Caninsulin dosage advice needed please

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Monica Lewis said:
Oh just one more thing, if Im unable to do curve right now what +hours would be the most important ones to aim for with the blood tests to get a better idea of her response to .25u? +2 +4 or +6?

I gotta pick one as don't want to push my luck when going so well or drag her out from under bush every two hours... Thank you
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It generally peeks 4-6, so any readings then.

5 is halfway.
 
Monica Lewis said:
Oh just one more thing, if Im unable to do curve right now what +hours would be the most important ones to aim for with the blood tests to get a better idea of her response to .25u? +2 +4 or +6?

I gotta pick one as don't want to push my luck when going so well or drag her out from under bush every two hours... Thank you
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I'd go for the +4 if you can get only one. :)
 
Monica, I agree that testing between +4 and +6 will generally catch the lowest reading but there are some kitties that drop a lot even earlier. Rather than testing at +4 every day, I would shuffle test times it a bit and randomly test from +2 through to +6 . I am curious about those red pre-shots. Not what I expected to happen and it makes me wonder if she is dropping before +4 and what you are seeing is actually a rise rather than the lowest reading of the cycle. Of course it could also be that Josie does need more insulin. Hold the dose for the moment and we'll see what she does. :)
 
Monica Lewis said:
Thanks Diana,
I love thunderstorms and I love the wonderfully gloomy grey wet British weather all year round! :)

Ok will keep it at .25 for a bit longer.

It's a bit tricky to dose.25 on a 40u syringe and I think you offered me before, when you can find the time could you please give me the link to which ones are the best 100u ones in the UK that I should use? I am totally clueless when comes to needles..
Many thanks!
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Hi Monica, it wasn't me actually who sent you the link, it was probably @Elizabeth and Bertie so by tagging her here she will hopefully see it and let you know...
 
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Elizabeth and Bertie said:
Hi Monica @Monica Lewis , here's the (Amazon) link to the BD U100's with half unit markings (labelled "+ Demi" on the box)
https://www.amazon.co.uk/MicroFine-...-U100/dp/B00K86ZO20?tag=felinediabetesfdmb-20
I can still send you some of mine to try if you wish..?

Remember you will need to use them with the conversion chart. Here's link to previous post with the link to conversion chart:
Reassurance required please for UK newbie - from anyone!

Eliz
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That's great, thanks very much Eliz!
 
MrWorfMen's Mom said:
Monica, I agree that testing between +4 and +6 will generally catch the lowest reading but there are some kitties that drop a lot even earlier. Rather than testing at +4 every day, I would shuffle test times it a bit and randomly test from +2 through to +6 . I am curious about those red pre-shots. Not what I expected to happen and it makes me wonder if she is dropping before +4 and what you are seeing is actually a rise rather than the lowest reading of the cycle. Of course it could also be that Josie does need more insulin. Hold the dose for the moment and we'll see what she does. :)
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Interesting point about shuffling times of read, will try to do that thank you!
 
Hello nice ladies,
I'm well pleased and relieved to see lower PS numbers and out of the reds! I'm hoping we are on the right track here but as Diana suggested will keep an open mind and prepared for anything..

Josie's been eating very well and a happy kitty, even up for playing which is a big thing for her lazy butt! :)

Will try to get random readings to include everyone's suggestions and if things are getting consistent we'll regroup in a few days time to review the action plan.

Ps. Vet couldn't open the link for spreadsheet so Im going to print out and hand it in to her, she specialises in diabetic cats so Im curious to see what she'll say..

As always thank you everyone for being there for me and Josephine, hope you all have a lovely weekend! :cat:
 
Monica Lewis said:
Hello nice ladies,
I'm well pleased and relieved to see lower PS numbers and out of the reds! I'm hoping we are on the right track here but as Diana suggested will keep an open mind and prepared for anything..

Josie's been eating very well and a happy kitty, even up for playing which is a big thing for her lazy butt! :)

Will try to get random readings to include everyone's suggestions and if things are getting consistent we'll regroup in a few days time to review the action plan.

Ps. Vet couldn't open the link for spreadsheet so Im going to print out and hand it in to her, she specialises in diabetic cats so Im curious to see what she'll say..

As always thank you everyone for being there for me and Josephine, hope you all have a lovely weekend! :cat:
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She may have to download Google Sheets to see it.
 
Ladies I need help please!

Josie's been eating well past few days and PS numbers bit high but consistent..
This morning she ate ok and even played a bit, seemed happy. I managed to do 3 readings before we went out around 1pm. It's been pretty warm today, we just got back around 5pm, Josie didn't want to eat,snack or drink water, she wasn't even interested in her favourite treats whilst testing her which has not happened since we got these freeze dried chicken treats as she goes nuts for them....

