My cat just tested significantly lower than he ever has... dosing advice?

KLD

KLD

Member Since 2024
Hi all,

To keep it short, my cat just tested at 5.2 (mmol/L) around his nadir. I know this is a very good, safe number for him to be at. However, it is significantly lower than he has ever been at his nadir (you can see the numbers in his spreadsheet), which have been around 12-14 on 3.5 units of insulin.

My question is about dosing at PM. What should I take into consideration regarding his dose? In particular, I'm supposed to be at an event tonight (basically gone from the time I give him his insulin until around +5), so I'm now worried about him going hypoglycemic. I do have high carb food just in case. But I won't be around to test him in the meantime.

Any advice? Thanks!
 
And by the way, WELCOME to the ProZinc forum!
As for this evening, I would wait and see where you are at that time. If Emmett is back up to a preshot level that you have shot before, then go ahead and shoot your normal dose.

That is a large dose to start with for a cat only recently diagnosed. How did you get to 3.5 units so quickly?
 
Suzanne & Darcy said:
And by the way, WELCOME to the ProZinc forum!
As for this evening, I would wait and see where you are at that time. If Emmett is back up to a preshot level that you have shot before, then go ahead and shoot your normal dose.

That is a large dose to start with for a cat only recently diagnosed. How did you get to 3.5 units so quickly?
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Thank you!

It is. He didn’t seem to be responding very well to the insulin (numbers weren’t budging from the high 20’s to 30’s range). I had done a couple increases based on vet recommendation before I found this forum. Hence, we are at 3.5 (though the vet wanted him to go to 4).
 
KLD said:
Thank you!

It is. He didn’t seem to be responding very well to the insulin (numbers weren’t budging from the high 20’s to 30’s range). I had done a couple increases based on vet recommendation before I found this forum. Hence, we are at 3.5 (though the vet wanted him to go to 4).
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Thank goodness you didn’t go to 4.
 
He’s on the verge of needing a reduction of .25 units. He came very close today.

What is his feeding schedule like? Is he getting LC snacks at +2 and +4?
 
Suzanne & Darcy said:
Thank goodness you didn’t go to 4.
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I know. It seemed way too high, especially after I learned the recommended way to increase dosage from this community. At the same time he went to 3.5, the vet gave him Cerenia to address nausea/pain from possible pancreatitis. She thought that could be contributing to his difficulty regulating. He seems to be feeling a lot better at any rate.
 
So he went from 94 to 223 in one hour?? LC wet food would not do that so it wasn’t the food. It looks like you will be able to shoot the regular dose tonight if he’s already gone back up into the yellow numbers.
 
KLD said:
I know. It seemed way too high, especially after I learned the recommended way to increase dosage from this community. At the same time he went to 3.5, the vet gave him Cerenia to address nausea/pain from possible pancreatitis. She thought that could be contributing to his difficulty regulating. He seems to be feeling a lot better at any rate.
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I’m glad the Cerenia helped! He’s a handsome boy by the way!
Since you won’t be home this evening until +5, hopefully you can leave his wet food for him while you’re away.
 
Suzanne & Darcy said:
So he went from 94 to 223 in one hour?? LC wet food would not do that so it wasn’t the food. It looks like you will be able to shoot the regular dose tonight if he’s already gone back up into the yellow numbers.
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I guess so! The way his numbers jump give me a headache. Thank you thank you
 
KLD said:
Yes. Today he was fed small snacks at +2, +4, and +6.
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That’s good. I don’t recommend feeding after nadir as it can shorten the duration of the insulin. If his typical nadir is at +6 then that’s okay. If you find you need to make it a little earlier that’s okay too. We will learn his patterns.
 
Suzanne & Darcy said:
I’m glad the Cerenia helped! He’s a handsome boy by the way!
Since you won’t be home this evening until +5, hopefully you can leave his wet food for him while you’re away.
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Change of plans and now someone will be with him until I’m back home, thankfully. They won’t be able to test him, but they can feed him.
 
