GA Dear Shelley, now at rest.

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Anthony Morgan

Anthony Morgan

Member Since 2017
My cats pre shot numbers are varying from 19 to 8. My vet insists that Caninsulin only works properly if given in the same dose consistently, 1.0u in my case. He says I should inject 1.0u as low as a pre shot number of 8.
As my cat had a hypo earlier this year this is making me very concerned that this could cause another?
Thank you for reading!
 
Anthony, I tend to agree with you. With Caninsulin, and a lower pre-shot with a 4.9 mid cycle during the previous day cycle, I'd be very wary of giving the full dose particularly on a night cycle when having to monitor intensely is not ideal. That said, the pre-shot of 10.6 could be slightly >11 or it could be slightly <10 given meter variance allowance. I always tend to be conservative particularly on night cycles when I cannot monitor as closely. That lower mid cycle can make kitty a little more sensitive to insulin for a few cycles too.

What you can do in a situation like this, if your schedule allows, is stall for 30 minutes without feeding Shelley and take a 2nd reading to see if she is rising on her own, staying steady or still dropping. If her BG is rising, then you could shoot the regular dose assuming she is very close to 11 mmol. If she is steady I'd reduce the dose slightly like 0.25u and if she is dropping I'd consider a big chicken shot of 0.25 to 0.5u. or just skip depending on the reading.

You have lots of data and a sliding scale of dosing might be something to consider at this point. I'm going to tag a member who has used Caninsulin and is good at suggesting sliding scales to get you more input on this.

@JanetNJ can you have a look at Shelley's SS and give Anthony your opinion/suggestions about a sliding scale. Thanks.
 
Hi Linda,
Thank you very much for your comments. What you suggest is basically what I have been doing. The 1st test this morning was 10.1. 2 hours later 10.3 with no insulin.
But the difficulty I have is that my vet says the sliding scale I have been using is causing the fluctuations in BG levels.
He wants me to shoot 1.0u consistently even at low pre shot levels and then do a curve after 10 days.
@JanetNJ has kindly had a look at my case before and confirmed that the sliding scale was the way to go.
Shelley is brighter on 1.0u but it is the hypo that worries me.
Thanks again!
P.s. sorry my spreadsheet is not right up to date, problems with my laptop.
 
Anthony, my feeling is that you know Shelly better than your vet ever will. You are aware of what's going on with her 24/7 and are in a better position to make decisions for her than the vet is. Our vets can give us guidelines but many don't seem to realize that this sugar dance is not a one size fits all proposition. Nor do they appreciate that they are NOT going to be the one dealing with a hypo cat in the middle of the night. You hold the needle and have to be comfortable with the treatment you are giving Shelley.

As for your vet's assertion that the sliding scale is causing fluctuating BG levels, I agree that in the early days when you are struggling to find the best dose, a sliding scale can muddy the waters but you have lots of data and at this point, can see how much she usually drops on several different doses so if you have any concerns at all about her possibly dropping too low, go with your gut. No two days' readings are identical even when you do consistently give the same dose with the same diet and activity so acting conservatively to keep Shelley safe and you sane is IMHO the only way to handle this. :)
 
Anthony Morgan said:
My cats pre shot numbers are varying from 19 to 8. My vet insists that Caninsulin only works properly if given in the same dose consistently, 1.0u in my case.
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If I gave Noah the same shot every time he wouldn't be here. Consistency is a fairy tale with too many variables. What and when he ate, did Lewis eat half his food when we turned our backs, did he eat and then promptly vomit in our huge basement, higher AM than PM. Your vet, like so many others, has his head buried in a book but you are there with your cat. If your cat goes HYPO all you'll get is a huge bill and his misplaced judgement.
 
Anthony, I know how frustrated you are about this and how you feel stuck in the middle, between wanting to do what the vet says yet knowing that his advice may not always be safe. You DO have to do what feels right for you. Shelley seems to throw an unexpected green now and then during the cycle and you certainly wouldn't want her going much lower than the 4s you've had a few times... you are well aware of the issues there.

