Beginner, need advice for dosing tomorrow morning

Status
Not open for further replies.
Anita and Stewie

Anita and Stewie

Member
Hi there, First of all, I'm new with this, and I've been reading like crazy, but I already goofed today with Stewie's shot and it makes me sad that I still don't have the knowledge I need...there is so much to learn! Stewie was diagnosed June 2nd, and his SS has the vet's readings first, sorry I copied and pasted from the USA sheet over to the World (I'm in Ottawa, Canada, EST) and the green colour came along when I pasted.
But I started his BG curve myself today, and I didn't know about the readings with the AlphaTRAK which I use, so I learned from someone on the forum, too late, that I should not have given him his morning dose as his reading was too low at 5.9. He went down to 3.0 as the lowest this afternoon, which I didn't know was bad (I thought 2.8 or lower was too low) but by luck I fed him small amounts of food a couple of times and he didn't go hypo. His reading went up to 7.5 by 7 pm.

I want to know about tomorrow morning, as I read this on one of the stickies for this group: NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.

Does this mean that tomorrow morning, if his BG reading is 14 or lower, that I should not dose him? when do I know to give half a dose, or just one dose a day?
As an added note: as soon as I found out he had diabetes on June 2nd, I switched to a low carb canned/wet food. He used to eat dry and wet. Thanks so much!
 
Glad you were testing to catch that 3.0, Anita :bighug:. Diet changes to all wet can have a big impact on numbers. If he's under 12.5 mmol/L in the morning and you won't be home to monitor, I would probably skip the insulin again. I think you skipped tonight's because the 7.5 is in +1 of PM cycle :). Keep in mind some cats show no signs of hypo until it gets really bad but I am glad to hear he didn't have a serious event. Well done with feeding small amounts too. Usually, when they hit the "take action" number (AT2 is 68) you feed tiny amounts, retest in 20 minutes. If number is the same or drops, feed tiny bit again, retest in 20 minutes. When you get above like 5.5, hold off on food, retest in 20 -30 minutes. The goal is to get 3 rising number tests without giving any food and then you can test in an hour, then a couple hours. Hope that makes sense :cat:

If he is like 12.6 - 14 and you will be home to monitor him and get mid cycle tests, you could try a 0.25U dose. You can also post his number, I think @Rachel checks in around 07:00am EST when she gets off work (I think :smuggrin:) to ask for help too.
 
Last edited:
Nice work! You have a signature, a spreadsheet, you're home testing, and you're on good food. You're doing great, and it looks like Stewie is too!

So it looks like you did not give a shot tonight. Is that correct? If so, can you put "NS" in the box for the PM dose? You can actually shoot below 14 as long as you can monitor (get mid-cycle tests like you did today).

If you aren't going to be home though, then yes, skip if the number is below 14. You don't have enough data yet to be sure what will happen, so that's why we say to skip the shot in the early days.

If you are going to be home, it looks like you need to reduce the dose anyway. Based on your pre-shot this morning, and the lower numbers today, it looks like 1.0u is too much. So whatever you get in the morning that's higher than 14, I would recommend reducing to 0.5u until you get a bit more data.
 
Anita and Stewie said:
I read this on one of the stickies for this group: NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.
Click to expand...
That can be a good starting point in the early days. I believe I said 11 (200) earlier and that could be your guide if you ask for advice here first.

Anita and Stewie said:
Does this mean that tomorrow morning, if his BG reading is 14 or lower, that I should not dose him?
Click to expand...
Please post here for advice. Someone will see it and help you. I'm usually on by 8 AM to check the forums.

Anita and Stewie said:
when do I know to give half a dose, or just one dose a day?
Click to expand...
First, you need to get more data. We can coach you through this data-gathering process and give dosing advice. Somewhere along the line you'll have enough data and confidence to decide doses for yourself. As for once a day - that isn't recommended because cats metabolize insulin very quickly. They need a dose every 12 hours.

Anita and Stewie said:
I switched to a low carb canned/wet food.
Click to expand...
This is excellent! The fact that you did it right away helps a lot.
 
I am here! I'm usually around a little after 5AM Central Time on weekdays. I wish I was getting off work, Yong...nope, I just go to work really early. :coffee:
 
Hi there, thank you everyone, I am home to monitor him today. I work from home often, and I am very lucky for that.
His reading just now, no food, was 4.9 I'm surprised, I thought it would be up. I am thinking no shot, but see what happens after food? I will wait to see what advice you have, but he's very hungry. I think he should eat? Thanks!! I updated his SS with today's reading.
 
