5/3/2015 Dosing Advice

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Michaellh33

Michaellh33

Member Since 2015
It doesn't seem like my cats values are going down according to my SS so I wanted to get some advice for the dose. Also there always seems to be a decent sized air bubble in the syringe so I don't know if I am just not giving him an actual 1.25 dose. Should I increase or is there a better technique I need to be using?
 
I push the plunger in as firmly as I can before drawing up the insulin.
Another tactic is to draw in a bit extra, point the needle upwards, and push out any air and excess.

We adjust the Lantus dose based on the nadir, not the pre-shot. The nadir for Lantus often falls in the +5 to +7 hour range; whenever you can, get a test some time in that period, even if you have to set an alarm overnight. Many cats go lower overnight.


 
I answered in your other thread - i think you should get new insulin and see if it makes a difference in his blood sugar.

Did you decide whether you are following Start Low Go Slow dosing method or the Tight Regulation Protocol? It makes a difference in the advice. If SLGS, you'd hold this dose for 2 more cycles and then do a curve, adjusting his dose based upon the results of the curve, combined with the tests you've already gotten. If you're following TR, you could increase by 0.25u. It's a good idea to get a test before bed every night, especially if you're working during the day. Even if it just shows all yellow, that still tells us something.

Does Brody have food available during the day? Timed feeder?
 
What works for me as far as bubbles in the syringe is to draw a little more insulin than needed and then flick the side of the syringe until you get the bubble to rise to the top. I then slowly draw out the extra insulin, causing the bubble to get drawn into the reserviour at the top. I use the ADW Ulti syringes which has a reservoir so there's always something left in there, which I assume is mostly the lubricant.

You can refine your technique practicing with a syringe filled with water. If you're using something different ,then you may need to adjust accordingly.
 
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I use a similar method with BD syringes, which don't have a reservoir. Draw a little extra, flick bubble to the top, if the bubble isn't in the right spot to be first out of the syringe (it will be at the top but sometimes isn't dead centre) then I draw in a little extra air which will join up with what was at the top of the syringe, then push the air out and adjust the dose. Because we're dealing with small doses an air bubble can make a big difference.
 
I would like to use the tight regulation as I really want him to go into remission. Sorry if I missed answering that previously. I used the new insulin this morning so I will check when I get home from work and will get a +9. I will try to get a +6 but that would require me to get up at 1 am and I already have sleep problems lately but I will try.

Thanks for the drawing suggestions, I appreciate it. Will give a try tonight.
 
I am giving him the new insulin and it doesn't seem to be going below 250s. I haven't been able to get a +6 pm shot though so I am not sure about that time frame.
 
You don't need a +6. Many cats don't have their nadir at +6. Get a before bed test and that is sufficient to at least tell you if he's going low later in the pm cycle.

Would you make sure and note the new insulin in the comments section of the spreadsheet, please? It can be significant. It can also take more than 1 cycle to show effects. Add "Tight Reg" to your signature line too. That's very helpful to know.
 
Yes, if you're following Tight Reg, you look at the nadirs and adjust the dose about every 3-5 days. You don't want to hold a dose too long that's not getting him into normal blood sugar range (50-120 on a human glucometer). If they stay too long in high numbers the cat's body will accept that as normal (called Glucose Toxicity) and it becomes more difficult to get them used to normal numbers again.

Here's the part from the Tight Regulation Protocol that would apply to Brody right now. He's having consistent nadirs (low points) in the 200's:
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
By the way, sorry no one saw your question about dose sooner. I think your question about dose got missed today because it's on an old post. We encourage people to start a new post for each new day. That helps keep the information current and it's a way that works to keep things manageable.
 
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