BG getting in the greens, dosage keeps dropping. Gut says lower dose

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StarburstMom

StarburstMom

Member Since 2021
Previous thread for continuity https://www.felinediabetes.com/FDMB...onights-dose-and-starting-in-the-morn.250700/

So Starburst never got over 175 from this mornings cycle. After waiting until 13 hours post AM shot I gave her a lower dose (from 3.4 to 2) and she ate, but her BG is still flat (169 most recent) at 1.5 post, she always comes up quite a bit by now. She does have a Libre on so I thought maybe that was wonky...so tested her on the other 2 glucometers I have. She read 252 on the Pettest Advocate (pet meter) and 165 on the ReliOn, so it appears the Libre matches the ReliOn pretty well. I'm kinda worried she may have just had her pancreas kick back in and isn't diabetic anymore....spontaneously....is that even a thing? I don't know if I will be able to sleep tonight if she doesn't come up a bit, her nadir overnight tends to be pretty late(~+8). Has anyone had this kind of refusal to budge on the BG before?
 
That's actually a pretty good cycle! Remember, as long as you're able to test, you are in control of her glucose level.

169 is a great place to start at Pre-shot!
 
Chris & China (GA) said:
That's actually a pretty good cycle! Remember, as long as you're able to test, you are in control of her glucose level.

169 is a great place to start at Pre-shot!
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But she's still there, fluctuating between 156 and 173, 3 hours later....after dinner. I'm worried the insulin will kick in and drop her low quickly since there isn't as much buffer.
 
StarburstMom said:
. I'm kinda worried she may have just had her pancreas kick back in and isn't diabetic anymore....spontaneously....is that even a thing?
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She's only in remission if she can maintain normal numbers for two weeks WITHOUT insulin support. Normal with a human meter is 50-120, so she's still a little high. The pancreas is working better for sure but she still needs insulin. ProZinc can last up to 14 hours, so it looks like you are getting a nice long duration from it and that's why there's overlap. That's what your want to happen so it keeps the numbers in a healthy range. Maybe you want to try a little lower shot today and see how she does. Rather than the 3.2 you planned maybe try 2.5 and see what happens.
 
JanetNJ said:
She's only in remission if she can maintain normal numbers for two weeks WITHOUT insulin support. Normal with a human meter is 50-120, so she's still a little high. The pancreas is working better for sure but she still needs insulin. ProZinc can last up to 14 hours, so it looks like you are getting a nice long duration from it and that's why there's overlap. That's what your want to happen so it keeps the numbers in a healthy range. Maybe you want to try a little lower shot today and see how she does. Rather than the 3.2 you planned maybe try 2.5 and see what happens.
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OK thanks.
 
@JanetNJ just to confirm, the minimum shot threshold of 200 BG isn't pertaining to Starburst anymore, right? She may not get up to 200 in the next hour (when showtime is) but should be the same or higher than yesterday.
I'm going to assume yes since that's what happened yesterday.
 
StarburstMom said:
@JanetNJ just to confirm, the minimum shot threshold of 200 BG isn't pertaining to Starburst anymore, right? She may not get up to 200 in the next hour (when showtime is) but should be the same or higher than yesterday.
I'm going to assume yes since that's what happened yesterday.
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Right because I think her duration is longer. You've really got the hang of testing... I mean obviously if it's really low stall and see what is going on... We wanna see the number heading up a bit. If it's not we stall or reduce the dose
 
StarburstMom said:
@JanetNJ just to confirm, the minimum shot threshold of 200 BG isn't pertaining to Starburst anymore, right? She may not get up to 200 in the next hour (when showtime is) but should be the same or higher than yesterday.
I'm going to assume yes since that's what happened yesterday.
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Just looked at your spreadsheet for today. So far so good! Looks like 2.5 might have been a good choice. Let's see.
 
StarburstMom said:
@JanetNJ just to confirm, the minimum shot threshold of 200 BG isn't pertaining to Starburst anymore, right? She may not get up to 200 in the next hour (when showtime is) but should be the same or higher than yesterday.
I'm going to assume yes since that's what happened yesterday.
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89! Nice! Looks like reducing further was a good call! So it's under 90 so next shot let's do 2.25
 
@JanetNJ she just hit 89, this cycle is so similar to yesterday's cycle. If it continues to follow yesterday's she will be low at PMPS but I can't stall for as long tonight. Since I'm using U100 syringes it was tough eyeballing 2.5 (was probably closer to 2.4). Should I plan on reducing down to 2.2 if she comes up in time? Would you think dosing her with a PS of 175 (as long as it's flat or coming up) is a good idea and if so should I reduce the dose more? Last night was a pretty long stall and a significant reduction.
 
