5/5 Misha: is twice a day best? plus two random questions

Status
Not open for further replies.
Squeakycats

Squeakycats

Member Since 2017
Hello, all--

I've been doing .1 unit (best guess) twice a day with my kitty Misha. His numbers are staying in the low blue zone. I'm finally going to be home this weekend to gather more data, and I want to experiment with bumping things up a little--but I don't know whether to try for .25 twice a day, or .5 once a day (the latter is what my vet last recommended, but that was a while ago). Any thoughts? I get the impression that twice a day is considered better here, but I wanted to check.

Random question #1: do your kitties ever seem uncomfortable after a shot? Misha doesn't put up a fuss when he gets his, but a couple of times lately I've found that 1o or 15 minutes later, he relocates from his favorite chair to a spot under the bed--not a place he normally spends time if he's feeling well. I'm not sure what might account for this.

Random question #2: is anybody using syringes with a short needle? (I don't have the measurements in front of me, but the first needles I got had one that was more than an inch; I ordered some that half-units marked, and realized when they arrived that the needle was shorter--maybe half an inch.) I don't know how concerned I should be about whether the needle is going in far enough.
 
Squeakycats said:
Random question #2: is anybody using syringes with a short needle? (I don't have the measurements in front of me, but the first needles I got had one that was more than an inch; I ordered some that half-units marked, and realized when they arrived that the needle was shorter--maybe half an inch.) I don't know how concerned I should be about whether the needle is going in far enough.
Click to expand...
My syringes have 5/16" needles. I wouldn't want longer ones. They just need to poke through the skin.
 
Cats metabolize insulin too quickly for once a day dosing to be effective. Your kitty is doing really well. Maybe post to ask for microdosing help?
 
Thank you both! He truly is doing well; I need to remind myself of that when I start feeling anxious about whether I can get him to stay in the beautiful green zone. Everyone here has been so incredibly helpful.
 
with Lantus, it's best twice a day because of the depot. If you vary the dose, then it acts like an increase or a decrease.
It needs to be consistent, that's how it was designed.
 
Squeakycats said:
Hello, all--

I've been doing .1 unit (best guess) twice a day with my kitty Misha. His numbers are staying in the low blue zone. I'm finally going to be home this weekend to gather more data, and I want to experiment with bumping things up a little--but I don't know whether to try for .25 twice a day, or .5 once a day (the latter is what my vet last recommended, but that was a while ago). Any thoughts? I get the impression that twice a day is considered better here, but I wanted to check.

Random question #1: do your kitties ever seem uncomfortable after a shot? Misha doesn't put up a fuss when he gets his, but a couple of times lately I've found that 1o or 15 minutes later, he relocates from his favorite chair to a spot under the bed--not a place he normally spends time if he's feeling well. I'm not sure what might account for this.

Random question #2: is anybody using syringes with a short needle? (I don't have the measurements in front of me, but the first needles I got had one that was more than an inch; I ordered some that half-units marked, and realized when they arrived that the needle was shorter--maybe half an inch.) I don't know how concerned I should be about whether the needle is going in far enough.
Click to expand...

I am so not an expert on dosing, and I hope someone gets on here that can answer you about that, but Lantus works best on kitties when it's given twice a day. I looked over Misha's numbers, and he looks like he's doing great. From what little I know, I think taking him up to .5 could be dangerous. I hope someone else can speak to raising him to .25 because I don't know if he needs a higher dose. I think I know just enough to be dangerous. LOL

I use the 8mm needles. I don't like the longer ones; they seem more awkward to me.

Callie has times she hides after or before shots and/or testing. I don't know if she's feeling bad or just not happy with me. How long does Misha stay in hiding? :bighug:
 
A few days ago he went into hiding for pretty much the entire day--I asked a neighbor to go check on him late in the afternoon, and he was in the same spot--not looking weird/distressed or anything, but it still seemed odd to me. I suppose it's possible he went out for a while and then came back because that under-the-bed area is just ever so comfy...who knows with kitties? :rolleyes: .

I think I'm going to try .25 on Saturday and just watch him like a hawk and test every 2 hours, or even more often, if I can get him to tolerate that. Obviously if a veteran sugar-kitty mom/dad comes along and tells me this is a dumb idea, I'll rethink!

I am learning so much here...I'm looking forward to sharing it with my vet. I think she'll actually listen and not be offended. She and her colleagues have accepted tips from me in the past when I wanted to share something that was working so they could pass it on to other clients--stuff like putting claw caps on the rear feet of a cat who has allergies and is scratching a lot, or using that Tomlyn pill coating instead of crumbly Pill Pockets for pilling cats who won't eat them. I'm pretty sure they'll at least be excited to learn about the syringes with the half-unit markings...maybe they'll start stocking them. I need to tell my regular pharmacist about them, too; they didn't know what I was talking about, but they said they fill a lot of prescriptions for cats and were intrigued.
 