I think for your own peace of mind, you have to make a decision about this... give 1u as the "default" dose, but when a PS number is around 10 or 11, either give a reduced dose or test again half an hour later, as Linda says, and make a decision then.

Vets just do not have the kind of hands-on, day-to-day experience of treating a diabetic cat to make sweeping statements about dosing... they may mean well and believe they are right, but as I think I've said a few times recently, cats are living beings, not robots...!
 
Linda and Noah & Me,

Thank you, I have just been getting the spreadsheet up to date.
Shelley was only picking at her food earlier which was another reason for caution. I just did another test and the result was 11.4.
I think I will wait until this evening now before I inject again.
Unfortunately my vet, who is fairly new but does discuss with senior colleagues, is adamant in his opinion, so I don't know how we can work together on this.
But I will have to continue to be cautious at these low numbers although I do worry that I am causing harm when I don't inject.
 
I think there are times when you just have to do what you have to do... does the vet need to know you don't always give 1u by looking at your spreadsheet? If he doesn't have access to it, don't show him so he won't know.
If you are pressed into explaining why you don't always give 1u just explain that you don't feel at all confident that the dose won't cause a hypo...
 
Diana&Tom said:
Anthony, I know how frustrated you are about this and how you feel stuck in the middle, between wanting to do what the vet says yet knowing that his advice may not always be safe. You DO have to do what feels right for you. Shelley seems to throw an unexpected green now and then during the cycle and you certainly wouldn't want her going much lower than the 4s you've had a few times... you are well aware of the issues there.

I think for your own peace of mind, you have to make a decision about this... give 1u as the "default" dose, but when a PS number is around 10 or 11, either give a reduced dose or test again half an hour later, as Linda says, and make a decision then.

Vets just do not have the kind of hands-on, day-to-day experience of treating a diabetic cat to make sweeping statements about dosing... they may mean well and believe they are right, but as I think I've said a few times recently, cats are living beings, not robots...!
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Thank you once again Diana. I have got the spreadsheet up to date and it looks like I will be skipping today's injection as Shelley is currently at 11.4.
 
Sorry, should have clarified. MrWorfMens' Mom and Janet NJ, among many others, have years and more years of practical experience, something not offered in any veterinarian college course. I was just giving you a pep talk. When it comes to actual medicine I defer to these members and, luckily for me, a vet who is willing to accept an alternate way of doing things. Her Dad was a vet as well and together we have taken care of 14 cats and a dog over the last 12+ years. Nothing is as simple as it seems. That's it for me, now you need help, not words. All my hope.
 
Diana&Tom said:
I think there are times when you just have to do what you have to do... does the vet need to know you don't always give 1u by looking at your spreadsheet? If he doesn't have access to it, don't show him so he won't know.
If you are pressed into explaining why you don't always give 1u just explain that you don't feel at all confident that the dose won't cause a hypo...
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That is a fair point and one way around the problem. It may be the best way to go.
 
Noah & me said:
Sorry, should have clarified. MrWorfMens' Mom and Janet NJ, among many others, have years and more years of practical experience, something not offered in any veterinarian college course. I was just giving you a pep talk. When it comes to actual medicine I defer to these members and, luckily for me, a vet who is willing to accept an alternate way of doing things. Her Dad was a vet as well and together we have taken care of 14 cats and a dog over the last 12+ years. Nothing is as simple as it seems. That's it for me, now you need help, not words. All my hope.
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Thank you very much, I am not doubting the validity of the advice received on the FDMB from the wealth of experienced members.
As you may notice, I am not blindly following the vets instructions but it's just that every time I get a low pre-shot number, I just have this doubt about what is best for Shelley. But obviously a few hours raised BG is much better than a hypo.
I appreciate the pep talk! Thank you!
 
