Dosage
- Thread starter Lenore
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Larry and Kitties
Member Since 2009
Without past data on how BG responds to insulin the general rule is not to shoot at less than 200.
Most of us here test or cats blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
What are you feeding? A low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned
http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/
Most of us here test or cats blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
What are you feeding? A low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned
http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/
Julia & Bandit (GA)
Member Since 2009
The canned or the dry DM? The canned DM is ok for diabetic cats, but the dry is too high in carbs for a diabetic cat and can present problems with regulation.
Did you get a mid-cycle test last night? Doses with Lantus are adjusted from the daily nadir, or lowest number of the cycle (usually somewhere around 6 hours after the shot). We recommend at least 3 tests a day with Lantus (once before each shot to make sure it's safe to give insulin, and once mid-cycle to see how low the insulin is dropping blood glucose levels). It sounds like you may be getting the necessary tests--could you create the a spreadsheet using the link Larry provided? It's an incredibly useful tool in determining adjustments, and he more data people here can see, the better they can advice you on what may be going on.
I agree that without seeing more data, I wouldn't shoot a full dose this morning. It's very possible that the dose may be a bit too high, but without a test from last night's mid-cycle we don't know for sure. How did you get up to that 1.75u? Can you give us a little more information about your cat? How old is he? How long has he been diabetic and on Lantus? How much does he weigh? Is he overweight/underweight? How much Lantus did he start with?
Did you get a mid-cycle test last night? Doses with Lantus are adjusted from the daily nadir, or lowest number of the cycle (usually somewhere around 6 hours after the shot). We recommend at least 3 tests a day with Lantus (once before each shot to make sure it's safe to give insulin, and once mid-cycle to see how low the insulin is dropping blood glucose levels). It sounds like you may be getting the necessary tests--could you create the a spreadsheet using the link Larry provided? It's an incredibly useful tool in determining adjustments, and he more data people here can see, the better they can advice you on what may be going on.
I agree that without seeing more data, I wouldn't shoot a full dose this morning. It's very possible that the dose may be a bit too high, but without a test from last night's mid-cycle we don't know for sure. How did you get up to that 1.75u? Can you give us a little more information about your cat? How old is he? How long has he been diabetic and on Lantus? How much does he weigh? Is he overweight/underweight? How much Lantus did he start with?
He is 20 years old and has been diabetic and on Lantus for 6 months. He is getting canned DM only and is under weight but eats approx 7 oz per day. No I didn't get up during the night for a mid cycle. Vet advised to do injections at that reading -110 but I didn't agree so I wanted to get other opinions. He has been regulated up until a couple weeks ago when he suddenly had BG readings in high 300s. Vet visit did not find any reason for this jump like an infection, UTI etc. He was at a .5 dosage at that time but we had to increase dose up to 1.75 to bring it down. In process of gradually bringing dosage back down now. Do you recommend staying at any reduction amount for 3 days to even a week?
Julia & Bandit (GA)
Member Since 2009
Well, it sounds to me like your vet knows what they are doing regarding diet and dosing! That doesn't happen often here, so you're pretty lucky. 
How much did your vet tell you to shoot after that 110? Did they want you to reduce?
Again, it's hard to give dose recommendations without seeing your data, but it seems to me from what you're saying that the dose was reached safely and in .5-.25u increments. I would strongly recommend getting some mid-cycle tests to get a better picture of how the insulin is working in your cat. When Bandit was on insulin, I worked weekdays and could not go home at lunch to get tests, so I would set an alarm for 1am to get his mid-cycle test and feed him, and then go right back to bed. I understand not everyone is willing to do that, but the data we collected allowed me to safely and more quickly bring his BG down and was definitely worth it. If you can get a mid-cyle during the day and then just grab a test at night before you go to bed 2-4 hours after your shot, that would work well, too!
The reason we get this daily test is because too much insulin can cause something called rebound hyperglycemia. When a cat drops too low, their livers will dump glucose into their bloodstream to compensate. This will keep their blood sugar high for up to 72 hours. This can also occur in an unregulated cat if the cat's body thinks it hit a number that was too low, even if it was a normal number. Without the daily nadir test, it's hard to tell the difference between not enough insulin, too much insulin, or the right amount of insulin and the cat just needs to get used to the dose. Does that make sense?
