Dosing advice needed please

[shawna]

Hello,
Could anyone please look at my spreadsheet from this weekend (he just went out of remission on Friday) and give me advice on what is the highest number that I should NOT give a shot tomorrow? Because I have to go to work and I won't be home for about ten hours.
He eats breakfast and this is my second go around with him and insulin - so I feel more confident, but I still feel scared not being with him all day to keep an eye on him.
I'm using the Relion meter.

I'd just feel a little better with another opinion with my own.

Thank you...xoxo

 

[Rachel]

Hey Shawna! You got some great data this weekend. I think if he was under 200, I'd be hesitant to shoot since y ou can't monitor. Any chance you'd be able to stall before work if you hit a lower number? It looks like that 1 unit you gave today got him to a nice, safe, dark green at +4. Maybe give a reduced dose if he's at 200...like 0.75?

Do you leave food out? If you have a frozen chunk of his wet food you could leave that out and by the time it thawed out, he'd be closer to nadir and might eat if he needs to steer himself. Or if you have a timed feeder...several of our members had one that they'd set to open around the cat's nadir so they could eat if they felt themselves going low.

I'd hate to see you skip the shot really since you're getting some good momentum. I'll be here in the AM around 5 AM Central Time (roughly). Not sure if you'll already be gone by then or not.

 

[shawna]

Hey Shawna! You got some great data this weekend. I think if he was under 200, I'd be hesitant to shoot since y ou can't monitor. Any chance you'd be able to stall before work if you hit a lower number? It looks like that 1 unit you gave today got him to a nice, safe, dark green at +4. Maybe give a reduced dose if he's at 200...like 0.75?

Do you leave food out? If you have a frozen chunk of his wet food you could leave that out and by the time it thawed out, he'd be closer to nadir and might eat if he needs to steer himself. Or if you have a timed feeder...several of our members had one that they'd set to open around the cat's nadir so they could eat if they felt themselves going low.

I'd hate to see you skip the shot really since you're getting some good momentum. I'll be here in the AM around 5 AM Central Time (roughly). Not sure if you'll already be gone by then or not.

Thank you for your reply Rachel! Thank you so much...
I can't remember, how long does one stall for? And is the purpose of stalling to see if the number will go up before eating?
I leave for work around 6:30. But I will test him around 5am... I'm eastern time though...you are one hour earlier than me ...so my 6am is your 5am right..

I do usually leave his food out and by the time I get home from work I throw away any leftover and give him fresh food for dinner. He usually eats the food I leave out before I get home. Will cats instinctively know to eat if their blood sugar goes low? Not that I am going to count on that, just wondering.
And now leaving food out is kind of hard because I wouldn't know when he ate, although as long as I wait two hours before his pm shot I will be ok right?

 

[Rachel]

Yep, I'm an hour earlier than you. So I probably will not be here when you do your test.

Stalling is to see if he'll go up. Usually around 20 minutes without food...it's been known to work for close to 200s. It could help if he's not quite high enough so that you can still give a shot.

Yep, most cats do know when their BG goes low and will eat to steer themselves. It's not a guarantee, but it's pretty common...just like humans they know when they feel weird and they dow hat they can to help fix it.

You might look into a timed feeder so you can set it to rotate to an empty slot 2 hours before PM shot...that way y ou won't have to worry about it!

 

[shawna]

Yep, I'm an hour earlier than you. So I probably will not be here when you do your test.

Stalling is to see if he'll go up. Usually around 20 minutes without food...it's been known to work for close to 200s. It could help if he's not quite high enough so that you can still give a shot.

Yep, most cats do know when their BG goes low and will eat to steer themselves. It's not a guarantee, but it's pretty common...just like humans they know when they feel weird and they dow hat they can to help fix it.

You might look into a timed feeder so you can set it to rotate to an empty slot 2 hours before PM shot...that way y ou won't have to worry about it!

Good idea about the timed feeder...I'm going to look into it. For now though if I get home around 3:30 or 4, as long as I wait until 6 to do his shot it will be accurate right?

Ok if he is 200 I will try .75. My needles don't have any half markings but I feel I can eyeball it pretty good.
Tonight he was at 151 and I still gave 1U, and I'm going to test him at 5+ to see what it says...

I'll just be cautious. Just wish I could stay home with him or bring him to second grade with me lol.

Thanks for your help!!

 

[Rachel]

Yep, that will be fine! So you can leave the food out and know he's got that in his arsenal if needed.

If he's over 250 I'd go the whole 1 unit. Between 200-250 maybe do the 0.75. I'm not a fan of sliding scales, but since he threw that lower number before the nadir, a slightly lower shot for that number when you can't monitor will be good.

I hear you! These dang jobs get in our way!

 

[shawna]

Yep, that will be fine! So you can leave the food out and know he's got that in his arsenal if needed.