Her readings were surprisingly high at 5pm - 21.9 / just under 400. She hasn't eaten since just laying there sad and no insulin given but 2 and half hours later her PMPS numbers gone down a bit to 19.8 / 350 ?!

How's that possible and what shall I do now?
As she's not eating Im holding off the insulin at the mo. Or as it's a small amount 0.25 shall we give her? Her ears and paws feel warm so might have a temperature ( or just hot in this weather..?)

The only thing she was willing to lick off my palm was a little blob of coconut oil which she always eats no matter how unwell she is... ( I adore coconut oil, use it and eat it, it's supposed to be good for cat's digestion and aid their wellbeing as well - although now certain websites say it's not good for diabetic cats so now I'm reluctant to give her the tiny odd treats.. any opinion on this subject would be appreciated too...)

Anyways, any suggestions what to do now?
Just when I thought we were actually finally getting somewhere..!:banghead:
 
Hi Monica, sorry to hear you sounding worried, these kitties do like to keep us on our toes and honestly, they can throw you an unexpected number out of the blue at any time with no rhyme or reason. But for now I think I'd try to tempt her to eat with the usual tricks - tuna, Parmesan cheese, anything strong-smelling? See if you can persuade her to eat even a little. It may be that she just feels a bit off because of her fluctuating BGs, and that plus the heat has tired her... I don't know about you but I don't want a lot to eat in this warm weather, it's very tempting to just flake out in the coolest place! My own little civvie, Sapphire, has been on and off (mostly off) her food all week and just lolls around or sleeps somewhere really cool... I've been quite concerned but she seems to recover her appetite late in the day when it's cooler. So give Josie a bit longer this evening and she may start to feel peckish soon. And I wouldn't worry *too* much about the 21.9 and 19.8 numbers, the difference is negligible really.

See if she eats something now it's starting to get cooler. You should be ok to dose 0.25u at a BG of around 20 but test again at say 9pm and let us know what her number is then if you're undecided.
 
I notice she dropped almost 50% of her pre-shot last night by +2 which makes me think she may have dropped even further and that would likely have set off a bounce likely contributing to the pre-shot this morning and likely still ongoing. It can take up to 3 days for a bounce to occur. She had a nice drop today by +4 and may have gone lower by +6 as she sometimes seems to nadir around +6. I don't think her BG is of any concern right now.

I'd keep trying to get her to eat and if need be, give her whatever she will take whether it's on her allowable food list or not. Got any deli meat or baby food on hand to get something into her tummy? A little poached chicken? You could try warming her cat food up a bit to make it smell more enticing to her. Sometimes you just have to jump start them!

I'd also test for ketones just to be on the safe side. I doubt that's the problem but better to check.
Breathe! These little monkeys can get fussy for unknown reasons sometimes and then will suddenly eat just fine. It's Ok if she misses a shot. Safety first. That said, if you check for ketones and get any indication of their presence, then we need to rethink skipping the shot.
 
Thank you ladies!
Just got back from supermarket with her favourite food tuna flakes in spring water. As soon as she heard the tin opener she got up slowly came in and sat by me. Then ate two mouthful of tuna drank little water and went back to lay down.
She growled at us before when we lifted her up to test which she only does when unwell and doesn't want to be bothered.
As only tested 90 minutes ago and it was high maybe we could give her a tiny dose without testing again?
No ketone strips I'm sorry. Meant to order but keep forgetting and vet said before no need at this stage..?
Will get some asap.
 
This is how she is leaning over her water bowl now, sometimes drinking but staying down there the whole time..
She was like this just before diagnosed and a once more a couple of weeks ago when she was sick with yellow foam.
Never got to the bottom it why she does this but apparently she's not the only one..
Any ideas?
 

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Well it's a good sign that she responded to the sign of the tin opener... if she was really unwell she wouldn't have reacted to that.

Hunching over the water bowl clearly shows she is thirsty which is a classic symptom/sign of an unregulated diabetic, so when Josie is highish as she seems to be at the moment, and the weather's warm, it's no surprise that she wants to drink. The yellow foam indiciates an acid tummy and therefore nausea which also means disinterest in food. It's a vicious circle because food would settle her tummy and make her feel better. I'd be inclined to keep trying to tempt her with the tuna - put some on your finger and see if she will take it that way - and give her a tiny dose.