Would you be able to create a spreadsheet with the tests you have done? Again, it's super helpful for the folks here to give you advice, and you can share it with your vet so they have a better picture of your data, too! Bandit's vet would consult his spreadsheet and email me dosing advice when he was on insulin again last year.
20 years! What an accomplished cat! Is he acting normal other than the high BG? Eating normal, activity is normal?
How much did your vet tell you to shoot after that 110? Did they want you to reduce?Again, it's hard to give dose recommendations without seeing your data, but it seems to me from what you're saying that the dose was reached safely and in .5-.25u increments. I would strongly recommend getting some mid-cycle tests to get a better picture of how the insulin is working in your cat. When Bandit was on insulin, I worked weekdays and could not go home at lunch to get tests, so I would set an alarm for 1am to get his mid-cycle test and feed him, and then go right back to bed. I understand not everyone is willing to do that, but the data we collected allowed me to safely and more quickly bring his BG down and was definitely worth it. If you can get a mid-cyle during the day and then just grab a test at night before you go to bed 2-4 hours after your shot, that would work well, too!
The reason we get this daily test is because too much insulin can cause something called rebound hyperglycemia. When a cat drops too low, their livers will dump glucose into their bloodstream to compensate. This will keep their blood sugar high for up to 72 hours. This can also occur in an unregulated cat if the cat's body thinks it hit a number that was too low, even if it was a normal number. Without the daily nadir test, it's hard to tell the difference between not enough insulin, too much insulin, or the right amount of insulin and the cat just needs to get used to the dose. Does that make sense?
Would you be able to create a spreadsheet with the tests you have done? Again, it's super helpful for the folks here to give you advice, and you can share it with your vet so they have a better picture of your data, too! Bandit's vet would consult his spreadsheet and email me dosing advice when he was on insulin again last year.
20 years! What an accomplished cat!
Is he acting normal other than the high BG? Eating normal, activity is normal?She recommended not to vary from the 1.75 dosage so he wouldn't spike later. That is what is hard for me to understand. If he was already 110 pre-shot wouldn't he just go lower, maybe dangerously lower?
So after discussing with you I didn't shoot him this morning and will test him in a little bit. So if is BG is high when I test will I just wait until the normal time tonight?
For 20-year-old cat is doing pretty well. Of course he walks around like an old man and isn't all that active at this point. I take him outside and get him to walk up the driveway twice a day. He eats very well but is still losing weight which is a concern to the vet and me. Looking to find some high calorie low-carb food to try to get him put some weight on. Could be something else going on.
I'll get some additional readings going forward. Thanks for your time and info.
So after discussing with you I didn't shoot him this morning and will test him in a little bit. So if is BG is high when I test will I just wait until the normal time tonight?
For 20-year-old cat is doing pretty well. Of course he walks around like an old man and isn't all that active at this point. I take him outside and get him to walk up the driveway twice a day. He eats very well but is still losing weight which is a concern to the vet and me. Looking to find some high calorie low-carb food to try to get him put some weight on. Could be something else going on.
I'll get some additional readings going forward. Thanks for your time and info.
Just did his mid-cycle, it was down more - 108
Larry and Kitties
Member Since 2009
Based on that mid-cycle and previous BGs I would give 1/2 or maybe 3/4 unit next shot. But that depends upon the preshot BG.
jayla-n-Drevon
Member Since 2015
There is a dry food that is high calorie and 0-5% carbs-
Disclaimer... I do not think dry is the best choice for a cat but at 20 years old and too thin I would consider it if it was my cat.
Young again 0 carb is a food that dry addicts often use because the carbs are very low -- it is expensive and the company makes claims that are not "exactly" true but in the end it is a quality food and carb acceptable.
Ziwi Peak wet food is a great quality but I am not sure the calorie count ( I suspect it is a bit higher than most other low carb wet foods)
Thank you.......I actually came across that food earlier today and sent an email to my vet to get her approval. As you said it is no carb and lots of calories. Could be a good option for my very old kitty. I thought I would start by just adding a little on top of his wet food and see how it goes. His stomach is sensitive to new things so I hope he can keep it down. Thanks again
Julia & Bandit (GA)
Member Since 2009
Wellness kitten canned is also good for putting on weight and diabetic safe. I used to feed that to my kitty with stomach cancer to keep her weight up and it worked very well.
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