Did I up dose too much?

Status
Not open for further replies.
meatball_mommy

meatball_mommy

Member
Hi there, new to monitoring (and new to feline diabetes as of a couple of weeks ago). Meatball shot a 564 this AM following a 455 last night. Our original vet had us on a fairly conservative protocol of 2 units twice a day following Meatball's second BGC @ the vet. Based upon the reading this AM I upped the dose to 2.5 units when I couldn't get a hold of the new vet and since I'm home all day and can test every 1-3 hours. Of course now I'm second guessing myself. We'll see what the vet says (left her a message), but curious if anyone here has any reactions / advice on whether or not that was appropriate. Being new I suppose my typically decisive nature is faltering a bit! Thanks, Jo
 
No way to know yet. Any time you dose, its really an experiment because so many factors influence the glucose level - activity level, absorption rate, glucose load of food eaten, production batch of food (the % calories from carbohydrates is from 1 batch and batch ingredients vary), other health conditions, and so on.

When you're still figuring out what is optimal, it pays to be prepared. So... do you have a hypo kit ready? Ample test strips? Karo syrup/honey/maple syrup? High carb gravied foods? Oral syringe?

You'll most want to check around the probable nadir. With ProZinc, that tends to be around +4 to +6 hours after the shot.

I'll check back after I get to the office.
 
No dosing advice, since Mr Chuck is the proverbial bouncing ball, but some momma bean advice: Take a deep breath, hold it for a second or two, then let it out slowly. :smile: Meatball will be fine, especially since you can test frequently today and are prepared for low numbers.

I always follow my gut instinct on dosing with PZ, which is really different from Lantus (Chuck was on Lantus about 5 years ago, went into remission, and just out of remission about 4 months now). For example, with his new dosing scale, his shot should have been .8U this morning with a 217 AMPS. Looked back over his spreadsheet and gut said, go low. I shot a skinny 1/2 unit (about .4U), and he's dropped from 217 to 56 in 3 hours.

So, my best advice is start a spreadsheet, test and record the BG numbers, and look for trends. I started Chuck's spreadsheet so long ago I don't remember how to do it, but there are plenty of folks here who can help you get started with it. And always remember, YOU'RE in charge, not the vet; test at home -- you can do curves at home, too. Listen to your gut and look at your whole cat, not just his diabetes.
 
Thanks, both! Helpful advice. I have started my spreadsheet (it's in my signature). +3 was 264. I'm meant to be gone between +4 and +6 but going to change my appointment so I can keep an eye on him. The deep breath advice was a good one :)

And, yeah, definitely have my hypo kit ready. Printed the instructions just in case I go blank in the moment, lol. One question I do have is, using the AlphaTrak2 (which I know reads a little higher typically than a human meter), what would be considered "too" low. Most of the info I found (e.g., under 40) was using a human meter. Thanks again! Really looking forward to having the data in my own hands going forward.
 
You want to keep him above 80 mg/dL when using the AlphaTrak. If he seems to drop overly fast, you can "steer" with food. this means to feed 1-2 teaspoons of food to slow down the drop. If you need to leave and are concerned, you feed a higher carb level.

Some folks routinely feed 2 or 3 mini-meals before +6 to match up the insulin with the food better. Less food spike increases in insulin, slower drop rate, which may reduce or prevent bounces in glucose level. A bounce happens when the cat drops very rapidly, OR drops a great deal, OR drops to a level which is significantly lower than recent numbers. These things may trigger the body to produce compensatory hormones which elevate the glucose.
 
Hi Jo,
Since most of us here use human glucometers, we'd like that Alphatrak in your signature to stick right out. Please go back into your signature and edit it to make the text large.

The editing commands have a drop down box in the middle labeled "Normal" . After you have selected your Alphatrak text with your cursor, go to those editing commands, click on the drop down arrow and you will see "Large" . Select that and submit to save. Your text for the Alphatrak should now stand out better.
 