Rachel said:
I am here! I'm usually around a little after 5AM Central Time on weekdays. I wish I was getting off work, Yong...nope, I just go to work really early. :coffee:
Click to expand...
Hi Rachel, I just took his AMPS at 4.9. I'm glad you're around, sorry you aren't getting off work!
 
Last edited:
Go ahead and feed him, Anita! I'll put more info in another post, but feed him and definitely no shot!
 
Okay, wanted to let you know you could feed so he didn't give you that betrayed look they all have when they're hungry. :smuggrin:

Generally, if you get a number that's too low to shoot, we do what's called stalling. Basically that means we wait for 15-20 minutes WITHOUT FOOD, and retest. Sometimes that is enough to get them up to above 200 so they can eat and get their shot. We try to avoid skipping shots since it can mean they'll be high for the next shot. HOWEVER, since you're using an AT (which means that 88 is basically a normal number for non-diabetics) and what with yesterday's numbers, stalling isn't even something I'd worry about. It's just too unlikely he'll come up since he's at a completely normal number. Most people who stall do so because they're closer to a shootable number and want to see if they can get the kitty there.

It is surprising that the number is so low! Since you're home to monitor, could you grab a test sometime mid-cycle today? I know it sounds a bit crazy, but it'd be interesting to see what his BG does with no insulin onboard. :)
 
Thanks, I know, I am surprised! He had a small feeding last night, maybe around 10 pm? Is that a no-no? He loves food and it keeps him from waking me up at ungodly hours, but I can stop at his dinner which is around 7 pm and leave him without until the next morning. I'll just have to deal with gentle and then more persistent paw pats on my eyes and grumbles in the night.

What does 'mid-cycle' mean....does it mean before I feed him again? I normally feed him 7 am breakfast, 11 am small amount, 3 pm small amount, 7 pm dinner, 10 pm small amount...that has usually been our routine as he pesters me relentlessly while I'm working (home office). But I can change this if I should. He is on a diet too, as he is a bit heavy, but not obese. I am trying to keep his amounts conservative.
 
That routine should be fine! We generally say no food 2 hours before the preshot to avoid it being food influenced, but that's it. Other than that, we all feed different times...whatever works for you and Stewie is fine!

For mid cycle, try to get a test between +5 (5 hours after you feed this morning) and +7 (7 hours after you feed this morning). That's called nadir (the middle point of the cycle, usually the lowest point. The nadir will vary based on the cat, but it's usually between 5 and 7 hours after the shot, or for you today, after you feed him this morning). Don't worry about it being food influenced. The only ones we want to avoid the food influence on are the before shot numbers.
 
Rachel said:
That routine should be fine! We generally say no food 2 hours before the preshot to avoid it being food influenced, but that's it. Other than that, we all feed different times...whatever works for you and Stewie is fine!

For mid cycle, try to get a test between +5 (5 hours after you feed this morning) and +7 (7 hours after you feed this morning). That's called nadir (the middle point of the cycle, usually the lowest point. The nadir will vary based on the cat, but it's usually between 5 and 7 hours after the shot, or for you today, after you feed him this morning). Don't worry about it being food influenced. The only ones we want to avoid the food influence on are the before shot numbers.
Click to expand...

Ok, thanks Rachel. so the test at 12 and then 2 pm. I will also send info to my vet as she knows I'm doing his BG curve at home, but to be honest, I trust everyone here more for their advice/knowledge.
 
Wow! What a great number this morning! Now that he's on low carb foods, his weight will likely go down slowly. It's carbs that make them hold weight.
 
This is an excellent BG number! No shot for sure this AM. I agree with the advice to check him mid cycle for information's sake.

A switch to low carb wet food only fed in reasonable amounts will get him slimmer and trimmer. Teasel's brother (non diabetic) was a little "fluffy" a year ago at his last checkup. I switched him to Teasel's low carb wet food and over the year he's lost a kilogram.

There's really no reason why you can't give him his late evening snack if he's happier with that. If you don't want to overfeed just divide his proper daily allotment into several meals including that evening meal.
 
Reading just now at noon was 4.8! That's good, right? He didn't eat anything between his morning breakfast and now. I just fed him after the reading.

Thanks Kris & Teasel, I'm glad he can have smaller amounts in more feedings, as it seems to make him happy. :)
 
With NS last night and this morning that's an excellent number! It's still in normal range.
 
Anita and Stewie said:
Wonderful! I'm looking for info on how a curve should look.
Click to expand...
ProZinc should give a "smile-shaped" curve where the AM and PM pre shot BGs are at the ends and the nadir is at the lowest point. Ideally the curve is shallow. You might see numbers like 10 or 11 at AM/PM PS and 5 or 6 at nadir (measured with the AlphaTrak meter).
 
