Diabetic cat with pancreas problems

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acccourt

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I have a 14 year old cat that was determined to have diabetes 6 months ago. I have had numerous tests on this cat including an ultrasound which the doctor said he had a large mass in his pancreas. Wanted to do much more invasive tests which I do not want to do.

The male cat has been fine eating approximately 4 cans of Fancy Feast a day. I have been giving him 3 units of Prozinc for 4 months.

Friday, four days ago, my cat stopped eating anything and looking very lethargic. I discontinued the insulin because of a previous hypoglycemic attack in which his blood sugar dropped to 30. He did not eat for 4 days. I was giving him syringes of water so that he might be able to keep his strength up.

I decided to get a human glucometer. After 4 days of not eating, I tested him with this glucometer. His sugar level was 404. I gave him 2 1/2 units of Prozinc. He still did not eat. After a few hours his sugar level dropped to 72. He began eating immediately.

I have been testing his glucose level with the human glucometer for two days. His sugar remains in the upper 200's. I keep adding a few units of insulin.

How much insulin is normal twice a day for an older cat? Is there something that I have missed? Please let me know any advice that you might have.

Thanks

Angela
 
hi there. it's hard to say what's going on but some ideas that come to my mind are not feeling well due to glucose levels being out of control. getting going on the home testing for that will help tremendously in that area so that's good you're doing that now.

then, have you heard of pancreatitis? or ketoacidosis?

do you test for ketones by chance? if not i would strongly suggest that is tested asap. ketones unchecked can be fatal so that needs to be ruled out asap. you can get ketostix at the pharmacy and you dip one in kitty's urine and watch for it to change colors, then compare it to a chart on the vial they are in. i want to say they run about $10 for a box of them.

it also sounds like possibly a pancreatitis attack. is kitty eating now? does kitty act like they are in pain?

i personally don't know much about it but i know that several people here do have experience with it. if you don't get much response in this forum soon about it, i would suggest also posting on the health forum so as to get more attention, just in case. the insulin support groups can be a bit slower than the main board sometimes.

it's critical that kitty eat/get enough nutrition so as to ward off further complications like ketoacidosis or hepatic lipidosis so the quicker this gets figured out the better ok. worst case, water down some canned food too and syringe feed kitty that too
 
Thank you. I am new to the forum. I apolgize in advance for sounding very illiterate. We all know that these four legged animals are our babies. All I want is the best for him. I don't want him to have any pain or suffering.

My vet does not seem to really understand what is going on. She told me he was diabetic and that I needed to give him insulin but that was about it. Not very helpful or educational at all.

Appreciate first hand information and knowledge from someone who really understands. I am just worried about giving him too much insulin. I don't want to overdose him. I am giving him 3 units of Prozinc every 6 hours. It still does not control it. Is this just too much or should I do a little more?

Any suggestions would be appreciated.

Thanks

Angela
 
with you just starting with the testing it is hard to say if it is too much, too little, or just right.

if you could log and post any numbers you have since you started testing that would help people help you figure that out. most people here use a spreadsheet that makes it easy to analyze the numbers. are you interested in setting one of those up? i can try and find you some help on doing that as i simply am not very tech savvy :-)

you said you are giving him 3 units every 6 hours? or did you mean every 12 hours?

if indeed it is every 6 hours, yes, there's a very good chance he's getting too much insulin.

hopefully some of the regular prozinc'ers will be on soon to advise you on what to do next. i'm thinking cutting back to giving insulin every 12 hours, rule out ketones asap, possibly changing the dose, and log some test data so everyone can see what's going on but let's see what everyone says
 
Hi Angela:

My name is Donna and I have been here with my sugar cat Asher since January. He is a 7 year old diabetic, not quite regulated yet but we are hoping :)

Here is a link as to how to set up your spreadsheet:

http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207

This will help people here see how your cat is reacting to the insulin at times throughout the day, and thus be able to advise you on a dose that would be most helpful.

We test our kitties before they eat, morning and evening, about 12 hours apart, and sometimes mid-cycle to see where their nadir or low point is. This gets recorded on your spreadsheet and is very helpful to look back on.

Most folks here shoot ProZync BID or twice a day, once every 12 hours. One of the more expert folks her should advise you on switching to that if you are interested.

Glad you are feeding canned food. Do you mix water with your food?

