Skipped dose

[Harold Kunzli]

I am nervous to keep missing doses as I have missed 2 already within the last week. My first test came up 4.8, 2nd came up 6.9. Not sure which to believe, should I test a third time?
Do I skip or give 0.5 or 0.25?

Sorry my spreadsheet is missing some info, have it written down at a different house.

 

[Harold Kunzli]

@JanetNJ @Bron and Sheba (GA) either of you online or able to give me some advice by chance?

 

[Harold Kunzli]

Hmph I tested a third time (15 min after the orignal tests) and it came as 6.1
Should there be this much of a difference between readings or should I be concerned this meter isnt working?
Think I will shoot .25 tonight & test again in 2 hours before bed.

 

[Bron and Sheba (GA)]

Can you stall? Not feed and test again in 20 minutes.
I would not give a dose if it doesn’t come up over 90
The 86 has earned a reduction in dose down to 0.25 units under SLGS method.
We really need to be seeing some tests in during the pm cycle to see what is going on. Are you able to do that?

 

[Bron and Sheba (GA)]

Hmph I tested a third time (15 min after the orignal tests) and it came as 6.1
Should there be this much of a difference between readings or should I be concerned this meter isnt working?
Think I will shoot .25 tonight & test again in 2 hours before bed.

6.1 is only 109.8
If you can only monitor for 2 hours, I would skip the dose. Two hours is not long enough to monitoring to make sure Harold is not going to drop down low.

 

[Harold Kunzli]

I cant really stall much longer, so I will skip. My schedule is very tight at the moment, on top of that I am desperately trying to find a place for us to live at the end of the month. Im not sure how else to work my schedule in order to get more tests. I currently live an hour drive away from my work. I leave my house at 9 am, work 10 am till 6 pm and dont get back home until normally after 7 pm as the drive is dark and treacherous. I am now viewing places most nights after work too so getting home even later. I also suffer from sleep conditions and often sleep for 9+ hours no mattter how many alarms are set. I have been trying to shoot at 8 a.m and 8 pm but completely messed that up this weekend. I shot today at 8:55 am before leaving as I was worried about skipping and ketones developing. Im scared of him going to low and Im scared of him developing ketones and Im at such a loss of what to do until I get a place D: Totally open to any advice and suggestions haha.

Also, his dose is technically at 1.5, I have been giving 0.5 as the preshot numbers have been so low the last few days. Even if they go back up, should I not re increase the dose?

Sorry for the book, stressed cat mom lol.

 

[Bron and Sheba (GA)]

Yes, I would skip and get on track in the morning timewise again.
Do you have an automatic timed feeder for him to eat from when you are away from the house? If not, I think that would be a great asset for you to get and would help him eat during the cycle while you are away. Making sure he is eating very well will help keep ketones away.
I don’t like skipping either but you need to do what is safe and in your situation, you need to get your self sorted out so life can return to normal for you and Harold.

Has he ever had ketones.? Or DKA?
If you are concerned about ketones, you can test anytime for them when you are home. Put the result into the remarks column of the SS so we can see.

Also, his dose is technically at 1.5, I have been giving 0.5 as the preshot numbers have been so low the last few days. Even if they go back up, should I not re increase the dose?

His dose is now 0.25 units because of the reduction he has earned. Don’t give more than that or you will risk a hypo, and we don’t want that.

 

[Bron and Sheba (GA)]

Can you make the PMPS square where you have put the 86, 124, 110 as green please Karli?

 

[Harold Kunzli]

Yes, I would skip and get on track in the morning timewise again.
Do you have an automatic timed feeder for him to eat from when you are away from the house? If not, I think that would be a great asset for you to get and would help him eat during the cycle while you are away. Making sure he is eating very well will help keep ketones away.
I don’t like skipping either but you need to do what is safe and in your situation, you need to get your self sorted out so life can return to normal for you and Harold.

Has he ever had ketones.? Or DKA?
If you are concerned about ketones, you can test anytime for them when you are home. Put the result into the remarks column of the SS so we can see.



His dose is now 0.25 units because of the reduction he has earned. Don’t give more than that or you will risk a hypo, and we don’t want that.

