Dosing advice needed please

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Myrtlesmum

Myrtlesmum

Member Since 2017
Ok, so Myrtle is very resistant to me testing her bg levels (has let me only do it twice so far) so I've been taking her to the vet once a week 5 hours after her am dose to get her checked at her most likely lowest bg point. 1st Saturday her bg was 12.2 (219), 2nd Saturday her bg was 11.2 (202), and yesterday (Friday as I couldn't go Saturday) it was only 4.2 (76) so the vet kept her a few extra hours and at 4.30pm - 2 hours before she was due for her next shot - it was 11.5 (207) - he said to go ahead and give her her usual dose as her bg was still a bit high.

I felt it was a bit low and I just gave her 1iu instead of her usual 1.5iu in the evening. This morning when she was due for 1iu, I gave her what I call a "conservative" one just above the 1iu line so a tiny bit less. Miracle of miracles, 5 hours after her dose this morning she let me test her bg! and it was 4.2 (76) again. So I have some questions would it be the insulin or diet bringing on this lower bg levels (even though she is still eating carbs it is less and lower cal than previously and she is eating much more wet food - she has also lost some weight in the last few months). Do you think I should lower the dose? Vet says to leave it but I don't want her having a hypo? I know I should test her regularly and I will try but Myrtle is very much a cat who only wants to be touched on her own terms and has started running from me sometimes now when she sees me coming because she thinks I'm going to do something to her :(. ( I actually named her after the main character in the book/movie "The dressmaker" who is very tough and prickly and pushs everyone away but she really just wants to be loved and accepted.)

Anyway, any advice would be greatfully accepted. Thanks!
 
Just adding that I managed to test her again just now - 10 hours after her morning dose and 2 hours before her dinner and next dose is due and her bg is 185. Is it OK at this reading to give her her insulin dose? What are the cut offs? That is, what is the lowest bg level at which you would give the next dose?
 
I would say that with a BG this low you shouldn't give insulin. You don't have enough data to know where she'll go. Do the best you can to get Myrtle with the testing program because BG data is how we judge a dose and keep out kitties safe. There's really no other way. Would you consider setting up a spreadsheet like the one we use here? It's viewable by all members and it the first thing we look at before offering advice.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
what kind of insulin is it? is it a human meter or pet meter? Could you add the insulin and meter type to your signature, please? Now that she's starting to be more cooperative with testing, you may consider setting up a spreadsheet which will make it easier for people to give dosing advice. If the BG is under 200 at preshot don't dose. If it's close to 200 please consider doing a reduced dose... like .75
 
Hi, thanks for the advice, in the end I did end up giving her about a .75 dose. She had had a snack and I guessed that 2 hours after I tested and her dose was due and she would have dinner her bg would be up further. She was fine all night and I just gave her .75 again this morning. I had done a signature before posting this morning but it didn't seem to appear - don't know what I did but it looks like it's showing now? I didn't put what meter I use - it's an Accucheck Proforma human meter. The insulin is isophane an intermediate acting human insulin where nadir in cats should happen at 5-6 hours (so far we've been testing her at 5 - 5.5 hrs). Also I feel so bad - I noticed this morning that I have pierced a hole through her ear on the opposite side of where we are supposed to prick! I was so nervous I did it in the wrong spot (but it bled well) do you think it will heal? Will try to do a spreadsheet but testing will probably be quite irregular .....
 
Myrtlesmum said:
Hi, thanks for the advice, in the end I did end up giving her about a .75 dose. She had had a snack and I guessed that 2 hours after I tested and her dose was due and she would have dinner her bg would be up further. She was fine all night and I just gave her .75 again this morning. I had done a signature before posting this morning but it didn't seem to appear - don't know what I did but it looks like it's showing now? I didn't put what meter I use - it's an Accucheck Proforma human meter. The insulin is isophane an intermediate acting human insulin where nadir in cats should happen at 5-6 hours (so far we've been testing her at 5 - 5.5 hrs). Also I feel so bad - I noticed this morning that I have pierced a hole through her ear on the opposite side of where we are supposed to prick! I was so nervous I did it in the wrong spot (but it bled well) do you think it will heal? Will try to do a spreadsheet but testing will probably be quite irregular .....
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piercing the ear is no big deal. I do it often. You can put a little neosporin with pain relief on it.
 
Thanks - that makes me feel better. No Neosporin in Australia - next time I'm at the vet or doctor I'll ask about an antibiotic ointment with pain relief - antibiotic ointments aren't available without a prescription here. I think most people would be surprised about Australia's limited choice of pet foods, insulins, meds and the restrictions on these things as well. Very frustrating sometimes.
 
Myrtlesmum said:
Thanks - that makes me feel better. No Neosporin in Australia - next time I'm at the vet or doctor I'll ask about an antibiotic ointment with pain relief - antibiotic ointments aren't available without a prescription here. I think most people would be surprised about Australia's limited choice of pet foods, insulins, meds and the restrictions on these things as well. Very frustrating sometimes.
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You can't get a first aid ointment for just cuts and scrapes in a pharmacy?
 