Anthony Morgan said:
Thank you very much, I am not doubting the validity of the advice received on the FDMB from the wealth of experienced members.
As you may notice, I am not blindly following the vets instructions but it's just that every time I get a low pre-shot number, I just have this doubt about what is best for Shelley. But obviously a few hours raised BG is much better than a hypo.
I appreciate the pep talk! Thank you!
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EXACTLY, Anthony! A few hours' raised BG is better than a hypo. Let that be your watchword and repeat it to the vet if necessary.
 
Most vets do not see people who test their kitties numerous times a regular daily basis. You are basically doing mini glucose curves each day so you have very good data on how Shelley is responding. With Caninsulin you need to look at both the preshot number AND the nadir. Also insulin absorption can vary from day to day with each kitty. The whole point is to get Shelley into good numbers BUT also keep her safe. A sliding scale is not a good choice for someone who is not testing or is only testing periodically, but you have a lot of data.



This is a guideline from the Caninsulin manual used by MSD

http://www.msd-animal-health.co.nz/binaries/CAN-350-2010_Caninsulin_Tech_Manual_Web_tcm51-37406.pdf

PAGE 6:

Blood Glucose Curve Results Recommended Action:

Nadir < 3 mmol/L Decrease dose by 50%
Clinical Signs of Hypoglycaemia Decrease dose by 50%
Nadir between 3 – 5 mmol/L Decrease dose by 10% (Dogs) Decrease by 1 unit (Cats)
Pre-insulin blood glucose < 10 mmol/L (Dogs)
Pre-insulin blood glucose < 15 mmol/L (Cats) Decrease dose by 10% (Dogs) Decrease by 1 unit (Cats)
Nadir between 5 – 9 mmol/L and Pre-insulin blood glucose for dogs > 10 mmol/L Pre-insulin blood glucose for cats > 15 mmol/L No Change
Nadir > 9 mmol/L and Pre-insulin glucose values > 15 mmol/L If clinical signs present, increase dose by 10% (Dogs) Increase by 1 unit (Cats)
 
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Anthony Morgan said:
Thank you Diana, you have devoted so much time to my issues, so generous of you!
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You are very welcome, Anthony. I do sympathise with your dilemma! But I think you should have more confidence in yourself and how you're treating Shelley... you've actually had at least as much if not more information given to you than vets have, and you have a good handle on it all now. I think you will feel much better if you stick to a simple plan, a plan that gives you less worry and ensures Shelley is safe - the vet can say what he likes but he is quoting the textbooks and cats as we all know do not conform to the rules!!
 
Tuxedo Mom said:
Most vets do not see people who test their kitties numerous times a regular daily basis. You are basically doing mini glucose curves each day so you have very good data on how Shelley is responding. With Caninsulin you need to look at both the preshot number AND the nadir. Also insulin absorption can vary from day to day with each kitty. The whole point is to get Shelley into good numbers BUT also keep her safe. A sliding scale is not a good choice for someone who is not testing or is only testing periodically, but you have a lot of data.



This is a guideline from the Caninsulin manual used by MSD

http://www.msd-animal-health.co.nz/binaries/CAN-350-2010_Caninsulin_Tech_Manual_Web_tcm51-37406.pdf

PAGE 6:

Blood Glucose Curve Results Recommended Action:

Nadir < 3 mmol/L Decrease dose by 50%
Clinical Signs of Hypoglycaemia Decrease dose by 50% Nadir between 3 – 5 mmol/L Decrease dose by 10% (Dogs) Decrease by 1 unit (Cats)
Pre-insulin blood glucose < 10 mmol/L (Dogs)
Pre-insulin blood glucose < 15 mmol/L (Cats) Decrease dose by 10% (Dogs) Decrease by 1 unit (Cats)
Nadir between 5 – 9 mmol/L and Pre-insulin blood glucose for dogs > 10 mmol/L Pre-insulin blood glucose for cats > 15 mmol/L No Change
Nadir > 9 mmol/L and Pre-insulin glucose values > 15 mmol/L If clinical signs present, increase dose by 10% (Dogs) Increase by 1 unit (Cats)
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Hello Mary Ann,
It is really good to hear from you. That is very useful, I will study those figures.
Unfortunately the vet and I are on different pages and I don't seem to be able to make a convincing argument to get him to agree with me. He is very adamant about consistency and full day curves, the text book approach but not necessarily the safest approach for Shelley.
Best wishes!
 
