? Random low numbers, cat hates blood glucose measuring

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inja

inja

Member Since 2022
Lately Eddie’s been randomly getting low numbers and I’m wondering if he’s going into remission. But now I’m stuck in an odd circle: if his number is low and I skip insulin, it will be high again in the next cycle. Also, he seems to be having some kind of Schrödinger’s Cat’s blood sugar levels: if I don’t measure they go down but then I will never know what they are and I can’t give him insulin blindly.

I have trouble finding a good vet in my area, most don’t know so much about feline diabetes and the one that does, is very eccentric and I can’t even get any directions or values from blood tests on paper. Since I have ADHD, I have so much trouble remembering details.

I guess I’m mostly just baffled about what I should do.

Eddie is doing well and is himself, doesn’t have any specific symptoms.
 
Previous posts
https://felinediabetes.com/FDMB/threads/wondering-if-my-baby-has-acro.265385/

Intro post
https://felinediabetes.com/FDMB/thr...e-on-insulin-not-working.259462/#post-2916658
If you can fill out what we call our signature ,information about your kitty
To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information


  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine

I see you are using lantus on your SS
Have you read the 2 dosing methods to choose one to follow
I'll give you the link to read about them
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
If you are feeding any dry food you can only follow SLGS
Anytime your kitty drops under 90 you would reduce by 0.25 units with SLGS

The dosing methods will tell you when an increase or decrease is needed
I see you are from Findland and using the lantus pen can you add you are from Findlsnd to your signature

Were you able to find the U-100 syringes with the half unit markings
With the pens you can only adjust the dose by full units
We usually adjust the dose by 0.25 units

You need to be testing more after the PMPS cycle
and you haven't gotten any tests in after AMPS since 7-21

If you haven't found the correct syringes you can order them here
http://www.alldaypharmacy.co.uk/products/BD-Micro%2dFine-Demi-0.3ml-Syringe-0.3mm-(30G)-x-8mm-%2d-Box-of-100.html

The ones I saw you posted on your intro thread are not the correct ones
which were these
https://kruuse.com/products/consuma...disposable-syringe-3-comp-0-5-ml-29g-x-100-pk


@inja

30-unit-insulin-syringe-markings.jpg





Here is a pic of the syringes I mentioned above
BD_Micro-Fine_Demi_0.3ml_Syringe_0.3mm_%2830G%29_x_8mm%281%29__74280_std.jpg
 
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Hi and welcome to the group. What you describe is something a lot of people go through, and I highly recommend you pick a dosing method like Tight Regulation or SLGS to help you with dosing and to get out of the cycle you are stuck in.

Also, if you were to post every day over on the Lantus/biosimlars forum then you could get expert guidance on any adjustments, whether or not you need to increase or reduce the dose, etc.
 
Okay, I’ve now updated my signature. There was no actual DKA event, when I say ”low numbers”, I mean around 7 (world). I would be happy with those numbers if I could maintain them but the issue still remains that if I measure his blood sugar all the time, it will stay artificially high. I don’t want that either. I can tell when I do it daily, it stops going down. When we take a few days off, it goes down. Doing a curve, I usually see it going up regardless of which part of a cycle he is. So I’ve tried to do it as little as possible.

I try to be as fast as possible with the BG and sometimes if I manage to do it as a ”surprise”, it will be low. By and large Eddie is the kind of cat that is very hard to fool, he won’t be fooled by treats or pets if something is happening. When I do the insulin on his sruff, then he usually continues eating but if I so the insulin on his side, even then he will usually stop eating, angle himself away and freeze a bit.

Will get those syringes.

As for the acromegalia, my vet said that since he’s had numbers like 7, it’s unlikely he’d have it.

I’ll look into the dosing methods, I’ve done it before but the issue of testing raising the BG is something I can’t solve.

Eddie eats ”freely” meaning I give many smaller meals a day. He’s very fussy with food so I often have to change it up but I only give him diabetic wet food or raw food (chicken & turkey). Sometimes I use dry diabetic food as a treat on top his meal if he’s being extra fussy or if I’m away for many hours.
 