StarburstMom said:
@JanetNJ she just hit 89, this cycle is so similar to yesterday's cycle. If it continues to follow yesterday's she will be low at PMPS but I can't stall for as long tonight. Since I'm using U100 syringes it was tough eyeballing 2.5 (was probably closer to 2.4). Should I plan on reducing down to 2.2 if she comes up in time? Would you think dosing her with a PS of 175 (as long as it's flat or coming up) is a good idea and if so should I reduce the dose more? Last night was a pretty long stall and a significant reduction.
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Haha. We were writing at the same time. Let's see what the preshot is. Yes reduce. 2-2.25
 
JanetNJ said:
What are you comfortable doing? I mean you need to sleep too. Hahaha
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I don't know.
Ideally I would stall, but took forever to move yesterday and she's lower today (and my other 5 cats and her are already giving me that "you need to feed us" look). I am torn between skipping (but I really don't want her to spike) and giving her like 1 unit. Do any of those sound better to you?
 
@JanetNJ
What am I going to dose her in the morning? If she stays blues/greens (not likely) but gets over 200 by AMPS should I dose 1.0 unit again? If she spikes in red/purple/black should I start at 2.2 (what she was supposed to get if she had higher PS)?
Thank you again!
 
StarburstMom said:
@JanetNJ
What am I going to dose her in the morning? If she stays blues/greens (not likely) but gets over 200 by AMPS should I dose 1.0 unit again? If she spikes in red/purple/black should I start at 2.2 (what she was supposed to get if she had higher PS)?
Thank you again!
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I think 2.2 is still going to take her low. I am inclined say go right to an even 2 tomorrow. (Unless she's real low again). Does that sound good? I'll be curious to see what 1 unit does tonight. 1.5 might have been better but 1 is safer and will let you get some sleep. Lol
 
JanetNJ said:
I think 2.2 is still going to take her low. I am inclined say go right to an even 2 tomorrow. (Unless she's real low again). Does that sound good? I'll be curious to see what 1 unit does tonight.
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My gut says the same about 2.2.
Even if she is in the greens/blues tonight but >200 PS, give her 2 units (I know this isn't likely)?
 
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StarburstMom said:
My gut says the same about 2.2.
Even if she is in the greens/blues tonight but >200 PS, give her 2 units (I know this isn't likely)?
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I see 1 was slightly less than she needed last night but that's fine.
Ok let's stick with 2 u am and pm for a few days (unless we need to reduce of course) and see what happens. If it's not enough you can go to 2.2.
 
@JanetNJ
I was just going to ask for confirmation, but you beat me to it. :)
Would it be OK to dose her a bit early since she will be >200? I had read on here prozinc has more wiggle room and can move up to an hour, but I don't want to change too much with her right now.
Thank you
 
StarburstMom said:
@JanetNJ
I was just going to ask for confirmation, but you beat me to it. :)
Would it be OK to dose her a bit early since she will be >200? I had read on here prozinc has more wiggle room and can move up to an hour, but I don't want to change too much with her right now.
Thank you
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Sure as long as it's also a good time in the evening. :)
 
How does she seem to be feeling since starting the b vitamins? That anemia definitely concerns me. Are you just giving b 12 or a b complex too?
 
JanetNJ said:
How does she seem to be feeling since starting the b vitamins? That anemia definitely concerns me. Are you just giving b 12 or a b complex too?
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I've only been doing the b12 (500-1000 mg/day). I do have the Jarrows b complex but haven't started giving it to her yet (the size 5 capsules seem huge). Her next appt is in 6 days and she'll have more labs at that point. My vet wasn't willing to treat anything other than the diabetes at the last appointment, he didn't think the values were bad enough yet. His focus was to get the BG down and see where she is after. She also had 2 bouts of subQ fluids since those lab results.
She seems way better. She is sleeping a lot (always has, but seems more comfortable) but I've definitely noticed improvement in her neuropathy. She's also more social.
With her labs, a week apart, how the diabetes manifested, her coat, etc I feel like something "acute" happened that may have triggered a domino effect. Her hydration and coat are way better. Crossing fingers her numbers next week are better.
 
