Dosing Advice Needed asap please!

Status
Not open for further replies.
@Diane Engoron literally you sound EXACTLY like me last week. I also am up at 4-something every day, am pregnant, and can't stay up. I 100% promise it gets easier. When you have more data, the decision become much easier to make. You're in the thick of it right now -- the hardest part
Don't mean to get off the subject congratulations on the baby and Buzzy sure is a handsome boy, he looks big, just like my Tyler
 
Good morning everyone - I want to apologize for being so frustrated last night. Once 7pm rolls around, I'm so exhausted. I'm training for the NYC Marathon to run for an animal charity as well as taking care of 4 other cats, two of which are disabled so by nightfall, I'm tired, frustrated and just want to go to bed. Honestly, I'm really not a whiny person!

Wenchie did well last night after +2 testing - she was at 115. This morning, she was at 201 pre-shot, which I feel is some progress. What worries me is her vomiting. She vomited at 5am. She can't afford to toss up any food. She was vomiting more often and now it's like every day and a half to 2 days. Any suggestions what I can do to help her with this?

I will do a retest around +2 or +3 to see what's going on with the insulin.
 
When you say 5:30am, is that before or after eating while taking her insulin?
Vomiting can definitely wonk w/ numbers. Someone more advanced with it will have to give advice. My former diabetic foster became a puker and he puked alllllllllllllllllllll the time. Fortunately, he went into remission, so we didn't have to worry about insulin anymore. We put him on a twice daily antiacid, he also was on bp medication, and I had a whole routine for his vomiting episodes (we're talking non-stop for hours) that involved withholding food til it stopped, slowly reintroducing food, and Cerenia at the worst of it. We did also have to change his diet, which seemed to help for brief periods of time, but the vomiting always started back up.
 
When you say 5:30am, is that before or after eating while taking her insulin?
Vomiting can definitely wonk w/ numbers. Someone more advanced with it will have to give advice. My former diabetic foster became a puker and he puked alllllllllllllllllllll the time. Fortunately, he went into remission, so we didn't have to worry about insulin anymore. We put him on a twice daily antiacid, he also was on bp medication, and I had a whole routine for his vomiting episodes (we're talking non-stop for hours) that involved withholding food til it stopped, slowly reintroducing food, and Cerenia at the worst of it. We did also have to change his diet, which seemed to help for brief periods of time, but the vomiting always started back up.

It’s before insulin and before eating. My husband takes the food away somewhere between 3 and 4 am (he’s not a good sleeper) and the pattern of vomiting is early morning, before testing, feeding and shot. It’s very strange as she doesn’t vomit all day long. It always seems like it’s around this same time wHen she does (now every 2 days approximately).

Wow - your poor baby! I can’t imagine that kind of vomiting.

I have thought about cerenia many times.

I am retesting her at +3 to see where she is on her 1/4 unit of lantus. I was really happy with this morning’s number. What a difference a good night of sleep makes!

Have a wonderful day and thanks for your reply!!!
 
Just retested at +3 and it read 66, which is low. Gave her a teaspoon of FF Beef Feast with gravy. Her AMPS was 201 and she had 1/4 unit of Lantus, which now my husband and I think should be cut down with another similar reading. I will retest this afternoon, most likely at +7 or +8. Sheesh - this is so unpredicatable!!!
 
Retested at +4 - 32!!!! Karo and FF Beef Feast with Gravy (high carb). Can you imagine if we followed the vet's protocol and gave her 1/2 unit of Lantus! This is happening on 1/4 unit!

We have to run out to drop off the car but coming straight back home to be with her and retest at a little more than +5
 
Retested at +4 - 32!!!! Karo and FF Beef Feast with Gravy (high carb). Can you imagine if we followed the vet's protocol and gave her 1/2 unit of Lantus! This is happening on 1/4 unit!

We have to run out to drop off the car but coming straight back home to be with her and retest at a little more than +5
Thank God you tested him when you did, good job with the HC and Karo
Please let us know
 
32?! Have you retested yet? How's your kitty doing?