Checking for ketones is a real good thing to do like Cindy said. Those strips are inexpensive and you can get them at most pharmacies and Walmarts or Targets. I can stick a strip under my kittie’s bum when he is peeing in his box. If your cat is more shy, some people here put aquarium gravel in a litter box to catch the urine to test. My understanding is the urine has to be real fresh to get a good reading.

Welcome to our group. Ask lots of questions. There are really kind and experienced folks here that help us so much.

Peace.....
 
I just wanted to welcome you!

There are some really experienced hands on experts on board here-- they will help you.

I don't have a lot to offer, as there are many more qualified to answer your questions-- but, 3 units every 6 hours seems like a lot of insulin. You may very well be giving too much insulin. Also, like the others have suggested, please test for ketones. The strips are cheap-- my Kitty, survived DKA and I can assure you that you want to ward that off if possible.

There really is help here-- just ask questions and the group will guide you.

Once again-- Welcome!

Kim
 
Hi Angela and welcome to our group, what it your kitty's name.

That sounds like a lot of insulin. The usual starting dose is 1unit twice a day 12 hours apart. Then you increase by small increments until you find the perfect dose. By starting on a higher dose you may have bypassed the right amount.

Until you get a ss set up could you post your bg #'s like this.

AMPS (am pre shot test) before food.
+1 - 1 hour after injection
+6 - 6 hours after injection
PMPS (pm pre shot test)

We are all in different time zones so this way we will all understand where you are in your cycle.

When you need insulin support you can come to this forum to get it. For the Pancreatitis I would post on the Health forum, there are alot more people with more experience with this there.

Come back and ask whatever questions you have as often as you want.

Robin
 
Hi Angela
Welcome to the group!
Everyone here is so very helpfuland they can answer all your questions
I am sorry but I can not give dosing advice as I am trying to figure that out for myself still
It takes awhile so try to be patient, you will get there

:mrgreen:

Denise and Shakes
 
Hi and welcome! Congratulations on your decision to home test--- you are ahead of the game - many people come here and have not started testing and find it quite a struggle in the beginning.
Can I ask you to clarify about your dosage? Is it 3U every 6 hours? That is fairly unusual. Most give PZI every 12 hours. And that would be quite a large dose. Was that your vet's recommendation? How was the dosage decided?
Keepposting and asking questions, we like to be helpful.
 
Thank you all so much for replying. With my job it makes it very difficult to check the message board as much as I would like to.

My cat's name is Wiggle Worm. He is 14 and has been on Prozinc for approximately 6 months. I have been keeping up with his sugar levels since Sunday when I finally took a shot at home testing.

Wiggle Worm was almost dead on Sunday. He could not hold his head up and had not eaten for 3 1/2 days. I was giving him water with an oral syringe just to try and keep him hydrated. I called my veterinarian on Saturday and she said it sounded like his sugar level was too low. Told me to give him some Karo syrup in a syringe. I did this unaware of what his sugar level was. He seemed to get sicker and sicker. On Sunday he went and hid and acted as if he was dying.

After a few hours I decided to watch a video on youtube on how to home test. My first reading at 3:00 p.m. was 406. I realized at that time that his sugar was too high. I gave him 1 1/2 units of Prozinc and retested at 7:00 p.m. His sugar was still 276. So, I gave him 1 1/2 units more.

He started perking up and eating a little. I have been testing each morning and evening and one day I tested at noon. In the mornings his sugar level is usually around 280. On Tuesday gave him 4 units and when I got home that evening his level was 62. That is the only time that he has dropped that far. Usually his level in the evenings is around 160. It is very hard to regulate when you are not at home during the day. He is back to normal as far as walking around and using the litter box now. I just need to somehow regulate the dose so that he will be all right.

What is NORMAL levels for a cat and when does it become dangerous? Any suggestions would be appreciated.

Thanks for all the responses.
 
Can you please advise me how frequently I should test Wiggle Worm's sugar level? Do you just do this twice a day before meals or how often are you supposed to test?

Thanks

Angela
 
Good to hear you are testing. But the situation is confusing. How much insulin are you giving and how often? Anything below a BG 40 is considered hypoglycemic and could be life threatening. If he was as low as you say at night (which was hour many hours past insulin shot?) he was probably lower during the day. The situation is very worrisome to say the least. It would be advisable to leave food out at all times so , if he is eating, he can use it to help regulate his BG. If you would like us to help we really need a clearer picture of his insulin dosage and BG numbers. I would also strongly recommend that you keep your vet fully apprised of what is happening. Not eating is very serious and he may need assisted feeding of some kind. Good luck!
 
