Yosh is at 134 preshot

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JanetNJ said:
haha i did the same thing the first time cc had a preshot under 200... I fed her then came on here and they said don't feed her yet... and I was like , um, too late. lol well I would say jut give a little token dose of like .25 or you can skip.
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Ok I'll do the .25 but my needle thing only has 1u marks
 
how long ago did you feed her? If it was less than 10 min ago you can grab a quick test and just see what it is.
 
Stressedcatmom said:
I kinda want to cry. I have to go to wk in an hour
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The safest thing is to give no insulin this AM because you won't be home to monitor. You should post here tonight for advice before feeding him if you're unsure, although he'll likely be high enough if he has no insulin this AM.

The routine when confronted by a low pre shot is:
  1. stall without food for 20 minutes then retest
  2. repeat the stalling for up to an hour without feeding, retesting after each 20 minute increment
  3. post here for advice until you've learned how to handle these situations on your own.
 
Kris & Teasel said:
The safest thing is to give no insulin this AM because you won't be home to monitor. You should post here tonight for advice before feeding him if you're unsure, although he'll likely be high enough if he has no insulin this AM.

The routine when confronted by a low pre shot is:
  1. stall without food for 20 minutes then retest
  2. repeat the stalling for up to an hour without feeding, retesting after each 20 minute increment
  3. post here for advice until you've learned how to handle these situations on your own.
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Thank you. This stalling business is new to me
 
Just an FYI I gave him .5. Thank you again. Fingers crossed. He's been dieting and that may be helping? He's at about 2.5 cans a day
 
I emailed my vet about all this and this is what she said:

I am really sorry for the stress and confusion. I did receive your question about the B12, but not the other questions (or I missed them in the note); I believe Colleen was planning to call you back this afternoon since I was out of the office earlier this week. There isn’t a lot of firm research behind using B12 for neuropathy, but it certainly wouldn’t be harmful. The injectable is cheap - $24.60 for a large bottle (will last a year at least). You would start out with once weekly dosing.


If Yoshi is at 150 or less, do not give insulin. A curve on Friday is fine. If you start at 7:30, go until at least 2:30 in the afternoon. The insulin levels are likely to decrease after the morning dose, and at some point in the afternoon you will likely see them increase again as the insulin starts to wear off – this is normal and expected, although flat lines can happen too. You can stop the curve if you see the increase starting to happen earlier than 2:30pm.


Diabetes is a long-term management disease for cats, so unless you see numbers below 150, do not feel like you need to make rapid changes in dosing. Variable doses based on blood sugar readings are not necessary for all cats. We will decide on whether or not to reduce the dose based on the curve; typically we reduce by 0.5 to 1 unit per dose. Based on the spreadsheet, I think we will decrease Yoshi’s dose to 1 unit twice daily, since it seems like he is making progress.

I responded with:

Thank you for your response. Yes, I'd like the B12. Can I pick it up on Friday? Do I inject it like I do the insulin? Or do you think a pill form is better? I asked Colleen about the curve, but not about the insulin. He didn't drop really low until last night and this am.

So in essence, if he's at say 152 or 155, I am supposed to give him the full 2 units? This seems like a lot. He was in the 150's last night and I gave him 1 unit and he was at 140 something this am.

Whenever you get a chance.

Thought some of you would find this interesting, in case you wanted some afternoon reading...
 
Have you fed him already? If not, it's been about 20 min...I'd get another test to see if he's coming up.
 
Hmmm...okay. Well are you able to monitor tonight? I honestly wouldn't give very much considering how he was already low this morning and got such a tiny amount of insulin...and ended up still low tonight! You could give a token dose...like draw up to just above the zero line like Kris suggested this morning and monitor...get some tests in to see what happened.

Or you can skip. It's not ideal to skip a dose, but it makes me nervous that he's that low and at this point you don't have much data. If you don't feel able to stay up and monitor, this may be the best option.
 
In the future, if you get a number like that, stall for about 20 minutes WITHOUT FEEDING and test again. Then you can see if he's going up at all or not....that's good to do both because he might get to a higher preshot that you can shoot, and it will also help you see that he is going up...not down which helps you decide about shooting or not.
 
Stressedcatmom said:
He's at 150 amps. Today may not be the best day to curve. Vet said don't shoot if he's at 150
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It's probably still not a bad idea to get some random pretests in there, just to see where he's at throughout the day. It would give you an idea of how a lower dose on low PSs would affect him. For example, if in 4 hours he's up to 400, then you know you could have probably safely given him .25U or so to keep it from going up. (It does take a bit for the insulin to kick in, thus the "curve" shape, so a high number at +4 to +8 would indicate that it was ok to give a smaller dose.) I hope that makes sense, how I explained it.
And for the first time since diagnosis I joined the NS club today! It's a good feeling!!!
 
