? DOSING ADVICE NEEDED PMPS213

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Rebecca88

Rebecca88

Member Since 2016
My cat was diagnosed about 3 months ago. Started on Prozinc switched to Lantus. I have a thread going on another post. I'm new to this so don't know where to post. Her BG was 398 on the 8th.She was on 8 units once a day. He raised her to 8 and 8!! Took her Tuesday and BG was 346. I just bought a kit myself and tested her at 3:00 pm. She had 8 units at 7:00 am with food. Her BG was 231. Just tested again at 6:00. Got 213. What dose should I give her? I'm seeing a new vet Saturday.
 
Rebecca, since nobody has jumped in yet and shot time is coming, would you consider going down to 1 unit twice per day and starting over?
 
Rebecca...just posted your condo in the FB group so they can hop over and help :) But like I said, I would personally start with one unit and hold that for a week till her shed drains from the higher dose. And keep testing at different times mid-cycle so you can find her "nadir" b/c dosing decisions with Lantus and Levemir are based on nadir numbers, not pre-shot numbers. And read all the stuff I sent on "Start Low, Go slow" method. That will tell you when/if to increase doses, etc. That's the info I sent on the FB messsage
 
At a starting dose of 8-10 units you most likely overshot her "good" dose. Giving too much insulin can often have the same effect as not enough, which is too high numbers. This is coming from YEARS AND YEARS of many lay people's experience. You could potentially be creating either glucose toxicity or a future hypoglycemic episode. How much Prozinc was she on before you switched her?
 
RobynWilson said:
At a starting dose of 8-10 units you most likely overshot her "good" dose. Giving too much insulin can often have the same effect as not enough, which is too high numbers. This is coming from YEARS AND YEARS of many lay people's experience. You could potentially be creating either glucose toxicity or a future hypoglycemic episode. How much Prozinc was she on before you switched her?
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She was on 5 units twice a day
 
There is always the option to continue to stall and test Rebecca, and you can wait until someone more experienced turns up I am going to tag some of our most experienced members see if someone is about that can help.
The problem with dropping all the way down to 1u if you are going to do SLGS is that it might take a long time to get to a good dose for her, if you were doing TR then you can fast track up the dosing scale more easily.
I certainly haven't got the experience to advise you on dose, but I would just stall and see if we get a response.
Another option is to do two 18hour cycles to buy you some time while we figure this out.
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Ladies would you please see if you can help Rebecca, no ss set up she has only just started testing and vet has made some questionable decisions on dosing, the original post is linked and is on the welcome to the group forum. thank you , I hope someone is about to help.
 
Okay I"m tagging like crazy over on the FB page to have some of the more experienced members back me up on this but I really strongly believe you should "start over" and go with Start Low Go Slow method. It's your cat and do what you feel in your heart but I'm just talking from my own 2 1/2 yrs experience and also seeing other cats who had started out on high doses and the numbers were high as a result of that. Are you Eastern time?
 
Gill & George said:
There is always the option to continue to stall and test Rebecca, and you can wait until someone more experienced turns up I am going to tag some of our most experienced members see if someone is about that can help.
The problem with dropping all the way down to 1u if you are going to do SLGS is that it might take a long time to get to a good dose for her, if you were doing TR then you can fast track up the dosing scale more easily.
I certainly haven't got the experience to advise you on dose, but I would just stall and see if we get a response.
Another option is to do two 18hour cycles to buy you some time while we figure this out.
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She just started testing today and have no idea what her schedule is like that she can do TR, which is why I suggested Start Low Go Slow. Anything's safer than what this vet has her doing now!
 
RobynWilson said:
Okay I"m tagging like crazy over on the FB page to have some of the more experienced members back me up on this but I really strongly believe you should "start over" and go with Start Low Go Slow method. It's your cat and do what you feel in your heart but I'm just talking from my own 2 1/2 yrs experience and also seeing other cats who had started out on high doses and the numbers were high as a result of that. Are you Eastern time?
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I just want to do what's right. What happens if I don't give her enough? Is not enough better than too much? And she usually eats at 7:00. Do I feed her now? I'm in Florida
 
Congrats on learning to home test....so quickly!!! Kudos to you.

As for dose, if you have cut out all the dry food, I'd start at 1 unit twice a day, then you can increase in 3 days if you are still seeing high numbers. I have a feeling that the highs were caused by the dry food which was around 30% carbs. If you change to low carb food, then you won't need as much insulin.
 
