Dosing advice ASAP

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OK, great! We'll keep the dry food in mind at the next test.

Just for information, we usually try to keep them "a little hungry" when fighting low numbers, so that when we need them to eat some HC, they will. Pending the next test, though, go ahead and let him munch on the dry for a bit, and then once we see the new number we can strategize. You can always do the honey-on-the-gums thing in a pinch, but you won't want to be doing that all day (neither will Forrest!).
 
Nan & Amber (GA) said:
Honey (and crunchies!) to the rescue!

I'd test again in an hour to make sure this 'sticks,' but looking good!
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Thank you, I will. I think I am gonna start the 1.5 units tonight and still leave out dry food tonight and tomorrow (since I can't be home to monitor him/can't test) then Saturday do 1.5 with no dry food since I will be home all day again. Does this sound reasonable?
 
Jessicaandforrest said:
So I was thinking maybe dropping him down to 1.5 units starting tonight maybe tomorrow
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I like that idea too. Even the 2U insulin dose is showing that it is too much, if he is dropping down to the 40's. "Feed the 40's".
Personally, if Forrest were my cat, I would not give him ANY insulin if his pre-shot BG was <150. Seriously, no insulin at all for now.

Jessicaandforrest said:
then Saturday do 1.5 with no dry food since I will be home all day again. Does this sound reasonable?
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Yes, that sounds reasonable to me too. IF, and only if his BG levels are 150 or above, should you go with the 1.5U dose.
Forrest is in the tree green or neon green BG levels right now, for all of your tests. Those are normal cat BG ranges. They are saying to me NO INSULIN for right now.

Even with only a handful of tests under your belt, I think that Forrest is telling you he may be ready for an OTJ (off-the-juice, insulin being the juice) trial.

Changing one factor at a time, can sometimes let you know narrow in on what is happening. If you changed the food and the insulin dose on the same cycle, then it's very difficult to pin down which change made the difference. But sometimes you have to change multiple factors. Right now, the limited test data is telling me you need to stop the insulin.

Don't be surprised if the next pre-shot test is very high. Both the dry food and the low BG numbers could have caused those numbers to spike. Dry food takes longer to digest because it has to get wet and break down in the stomach first before it enters the bloodstream, which is why we suggest you have some high carb canned food on hand in your hypo toolkit. Something like the Fancy Feast Gravy Lover's foods are a good choice. After opening the lid, you then leave the lid on top of the can and "squeeze" the gravy (the high carb part of the food) out into a dish.

I think that Forrest is going to need another dose reduction really, really soon. Even that 1.5U dose is likely to be too much for him. Keeping all paws crossed here that he continues to be ok. When cats drop really low, they can be MORE sensitive to the insulin. Which is why I'm saying I think that even the 1.5U dose will be too high.

If you do go ahead with a diet change, eliminating the high carb dry food this weekend, you probably want to drop the dose down very, very low or stop the insulin entirely and try the diet change alone. What do I mean by very, very low? Like to 0.5U of Prozinc for a maximum. It's easier to increase the dose again in small increments, than to stay up late at night with a cat in very low BG ranges. Or have to rush your cat to the emergency 24 hour vet clinic.

So patience please. Please.
 
Honestly, when I got my first successful home test a couple of days ago and it was only 95 and then it was only 86 this morning I was kind of thinking the same thing.. Especially because of the way he's been acting and the neuropathy that he had is practically reversed. No shot tonight then. Tomorrow my mother typically gives him his insulin, both doses, but no testing because she can't test by herself (neither can I) should we maybe consider skipping both doses tomorrow? I can test him when I get home but that wont be till 2030-2100. or maybe only giving him 1U?
 
I'd skip tomorrow too.

You could test him before you head off to work. Even if that is not his normal shot time, having another test would be helpful.

No dry food tonight or tomorrow is fine too.
Does Forrest like his canned food well enough, that he will have something to eat?
Will your mom remember to not put any dry food out for Forrest?