If he's over 250 I'd go the whole 1 unit. Between 200-250 maybe do the 0.75. I'm not a fan of sliding scales, but since he threw that lower number before the nadir, a slightly lower shot for that number when you can't monitor will be good.

I hear you! These dang jobs get in our way!

I just checked him at 4+ (after giving 1 unit when he was at 151) and now he is at 65.
That is way too scary if I wasn't home... so if by chance he is way under 200 I won't give him a shot.

I don't know that much but it seems like sliding scales are good for when numbers change a lot???

And it's ok for me to give him some food right now right? Even if he wasn't 65 I still feel like he needs a snack. And it's ok to feed him at night right? Just checking

 

[Djamila]

Yes, you can feed him. Did you change him back to low carb food again? Maybe that’s why you’re getting lower numbers?

 

[shawna]

Yes, you can feed him. Did you change him back to low carb food again? Maybe that’s why you’re getting lower numbers?

Yes I switched him back to his low carb food on Friday night when I got that first real high reading. He only ate the k/d food for about a week...and I am certain that caused him to go out of remission I guess it's called when he didn't need insulin.

Thanks for your reply! sometimes I feel he needs to eat more because he doesn't like eating just two big meals.

 

[shawna]

I'm going to start feeding him the weruva best friends food so it'll be low carb and good for his kidneys - just need to buy some! So until then fancy feast and pro plan are what he's eaten the last couple months when he didn't need insulin.

 

[Djamila]

Well, it looks like you caught his high numbers quickly since you've been good about continuing to test. Well done! As long as you're feeding him low carb you can pretty much feed him whenever he's hungry. We generally say to avoid feeding during the two hours right before the pre-shot test, but other than that it's fine for him to eat.

Hopefully since you caught it so quickly he'll head back into remission quickly too.

Sliding scales with Prozinc are often the cause of lots of bouncing, but when you have a kitty whose need for insulin is changing rapidly, you do have to adjust the dose quickly to keep him safe. It looks like Teddy might be in that category. I think Rachel gave you some good advice about being a little cautious with the dose since you won't be home, and I agree with her ranges as well.

And I'm pretty sure your 2nd graders would love it if you brought Teddy to class tomorrow!

 

[shawna]

Well, it looks like you caught his high numbers quickly since you've been good about continuing to test. Well done! As long as you're feeding him low carb you can pretty much feed him whenever he's hungry. We generally say to avoid feeding during the two hours right before the pre-shot test, but other than that it's fine for him to eat.

Hopefully since you caught it so quickly he'll head back into remission quickly too.

Sliding scales with Prozinc are often the cause of lots of bouncing, but when you have a kitty whose need for insulin is changing rapidly, you do have to adjust the dose quickly to keep him safe. It looks like Teddy might be in that category. I think Rachel gave you some good advice about being a little cautious with the dose since you won't be home, and I agree with her ranges as well.

And I'm pretty sure your 2nd graders would love it if you brought Teddy to class tomorrow!

Aw thank you yes I'm really hoping he gets back to where he was before this k/d food situation....I wish I would have known but I was caught up in worrying about his kidneys...so I guess it's all a learning experience...and I'll try my very best to get him back where he was.
And yessss my second graders would love it. I was their first grade teacher too (I went to second with them) so they know Teddy well and they love seeing pictures. I've even done videos where I do a voiceover pretending to be teddy talking and they crack up so bad lol!!!
Thanks for all your help! I'm going to be super cautious in the morning xoxoxoxo

 

[shawna]

Good morning,
At 5am Teddy tested at 125. Then I waited until 5:30 and he's at 137. That's a huge difference from the last two days!
He is eating now and I won't give him a shot. And I will check him tonight...and if he is high when I get home from work I can always give him his pm shot right.
I hope everyone has a nice day!

 

[Rachel]

Wow! Good numbers there Teddy! That no shot was a very good decision for today...and plus side you don't have to worry about him! And yes, you can give him his shot tonight as soon as you get home if he's high.

 

[shawna]

Wow! Good numbers there Teddy! That no shot was a very good decision for today...and plus side you don't have to worry about him! And yes, you can give him his shot tonight as soon as you get home if he's high.

Yay thanks for checking in, I appreciate you!! and I hope you have a lovely day!!

 

[Djamila]

Yeah! Go Teddy!

 

[Kris & Teasel]

Recent numbers look good, Shawna. How is he feeling aside from his neuropathy issues?

 

[shawna]

Recent numbers look good, Shawna. How is he feeling aside from his neuropathy issues?

Hey there!
Well I don't understand today's numbers...At pmps he was 153 and I gave one unit since I am home all night. It only went down to 124 and now at 6+ he is at 274. I guess from eating it went high? Actually those numbers are probably normal...I'm just use to him going lower from one unit with that low of a pre shot number.

