Advice on Dosing

Kay_Libra

Kay_Libra

Member
Some background before reading the chart: We started at 0.75U because at first he didn't want to eat his new cat food then I went with the numbers that the vet suggested (Before I found this group) then upped it by 0.25U to see a change (But vet suggested we do 2.5U from the curve which is insane). However, with his new dose yesterday his numbers dropped down very low that it had me scared that this dose is too much (from the bouncing) and that I should reduce. Do I reduce it from the 1.75U or try to start from 1U and adjust from then after a few cycles?

https://docs.google.com/spreadsheet...SFuW5ZgbUyHP-16ZBwWZfYUHVS8/edit?usp=drivesdk
 
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Those blue numbers from yesterday are fantastic. Those tests were taken with a human meter, correct? What is the new food that he is eating? Is it all low carb wet food?
 
Today’s high preshot is probably just because of a combination of a little bouncing from the blues and also last night’s skipped shot. Normally I would not recommend completely skipping the shot, but it’s okay and I totally understand. As you gather data on him you will be able to determine what his safe to shoot number is, as well as what kind of reduced doses you can shoot based on his preshot tests. All of your preshot tests are “fasting preshot” tests, right? (Meaning he hasn’t eaten anything for two hours prior to the test). I just want to make sure since I don’t know yet. :)
 
Suzanne & Darcy said:
Those blue numbers from yesterday are fantastic. Those tests were taken with a human meter, correct? What is the new food that he is eating? Is it all low carb wet food?
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They were with a human meter but I also used the Alphatrak2 just in case cuz one number it gave me was 5.9mmol when it said 8mmol.

He gets Friskies Pate in chicken flavor and sometimes purebites chicken sprinkled ontop
 
Suzanne & Darcy said:
Today’s high preshot is probably just because of a combination of a little bouncing from the blues and also last night’s skipped shot. Normally I would not recommend completely skipping the shot, but it’s okay and I totally understand. As you gather data on him you will be able to determine what his safe to shoot number is, as well as what kind of reduced doses you can shoot based on his preshot tests. All of your preshot tests are “fasting preshot” tests, right? (Meaning he hasn’t eaten anything for two hours prior to the test). I just want to make sure since I don’t know yet. :)
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So far each Fasting is the recommended two hours! In that moment when I skipped I didn't realized that I could've given like 0.25U or something just to still have some insulin in him! Do you think it's still good to continue woth the 1.75U for now until I do a glucose Curve on him?
 
Kay_Libra said:
They were with a human meter but I also used the Alphatrak2 just in case cuz one number it gave me was 5.9mmol when it said 8mmol.

He gets Friskies Pate in chicken flavor and sometimes purebites chicken sprinkled ontop
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Which meter said 5.9 (106) and which 8 (144)? That’s not a huge difference when you consider the twenty percent meter variance that happens sometimes with the same drop of blood— but it’s disconcerting when trying to decide about doses and sometimes about what to feed (e.g. do I meed to give a higher carb snack, etc.)
 
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Kay_Libra said:
So far each Fasting is the recommended two hours! In that moment when I skipped I didn't realized that I could've given like 0.25U or something just to still have some insulin in him! Do you think it's still good to continue woth the 1.75U for now until I do a glucose Curve on him?
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And yes, you can give a token dose or a reduced dose. Sometimes it takes a while of gathering data on your spreadsheet before you can know what to shoot with the lower preshot numbers. It’s still very new. Better to be safe.
 
Suzanne & Darcy said:
Which meter said 5.9 (106) and which 8 (144)? That’s not a huge difference when you consider the ten percent meter variance that happens sometimes with the same drop of blood— but it’s disconcerting when trying to decide about doses and sometimes about what to feed (e.g. do I meed to give a higher carb snack, etc.)
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The 5.9 was from Human and the 8 was from Animal! Yeah I give him the same thing everyday but sometimes remove his bone broth to see if that makes any difference
 
Kay_Libra said:
The 5.9 was from Human and the 8 was from Animal! Yeah I give him the same thing everyday but sometimes remove his bone broth to see if that makes any difference
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Okay. That makes sense since the pet meters tend to read a little higher than the human meters.
 