Diana&Tom said:
I've said a few times recently, cats are living beings, not robots..
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I wish with all my heart that vets would acknowledge this and appreciate rather than berate any client who takes the time to really understand their pet and work so hard to keep them not only healthy but also safe which you are so evidently doing.

The next time the vet suggests you keep shooting 1u despite a lower pre-shot or a low nadir, ask for an after hour telephone number at which they promise to be available to deal with the fallout at any time day or night. ;) I'm betting that would turn off the negative rhetoric.
 
Diana&Tom said:
You are very welcome, Anthony. I do sympathise with your dilemma! But I think you should have more confidence in yourself and how you're treating Shelley... you've actually had at least as much if not more information given to you than vets have, and you have a good handle on it all now. I think you will feel much better if you stick to a simple plan, a plan that gives you less worry and ensures Shelley is safe - the vet can say what he likes but he is quoting the textbooks and cats as we all know do not conform to the rules!!
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Yes, I am sure you are right! Thanks again!
 
MrWorfMen's Mom said:
I wish with all my heart that vets would acknowledge this and appreciate rather than berate any client who takes the time to really understand their pet and work so hard to keep them not only healthy but also safe which you are so evidently doing.

The next time the vet suggests you keep shooting 1u despite a lower pre-shot or a low nadir, ask for an after hour telephone number at which they promise to be available to deal with the fallout at any time day or night. ;) I'm betting that would turn off the negative rhetoric.
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Absolutely.
 
MrWorfMen's Mom said:
I wish with all my heart that vets would acknowledge this and appreciate rather than berate any client who takes the time to really understand their pet and work so hard to keep them not only healthy but also safe which you are so evidently doing.

The next time the vet suggests you keep shooting 1u despite a lower pre-shot or a low nadir, ask for an after hour telephone number at which they promise to be available to deal with the fallout at any time day or night. ;) I'm betting that would turn off the negative rhetoric.
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That's a thought! Thank you!
 
Anthony Morgan said:
That's a thought! Thank you!
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Courage, Anthony!!!
Did you know that there have been occasions on this board when vets have eventually bowed to the superior knowledge of their clients who are members here and have educated themselves in all the ins and outs of FD... it takes a certain kind of vet to admit that but there are some. Remember, vets are like our GPs....they can listen, examine and diagnose, but they are not equipped with ALL the right information to treat EVERY disease that presents in the surgery. We humans have specialist diabetic clinics, don't we...can't expect that for cats but it does prove that diabetes needs more specialist treatment than the GP can offer. Same with vets. In this case, we on FDMB are the "specialists"!
 
Anthony Morgan said:
the text book approach but not necessarily the safest approach for Shelley.
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Anthony

The link I posted IS a text book approach. It is a Caninsulin technical manual that shows that sliding scales ARE used. In the beginning it is usually advised not to change the dosing for the first week and to do dose increases weekly as needed. However when it comes to hypos there is no hard and fast rule about holding a dose that takes your kitty too low. High glucose numbers are hard on a kitty's body over time, but a hypo can cause serious or deadly results. Once a kitty has been on Caninsulin for awhile the way Shelley has been, then dose changes need to be based on empirical data, which you are gathering each and every time you test. The often quoted ECID (every cat is different) plays such a big role in determining what approach to use. The body is not a static entity and needs can change daily. Caninsulin is one of the best insulins to use a sliding scale with since it is an "in and out" insulin and does not leave residual effects once it has worn off.

