Help with pm dose!

[Luxe]

Hey all. So oj has been seeing progressively lowerish numbers. He's had a couple pm preshots in the evening where i've been giving him less of a dose. Tonight he was at 107. I rechecked and it was 120. He's never been that low 12hrs after insulin. I did give him half a can of fancy feast just now because he's starvingg. Practically ran out the door when i opened it because i was half hour later than his normal dinner time. He's eaten continually the whole day but had his last meal (some boiled chicken at dinner) 3 hours ago. Im not sure if i should wait like an hour and see if the half can brought him up at all? Should i only give like one unit if he's still in the 100s? I know i shouldnt skip a dose since he had dka back in november. I can def set alarms throughout the night and check him as well. Any dosing advice is greatly appreciated. Im wondering if i should lower his dose in general as well but the 4units are really the only greens and blues we've been seeing.

 

[Bron and Sheba (GA)]

Because you have fed him your BG is going to be food influenced. Can you wait a couple of hours, don’t feed any more and test again to see if he is high enough to shoot? It will throw out your schedule, can you work around that?. But you don’t want to skip with DKA in the picture.
Next time this happens STALL, DONT FEED and test again in 20 minutes to see if the BG is going up. And post and ask for advice.

I can’t stay around unfortunately but I’ll tag a couple of people who may be able to help
@tiffmaxee @Wendy&Neko
I’m the meantime test in 1 hour to see how the BG is going

 

[Luxe]

Okay thanks will do. With the not skipping insulin with the dka, does that mean he'll never go into remission? If he stayed in a normal range would he still need shots forever?

 

[Wendy&Neko]

We dose Lantus based on nadirs, not preshots. Now that you've been doing different AM and PM doses, the depot will be wonky. If you are having to reduce all the time (though I'm not sure why you have been reducing for PMPS above 300), it's better to reduce the over all dose. Try 3.75 both AM and PM.

With the not skipping insulin with the dka, does that mean he'll never go into remission? If he stayed in a normal range would he still need shots forever?

Cats who have gone into DKA can go into remission, that doesn't hurt their chances. What you have to do is focus on regulation first, it's a prerequisite to remission. If he gets regulated, he may start needing less insulin. There are no guarantees about this either.

 

[Luxe]

We dose Lantus based on nadirs, not preshots. Now that you've been doing different AM and PM doses, the depot will be wonky. If you are having to reduce all the time (though I'm not sure why you have been reducing for PMPS above 300), it's better to reduce the over all dose. Try 3.75 both AM and PM.


Cats who have gone into DKA can go into remission, that doesn't hurt their chances. What you have to do is focus on regulation first, it's a prerequisite to remission. If he gets regulated, he may start needing less insulin. There are no guarantees about this either.

I've been reducing because he goes a lot lower at night and im not able to catch hypos if he were to have one. His pmps is 1030pm and i go to bed pretty much right after as i have to get up and be out of the house between 5-6am depending. I cant change his shot times with my work schedule. Its the only times that work for me. Im just afraid he's going to have a seizure or die overnight on me or something and im not going to be up to catch it.

 

[Wendy&Neko]

The problem with the strategy of lowering the dose at night is the depot. The larger depot will influence the following cycle, even if you do a reduction. If you are worried about lower numbers, reduce the dose. Are you leaving lots of food out for him to eat overnight?

 

[Luxe]

The problem with the strategy of lowering the dose at night is the depot. The larger depot will influence the following cycle, even if you do a reduction. If you are worried about lower numbers, reduce the dose. Are you leaving lots of food out for him to eat overnight?

Im not. I have 7 other kitties who just scarf and barf so we dont let anyone graze. My mom usually gives him another can about 2hrs after his shot but then thats it and he snoozes shortly after for the night. Its been an hour and i just checked again and its only up to 148.
Also, if i reduce the dose in general he's going to be back in the 400-500s all the time which isnt good for him either correct?

 

[Wendy&Neko]

Right now you seem to be averaging 7.25 units per day. Going to 3.75 units twice a day is a total of 7.5 units per day, so not actually decreasing.

 

[Luxe]

Right now you seem to be averaging 7.25 units per day. Going to 3.75 units twice a day is a total of 7.5 units per day, so not actually decreasing.

Okie. I did the 3.75 today. He was higher but probably because i really wasnt sure what to do last night and just gave a very small dose.