Confused about dosing

PatJ

PatJ

Member
Can I just confirm with you clever people out there that giving my cat 3.50 units if he's as low as 5.0 mmol shouldn't be too much and that he's unlikely to have a hypo, because he dropped to hypo numbers -2.5 mmol (although there were no ill effects )when his pre-shot number was 10.3, and I'm just a bit paranoid about him doing it again, because occasionally now at pre-shot time his numbers are beginning to get much lower and my vet says carry on with 3.50 no matter how low he goes (except for hypo numbers) and that I should have some honey on standby! because changing the dose all the time will make his body crazy, but on the other hand I've read that you should lower the dose accordingly if his pre-shot numbers are lower than usual, which I really am not sure how much that should be. Would be so grateful for any help. Thanks.
 
Hi Pat - I’m not sure I’m understanding your question. It looks like the 5 is in the middle of your cycle, not at PS. I would not shoot the full dose on a 5, but I think William will be higher than that in a few hours when it’s time to shoot. Maybe post closer to PS time when you know how high he is at that point?
 
Thanks Djamila, I was asking for future reference (sorry I didn't make that clear) because he gets lower well after he should have reached a nadir, for example he was at 5mmol at 4.30pm this afternoon, now, at 6.30pm, he's at 4.1 and he is due in 2 hours for the PMPS and it's quite possible that he will have hardly risen although you never know! So I've been told by the vet that it won't hurt to dose him on a low number, without changing the dose but everything that I've read seems to suggest that you have to adjust the dose, which he has told me confuses his body and makes it crazy. My vet is really nice and I don't want to upset him but I don't want to overdose my poor cat either.
 
My personal opinion is that shooting a 3.5 u dose on a PS of 5 mmol/L - should that occur - isn't wise. I would try the stall without feeding technique to see if he rises or I'd give a reduced dose. Your colourful SS shows that William is a volatile kitty like Teasel is. I think an extra degree of caution is warranted with kitties like these.
 
I'm glad you said that about an extra degree of caution because my vet said that even at 4mmol it's OK to give 3.5 u and that makes me very nervous. I know you said it's OK to give him a shot round about the 10 mark, but I'm all at sea when it comes to the lower numbers. Tonight he has ended up at 7.8 at PMPS, and gone down to 6.8 half an hour later, then up to 9.8 half an hour later and then back to 8.5 , have confirmed with my other meter that the readings were right, I know he should have some insulin but don't know how much. He's had nothing tonight because he was only 8.5 and it was getting too late to wait much longer for his BG to rise. I would be SO grateful if you could tell me how much I should reduce the dose by and also, when NOT to give him anything. Thanks, Kris.
 
PatJ said:
even at 4mmol it's OK to give 3.5 u
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Absolutely not. :eek:

Did I give you this general guide before?

Once you begin to get more PSs below 11 you can try a variety of things:
  • if close to 11 (maybe 10 and above), stall without feeding for 30 minutes and retest. If BG has risen try the full dose.
  • if in the 8 to 10 range, try stalling up to an hour and if rising do the above. If BG isn't rising much give a reduced dose. How much to reduce is always a conundrum. Maybe try a 2/3 dose.
  • if BG is much lower (say, 6 to 8) give token dose - size depends on what the normal dose is. Only do it if you can monitor. You can be braver with this once you have a lot of data. It's best to avoid skipping if you can but sometimes that's the safest thing to do.
 
Thanks Kris, for this information. You have told me before what to do when his numbers go down to 10 but not below and I am never sure what I should be doing when that happens, so I'm really glad I know now. Thank you! Could you just tell me what a token dose of 3.50 is because I really have no idea (sorry). Again, thanks very much.
 
PatJ said:
Thanks Kris, for this information. You have told me before what to do when his numbers go down to 10 but not below and I am never sure what I should be doing when that happens, so I'm really glad I know now. Thank you! Could you just tell me what a token dose of 3.50 is because I really have no idea (sorry). Again, thanks very much.
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That's guesswork too. To me, a token dose when the full dose is 3.5 u would be something in the range of 1.0 u or a little less (ie. 1/4 to 1/3 of the regular dose). Like other guesswork situations, you learn by trying something and seeing what happens. There are no hard and fast rules. You also have to be very familiar with your kitty's patterns and if he's volatile err on the side of greater caution.
 
Thanks for that, Kris, that sounds much less stressful. Can I just ask you something that I forgot this morning and then I hope I won't have to bend your ear for a while (I'm sure he'll find something to stress me out with quite soon). When he's due for a pre-shot in the evening and his numbers are still falling but not too low, is it still all right to give him a dose or do I have to wait till his numbers start to rise again even if his numbers are high i.e. 10 or more? Hope that's not as clear as mud! Thanks so much for your help. It's always appreciated.
 
If his numbers are above 10 you could likely give the full dose. You'd be betting on the previous dose's duration just about fizzling. When you're in doubt about what you've tried, get a +2 test to see what's going on. I think I've mentioned that to you before:
  • if +2 is higher than PS - likely an uneventful cycle ahead
  • if +2 is about the same as PS - test again at +3 and if rising you can relax
  • if +2 is lower than PS by a significant amount feed a small snack of low carb food and test again at +3. If BG is still dropping at +3 it could be an active cycle requiring intervention with food and more frequent testing.
 
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