So he was started at 4 units twice a day? That's a VERY high starting dose. However, until you begin to gather blood glucose test results at this dose and while feeding him as you have been
don't change it.
Do you have a blood glucose meter to test him at home? If not, go buy a human meter at any pharmacy or go to Walmart and buy one of their ReliOn store brand models. You want one that uses test strips that give a result with a very tiny blood drop. I believe two popular ReliOn models are the Micro or the Confirm. You'll need test strips that work for the meter you choose - somewhere around $30 for 100 strips.
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Here's the basic testing routine we recommend:
- test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
- test at least once near mid cycle or at bedtime daily to see how low the BG goes
- do extra tests on days off to fill in the response picture
- if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
- post here for advice whenever you're confused or unsure of what to do.
We all rely on a member logging their BG data on this spreadsheet:
http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/
It's viewable by all members and is the first thing we look at before offering advice. There are techies on here to help set it up if you have a problem. Here's how the spreadsheet works:
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
If your kitty is easy to handle doing the blood testing by pricking his ear will be no problem. You might need to work a bit on desensitizing him to having his ears handled and it's best to set up a whole ritual around testing. Here's a link to a lot of helpful info:
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
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Here's an explanation of why too high a dose can lead to high BG numbers because of bouncing:
- BG goes low OR lower than usual OR drops too quickly.
- Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
- Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
- These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
- Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
- Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
- Many vets have little/no understanding of the bouncing phenomenon.
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When BG numbers are high we also recommend that you test urine for ketones. If ketones build up the kitty can become very ill and treatment is $$$$. Urine ketone test strips can be bought in any human pharmacy. Here are some tips for testing:
- put the end of the test strip right in his urine stream as he's peeing
- slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
- put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
That should get you started. Ask lots of questions. We're here to help!
