Dosage - his BG is going up and staying up lowering dose

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Michele&Errol

Michele&Errol

Member Since 2013
Following on from my newbie thread of earlier. I have just taken Errol's BG and it is still 20.5 which it was almost +2hrs this am.
What do I do now? Is 1U too low for him? He goes through phases where he is flat, and then towards the evening and towards supper time, becomes a little more chipper. Please help! Am I on the right track here?
 
Lantus is a depot insulin it takes 3-5 days for a dose change to level off. PATIENCE! (Deb'll get you some patience pants, I'm sure!) You have to wait it out sometimes. Note that a low glucose which hasn't been experienced in some time may provoke counter-regulatory hormones to release stored sugar. The 77 last night may be part of why he is higher today.

Also, 2 hours after eating is when the food tends to have its peak effect and boost the glucose. This is normal, particularly if you meal feed.

It is helpful, once you are already on insulin, to change only 1 thing at a time - food OR insulin dose.

If you want to adjust the dose, keep the food consistent in terms of carb amount, whatever it is (I see you're working on change.)

If you want to adjust the food, monitor the insulin dose for needed reduction, but otherwise hold steady.

And please take of the 911. This is NOT an emergency where the cat's life is in imminent danger.
 
Since I need to give him his shot soon, I thought it was quite important to ask first as it wasn't answered on the previous thread. Apologies, I didn't know.

So do I keep him on the 1U? His BG is back up and staying up on 1U. I cannot adjust the food in such a short period of time however much I want to. Short of him going hungry I have to feed him the dry until such time as he will eat wet. I've read it's not a good idea to try and force a sick cat to change diet so radically, so I'd rather he ate something than nothing at all. I need to give him insulin tonight, but should I increase it by .25U or not?
 
See if you can hold constant with both insulin and food for a couple of shot cycles (each 12 hour period being 1 cycle) and monitor to see how it levels out. You've only been at 1 unit for a few days and it takes 3-5 for it to stabilize at a dose.

You do need him to eat. I think I would work on glucose control this week and work on the diet adjustment next week. You can alternate weeks and gradually step down into better diet and numbers.
 
By the way - there are a few low carb dry foods.
Stella & Chewey's freeze dried and Evo Cat and Kitten at specialty pet stores.
Young Again 0 Carb via internet only (pricey, but supposedly they eat less so it may average out.)
 
Thank you! I think I may have seen Evo here.. I'll be on it first thing in the morning.
How about Orijens and Earthborn grain free?
 
Look at ingredients. If it has any kind of grain, root vegetable (potatoes, carrots), fruit, or legume (peas, beans) in it, it is much less likely to be low carb. Many of those are put in because they are good for humans and humans are sufficiently naive to believe they'd be good for cats ... not.

Cats have the ability to break apart a protein or a fat molecule and create glucose if needed. There is no biological need to give them any carbs.
 
I saw a request for some patience pants, so coming right up, from the vast and expansive and never empty lending closet, here are some patience pants just for you! ;-)


Pick a color, any color. I'm sure your favorite will be here.

Or perhaps these, with the holiday theme and a treat for you will be more to your liking. ;-)

US beans need our treats too. :cool:
 

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Hi there

Can you get some night time tests later at night? It does look like he is dropping lower at night given both on the 3rd and last night the +2 was a lot lower than the pre shot. Many cats drop too low at night and when you see a drop like those days I would set the alarm for a test at say +5. You want to check he isn't dropping too low.

Todays red is likely a bounce (let me know if i need to explain this) off of an overnight low. the question is, how low was that low? Was it low enough to mean a dose decrease is needed or was it just low enough that it panicked the liver after its hypo the other day. Also it looks like he is clearing the bounce. Tomorrow morning you might see a low number so you might want to get a PMPS+11 tonite so you cn be prepared and know which way his blood is going. Rememeber no food two hours before the shot


Wendy
 
Hi Wendy
I'm going to do a curve from this pm to tomorrow pm. (New) Vet suggested I do 2hours pm and 1hr am so I don't miss a bounce.
Please explain the no food 2hours before shooting. I have obviously totally misunderstood because I thought he had to eat almost immediately BEFORE a shot?

I took him and urine to the vet yesterday pm when I saw the red, and they couldn't find any ketones. He has shown preference for Royal Canin RD and I am trying hard to wean him off the w/d and Diabetic kibble. I even managed to get him to eat 1/4 sachet of Whiskas Beef and Lamb (albeit in jelly so probably high in carbs but at least it's WET FOOD!) He seems much brighter when his levels are around 4.3 -5 mmol/L, there's a marked difference in his attitude. Even though I haven't done a curve yet, unless it's my imagination, I think I see the BG at far better levels (and therefore his attitude) after the wet food.

Though he is NOT enjoying having his ears pricked. They got quite hot and therefore sore so I've been putting F10 ointment on them, and to clean it off before lancing I've used F10 liquid. It helps with the heat, but he's still not a happy chappie about this ear malarky.
 
Deb & Wink said:
I saw a request for some patience pants, so coming right up, from the vast and expansive and never empty lending closet, here are some patience pants just for you! ;-)


Pick a color, any color. I'm sure your favorite will be here.

Or perhaps these, with the holiday theme and a treat for you will be more to your liking. ;-)

US beans need our treats too. :cool:
Click to expand...

Considering how much weight I've lost in the past week due to this, I'm beginning to wonder if I should be checking my BG too... nailbite_smile
I don't mean to be impatient, I just don't want to make an avoidable mistake and by doing so jeopardise Errol the Feral's chances of getting OTJ. Love the big (little) guy so much, I'd do anything for him.
 
In a 15 minute period, it is test, feed, shoot. You test before you feed.
Leave food down for up to 10 hours.
Pick up food at +10.
Repeat.
 
The reason for the no food 2 hours before the pre-shot test, is if the number is below your shoot/no shoot threshold, you don't know how much of that BG number is caused by the food intake. Is it safe to shoot? We like to see that pre-shot test number without a food influence if possible. Since food will raise the BG levels, we want to get a pre-shot test without the food influence.

There are some of the quick acting insulins, like Humulin N and Novolin N, where you need the food to be in the cat's digestive system 30-45 minutes minimum before the insulin is given. That is not the case with some of the other insulins like Lantus and Levimir. The onset of those insulins is much more gradual and the food has time to start working and balance out the insulin shots by the time the insulin starts to take effect.
 
Lol on checking your own BG.. just make sure you give yourself a treat after!

Maybe spend some time rubbing his ears and giving him a treat, without testing, so he doesn't always associate it with bad pokies.

Remember we need to hold the dose for 3-5days to see if its working properly - to give the depot a chance to fill up. I am wondering if the 1.25 is too high right now. If you find you have to skip another shot because he is under 175, or if he goes under 50, then I would reduce back to 1 unit.

Wendy

Ps you can buy ketone strips at any pharmacy and test the pee yourself...
 
Thanks for the explanation.

Just can't get ketone strips here anywhere - haven't been imported for some years now. What I do is, if the BG looks too high I take a sample to the vet to test.

But at least he is eating a variety of wet canned and sachet food. No pates here, but I read that any wet food is better than dry so I'm feeling far more hopeful now.

How would I find out the carb content of Eukanuba Restricted Calorie wet food? Ignore this <-- they answered me : 7%.
 
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