It does look as if how she is presenting at the moment is a mixture of high BGs, warm weather and nausea combined... not a nice way to feel and that's no doubt why she is growling at you. Spend a bit of time with her to soothe her and she may relax and eat a little for you... all fingers and paws crossed here.
 
I see where you lowered her dose a few days ago when she had a yellow PMPS. I read your note that you did it to be on the safe side because she hadn't eaten much. Then you kept the lower dose in an experiment to see if it would alleviate the bouncing. In my opinion it looks like 0.25 u is too low because she's been in higher numbers since. Urine ketone test strips can be had at any human pharmacy. I recommend you go buy some ASAP and test her for ketones. I'd also increase back up to 0.5 u tonight.
 
Diana&Tom said:
Well it's a good sign that she responded to the sign of the tin opener... if she was really unwell she wouldn't have reacted to that.

Hunching over the water bowl clearly shows she is thirsty which is a classic symptom/sign of an unregulated diabetic, so when Josie is highish as she seems to be at the moment, and the weather's warm, it's no surprise that she wants to drink. The yellow foam indiciates an acid tummy and therefore nausea which also means disinterest in food. It's a vicious circle because food would settle her tummy and make her feel better. I'd be inclined to keep trying to tempt her with the tuna - put some on your finger and see if she will take it that way - and give her a tiny dose.

It does look as if how she is presenting at the moment is a mixture of high BGs, warm weather and nausea combined... not a nice way to feel and that's no doubt why she is growling at you. Spend a bit of time with her to soothe her and she may relax and eat a little for you... all fingers and paws crossed here.
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Yes a nice little combo is just what I needed on top of the sick child and flea infestation Im dealing with at the mo! Once better I will praise Josie for her excellent timing skills!

She ate a tiny bit more so we gave her a tiny dose just to keep the numbers down a bit for the time being..
 
Monica Lewis said:
Yes a nice little combo is just what I needed on top of the sick child and flea infestation Im dealing with at the mo! Once better I will praise Josie for her excellent timing skills!

She ate a tiny bit more so we gave her a tiny dose just to keep the numbers down a bit for the time being..
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Hi Monica,
Could you clarify please: what tiny dose did you give and at what time? Please add it to your SS. My sympathy to you - these things always seem to happen together.
 
Yes I think you're right and we probably need to increase her dosage eventually as .25 doesn't seem to be keeping her low enough ( unless things change.. ) but I think i'd be nervous increasing the dosage tonight as she's not eating much and not looking too well..

Gave her a small dose to get her numbers lower for the night and will rethink dosage as soon as she's eating well again. Thank you!
 
So sorry this is adding to your woes, Monica... it never rains but it pours.
I know you've had different thoughts again here this evening and it does get confusing trying to think it all through, so I was going to suggest the usual "go with your gut" which you have done... let's see how Josie is in the morning and meanwhile give yourself a nice drink or some treat to keep you going with all that's going on.
Try to get a good night's sleep!
 
Monica Lewis said:
Yes I think you're right and we probably need to increase her dosage eventually as .25 doesn't seem to be keeping her low enough ( unless things change.. ) but I think i'd be nervous increasing the dosage tonight as she's not eating much and not looking too well..

Gave her a small dose to get her numbers lower for the night and will rethink dosage as soon as she's eating well again. Thank you!
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Please get urine ketone test strips and start testing. I'm sorry if I'm pressuring you but I went through an episode of diabetic ketoacidosis (DKA) with Teasel. I'm not saying that's what's going on with Rosie but not eating much along with high-ish BGs is part of the recipe for ketone development. Caught early, they're treatable at home. They can increase quickly and kitty can become very ill.
 
Kris & Teasel said:
Please get urine ketone test strips and start testing. I'm sorry if I'm pressuring you but I went through an episode of diabetic ketoacidosis (DKA) with Teasel. I'm not saying that's what's going on with Rosie but not eating much along with high-ish BGs is part of the recipe for ketone development. Caught early, they're treatable at home. They can increase quickly and kitty can become very ill.
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Yes will try to get them tomorrow. We live in the countryside with no overnight pharmacy and I don't drive so will have to wait til tomorrow.
Asked my vet on our last visit about ketones and she told us not to be concerned about ketones at this stage so we left it.
Thank you, no worries I understand now that it could be important. Although not sure how I'm going to test as Josie doesn't have a litter tray and uses the garden through her cat flap as and when needed.
I'll just have to figure that one out somehow.
 