I know!!!! I retested at +7 and she is at 122. Now I realize just how important it is to retest when we get a low number. And thankfully I'm not following the Vet's protocol of 1/2 unit twice a day - could you imagine if I gave her 1/2 unit this morning????
 
Thank God you tested him when you did, good job with the HC and Karo
Please let us know

I keep two bottles of Karo and a ton of carb canned & dry food in the house. She's back up now. It will be interesting at PMPS to see what's what.

Is it anyway possible that she could finally be making her own insulin? My husband asked me that and I don't know the answer. I'm just happy we're home with her and can watch her.

This disease sucks!!!!
 
No apologies needed here. Ever. Sheesh, you were simply trying to help your Wenchie. We all understood.

And thankfully I'm not following the Vet's protocol of 1/2 unit twice a day - could you imagine if I gave her 1/2 unit this morning????
Yup, we could imagine what would happen if you were giving the vet recommended dose.
Or not home testing.

FYI for NEXT TIME
Change the title on your post when you get low numbers like that 32!!!! Late to do that now.
Do you know how to do that?
Put the 32 BG reading in your post, put the 911 prefix on your post and scream for help. Just like calling 911 for your local emergency services.

Don't need to do that now. But looking at the titles of posts helps us to prioritize who needs help faster.
 
No apologies needed here. Ever. Sheesh, you were simply trying to help your Wenchie. We all understood.


Yup, we could imagine what would happen if you were giving the vet recommended dose.
Or not home testing.

FYI for NEXT TIME
Change the title on your post when you get low numbers like that 32!!!! Late to do that now.
Do you know how to do that?
Put the 32 BG reading in your post, put the 911 prefix on your post and scream for help. Just like calling 911 for your local emergency services.

Don't need to do that now. But looking at the titles of posts helps us to prioritize who needs help faster.

Will do! I’m being optimistic when I say I hope I will never have to post this again! Thank you!
 
Are you still using an AlphaTrak meter? The 32 is even more worrisome if so.

What syringes are you using?

Please keep monitoring. Karo wears off quickly.
Yes still using the Alphatrak. And I’m still monitoring. Just on my iPad right now as my husband is on the desktop. She’s absolutely fine. Eating, purring, sitting on my lap. Very scary but thankful I knew what to do right away.

i am using BD Insulin Syringes, 31 gauge, 6mm length.
 

Attachments

  • EB80BD54-0BB2-43D8-B65E-6677F837976B.jpeg
    EB80BD54-0BB2-43D8-B65E-6677F837976B.jpeg
    67.7 KB · Views: 135
I keep two bottles of Karo and a ton of carb canned & dry food in the house. She's back up now. It will be interesting at PMPS to see what's what.

Is it anyway possible that she could finally be making her own insulin? My husband asked me that and I don't know the answer. I'm just happy we're home with her and can watch her.

This disease sucks!!!!
Yes it would be interesting to see what tonight brings, only a suggestion you might want to change your signature to read that you are giving 0.25 of lantus twice a day, only if you want to so members can take a quick look at it
 
A half unit is a very reasonable starting dose, but I too had a diabetic who was very sensitive to insulin and would show large drops in BG on very small doses. That’s why it’s so important to home test. Kudos for educating yourself and knowing exactly what to do when the BG went so low.

Has anyone asked or verified that you’re drawing insulin to the correct spot on the syringe? I mention that only out of an abundance of caution as we’ve had members inadvertently give 2.5 units rather than 0.25 by misinterpreting the syringe markings. It should be just barely past the very first line (zero line) on the syringe.
 
A half unit is a very reasonable starting dose, but I too had a diabetic who was very sensitive to insulin and would show large drops in BG on very small doses. That’s why it’s so important to home test. Kudos for educating yourself and knowing exactly what to do when the BG went so low.

Has anyone asked or verified that you’re drawing insulin to the correct spot on the syringe? I mention that only out of an abundance of caution as we’ve had members inadvertently give 2.5 units rather than 0.25 by misinterpreting the syringe markings. It should be just barely past the very first line (zero line) on the syringe.

Thanks for your response - I had a tutorial at my vet and I was adamant at making sure I was measuring correctly. When I draw the insulin, I then have my husband check the syringe before shooting. It's so nerve wracking!
 
