? Insulin dosage ?

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Hi Helena!!

It's important that you TRY to ignore the high numbers at Pre-shot....and believe it or not, 314 isn't TERRIBLE...we've seen cats that sat in the 600+ range for much longer

Lantus dosing is based on how LOW it takes them with only a little consideration going to the Pre-shot numbers.

I know you have special challenges, but it really is very important to try to get those tests on the PM cycle too...we've seen cats go from 400 to 40 and back to 400 in the same cycle....without those tests, we'd never know that the cat was getting too much insulin!!

What's your current shooting schedule? Is there any way you can move it so you'd be able to always get at least a +2 or +3 on the PM cycle? I HATE morning....always have!!...but when I moved China's shot schedule to 6am/6pm, although I still hate to get out of bed that early, I can usually go back to sleep in the morning and it lets me get tests on that PM cycle that are so important.

It's important for you to HOLD each dose for at least 3 days (6 cycles) but since you've increased to 2.5, go ahead and stay there for now. Looks like this morning's dose was cycle #2 so just hold that same 2.5u dose for at least 4 more cycles and try to get some tests sprinkled in at different times.

I'd like to go ahead and invite you over to the Lantus Forum too. Everyone there uses Lantus or Levemir so you'll get the most experienced eyes watching out for you and Belle!!
 
@Chris & China

thanks chris, will keep that in mind.
so, what dosage should be given to him after 4 more cycles?

yes, i will check out the lantus forum when i get home later tonite

tested him again 2 hrs after insulin @ 1pm, his BG is 266
and the Evo dry food just arrived, so i hv replaced the DM dry, hopefully that would also help him a bit too

i will try to do one more test cycle PM after insulin (i tired last nite, but failed, not enough blood)
 
Are you heating his ear before trying to poke? It can make a big difference in whether you get blood or not. A small pill bottle filled with warm water or a small sock with a few teaspoons of rice that you microwave for 20 seconds or so can really help!!

What size are the lancets you're using to poke with? Most of the lancets are 33 gauge which is very tiny...it will help to buy some for "Alternate site testing" that are 25-28 gauge since they make a bigger "hole".

Another trick that some people use is to poke quickly twice in the same place on the ear.

icesnow said:
so, what dosage should be given to him after 4 more cycles?
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It depends on which protocol you're going to use with Belle. The Tight Regulation Protocol gives cats the best chance at remission but it's VERY important that you're able to get at least 4 tests per day (and there are times you'll need more than that to keep him safe) On TR, dose adjustments are made as often as every 6 cycles and they don't earn reductions in dose until they drop below 50 on a human meter. It's an aggressive protocol, but it's backed up by a scientific paper that's been published in a veterinary journal. ONE IMPORTANT NOTE....to do Tight Regulation Protocol, Belle MUST be on canned or raw food only...NO dry (which I understand is a problem for you)

The Start Low, Go Slow method is your only option as long as dry food is in the picture. The main differences between TR and SLGS is that on SLGS you'll hold the dose for 7 days (which means you may have to accept higher numbers for a longer period of time) and reductions are earned if they drop below 90. On SLGS, after a week at the same dose, you'd need to run a curve....testing every 2 hours for 12 hours or every 3 hours for 18 hours and then make decisions on whether you should continue with the same dose for another week or increase. It's still always important to get the PS tests in and if at all possible, a mid-cycle on the AM dose and a "before bed" test on the PM cycle

The one BIG problem is the dry food...although you're right that the Evo is lower carb so it's much better than DM, it's still dry and that means it's not possible for Belle to be on Tight Regulation.....but we've had some cats on SLGS get into remission too
 
icesnow said:
@Chris & China

thanks chris, will keep that in mind.
so, what dosage should be given to him after 4 more cycles?

yes, i will check out the lantus forum when i get home later tonite

tested him again 2 hrs after insulin @ 1pm, his BG is 266
and the Evo dry food just arrived, so i hv replaced the DM dry, hopefully that would also help him a bit too

i will try to do one more test cycle PM after insulin (i tired last nite, but failed, not enough blood)
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Dear, did you buy dry food?
Please, dry food is not at all what your cat should eat. That will keep his glucose high. You need to feed wet, canned or raw, but NEVER DRY.
 
@Silvina Helena doesn't really have a choice about including dry food in her circumstances so she has bought a very low carb one. It's not ideal but everyone just needs to do the best that they can in their circumstances - but I love that you're looking out for this with people - definitely keep promoting that message :)
 
Oh Im trully sorry about that, I didn't know that part.
Well, do you know if dry can be mixed with little water? I read it somewhere and some people do, but the recipient then after the cat eats has to be cleaned up immediately, not leaving any leftovers, since they will get bacteria.

But if the cat is willing to eat dry with little water that will help to his kidneys and also with glucose.
 
thanks everyone.
one of the reason i hv a schedule of 11am/11pm insulin time is becos sometimes i get home late at nite, and don't want to miss his insulin time.

i just tested him PMPS (11pm), and his number is 221... even lower than his 2+ of 266 ! (1pm)... is that not normal?
PM +2.5 (130am) is 165

@Chris & China yes, i heat his ear with rice sock everytime. and use 30 guage. but he keeps moving around a lot. he keeps turning away so i cannot get to the blood... blood came out...then soaked by his fur... ... ...

i have been trying feed him more canned food now, but can't really totally take dry food off...
 