I couldn't agree more with what Sandy/Black Kitty posted. Before raising the dose, you need some data that tells you what's going on with regard to your cat's numbers at nadir. How about doing a curve versus raising the dose? With any dosing strategy, you need to have some insight into just how low a current dose in bringing your kitty's numbers.

It's possible that Misha is reacting to the acidic nature of Lantus. Most cats don't react unless they are on a large dose of insulin. However, every cat is different. It may be that what you're seeing is that Lantus stings.
 
OK--it's going to be National Ear-pricking Weekend! Nobody ever officially told me to go down to .1, and I feel like I might just have been being a chicken and should maybe have stayed at .25--but yeah, my data is so limited!

I bet it does sting :( Poor little guy.
 
I agree with Sandy you need more data during each cycle. My bet is that he is going lower into the greens on each cycle.
Please don't increase till you see what he is doing. Are you following either one SLGS ot TR?
You want to keep him safe and by increasing the insulin and not testing you have no way of knowing where he goes in the cycle.
He is a regulated cat right now. That is so nice.....:)
 
OK! I will put on the patience pants...thanks, everyone!

I'm not really following a protocol because we had already gotten started (following the vet's instructions...I now wonder if it was nuts to start at 2 units!) before I discovered the approaches here, but maybe I need to take a look at SLGS and think about whether I could do that. I have thought about TR but just don't think I can make it work with my unpredictable (and not 100% controllable) work schedule. Or with my general level of anxiety :nailbiting:
 
Your doing a fantastic job! We share our patient pants a lot around here!
images
 
I am not an expert in dosing, my approach would be to hold and do the curve for a day and evening cycle at least. The thing with insulin, is that it is a X doesn't always give you a Y scenario. And more insulin doesn't mean better results. Some days are better then others, so you would like to see a pattern with consistent use. You are seeing some nice blues, so I agree with everyone above, you may have some greens in there.

For Jones his pattern was pretty consistent- hit below 90 to earn the reduction - bounce for 1-2 cycles then usually within 4 cycles of the reduced dose he was back earning a reduction. But that is Jonesy and he was in control on how this was going...not me. CIC - cat in charge!

And I have become an expert on the fine dosages with Jones! I can squeeze drops out of syringe like nobody's business :D
 
Squeakycats said:
A few days ago he went into hiding for pretty much the entire day--I asked a neighbor to go check on him late in the afternoon, and he was in the same spot--not looking weird/distressed or anything, but it still seemed odd to me. I suppose it's possible he went out for a while and then came back because that under-the-bed area is just ever so comfy...who knows with kitties? :rolleyes: .

I think I'm going to try .25 on Saturday and just watch him like a hawk and test every 2 hours, or even more often, if I can get him to tolerate that. Obviously if a veteran sugar-kitty mom/dad comes along and tells me this is a dumb idea, I'll rethink!

I am learning so much here...I'm looking forward to sharing it with my vet. I think she'll actually listen and not be offended. She and her colleagues have accepted tips from me in the past when I wanted to share something that was working so they could pass it on to other clients--stuff like putting claw caps on the rear feet of a cat who has allergies and is scratching a lot, or using that Tomlyn pill coating instead of crumbly Pill Pockets for pilling cats who won't eat them. I'm pretty sure they'll at least be excited to learn about the syringes with the half-unit markings...maybe they'll start stocking them. I need to tell my regular pharmacist about them, too; they didn't know what I was talking about, but they said they fill a lot of prescriptions for cats and were intrigued.
Click to expand...
Sometimes when Callie's numbers get lower than she is used to she seems to feel funny, maybe almost as bad as when they're high. She's hiding under the bed right now, and her numbers tonight are lower than usual. I don't know--they do keep us guessing, huh?! Hope you and Misha have a great weekend.
 
Tracey&Jones said:
I am not an expert in dosing, my approach would be to hold and do the curve for a day and evening cycle at least. The thing with insulin, is that it is a X doesn't always give you a Y scenario. And more insulin doesn't mean better results. Some days are better then others, so you would like to see a pattern with consistent use. You are seeing some nice blues, so I agree with everyone above, you may have some greens in there.

For Jones his pattern was pretty consistent- hit below 90 to earn the reduction - bounce for 1-2 cycles then usually within 4 cycles of the reduced dose he was back earning a reduction. But that is Jonesy and he was in control on how this was going...not me. CIC - cat in charge!

And I have become an expert on the fine dosages with Jones! I can squeeze drops out of syringe like nobody's business :D
Click to expand...
Wouldn't it be wonderful if X always gave you Y with the insulin and the BG numbers?! I'm working on getting my drops uniform. I watched the sticky on it, but do you have any tips?
 
Gently roll and press the plunger until I get the drop size I am looking for. Then a knock that drop off and start again. So, far his .1 less X drops. I would get to the point I was happy with the .1 amount using the print out and then do the roll and press and get rid of X drops. Then use what was left. All syringes are not equal! There are some I couldn't get 7-8 drops out of. So I would toss it and get a new one.
 
