PatJ responding to Djamila about spreadsheet

Hi Pat - I know this can feel so perplexing and overwhelming at the beginning.

To give you a frame of reference, a healthy non-diabetic cat will usually have blood glucose around 50-80. So you can see how high William is in relation to that. I would increase back to 2.5u on his next shot. Normally we do smaller increases, but when your lowest number is still not even yellow, it's okay to make a larger increase. So go ahead and do that tonight. He was starting to get some nice blue numbers at 2.5u before, so I'm hoping those will return in a cycle or two.

Try not to worry too much if he seems lethargic at this point, as long as he's eating. If he's lethargic and stops eating, that's when you need to be concerned. As long as he's enthusiastic about his meals though, he's doing okay.

I also just noticed your note that he's having some dental issues. When was his last teeth cleaning? Can you get him in for one sometime soon? Dental issues have a way of elevating BG and making it hard to bring it back down.
 
Thanks Djamila, Can I just ask you about what confuses me? I'm always nervous to give him 2.5 when his BG numbers are sometimes lower than others. That's why I dropped the dose. Big mistake! For example, doesn't happen that often, but sometimes his BG can be 15.0 mmol at shot time, and I'm always afraid that I'm overdosing him. So, of course I'll give him 2.5 from now on, but if the numbers drop much lower, should I still give him 2.5. And just to clarify, because I don't want to make a mistake, is 2.5 the next one up from 2.25? His teeth aren't covered in tartar, but he does have gingivitis which I wanted treated, but the vet said he was reluctant to treat it, because he said antibiotics would interfere with the insulin. Have you heard of that? Will let you know how he's doing in a few days. The vet is going to change him to Lantus some time in the next few days because he doesn't seem very good on Prozinc, but maybe it's my fault and might not be necessary. Thank you so much for your help. I really needed it!
 
15.0mmol is still quite high. It's okay to give the full dose on that number. Especially since you monitor so much. You are keeping a close eye on William. And if he got into the greens, all you need to do is give him some food and keep an eye on him.

You can post every single cycle if you want and ask for advice. There's no such thing as too many questions. This is a small forum, and there isn't always someone here, but someone will respond as soon as they can.

As far as switching insulin, Lantus is a great insulin and it's fine to switch if you and your vet think it's best. If you decide to stay with Prozinc, we are all happy to help you get into some better numbers. My hunch is that William is going to need a fairly large dose, no matter which insulin you use. So it will be important to be brave and keep going with the dose increases to help him reach some healthier numbers. You don't have to do that alone though. If you are in Prozinc-land, we are here to help, and if you switch to Lantus, there are kind people like @Chris & China who helped you with the spreadsheet, and she can keep an eye on you in Lantus-land. So either way you'll be fine.

I have not heard of antibiotics interfering with insulin, although I'm not as well versed in meds as others around here. I can say that I've had my kitty on antibiotics a few times over the years and it hasn't seemed to do anything but make his numbers better (because it helps heal whatever is ailing him). Maybe someone else can chime in and confirm or correct that.
 
Thanks Djamila for your help. I've been so stressed out about my poor cat, watching him lay about, worried about giving him the right dose etc, but reading what you've just sent me, I don't feel half so worried. Although I just wonder how long he'll have to go before he starts to feel better. And I will definitely get those antibiotics. I think my vet is genuinely concerned to help William because he takes a lot of time with him (unlike the first vet) but I think he is still on a learning curve with diabetic cats so maybe that's why he's cautious about giving them to him. Could I just ask you for future reference, what number is too low to give the full dose, because now and then he has gone a lot lower and I've ended up giving him nothing just because I was frightened of overdosing him. They say a little learning is a dangerous thing! Many thanks for all your help.
 
PatJ said:
what number is too low to give the full dose, because now and then he has gone a lot lower and I've ended up giving him nothing just because I was frightened of overdosing him.
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At the start it's usually recommended that you don't give a dose if BG is below 200 on a human meter like yours or around 250 on a pet meter. As you get a lot more data on your spreadsheet you can try slightly lowering that number to see where William's "margin" is. It varies with the kitty and how dramatic their response to insulin is. A reduced dose can also be given but, again, it takes experimentation and data on your spreadsheet to see how much of a reduction to use. It, too, is individual to the kitty.

Do you have any BG numbers you can put on your spreadsheet now that it's set up?
 
@Kris & Teasel - her spreadsheet dates start in August. If you scroll down a ways, you'll get to December and see the current data. She's really done a great job of monitoring, so there's lots of data to see what's happening. :)
 
Pat, I'd increase to 2.5 u today for sure. You dropped down from that on 13 Dec because the yellow PS scared you. I think the dose would have been safe at that PS as measured on a human meter.
 
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