A half unit is a very reasonable starting dose, but I too had a diabetic who was very sensitive to insulin and would show large drops in BG on very small doses. That’s why it’s so important to home test. Kudos for educating yourself and knowing exactly what to do when the BG went so low.

Has anyone asked or verified that you’re drawing insulin to the correct spot on the syringe? I mention that only out of an abundance of caution as we’ve had members inadvertently give 2.5 units rather than 0.25 by misinterpreting the syringe markings. It should be just barely past the very first line (zero line) on the syringe.

This is a great point, it's a bit uncommon (but not unheard of) for a cat to drop that low on .25 units of Lantus. With that 33 on the Alphatrak, I would lower the dose to .1 units if you were shooting a true .25 units. Here's a couple pictures of what .25 and .1 units look like. They're very small!
025unit-1.jpg
01unit-1.jpg


Don't get freaked out if Wenchies BG is high tonight. Often times you'll see high numbers a cycle or two after a hypoglycemic incident.
 

Attachments

  • 025unit-1.jpg
    025unit-1.jpg
    18.5 KB · Views: 351
  • 01unit-1.jpg
    01unit-1.jpg
    19 KB · Views: 384
This is a great point, it's a bit uncommon (but not unheard of) for a cat to drop that low on .25 units of Lantus. With that 33 on the Alphatrak, I would lower the dose to .1 units if you were shooting a true .25 units. Here's a couple pictures of what .25 and .1 units look like. They're very small!
View attachment 51441 View attachment 51442

Don't get freaked out if Wenchies BG is high tonight. Often times you'll see high numbers a cycle or two after a hypoglycemic incident.

Thank you for this pic! Now I know I’m right on target.

Her BG was 282 tonight so we shot a .10. I am thinking she is extremely sensitive to Lantus or the drug just works really well.

I will be retesting tonight just to double check.
 
Thank you for this pic! Now I know I’m right on target.

Her BG was 282 tonight so we shot a .10. I am thinking she is extremely sensitive to Lantus or the drug just works really well.

I will be retesting tonight just to double check.

Exactly what I would do! With Lantus, it's great to get at least 1 mid-cycle test, but perhaps one or two more if you're able. We do the preshots to make sure it's safe to give insulin, but the mid-cycle numbers really tell us how the insulin is working to lower her blood sugar. It's very hard to find the right dose with Lantus without a daily mid-cycle test(s).

I would hold the .1 units for 3 days (as long as she doesn't drop too low again) and see what happens! It's very possible some of those high preshot numbers you've been seeing the past few weeks are because she was dropping too low mid-cycle (because we generally see high numbers after a cat drops low).

This is great news--it's very possible she's going into remission quickly. Some cats do that after a diet change and/or a cleared infection and don't need insulin long.

I see that you're feeding the YA dry in addition to the canned food--just a word of caution, the YA dry can cause BG spikes in some diabetic cats. The starch used to bind the food is low carb, but not low glycemic, and some cats are sensitive to that more than the carb content. I could feed Bandit a lower glycemic canned food with 8-10% carbs with no affect on his BG, but his BG would spike after a handful of the YA zero. Just want to mention that in case you see some wonkiness in numbers after the .1 unit dose settles--if that happens, I would pull all the dry and see what happens before you raise the dose back up.

Good luck!
 
Exactly what I would do! With Lantus, it's great to get at least 1 mid-cycle test, but perhaps one or two more if you're able. We do the preshots to make sure it's safe to give insulin, but the mid-cycle numbers really tell us how the insulin is working to lower her blood sugar. It's very hard to find the right dose with Lantus without a daily mid-cycle test(s).

I would hold the .1 units for 3 days (as long as she doesn't drop too low again) and see what happens! It's very possible some of those high preshot numbers you've been seeing the past few weeks are because she was dropping too low mid-cycle (because we generally see high numbers after a cat drops low).

This is great news--it's very possible she's going into remission quickly. Some cats do that after a diet change and/or a cleared infection and don't need insulin long.

