Caninsulin dosage advice needed please

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Diane and Monica, thank you both!
The vet asked me to contact him if I wasn't going to inject 1.0u. He does seem genuinely interested in Shelley's well being but he is quite adamant in his views and is already frustrated with me.
But as you say the final decision is mine.
 
I understand your vet's reasons but I think they need to be more flexible and open to adjusting the recommended dosage if it's not safe to carry on with the current dosage. As your PS numbers indicate I think you would be taking more risks by injecting one unit than a reduced dosage.. When I have to make a decision I always go with the more sensible option.
To me the vet's frustration is secondary compared to my pet's safety.
 
Monica Lewis said:
I understand your vet's reasons but I think they need to be more flexible and open to adjusting the recommended dosage if it's not safe to carry on with the current dosage. As your PS numbers indicate I think you would be taking more risks by injecting one unit than a reduced dosage.. When I have to make a decision I always go with the more sensible option.
To me the vet's frustration is secondary compared to my pet's safety.
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Agree 100 per cent!
 
Dear all,
I just wanted to share with all of you nice people as I know you've been rooting for me that I've just done a blood test on my own!
Took me 26 minutes, 7 attempts and 2 strips and nearly cost me a scratched out eyeball... but I did it!
I honestly hope that the saying 'things can only get better from here' is going to be accurately describing the situation here!
And after the 'CAN DO' attitude failed me the 'PULL YOURSELF TOGETHER WOMAN AND JUST DO IT OTHERWISE YOU AND YOUR KITTY WILL HAVE A SERIOUS PROBLEM ON YOUR HANDS' attitude took over..
Thank you everyone for having faith in me!
 
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Yeah Monica! Congratulations! It does get easier. I promise. Now give Josie a treat and grab some chocolate for you! You both earned a reward! :joyful:
 
MrWorfMen's Mom said:
Monica, I maybe blind but I didn't notice anyone mentioning the size of the lancets you are using. If they came with the meter, they may well be 31 or even 33 gauge and that may be part of your problem. If you can get some 28 gauge lancets (lower number means thicker needle) you may find your pokes are more successful first time.
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Monica, just remembered I meant to pick up on this yesterday...I looked on the Boots website where I think you said you got your meter, but couldn't see what gauge lancets come with it. It is worth checking the packet though for the reason Linda says. And I'm not sure if you're using some kind of pen/device that makes a clicking sound when you use it - if so that could be making life harder not easier... I would always just use a lancet freehand, easy to see/control what you're doing and no noise to startle Josie.
Have a good day!
 
Diana&Tom said:
Monica, just remembered I meant to pick up on this yesterday...I looked on the Boots website where I think you said you got your meter, but couldn't see what gauge lancets come with it. It is worth checking the packet though for the reason Linda says. And I'm not sure if you're using some kind of pen/device that makes a clicking sound when you use it - if so that could be making life harder not easier... I would always just use a lancet freehand, easy to see/control what you're doing and no noise to startle Josie.
Have a good day!
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You know I meant to get back to @MrWorfMen's Mom about the lancets as well as I looked into it but completely forgot!! So thanks for reminding me.
And thank you Linda for pointing this out!

We got a box of 100 lancets from Boots Pharmacy but even after both of us looking we just cannot find the size on the box! Will try to attach a photo of the box.

Going to the pharmacy today and ask specifically for a 28 gauge right?

Ps. The lancet pen device that came with the meter drove us bonkers so we ditched it within a day!
 
No I can't see mention of gauge on that packet either... too many foreign words to make much sense but no numbers that would suggest what we're looking for.
Yes 28 gauge... looked again on Boots site and you can get a box of 100 for £4.99... doesn't have to be a Boots store of course, you can get lancets at any pharmacy.
Much better to use lancet alone so you're on the right track there!
 
