DOSE ADVICE?? 8/11 Sushi: AM +3~255 | +5~254 | PMPS~97!!

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Sushi (GA 5/05-3/14)

Sushi (GA 5/05-3/14)

Member Since 2011
Hello! Hope this finds everyone doing well!
Yesterday brought up a lot of questions:
1. Tips/tutorials/techniques for giving injections
2. Schedule changes -- is it better to (a) keep the time that injections are given consistent but have to skip 2
or (b) Only skip one injection but steadily change the dose time in 15min incriments over the week?
Sushi said:
Which would you suggest is the better option:
SCHEDULE A:
offers more consistency as far as the times the shots are given, but it involves skipping twice.
[Usually dose @ 5:30am/pm]
Tomorrow: [am]5:30 / [pm]skip
Friday: 5:30am/pm
Saturday: 5:30am/pm
Sunday: [am]skip / [pm] 5:30
Monday-Wednesday: move dose in 15min incriments to 6:30am/pm
Thursday-Sunday: 6:30am/pm

SCHEDULE B:
only skips once, but the dose time will be steadily changing.
[Usually dose @ 5:30am/pm]
Tomorrow: [am]5:30 / [pm]11 (I could even do the am dose at 11am or whenever)
Friday: [am]10:45 / [pm]10:30
Saturday: [am]10:15 / [pm]skip
Sunday-Wednesday: move dose in 15 min incriments to 8am/pm (Sunday: [am]10/[pm]9:45 -- Monday:[am]9:30/[pm]9:15 --Tuesday: [am]9/[pm]8:45 -- Wednesday: [am]8:30/[pm]8)
Thursday: 6:30am/pm -- THAT'S AN HOUR AND A HALF JUMP!
Friday-Sunday: 6:30am/pm
Click to expand...
Julie gave some great insight, but I'd love to hear what others think as well!

...last night was our first meal of 100% canned food.
Julie, I went with your advice. We're going with schedule B, and I gave Sushi his AM dose @ 8am.
 
Re: 8/11 Sushi: AMPS 317 | +3~255 | +5~254

well let's hope it was good advice! i've only been doing this since february, and i was just guessing as much as anything. :-D

sometimes you just gotta step out and see where you land. ;-)
 
DOSE ADVICE?? 8/11 Sushi: AMPS 317 | +3~255 | +5~254 | PMPS

Just flew home as fast as I could, checked Sushi's BG and got 97 and 105!! That's the lowest we've ever had!
I usually dose him at 5:30am/pm, but switched to 8am today and need to give his PM dose ASAP. So we're at +14.5 right now.
I usually give 5 units.

He hasn't eaten much today at all--maybe a 1/4c of canned food?

What should I do???
 
Will you be around tonight to test? Do you have a hypo kit? Has he eaten since you tested? Can you wait 15 mins from the last test and test again?

Sorry. Just trying to figure out where you are at.
 
Will you be around tonight to test? yes
Do you have a hypo kit? yes
Has he eaten since you tested? yes--are his #s low because he was starving? : (
Can you wait 15 mins from the last test and test again? I can, but we're waayyy off schedule and a lot rides on dosing him ASAP
 
...actually I'm pretty low on strips, so I'm not sure I would say my hypo kit is complete.

Just checked again and we're still at 106:
10:15 - 97
10:18 - 105
10:54 - 106

He ate about 1/8c between 10:15 and 10:54.
 
Since he has eaten since you tested him, it won't do any good to wait the 15 mins because it will be food induced. For future reference, if a number is that low you should not feed and test every 15 mins to see if they are on their way up. Now your choices are to skip the shot, give a token dose or shoot the full dose and then keep testing and watch him. It really depends on your comfort level.

There are some general guidelines here: viewtopic.php?f=9&t=147

There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise. In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine. Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
 
Since you don't have data shooting that low and you are below 150, the guideline would say to skip the shot. If you are low on strips, I would tend to agree with that.
 
:YMSIGH: Whew!! Thank you sooo much!! I so needed some help here!

So what do I do about tomorrow? What time do I give him his AM dose?
Can I move our does time to 6:30am/pm?

Again, our schedule has been 5:30am/pm
I dosed this morning at 8am
We were moving to this schedule:
Today: [am]8 / [pm]11
Friday: [am]10:45 / [pm]10:30
Saturday: [am]10:15 / [pm]skip
Sunday-Wednesday: move dose in 15 min incriments to 8am/pm (Sunday: [am]10/[pm]9:45 -- Monday:[am]9:30/[pm]9:15 --Tuesday: [am]9/[pm]8:45 -- Wednesday: [am]8:30/[pm]8)
Thursday: 6:30am/pm -- THAT'S AN HOUR AND A HALF JUMP!
 
I am not sure about the dosing schedule. I would think it would be ok to move to the 6:30 am/pm schedule since you skipped tonight and I would probably go ahead and move it myself. With that said, the rule I have always heard is to move it either 15 mins each shot or 30 mins for one shot each day. That would take you 3 days to get to the 6:30. However, I have never had to move the dose time so hopefully someone will come along with more experienced eyes and let you know.

As far as BG's affecting hunger, Tarragon is always way more hungry in the higher numbers and not so much in the lower ones. If Sushi was really hungry tonight, I would think it would have more to do with switching to canned food than his BG levels. How many cans are you feeding him? Also, one trick I learned to make sure the canned filled Tarragon up was to add quite a bit of water to his canned food. This made sure he stayed hydrated and also filled his tummy up better.
 
Great!! Thanks for the info.

I still haven't figured out how much to feed Sushi or how much he's eating. We're still getting the hang of it. I'm leaving food out for him mixed with lots of water, but after it's been out for about 10 hours or so he won't have anything to do with it. I'm having to open up fresh food so he'll eat; just poured at least a whole can of old down the sink. :?
If I had to guess I would say he's eating between 6oz and 8oz? That's about 1/2 of what he usually eats!
 
Champ is an 18-pound cat and he eats between 5-6 oz. a day (when he has a good appetite) plus a couple small snacks. A cat's BGs will fall if they don't eat enough and 1/4 can really isn't enough in a 12-hour cycle. You can try freezing some cat food in an ice cube tray and leaving some of that out for him to eat throughout the day while you're gone. It won't get all crusty and nasty and he might actually eat it. Of course, he can't be like my cat who requires me to heat his food up if it's been in the refrigerator.
 
[am]9/[pm]8:45 -- Wednesday: [am]8:30/[pm]8)
Thursday: 6:30am/pm -- THAT'S AN HOUR AND A HALF JUMP!
Click to expand...
And that 90 min. shift is a problem. It's less of an issue to shoot late. Shooting early is like a dose increase. Unless Sushi is sitting in very high numbers, I don't think this is wise.

I also want to encourage you to not be in a position where you are seeing low numbers and are low on strips. It can be dangerous. Unless you have a store nearby where you can purchase strips, please make sure you are well stocked. Our cats are uniquely able to drop into low numbers when you are least prepared. Murphy's Law really does apply.
 
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