We get to be such creatures of habit, that we can forget when there is a change in routine. It's why I'm asking about your mom and the food.
 
Deb & Wink said:
I'd skip tomorrow too.

You could test him before you head off to work. Even if that is not his normal shot time, having another test would be helpful.

No dry food tonight or tomorrow is fine too.
Does Forrest like his canned food well enough, that he will have something to eat?
Will your mom remember to not put any dry food out for Forrest?

We get to be such creatures of habit, that we can forget when there is a change in routine. It's why I'm asking about your mom and the food.
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He does like his canned food! Typically he eats the whole can of fancy feast. She won't put the dry food out if I tell her not to especially if we are skipping the doses tomorrow. I like the plan of skipping the doses, much safer, especially after the 40s scare today. Also, thank you so much for your help I truly do appreciate you and everyone who banded together on this forum to help me!!!
 
Jessicaandforrest said:
He does like his canned food! Typically he eats the whole can of fancy feast.
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Good! I didn't want him to go hungry. Wink hated canned food, so it was a struggle to get him switched from dry to wet food.
Is Forrest maintaining his weight on the FF (fancy feast)? With only that food being fed, he might need more than 1 can in the AM and 1 can in the PM. To make up for taking away the dry food and the calories that provided him.

Jessicaandforrest said:
Also, thank you so much for your help I truly do appreciate you and everyone who banded together on this forum to help me!!!
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It's what we do Jessica. In the beginning, we all needed help. Just paying it forward to the next group of people learning to grapple with a feline diabetes diagnosis.
 
Deb & Wink said:
Good! I didn't want him to go hungry. Wink hated canned food, so it was a struggle to get him switched from dry to wet food.
Is Forrest maintaining his weight on the FF (fancy feast)? With only that food being fed, he might need more than 1 can in the AM and 1 can in the PM. To make up for taking away the dry food and the calories that provided him.


It's what we do Jessica. In the beginning, we all needed help. Just paying it forward to the next group of people learning to grapple with a feline diabetes diagnosis.
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So far, yes he is maintaining weight when we first started he dropped a lot of weight but gained some of it back the last time he was at the vet probably about a month ago he was around 13lbs I believe and I think he might be a little heavier than that now... he was a chunky boi :cat:
 
I would say that Forrest is on an OTJ trial. Day 2.

Here is what you want to do during an OTJ trial, as regards to testing. Realize you can't get these tests all the time, because of your work schedule. But do try to get a BG test when you can.


OTJ Trial Guidelines (These are the criteria we use when following an OTJ Trial.)

Here are the instructions for an OTJ trial: If on Lantus or Levimir, depot has to drain first before trial starts, about 3 days or 6 cycles. No depot with in and out type insulins (NPH, Vetsulin/Caninsulin, Prozinc). The trial starts when numbers are in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range. Start the trial on the next green pre shot.

If you are posting in the Lantus/Levimir forum, please start a new thread each day which says ‘[Cat name] OTJ trial Day 1 BG xx’ (where xx is the BG reading for that cycle PM), then day2,3 etc. If you are posting in the Main Forum, we don’t require you or need you to do that separate post for each day. In fact, if you have never posted before over in the Lantus/Levimir forum or use a different insulin, you are fine staying in the Feline Health (Welcome & Main Forum). Or in the specific ISG (Insulin Support Group) for your insulin. We’ll cheer you on!

1. Test at your normal AMPS and PMPS times. Remember, you want a 2 hour fast before those AMPS and PMPS test times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.

2. If your cat is green (0-99 mg/dL human meter, 0-130 mg/dL pet meter, 0-5.5 mmol/L) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue or higher (100-199 human meter, 130-230 petmeter, 5.5-11 mmol/L), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!

3. Your cat may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

4. After 2 weeks, 14 full days, if everything is looking good, we have a party!

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.
 
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