Diana&Tom said:
No I can't see mention of gauge on that packet either... too many foreign words to make much sense but no numbers that would suggest what we're looking for.
Yes 28 gauge... looked again on Boots site and you can get a box of 100 for £4.99... doesn't have to be a Boots store of course, you can get lancets at any pharmacy.
Much better to use lancet alone so you're on the right track there!
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They had a few to choose from but we didn't know the difference so just went with the big box with pretty colours! :D

Will go to town this morning and get the 28 gauge ones. Thanks very much ladies!
 
Actually... just did a quick search online for these lancets and I think they may be 28 gauge so no need to get more just yet... but to check you could take box into pharmacy and ask them.
 
Diana&Tom said:
Actually... just did a quick search online for these lancets and I think they may be 28 gauge so no need to get more just yet... but to check you could take box into pharmacy and ask them.
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Only have a few left so due for a new box anyway. This time will get the ones specifically saying 28 on the box..
 
You're quite welcome Monica! I did a quick check and the boxes here in Canada don't have a gauge on them either but the website for the lancing device they're made for, says the lancets are narrow gauge which likely means 31 or even 33 gauge. The narrow gauge seems to be fairly standard these days. I believe you can get Freestyle Lite lancets that are 28 gauge in your neck of the woods.

One other suggestion.....if Josie starts getting fidgety after you get some blood but before you get the meter to it, try to grab the bead on a topside of your fingernail and test from there. Works a treat when my middle furchild decides to supervise Menace and me at the wrong moment! ;)
 
I had another attempt earlier on with blood test and realise now that the problem is me and not the cat.
Josie sat on the table so patiently for a good 15 minutes letting me do stuff bless her little stripey cotton socks whilst I just kept poking and re-poking as nothing much came out. Wasted two strips as couldn't get enough blood. Eventually managed to do it but by then Josie was quietly growling and tried to scratch me..
Then my husband popped home two hours later and did another blood test on her on his own within 20 seconds including preparation!
I am so annoyed with myself for being such wuss. I will carry on as I have no choice but I feel so sorry for the poor cat!
I know EXACTLY what Im supposed to do and how to do it as watched my hubby probably a hundred times whilst holding Josie and countless videos I just haven't got the heart to pierce her ear firmly as I don't want to hurt her plus she cries every time I poke her so that doesn't help.
I'm grateful and taking on board what everyone suggested and I will keep trying but just wanted to say that Josie is a superstar and I am the total bum here...:(
 
Awwww you're not that bad Monica! Don't give yourself a hard time! You're not the only one who finds it tricky at first. It is difficult for those of us who are a bit squeamish and don't want to hurt our babies, but it's best not to think about it, I reckon, just get on and do it, sing to yourself or something as you prepare as a kind of diversionary tactic! The more you hesitate and get anxious, the harder it is to physically do it, take that lancet to your cat's ear, make it bleed... poor little thing, did it hurt her... oh dear I feel terrible about this... I must do it better next time... etc etc. It becomes a vicious circle.

Wasn't there some tv ad campaign recently with a slogan something like Just Do It.. I can't remember, it sounds vaguely familiar and it's appropriate in this case. The more matter-of-fact you can be about it, the better for you AND Josie, the more in control you make yourself, the less anxious you will be and the easier the whole procedure becomes.

Here endeth today's sermon.
 
I second Diana's thoughts. Don't beat yourself up. You'll get there and Josie will help you. Concentrate on how nice and calm she is and use that to bolster your courage. We are all cheering you on but please do be patient with yourself. This is still all very new! :bighug:
 
Haha great sermon thank you! I actually don't hesitate, I do get on with it, I even provide live sarcastic commentary of what Im doing to the cat, I just totally suck at it! lol
 
