. My main concern is at night, because during the day I can keep an eye on her.
 
Because their pancreas is not working properly, they are typically going to be hungry all the time, however, every cat is different (ECID). In fact, if you don't treat diabetes (with insulin), then cats typically starve. With Merlin, I do not feed two hours prior to the AMPS and PMPS test. This is because I do not want his test numbers to be food influenced. Food increased the BG numbers so I don't want to shoot a number that is over inflated. Then once I get the test number, I go fill the syringe, feed Merlin and then shoot...so test, feed, shoot are the steps.

I typically feed Merlin almost every 2-3 hours throughout the day. Again, when I test during the day, I schedule it so he has not had anything to eat for maybe an hour or two. However, sometimes, it doesn't always work that way and I have to test after he eats. He usually does not want much to eat; maybe a tablespoon or two but he does like to eat quite a few mini-meals throughout the day. At night, he typically wants only 2-3 mini meals. I use an auto feeder sometimes but since I am usually at home, I feed when he hollers at me.

Feeding these sugar kitties mini-meals throughout the day, is good for the pancreas. It helps the numbers not to take a dive or even things out a little so they are not on a huge roller coaster.
 
I have heard about the auto feeder, hopefully i can head out to the store this weekend and get one, I think that would help tremendously with Jelly since everyone here has a busy schedule I know there are times when she seems like she is starving, plus it will help multiple people feeding her throughout the day. I think that happens sometimes.

Definitely great information that I will remember for future reference!
 
My favorite feeder is the PetSafe5. (I have tried three; the other two my cat was able to break into). It has 5 compartments that you can set for any times you want, and you can set it to close up 2 hours before shot time so she doesn't eat during that time. I got mine at PetSmart; I have also seen it on line.
 
Wow! It looks like one unit took her too low mid cycle and gave you a pmps too low to shoot last night. I think I'd reduce to .5 even though she will be high this morning. She is likely to be high because it's been 24 hours since her last shot, but since one unit dropped her too low, I'd still reduce.

It looks to me like she might be headed off insulin (anti jinx). If so, and her numbers continue to drop, you need to continue to lower the dose. We have a way to measure just drops.
 
Sue and Oliver (GA) said:
My favorite feeder is the PetSafe5. (I have tried three; the other two my cat was able to break into). It has 5 compartments that you can set for any times you want, and you can set it to close up 2 hours before shot time so she doesn't eat during that time. I got mine at PetSmart; I have also seen it on line.
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Thank you I am going to check into getting one. I am going to be gone for 2 days and my mom will be watching Jelly, so since I won't be available to give her insulin she is going to be on strictly low carb wet food to at least keep her BG as low as possible. I think an automatic feeder would be great.
 
Sue and Oliver (GA) said:
Wow! It looks like one unit took her too low mid cycle and gave you a pmps too low to shoot last night. I think I'd reduce to .5 even though she will be high this morning. She is likely to be high because it's been 24 hours since her last shot, but since one unit dropped her too low, I'd still reduce.

It looks to me like she might be headed off insulin (anti jinx). If so, and her numbers continue to drop, you need to continue to lower the dose. We have a way to measure just drops.
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I updated Jelly's SS this a few minutes ago. I am starting to wonder if the 1 unit is getting to be too much. I felt horrible because I checked her this morning and gave her 1 unit of insulin and had to go do some errands came back and retested her roughly 6 hrs after her AM dosage and her BG dropped to 25. I gave her a little bit of higher carb wet food she ate it so fast and I am going to retest her here in a few minutes. Right now she is sitting next to me and I am giving her some cuddles. poor Jelly :nailbiting:
 
With these kinds of numbers, I really want to encourage you to go to .5 units tonight (if she's over 200). She's dropping far too low. Why not try the lower dose tonight (if over 200) and we'll see where that takes her? Don't worry...we can figure this out! :)
 
Rachel said:
With these kinds of numbers, I really want to encourage you to go to .5 units tonight (if she's over 200). She's dropping far too low. Why not try the lower dose tonight (if over 200) and we'll see where that takes her? Don't worry...we can figure this out! :)
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Thanks! I wasn't able to shoot Jelly tonight, as you can see her numbers are slowly creeping up but still under 200. If I have to shoot in the morning I will give her .5 units and see how that does. She goes to the vet Monday and i am going to print out her SS so the vet can see. Yeah I think Jelly has given me like 10 white hairs as we speak lol
 
Definitely agree. Maybe even consider a .25

When cats are going off the juice (anti jinx) you do have to keep adjusting the dose down. Here is some info in what we call mini dosing:

When your cat is consistently in numbers too low to shoot at shot time and in numbers in the 100 range and below during the cycle, you can consider micro dosing. This process should be guided on the forum by experienced members and will require more frequent testing. You may be shooting at times other than the 12/12 schedule, when the blood glucose levels rise enough to require a small dose of insulin. You will need to pick a number somewhere near the 150 range at which you will plan to shoot, being sure that the number is indeed rising. The dose at these low numbers will vary with each cat and its patterns, so advice should be solicited. But you may be considering doses below .25 and even considering a “drop” of insulin. At this point, U100 needles and the conversion chart will be necessary. It is important during this period to offer small frequent meals. You may want to experiment with the lowest carb foods to help bring down the numbers, staying away from seafood more than once or twice a week.
 
Thank you all for the helpful info. I will be leavig tomorrow afternoon and not home till Wednesday night. Jelly has an appointment with the vet and I am going to be printing out her SS so he can look over it. I can not make the appointment but my mom will be there and they usually have me on speaker in case the vet has any question. My mom doesn't feel comfortable giving Jelly her shots, can't blame her however I told her just to feed her small meals throughout the day only wet food and to make sure the dog food is put up sometimes Jelly likes get into it. 2 days seems like forever being away from Jelly. I would feel more comfortable leaving if I knew her BG was regulated. *sigh* I hope she does well at the vet.

Anyways I will be in touch once I get back. Take care all!
 
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