? Low blood sugar - dosing advice

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That does look more like 0.25 than 0.1
I can tell you from experience that 0.1 and a drop of insulin can make a big difference.
I’ll tag @Suzanne & Darcy about the dose because I think you most like have more than 0.1 dose but let’s see what she says.
How many hours til PMPS?
 
Bron and Sheba (GA) said:
That does look more like 0.25 than 0.1
I can tell you from experience that 0.1 and a drop of insulin can make a big difference.
I’ll tag @Suzanne & Darcy about the dose because I think you most like have more than 0.1 dose but let’s see what she says.
How many hours til PMPS?
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About 2 hours till pmps. I’m definitely going to error more on the side of caution with a lower dose tonight.
 
Unfortunately Suzanne has not been around.
You have two options.
You can either shoot the 0.1 unit making sure it is not more than that OR you could shoot a drop?
I’ll tell you how to get a drop if you decide to do that. the reason I am suggesting a drop is because of the drop to 81 last cycle….you did say you thought you had giving more than 0.1
 
Bron and Sheba (GA) said:
Unfortunately Suzanne has not been around.
You have two options.
You can either shoot the 0.1 unit making sure it is not more than that OR you could shoot a drop?
I’ll tell you how to get a drop if you decide to do that. the reason I am suggesting a drop is because of the drop to 81 last cycle….you did say you thought you had giving more than 0.1
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Yeah, like I showed above I likely have a tad more than 0.1. But there’s so little margin for error when you’re eye balling it.

A drop?? So there’s a dose less than 0.1?? I guess you can show me. You think giving no insulin is/shouldn’t be an option? Tbh, I’m considering a no shot in the AM since I don’t have a lot of time to monitor. Sorry but these little teenie tiny does on insulin are mind boggling
 
If you are uncomfortable with the 0.1 you can try a drop dose. Yes a drop can make a difference. To dose a drop dose. Take the syringe and depress the plunger with your thumb. While still keeping the plunger depressed, insert the syringe in to the vial of insulin. Once it is inserted, release the plunger, which will draw in a drop of insulin.
 
Suzanne & Darcy said:
If you are uncomfortable with the 0.1 you can try a drop dose. Yes a drop can make a difference. To dose a drop dose. Take the syringe and depress the plunger with your thumb. While still keeping the plunger depressed, insert the syringe in to the vial of insulin. Once it is inserted, release the plunger, which will draw in a drop of insulin.
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What would you recommend in your opinion?
I did a couple test with a syringe to get the drop. Sometimes it works. Sometimes it doesn’t after pulling it out of the bottle. Should I pull the plunger back slightly when I got to give it to her and inject?
 
So I decided to go with the 0.1u but I think (hopefully) errored on the side of caution and maybe have a little less? Below is what I gave her.

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I’ll try and get a +1 and +2 and/or +3 and see what happens.

I also bought some Ziwi air dried food and of course she loves it. So I’m going to try and slowly reduce the high carb dry and add some of the Ziwi over the next handful of days.

Im curious, could there be another reason as to why she suddenly has such sensitivity to the insulin and drops so much so fast?
 

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That looks more like 0.1
I’ll be interested how she goes.
Great she likes the Ziwi dried.

Some cats just do this with insulin. It’s great she is responding so well
 
Bron and Sheba (GA) said:
That looks more like 0.1
I’ll be interested how she goes.
Great she likes the Ziwi dried.

Some cats just do this with insulin. It’s great she is responding so well
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As far as the “drop” of insulin. I may decide to try that in the morning as to not have to worry as much and maybe get out the door sooner. Can you give more advice on how? As I mentioned above, I did a test a few times and it work a couple times but then a couple times nothing came out.
 
David - coco said:
As far as the “drop” of insulin. I may decide to try that in the morning as to not have to worry as much and maybe get out the door sooner. Can you give more advice on how? As I mentioned above, I did a test a few times and it work a couple times but then a couple times nothing came out.
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That can happen sometimes. Just keep
practising with a used syringe and water.
 
Bron and Sheba (GA) said:
Do you mean when the syringe is in the insulin or in the body? either way I would not do it.
You just need to release the plunger once it’s in the insulin
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No I mean when injecting into her. I guess to make sure the drop comes out, but I suppose you would also be injecting air which may not be good.

or do you just release the plunger once it’s in the bottle, then just push the plunger from there after poking.

I just would wonder if the drop actually comes out…
 
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Bron said it all. Don’t pull back on the plunger when the needle is inserted into Coco. But you can practice inserting it into your vial with the plunger depressed and then after you pull it out of the vial you can check to see if you got a drop in there by pushing the drop out. Is that what you were trying last night? And sometimes you got a drop and sometimes not?
 
