Cat was low. Am I doing the right thing?

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Sarah & Sammie

Sarah & Sammie

Member Since 2017
I use the alphatrak2 meter

Sammie has been on 3 units Lantus since February when two units was no longer controlling her diabetes. I don’t test daily but periodically spot check and she’s always between 110-180 unless I miss a dose.

Saturday morning I had this strong feeling I needed to test. My partner fed her without me knowing, so I didn’t test until halfway through her breakfast. Her BGL was 49. I tested again to be sure and it was 56. I gave her a few treats and a few minutes later she was at 96 and within a half an hour 131. I skipped her dose because I didn’t want to risk her going too low. Saturday night she was at 355 so I gave her 2 units.
Since then it’s been as follows
Sun am 149 gave 1.5 unit
Sun pm 175 gave 1 unit
Mon am 159 gave 1 unit

I have only had the chance to communicate with our vet via email. She said to continue giving her the regular dose so long as she eats, but I’m afraid to. Am I doing the right thing by adjusting her dose? I can do a curve on Wednesday to get a better idea.
 
I think you are right about lowering her dose. 3 units appears to be too much. I don't know what your starting dose and how quickly the dose was raised to 3 units. You may have missed your optimal dose.

As you have found out, it is important to test before every shot. Not only does it prevent you from giving insulin when the glucose is too low, but it also lets you know how well the dose is working.

My recommendation is that you continue to keep the dose at 1 unit for several days and test before every shot. Then if you feel that you need to increase it, only raise it by 1/2 unit . Keep at the same dose for a week before increasing it again if needed. The goal is to find the dose that works best for your cat.
 
That 49 preshot is way too low on AT2. Any number under 68 on AT2 would require intervention to bring the number back up. The fact that you got it at preshot makes me wonder how low she was overnight. I am most definitely glad you skipped! You are actually seeing good numbers, the next few days after your skipped shot, but that may be the 3u depot still having some affect. The thing with Lantus is we need to see how low the dose is taking your cat, and right now, that's a bit of a guess although you mentioned spot checks here and there. I would hold the dose for a few more days and see if you can get a before bed test maybe tonight and see if the numbers are coming down. Even a +2 or +3 may give you additional data that will help you decide if you should increase or not. Many kitties like to go lower at night. The dosing methods for Lantus that are followed here would provide some guidelines on when to increase, if you're interested in some additional info, see here
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

I'm not sure how long your kitty has been on insulin, but for Lantus we typically dose in 0.25 unit increases or decreases based on the BG patterns we see, including how low the dose is taking the kitty. i would hold the 1u dose for now, see if you can get some mid-cycle tests over the next few days, and those extra tests will tell you a great deal more.

ETA: I have to rush out, but if you have additional questions, please continue to post here, or over on the Lantus subforum as well, many folks here really are happy to help with any question!
 
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Christie & Maverick said:
That 49 preshot is way too low on AT2. Any number under 68 on AT2 would require intervention to bring the number back up. The fact that you got it at preshot makes me wonder how low she was overnight. I am most definitely glad you skipped! You are actually seeing good numbers, the next few days after your skipped shot, but that may be the 3u depot still having some affect. The thing with Lantus is we need to see how low the dose is taking your cat, and right now, that's a bit of a guess although you mentioned spot checks here and there. I would hold the dose for a few more days and see if you can get a before bed test maybe tonight and see if the numbers are coming down. Even a +2 or +3 may give you additional data that will help you decide if you should increase or not. Many kitties like to go lower at night. The dosing methods for Lantus that are followed here would provide some guidelines on when to increase, if you're interested in some additional info, see here
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

I'm not sure how long your kitty has been on insulin, but for Lantus we typically dose in 0.25 unit increases or decreases based on the BG patterns we see, including how low the dose is taking the kitty. i would hold the 1u dose for now, see if you can get some mid-cycle tests over the next few days, and those extra tests will tell you a great deal more.

ETA: I have to rush out, but if you have additional questions, please continue to post here, or over on the Lantus subforum as well, many folks here really are happy to help with any question!
Click to expand...

Thank you for your response! Sammie has been on Lantus for 1.5 years now. We started at .5 units, and she had a long stretch at 1.5 units and another at 2. She had some health complications at the end of last year and her levels spiked. She was regularly testing in the 400-500 range at the end of January so her insulin was raised to 3 units.

She just tested 136 pre shot. I’ll do another test before bed and in the morning.
 
Lisa and Witn (GA) said:
I think you are right about lowering her dose. 3 units appears to be too much. I don't know what your starting dose and how quickly the dose was raised to 3 units. You may have missed your optimal dose.