Kris & Teasel said:
ProZinc should give a "smile-shaped" curve where the AM and PM pre shot BGs are at the ends and the nadir is at the lowest point. Ideally the curve is shallow. You might see numbers like 10 or 11 at AM/PM PS and 5 or 6 at nadir (measured with the AlphaTrak meter).
Click to expand...
Ah, ok! So he is kind of the opposite? Lower at AM PS, then higher in midcycle? What does a BG curve for a healthy non diabetic cat look like? I'm still reading all of YourDiabeticCat.com, but no curves there.
 
A non-diabetic cat will be pretty flat. Maybe a little higher right after eating, a little lower if they're hungry, but really not a whole lot of variation. They usually range between 50-80, but up to 120 is normal. (Sorry, I'm not sure on metric numbers?)
 
Anita and Stewie said:
Ah, ok! So he is kind of the opposite? Lower at AM PS, then higher in midcycle? What does a BG curve for a healthy non diabetic cat look like? I'm still reading all of YourDiabeticCat.com, but no curves there.
Click to expand...
A non diabetic cat wouldn't have a curve per se but a series of small fluctuations through the day depending on whether they'd just eaten, undergone extra physical activity, etc. It's an infinitely responsive physiologic system. Giving insulin to a diabetic cat only roughly approximates what the body of a non diabetic cat does on its own. It's the action of the insulin we shoot into them that creates the BG curve we talk about.
 
Last edited:
I see, thank you, this is all so important to know and I keep reading more every day. For metric, I read to divide by 18.
I'll do another BG test of Stewie tonight. And, of course continue tomorrow as per the 3 days. My vet will be interested for sure, to see these readings.
 
Stewie's reading tonight at 10 pm was 5.7. I know that it's too early to get out the party favors, but I'm smiling a lot more than I have been since June 2nd. :D
 
Awww, you're all so sweet and supportive! His reading just now was 6.4. Still good, but it has slowly been creeping up? Maybe that's normal with no insulin and it will stay anywhere from 4 to 8? Fingers crossed. One nice thing, his yukky dandruff is almost gone, and he's lost a little weight. His fur is shinier and silkier. He always has had nice fur, but it's much nicer and losing the dandruff is great. Look out, he's going to be the George Clooney of cats! haha! PS I hit a spot in his ear this morning that made him bleed more than usual, awww, I hate this part. I am too gentle at first and nothing happens, and then I might be a bit too hard, and this time, oops, quite a bit of blood. It's hard to get the hang of it. Luckily he forgives me quickly.
 
Anita and Stewie said:
Awww, you're all so sweet and supportive! His reading just now was 6.4. Still good, but it has slowly been creeping up? Maybe that's normal with no insulin and it will stay anywhere from 4 to 8? Fingers crossed. One nice thing, his yukky dandruff is almost gone, and he's lost a little weight. His fur is shinier and silkier. He always has had nice fur, but it's much nicer and losing the dandruff is great. Look out, he's going to be the George Clooney of cats! haha! PS I hit a spot in his ear this morning that made him bleed more than usual, awww, I hate this part. I am too gentle at first and nothing happens, and then I might be a bit too hard, and this time, oops, quite a bit of blood. It's hard to get the hang of it. Luckily he forgives me quickly.
Click to expand...
Just keep testing to see where his BG settles. You probably hit the tiny vein slightly in from the edge of his ear and that can cause a lot of bleeding. It's harder to see where to poke in black cats. Good boy for being so forgiving. :)
 
eknodt said:
Hi Anita,

I am new here too, your numbers look amazing. Just want to say hi.

eva & cookie
Click to expand...
Hi Eva & Cookie! I'm so glad to have found this group! Hello and welcome too! I'm excited about the numbers for Stewie, being that he was only diagnosed June 2nd. I think the change of diet from dry/wet to just wet has been the key. Good luck with Cookie!!
 
Stewie's morning reading, 5.8!! I didn't do one last night, so I only had the two readings from yesterday. I think I'll only do two today.

I would love to share! I'll post a couple of videos first to show his lovely playfulness.
This is him playing fetch. Someone must have taught him before I had him. I adopted him from the local shelter at 6 years old.
 
Anita and Stewie said:
Stewie's morning reading, 5.8!! I didn't do one last night, so I only had the two readings from yesterday. I think I'll only do two today.

I would love to share! I'll post a couple of videos first to show his lovely playfulness.
This is him playing fetch. Someone must have taught him before I had him. I adopted him from the local shelter at 6 years old.
Click to expand...
He's so cute! Lucky boy too to be adopted into a good home. :) Great number this morning. No shot needed.
 
Status
Not open for further replies.
Back
Top