If changing the doses is becoming a huge area of contention with you and your vet, you could "lie" to him about what dosing protocol you are using and still follow your own gut feelings and the advice that everyone on here has given you. Not the approach I would prefer, but your data shows that a consistent dose is not the best approach. You need to do what is best for Shelley.
 
Tuxedo Mom said:
Anthony

The link I posted IS a text book approach. It is a Caninsulin technical manual that shows that sliding scales ARE used. In the beginning it is usually advised not to change the dosing for the first week and to do dose increases weekly as needed. However when it comes to hypos there is no hard and fast rule about holding a dose that takes your kitty too low. High glucose numbers are hard on a kitty's body over time, but a hypo can cause serious or deadly results. Once a kitty has been on Caninsulin for awhile the way Shelley has been, then dose changes need to be based on empirical data, which you are gathering each and every time you test. The often quoted ECID (every cat is different) plays such a big role in determining what approach to use. The body is not a static entity and needs can change daily. Caninsulin is one of the best insulins to use a sliding scale with since it is an "in and out" insulin and does not leave residual effects once it has worn off.

If changing the doses is becoming a huge area of contention with you and your vet, you could "lie" to him about what dosing protocol you are using and still follow your own gut feelings and the advice that everyone on here has given you. Not the approach I would prefer, but your data shows that a consistent dose is not the best approach. You need to do what is best for Shelley.
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Thank you Mary Ann. I just had to go out but I will have a close look at that later.
I think I will have to steer a middle course for Shelley's benefit.
As I have learnt here Caninsulin is an in and out insulin but I was only told last week at the vets, that it is long acting and yesterday's dose has an effect on today's BG. Obviously there is some doubt about the validity of this advice.
 
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Hmmm yes this an interesting point... I don't have the info to hand but @Tuxedo Mom will be able to tell you how Caninsulin works... it has a first and second stage, in simple terms. But there is also the issue of dose of course... a very small dose might be used up quickly and be completely out of the system by the time the next shot is due. So when you get a high pre-shot number it would suggest that the insulin is all gone, and when you get a lowish one it might mean that there is some overlap... but I don't think you can say anything with certainty. It would be interesting to see what others say about this.
 
Diana&Tom said:
Hmmm yes this an interesting point... I don't have the info to hand but @Tuxedo Mom will be able to tell you how Caninsulin works... it has a first and second stage, in simple terms. But there is also the issue of dose of course... a very small dose might be used up quickly and be completely out of the system by the time the next shot is due. So when you get a high pre-shot number it would suggest that the insulin is all gone, and when you get a lowish one it might mean that there is some overlap... but I don't think you can say anything with certainty. It would be interesting to see what others say about this.
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I have just done another test and Shelley's BG was 9.3. So I will not give a shot yet. If this were to continue I believe I would need to check for ketones?
 
Anthony Morgan said:
As I have learnt here Caninsulin is an in and out insulin but I was only told last week at the vets, that it is long acting and yesterday's dose has an effect on today's BG.
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From the Caninsulin manufacturer:


"
How does Caninsulin work in cats?

A lente (intermediate-acting) form of insulin, Caninsulin contains approximately 30 percent amorphous insulin for rapid onset of activity. The remaining approximately 70 percent of the formula is crystalline insulin which is absorbed more slowly. This formulation allows for a more continuous utilization of glucose to support the body's basic functions. In cats, the peak activity following subcutaneous administration of Caninsulin occurs between 1.5 and 8 hours (with an average of about 4 hours), and a duration of activity varies between 8 and 12 hours. Caninsulin should be administered subcutaneously twice a day in diabetic cats."

http://www.caninsulin.ca/faq-answers-p.asp

Caninsulin does not have any carryover and in many, many kitties the duration of effect is only an average of 8-10 hours, which is why you will see the numbers rising after this time. Some more advanced users have actually shot Caninsulin 3 times a day in order to keep glucose levels lower and level, because of this short duration. Again ECID as to how long a duration they will get from Caninsulin. You could try doing another full glucose curve...testing every 2 hours for 12 hours. The last full curve you did was March 5 and you will see that the effects were definitely wearing off at +10.