Partway through a curve aimed at identifying the nadir for Misha, and guess what? I am SO GLAD I listened to the wisdom of the elders and stuck with .1!!!! He started out this morning at 102, and just now, at +7, he hit 61! He seems to be feeling just fine, so I'm not intervening in any way (I let him have a snack as he often does in the afternoon) and will test again in a few minutes to see what +8 brings. I am so grateful to everyone! :bighug:
 
Back at 108 at +8! Weird--that was fast! I'll have to repeat testing in this time frame tomorrow and see what the pattern is. If I had been doing every 2-3 hours instead of every hour, I would've missed the 61.
 
Tracey&Jones said:
Gently roll and press the plunger until I get the drop size I am looking for. Then a knock that drop off and start again. So, far his .1 less X drops. I would get to the point I was happy with the .1 amount using the print out and then do the roll and press and get rid of X drops. Then use what was left. All syringes are not equal! There are some I couldn't get 7-8 drops out of. So I would toss it and get a new one.
Click to expand...
Thank you for taking the time to explain this. I'm not quite sure what you mean by roll the plunger? And then did you just get used to drop size through practice?
 
Glad you didn't raise the dose.

What's Misha's normal feeding schedule?
When George got to small doses of insulin he did best with small regular meals, I fed every three hours, he got 3 ounces(his main meals) and amps and pmps, then 2 tsps at +3+6+9 in am and pm cycles, I used an autofeeder to keep the feeding consistent.

That 61 earned her a reduction.
How are you measuring the 0.1u, do you think you could take it down a drop?

She doesn't look ready to come off insulin altogether, with those numbers in the mid blues just a few days ago it would be nice to see less blue in there, ideally we like to see them spend most of the time in the range of a healthy cat with a human meter that's been found to be 50-80, and overall below 12o, not sure what that equates to with the AT if I recall we are probable looking at above 68 but below 120 (don't quote me on that though I tried to find the info and wasn't successful), the relationship between the AT and human meters isn't linear.
 
Thanks, @Gill & George...Misha normally gets a meal around 7:30 a.m., has a little bit of freeze-dried food around to munch during the day if he's hungry, gets another meal around 6:30 pm, a snack around 10:00 pm, and a little more freeze-dried to munch overnight--he generally never eats a ton at once, but I'm not super-precise about it. I used to have what was supposedly a cat-proof timed feeder, which he proceeded to break into within about 3 days; I now put his daytime/night snacks in a feeding box we built for him (a big plastic tub with a cat door in it that reads his microchip so that he can get in there and his greedy "sister" can't).

What I'm calling ".1" should perhaps more accurately be described as "less than .25"--I'm trying to keep the tip of the plunger a consistent (very small) distance from the 0 mark on the syringe, but I don't know how I could measure the actual volume. I think I may have to learn the "dose minus x drops" method--like, draw up .5 units (since I have the syringes marked with that) and then remove a consistent number of drops--or something. The .5 unit syringes seem harder to control than the 1 unit ones I had at first--the plunger just doesn't slide as smoothly, which makes it difficult to be precise.

Do you think it would be helpful if I switched to a human meter? I have the Relion one (bought when I was out of AlphaTrak strips and freaking out). A lot of the time I get a large enough blood drop that I might be able to use both.
 
Just did that for his PMPS--88 on the AlphaTrak, 56 on the Relion. I'm going to go experiment to see if I can consistently draw up a smaller dose--it seems like whatever it is that I'm getting now (my attempt at .1) is enough to keep him in a pretty good place during the day, but too low to do a PM shot--which means he ends up higher in the morning (and presumably overnight) than I'd like. I'm planning to take a vacation day on Wednesday and will try to get more measurements then--I think his poor ears are getting pretty sore, so I need to at least give him a couple of days. This is tricky!!!!
 
Hope you can find a dose that is smaller than what you are shooting right now, and that you can keep it consistent. I think that as long as is smaller and always the same you will be ok, because is definitely better if you shoot AM and PM and do not skip shoots .

I don't know what syringes you are using but I did found that with mine (BD ) .1 was around 3 drops, so I started going down to 2 drops ( kind of a .1 s ) and eventually to one drop, I did measured .1 with a caliper originally and ended up drawing small lines on a piece of paper to compare the next measures every time
 
OK! I'm trying the "push the plunger in as hard as possible, insert syringe in pen, release" method of getting a consistent drop. I'm using the half-unit syringes I found online: Monoject Ultra Comfort U-100 Insulin Syringes Short Needle 31G 5/16" 3/10cc 30 Units. If someone can recommend better options, I'm up for ordering more, even though I still have a ton of these left (it was a box of 100)--all I knew when I was ordering them was that they had to be U-100 and I wanted half-unit markings. Are these the BD ones? https://www.adwdiabetes.com/product/6941/bd-ultra-fine-insulin-syringes.
 
No BD is the brand and the ones you got are Monoject, but I think yours look ok too, I haven't used those so I could't say.

I think the most important thing is that you manage to get a consistent dose that you are shure is smaller than the one you were inyecting.
 
Status
Not open for further replies.
Back
Top