I see that you're feeding the YA dry in addition to the canned food--just a word of caution, the YA dry can cause BG spikes in some diabetic cats. The starch used to bind the food is low carb, but not low glycemic, and some cats are sensitive to that more than the carb content. I could feed Bandit a lower glycemic canned food with 8-10% carbs with no affect on his BG, but his BG would spike after a handful of the YA zero. Just want to mention that in case you see some wonkiness in numbers after the .1 unit dose settles--if that happens, I would pull all the dry and see what happens before you raise the dose back up.

Good luck!

Wow - thank you for your detailed response!!! It's funny, when I got the samples of YA, she went nuts. Now, I put it down next to her wet food and she doesn't touch it much. We're pulling it from her diet for at least the next week to see if it makes a difference. My other cats love it - which is good because I bought a 25 pound bag! Live and learn. The good thing is she LOVES all the wet food. I bought just about every FF pate brand (only one seafood and she gets that on Sunday mornings only) plus some Purina One and Pro Plan. I'm hoping that this radical change in diet is starting to kick in. My husband even said I wonder if she's starting to make her own insulin. Time will tell. I'm retesting her at +2 (in 45 minutes). She's acting normally right now - she opened one of the cabinets and is sitting on my dish towels, which she always used to do. I take that as a good sign.

I will definitely hold her to the .1 unit for at least 3 days depending on her BG number. I'm thankful I found this group because I really don't feel like my Vet knows enough about this disease. I like her but, like anything else, always do your own research. I guarantee if I hadn't found this group we would have lost her by now.

Thank you! Thank you! Thank you!!!
 
Exactly what I would do! With Lantus, it's great to get at least 1 mid-cycle test, but perhaps one or two more if you're able. We do the preshots to make sure it's safe to give insulin, but the mid-cycle numbers really tell us how the insulin is working to lower her blood sugar. It's very hard to find the right dose with Lantus without a daily mid-cycle test(s).

I would hold the .1 units for 3 days (as long as she doesn't drop too low again) and see what happens! It's very possible some of those high preshot numbers you've been seeing the past few weeks are because she was dropping too low mid-cycle (because we generally see high numbers after a cat drops low).

This is great news--it's very possible she's going into remission quickly. Some cats do that after a diet change and/or a cleared infection and don't need insulin long.

I see that you're feeding the YA dry in addition to the canned food--just a word of caution, the YA dry can cause BG spikes in some diabetic cats. The starch used to bind the food is low carb, but not low glycemic, and some cats are sensitive to that more than the carb content. I could feed Bandit a lower glycemic canned food with 8-10% carbs with no affect on his BG, but his BG would spike after a handful of the YA zero. Just want to mention that in case you see some wonkiness in numbers after the .1 unit dose settles--if that happens, I would pull all the dry and see what happens before you raise the dose back up.

Good luck!

As you said, she did have a bounce tonight - 387 at +2. She was really feisty and didn't want to be tested but we won this battle. She seems like she's feeling good tonight and happily eating her FF. I will be really interested in tomorrow morning's number.

I'm off to bed - night night! Thank you for all your help!!!
 
Thank you for this pic! Now I know I’m right on target.

Her BG was 282 tonight so we shot a .10. I am thinking she is extremely sensitive to Lantus or the drug just works really well.

I will be retesting tonight just to double check.
Hi Diane from one Diane to another, that's exactly what Tyler is on 0.10 units
Can't wait to see how you girl does on that dose
 
Hi Diane from one Diane to another, that's exactly what Tyler is on 0.10 units
Can't wait to see how you girl does on that dose

Me too. I think that's exactly enough for her. Just tested her and we did see a bounce from today's hypo event but she's feeling good and feisty, happily eating her FF. I can go to bed feeling somewhat relieved.

Thank you for checking in!!!! You guys are all so incredible! Night night!
 
Me too. I think that's exactly enough for her. Just tested her and we did see a bounce from today's hypo event but she's feeling good and feisty, happily eating her FF. I can go to bed feeling somewhat relieved.

Thank you for checking in!!!! You guys are all so incredible! Night night!
You are doing great, and so cute she opened one of the cabinets and sitting on the dish towels, she's such a beautiful cat, sleep well
 
Status
Not open for further replies.
Back
Top