Rebecca88 said:
I just want to do what's right. What happens if I don't give her enough? Is not enough better than too much? And she usually eats at 7:00. Do I feed her now? I'm in Florida
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It is definitely better to have high numbers for a few days, then too low for even a minute. Test, feed, shoot is the order I did Zoe in......and hello from Ft. Myers!!
 
Not enough is better. If given to much she could have a severe hypo episode that could be fatal. That is why I asked if you have syrup in house.
 
We also have the concern here that she was using U40 syringes to shoot U100 insulin so actually was probably not shooting 8 units, I think a starting dose of one unit would be good but certainly no more than two.
 
Woodsywife said:
I so agree 1u or 1.5u. Lantus builds a depot, so she does have some in reserve. What would you be comfortable with?
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I don't even know the answer to that question. I am so unfamiliar with this drug and it's very confusing. I will go with what you guys are saying I guess. I don't know.
 
Rebecca88 said:
I don't even know the answer to that question. I am so unfamiliar with this drug and it's very confusing. I will go with what you guys are saying I guess. I don't know.
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Please do, the peeps on this forum have so much more knowledge about Feline Diabetes that most vets do. I am not trying to slam your vet but sadly it's true.
 
We all just want Mercedes safe. Using the u100 syringe give her the dose and let us know how much you gave. Kudos for the paw test. I just tried it on Smokey and didn't get one drop.

Her readings could be high for a few days. It will be normal.

Now in your title edit so after the word needed, put PMPS 213. If you can get a test @+2 (9pm) and +3 (10pm). Theses two tests will show if she is going up or going down.
 
Woodsywife said:
We all just want Mercedes safe. Using the u100 syringe give her the dose and let us know how much you gave. Kudos for the paw test. I just tried it on Smokey and didn't get one drop.

Her readings could be high for a few days. It will be normal.

Now in your title edit so after the word needed, put PMPS 213. If you can get a test @+2 (9pm) and +3 (10pm). Theses two tests will show if she is going up or going down.
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How do I edit? I'm so confused. Sorry
 
Rebecca88 said:
I usually give her a little dry low carb food after the wet food. And 7 and 7. She didn't eat much wet food. She never does
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Do you know what the carb count for the dry food is. We recommend wet food under 10 % carbs. Dry is usually to high except EVO and Young Again dry.
 
Just so you know Rebecca although orijen is lower carb than some other kibble, I think it's approx 18% carb, ideally for a diabetic cat you want to be looking at below 10%, but if you are going to change the diet be aware that if you remove it suddenly it can have a dramatic effect on her BG so it might be best to do that slowly should you decide to remove the dry food.
If she is on dry food then look at the SLGS sticky they give you the guidlines for dosing that we would use when there is kibble in the picture. If you want to attempt to follow Tight Regulation Protocol then you need to get the dry food out of the picture.
 
Bobbie And Bubba said:
Do you know what the carb count for the dry food is. We recommend wet food under 10 % carbs. Dry is usually to high except EVO and Young Again dry.
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It says 18.5 but I don't allow her to free feed anymore. I'll probably give her a carb free food after seeing the new vet Saturday. But I didn't want to take it away cold turkey especially with not knowing how much insulin to give her
 
Rebecca88 said:
It says 18.5 but I don't allow her to free feed anymore. I'll probably give her a carb free food after seeing the new vet Saturday. But I didn't want to take it away cold turkey especially with not knowing how much insulin to give her
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I think that is a good idea, now that you are home testing you will be better able to keep her safe and that new vet visit can't come too soon.

How much testing will your Schedule allow?
 
I would NOT drop her down to 1 unit and start over, but if you're going to reduce the carbs by getting rid of the dry and start testing, I'd suggest dropping down to maybe 5U and see how she does while you gather data

While it's totally possible she's getting way too much insulin, by dropping back that quickly without proof that she doesn't need that much will probably just lead to glucose toxicity setting in and her ending up needing an even higher dose than she might otherwise.

What's important right now is getting her onto a low carb canned diet, and getting some testing in so we can see how she's really doing. If she needs less, she'll tell us!

It's very important that you start keeping your test results on our spreadsheet too. It's a very valuable tool and will help us to help you going forward. Here are Instructions on setting up the FDMB spreadsheet...if you have any trouble, let us know...we can help!
 
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