Well besides the nerve pain he is ok! He is eating good. And I cuddle with him every day. But he can't walk very well...and some days not at all...I have to help him. But most days he can still limp to his litter box. The adequan shot that I give him works wonders!!! I can't give that often though...well the vet said there just isn't enough research on it so she said I can give it at my discretion. But I'm trying to wait at least over two weeks. But it literally lets him walk the next day!!!
I have to wash him a lot because since only three legs work he falls when he goes to the bathroom or he will step in it trying to get out. I don't mind doing any of this, of course, I just feel bad for him.

Some days I get really sad thinking he is not doing well and then other days he will limp over to his box and I think he is doing ok. It's been such a roller coaster of emotions. I sure do love this little guy, as we all love our fur babies. It just is so difficult going through this and watching them struggle.

Xoxoxoxoxoxo thanks for caring

 

[Djamila]

Last night when you gave him one unit and he went down to 65, what did you feed him at the 65? was that low carb food that took him to the 152?

 

[shawna]

Yes ever since I got those two high readings on Friday I switched back to his old food (until I can try him with the Weruva bff).

The whole time he didn't need insulin I fed him the pro plan pate for 11+ cats and fancy feast...both the FF pate and sometimes the FF gravy lovers becaue his blood sugar stayed under 100 and he loves that stuff. I didn't give him the gravy one all the time though. And I made sure his numbers stayed in the right spot.

So the other night when he went to 65 he wouldn't eat the FF pate so I had him eat his gravy lover chicken one because he ate all of it.

Yesterday when the one unit didn't really seem to do much? he had a couple bites of both pro plan and ff gravy lovers. I probably neeed to give no ff gravy until he is regulated again. He just gobbles it lol..I only give that once in awhile when he was within good numbers. But maybe until I get to those numbers again, hopefully.

This morning he is at 140, so I won't give him a shot before I go to work again. Last night he went up to 274, that must have been a spike from his food??

So long question short, lol! yes I'm back to the food that he stayed in good sugar levels and I am hoping once I get some he likes the weruva bff food so that it can be low carb and good on kidneys I was told.

Xoxoxoxox I hope you have a good day!

 

[Djamila]

If you do shoot tonight, I would recommend lowering the dose and maybe trying 0.5u. I'm guessing that the 274 was a reaction to too much insulin. I could be wrong and it could be a legit high number, but if you lower the dose and he goes high again, then we'll know and you can raise it again for the next time.

 

[shawna]

If you do shoot tonight, I would recommend lowering the dose and maybe trying 0.5u. I'm guessing that the 274 was a reaction to too much insulin. I could be wrong and it could be a legit high number, but if you lower the dose and he goes high again, then we'll know and you can raise it again for the next time.

Thank you! Does too much insulin cause high numbers??? I never knew that I don't think? I thought the more insulin would heal the pancreas? And not too much where they go too low though. I'm interested to know...either I am confused or I didn't know that! Thanks so much for sharing!!!!

 

[Djamila]

Sometimes if a cat gets too much insulin, the liver will dump a bunch of glucose and it makes the numbers go up. If you keep giving too much, you'll usually start to see bouncing. Since it was just one cycle, it's really not enough to know yet, but since he stayed in the blues all day without insulin, it made me wonder if he really needed that much in the evening. Especially since that 274 seemed a little odd and out of place. It's one of those "time will tell" kinds of things. A lower dose is just a guess.

 

[shawna]

Teddy is at 142 for his pm pre shot -- should I
still give him a little insulin?
Edit - I gave him 0.25
It's hard to really tell since these needles don't have any marks besides while units, but I did my best to get .25 - it was the tiniest amount.

 

[shawna]

Sometimes if a cat gets too much insulin, the liver will dump a bunch of glucose and it makes the numbers go up. If you keep giving too much, you'll usually start to see bouncing. Since it was just one cycle, it's really not enough to know yet, but since he stayed in the blues all day without insulin, it made me wonder if he really needed that much in the evening. Especially since that 274 seemed a little odd and out of place. It's one of those "time will tell" kinds of things. A lower dose is just a guess.

Ok thank you!! Good info to know! I think I got over confident and thought giving him one whole unit would be beneficial to him since I would be home last night to monitor him. But that makes sense now. Thank you....with all my heart! This is complicated stuff! I'm glad for everything I've learned here for sure!

 

[shawna]

Sometimes if a cat gets too much insulin, the liver will dump a bunch of glucose and it makes the numbers go up. If you keep giving too much, you'll usually start to see bouncing. Since it was just one cycle, it's really not enough to know yet, but since he stayed in the blues all day without insulin, it made me wonder if he really needed that much in the evening. Especially since that 274 seemed a little odd and out of place. It's one of those "time will tell" kinds of things. A lower dose is just a guess.

Djamila, I think you were definitely right! His numbers tonight with only 0.25 insulin (tried my best to get that) seemed to work so well!! Thank you for sharing that information with me...that was definitely something new I learned.

xoxoxo