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StarburstMom said:
I've only been doing the b12 (500-1000 mg/day). I do have the Jarrows b complex but haven't started giving it to her yet (the size 5 capsules seem huge). Her next appt is in 6 days and she'll have more labs at that point. My vet wasn't willing to treat anything other than the diabetes at the last appointment, he didn't think the values were bad enough yet. His focus was to get the BG down and see where she is after. She also had 2 bouts of subQ fluids since those lab results.
She seems way better. She is sleeping a lot (always has, but seems more comfortable) but I've definitely noticed improvement in her neuropathy. She's also more social.
With her labs, a week apart, how the diabetes manifested, her coat, etc I feel like something "acute" happened that may have triggered a domino effect. Her hydration and coat are way better. Crossing fingers her numbers next week are better.
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I was able to mix the b complex directly into CC'S food. I would empty the capsule into a small pill container, then use the pinch size spoon and add it into her food. These are the spoons. 2lbDepot Measuring Spoons Set of 3 (Tad 1/4 teaspoon, Dash 1/8 teaspoon, Pinch 1/16 teaspoon), Chrome Finish, Premium Heavy-Duty Stainless Steel, Narrow, Long Handle Design Fits in Spice Jar https://www.amazon.com/dp/B079TDP8D8/?tag=felinediabetesfdmb-20

Between the two labs the white blood counts went up... So there was an infection. Size 5's are the tiniest that are made. They are really small when the ends are together
 
JanetNJ said:
I was able to mix the b complex directly into CC'S food. I would empty the capsule into a small pill container, then use the pinch size spoon and add it into her food. These are the spoons. 2lbDepot Measuring Spoons Set of 3 (Tad 1/4 teaspoon, Dash 1/8 teaspoon, Pinch 1/16 teaspoon), Chrome Finish, Premium Heavy-Duty Stainless Steel, Narrow, Long Handle Design Fits in Spice Jar https://www.amazon.com/dp/B079TDP8D8/?tag=felinediabetesfdmb-20

Between the two labs the white blood counts went up... So there was an infection. Size 5's are the tiniest that are made. They are really small when the ends are together
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I have the spoons but would rather mix it in the food but others stated it was too bitter and their cats wouldn't eat it. I'll try it tonight (or maybe lunch) in their food, all the cat's could use some B vitamins probably.
Yes, her WBC went from 15 to 11 so it improved. Her tongue does look more pink to me and she has a good appetite so I hope she's continuing to improve.
 
StarburstMom said:
I have the spoons but would rather mix it in the food but others stated it was too bitter and their cats wouldn't eat it. I'll try it tonight (or maybe lunch) in their food, all the cat's could use some B vitamins probably.
Yes, her WBC went from 15 to 11 so it improved. Her tongue does look more pink to me and she has a good appetite so I hope she's continuing to improve.
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We’ll give it a try and see if she notices it. You could also try hiding it in a bit of butter if she likes that.
 
JanetNJ said:
I was able to mix the b complex directly into CC'S food. I would empty the capsule into a small pill container, then use the pinch size spoon and add it into her food. These are the spoons. 2lbDepot Measuring Spoons Set of 3 (Tad 1/4 teaspoon, Dash 1/8 teaspoon, Pinch 1/16 teaspoon), Chrome Finish, Premium Heavy-Duty Stainless Steel, Narrow, Long Handle Design Fits in Spice Jar https://www.amazon.com/dp/B079TDP8D8/?tag=felinediabetesfdmb-20

Between the two labs the white blood counts went up... So there was an infection. Size 5's are the tiniest that are made. They are really small when the ends are together
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Did you dose that (1/16th) 1x a day or that much with each meal? My spoons are a bit different, but converting. 3 of my Dash spoons is 1/16th, so I could add 1 dash to 3 meals and she'd be covered I think.
 
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StarburstMom said:
Did you dose that (1/16th) 1x a day or that much with each meal? My spoons are a bit different, but converting
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Technically 1/10th is a dose, so I think I actually used the dash one not the pinch one…. 1/8 but didn’t go all the way to the top. Here’s a bit from tanyas site about Jarrows and using a gel cap to measure.
http://www.felinecrf.org/vitamin_b.htm


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JanetNJ said:
Technically 1/10th is a dose, so I think I actually used the dash one not the pinch one…. 1/8 but didn’t go all the way to the top. Here’s a bit from tanyas site about Jarrows and using a gel cap to measure.
http://www.felinecrf.org/vitamin_b.htm


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Thanks, I was just reading that. I measured out one capsule was 30 of the "dash" spoons that I have. The paragraph above that one says to ideally split that amongst 2-3 meals, so I will just do 1 dash spoon in 3 meals a day. Thank you
 
StarburstMom said:
Thanks, I was just reading that. I measured out one capsule was 30 of the "dash" spoons that I have. The paragraph above that one says to ideally split that amongst 2-3 meals, so I will just do 1 dash spoon in 3 meals a day. Thank you
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Or maybe I did a pinch but twice a day. Wow how quickly I forget. Hahah
 
JanetNJ said:
Nice numbers today
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@JanetNJ they are nice....she's just cruising. My gut is telling me she won't break 200 at PMPS. My field work got pushed off to next Monday so I can stall tonight if needed, or do a reduced dosage. I'm wondering if she would benefit from a lower dose in the AM with a slightly higher dose in the PM, but it's probably too soon to get that complicated.
 