Stressedcatmom said:
He's at 150 amps. Today may not be the best day to curve. Vet said don't shoot if he's at 150
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He's right on the no shot margin. Are you at home today to monitor? If you are you could do a "mini curve" by testing at +3, +6 and +9 after giving 0.25 u again. It would give you a better idea of how he's doing because he might be on his way to remission. You need a lot more data though.
 
Frank's Mom said:
It's probably still not a bad idea to get some random pretests in there, just to see where he's at throughout the day. It would give you an idea of how a lower dose on low PSs would affect him. For example, if in 4 hours he's up to 400, then you know you could have probably safely given him .25U or so to keep it from going up. (It does take a bit for the insulin to kick in, thus the "curve" shape, so a high number at +4 to +8 would indicate that it was ok to give a smaller dose.) I hope that makes sense, how I explained it.
And for the first time since diagnosis I joined the NS club today! It's a good feeling!!!
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Congrats! I'm actually completely confused. I was going to curve today but not shire if I should even shoot w this #
 
@Stressedcatmom Do you have any idea how long Yoshi has had diabetes? I know you were just diagnosed, but had you seen signs of it for a while? The quicker you catch their diabetes the better the chance is that they go into remission, so maybe you caught it super early and he's already on his way to being OTJ.
 
Kris & Teasel said:
He's right on the no shot margin. Are you at home today to monitor? If you are you could do a "mini curve" by testing at +3, +6 and +9 after giving 0.25 u again. It would give you a better idea of how he's doing because he might be on his way to remission. You need a lot more data though.
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I'm home. I don't know what to do. The vet said to curve every two hours till 2:30 my time
 
Stressedcatmom said:
I'm actually completely confused. I was going to curve today but not shire if I should even shoot w this #
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That's a tough one. I'm at much higher dose than you are, so I would still give SOMETHING for a shot. But you're dosing what I'd give as an adjusted shot. I think Kris recommended a .25 IF you'd be home to test throughout the day, and that's probably what I'd do, too. You said you were going to do a curve today, so that tells me that you'll probably be around to monitor Yoshi, so you should be ok to do a small .25 and see what happens.
 
Stressedcatmom said:
I'm home. I don't know what to do. The vet said to curve every two hours till 2:30 my time
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Then go ahead with the vet's schedule. You need data on how Yoshi is responding and with the 150 being right on the cut off margin I think it's worth doing that partial curve.
 
Kris & Teasel said:
He's right on the no shot margin. Are you at home today to monitor? If you are you could do a "mini curve" by testing at +3, +6 and +9 after giving 0.25 u again. It would give you a better idea of how he's doing because he might be on his way to remission. You need a lot more data though.
Click to expand...
Frank's Mom said:
It's probably still not a bad idea to get some random pretests in there, just to see where he's at throughout the day. It would give you an idea of how a lower dose on low PSs would affect him. For example, if in 4 hours he's up to 400, then you know you could have probably safely given him .25U or so to keep it from going up. (It does take a bit for the insulin to kick in, thus the "curve" shape, so a high number at +4 to +8 would indicate that it was ok to give a smaller dose.) I hope that makes sense, how I explained it.
And for the first time since diagnosis I joined the NS club today! It's a good feeling!!!
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I think I understand now
 
Kris & Teasel said:
Then go ahead with the vet's schedule. You need data on how Yoshi is responding and with the 150 being right on the cut off margin I think it's worth doing that partial curve.
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The vet also told me to keep giving two units if he was above 150. I was like "what?!" Then she said you can do 1 u if he's 150-200, if it makes you more comfortable....
 
Going to give the .25. I hope the curve will still help even if he's at a way lower dose. He is def not a fan of all this ear pricking. I just hope we figure something out.

Rachel told me to test again 20 min after when this happens so I'm debating that. I just don't want any pokes that aren't vital
 
Stressedcatmom said:
Going to give the .25. I hope the curve will still help even if he's at a way lower dose. He is def not a fan of all this ear pricking. I just hope we figure something out.