Suzanne & Darcy said:
Bron said it all. Don’t pull back on the plunger when the needle is inserted into Coco. But you can practice inserting it into your vial with the plunger depressed and then after you pull it out of the vial you can check to see if you got a drop in there by pushing the drop out. Is that what you were trying last night? And sometimes you got a drop and sometimes not?
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@Suzanne & Darcy
I didn’t mean to pull the plunger back after it’s inserted into her but before. I meant to pull it back slightly to maybe, 1/2u, then insert it into her and push. I guess to make sure there’s enough force to push the drop out? If you get what I’m saying. But I suppose that’s not necessary. I guess you just depress the plunger hard when you insert it and it’s enough pressure to release the drop?

But yes, I practiced maybe 5 times and I think only twice did I see a drop come out. So that would make me wonder if it even worked or not if I tried that dose option.

Her amps was 296. I keep expecting to see a lower number for the ps years but they jump back up pretty good. Are these number what you would expect to see?

As to not have a repeat of the last 3 mornings and having to monitor her for 2-3 hrs, I’m likely to at least TRY the drop method and if it works, it works. Or it doesn’t. Either way hopefully she won’t plummet right before I leave and test her at about + 1.5. I guess that would be better than skipping altogether?
 
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Did you do the drop? The 0.1 seemed to help her into blue numbers last night. Definitely try to get a test before you leave.
 
Suzanne & Darcy said:
Did you do the drop? The 0.1 seemed to help her into blue numbers last night. Definitely try to get a test before you leave.
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Yes, I tired the drop method so we’ll see if it worked. I’ll get a +1 and +1.5 for sure.

So the numbers last night and even the night before, are good drops? Meaning the 0.1 is a good dose at this time?

Are the higher pre shot numbers normal to you? I keep expecting them to be a little lower every time. Maybe she’s in a big bounce since she’s gone low a lot the last 4 days?

+1 dropped to 120….. with a drop dose. Dropped lower with less insulin versus last night…

+1.5 is now 109….
+2 123
 
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Bron and Sheba (GA) said:
Great she likes the Ziwi dried.
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The only issue I realized is the ziwi all have bone in them so phosphorus levels are about double the recommended amount for ckd, same for the Koha wet food I’m trying to get her transitioned to. She’s early stage 2 at this point. But I suppose in the short run, I’m more concerned more with her eating a consistent meal. She didn’t do well on the kidney specific diet. I know I’ll need to have her kidneys checked in a few months.
 
David - coco said:
The only issue I realized is the ziwi all have bone in them so phosphorus levels are about double the recommended amount for ckd, same for the Koha wet food I’m trying to get her transitioned to. She’s early stage 2 at this point. But I suppose in the short run, I’m more concerned more with her eating a consistent meal. She didn’t do well on the kidney specific diet. I know I’ll need to have her kidneys checked in a few months.
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If her phosphorus levels are too high then you can consider using a phosphate binder to bring it down to safe levels (you want it to be around 4). Of course, you already know that excess phosphorus creates more work for the kidneys to clear it.
 
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David - coco said:
Yes, I tired the drop method so we’ll see if it worked. I’ll get a +1 and +1.5 for sure.

So the numbers last night and even the night before, are good drops? Meaning the 0.1 is a good dose at this time?

Are the higher pre shot numbers normal to you? I keep expecting them to be a little lower every time. Maybe she’s in a big bounce since she’s gone low a lot the last 4 days?

+1 dropped to 120….. with a drop dose. Dropped lower with less insulin versus last night…

+1.5 is now 109….
+2 123
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It looks like you did get a drop into her today with those blue numbers. The good news is that the three tests that you got were nice flat blue numbers, so she's not doing any dives.
 
David - coco said:
Are the higher pre shot numbers normal to you? I keep expecting them to be a little lower every time. Maybe she’s in a big bounce since she’s gone low a lot the last 4 days?
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This is hard to say. With ProZinc, sometimes I don't see lower preshots like I do with a depot insulin like Lantus. The depot tends to smooth things out. Some cats will get lower preshots over time with ProZinc. I think we just need to be patient at this point and see how she does. Of course, lower preshots will mean lower mid-cycle numbers. With ProZinc, a blue preshot may well give you greens mid-cycle (so that would have to be something that is acceptable to you.)

Oh, and she's not bouncing or she would not be having these nice blues this morning.
 