Good. A yellow preshot. An improvement. I would shoot the 1.75 units as long as you can monitor him today. Give a snack by at least +2
 
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That is an excellent nadir for today. And let’s see how he does on the 1 unit with that 205 preshot. Please try to get a few tests in so that you can gather data on how he does with a preshot of approximately 200 and with just a 1 unit dose. He is doing well - much better. Many cats do tend to drop lower at night, so we always advise getting a “before bed test” which is usually a few hours into the cycle. This test will tell you if you need to intervene and whether or not you need to set an alarm to wake up and test/feed, etc.
 
Hi there. I’m checking in with you to see how it’s going. I’m sorry you were unwell.

I think there have been too many dose changes lately. It would perhaps be better if we could find a slightly reduced dose that can be given more consistently. On the couple of recent days where you have had a low-ish preshot values, you haven’t been able to test so we can see what’s been going on. Those black preshot numbers are undoubtedly bounces from a low number, but we don’t know how low. He’s very bouncy so I am not thinking that it was hypo territory, but anything is possible- since we don’t have information to the contrary.
 
Suzanne & Darcy said:
Hi there. I’m checking in with you to see how it’s going. I’m sorry you were unwell.

I think there have been too many dose changes lately. It would perhaps be better if we could find a slightly reduced dose that can be given more consistently. On the couple of recent days where you have had a low-ish preshot values, you haven’t been able to test so we can see what’s been going on. Those black preshot numbers are undoubtedly bounces from a low number, but we don’t know how low. He’s very bouncy so I am not thinking that it was hypo territory, but anything is possible- since we don’t have information to the contrary.
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Lately I've been thinking of a reduced but don't know by how much and when I see it too low I just give the 1U so at least he still has something in his system. I was going to do a curve today to see how he drops throughout the day but I was sick as a dog and couldn't move
 
Suzanne & Darcy said:
Hi there. I’m checking in with you to see how it’s going. I’m sorry you were unwell.

I think there have been too many dose changes lately. It would perhaps be better if we could find a slightly reduced dose that can be given more consistently. On the couple of recent days where you have had a low-ish preshot values, you haven’t been able to test so we can see what’s been going on. Those black preshot numbers are undoubtedly bounces from a low number, but we don’t know how low. He’s very bouncy so I am not thinking that it was hypo territory, but anything is possible- since we don’t have information to the contrary.
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What number do you think we could try to do?
 
I’m so sorry you’ve been ill! That sounds terrible. Actually, if you’ve been ill and his preshots have been a little lower than normal then you have done well to shoot a reduced dose. I hope you will be all better soon! We can try to keep up with the 1.75 units and if he’s 250 or above then shoot the 1.75 dose. Below that then you may want to shoot a slightly reduced dose — and hopefully you will feel better and be able to gather test data so we can see what happens. You are doing great. It’s just that we missed a few opportunities this week to see what happened with the lower preshots/ reduced doses. You were sick and did what you could, I understand.
 
4.6 (83) is okay. Safe number but probably just a good time to give a low carb snack and retest in an hour if you’re at home or 30 minutes if you had to leave.
 
Suzanne & Darcy said:
4.6 (83) is okay. Safe number but probably just a good time to give a low carb snack and retest in an hour if you’re at home or 30 minutes if you had to leave.
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I stayed an hour and he went back up to 6.3 but then accidentally left the semi carby snack there and his bg JUMPED UP ‍♀️
 
Kay_Libra said:
I stayed an hour and he went back up to 6.3 but then accidentally left the semi carby snack there and his bg JUMPED UP ‍♀️
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Wow. Black. :( he probably had a little help also from bouncing a little from the green number - but we don’t know for sure because of the food. He may be extremely carb-sensitive. Hope today will be a good day!
 
Suzanne & Darcy said:
Wow. Black. :( he probably had a little help also from bouncing a little from the green number - but we don’t know for sure because of the food. He may be extremely carb-sensitive. Hope today will be a good day!
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Today was a good day but scared me when he dropped 15mmol (200+) from his shot to his +2 but he had a nice blue and had a lowish number for the evening
 
That is a lot - a very steep drop indeed. It looks like he was breaking the bounce. We want to avoid steep drops as much as possible because they can, in and of themselves, trigger another bounce. Did you give a snack at +2? Some people with what I call “diving kitties” need to give a +1 snack as well.
 