Monica Lewis said:
I had another attempt earlier on with blood test and realise now that the problem is me and not the cat.
Josie sat on the table so patiently for a good 15 minutes letting me do stuff bless her little stripey cotton socks whilst I just kept poking and re-poking as nothing much came out. Wasted two strips as couldn't get enough blood. Eventually managed to do it but by then Josie was quietly growling and tried to scratch me..
Then my husband popped home two hours later and did another blood test on her on his own within 20 seconds including preparation!
I am so annoyed with myself for being such wuss. I will carry on as I have no choice but I feel so sorry for the poor cat!
I know EXACTLY what Im supposed to do and how to do it as watched my hubby probably a hundred times whilst holding Josie and woke countless videos I just haven't got the heart to pierce her ear firmly as I don't want to hurt her plus she cries every time I poke her so that doesn't help.
I'm grateful and taking on board what everyone suggested and I will keep trying but just wanted to say that Josie is a superstar and I am the total bum here...:(
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Poke right through to the other side of you have to. No biggie. The video of me testing my cat I actually did poke all the way through which is why she twitched.... But really it didn't hurt.
 
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Hello everyone,
I've been laying low for a while for many reasons and just following relevant threads here and observing people's advice.

I had to take a step back as I've become so obsessed with the whole blood testing, getting frustrated by being unable to do it, constantly checking and analysing numbers and freaking out by seeing high numbers...etc. that general anxiety and no sleep took over my life.
So had to stop, breathe and remind myself that Josie is not a dummy test project with numbers but a real breathing stripy and very pretty pet creature who is still in need of TLC.
So I took a chill pill ( or more like a whole damn packet!) and made some changes.
Now I don't try to get her out by all means for testing from under the bush outside where she's happily laying all day long to hide from the heat. I'm still rubbish at testing but made a rule that if I don't succeed in 2-3 pokes and she's losing patience I just stop and let it go instead of getting both of us all worked up and end up in a cat fight! :) My husband is around for the important PS tests to do them and the rest will be bonus if/when I succeed. I will keep trying. I can only get better at it as I doubt that I could get any worse! :banghead:
Also accepted that I cannot control everything and make sense of all the numbers why so high or so low and I shouldn't get so obsessed with them just take them as they are. This way I get to keep my sanity! I also started paying attention to the rest of the family. They seem like nice people..
Josie is a happy cat right now on mid numbers and if I can get her BG well under control it will be great but if I can't it's not the end of the world.

So anyways now that I'm all chilled and Josie's been on 0.5u for 10 days I would like to ask your opinion on her dosage. @JanetNJ @MrWorfMen's Mom @Yong I think we should increase to 0.75u to get her in the healthy range for longer, @Diana&Tom suggested the same so I was just wondering if anyone else would support this or would suggest any different..?
I'm really embarrassed and apologise for the lack of readings compared to everyone else's, will try to get as many as I can if and when, we just have to make decisions based on these figures for now.
Thanks very much guys, have a nice day! :cat:
 
I have many positive things to say: :bighug:
  • kudos to you for recognizing your limits and that Josie is more than BG numbers!!! (this is a huge leap forward) :D
  • your attitude toward all this - finding a happy medium, recognizing the value of life outside of FD - is stellar :)
  • seeing that it's absolutely impossible to explain every number so there's no point in obsessing is a breakthrough :smuggrin:
  • this dose of 0.5 u seems to be working well for Josie right now - the blues yesterday were great but you still had a "Comfy Caninsulin Cushion" :woot:.
Many people stay stuck in those earlier fretting stages and then the FD takes over their life and they pay a price mentally, emotionally and physically. I've seen it here on FDMB.

Keep doing what you're doing - it's excellent! :cat:
 
It's so difficult to give a definitive answer... there are indeed some nice blues in the cycle but pre-shot numbers in the high pinks means that the Caninsulin isn't lasting as long as we want it to. I think I'd be inclined to try 0.75u on a day when you can be home to monitor and see how that goes... it may be that Josie gets better duration from that but if she drops too steeply too soon, we'd know that it's too much. Only trial and error gives answers sometimes.

I liked @JanetNJ 's suggestion of a sliding scale recently - can't recall whether it was on this thread or Anthony's latest one - sliding scales make sense to me although I know vets prefer consistency in dosing.

