3/25/24 Daphne AMPS 387 +7 62 +8 109 Dose?

My name is Karen and my 14-year-old cat is Daphne. I have just begun to use this site because my vet does not seem well-versed in the management of diabetes.

I need advice on how much Glargine I should give her on her next dose because a couple of hours ago at +7 her BG was 62. I rubbed her gums with Karo syrup and then headed to the store for some FF in gravy. She ate several TBL and then 20 min. later at +9, I tested again. She was up to 109. She will be due for her next dose in a couple of hours. I know I will get a BG before the feeding, but how much could someone please advise how much I should give her depending on a range of scores? I realize my communication is probably all wrong, but I don't have the time to go into the threads and need help soon! Thank you.

I just set up a spreadsheet but neglected to put in the only numbers I have from yesterday:

110 @+8
PMPS 145 @ +12 (.5 unit)
This morning before feeding:
AMPS 387

 

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I myself would have used Karo but I am concerned that dose should be reduced but I rrally can't tell since your SS is not viewable.

 

I think you should have access now. I hope.

 

Let me tag avfew member for you, I don't use the Alpha Trak,most of us use a human meter that's what our numbers are based on
@Suzanne & Darcy
@Wendy&Neko
@Bron and Sheba (GA)

Hi ladies should Karen reduce the dose at PMPS
since she got 62 @+7

Here is some information she has if you tap on her profile then information
My husband and I learned in 2023 that our 13-year-old female, Daphne, was diabetic. Following several months of ProZinc, she went into remission.

We learned a couple of months ago that she is again diabetic. Our vet is very hands-off, so it's clear that I am going to have to do this myself. I am somewhat overwhelmed by this site but will do my best to navigate it and not make it difficult for people to help me.

I look forward to reading your posts and getting your help.

 

Thank you. Her PMPS is 140; she's just eaten a tiny bit, and I'm in a holding pattern on her second Glargine dose.

 

How much more time until you shoot
@Daphne'sChallenge

 

Hi Karen,
With the +7 of 62 you need to reduce the dose of insulin.
However with only 2 doses in the SS and one being 2 units and the other 0.5u, it is very difficult to tell you what dose to give.
Can you tell me how much insulin you have been giving in the past week?

Also are you testing the urine for ketones? To do this you need a bottle of Ketostix from Walmart or a pharmacy and follow the instructions on the bottle.

What foods are you feeding and how often? Do you give snacks during the cycles?

 

She ate about 20 min. ago, so she's due now.

Daphne was on 1 unit for about 6 weeks. I regret to say that I have not been testing her. About 4 days ago, I tested her and she was at 387. When I called my vet, she told me to move from 1 unit to 2 units, and she's been on 2 units about 6 days.

My vet has not mentioned ketones. I honestly can't imagine catching her using the litter box unless I move it from the basement to the first floor. Is that what people do? Daph is scheduled for a kidney panel in April.

I feed her FF pates 2x daily, but she only eats a few tablespoons in several short visits to the food bowl. We throw out a lot of dried out FF. My vet suggested we get Hill's Gluco Support and leave that out all the time, so we've been doing that for 6 months. From what I've read today, I am removing that kibble entirely.

We have been giving her some Trader Joe's treats; however, today I ordered some freeze-dried high protein snacks I read about here.

 

@Bron and Sheba (GA)

 

Try replacing the regular litter with special litter that is designed to make urine collection easy. https://checkupkit.com/kit4cat/ You do want to sort of stalk the cat and get a sample of urine onto a ketone strip within a few minutes. Could you put the litter box in the bathroom and confine the cat to the bathroom for a few hours or until there is urine in the box?

There are blood glucose meters that also test for ketones. I'm not sure if the result from a meter is the same as the result from a urine test strip.

There's nothing wrong with dried canned food. It's not spoiled, just dry. Add some water and mix to re moisten it. You do want to throw out any uneaten food at the end of the day. Maybe use a timed feeder so your cat has access to small meals throughout the day. Put only enough food into each compartment that you know your cat will eat up. You can also freeze portion sizes of food and put the frozen chunk into the feeder to slowly defrost.

