? 77 AM Pre-shot. 161 tonight. Advice?

[C.W. Gortner]

Hi all,
I've posted here about my female cat Mommy, who was diagnosed and hospitalized on 12/3. She's had a remarkable recovery, healthy appetite and gaining much-needed weight, also more energetic. Overall, more like herself again. Home-testing her BG has been a steep learning curve for both of us, with my vet being less than supportive of it, but I've been random testing as I can. Yesterday, after her a.m. meal and 2u morning shot, I managed to get a test done and she read at 74, which panicked me. I watched her carefully all day for hypo, but she seemed fine. In the evening, I tested her again and she was 297, so I shot her pm. 2u dose.

This morning, however, within literally 5 minutes of her morning meal, she tested at 77. I'm not comfortable shooting her when she's that low, so I held off shooting. Tonight at 6:45 p.m. with just a snack in her belly from 4:30, she was 161. I called the vet hospital where she stayed during her crisis, and the on-call doc told me to not shoot tonight either and re-test her in the morning.

I've been reading the stickies here, and it seems I could also reduce her dose by 25%. Would that be 1.25u? Or should I simply hold off and wait? I can't get more than two tests in a day right now, she's an ex-feral and while not a tiger by any means, she hides under the bed after the prick and can be uncooperative if I go at her too often with the dreaded lancet. We're slowly striving toward the goal of more daily tests. She just went so low these past two mornings, I'm concerned her 2u twice a day dose is too high (worried in a good way, as these numbers are much better than where she started, in the high 700s.) Thanks!

 

[Tricia Cinco(GA) & Harvey]

Have you been giving her a treat when you do test (whether you get blood or not)? That can help get them more accustomed to it. In case no one shared it with you before, here's a post with some good tips for testing.

If you can only test twice a day, the preshot tests are the most important. You need to know it's safe to shoot.

I watched her carefully all day for hypo, but she seemed fine.

Just so you know, hypo symptoms are not always apparent. My boys both hit the 20s on more than one occasion, with NO visibile signs. I'm not being critical, just want you to know you can't rely on how they look to tell you they are safe.

it seems I could also just reduce her dose by 25%. Would that be 1.25u?

If you are following SLGS, then yes, you should reduce by .25. Your SS says you are shooting 2.00, so your new dose would be 1.75.

 

[C.W. Gortner]

Thanks. I know hypo isn't always visible, so I plied her with food when she tested at 74. She ate. This morning, however, when she tested at 77, I didn't shoot. So, as she's at 161 tonight, it's safe to shoot 1.75u?

She's not much of a treat cat, never has been, and I've tried all the suggested tricks of the trade. I recently stumbled upon a method that works for us, in how I hold her and do the prick, but she hates the pricking part and there's just no getting around it; it takes patience and time with her, along with an established routine that she can deal with.

 

[Tricia Cinco(GA) & Harvey]

Sorry I wasn't around to answer your question. I would have said yes. Did you shoot?

 

[C.W. Gortner]

I did shoot, thanks, but I reduced the dose. I'll see how her BG is in the morning.

 

[C.W. Gortner]

Last night, I gave her only 1u because I was worried she'd fall too low again. This morning, she came in at 291 so I gave her another 1u and called her vet. She probably needs between 1.25 and 1.75 but I'd already prepared the syringe (poor calculation on my end) and I had her on the bed after the BG test, so there was no going downstairs to re-fill a syringe and avoid her scrambling under the bed. I can add a .5 if needed, but I'll let her coast on 1u today and of course, re-check in the evening. I know I screwed up by taking her dose down by half.

 

[Carol in Chicago]

Congrats on the greens! I know you are beating yourself up over the significant reduction. Having done this several times myself, I know how you feel.

It takes time for you both to be comfortable with lower numbers.

 

[Kris & Teasel]

I know I screwed up

No such thing! It's called "learning".

 

[Myagi (GA) and Heidi]

Ot, just gotta say Mommy and Boy are so beautiful! Is she the long hair?

 

[C.W. Gortner]

Yes, Mommy is long hair. Boy isn't but he's very handsome.

Dr Dick just called me back. To my surprise and relief, he endorsed my dose reduction to 1u 2x. He said to keep testing her morning and night, and not sweat any slight rises during the first week or so of her dose adjustment; if she goes higher than 350, however, I can add .25 u and so on, until we find the optimal dose. He said it was quite normal to have to adjust after a certain time on insulin and better we have to lower her dose than increase it from 2u, though he was of course grumpy. Evidently, he's not a fan of home testing, as it forces him to actually consider a kitty parent might be competent enough to handle it, but he was impressed by my "diligence." I'll take her in to see him on 1/23 for a follow-up fructosamine, but in his opinion, she's doing much better than expected, thus far. The man is a real charmer (not).

Go, figure. I'm wiped.

 

[Carol in Chicago]

You are doing a great job. It is not easy to impress a Dr. Even if the Dr. is Dick.

Just a comment on fructosamine. I see no value in it. Others may have a different opinion, but for those who are home testing, I don't think this test offers any value. Vets use it as a tool because not many people do home testing and they can get some visibility to the "average" BG over time. However, if you are doing home testing with some mid cycle tests, you have far more data in your SS than fructosamine can provide. Personally I would save the $$.

Again - you are doing all the right things and it is great to hear Mommy is doing better than expected!