Rachel told me to test again 20 min after when this happens so I'm debating that. I just don't want any pokes that aren't vital
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Rachel was suggesting the stall and retest technique to see if Yoshi's BG was coming up on its own. You have a different plan now:
  1. feed his usual low carb wet food then give 0.25 u
  2. test again in 2 hours as per your vet's curve instructions
  3. fit in his mid day meal so it's 2 hours before one of your curve tests
  4. be prepared to abort the curve if one of the BGs is too low (68 or lower on the AlphaTrak meter) by giving a higher carb small snack
  5. only do #4 if necessary
  6. update your SS as you go so we can follow.
Stressedcatmom said:
I don't get it. Aren't they vets? Why are all of you smarter than them
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Most vets have little training in treating feline diabetes so they follow some very general set of instructions or go at it as though they're treating dogs. People here live and breathe FD 24/7 and have amassed a huge amount of experience and knowledge about what works and what doesn't.
 
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Kris & Teasel said:
Rachel was suggesting the stall and retest techniques to see if Yoshi's BG was coming up on its own. You have a different plan now:
  1. give 0.25 u, then feed his usual low carb wet food
  2. test again in 2 hours as per your vet's curve instructions
  3. fit in his mid day meal so it's 2 hours before one of your curve tests
  4. be prepared to abort the curve if one of the BGs is too low (68 or lower on the AlphaTrak meter) by giving a higher carb small snack
  5. only do #4 if necessary
  6. update your SS as you go so we can follow.

Most vets have little training in treating feline diabetes so they follow some very general set of instructions or go at it as though they're treating dogs. People here live and breathe FD 24/7 and have amassed a huge amount of experience and knowledge about what works and what doesn't.
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Oh Jesus I just fed thin them was going to shoot. You said insulin first. Was that a typo? I hope?
 
We also understand the anguish of going against your vet's instructions, especially if he/she is otherwise a great vet. I've been there.
 
Kris & Teasel said:
Rachel was suggesting the stall and retest techniques to see if Yoshi's BG was coming up on its own. You have a different plan now:
  1. feed his usual low carb wet food then give 0.25 u
  2. test again in 2 hours as per your vet's curve instructions
  3. fit in his mid day meal so it's 2 hours before one of your curve tests
  4. be prepared to abort the curve if one of the BGs is too low (68 or lower on the AlphaTrak meter) by giving a higher carb small snack
  5. only do #4 if necessary
  6. update your SS as you go so we can follow.

Most vets have little training in treating feline diabetes so they follow some very general set of instructions or go at it as though they're treating dogs. People here live and breathe FD 24/7 and have amassed a huge amount of experience and knowledge about what works and what doesn't.
Click to expand...
Thank you for this. I will follow your instructions. Do you think this curve will even show anything with such low insulin? I'm eyeballing the .25 and it looks so small
 
Frank's Mom said:
@Stressedcatmom Do you have any idea how long Yoshi has had diabetes? I know you were just diagnosed, but had you seen signs of it for a while? The quicker you catch their diabetes the better the chance is that they go into remission, so maybe you caught it super early and he's already on his way to being OTJ.
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I don't know how long he's had it. He has neuropathy so he either had a bad hypo when I wasn't home once or he's had it for a while. No clue. He's always been a big eater which got him into this mess. But he was drinking water like a maniac I would say for about the past two months
 
Kris & Teasel said:
Rachel was suggesting the stall and retest techniques to see if Yoshi's BG was coming up on its own. You have a different plan now:
  1. feed his usual low carb wet food then give 0.25 u
  2. test again in 2 hours as per your vet's curve instructions
  3. fit in his mid day meal so it's 2 hours before one of your curve tests
  4. be prepared to abort the curve if one of the BGs is too low (68 or lower on the AlphaTrak meter) by giving a higher carb small snack
  5. only do #4 if necessary
  6. update your SS as you go so we can follow.

Most vets have little training in treating feline diabetes so they follow some very general set of instructions or go at it as though they're treating dogs. People here live and breathe FD 24/7 and have amassed a huge amount of experience and knowledge about what works and what doesn't.
Click to expand...
I go to a cat vet. They only treat cats. Which is part of the reason I'm so frustrated with them. I think I'm going to switch once this settles.
 
Stressedcatmom said:
Thank you for this. I will follow your instructions. Do you think this curve will even show anything with such low insulin? I'm eyeballing the .25 and it looks so small
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That's why you need to do a curve. However, insulin is a very powerful hormone and can have an effect even when the tiniest dose is given.

If you like your cat vet for everything else and they either:
  • will work with you as a hands on owner OR
  • you can agree to disagree without them going ballistic
then there's really no need to change. We can help you here with Yoshi's FD.
 
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