Because of the make-up of Caninsulin the faster acting portion will drop levels earlier in the cycle and then wear down. The slower acting portion is then working to keep the numbers more level. Some users will see a slight dip when the slower acting portion takes effect but it is no where as drastic as the initial drop from the fast acting part.

Not to be unkind but perhaps your vet should check with the Caninsulin manufacturer and get accurate information.


ETA The longer a kitty stays in better numbers the better the chance for the pancreas to start to heal itself (something that kitties are able to achieve) and begin working more efficiently at producing insulin again. There is no time frame for when this happens or how quickly this happens. With proper food and good glucose control the healing is happening. This is another reason that home-testing is so important and watching the numbers is critical. The endocrine system is a very dependant on everything working properly and if the pancreas decides to start "sputtering" into action again that will certainly affect the glucose levels.
 
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Anthony Morgan said:
Linda and Noah & Me, Thank you.
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A thank you is always nice, truthfully a little ego boost, but never required. We're all friends here.
Do you know how to "tag" someone? If you want someone's attention and they're in another thread do this:
Type @, then leave a space, then start typing that persons name. For example, as you slowly type N, then O, then A, a list will appear with all the members whose name matches what you've typed so far. With each letter you type the name gets more specific, then just click on the name and you're done. @Anthony Morgan
The tag will appear in that members Alerts. It can be helpful if that member is occupied elsewhere or even logged off. It's not rude so forget that part. We don't do rude here, only help. Make sense?
 
What do you think of this scale....

250+ (13.9) 1 unit
200-250 (11.1-13.9). 0.5 units
170-200 (9.5-11.1) 0.25 units
Below 170 just a small few drops
If the 0.5, and 0.25 prove to not be enough, you could shift it to be 0.75 and 0.5 respectively.
 
Noah & me said:
A thank you is always nice, truthfully a little ego boost, but never required. We're all friends here.
Do you know how to "tag" someone? If you want someone's attention and they're in another thread do this:
Type @, then leave a space, then start typing that persons name. For example, as you slowly type N, then O, then A, a list will appear with all the members whose name matches what you've typed so far. With each letter you type the name gets more specific, then just click on the name and you're done. @Anthony Morgan
The tag will appear in that members Alerts. It can be helpful if that member is occupied elsewhere or even logged off. It's not rude so forget that part. We don't do rude here, only help. Make sense?
Click to expand...

Certainly does!
 
JanetNJ said:
What do you think of this scale....

250+ (13.9) 1 unit
200-250 (11.1-13.9). 0.5 units
170-200 (9.5-11.1) 0.25 units
Below 170 just a small few drops
If the 0.5, and 0.25 prove to not be enough, you could shift it to be 0.75 and 0.5 respectively.
Click to expand...

Hi,
Yes, that makes sense. The last number I got tonight was 11.2 and I decided to inject 0.5u, so that fits. Unfortunately my current batch of syringes only have 1u increments, so it is a guesstimate. Thank you!
 
Anthony Morgan said:
Hi,
Yes, that makes sense. The last number I got tonight was 11.2 and I decided to inject 0.5u, so that fits. Unfortunately my current batch of syringes only have 1u increments, so it is a guesstimate. Thank you!
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Are there syringes with half unit markings available where you are? If so you may want to pick them up for fractional doses and use the 1u increment syringes when dosing 1 unit.
 
JanetNJ said:
Are there syringes with half unit markings available where you are? If so you may want to pick them up for fractional doses and use the 1u increment syringes when dosing 1 unit.
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Yes Janet, but I usually get the from the vets and the type vary each time I order. I will have to get some of the others.
Thank you!
 
It has been extremely hot today. Shelley had slept most of the day. She has eaten small amounts. I got a few tests in and the low point at +4 was 4.7 on 0.5u. She has just been in the garden eating grass. Just did the pmps which was 9.5 and she had about a tablespoon of food.
Trying to decide whether to inject 0.25u or skip the dose?
 