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inja said:
Sometimes I use dry diabetic food as a treat on top his meal if he’s being extra fussy or if I’m away for many hours.
Click to expand...
Instead of using the dry you can get any freeze dried treats to use
Just Google it
Can you add you're from Finland to your signature :cat:
 
Diane Tyler's Mom said:
What dry diabetic food are you using as a topper and when you're away for many hours.
Click to expand...

I have Brit diabetic dry food. I can switch it up if somebody recommends something else. Mostly I just put a few in there and even when I’m gone for longer periods of time (which I rarely am), I put more wet food than dry food.

I have another cat in addition to Eddie, she’s a former feral cat who is very imprinted on Eddie and often will only eat with Eddie next to her. I also feed her the diabetic kibble because she likes it and also, if Eddie goes into her food, at least it will be diabetic dry food. The feeding situation is very complicated dance with a weird feral cat who I can’t touch. But the point was that while Eddie won’t eat a lot of dry food, I can’t say that he will never eat it.

Will update the signature, thank you!
 
My cat was growling at me at test time and I got some really good tips that made quite a change. Maybe something like these will help you with Eddie.

Choose a testing place. I use the top of my desk. I use Dr. Elsey's Clean Protein Bites (low carb) as a bait and then as a treat after the test. Get him used to going to the testing place where he gets a treat, but don't stick him just give the treat and pet/pat him so he associates that place with a pleasant experience. I know you need to be testing so maybe try to squeeze in these treat, but no test moments, just a time or two in between current testing.

I also found out that my cat Newman, does not like to be restrained in any manner. During the testing I was snugging him against me to keep him from moving. That had the opposite effect, causing him to tense up and want to get away. He is much more relaxed if I allow him to feel free.

So, a test goes like this for us. I get the meter and lancet ready. I rattle the treats to get him to come to the test place. I give him 4 pieces of the bites and when he takes the last piece, I push the test strip into the meter and as soon as he swallows the last bite, I gently poke his ear and collect the droplet. Immediately after, as I lightly pinch the test spot to stop the bleed, I give him 4 more pieces of treat bites. We're done. He doesn't mind at all.

He has actually gotten to the point where he jumps up on the desk at AM and PS test times on his own. Test times during the cycle I need to shake the treats to get him to want to come for treats. And there are times when he doesn't come no matter what I do, but those times are not the norm.

I have another cat and a small dog, so I know that feeding arrangements can be complicated, although your situation with the feral cat is probably more complicated. And, I also have a less than helpful vet.

Hang in there, it really does get better. The people here are great. I am still working on getting to the best dose for Newman. Things do start to fall in place. Good luck to you with Eddie.
 
inja said:
I have Brit diabetic dry food. I can switch it up if somebody recommends something else.
Click to expand...
Hi do you know how many carbs are in it, I have never heard of it
If you can find somewhere in Finland that sells Dr Elsey's Clean Protein Chicken flavor I know that's about 5 or 6% carbs which is ok
I found Amazon International Shipping
https://www.amazon.com/International-Shipping-Direct/b?ie=UTF8&node=230659011

https://www.amazon.com/s?k=Dr Elsey's clean protein&bbn=230659011&crid=40D05B8ZYQMK&sprefix=dr elsey's clean protein ,aps,205&ref=nb_sb_noss

It is expensive though

Also found this web site
https://www.u-buy.co.uk/product/45EDGBG-dr-elsey-x27-s-cleanprotein-formula-dry-cat-food

I hope this helps :cat:
 
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inja said:
As for the acromegalia, my vet said that since he’s had numbers like 7, it’s unlikely he’d have it.
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Blood sugar numbers are not a reason to say a cat has acromegaly or not. You need to send blood work to the Royal Veterinary Clinic who do a test for it. We've had a few cats with confirmed acromegaly that are fairly regulated.

As for your insulin dose, since you are feeding dry food, 5.0 units has shown that it's too much insulin. You need to lower the dose by 0.25 units. Once you get the syringes you'll be able to do that. We find it's best with our dosing methods if you can find a dose that you can give the same dose consistently in the AM and PM. If you are having to skip all the time, that's another clue the dose is too high.

Testing is likely not raising the BG significantly.
 
Diane Tyler's Mom said:
Hi do you know how many carbs are in it, I have never heard of it
Click to expand...