In answer to your question, we test before every shot and then, if possible, during the 12 hour cycle a few times around the middle of the cycle to see how low he goes between shots. We call the tests amps(morning preshot) and PMPS ( evening preshot). We use these numbers to make decisions about dosage. Hope this helps.
 
I am sorry my questions are so vague. I am new to all of this and don't understand a lot of the terminology. My problem is that I cannot test during the day because I am not home. Wiggle Worm has been eating well for the past 4 days. I have a multi-cat household and the other cats eat dry food. I give Wiggle Worm Fancy Feast wet food every morning and every night. He has access to dry food, but sometimes has difficulty swallowing it.

His levels in the mornings are in the upper 200's. After 12 hours his readings are in the mid to upper 100's. I have been recording his numbers, but they are at my home. I will post these this weekend.

Thank you

Angela
 
At first there is Lots to learn, tons of new information. We can help you with the terminology, just ask us whatever you need to know( the abbreviations drove me a little crazy in the beginning)
So glad to hear he is eating. We have others who cannot test during the day. That's the reality of life and having to work. Those people usually try to do more testing on the weekends.
If your cat is eating dry food and still has numbers as low as you have said, the dry food may be protecting him from a hypoglycemic event. The question I would really like you to answer is how much insulin are you giving and how often?
 
acccourt said:
I have a 14 year old cat that was determined to have diabetes 6 months ago. I have had numerous tests on this cat including an ultrasound which the doctor said he had a large mass in his pancreas. Wanted to do much more invasive tests which I do not want to do.
Click to expand...

Have they done any other tests recently on your cat, like a spec fPL test or PLI? These tests are used to diagnose and monitor pancreatitis. Did your doctor feel the mass was a cancer? Or was it an enlarged pancreas due to inflammation? If there is just pancreatic inflammation, getting control insulin levels can be problematic at times. Have they prescribed any medication to help control the inflammatory process or slow down the growth of a tumor if they feel there is one? If there is a tumor,this can lead to insulin output being unpredictable. My cat has pancreatitis so when she has flareups her blood sugar goes wild. This may be what you are seeing. What does your vet say? Assuming the mass they detected is a form of cancer, you may find this article helpful: http://www.ehow.com/about_5491904_pancr ... -cats.html. From what they say, tests like the spec fPL or PLI may or may not show pancreatittis present, but that's the same for cats with simple pancreatitis with no masses. If inflammation is severe, the test will detect the presence of the pancreatic enzymes in the blood. If the inflammation is more chronic and less severe, it may show nothing at all even though something is present.

That said, appetite loss and lethargy, along with pain, are classic symptoms of pancreatitis. If your cat doesn't wish to eat and seems to be feeling poorly, she needs to see the vet. Pancreatitis is VERY painful for the cat. Common treatment is subQ fluid, anti-nausea drugs, and pain control, and occasionally steroids if the inflammation is severe enough. My cat takes ondansetron for nausea, and in flareups she gets buprenorphine for pain and subQ fluids. Right now she's also on antibiotics because her pancreatitis seems to be the necrotic type, so she usually gets a fever and/or rising white cell counts during flares along with the other symptoms. Even if you don't think your cat is nauseated or in pain, understand that usually cats hide this very well. I was initially surprised at how much of a difference buprenorphine makes in my own cat when we think she is having a flareup. It is like night and day. If the buprenorphine has no impact, then I know her symptoms are due to something else, but if it is pancreatitis, she calms down immensely and her appetite improves with pain treatment.

I'm sorry that Wiggle Worm doesn't feel well right now. I'll let the others address the blood glucose issues since I'm new to PZI, but if your cat has pancreatitis I understand only too well how difficult blood glucose control can be during flareups. I'm dealing with that now myself.
 
I probably misunderstood something--- did you say you gave insulin at 3 pm and retested at 7 pm and gave more?

If so, that could be extremely dangerous. Normally, the insulin works or is dosed on a 12 hour cycle-- it doesn't work immediately. There are high points and low points in the cycle. You should not give an additional dose within that cycle--- well, not under normal or any circumstances I know of. Normal protocol is to dose ever 12 hours.