My overview would be that you're right to chill and not obsess over the numbers, but if you can get those pre-shot numbers down even a little, Josie will feel better for that and therefore so will you!
 
I too am impressed with your new found attitude. That above all will get you and Josie into a routine and well on your way to dealing with this without getting Josie in a fluff and so you can have a life too! I think you are doing marvellously with the testing.

I would suggest you try to get a test in every evening before bed. Ideally if you can test at +2 or +3 in the evening, it will give you a better idea of what Josie is or might do overnight. I am wondering if she is going lower overnight leading to more bouncing because a lot of cats do go lower at night. She is dropping more than 50% some cycles and while those low numbers look great on the spreadsheet, they can also lead to bouncing, I find it interesting that at a dose of 0.50u you saw some pretty low numbers mid May and I think at that point in time I would have backed off the dose to 0.25u to see how that worked for her.

While no one can say for sure, my gut feeling is that she is bouncing and if she were my girl, I'd drop her back to 0.25u for a few days and see how that goes. It can take up to 3 days for bouncing to settle. The goal would be to flatten out the cycles a bit so that the pre-shots are lower. That may mean the mid cycles won't be as low but Josie needs some time to get reacquainted with more normal BG levels so if you can keep the drops in BG to less than 50% of the pre-shot readings each cycle, I think she might flatten out a bit. Then if need be, you can raise the dose back up. Sometimes you have to coax the BG down rather than hit it with a hammer.
 
A few options here, Monica! Raise the dose a little, and monitor; reduce the dose to see if she's bouncing; or try a sliding scale. If she is bouncing as Linda suggests it would be good news because in the longer term you'd likely be looking at a lower insulin dose as the norm, which feels rather less scary than giving higher doses.

Maybe try one of these options for a few days, monitor as well as you can, and we'll all look in and see how it's going and if you need to stick with that option a while longer or try Plan B...
 
Agreeing with the others to your great progress and mindset :). I would be curious to see what the 0.25U does and if that isn't the right direction we can always try the increase. Keep in mind, bouncing can also show as flatter cycles. Wonderful you are able to get the two most important tests, the pre-shots :cat:. We understand the frustration and emotional/physical toll the sugar dance can take, feel free to vent here too :bighug:
 
@Kris & Teasel you actually made me cry with your nice words, thank you.

I knew I could count on you ladies for support and advice. Now I have 3 totally different approaches to choose from which all make sense, couldn't you all have just come up with the same answer to make it easier for me..?! :D

Making supper at the mo and generally buzzing around but will sit down later on, re-read your comments properly and have a think which way to go. Also waiting for the vet to get back to me with her advice as well so my DH can't say that I'm 'following some random stranger's advice on some internet cat forum'..:banghead:

Thanks very much everyone!
 
Monica Lewis said:
@Kris & Teasel you actually made me cry with your nice words, thank you.

I knew I could count on you ladies for support and advice. Now I have 3 totally different approaches to choose from which all make sense, couldn't you all have just come up with the same answer to make it easier for me..?! :D

Making supper at the mo and generally buzzing around but will sit down later on, re-read your comments properly and have a think which way to go. Also waiting for the vet to get back to me with her advice as well so my DH can't say that I'm 'following some random stranger's advice on some internet cat forum'..:banghead:

Thanks very much everyone!
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pick one, try it for a week or two, if it doesn't work, try something else. The most conservative approach is the .25 "Stop the Bounce" approach. Try it for a week. If it doesn't work, try the "Raise for Pinks" scale approach where you give a little more for the pink preshots. No way of knowing the best approach until you try it.
 
Monica Lewis said:
@Kris & Teasel you actually made me cry with your nice words, thank you.