Do you think she filled up on grass? My old guy eats grass and then promptly divests himself of it if you get my drift so I'd be a bit concerned if Shelley tends to do the same! If you are sure she will eat more then I think 0.25u should be fine but if there is any question about her eating, conservative me would skip.
 
Hello Linda,
Thank you for replying. I think she ate only a few blades, which she does occasionally. It has made her sick sometimes.
It's a close call. As I said, it has been very hot today and I don't think it has agreed with her. I can test again a bit later and see where it's going.
 
Hi Anthony, how are things? Haven't seen you here for a while. Just looked at Shelley's ss though and am pleased to see some very nice numbers in the past week! Hope it continues.

Diana
 
Diana&Tom said:
Hi Anthony, how are things? Haven't seen you here for a while. Just looked at Shelley's ss though and am pleased to see some very nice numbers in the past week! Hope it continues.

Diana
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How spooky i was just wondering about Anthony myself today! Look forward to hearing from him
 
Monica Lewis said:
How spooky i was just wondering about Anthony myself today! Look forward to hearing from him
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Yes! And take heart from Shelley's numbers, Monica... look at the improvement over a period of time as the doses have been tried and tweaked... hopefully Anthony is feeling better about it all now.
 
Hi Diana and Monica,
Very nice to hear from you. Shelley's numbers have been keeping in a lower range. She seems well but I haven't noticed much difference in her behaviour, except not drinking as much.
Slight concern when she dropped to 4.3 on 25/6.
I decided to get in touch with the vet who treated her previously who is now at a different branch, just to see what he thought about dosing. Whilst he is an advocate of consistency, he did agree that a small dose was appropriate at these levels, 0.5 or 0.25u.
I did get some of the syringes with the 0.5 increments but still getting use to them. 0.25u seems even less on these, I did wonder if I had actually injected any. I'm sure I will get use to them though.
I am happier about these better numbers but still feel worried if I notice anything different around the time of the nadir. So just pressing on and keeping vigilant.
Thank you for looking in!
 
I wondered the same thing when I had to draw those tiny doses :). After you give her a shot, push hard on the plunger towards the needle. Chances are you'll still get a drop to come out from residual left in the needle. Don't give to her lol, just to see for yourself, if you push the plunger before drawing insulin, it does in fact draw a drop into the needle before you see it on the markings. I hope that made sense :smuggrin:
 
Anthony Morgan said:
Hi Diana and Monica,
Very nice to hear from you. Shelley's numbers have been keeping in a lower range. She seems well but I haven't noticed much difference in her behaviour, except not drinking as much.
Slight concern when she dropped to 4.3 on 25/6.
I decided to get in touch with the vet who treated her previously who is now at a different branch, just to see what he thought about dosing. Whilst he is an advocate of consistency, he did agree that a small dose was appropriate at these levels, 0.5 or 0.25u.
I did get some of the syringes with the 0.5 increments but still getting use to them. 0.25u seems even less on these, I did wonder if I had actually injected any. I'm sure I will get use to them though.
I am happier about these better numbers but still feel worried if I notice anything different around the time of the nadir. So just pressing on and keeping vigilant.
Thank you for looking in!
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Pressing on and keeeping vigilant is good, Anthony. You're doing really well, give yourself some credit!
 
Yong said:
I wondered the same thing when I had to draw those tiny doses :). After you give her a shot, push hard on the plunger towards the needle. Chances are you'll still get a drop to come out from residual left in the needle. Don't give to her lol, just to see for yourself, if you push the plunger before drawing insulin, it does in fact draw a drop into the needle before you see it on the markings. I hope that made sense :smuggrin:
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Hi Yong,
Yes it does, thank you. I actually tried with a used needle and some water and although not much appeared on the scale, it was there.
Kind regards!
 
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