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do you have some Neosporin with pain relief ointment? Or some plain Vasoline? By applying a very thin layer before you poke, the blood will "bead up" instead of soaking into the fur
 
For dry food, if you must use it, check out Young Again 0 Carb online (about 5% calories from carbohydrate as we calculate it) or Evo Cat and Kitten Dry found in pet specialty stores (about 8% calories from carbohydrate as we calculate it)
 
this morning AMPS @ 1130am is 208
thanks for the advice, will try using Neosporin next time, let me go find/buy it
i just bought EVO per chris' advice, someone else also suggested young.again, but chris said EVO is better, and also price is lower than young/again. used to be on DM dry
(now i m mixing DM and EVO to slowly do the switch)

also, can someone tell me what is the normal BG number range (for cats on human meter) is?
thanks!
 
Evo isn't any "better"....just usually a little cheaper than the Young Again Zero Carb....but BOTH are much better (carb-wise) than the DM!!

Normal numbers on a human meter are 50-120
 
i was out for the day , and just got back home, tested him again @ around 9pm, and he is 106 @ 9+
just gave him his dinner. n i saw that he ate some Evo dry when i was out
 
Just a little something to remember for "next time"....We've seen that +2 be a lot like a crystal ball in a lot of cats, so it's a good test to get to get an idea of what might be going on later in the cycle

If the +2 is about the same as the Pre-shot, usually they're going to have a fairly "normal" cycle...slowly dropping to nadir and then slowly heading back up until the next PS

If it's higher than the PS, that can indicate the beginning of a bounce and those are the cycles where you can usually get by without testing as much

If the +2 is lower than the PS, that's your "early warning"....those are the cycles where it's important to try to get more tests in...but if you can't, you might want to leave some higher carb food down for him....it sounds like he may have "helped himself" today by eating the Evo
 
so, in a normal cycle, the +2 should be higher than the PS?
his testes indicates that he always have a lower +2 than the PS, which is not a good sign?
does that mean the dosage is too high?
 
It's really too early to say what Belle's "normal" cycle is going to look like

icesnow said:
so, in a normal cycle, the +2 should be higher than the PS?
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No...if the +2 is about the same as the PS, that's usually a more normal cycle

icesnow said:
his testes indicates that he always have a lower +2 than the PS, which is not a good sign?
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On 11/26 AM cycle...his +2 is about the same number as his AMPS (remember, all meters are allowed a 20% variance)....but again, since he's so new to the sugardance, he's not going to have really "normal" looking cycles yet.

Now last night, when he went from 221 to 165 in 2 hours, I would have tried to get another test in at about +4/+5...that's a pretty significant drop (as was 11/25's AM cycle and this morning's)

icesnow said:
does that mean the dosage is too high?
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For now, you just want to hold this dose for 7 days (unless he drops below 90 at any time)...as he gets further along and you get more data, you'll start to learn to watch for certain patterns that are unique to Belle
 
@Chris & China
i just tested him his PMPS, his BG is very low, 77, (despite he just had dinner 2 hrs ago), should i skip his insulin tonite ?
afraid he might go hypo at night
 
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Since you're doing SLGS, that drop to 77 earns him a reduction in dose....down to 2.25

If I could stay up with you tonight, I'd encourage you shoot a reduced dose, but my internet connection has been lousy tonight

It'll be safer for Belle to just call it a "furshot' and start over tomorrow morning but at the new 2.25U dose
 
thank you , what is a "furshot" ?
i would not be able to stay up with him, so should i skip tonight? and start tomorrow.
 
test AMPS 1230pm, his BG is 281,
the syringe i hv goes up per unit, so when i was giving him 2.5, i kinda go between 2 & 3
now, i just gave him 2.25, bit above 2
 
icesnow said:
thank you , what is a "furshot" ?
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A furshot is what we call it when we try to give a shot of insulin, but it doesn't all go INTO the cat...like if the cat moves as you're pushing the plunger. Even if you know you gave a furshot, you never try to go back and shoot over again though since there's no way to know exactly how much insulin actually got into the cat

Sometimes when we skip the dose on purpose, we'll just say "call it a furshot"....either way it means you either didn't shoot at all or you're not sure how much might have actually gone into the cat so you just hang in there and wait for the next shot time

When you skip on purpose, you can put N.S. into the U column on your spreadsheet...that means "No Shot"

It'll help with those ".25" doses if you'll get some syringes with half unit markings. We all wish they'd make syringes with .25 unit markings, but half unit is as low as they go
 
I want to invite you over to the Lantus Forum too. Now that you have the basics down, it'll be best for you to start posting over there so you get the most experienced eyes watching over you and Belle.

Each day (I'd start today if you have the time) you start a new post with the date, cats name and the AMPS number in the subject line....so for today your subject line would read

11/29 Belle AMPS 281

As the day goes on and you get more tests in, you "edit" the subject line and add the new test results (if you look at other posts in the Forum, you'll see what I mean)

In the body of the post you first put the link to the prior day's post (so it's easy for people to quickly go back and read what's been going on with Belle) and then just add information about how Belle is doing overall.....We call it the WCR (Whole Cat Report)

If you have a question, you'd also ask it in the body of your post...and if your post includes a question that day, you can use the ? "prefix" in your subject line so the people who scan the board will see that your post that day includes a question

Spend a little time reading others posts and you'll quickly pick up how we do it...and probably learn some things too!!
 
Chris & China said:
It'll help with those ".25" doses if you'll get some syringes with half unit markings. We all wish they'd make syringes with .25 unit markings, but half unit is as low as they go
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thank you for the explaination of the "furshot"

the syringes i can get here doesn't have the half unit markings, they strictly requires prescription here, i can only get what is prescribed + what is available
 
just tested him again +2 @ 230pm, his BG is now 170,
looks like a huge drop again

Belle was pretty mellow, but now he gets very angry about BG testing, and will put up with a fight
 
thanks,
tested him again +4 @430pm, and his BG is 85,
does it mean he earns another reduction?
 
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