Suzanne & Darcy said:
That is a lot - a very steep drop indeed. It looks like he was breaking the bounce. We want to avoid steep drops as much as possible because they can, in and of themselves, trigger another bounce. Did you give a snack at +2? Some people with what I call “diving kitties” need to give a +1 snack as well.
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He was given snacks, I let him graze some freeze dry raw in case I can't get an early break from work and once again we woke up to a high number this is a lil frustrating honestly but I know this is a marathon so it'll take time to find the right balance for him
 
Some cats need a little more carbs early in the cycle if they are diving kitties. Higher end low carb food (up to ten percent is still considered low carb) or medium carb food can be tried to stave off diving. Just a teaspoon or two. Some cats actually do better with a few more carbs rather than zero carbs.
 
Suzanne & Darcy said:
Some cats need a little more carbs early in the cycle if they are diving kitties. Higher end low carb food (up to ten percent is still considered low carb) or medium carb food can be tried to stave off diving. Just a teaspoon or two. Some cats actually do better with a few more carbs rather than zero carbs.
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Really? I didn't know that, I just keep reading "feed them under 10% carbs" and just so many things that either contradict or confuse!
 
Well you have to kind of experiment with carbs a little bit and see how your cat responds. Some cats are very carb sensitive and some are not as much. Anything below 10 percent is considered low carb. So some people will try a little snack that’s maybe 6 or 8 percent carbs and see if that helps slow them down if they are diving early in the cycle. Others sometimes need to give a medium carb snack of around 15 percent. There’s a lot of trial and error involved sometimes. I’m of course not advocating giving high carb food all the time. High carb food that’s over 20 percent is usually reserved for situations where the cat has dropped below 50 (human meter) and/or karo syrup. Even then it’s given in small amounts. I hope I didn’t confuse you.
 
Suzanne & Darcy said:
Well you have to kind of experiment with carbs a little bit and see how your cat responds. Some cats are very carb sensitive and some are not as much. Anything below 10 percent is considered low carb. So some people will try a little snack that’s maybe 6 or 8 percent carbs and see if that helps slow them down if they are diving early in the cycle. Others sometimes need to give a medium carb snack of around 15 percent. There’s a lot of trial and error involved sometimes. I’m of course not advocating giving high carb food all the time. High carb food that’s over 20 percent is usually reserved for situations where the cat has dropped below 50 (human meter) and/or karo syrup. Even then it’s given in small amounts. I hope I didn’t confuse you.
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No I understood but that's honestly good to know! Because he does tend to dive a lot when I check around his +2!
 
Hello there, Kayla. How’s it going? I see a lot of bouncing and some diving. Have you been trying the snacks in the early portion of the cycle (even if, and maybe especially if, he is starting out from a very high place?). Have you been able to find some different carb percentages to experiment?
 
Suzanne & Darcy said:
Hello there, Kayla. How’s it going? I see a lot of bouncing and some diving. Have you been trying the snacks in the early portion of the cycle (even if, and maybe especially if, he is starting out from a very high place?). Have you been able to find some different carb percentages to experiment?
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Hey! It's been a bit stressful but I've been trying different things here and there and it's just throwing my head in circles and after reducing his dose a little but he still was dropping very low from his high pre shots so I decided that I'll start at 1U with him and see if there should be an increase or decrease after all that. As well as bought calipers if I have to do a weird in in between numbers!
 
Well he earned a .25 unit reduction when he hit 76 (even though that is a very good, normal, healthy BG number for a cat). So he should have been taken down to 1.25 units at that point.
Keep feeding during the early portion of the cycle. He dives — and then comes back up again quickly. As it is, hold his current dose for 7 days to stabilize.
 