I knew I could count on you ladies for support and advice. Now I have 3 totally different approaches to choose from which all make sense, couldn't you all have just come up with the same answer to make it easier for me..?! :D

Making supper at the mo and generally buzzing around but will sit down later on, re-read your comments properly and have a think which way to go. Also waiting for the vet to get back to me with her advice as well so my DH can't say that I'm 'following some random stranger's advice on some internet cat forum'..:banghead:

Thanks very much everyone!
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Oh my, Monica! I'm so glad I could help but I'm sorry I made you cry. :bighug: Yes, it's part of the FDMB thing that you'll get different viewpoints. It can be confusing or, viewed another way, give you options. We all think carefully before we offer our opinions and advice and it's always coming from a place of "do no harm". Think over what's been said along with your vet's take on it. Go with your gut in the end. :smuggrin:
 
So sorry if we've added to, rather than calmed any confusion about how to proceed, but in the early days, there can be a lot of trial and error because every cat is unique. Over time, Josie will reveal her unique way of dealing with the insulin but until then you may feel like you are doing a bit of a two step.....two steps forward and one step back. It's the nature of the beast.....there is no one size fits all. Make a decision that you are comfortable with and know this will get easier with time! :)
 
Well the answer is kinda presented itself as with low food intake and low-ish PMPS numbers decided to play it safe this eve with a reduced dose of .25U

To start from the bottom of testing out the dosage I suppose now from here maybe we should keep her at .25u for a few days and see how it goes and work our way up if necessary?
My only question is though shall I stick with the .25u for a few days regardless of the PS numbers being high if that happens to be the case..?

And Janet as for lancet I just bought a box of 200 28 gauge lancets last week, they seem to be good and working well for my hubby.
I think my problem is still that I hate piercing through cos I don't want to hurt/upset her and she squeeks and moves most of the time we pierce.. Also hate that 'crunching' sound as Im pushing the needle through ..eeww!!
But I just have to man up and get over it!
 
Ps. Just went to lure in cat from front garden but she's not interested whatsoever. Took her favourite freeze dried chicken treats happily but growled and moved away when I tried to get her inside..
I honestly don't know what's so fascinating about the front garden bushes that she does not want to move from there day or night!:arghh: Oh well at least she comes in to eat..
So I guess there will be no testing tonight... :(
 
Monica Lewis said:
My only question is though shall I stick with the .25u for a few days regardless of the PS numbers being high if that happens to be the case..?
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Yes Monica. If you hold the dose for a few days, it will be enough time for any bouncing to clear, if that's what's happening and give you a chance to see if the pre-shot numbers are coming down a bit. If after a few days you don't see any lowering of the pre-shots or the pre-shots are consistently higher, then I'd re-evaluate. It's the pattern of the readings (pre-shot and nadir) rather than individual readings that will shed light on how Josie is reacting and how to proceed. :)

Glad she made a decision for you! I'm sure you'd be scratching your head raw otherwise! :woot:;)
 
Kris & Teasel said:
Oh my, Monica! I'm so glad I could help but I'm sorry I made you cry. :bighug: Yes, it's part of the FDMB thing that you'll get different viewpoints. It can be confusing or, viewed another way, give you options. We all think carefully before we offer our opinions and advice and it's always coming from a place of "do no harm". Think over what's been said along with your vet's take on it. Go with your gut in the end. :smuggrin:
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Yes - different viewpoints and options can be confusing for the caregiver trying to work out the best course of action, but "go with your gut" is definitely where I would start off in this situation. Although we are all commenting based on what we see on your spreadsheet, there is inevitably also an element of our own experience and instinct coming into play. You're the one living with Josie and noting her behaviour throughout the day. This is exactly why we encourage people to post on the public forum and not give advice via PM... individual suggestions can be reviewed by other members and you get a nice rounded full picture. It's a bit like going straight to one of your favourite clothes shops for a new outfit v going to several shops and weighing up some other options you hadn't thought of but also look good!

