At the simplest:
* the preshot tests will tell you whether or not Harrison's BG is high enough to give the next dose of insulin.
* the mid-cycle tests will tell you how low each dose takes him, and also information on dose duration.
For cats with limited data, the recommendation is to set 200 (human meter) as a 'no shoot' limit. (NB: For cats with a history of ketosis or DKA it's not advisable to skip doses so, depending on the size of the regular dose, a reduced or token dose should be considered. If on a very low dose, post to ask for suggestions as to how to proceed.)
In case you've not found it yet, here's a link to the
FDMB Caninsulin Guide.
For cats with less than 3 months' worth of data, if a preshot BG is under 200 the guideline is to stall without feeding and then recheck BG in 20-30 minutes to see whether it has risen high enough to give the dose. (Tip: While waiting to do the next test, post for help, including the phrase 'STALLING - Need Help' somewhere in the title.) See the Caninsulin guide for further info.
When it comes to dose adjustment, both increases and reductions are driven by the nadirs. From the Guide:
The general guidelines for making dose changes are:
- If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
- If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
- If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
- HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.
As always, please post for help and advice any time you need it or with any questions you have. And maybe post some more piccies of that incredibly handsome boy of yours!
Mogs
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