Okay sounds good. 0.25 it is. & no, he has never had ketones or DKA but I also dont check often. There wasnt any at diagnosis and I bought sticks I want to say 3 or 4 months ago and tested then and there was none. Will be checking the next time I catch him peeing. Yes, I do have a timed feeder, and there is always food leftover these days. His appetite has definitely decreased or returned to a normal cat appetite haha.

 

[Bron and Sheba (GA)]

That is good there are no ketones or DKA in the history. But it’s a good idea to get into the habit of testing for the ketones each week. Far better than suddenly finding them.

I’m glad you have a timed feeder. Do you use it each day?
If the Preshot is a bit lower than normal and you are concerned and have to go to work, you can put some higher carb food into the feeder to open at +2 and +4

 

[JanetNJ]

I agree, skip.

 

[Harold Kunzli]

That is good there are no ketones or DKA in the history. But it’s a good idea to get into the habit of testing for the ketones each week. Far better than suddenly finding them.

I’m glad you have a timed feeder. Do you use it each day?
If the Preshot is a bit lower than normal and you are concerned and have to go to work, you can put some higher carb food into the feeder to open at +2 and +4

Yes I use it everday, I have it set to open at +4 and +8 during both the am and pm cycle. That is a great idea tho, I will keep that in mind going forward! & okay, I wasnt really sure the whole protocol with checking Ketones. I will start checking every weekend.[/QUOTE]

 

[Bron and Sheba (GA)]

I agree, skip.

Thanks Janet, @JanetNJ I wasn’t sure if you were around still……I haven’t got my head around the new times with daylight saving.

 

[JanetNJ]

Thanks Janet, @JanetNJ I wasn’t sure if you were around still……I haven’t got my head around the new times with daylight saving.

Ha ha I wrote in the middle of the night. Bit of insomnia last night. I have a cat that will be at the vet until Fri and it must be on my mind.

 

[Bron and Sheba (GA)]

Karli asked me in a PM to look at her SS and is seeking advice
Hi Karli,
It looks like Harold was bouncing yesterday when you gave the two 0.25 doses after the green preshot the evening before.
Then today he has come off the bounce and you have given 0.1 units for the am and pm shots.
I would try and get at least one or two tests in during the pm cycles if you can as cats often drop lower at night.
He looks like he is needing less and less insulin and could well go into remission. But to do this well, we really need to see more tests so we can safely tell you about dosing.
And if he does go into remission we want that remission to be a strong remission and to do that we need to keep him on insulin as long as is needed for his pancreas.
So the more tests you can do the better. I would start posting every day now to get advice.
I’m going to tag @JanetNJ as she is a Prozinc user.

 

[Harold Kunzli]

Okay thank you. Should I remain at the 0.1 dose even if he goes up at this point? I am going to do a full curve on Saturday, I'll try to extend to 18 hours or so, to see both cycles. I will make sure to start getting tests in each night.

Unrelated, but tonight he started showing signs of a urinary issue (licking his privates). Im going to call and make a vet appointment as soon as they open, but I'm assuming he will need an antibiotic. Will that mess with his levels?
Also, is there anything I should have him tested for besides ketones? He hasn't had a check up regarding diabetes since diagnosis since I do all his testing at home.

 

[Bron and Sheba (GA)]

. Should I remain at the 0.1 dose even if he goes up at this point? I am going to do a full curve on Saturday

You need to let the BG numbers guide you with the dose. If you are unsure post and ask for help.

I will make sure to start getting tests in each night.

Excellent. That will be a big help

Unrelated, but tonight he started showing signs of a urinary issue (licking his privates). Im going to call and make a vet appointment as soon as they open, but I'm assuming he will need an antibiotic. Will that mess with his levels?

Just check with the vet that the antibiotic, if he does order everything, doesn’t have any sugar in it.
It is more likely to give him a bit of an upset tummy, if anything.

Also, is there anything I should have him tested for besides ketones? He hasn't had a check up regarding diabetes since diagnosis since I do all his testing at home.

I would ask the vet to check his teeth while you are there.

 

[JanetNJ]

I’d like to see more days on the 0.25 dose