So yes, make a decision and stick to it until say the end of the weekend. If you're going for the bouncing theory first, it may be tempting for you, if the 0.25u doesn't do enough or sends Josie higher than usual pre-shot, to raise the dose - but be resolute, it takes a while for the results of the experiment to become evident. If you're going for the sliding scale suggestion, you'd see the effect sooner. It will be very interesting to see what your vet says too.

Oh and don't worry about Josie hiding in the garden... in this heatwave we all look for the coolest places around the home and it may well be that a shady area outside is the most comfortable place for Josie. Hopefully it will cool down over the weekend and we can all - kitties included - get back to some kind of normal!
 
Yong said:
Just curious about "crunching" sound, that's usually something expected when going through cartilage. Shouldn't be any sound from the lancet poking through skin o_O. Even if you do go through.

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The crunching sound could just be in my head and I was imagining it as Im so reluctant to pierce..?
Yes I am aiming for the sweet spot and working my way more towards the edge these days. Got it right this morning, probably just got lucky..! :)
 
Monica Lewis said:
The crunching sound could just be in my head and I was imagining it as Im so reluctant to pierce..?
Yes I am aiming for the sweet spot and working my way more towards the edge these days. Got it right this morning, probably just got lucky..! :)
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It'll get better. You'll still have the odd complicated poke but they won't mortify you as much. Are you putting firm pressure on the poke spot afterward? That stops bleeding and prevents bruising.
 
Last three tests on my own I did it with only ONE poke I cannot believe it, honestly. There were tears of shock, relief and happiness.. :)

Next major challenge will be to master injecting insulin..!:nailbiting:

So PS numbers are high but weather's been hot, not eating daytime, she stayed outside for the night and didn't eat overnight, no exercise... etc. so will keep dosing .25 for a few more days is that right?

Although seeing red numbers making me a bit twitchy..
 
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OK Monica...
First, congratulate yourself on getting the knack of testing... I know it's horrible at first for some of us (I'm like you and a bit squeamish) but now you're on a roll and that should give you a boost!

I was almost exepcting to see those red pre-shots and it could be due to a few things. This dreadful heat is too much for all of us and I do feel sorry for our poor kitties and all animals come to that. It's stressful for them and that can raise BGs at the best of times.

Disregarding the heat... it MAY be that 0.25u isn't enough for Josie. It MAY be that she is showing the effects of bouncing... I'm just running off to work but I think you know the basic theory? Give it a bit longer and meanwhile do what you can to keep her cool and tempt her to eat. Actually I think thunderstorms are predicted for today so we'll all be moaning soon and wondering where the summer went...

I'll check in later...
 
Diana&Tom said:
OK Monica...
First, congratulate yourself on getting the knack of testing... I know it's horrible at first for some of us (I'm like you and a bit squeamish) but now you're on a roll and that should give you a boost!

I was almost exepcting to see those red pre-shots and it could be due to a few things. This dreadful heat is too much for all of us and I do feel sorry for our poor kitties and all animals come to that. It's stressful for them and that can raise BGs at the best of times.

Disregarding the heat... it MAY be that 0.25u isn't enough for Josie. It MAY be that she is showing the effects of bouncing... I'm just running off to work but I think you know the basic theory? Give it a bit longer and meanwhile do what you can to keep her cool and tempt her to eat. Actually I think thunderstorms are predicted for today so we'll all be moaning soon and wondering where the summer went...

I'll check in later...
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Thanks Diana,
I love thunderstorms and I love the wonderfully gloomy grey wet British weather all year round! :)

Ok will keep it at .25 for a bit longer.

It's a bit tricky to dose.25 on a 40u syringe and I think you offered me before, when you can find the time could you please give me the link to which ones are the best 100u ones in the UK that I should use? I am totally clueless when comes to needles..
Many thanks!
 
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Oh just one more thing, if Im unable to do curve right now what +hours would be the most important ones to aim for with the blood tests to get a better idea of her response to .25u? +2 +4 or +6?

I gotta pick one as don't want to push my luck when going so well or drag her out from under bush every two hours... Thank you
 
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