Got it. Great. So:

7 AM dosed 2.5 U = 564 (actually taken after he'd eaten his can of food which took about 5 mins, but before insulin)
+1 353
+3 264 (very small blood sample and took a bit)
+4 321 (he was on "high alert" with a squirrel outside the window; not sure if that makes a difference. Was the best blood sample yet)

Will test again @ +6
 
+6 was 330 so definitely looks like the 2.5 U wasn't trouble. Going to talk to the vet about upping his ProZinc to 3 units consistently. Between the two curves the vet did (one week apart) and the one I did today (another 1.5 weeks from the last) he's living most of his time in the 300s with one exception of the 264 today (which hopefully wasn't a poor measurement on my part). The new vet through email today is asking if we want to try Lantus with a strict protocol now that we seem to have the (general) hang of home testing. Something to ponder, but seems to me something has to get adjusted. Thanks again to all!
 
There is a lot of information in the ISG Lantus Tight Regulation forum on Lantus and Levimir use. The topics that start with the word Sticky have so much information, it may even be a bit overwhelming at first.

One of the trickier aspects of switching from Prozinc to Lantus, is understanding the depot and how the dose you give today, might not have it's full effects show up for several days as the depot fills or drains.

Lantus is also much better dosed on a stricter 12/12 hour schedule. There have been members that dosed Lantus on different schedules, but it gets trickier.

I would suggest you read those stickies over in the Lantus TR forum before you decide. Then, come back here of in the Feline Health forum and ask questions
 
Deb & Wink said:
Lantus is also much better dosed on a stricter 12/12 hour schedule. There have been members that dosed Lantus on different schedules, but it gets trickier. I would suggest you read those stickies over in the Lantus TR forum before you decide. Then, come back here of in the Feline Health forum and ask questions
Click to expand...
Thanks so much! After reading and discussing the vet tonight we're switching to Lantus. Already picked it up at Walgreens. We'll start tomorrow with 2 units twice a day. We have two things going for us I hope; one, we're new to this, but have maintained a very strict 12/12 so far so it won't be atypical. Two, Meatball is being boarded at the vet with the internal medicine specialist we're working with starting Tuesday for a whole week. We'll start the switch to Lantus tomorrow and they'll pick it up Tuesday through the following Monday. We're sad to be leaving him and don't love the idea of boarding him, but have decided it's the best thing for him right now and an opportunity to be closely monitored through the transition. They'll do a curve and regular monitoring so we feel good about that. Then we'll pick it up from there. Thanks again to all for the advice for a newbie. I have much to learn from you all and appreciate any/all advice, criticism, and suggestions! It's all about meatball :)
 
Pease - Check the Lantus TR groups stickies. 2 units twice a day may be too much.
 
BJM said:
Pease - Check the Lantus TR groups stickies. 2 units twice a day may be too much.
Click to expand...
Will re read first thing tomorrow AM before first dose. Vet calculated based on his weight (9.6 lbs) but will do my research. Thanks for the advice.
 
9.5 / 2.2 * 0.25 is current formula used in Lantus TR group. Works out to about 1 unit per shot.
 
9.5 / 2.2 * 0.25, rounded down = about 1 unit BID per current Lantus protocol.
 
And, while I'm definitely no expert on Lantus (Chuck's first insulin 5 years ago), I'm a great fan of the start low and go slow club. You'll likely see higher/weirder numbers at the beginning with Lantus, but it takes 3-4 cycles for the depot to fill. I'd say 2 units BID is too much to start with -- it doesn't fill the depot any faster to go with more insulin, as far as I know. Switching to a different insulin definitely requires patience pants!
 
Thanks all! Started with 2 units this AM but soon after worked with vet and we'll be switching to the protocol used here for Lantus. Now I'm trying to figure out what tonight's dose is. I started a thread in the Lantus forum at viewtopic.php?f=9&t=99863. Thanks for your help - and open to ideas on tonight's dose over in the other thread if you have them! Jo
 
Status
Not open for further replies.
Back
Top