Normally, it is suggested to start at 1 unit twice a day and to test before each shot and during the cycle to see what the readings are. Based on those readings, the dose is adjusted up or down.

There is a lot of help here and a great group of people--- just ask questions.
 
I will apologize first off because this is such a very lengthy post.

Wiggle Worm is eating very well now but his sugar levels I just can't figure out. I am going to list what his levels were for the last 6 days and how much insulin I gave each time. He was all right until Friday, April 22. Then he refused to eat, was very lethargic. I called the vet and she asked was he lethargic. She said that his blood sugar may be down very low. Advised me to give him oral syringe of Karo Syrup, which I did. I tried to give him water through an oral syringe throughout the day on Saturday. By Sunday morning, he could barely walk. Did not have any control of his urine. Had peed in same chair where he had been laying. I continued to give water through a syringe. Then he got up and staggered over into a corner under a cat condo as if he was going to die. I finally got enough courage to get my father's glucometer and attempt to test his sugar. This is what I discovered.

Sunday, April 24

3:00 p.m. - sugar level - 406
Called pet emergency clinic and they advised to give him 1 1/2 units of PZI.

8:00 p.m. - sugar leve 276
Gave 1 unit of PZI

Monday, April 25

6:30 a.m. - sugar level - 294
Gave 3 units of PZI

11:30 a.m. - Sugarl level - 72
He finally ate 1/3 can of Fancy Feast

5:15 p.m. - sugar level - 271
Gave 2 1/2 units of PZI
He ate 1 1/2 cans of Fancy Feast.

10:00 p.m. - sugar level - 244

Tuesday, April 26

6:15 a.m. - sugar level - 333
Gave 3 units of PZI
He ate 1/2 can of FF

11:15 a.m. - sugar level - 283
Gave 2 units of PZI
He ate 1/2 can of FF

7:30 p.m. sugar level - 131
He ate 1 can of FF
He was very alert and walking around using litter box

Wednesday, April 27

6:20 a.m. - sugar level - 293
Gave 4 units of PZI
He ate one can of FF

9:30 a.m. - He ate 1/2 can of FF

5:55 p.m. - Sugar level - 62
He ate 1 can of FF
I did not give any PZI

Thursday, April 28

7:30 a.m. - sugar level - 298
Gave 3 1/2 units of PZI
He ate 1 1/2 can of FF

8:00 p.m. - sugar level - 179
Gave 1 1/4 units of PZI
He ate 1/2 can of FF

Friday, April 29

7:15 a.m. - sugar level - 285
Gae 3 1/2 units of PZI
He ate 1 can of FF

6:50 p.m. - sugar level - 108
He ate 1 can of FF

Saturday, April 30

5:40 a.m . - sugar level - 309
Gave 3 1/2 units of PZI
He ate 1 can of FF

12:15 p.m. - sugar level - 62
He ate 1 can of FF
Very alert, walking around, using litter box

Wiggle Worm lives in a multi-cat household. There is always dry food (Science Diet - Sensitive Stomach) available for him at all times. He sometimes has trouble swallowing the dry food and sometimes will throw up. But he does eat it some.

It just seems that his sugar level is always high in the morning. Can't figure out how to get a grip on this. Any suggestions?

Thanks

Angela
 
wow! first problem i see is of course the food. dry food is going to be higher carb and that is going to keep the levels higher than you're going to like but i don't think that's the biggest concern at the moment really.

what i think is the biggest problem is that the dosing is out of control. each dose is different and there is a couple days you gave two shots within a few hours of each other? then no evening shot was needed, probably because he got overdosed earlier in the day. when there's no evening shot, that causes the next number (the next morning) to be higher. and there's one day there where it says you gave 3.5 units of insulin on a glucose level of 28. i'm going to assume, and pray, that that is a typo?

i think you need to start with getting things under control a bit. shoot a steady dose twice a day, approximately 12 hours apart and steady kitty out a bit. then if changes need to be made, do them methodically

also, can you clarify the date you mention in the second paragraph? i assume there's a typo there too so which day he was lethargic i'm not clear on
 
I apologize for my typos. I think I have been more stressed out than Wiggle Worm this week. He started being lethargic on Friday, April 22. Also typo on Thursday- April 28. 7:30 a.m. sugar level shoul have been 298.