Here’s info I found on the Brit Care food:

COMPOSITION:

dehydrated chicken (48%), yellow peas (20%), yellow pea protein, chicken fat (4%), potato protein, bamboo lignocellulose (2%), salmon oil (2%), hydrolysed chicken liver (2%), minerals, sodium chloride, psyllium husks and seeds (0.5%), dried algae (0.5%, Ascophyllum nodosum), hydrolysed crustacean shells (a source of glucosamine sulphate, 0.035%), hydrolysed cartilage (a source of chondroitin sulphate, 0.023%), yeast extract (source of mannan-oligosaccharides, 0.018%), β-glucans (0.018%), sea buckthorn (0.015%), fructo-oligosaccharides (0.012%), Mojave yucca (0.012%)

METABOLISABLE ENERGY:

3,740 kcal/kg

ANALYTICAL CONSTITUENTS:

crude protein 46.0 %, fat content 13.0 %, crude fibre 3.0 %, crude ash 7.7 %, moisture 10 %, omega 3 0.55 %, omega 6 1.6 %, calcium 1.3 %, phosphorus 1.0 %, sodium 0.4 %, magnesium 0.07 %, starch 15 %, total sugars 0.8 %

Will look for the recommended wet food or what other kind of options I have available.

ETA:

A friend helped me with the calculation and said that the Brit has about 22,5% carbs if subtract the moisture.
 
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Okay, so I’ve continued to do preshots and I think that’s mostly going ok, I feel Eddie doesn’t get very stressed about that anymore. I’m now in a place where I have to think about the insulin dose every time I shoot because his AMPS and PMPS numbers can be between 19 and 9 (world values, some higher ones are also bcs he got into my other cat’s food, sometimes he’s super fast even if I try to be really vigilant about it ). His dosing is 5 units in the morning and 4 in the evening. Sometimes those would be too much but sometimes they are good so I’m not really sure what to do.

I don’t mind adjusting his dose each time but is it healthy for him? Should I just go with a lower dose even if the BG numbers stay higher? Is a consistent dose more important than a higher BG?

I also now have the needles so I can do 0,5 units. Technically I could do 0,25 units but eyeballing it is a bit of guesswork bcs the difference is so small. Plus because of illnesses and medication, I have shaky hands do it’s hard to get that 0,25 or 0,75 but I’m trying. 0,5 is okay.

For the past few days I feel Eddie has been breathing a bit ”fast”, it’s been very hot here so it could be that but I have a vet booked for tomorrow anyway.
 
inja said:
I don’t mind adjusting his dose each time but is it healthy for him? .
Click to expand...

No, it is not.

Lantus works best with consistent dosing, with dosing based on how low the cat goes on the dose not the pre-shot number. It is not a good idea to give different amounts of insulin every 12 hours.

I highly recommend you pick a dosing method that will help guide you in dosing, when to increase, when to decrease, how long to hold a dose, etc.

You can read about the different options here:

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/


And then, post a daily thread on the Lantus forum for specific guidance and extra help from the Lantus experts there. That's what I did and my cat is now in remission; I followed Tight Regulation.
 
If you can find this dry food in Finland it's better than the Brit
About 5 or 6 % carbs
If you can find somewhere in Finland that sells Dr Elsey's Clean Protein Chicken flavor I know that's about 5 or 6% carbs which is ok
I found Amazon International Shipping
https://www.amazon.com/International-Shipping-Direct/b?ie=UTF8&node=230659011

https://www.amazon.com/s?k=Dr Elsey's clean protein&bbn=230659011&crid=40D05B8ZYQMK&sprefix=dr elsey's clean protein ,aps,205&ref=nb_sb_noss

It is expensive though

Also found this web site
https://www.u-buy.co.uk/product/45EDGBG-dr-elsey-x27-s-cleanprotein-formula-dry-cat-food
 
Diane Tyler's Mom said:
Any freeze dried treat , just Google it, I don't know what you have in Finland
Click to expand...

Yes, I’ve done research and I’ve ordered treats, I think the brand is Cosma. I’ve also found one treat sold here in shops that he really likes and is okay for him to eat. I’ve now stopped giving him dry food completely. If he’s fussy about food, I put some other food on top of it (I have a variety of diabetes food for this reason) or if it’s raw food, I heat it up a little or poke it with my finger. For whatever reason, if I poke the raw meatball with my finger, he’s more likely to eat it.