@JanetNJ I don't know if this is a good choice but I stalled for 30 minutes, number not really moving (166 to 158). She did fine with 2 U a few nights ago with PMPS of 169 and went low 200s last night at 1 U with PMPS of 148. I think I want to give her 1.5 and see what that does. I know I shouldn't jump around on doses but I'd really like to find that sweet spot where duration is just right. I'm looking for goldilocks
 
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I saw you lowered to 1.5 tonight. It got down to 114 ish which is pretty good... You would be ok to do 2 units am and pm in the future. :). I'd like to see the nadir dip is toes in the greens. Or maybe 1.8 am/pm. I know the reduce number is 90, but now that you are fine tuning doses I think that lowering that reduce threshold to 80 would be better now that you have more consistent nice steady numbers. Those greens are where that pancreas can really rest and heal if the ultimate goal is remission. What a difference from a couple weeks ago. I'm really looking forward to seeing improvement on those labs next week.
 
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JanetNJ said:
I saw you lowered to 1.5 tonight. It got down to 114 ish which is pretty good... You would be ok to do 2 units am and pm in the future. :). I'd like to see the nadir dip is toes in the greens. Or maybe 1.8 am/pm. I know the reduce number is 90, but now that you are fine tuning doses I think that lowering that reduce threshold to 80 would be better now that you have more consistent nice steady numbers. Those greens are where that pancreas can really rest and heal if the ultimate goal is remission. What a difference from a couple weeks ago. I'm really looking forward to seeing improvement on those labs next week.
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@JanetNJ my concern is the low preshots....I get nervous with them not being over 200. How low for a preshot do you think is safe enough for a 1.8 unit dose with her?

Yes, huge difference from a few weeks ago. She was DX less than a month ago and is doing so much better....thank you so much for getting her where she is now. I'm crossing fingers her labs will be better.
 
StarburstMom said:
@JanetNJ my concern is the low preshots....I get nervous with them not being over 200. How low for a preshot do you think is safe enough for a 1.8 unit dose with her?

Yes, huge difference from a few weeks ago. She was DX less than a month ago and is doing so much better....thank you so much for getting her where she is now. I'm crossing fingers her labs will be better.
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She hasn't been going too low with preshots over 150 ish. If it makes you nervous, you can continue with the 1.5 dose for several days and see what happens.
 
JanetNJ said:
She hasn't been going too low with preshots over 150 ish. If it makes you nervous, you can continue with the 1.5 dose for several days and see what happens.
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I already did the 1.8 for today. If she doesn't get up to at least 150 or goes too low today I will likely reduce that a touch (she almost didn't make 150 with a 1.5 dose so I think she will be lower than that, but we shall see). I do want her to get to remission, I just want to have my cake and eat it too by not having a lime green.

I would prefer to stall when her numbers are too low rather than jumping around on dosage but my cats are getting aggressive to each other (not her, she's always kept to herself more and the others don't mess with her) when mealtime is delayed. I may play around with feeding times so they aren't soooo ravenous if we have to stall (I will make sure no food for 2 hours prior to shot time though).
Thank you Janet, your guidance has been invaluable.
 
Starburst has really dropped dosage in the last few days. Yeatetday I panicked when she hit double digits and gave her a whole can of gravy lovers turkey, today I'm trying to let her glide with LC food. My hunch is her dose should be reduced closer to half what it is now. It's dropped so much already but she's going green at +3. Is this normal? @JanetNJ
 
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StarburstMom said:
Starburst has really dropped dosage in the last few days. Yeatetday I panicked when she hit double digits and gave her a whole can of gravy lovers turkey, today I'm trying to let her glide with LC food. My hunch is her dose should be reduced closer to half what it is now. It's dropped so much already but she's going green at +3. Is this normal? @JanetNJ
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You did a great job of steering today. Remember that the normal range is 50-120 so she never got too low.
 
JanetNJ said:
You did a great job of steering today. Remember that the normal range is 50-120 so she never got too low.
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Thanks, but this is too much of a dose. I had to put food in front of her a ton, she's starts dropping into the 60s when the food starts wearing off and then I give her more. Trying to work while also keeping her in a safe range was a bit stressful.
 
StarburstMom said:
Thanks, but this is too much of a dose. I had to put food in front of her a ton, she's starts dropping into the 60s when the food starts wearing off and then I give her more. Trying to work while also keeping her in a safe range was a bit stressful.
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Well obviously she earned a reduction. You said your were doing to do 0.6 or0.8 next, correct? I think i'd go 0.6.
 
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