when do you adjust insulin dose or skip a dose

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Charlie's Mum

Charlie's Mum

Member Since 2020
My cat Charlie is on 6 units of Lantus 2 times daily. His BG has always been very high (300-700 range) until his insulin dose was raised to 6 units. The lower BGs are also a result of feeding him less frequently and feeding about 30 minutes after giving him his insulin (all of this approved by vet).

My question now is when I test his BG prior to giving insulin, now the BG reading is within the normal range (for example 78). Do I still give him his regular insulin dose? I emailed my vet over a week ago and again today only to get a message that he is out so I thought I would see if anyone here has some advice in the meantime.

I think the issue is that I'm not used to the numbers being so low. I checked his BG in the middle of the day and it was 44. I gave him some maple syrup and he was ok (BG went up). I'm a bit stressed worrying about the insulin dropping suddenly (too low). Thanks for your help.
 
Hello and welcome! :-)

6U of Lantus is a huge dose! Was he started at 6U or was it increased over a period of time?
Which meter do you use? 44 is indeed a low number by human and pet meter standards. It means that 6U is too high a dose for Charlie.
Are you using a Lantus pen to give him his insulin shots?

We follow two dosing protocols here. You can read more about them here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

We normally ask people who do not have enough data on their cats to not give insulin if the pre-shot BG is less than 150.

If you could set-up a spreadsheet with Charlie's test data, we can help you with dosing. I can help you with setting up the spreadsheet. Won't take me a minute :-)
How to Create a Spreadsheet
 
Bandit's Mom said:
Hello and welcome! :)

6U of Lantus is a huge dose! Was he started at 6U or was it increased over a period of time?
Which meter do you use? 44 is indeed a low number by human and pet meter standards. It means that 6U is too high a dose for Charlie.
Are you using a Lantus pen to give him his insulin shots?

We follow two dosing protocols here. You can read more about them here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

We normally ask people who do not have enough data on their cats to not give insulin if the pre-shot BG is less than 150.

If you could set-up a spreadsheet with Charlie's test data, we can help you with dosing. I can help you with setting up the spreadsheet. Won't take me a minute :)
How to Create a Spreadsheet
Click to expand...
His insulin has been increased gradually over many months -all adjustments were per Dr. From what I have read, cats receiving over 2 units of insulin typically have secondary conditions that are contributing to the insulin not working. I am overwhelmed with all of this and all the tests he has had. I did actual adjust the insulin to 5.5 units because the 6 units seemed to dip too low. But when I gave him 5 units, his BG was in the 300-500 range. I get Lantus in a vial and use syringes to administer. I'll look at the articles you mention above. I want to work on the spreadsheet. I'm just very overwhelmed here and there is so much to read and then I'm trying to address his immediate needs. FYI -I have skipped his insulin dose when his BG was 78. The result was that a few hours later, his BG skyrocketed to the upper 400 range and remained this way for the next 24 hours (even after giving him his next dose of insulin). I'm happy that his BG are coming down but I'm up all night checking his BG to make sure it doesn't get in the danger zone. I've emailed my vet to see if another doctor can advise me. Thanks for your help.
 
Bandit's Mom said:
Hello and welcome! :)

6U of Lantus is a huge dose! Was he started at 6U or was it increased over a period of time?
Which meter do you use? 44 is indeed a low number by human and pet meter standards. It means that 6U is too high a dose for Charlie.
Are you using a Lantus pen to give him his insulin shots?

We follow two dosing protocols here. You can read more about them here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

We normally ask people who do not have enough data on their cats to not give insulin if the pre-shot BG is less than 150.

If you could set-up a spreadsheet with Charlie's test data, we can help you with dosing. I can help you with setting up the spreadsheet. Won't take me a minute :)
How to Create a Spreadsheet
Click to expand...
Thanks for your offer to help with the spreadsheet. I am working right now. Could I contact you after my work day is over? Thanks again.
 
Pretty much everyone feels completely overwhelmed when they land here! It's a good thing (sort of) because we do our best to educate you about feline diabetes so you can plague your vet with questions and become a knowledgeable caregiver. Well, that and to prove we are not the "crazy cat ladies of the internet." In all seriousness, there's a lot of expertise here. Many of us have been paying our experience forward for quite some time.