Like I said earlier, in rare occasions he gets into the other cat’s food but I’m being as vigilant as I can about it. The other cat gets the Brit dry food now bcs she likes it (she’s a weird one). Dr Elsey’s isn’t available in Finland and I can’t pay those shipping costs. Eddie is something like 99% off any dry food and I will keep working to make it 100%.
 
As for dosing, I’ve been using the A4.4 answer as my guideline, and analyzing earlier results to see how a particular dose might affect him but never going over the doses the doctor gave me (5 in the morning and 4 in the evening). I can’t hold the dose if it’s likely to give him low numbers. This means that I could give him smaller doses but then the numbers will be higher again, but is that okay?
 
inja said:
As for dosing, I’ve been using the A4.4 answer as my guideline, and analyzing oearlier results to see how a particular dose might affect him but never going over the doses the doctor gave me (5 in the morning and 4 in the evening). I can’t hold the dose if it’s likely to give him low numbers. This means that I could give him smaller doses but then the numbers will be higher again, but is that okay?
Click to expand...
I have no idea what the A4.4 answer as your guideline means
Looking at your spreadsheet first thing I noticed is that you ate not getting any tests in after the PMPS shot, You need to be getting at least another test in @+6
I would even get a test in @+3 and +6 . You are only seeing half the picture in how the insulin is working.

Next you are switching the does way too much. Lantus likes consistency.
You need to find a dose that you can shoot the same amount of insulin for both cycles
You are not giving the Lantus a chance to work effectively.

I'm going to tag a few experienced members to take a look at your SS and explain better than me about dosing.

You need to definitely need to pick a dosing method by now,
I'll give you the link so you can read about it and choose one and add it to your signature and at the top of your spreadsheet

Remember if Eddie is eating any dry food at all you will have to follow the SLGS method, I'm not talking about freeze dried treats they are OK. The treats that you bought are they freeze dried treats? I looked up the Cosma treats and they say freeze dried so that's good for treats

Link for the dosing methods

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/


The way you are changing up the doses you are giving you will never get him regulated
We also do not increase by whole units we increase by 0.25 units at a time .
As Kyle said above we base how much insulin we give by how low the cat is dropping, not on how the BG Pre Shot numbers are

@tiffmaxee

@Suzanne & Darcy

@Wendy&Neko

@Bron and Sheba (GA)

@Chris & China (GA)

Hi ladies can you please read her post #14 since that the latest, I tried to explain the best I could about not to keep changing the the amount of insulin she is shooting and having no tests at night

Thanks :cat:

There are only 2 previous posts
Previous posts
https://felinediabetes.com/FDMB/threads/wondering-if-my-baby-has-acro.265385/

Intro post
https://felinediabetes.com/FDMB/thr...e-on-insulin-not-working.259462/#post-2916658
 
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@inja your best bet if you need help with dosing is to start posting on the Lantus Board everyday
You would put the
Date Eddie AMPS # and any other tests after that and can continue with the PMPS # and any tests after that
A new post everyday and you would link your previous days post to the new one .
To add additional tests to your Title you would look to the right and tap on the word Thread Tools then tap on Edit Title and add the tests and tap Save
 
A4.4 is the guide for what to do when you’re getting low numbers, you can see it here: http://www.felinediabetes.com/fdmb-faq.htm#glucose

It’s on the page you linked. I am aware of the two dosing methods but I can’t find either of them giving me an answer to this:

- if BG is sometimes low enough for me not to shoot any insulin but other times high enough to warrant a 5 unit dose, how could I choose a consistent dose? I also can’t hold a dose that would mean giving, for example, 4 units when his BG is something like 10.

Both methods require me to change the dose the doctor has ordered. Based on Eddie’s ideal weight, I should change Eddie to a 1,5 - 2 units dose and as a long-term dose, we’ve seen it wasn’t enough.

Or am I understanding it wrong? I do struggle understanding some of the things written because of ADHD.