Diana&Tom said:
So sorry this is adding to your woes, Monica... it never rains but it pours.
I know you've had different thoughts again here this evening and it does get confusing trying to think it all through, so I was going to suggest the usual "go with your gut" which you have done... let's see how Josie is in the morning and meanwhile give yourself a nice drink or some treat to keep you going with all that's going on.
Try to get a good night's sleep!
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I can't drink Diana, I need to stay focused here! :)
 
Josie only ate late around 10.30 this morning, little tuna and a spoonful of plain greek yogurt so gave her delayed shot of .25u at 10.30. She ate again since steamed white fish and another little spoon of yogurt. She's laying upstairs, she was purring when went to talk to her and rolled on her back exposing her belly waiting for strokes. I suppose it's a good sign..?
Also not seeing any other visible signs of illness only lacking of energy..

Just tested her, it was 18.4.

As numbers are consistently higher since on .25u if she eats ok this eve would it be a good idea to increase her dosage from tonight to 0.5u and keep her on it for a while?

Also as morning short was delayed by about 3 hours when should we give her the evening dose?

Many thanks!

Ps. Would you take her to the vet tomorrow for check up, maybe ask for new blood tests and pancreas test or anything else? She had last work done end of April when diagnosed and it all came back clear..

Or just leave vet if she recovers fully ( like she usually does within a couple of days...)?
 
Monica Lewis said:
purring when went to talk to her and rolled on her back exposing her belly waiting for strokes. I suppose it's a good sign..?
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I agree. Fingers crossed. :)

Monica Lewis said:
As numbers are consistently higher since on .25u if she eats ok this eve would it be a good idea to increase her dosage from tonight to 0.5u and keep her on it for a while?
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Yes, I think she needs to go up. However, with the three hour delay this AM, the dose timing this evening will be tricky. There's about an hour plus or minus in time flexibility with Caninsulin. You could plan to test/feed/dose about two hours later than normal this evening, one hour later tomorrow AM and then you'll be back on track tomorrow PM. The dose you give will depend on the PS BG number quite a bit because it's possible that there'll be a little overlap between doses.

Monica Lewis said:
Ps. Would you take her to the vet tomorrow for check up, maybe ask for new blood tests and pancreas test or anything else? She had last work done end of April when diagnosed and it all came back clear..
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Why not give it another day or so to see if she rallies? If she'll eat something (break all the rules if you have to) she *should* be OK. I'd get those ketone test strips and start that routine soon, though.
 
Monica....a couple of requests........Can you please put the doses she got last night and this morning into the regular unit columns because you still want to be able to see what she is up to at any given hour post shot. If you are unsure how to do this, have a peak at my girl's sheet at the end of the evening cycle 25Apr17 and beginning of the day cycle 26Apr17 when I had to do something similar. You will have to manually colour code the boxes if there is any extra text added like the hour in any box. Right now with a quick peak, it looks like she missed two shots which she didn't. ;)

I agree with Kris' suggestions for getting back onto your normal shot schedule and about the vet and ketones if you can manage to test Josie. Any chance you'd be able to sneak a long handled spoon under Josie's butt while she's tending her business in the yard?

It is looking like Josie may need a bit more insulin but if she is feeling poorly that could also explain the higher numbers. See what her pre-shot is tonight and then decide on dose.
 
Kris & Teasel said:
I agree. Fingers crossed. :)


Yes, I think she needs to go up. However, with the three hour delay this AM, the dose timing this evening will be tricky. There's about an hour plus or minus in time flexibility with Caninsulin. You could plan to test/feed/dose about two hours later than normal this evening, one hour later tomorrow AM and then you'll be back on track tomorrow PM. The dose you give will depend on the PS BG number quite a bit because it's possible that there'll be a little overlap between doses.


Why not give it another day or so to see if she rallies? If she'll eat something (break all the rules if you have to) she *should* be OK. I'd get those ketone test strips and start that routine soon, though.
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Yes we'll see how things are. Ketone strips are on top of my list now, not sure about the ladle or going back to setting up a litter tray and try to keep her indoors, she'd probably be confused and drive us mad scratching on the cat flap and door for hours!

Ill figure something out.. Or maybe the vet will do it for us when she's in for check?

If her PMPS numbers are high and she's eaten then maybe should be ok to give her 0.5u dose without waiting an extra 2 hours as 0.25u Caninsulin wore off already? As it's only effective for 8-10 hours?

Of course I will delay if that's how it must be done, I was just thinking maybe no need to delay that much longer as it was a tiny amount in the morning and she'd probably have high readings anyway. Maybe delay only by one hour?

Will test her around 8pm instead of 7.15 and post the numbers if anyone is around to check?