As you have found out, it is important to test before every shot. Not only does it prevent you from giving insulin when the glucose is too low, but it also lets you know how well the dose is working.

My recommendation is that you continue to keep the dose at 1 unit for several days and test before every shot. Then if you feel that you need to increase it, only raise it by 1/2 unit . Keep at the same dose for a week before increasing it again if needed. The goal is to find the dose that works best for your cat.
Click to expand...

Thank you, this is useful. I feel the vet was wrong to suggest to continue three units, perhaps a misunderstanding through email. I’m glad you agree with the 1 unit.
 
Christie & Maverick said:
That 49 preshot is way too low on AT2. Any number under 68 on AT2 would require intervention to bring the number back up. The fact that you got it at preshot makes me wonder how low she was overnight. I am most definitely glad you skipped! You are actually seeing good numbers, the next few days after your skipped shot, but that may be the 3u depot still having some affect. The thing with Lantus is we need to see how low the dose is taking your cat, and right now, that's a bit of a guess although you mentioned spot checks here and there. I would hold the dose for a few more days and see if you can get a before bed test maybe tonight and see if the numbers are coming down. Even a +2 or +3 may give you additional data that will help you decide if you should increase or not. Many kitties like to go lower at night. The dosing methods for Lantus that are followed here would provide some guidelines on when to increase, if you're interested in some additional info, see here
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

I'm not sure how long your kitty has been on insulin, but for Lantus we typically dose in 0.25 unit increases or decreases based on the BG patterns we see, including how low the dose is taking the kitty. i would hold the 1u dose for now, see if you can get some mid-cycle tests over the next few days, and those extra tests will tell you a great deal more.

ETA: I have to rush out, but if you have additional questions, please continue to post here, or over on the Lantus subforum as well, many folks here really are happy to help with any question!
Click to expand...

Sammie was in the 180s about 3 hours after her dose last night. This morning she was 146.
 
SammieCat said:
Sammie was in the 180s about 3 hours after her dose last night. This morning she was 146.
Click to expand...
Thank you for the update, I had wondered how Sammie did last night :).

Health complications, infections, teeth issues, pain, steroids, among other things can definitively affect BG levels. Increasing to 3u during that time may likely have been the right dose back then, but insulin needs can, and do change. I think Sammie likes 1u for now. Since it’s been only a few days since the 49 on AT2 and the numbers don’t appear to be going up, I’d continue with 1u if it were my cat.
 
Christie & Maverick said:
Thank you for the update, I had wondered how Sammie did last night :).

Health complications, infections, teeth issues, pain, steroids, among other things can definitively affect BG levels. Increasing to 3u during that time may likely have been the right dose back then, but insulin needs can, and do change. I think Sammie likes 1u for now. Since it’s been only a few days since the 49 on AT2 and the numbers don’t appear to be going up, I’d continue with 1u if it were my cat.
Click to expand...
I agree.
 
Quick question: can prick her ears each day to test? I’ve only ever done as much as a curve and I don’t know if is ok to prick where there is a scab. I guess it’s most likely just dried blood on her fur? She doesn’t like having her paws touched so I’d like to avoid that if possible.
 
Have you seen this pic before? Aim for the edge of the ear.
http://www.felinediabetes.com/images/laur_danny_famoussweetspot.jpg

I tried the paw only once, and Mav told me exactly what he thought of that! It is probably just a bit of dried blood, when I do the ear pokie, I have a makeup cotton pad ready to go, and hold it on my kitty's ear for a few seconds, just a little pressure, that helps with any little extra blood drop(s). I do multiple tests a day, it really doesn't hurt them. I give a treat afterward, and Maverick walks off happily. A dab of neosporin helps too, if you see any redness.
 
Christie & Maverick said:
Have you seen this pic before? Aim for the edge of the ear.
http://www.felinediabetes.com/images/laur_danny_famoussweetspot.jpg

I tried the paw only once, and Mav told me exactly what he thought of that! It is probably just a bit of dried blood, when I do the ear pokie, I have a makeup cotton pad ready to go, and hold it on my kitty's ear for a few seconds, just a little pressure, that helps with any little extra blood drop(s). I do multiple tests a day, it really doesn't hurt them. I give a treat afterward, and Maverick walks off happily. A dab of neosporin helps too, if you see any redness.
Click to expand...

Yes! Just a little bit ago. Thanks. She’s pretty good with letting me test. I’ll give an update to you once I complete a curve. Have a great day!
 
Last night I bumped Sammie up to 1.5 units. Her levels started rising Tuesday night and have been in the low to mid 200s
 
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