As Bhooma (Bandit's Mom) indicated, Charlie is getting a large dose of insulin. However, the best dose is the dose that gets your cat in good numbers. The business of more than 2u means there's something else going on may be correct, or it may be hogwash. We have a very popular saying here, every cat is different (ECID). One immediate thought I had is what are you feeding Charlie? We are strong advocates of a low carbohydrate, canned food diet. If you are not feeding your kitty low carb food, it may be one explanation for the higher numbers.

Bhooma will give you a hand with your spreadsheet. She's in India so the time zone is very different!

In the meantime, when you have a minute, could you take a look at this post on helping us to help you? There's information on what to include in your signature along with other helpful information.
 
Charlie's Mum said:
Thanks for your offer to help with the spreadsheet. I am working right now. Could I contact you after my work day is over? Thanks again.
Click to expand...
Take your time! :bighug:

I will send you a PM with the info I need to set-up your Spreadsheet as well as your Signature block. Those contain the basic information we need to be able to give any advice. Having the info readily accessible means we don;t waste your time asking you the same questions again and again when you post here for advice!

If you go to Inbox in the menu at the top of the page, you will see a message from me in a minute! :-)
 
Sienne and Gabby (GA) said:
Pretty much everyone feels completely overwhelmed when they land here! It's a good thing (sort of) because we do our best to educate you about feline diabetes so you can plague your vet with questions and become a knowledgeable caregiver. Well, that and to prove we are not the "crazy cat ladies of the internet." In all seriousness, there's a lot of expertise here. Many of us have been paying our experience forward for quite some time.

As Bhooma (Bandit's Mom) indicated, Charlie is getting a large dose of insulin. However, the best dose is the dose that gets your cat in good numbers. The business of more than 2u means there's something else going on may be correct, or it may be hogwash. We have a very popular saying here, every cat is different (ECID). One immediate thought I had is what are you feeding Charlie? We are strong advocates of a low carbohydrate, canned food diet. If you are not feeding your kitty low carb food, it may be one explanation for the higher numbers.

Bhooma will give you a hand with your spreadsheet. She's in India so the time zone is very different!

In the meantime, when you have a minute, could you take a look at this post on helping us to help you? There's information on what to include in your signature along with other helpful information.
Click to expand...
Thanks! I'm printing the posts and will read today. Charlie has actually been on a homemade raw cat food diet and store bought low carb wet diet the entire time I've had him (adopted from shelter when he was 7 years old). Charlie has a very sensitive stomach and there aren't many commercial wet foods that I can feed him and I'm even having problems finding a good protein for his homemade food (seems like he has developed allergies). He likes to eat, and is overweight. I think maybe his being overweight contributed and my feeding him throughout the day rather than at scheduled times. I think he may be insulin resistant. I feel terrible about this. I'm trying to monitor his food but then he has episodes of vomiting and diarrhea. Lots going on... I am going to work on the spreadsheet when I have free time. Thanks again!
 
Bandit's Mom said:
Take your time! :bighug:

I will send you a PM with the info I need to set-up your Spreadsheet as well as your Signature block. Those contain the basic information we need to be able to give any advice. Having the info readily accessible means we don;t waste your time asking you the same questions again and again when you post here for advice!

If you go to Inbox in the menu at the top of the page, you will see a message from me in a minute! :)
Click to expand...
Thank you!!
 
If you are at 6 units or thereabouts, I would consider testing for acromegaly and IAA. If you are in the States, they are both run at the same lab at Michigan State. They are the only lab who can do the IAA test but other countries can run the IGF-1 for acromegaly. That way you know for sure if you are dealing with insulin resistance or acromegaly that is impacting how his body is using the insulin. I totally hear you on being overwhelmed. Even now, I feel like there are lots of things I thought i would never get. If Charlie does test positive for either of them, there is a whole forum on here for those of us who have these extra special kitties that has been a godsend.

Howie has a sensitive tummy too. Once I got him on food that didn’t contain additives like carrageenan and guar gum, he got much better. I use Dr. Elseys CleanProtein pate in pork as more of a special/novel protein. He can’t handle chicken or turkey so it was recommended to avoid those two proteins. Big hugs with all that you’re trying to manage!
 
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