Yes, you can get antiseptic/disinfectant ointments which are quite different to antibiotic ointments. Also tend to have a really strong smell (the one I have at home does) and I don't know that a cat could tolerate that smell so close to her nose especially. Also don't know if it would be safe to use on her...
 
Kris & Teasel said:
I would say that with a BG this low you shouldn't give insulin. You don't have enough data to know where she'll go. Do the best you can to get Myrtle with the testing program because BG data is how we judge a dose and keep out kitties safe. There's really no other way. Would you consider setting up a spreadsheet like the one we use here? It's viewable by all members and it the first thing we look at before offering advice.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
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Thanks, I've done a spreadsheet now and linked it to my signature - did it in US measurements to make it easier for the majority to understand.
 
Congratulations on getting the spreadsheet up. I know testing is a challenge right now but it's very important to test before each shot (no food 2 hours beforehand) to see if the planned dose is safe.
 
Kris & Teasel said:
Congratulations on getting the spreadsheet up. I know testing is a challenge right now but it's very important to test before each shot (no food 2 hours beforehand) to see if the planned dose is safe.
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Unfortunately I get home from work about 15 minutes before her evening meal/shot and as I leave food out for her all day there is no way of knowing whether she ate 5 minutes before I got home or 5 hours before I got home. Same in the morning, and as I get up at 6am as it is, and always in a rush I don't know that it will be practical, I'm not 100% either and the lack of sleep I'm getting is already affecting my health. I don't really feel that I can get up at 3.30am to take her food away and then again at 5.30am to test her again. While I know your advice is the optimal thing to do, unfortunately I'm not up to being the perfect diabetes mum - but I'll do the best I can :)
 
Myrtlesmum said:
Unfortunately I get home from work about 15 minutes before her evening meal/shot and as I leave food out for her all day there is no way of knowing whether she ate 5 minutes before I got home or 5 hours before I got home. Same in the morning, and as I get up at 6am as it is, and always in a rush I don't know that it will be practical, I'm not 100% either and the lack of sleep I'm getting is already affecting my health. I don't really feel that I can get up at 3.30am to take her food away and then again at 5.30am to test her again. While I know your advice is the optimal thing to do, unfortunately I'm not up to being the perfect diabetes mum - but I'll do the best I can :)
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All we can do is the best we can. Just make the most of days off where you can really do proper testing and curves. :)
 
Myrtlesmum said:
Unfortunately I get home from work about 15 minutes before her evening meal/shot and as I leave food out for her all day there is no way of knowing whether she ate 5 minutes before I got home or 5 hours before I got home. Same in the morning, and as I get up at 6am as it is, and always in a rush I don't know that it will be practical, I'm not 100% either and the lack of sleep I'm getting is already affecting my health. I don't really feel that I can get up at 3.30am to take her food away and then again at 5.30am to test her again. While I know your advice is the optimal thing to do, unfortunately I'm not up to being the perfect diabetes mum - but I'll do the best I can :)
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I know how hard this FD thing can be. I like JanetNJ's suggestion to do more on days off if possible. :)
 
You have a lot of nice green mid cycle readings..... But it makes me wonder what the preshots are. Can you test /feed/shot within a short time span? I'm glad you started reducing to 0.75.
 
JanetNJ said:
You have a lot of nice green mid cycle readings..... But it makes me wonder what the preshots are. Can you test /feed/shot within a short time span? I'm glad you started reducing to 0.75.
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I've done a preshot reading last night and tonight and they were fairly consistent so I'm hoping I can assume that the morning preshot would be about the same seeing as she tends to eat about the same during the night as she does during the day? maybe even a little bit more. I'll try to get an am preshot too. By the way, on my spreadsheet where it says <1 it's what my vet calls a miserable one compared to a full one unit. I'd say it's about 0.8 of a unit.
 
Myrtlesmum said:
I've done a preshot reading last night and tonight and they were fairly consistent so I'm hoping I can assume that the morning preshot would be about the same seeing as she tends to eat about the same during the night as she does during the day? maybe even a little bit more. I'll try to get an am preshot too. By the way, on my spreadsheet where it says <1 it's what my vet calls a miserable one compared to a full one unit. I'd say it's about 0.8 of a unit.
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It's what we call a skinny 1. :)
 
Myrtlesmum said:
I've done a preshot reading last night and tonight and they were fairly consistent so I'm hoping I can assume that the morning preshot would be about the same seeing as she tends to eat about the same during the night as she does during the day?
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Please do not take this the wrong way but NEVER assume. As soon as you do, kitty will throw a wrench in the works :cat: Always do AMPS and PMPS, even if that's all you do for the day. Myrtle is headed in a very good direction but that doesn't make her numbers predictable. We want her safe too :bighug:
Glad to see NPH is working for her too!
 
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