 

I would recommend you look at testing the urine for ketones on a regular basis…once a week if there or no ketones.
Or you could buy a blood ketone meter.
As far as food goes…swapping from dry to wet can result on the BGs dropping a lot. So I would do it slowly.
And I would feed more than twice a day. As mentioned above a timed feeder is a very good idea if you are not at home during the day.

Re the dose of insulin: when you got the BG 387, when was it in the cycle? Was it before insulin or several hours after insulin?
Going from 1 unit to 2 unit is not a good idea. That is doubling the dose. We increase the dose in 1/4 unit increments.
I would be inclined to go back to 1 unit for a few days so we can see what is happening.
Test before every dose to see it is safe to give the insulin and then test sometime during the cycle to see how low the dose is taking your kitty.
So you need to test the BG, feed and then give the dose of insulin and then try and get a test around +4 to +7 in the cycles.
Do you think you could do that?

 

@Daphne'sChallenge
Do you have the U-100 syringes with the half unit markings,
Since we increase or decrease by 0.25 units at a time
If not
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

 

I actually ordered a box yesterday after reading how important these half-marks are.

For some reason, my vet had me purchase narrow .5 ml syringes with a capacity of 50 units. I tried to post a photo but do not have permission.

It seems like those fatter syringes will change the amount of insulin I've been giving. I guess I'll play around with water to compare the volume between the 2.

 

The syringes you need are the U100 3/10ml, 30 or 31 gauge, 6 or 8 mm 1/2 unit insulin syringes.
The 0.5 ml syringes are not ideal for measuring small amounts.

The best way to post a photo is to copy and paste it

 

Thank you. I will get the ketone strips and master this next skill. I am retired and able to be tuned into feeding and testing, but want to get her regulated before we have a petsitter with us in June for 3 weeks.

Are you saying that I can put frozen soft food into a timed feeder?!

I'd like to get her weight up a bit. She's at 9.6 lbs and part of that is because she is so picky. Our vet suggested that we leave the dry Gluco Support out to help her put on weight, but clearly with regard to her diabetes, that isn't a good idea. I almost purchased an alternative low-carb dry food yesterday (Dr. Elsey), but the recent reviews state that the formula was changed last year and many cats are vomiting with the new product. In the end, I ordered some freeze-dried protein snacks to offer during the day.

To answer your question about the 387, that was before the first injection of the day, but she may have been eating dried kibble during the night.

I did a +3 test today and she dropped from AMPS 299 to 257.

 

Here's a photo of her current syringe. I've ordered the correct syringes, but I'm not sure if 1 unit on my present .5 ml syringe will = 1 unit on the 3/10 ml syringe. Do you know?

 

One unit is one unit regardless of the capacity of a syringe as long as both syringes are for the same type (i.e, U100 of insulin). .
The 3/10 ml syringe will have a smaller diameter than the ½ ml syringe

 

OK, thank you!

 

Thanks to your help, I ordered kit4cat and will soon be able to test for ketones. I also appreciate your suggestion to freeze soft food an dput in a pet food dispenser! I would never have thought of that.

 

I just wanted to confirm that my Vet said the same thing. We don't increase the dose by more than .25 at a time. And also to maintain the dose for at least a week. That was when I asked her if I could bump up .5.

I was just confirming that I agreed when I saw the 1 to 2 unit suggestion might not be best. My Vet echoed everything back to me that I heard on this forum.

 

I hope Daphne will be better regulated for you in June.
So you are going away for 3 weeks but will have a pet sitter come in .
Will the pet sitter be testing Daphne during the day and night and feeding her multiple times during each cycle ?
@Daphne'sChallenge

 

I see you got BGs of 49 today at + 7 and 71 @+5 two days ago. Anytime you get a BG below 90 when you are doing SLGS you need to reduce the dose by 0.25 U. So your new dose is 0.75U moving forward. I see you gave no shot this pm cycle.
Also I would encourage you to try and get at least one BG test in each of cycle as cats often drop lower at night. Even a before bed test is useful.