Suzanne & Darcy said:
This is hard to say. With ProZinc, sometimes I don't see lower preshots like I do with a depot insulin like Lantus. The depot tends to smooth things out. Some cats will get lower preshots over time with ProZinc. I think we just need to be patient at this point and see how she does. Of course, lower preshots will mean lower mid-cycle numbers. With ProZinc, a blue preshot may well give you greens mid-cycle (so that would have to be something that is acceptable to you.)

Oh, and she's not bouncing or she would not be having these nice blues this morning.
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So would you say to stick with the "drop" dose for right now?

I guess where I'm still mind boggled and confused is how so little insulin she is needing right now AND what that means and what's going on right now??

Excuse my ignorance and I mean no offense but the "drop" dose of insulin just seems darn near pointless. No vet out there is going to say you need to give your cat a drop of insulin as a dose.

Is she heading towards remission at this point, is that what's happening and the sudden need for basically no insulin?? What would be the signs of remission and what signs aren't we seeing yet to point to that? Someone above made the comment, "she still needs insulin". How do you know that? And one tiny drop is going to do that?

Sorry, I'm just frustrated not knowing what's going on and I still can't fathom the one drop dose being any different then no dose.
 
David - coco said:
Someone above made the comment, "she still needs insulin". How do you know that?
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. I wasn’t the one who said it, but I would have said it if it hadn’t already been said.
I know that she needs insulin because normal blood glucose levels for a cat are roughly between 50 and 100 on a human meter. That is where a non-diabetic cat and a diet-controlled diabetic cat (who is in “remission” meaning they are maintaining these normal numbers without the aid of insulin) spend most of their time - between 50 and 100. They should not be in the mid to higher blues or higher - not even on an Alpha Trak meter.

The drop dose was offered as a suggestion for a safe alternative because you were going to be working and not able to test her very much.

You’re right. Most vets would not even know about a drop dose, and would be surprised to see the effect it had on Coco today. But then vets receive little to no training in feline diabetes and they don’t understand about doing dose changes smaller than whole units.

I understand your frustration. It’s not a problem to ask questions here. We will try to answer them.
 
Suzanne & Darcy said:
. I wasn’t the one who said it, but I would have said it if it hadn’t already been said.
I know that she needs insulin because normal blood glucose levels for a cat are roughly between 50 and 100 on a human meter. That is where a non-diabetic cat and a diet-controlled diabetic cat (who is in “remission” meaning they are maintaining these normal numbers without the aid of insulin) spend most of their time - between 50 and 100. They should not be in the mid to higher blues or higher - not even on an Alpha Trak meter.

The drop dose was offered as a suggestion for a safe alternative because you were going to be working and not able to test her very much.

You’re right. Most vets would not even know about a drop dose, and would be surprised to see the effect it had on Coco today. But then vets receive little to no training in feline diabetes and they don’t understand about doing dose changes smaller than whole units.

I understand your frustration. It’s not a problem to ask questions here. We will try to answer them.
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So should I stick with 0.1u as her dose for the foreseeable future then, in your opinion? Or stick with a drop? Her number dropped lower this morning vs last night on the lower dose. The constant lower number make nervous during the day since I can’t monitor her. I also don’t want to test her to death but I guess that’s part of it. With such little insulin, a curve doesn’t really seem necessary.

Do some people give this little of insulin as a dose long term?? Or does this typically mean somethings changing and at some point soon, its going to come to a head?

What will I be looking for to determine what to do next?

Sorry I keep asking but you’re saying since she keeps going into the yellows and upper blues, she's not in remission? So if she starts having lower ps then maybe we’re closer? But do you think that the reason this is happening is that it's possible that's where we're headed? I'm not sure what the typical signs of remission are or when you know.

I read that they are considered in remission when they maintain normal glucose for 4 weeks without insulin. At what point do you know to try that?

Hypothetically if I were to not give her insulin and her number still dropped after her meal, what would that mean? Or do you not see that as possible? I guess I’m my mind that would mean she able to produce insulin in her own, no?

Is it possible that her body is bringing down the BG early in the cycle more so than the insulin?

I’m just not sure what to expect from here.
 
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When a cat is in remission, the numbers are consistently in normal range (50 - 120) with a lot more green than blue numbers. So, to answer your question, Coco is not in remission.

If numbers drop after you feed your kitty, it strongly suggests that the cat's pancreas is working. Food stimulates the beta cells in the pancreas to produce/release insulin.

A housekeeping note -- we try to limit threads to 50 posts. There's a lot to read here and frankly, I was skimming. If threads get overly long, there's a lot to wade through. Would you mind starting a new thread?
 
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