Suzanne & Darcy said:
Well he earned a .25 unit reduction when he hit 76 (even though that is a very good, normal, healthy BG number for a cat). So he should have been taken down to 1.25 units at that point.
Keep feeding during the early portion of the cycle. He dives — and then comes back up again quickly. As it is, hold his current dose for 7 days to stabilize.
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Been trying to keep his 1U stable but he keeps getting lower with each pre shot, even today I have given him high carb wet and dry food for a bit to stop a dive from happening but his evening preshot was pretty low
 
Kay_Libra said:
Been trying to keep his 1U stable but he keeps getting lower with each pre shot, even today I have given him high carb wet and dry food for a bit to stop a dive from happening but his evening preshot was pretty low
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I'm not familiar with world numbers & I didn't see a tab on your spreadsheet for US numbers. I see @Suzanne & Darcy has been helping you so I've tagged her, but she's probably sleeping right now. So I'm going to tag a couple of other members that may be on right now about whether he has earned a reduction & also to see if they can fix your spreadsheet. @Bron and Sheba (GA) @Ale & Bobo & Minnie (GA) @Bandit's Mom
 
Kay_Libra said:
Been trying to keep his 1U stable but he keeps getting lower with each pre shot, even today I have given him high carb wet and dry food for a bit to stop a dive from happening but his evening preshot was pretty low
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Hi there. Yes, to give a reduced dose last night due to the low preshot was fine. I would have probably given .5 units just for that one cycle as long as I was able to monitor him periodically during the night and give food, etc. as needed. He did okay, but ended up with a little higher preshot.

I see that you shot a reduced dose this morning, but he hasn't really earned another reduction and he did have a yellow preshot. I think it would be better if we could find a dose that you could shoot more consistently for a week or so if you are uncomfortable with the numbers that you are seeing. Do you think you could try sticking with the .75 units and holding it for 7 days? This would be held unless he has a low preshot of maybe less than 150 (8.3) and then perhaps you could shoot a .5 units as long as you can do your usual excellent job of monitoring him. I really think that his body needs to stabilize a bit with the insulin doses and his BG (hopefully).

I would also like to see about getting your spreadsheet data put into our standard format where there's a tab for US numbers and a tab for world numbers. You would not need to do anything different, just enter your own world numbers as usual and it would automatically populate the US tab for you. I can ask someone to help you with this. We have a wonderful member who can do this for you. This way, when you have questions, more people would be able to give you some input.
 
Suzanne & Darcy said:
Hi there. Yes, to give a reduced dose last night due to the low preshot was fine. I would have probably given .5 units just for that one cycle as long as I was able to monitor him periodically during the night and give food, etc. as needed. He did okay, but ended up with a little higher preshot.

I see that you shot a reduced dose this morning, but he hasn't really earned another reduction and he did have a yellow preshot. I think it would be better if we could find a dose that you could shoot more consistently for a week or so if you are uncomfortable with the numbers that you are seeing. Do you think you could try sticking with the .75 units and holding it for 7 days? This would be held unless he has a low preshot of maybe less than 150 (8.3) and then perhaps you could shoot a .5 units as long as you can do your usual excellent job of monitoring him. I really think that his body needs to stabilize a bit with the insulin doses and his BG (hopefully).

I would also like to see about getting your spreadsheet data put into our standard format where there's a tab for US numbers and a tab for world numbers. You would not need to do anything different, just enter your own world numbers as usual and it would automatically populate the US tab for you. I can ask someone to help you with this. We have a wonderful member who can do this for you. This way, when you have questions, more people would be able to give you some input.
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I reduced in fear because around that time he would stop eating his food and would look nauseous so went to my vet who have us pills for that and did a radiography just in case but everything was fine (had a hairball in him). But now his numbers are so low after that visit that he hasn't been given insulin which has me skeptical because I've never seen these numbers from him for preshots!

But no if anyone is willing to help with that I would greatly appreciate it

(Also can't login into the main account I made for this post so made another one)
 
Wow. I can’t believe Rusty is doing so great. Wonderful! Those greens the last couple of days are perfectly normal numbers. Keep testing and charting the numbers to make sure he stays like that! :D:D:D Two weeks in normal numbers (between 50 and 120) with no insulin would mean he is a diet controlled diabetic — aka in remission!
 
Suzanne & Darcy said:
Wow. I can’t believe Rusty is doing so great. Wonderful! Those greens the last couple of days are perfectly normal numbers. Keep testing and charting the numbers to make sure he stays like that! :D:D:D Two weeks in normal numbers (between 50 and 120) with no insulin would mean he is a diet controlled diabetic — aka in remission!
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I can't believe it either! We got 9 more days to go before remission I AM SO NERVOUS
 
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