I’m trying my hardest to work with what I know about my cat and how I’ve seen insulin work on him. I do of course want to give him the best treatment possible and never do anything to hurt or stress him out.

The treats are freeze dried chicken, I got a few from my friend and Eddie seems to like them. I don’t give him dry food but there is no way to say he will NEVER eat one piece of it because I have a former feral (that is afraid of touch) who eats diabetes dry food and Latz wet food (she won’t eat other wet food) and she wants to eat next to Eddie and will most likely not eat enough if I hide her food under the couch where Eddie can’t get to. They are both incredibly fussy eaters.
 
I do understand that I should not change the amount of insulin I’m shooting. There is no need to talk about me as if I can’t read.

I was following this guideline that I talked about earlier:

”Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.”
So when the BG was over 11.1, I went back to the doctor-ordered dose. Below that, I did what that guide said. At some point I thought I should try to decrease it so I could find a bit smaller dose that could be consistent but the BG always crept back up. I get that I possibly should have held the dose for a while and seen what happens then. I will do that next, also depending on what the vet says today.

But I’m still asking for a rule of thumb answers for the questions I asked above:

1. Both methods require me to change the dose the doctor has ordered. Based on Eddie’s ideal weight, I should change Eddie to a 1,5 - 2 units dose and as a long-term dose, we’ve seen it wasn’t enough because his dose had to be raised from that.

2. If BG is sometimes low enough for me not to shoot any insulin but other times high enough to warrant a 5 unit dose, how can I choose a consistent dose? I also can’t hold a dose that would mean giving, for example, 4 units when his BG is something like 10.


I have to be able to make these decisions by myself, I can’t post all the time to ask for advice before every dose, which is why I’m asking for advice in general.
 
The "guide" you mention is just one line in the FAQ and is not sufficient to help you get your cat to regulation.

I don't think just because you decide to start SLGS that you have to start back at 1-2 units. I think that could be modified for your situation but I am not positive. Let's see what the experts say when they pop in here.
 
Hey Hello and welcome! Before you get some answers from the experts I would like to offer you some insight.

First, take a deep breath! You obviously care very much for Eddie and are doing your best. Remember to be patient, feline diabetes is a marathon not a sprint. When I first started treatment I felt rushed and anxious too. Many of your questions will be answered with time.

With lantus it can take several days to see the result of a dose change. And testing gets better over time once you and Eddie settle into a positive routine. Right now you need more DATA which means more testing. So you need to ask yourself how many times a day you can test and that will determine what dosing method to follow. I see that you got some good mid cycle tests in this morning, that’s a great start!

Everything you could possibly need is here and very smart experienced people who can help. Make sure you carefully read every reply and try to learn as much as you can, I know it’s a lot at first.
It will get easier trust me but pace yourself. It took me a few months to get my cat regulated. Right now you are learning and settling into a dose and testing routine. Don’t rush it. You’ve got this! :)
 
Hi there. I would like to try to explain the need for consistency in dosing a depot insulin like Lantus. I hope it will shed some light on things. This is copied from another post I made to a different member about why the need for consistent dosing as much as possible (i.e., unless there's a need for a reduction or if the cat is ready for an increase.) Here goes:

I’m trying to think how to explain why the need for consistency. Think about the depot. Every time you shoot a lower dose, the depot is depleted a bit. Then you shoot a little more and the depot starts to rebuild- then at night you shoot a little less again— but the depot still influences at least the first part of the cycle anyway. So you really can get some wonky numbers, and it also could make dosing decisions about whether to increase or reduce almost impossible. It also would detract from the ability of the depot insulin to give nice flat cycles, which is the beauty of the depots to begin with. Now, I know you don’t feel like you are seeing flat cycles yet, but you are dealing with bounces as well right now and that can’t be completely controlled. But you will get there. I hope this makes sense.
 
Now having said that about the need to shoot the same dose both morning and evening under most circumstances, you really do need to get at least a few tests in at night if you are to see how low the dose is taking the cat. Many cats drop into lower numbers at night, it's quite a common phenomenon. Dosing decisions are based upon the nadir, or how low the dose it taking Eddie and not on preshot numbers for the most part. If we don't have any clue as to what Eddie's night time nadir is, then we can't really assess whether or not the dose is really safe or effective for him. It might be indicating too much insulin or it might be showing that it's not enough insulin. So more data gathered at night would be so beneficial to finding Eddie's correct dose.