Thank you!
 
MrWorfMen's Mom said:
Monica....a couple of requests........Can you please put the doses she got last night and this morning into the regular unit columns because you still want to be able to see what she is up to at any given hour post shot. If you are unsure how to do this, have a peak at my girl's sheet at the end of the evening cycle 25Apr17 and beginning of the day cycle 26Apr17 when I had to do something similar. You will have to manually colour code the boxes if there is any extra text added like the hour in any box. Right now with a quick peak, it looks like she missed two shots which she didn't. ;)

I agree with Kris' suggestions for getting back onto your normal shot schedule and about the vet and ketones if you can manage to test Josie. Any chance you'd be able to sneak a long handled spoon under Josie's butt while she's tending her business in the yard?

It is looking like Josie may need a bit more insulin but if she is feeling poorly that could also explain the higher numbers. See what her pre-shot is tonight and then decide on dose.
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Yes the spreadsheet blip bugs me too, will try to correct it thank you!

I was thinking about what you said Linda that she still might be bouncing but she's been on .25 for 5 days now so Im inclined to think that it was long enough time to clear the bounce if that was the case?
 
Oh bugger!!! Good news and bad news.

I've just discovered as was about to test Josie that I have only ONE test strip left and the spare box been used up!:banghead:

Pharmacy will open tomorrow morning..

The good news is that Josie just came downstairs and asked for food then just finished a small plate of steamed white fish! :)

Oh dear, dear what is one to do now.....
 
Monica Lewis said:
Oh bugger!!! Good news and bad news.

I've just discovered as was about to test Josie that I have only ONE test strip left and the spare box been used up!:banghead:

Pharmacy will open tomorrow morning..

The good news is that Josie just came downstairs and asked for food then just finished a small plate of steamed white fish! :)

Oh dear, dear what is one to do now.....
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Glad about the food. Darn it all about the strips! I like Diana's plan. :)
 
Well it has to be. I cannot tell you how annoyed I am with myself. Just like the emoji above I could bang my head against the wall for being so dumb!:(

Well fingers crossed we won't mess up tonight's read...
 
Take a chill pill, Monica :-) it will be fine. Josie is unlikely to be too low to shoot, so as long as she eats something that's fine, maybe stick to the current 0.25u if you do mess up the test and are worried.

BTW if you have any human friends/relatives/neighbours with diabetes, you could always ask to borrow a meter and strips from them - may not be exactly the same as your meter but would give you a ballpark figure.
 
Diana&Tom said:
Take a chill pill, Monica :) it will be fine. Josie is unlikely to be too low to shoot, so as long as she eats something that's fine, maybe stick to the current 0.25u if you do mess up the test and are worried.

BTW if you have any human friends/relatives/neighbours with diabetes, you could always ask to borrow a meter and strips from them - may not be exactly the same as your meter but would give you a ballpark figure.
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haha yes I was thinking exactly the same about the chill pill:D
 
Not helping that we are dealing with yet another flea infestation at the moment and just caught a flea on my little boy's face... To say that I am not a happy bunny would be an understatement...!:mad:
 
Good morning,
Got the strips,
AMPS is much lower at 17.4. Shall we start on the 0.5 unit then or keep the same 0.25 as it might've gone down by itself and bounce is clearing???
Hopefully one of you will see this soon, just prepping kitty's breakfast in the meantime thank you!
 
Couldn't keep her waiting anymore for food so went for .25u for once more.
If PS numbers keep staying low then I guess I made the right decision, if goes up will increase to 0.5. Fingers crossed once again...
 
I think you have a good understanding now Monica and yes probably the right decision to stick with the lower dose for a couple more days if necessary... last week's extreme weather could have contributed to the higher BGs so now that factor is out of the equation (phew!) we can see a more realistic picture with the 0.25u, hopefully.

When in doubt, it may help to look back at your spreadsheet and see what dose you gave on a given number and how Josie responded then... I like the curve on 19 June when you got some nice blues mid-cycle, and not too steep a drop or rise. But other days have seen a different pattern. The more I see of this the more I think a sliding scale might be appropriate - adjusting the dose depending on the number. It muddies the waters in some ways and clarifies it in others... vets don't usually approve but if you get better results from it that's what counts. So if the 0.25u doesn't cut it after a couple more days, I personally would try a sliding scale. But you have other options too - raise the dose in tiny increments - and others here may have other opinions. As we keep saying, we can chip in with our thoughts but that's all they are - suggestions for you to consider taking into account everything else that's going on with Josie.

Paws crossed for some nice numbers this week!
 
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