Suzanne & Darcy said:
That’s good. I don’t recommend feeding after nadir as it can shorten the duration of the insulin. If his typical nadir is at +6 then that’s okay. If you find you need to make it a little earlier that’s okay too. We will learn his patterns.
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I think I’m finding that to be the case with him in terms of shortening the duration. He sure doesn’t like waiting that long between meals but we’ve gotta do what we gotta do :)
 
I’m glad you posted over here because I will get an email whenever someone posts on this ProZinc forum. Otherwise I won’t find out there’s a new ProZinc user until someone tags me. I see Bron was helping you over on health. Bron is a gem!
 
Suzanne & Darcy said:
I’m glad you posted over here because I will get an email whenever someone posts on this ProZinc forum. Otherwise I won’t find out there’s a new ProZinc user until someone tags me. I see Bron was helping you over on health. Bron is a gem!
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Finding this community has been a lifesaver for me. SO much helpful information
 
KLD said:
I think I’m finding that to be the case with him in terms of shortening the duration. He sure doesn’t like waiting that long between meals but we’ve gotta do what we gotta do :)
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Yes. Sometimes even LC can shorten the duration. You can play around with that final snack time and move it earlier if you need to. And maybe you can make the last snack a little larger if it helps him wait longer? Usually we won’t see such a dramatic jump in numbers as you saw today. His body may also be reacting to the green number that he had today. He’s not used to those numbers.
 
So it sounds like you are following the no food for two hours prior to the preshot tests guideline.

He can still have his LC treat with every ear test though.
 
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Suzanne & Darcy said:
Yes. Sometimes even LC can shorten the duration. You can play around with that final snack time and move it earlier if you need to. And maybe you can make the last snack a little larger if it helps him wait longer? Usually we won’t see such a dramatic jump in numbers as you saw today. His body may also be reacting to the green number that he had today. He’s not used to those numbers.
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This is all very helpful, thank you. I’m going to play around and see what works best for him with the food.
 
And you know that with the Alpha Trak meter your “take action number” is 68. That just means that you can feed and test in 20 minutes to make sure the BG is coming up. Not all cats need Karo syrup or honey or high carb food at that time. Some will do fine on LC or MC. But until we document his response to carbs I would at least try medium carbs and retesting in 20 minutes.

You have your hypo kit available? MC food and HC food? And remember when using HC or MC it only takes a very small amount. With HC sometimes just a little gravy from the food will do the trick. We always want to avoid filling them up too quickly in case we need to use food to steer the numbers for a few hours.
 
I’m really impressed with how quickly you have gotten up to speed with testing and learning all this new stuff. Well done!
 
Tell me what time zone you’re in and your shot time. If you can please keep your spreadsheet up to date I will check in on him.
I am in the Eastern time zone.
 
Suzanne & Darcy said:
And you know that with the Alpha Trak meter your “take action number” is 68. That just means that you can feed and test in 20 minutes to make sure the BG is coming up. Not all cats need Karo syrup or honey or high carb food at that time. Some will do fine on LC or MC. But until we document his response to carbs I would at least try medium carbs and retesting in 20 minutes.

You have your hypo kit available? MC food and HC food? And remember when using HC or MC it only takes a very small amount. With HC sometimes just a little gravy from the food will do the trick. We always want to avoid filling them up too quickly in case we need to use food to steer the numbers for a few hours.
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Yes, I have a hypo kit ready! That’s good advice.
 
Update: Emmett’s BG shot up to around 23 around +8. I guess his body really didn’t like that lower number. I think it’s safe to say he will be testing high enough for his full dose tonight.
 
KLD said:
Update: Emmett’s BG shot up to around 23 around +8. I guess his body really didn’t like that lower number. I think it’s safe to say he will be testing high enough for his full dose tonight.
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Well at least you won’t have to worry for this evening. I look forward to seeing those preshot numbers come down.
 
Me too. He seems to have such an extreme reaction to lower numbers. His PMPS was in the high 30s and evening nadir at 31.7/570ish. Absolutely wild change. I hope those numbers come back down.
 
Do you test for ketones at home, either with a blood ketone meter or the keto stix urine strips? It sounds like he feels okay and is eating and drinking enough? No history of DKA?
 
