? 3/18 Millie AMBG 79 +9 294

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Sylvia & Millie

Sylvia & Millie

Member Since 2017
We are still trying to figure out Millie's dosing. She continues to go low at 2 U of Lantus. The ER vet last week said NOT to lower her insulin. We saw the regular vet on Friday and were told to lower to 1.5 and withhold insulin if she has a bg reading of 200 or less. Millie has been all over the place with her readings and my concern is the on/off of her meds might just exacerbate this. She was hospitalized twice in March for DKA. We skipped her dose this morning because her bg was 79 at the 19+ hr. She did not eat and seems quiet/tired. Her ketones have been negative.

We were planning on spending the day testing but we are low and meter strips, a new batch is coming later today. Once they arrive, we will begin testing every few hours.

Marjorie helped me with my spread and will be posting it on here for me soon.
 
Hi Sylvia. I'm still brand new at this, so I won't give any advice. But what I will say is that the vet had me doing the same thing with Chase... if he went under 200 I was to not give insulin. They had me doing several things that are no-no's, to include giving insulin without home testing. Then I came to this site. One of the things they have stressed the most to me, here, is consistency. The way I've changed Chase's food has made all the difference in the world. The people here are so wonderful and they have guided me every step of the way. Now Chase's numbers are very good. I know you will find good things here, too. :)
 
Sylvia

The last thing you should do right now is skip Millie's insulin. As I posted the other day, if you get a number below 150, you should not feed and post and ask for help and another member gave you an example of a subject title that would get ate tion such as "3/18 Millie AMBG 79 stalling need help".

You would have likely gottn some input with that title and stalling for 30-60 mi ut s might have shown her number rising so you could shoot some insulin.

At three hours past shot time, it will be difficult for you to get back on track. We sometimes do 18 hour cycles but I don't think that is a good idea with Millie. What I would suggest is you test her at + 21 (which would be +9 if you had shot) and post with the intention of shooting at +10 so you can get insulin into her as soon as possible.

I'll check back in later to see what she's doing today and what dose you should give later.
 
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Sorry, I didn't remember your original suggestion since it was a number of posts ago. I will test at +21 and write down how she is doing.
 
Sylvia & Millie said:
Eastern time zone. =21 is 6:00.

Just tested her, bg is 294.

Fructosamine test came out normal.
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So at 7 pm your time (15 minutes), she will be at +22, yes? If you shoot at 7 pm, you will be shooting two hours early. A couple things to consider:
  • do you have any flexibility in shot time because going forward, you will either continue to shoot on 7/7 or we move back the shot time in smaller increments. If two hours is too difficult for you to do, how about one hour? If you shot one hour early tonight, you could shoot late 30 mins tomorrow morning and 30 mins late tomorrow night to be back on 9/9 shot time
  • sometimes shooting early can almost act like a dose increase; some cats, it doesn’t affect them when they are this high but there isn’t enough data on Millie to know. If you shoot early, you will need to be able to test her at +2 and then see where she is going from there. If she’s headed down, you’ll have to be able to stay up and do some additional testing.
I wouldn’t get too wrapped around a fructosamine result. It’s just an average over a few weeks. Well regulated cats on insulin will also have a normal fruc test.
 
Recommendations for the 9:00 Lantus shot. We will be doing the SLGS approach (since it's what we've been doing from the beginning).

Should we leave the dose at 1.5?
 
I responded on your other thread about the SLGS protocol. Under that one you would reduce the dose by 0.25 u if you got a BG reading of 90 or less on a human meter. You're using a pet meter which reads higher so you could probably make the cut off point be 100 - 110. The green 79 this AM means a dose reduction to 1.25 u for this evening.
 
Kris & Teasel said:
I responded on your other thread about the SLGS protocol. Under that one you would reduce the dose by 0.25 u if you got a BG reading of 90 or less on a human meter. You're using a pet meter which reads higher so you could probably make the cut off point be 100 - 110. The green 79 this AM means a dose reduction to 1.25 u for this evening.
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Not true. The reduction point for SLGS for any meter, human or pet, is 90.
 
Kris & Teasel said:
I stand corrected.
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Let me explain why it's the same regardless of the meter the CG is using.

SLGS was developed specifically for human meters. There is no formula for converting human meter numbers to AT numbers. Roomp/Rand state in Management of Diabetic Cats with Long-acting Insulin that at the lower end of the normal range we use (so 50 on a human meter for TR), the difference is about 18 mg/dL. But that does not mean we can extrapolate it or make any other correlation. If a member decides to use a pet meter to do SLGS, than the numbers in that method are what they are. We should not advise differently or guess what they would be on an AT.

Further, I found in comparing my Micro to my AT, that the BGs did not always translate the same. In other words, a 60 on my human meter was not always an 80 on my AT. It varied and that was using the same Micro and the same AT the entire time I did comparisons.
 
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Marje and Gracie said:
Let me explain why it's the same regardless of the meter the CG is using.

SLGS was developed specifically for human meters. There is no formula for converting human meter numbers to AT numbers. Roomp/Rand state in Management of Diabetic Cats with Long-acting Insulin that at the lower end of the normal range we use (so 50 on a human meter for TR), the difference is about 18 mg/dL. But that does not mean we can extrapolate it or make any other correlation. If a member decides to use a pet meter to do SLGS, than the numbers in that method are what they are and we should not advice differently or guess what they would be on an AT?

Further, I found in comparing my Micro to my AT, that the BGs did not always translate the same. In other words, a 60 on my human meter as not always an 80 on my AT. It varied and that was using the same Micro and the same AT the entire time I did comparisons.
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Thanks for the explanation, Marje. :)
 
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