At what numbers should I not give him any insulin at night? Like this morning he was at 309. And 7 hours later he is at 62.
 
I also wanted to add that in May of 2010 is when the vet diagnosed Wiggle Worm with diabetes. He said that she felt a mass in this stomach. I then took him to have an ultrasound done.

The specialist that I took him to is not my favorite person. She had misdiagnosed a previous cat of mine and suggested that I put him to sleep because of a stomach mass. He never had any problems with his stomach and lived 10 more years. I chose to use this vet again for the ultrasound because she is supposed to be the BEST in Nashville, TN.

After the ultrasound she showed us an x-ray and said that he had a large mass in his pancreas. She told us that when you see this on ultrasound that 99 percent of the cats have cancer and don't live very long. She asked did we want it biopsied but it would probably cause him discomfort.

At that time my husband and I were so emotional that we told her no. We did not want to cause him any pain. She then stated that he probably would not live but a few weeks. That we should just take care of him and make him comfortable. She then charged us $1,500. This was in November of 2010.

Since that time he has done fine with 3 units of insulin until this episode last week. I know we have to be more consistent. Just don't know what to do.

Thanks

Angela
 
Hi Angela,

The recommended starting dose of Prozinc is 1 unit twice a day, 12 hours apart. I would suggest you do that now and start over, now that you are testing you will be able to make decisions based on what his blood sugar is before every injection. We can help you with that.

You post a new topic every day and tell us what his # is and we can help you decide what to do.

I think the dry food is what is keeping him alive right now so don't switch that until you drop your dose.

I'm glad you're here, please keep us updated more often.

Robin
 
Hi Angela,

Please listen to Cindy and Robin. There really is help for you and Wiggleworm here.

You need to give the insulin 12 hours apart. Like I stated in an earlier post to you-- the insulin doesn't work immediately. There are high and low points in the cycle.

The way you are dosing is extremely dangerous for Wiggleworm.

Please let the group help you.

Kim
 
Hi,

Thanks so much for your help. Please let me know should I start over with 1 unit or will that not be enough?

Today his levels were as follows:

5:40 a.m. - sugar level - 309
I gave him 3 1/2 units of PZI
He ate one can of FF

12:15 p.m. - sugar level - 62
He ate 1 can of FF

7:40 p.m. - sugar level - 355
I gave him 3 units of PZI
He ate 1 can of FF

If I go back to 1 units twice a day, will that be enough? I guess I'm just scared it will get too high.

Thanks,

Angela
 
Yes, 1 unit will be enough for now, his bg's may go up for a few days until we can get a handle on it but once we do we can start to bring them down or his bg's may go down right away if he is getting too much insulin right now.

Trust me, the people here have years of experience with this.

Please feel free to look at my ss under my signature to see how far we have come.
 
Someone will answer you dosing question-- just keep checking back.

I am by no means a dosing expert -- but, remember it is better for the glucose to be too high than too low. If he goes high you will adjust the insulin in the next cycle. The biggest change concerning dosing that you need to make at this time is to only give insulin once in a 12 hour cycle.

It took me awhile to understand that a cat will not just immediately die if he is too high . The same cannot be said for being too low.

If you could test 4 hours and 8 hours after giving the insulin and post the numbers, it will help the"dosing experts" to help you.

Keep asking questions---the group will help you.
 
Hello everyone,

Thanks for your advice. It really helps to have someone who understands. I checked Wiggle Worm"s sugar level this morning at 7:00 a.m. It was 242.

I followed your advice and only gave him 1 unit of PZI. I will recheck in a few hours.

Thanks

Angela
 
Good Job! The preshot number of 242 is good---Kitty and I would gladly trade you!!!

Just check Wiggleworm some today and post the numbers. Don't get alarmed at the numbers, irregardless what the are. The group will help you adjust the dose if necessary.

Don't give any additional insulin during the 12 hour cycle!!!!

Once again, Good Job!

Kim
 
Hello again,

Now is 10:00 a.m. This is 3 hours after giving Wiggle Worm 1 unit of PZI. His sugar level is 156. I will test again in a few hours.

Thanks

Angela
 
Awesome! The 1 unit is working perfectly for Wiggle Worm. Your next test should be the lowest point in his cycle and then he will start going back up.