His BG must have continued to drop a little bit throughout the night because he was at 27ish this morning. I haven’t had a chance to test him yet this afternoon but I imagine we will be dealing with a bit of a bounce
 
Suzanne & Darcy said:
Do you test for ketones at home, either with a blood ketone meter or the keto stix urine strips? It sounds like he feels okay and is eating and drinking enough? No history of DKA?
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Yep, I’ve got the ketostix and have been testing him as much as I can. So far negative (he was positive for ketones when he was first diagnosed at the vet, but since then I haven’t gotten a positive). He’s feeling fine as far as I can tell and eating and drinking is no issue. No DKA
 
KLD said:
His BG must have continued to drop a little bit throughout the night because he was at 27ish this morning. I haven’t had a chance to test him yet this afternoon but I imagine we will be dealing with a bit of a bounce
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Today’s cycle looks like he may be bouncing, yes.
 
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Hello, I’m wondering if I could get some advice on Emmett’s recent numbers. As you can see, his numbers finally came back down following that bounce from the lower number the other day. I thought we were making progress with him getting back down to 11.3 today, but two hours later he was back up in the high 20s. Is he just going to continue bouncing around like this? Is there anything I should be doing to help bring those numbers down?

Also, tomorrow I will be switching to a human monitor. Is there a way I should be noting that in his spreadsheet?

Thanks!
 
KLD said:
Hello, I’m wondering if I could get some advice on Emmett’s recent numbers. As you can see, his numbers finally came back down following that bounce from the lower number the other day. I thought we were making progress with him getting back down to 11.3 today, but two hours later he was back up in the high 20s. Is he just going to continue bouncing around like this? Is there anything I should be doing to help bring those numbers down?

Also, tomorrow I will be switching to a human monitor. Is there a way I should be noting that in his spreadsheet?

Thanks!
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Can you put a large line horizontally across the spreadsheet to say Switched to a Human Meter.

I do think you should increase to 3.75 units. I am sorry for the bouncy jumps. You are making progress, but it’s really hard to see when there are so many high numbers and so few lows. It’s not anything that you are doing wrong.
 
Suzanne & Darcy said:
Can you put a large line horizontally across the spreadsheet to say Switched to a Human Meter.

I do think you should increase to 3.75 units. I am sorry for the bouncy jumps. You are making progress, but it’s really hard to see when there are so many high numbers and so few lows. It’s not anything that you are doing wrong.
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Thank you. I appreciate all your help. I didn't end up upping his dose this morning because his AMPS ended up being on the low end of typical for him (19.4/349), even accounting for the difference between pet and human meters. Currently, at +4 he is at 7.4/133. The relief I feel is immense. I do hope he can keep up these numbers. I'll be keeping a close eye on him today, as his nadir is typically around +6.
 
Nice cycle today! If you had increased you probably would have seen some green, but I don’t know if you are mentally prepared for that yet! All things in good time. I am really happy to see that string of decent blues! Good job with the holding of the dose and monitoring. Unfortunately, he may bounce later, but hopefully won’t take too long to clear it. I am very optimistic for him overall.
 
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Suzanne & Darcy said:
Nice cycle today! If you had increased you probably would have seen some green, but I don’t know if you are mentally prepared for that yet! All things in good time. I am really happy to see that string of decent blues! Good job with the holding of the dose and monitoring. Unfortunately, he may bounce lated, but hopefully won’t take too long to clear it. I am very optimistic for him overall.
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I agree, I think his dose still needs some tinkering, but I think you may have hit the nail on the head that after all the bouncing I was not mentally prepared to change anything this morning lol.

Yes, very happy with the blues today! Honestly, at first I thought my new meter was broken until he shot back up to 17.9 at +8. I wonder if his nadir is earlier than I thought, or has been changing.

Emmett went to the vet today for a quick weigh in and he is up a pound since diagnosis! He lost a lot of weight from the diabetes, so this is good news and puts him back around his ideal weight. His vet is very happy with this, and said it was a good sign of overall adequate sugar management.
 
Suzanne & Darcy said:
Unfortunately, he may bounce lated, but hopefully won’t take too long to clear it. I am very optimistic for him overall.
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FYI you were right on the money with this one. Thankfully it doesn’t seem as extreme as some of his previous bounces. I’m increasing his dose to 3.75 tomorrow morning. I’ve been really sick the past few days and just haven’t had the mental capacity for any major changes with Emmett.
 
I’m so sorry you have been ill. I understand about just doing the minimum to keep him safe and nothing more. I think you’re on the verge of getting some green numbers.
 
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