Depot insulins do not work well with dose changes all the time. Perhaps your vet is not really very familiar with depot insulins like Lantus or Levemir. For a single cycle insulin like ProZinc or Vetsulin/Caninsulin sometimes these type of changes are warranted (although consistency is usually best there too, when possible). But this is just not the way a depot insulin like the one you are using will work best for your Eddie.
 
inja said:
I have to be able to make these decisions by myself, I can’t post all the time to ask for advice before every dose, which is why I’m asking for advice in general.
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If you cannot make a new post for each day, then that is fine. You can find the general guidelines in the dosing methods for SLGS and TR. I believe you are still feeding dry food so it would be SLGS, and you might be more comfortable starting with that anyway at this point. Either way, a night time test at varying times would be my minimum request (in addition to the tests you've been getting.) Just be sure to keep your spreadsheet up to date in case you do find that you need help quickly in a pinch.
 
Now, a little further down in the document that you have been referencing from the SLGS dosing method, it also says:

Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus, Levemir, and Biosimilars users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.

We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.
 
So, the guidelines that you have referenced above are for beginners who have very little data on their cats. You are gathering more and more data through testing at this point, which is fantastic. Here's where we really need to know about his nadirs so that you will know if a certain preshot number is safe to shoot the full dose... what happens is that you will gradually lower down the "no shoot" number as you lower the preshot number. A lot of the decision about what number is safe to shoot is also based on your ability to monitor Eddie and intervene with high carb food and/or honey/karo syrup if necessary. If you are at home and testing, then you are in control of the cycle.
 
inja said:
Both methods require me to change the dose the doctor has ordered. Based on Eddie’s ideal weight, I should change Eddie to a 1,5 - 2 units dose and as a long-term dose, we’ve seen it wasn’t enough.
Click to expand...
You would not start back at the beginning like a new person who is giving their cat their first day of insulin. A dose would be based on prior doses and data collected. You would not ignore everything that has gone on before, this would not make sense at all, I agree with you. Your vet, however, is wrong about the different doses morning and evening though -- I don't know of any "tactful" way to say it. This is not correct dosing for depot insulins.
 
inja said:
. If BG is sometimes low enough for me not to shoot any insulin but other times high enough to warrant a 5 unit dose, how can I choose a consistent dose? I also can’t hold a dose that would mean giving, for example, 4 units when his BG is something like 10.
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If you found that giving 4 units when his BG was 180 causes him to drop lower than 90, then you would know that the dose is too high an you would decrease the dose. Also, if you are able to select a dose and then gradually lower the "no shoot" threshold, then you are able to gradually and safely determine what is a safe dose and what is a safe preshot value at which to give the insulin. Honestly, there's a reason why, when starting insulin you should start with a lower dose and then work you way up -- as opposed to starting with a higher dose and working your way down. Starting low allows you to see that the kitty needs more insulin (if they do) without hypos. Starting high and then reducing when you see that the dose was too high is just potentially very dangerous. This is the same reason why doing whole unit increases is not a good idea. And you have no idea if you have just raised the insulin beyond your cat's best dose (which could have been just .25 more or .5 more.) If you increase by a whole unit and then your cats starts dropping too low while you are not testing (for example, at night) then the cat will bounce and you will have a lot of really high numbers as a result (including most likely your preshot numbers) and you will think.... "see, he needs more insulin" when it could be that he actually needs less insulin.
 
I really would like for @Wendy&Neko to take a look at your spreadsheet and advise on a possible consistent starting dose for Eddie, if possible. She also has a very excellent way of explaining things -- cutting to the heart of the matter (whereas I am much more wordy! sorry). She is a moderator and is super busy helping people all the time and she gets a jillion tags, but I hope she will be able to assess your spreadsheet and provide advice when she is able to.
 
I am unable to suggest a dose to start with as I have no idea what is happening at night and the doses aren't consistent. Can you get later tests at night after PMPS? Even right before going to bed if it's at least 2-3 hours after the PM shot. What I might suggest as an "experiment dose" would differ depending on how much monitoring can be done.
 
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