You are doing great. :-D
 
Hello,

I tested Wiggle Worm's sugar at 3:15 before I gave him a can of FF. His sugar level was 181. He gobbled down a can of FF after that. I will retest again at 7:00 p.m. tonight. Thanks for all your responses.

Angela
 
Wiggleworm's numbers are looking good. I would expect him to be back up tonight.

Come back and post and let us know what the numbers are.

Food can, and normally will spike the glucose level. I try not to feed 2 hours prior to getting the preshoot test, because I don't want to inflate the test. I like to feed at preshot and in the middle of the 12 hour cycle--- 4 to 8 hours after giving the insulin. I have found by doing this i will get truer readings.

You are doing good--- the one unit looks to be working!

How is he feeling today?

Kim
 
Good Job!

You might want to set up a spreadsheet to track your test/numbers. The spreadsheet will also help others help you. You can include the spreadsheet in your signature, making it available for others to see. I would love to direct you to the site with the spreadsheets-- but I am using my phone and have trouble navigating on it!

If you are interested in the spreadsheet, post a new topic and ask for spreadsheet help-- someone will provide you the link. The spreadsheets are very helpful to collect and review data.

You are doing good!

Kim
 
Hello Everyone,

I tested Wiggle Worm this morning at 7:30 and his sugar level was 202. I gave him 1 unit of PZI again. He ate 1 1/2 cans of Fancy Feast as well.

I went to the site to make a spreadsheet. I was able to create the spreadsheet but I cannot figure out how to be able to post it. I am not very computer savvy, so maybe I just don't get it. I wasn't able to figure out the part about the text link. I don't understand what to put for the link. I got to the part to publish as a web page and clicked that, but did not know what to put where it says the link.

Any help would be appreciated.

Thanks

Angela
 
Glad Wiggle Worm is responding so well. Has anyone mentioned that if your PS bg is under 200 we don't give the insulin. You would wait and test again in 20 to 30 minutes to see if it is over 200 and then give the shot. I wanted to be sure that you knew that in case your next PS is below. Come and post your number and let someone guide you.

You are both doing so well. Congratulate yourselves.
 
Wiggle Worm is doing great on 1 unit! You are getting some really good numbers.
After you hit publish as web page for your spreadsheet, you should also tick the box to automatically update and republish in drop down box that appears while you have your spreadsheet open in Google Docs. Then copy the link after hitting publish as webpage, from your browser search box while you have that page open, then come to FDMB, go to your user control panel, click on profile, in about me box, post the link to your spread sheet there. If you like, in front of link, you can put, Wiggle Worm's ss or such.
 
Good Job, do not shoot on that number. He will be ok. Remember, it is better to be too high than too low.

He probably/maybe will go up- but don't worry. The one unit is working and in fact might be too high.

Don't get alarmed if he is higher in the morning. I am no dosing expert, but some of the others will help you with that.

I just wanted to say good job!
 
Hello,

Tested Wiggle Worm this morning after not giving him any insulin last night. At 6:30 he was at 256. I gave him 1.25 of PZI. Will try to get home and retest him about 7:00 p.m. tonight. Wish me luck.

Thanks for all of your advice. It's very comforting to know that someone else knows how you feel.

Thanks

Angela
 
Angela,

You might want to start a new thread each day, just put the date in so everyone will see it's a post from that day. Good job testing! I can't give any dosing advice, I'm pretty new here also.

Barbara
 
Hi Angela,

I agree with Barbara it would be good if you started a new thread.

Now to the dosing--hopefully someone else will respond, but you want to find a dose that you can shoot twice a day in 12 hour intervals. I would not increase to 1.25 units. Truly, I hope someone else responds-- but, I would have lowered the dose before I increased it. The 1 unit on 202 left you too low to shoot last night. You want to find a dose that you can give twice a day at 12 hour Intervals.

You are doing good-- great job not shooting last night on the low test. Remember--better too high than too low.

Come back tonight and let us know what the test is.

Kim
 
Hi Angela,

There sure is alot to learn isn't there? You are doing a great job testing.

Please don't increase Wiggle Worms insulin dose. The 1 unit looks like it may be a bit high for him.

Actually I was going to suggest a dose decrease to maybe .75u when his bg is around 200.

Good call not giving him insulin when his bg was 116, that was exactly the right thing to do.

Come back and post your next PS so we can see what you should do for the dose.

Robin
 
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