Dosing Advice Needed

[Merlottes Parents]

Please, if anyone might be able to give us some advice on dosing? If you look on his spreadsheet you can see that it is still much to high. We are at a 1.5 (lantus) at the moment. Our vet had us go to a 2.0 but Merlotte's BG seemed to start to go higher and that left us very confused. You would think that more medicine would help his numbers to go down... but it didn't seem to work that way. Also, I would like to add that from the moment that he was diagnosed he has been on a low carb soft food diet (Friskies and Fancy Feast mostly). No hard food at all. And for "good boy' ear pricks he gets Whole Life pet Just One ingredient chicken or turkey treats. Thank you for any time you take to help with our concerns.

 

[Bron and Sheba (GA)]

Hi,
It would help if you could fill out your signature which is at the top right of this page under your user name. When finished press save. We need information about your kitty so we can help you.
In your signature put name of kitty, date of diagnosis, what insulin you are using, what meter you are using, whether you are following the Start Low Go Slow or the tight regulation protocol or haven't decided yet.Any other health problems. Diet.
Also if you are able to link your previous post to your current post each time you start a new post, it helps us to see what has been happening with Merlotte. Thanks
I actually can't find any other posts from you. Is this your first post?
Just a couple of observations.......it is great you are testing the blood sugar levels.........make sure you always test before giving insulin to see it is actually safe to give the insulin. I see there are a few blanks in the dose given column in the SS. Did you skip the dose or did you just not put the dose in?
Are you able to test at all during the day during the cycle.? I see you did a curve a couple of nights ago. That's good! If you are able to get some more tests in during the day or the evening it would be very helpful. If you work during the day, you might be able to get a test in before you leave the house or when you get back or some tests in at night even if it is a before bed test as a lot of kitties go lower at night.
We change the dose according to what the nadir (lowest point) of the cycle is, not the preshot so it is important to try and get those inbetween tests if you can. Otherwise we do not know if he is dropping low during the cycle and bouncing back up at preshot. If you only get the preshots it can look like he is high all the time, when in fact he could be dropping during the cycle and coming back up at preshot.........does that make sense?
It does look as if Merlotte needs some more insulin though,looking at the curve you did. We increase the dose by 0.25 units each time so that would mean his new dose would be 1.75 units. Try and get a few inbetween tests so we are able to see how he likes this dose.
Keep posting and asking questions. It is great you have him on the correct food and are testing the BSLs.
Merlotte is a gorgeous boy.
Bron

 

[tiffmaxee]

Welcome. To add to Bron’s good suggestions, I can’t figure out how you are deciding dosing in the past. Both our protocols go up and down in .25 increments. I only see one time when we would have reduced from 2.0 to 1.75. Are you using a pen that only has unit dosing? If so you need to get U100 syringes with half unit markings. In the U.S. you usually need an RX for them. Then you use the pen like a vial.

 

[Sienne and Gabby (GA)]

And another question -- you noted you're feeding your kitty Friskies and Fancyi Feast. Which varieties? Not all of the flavors/varieties are low in carbohydrates.

 

[Merlottes Parents]

I updated our signature as asked with the following info -
Cat's Name: Merlotte (age 6)
Date of Diagnosis: 07/10/2018
Insulin: Lantus (bottle not pen)
Meter: ReliOn Confirm/Micro
Food: We follow Dr. Pierson's food chart feeding foods lower than 10% carbs.
Our one previous post is http://www.felinediabetes.com/FDMB/threads/new-to-the-site-hi-from-merlotte.200515/

(Quick note: We have never missed a dose. The chart was just off)

Knock on wood, Merlotte has no other health problems. He started to loose weight after he had his teeth cleaned and a few pulled. We got worried about his weight loss and took him back to our vet where he was diagnosed with diabetes. Dosing has been hard because, at first, we followed exactly what the vet told us. He told us to start at one unit every twelve hours. Then after some time we sent him the numbers and he told us to go to 2 units every 12 hours. That is when we posted our first post on these message boards and were pointed to the start low go slow post. That information worried us so we dropped the dose to 1.5 every twelve hours. I guess it was a happy medium between our vet and the message board. Our vet told us that we only needed to test him once a day but, with my husband being a type one diabetic, that sounded a little to little for us so we test him before his insulin is given every twelve hours and once in a while at odd times just to see where his B/G is at. I know we should do more but I hate bruising up his ears. I'm getting better at it and will do it more frequently in the future.

As far as foods that we feed him and the schedule: We feed him foods that are less than 10% carbs from the Dr. Pierson's food chart. Mostly it is the classic pates from Friskies and Fancy Feast because it is what we can afford, but we will pick up better foods listed on Dr. Pierson's chart (less than 10% carbs, of course) when they are on sale at Petco or Petsmart. The schedule is a bit tougher... we have 4 cats and we have been able to get 3 of them (Merlotte, Tasia and Sasami) off of hard food all together and one cat (Dexter) that flat out refuses to eat anything but hard food. So, this is what we have been trying: All three will split one can of fancy feast at noon, one fancy feast at 3pm and one larger friskies at 5pm after Merlotte's 5PM shot. At night the spit one friskies or fancy feast at bedtime between the three of them and then one Friskies to split at 5AM when Merlotte gets his morning shot. Dexter eats his hard food while the rest are eating. All of them are closely watched so Merlotte can never get at the hard food. It is put away as soon as Dexter is finished eating.

All and all Merlotte is doing real good. He plays every day and is acting like his normal sweet self. It is just that we can't get his numbers in a better place that worries us. Our vet is VERY expensive so we can't take Merlotte in for every little thing and that drives my anxiety though the roof. If it were up to me I would have the vet on speed dial and talk with him every day. We are on a fixed income so that is another worry with the growing vet bills, insulin cost and testing supplies. We applied at the Diabetic Cats in Need website the moment we we diagnosed, but sadly, we have never heard back from them as of yet. Ok.. I'm starting to ramble. *laughs* Thank you again for taking the time to read our post and thank you SO much for the information that you all have posted!

 

[Wendy&Neko]

All and all Merlotte is doing real good. He plays every day and is acting like his normal sweet self.

Cats are more than their numbers. This report on Merlottes is very good. However, it would also be good to get his numbers in a better place. You are right that you need to be testing more often. We can help you decide how to change the dose so you don't need to go to the vet for that. If you are following Start Low Go Slow, could you put SLGS in your signature so people know at a glance? We determine how to dose a cat based on how low that dose takes him. Since blood sugar values or more or less a curve shape (see the New to the Group Sticky for a sample curve), we need to get some of those tests somewhere in the middle of the cycle. It's great you got a curve in the other night. Random tests in the middle of the day/night will really help us figure out what to do next with the dose. For now I would hold the dose and gather a little more data for the next couple of days.

Sorry about Merlottes' ears, but putting pressure on it after the poke will help prevent bruising, and a little Neosporin on the spot afterwards will help with the sting and help heal. Poking him is helping him.