Dosing advice needed

Heather and Gizmo

Heather and Gizmo

Member
Hi Everyone. Here I am again asking for some help with dosing. I have been holding 2.75 u for about 13 days, until Gizmo had a low PMPS reading of 72. I have been giving 2.5u for the last three cycles. When I came home at lunch his BG reading was 71 and he had no food on his plate to help bring the numbers up. He usually has half of his food left when I come home for lunch. So I gave him some more of his low carb we food which he only ate a few bites from. I waited 30 min. and he was up to 87. It is rough on the nerves when you have to leave your kitties at such low numbers. I took a reading when I got home at 5:30 pm and he was up to 253 and I just did his PMPS and he is up to 343.

I took Gizmo to the vet last night and they took a urine sample and did blood to complete a fructosamine (not sure if I am spelling this right) test. They called me tonight and let me know that his urine is still showing sugar but no infections. The fructosamine showed 412. I guess this is in fair level control. The vet wants me to continue the 2.75 u for two weeks and then he wants to do a spot check. I am nervous about going back up to 2.75u after the nadir this last cycle was 71.

Should I bump him back up or hold him at 2.5u for a week?
 
That 71 was at +4, so it is possible he could have gone even a bit lower than that today. Since you are using an AT meter, that is pretty low. So, I would definitely NOT go back up to 2.75u, and I am wondering if 2.5 might even be a little too much. Hmm... thinking.... I think I would hold the 2.5 at least another cycle to see how he does. He may end up needing another small reduction.

That's my two cents! I hope some others come along to give theirs, too.
 
Yeah I would NOT go back to 2.75. 2.5 brought you down to a blue preshot and then a green at +4 and it does seem like that is a bit too low for that early in the cycle.

I agree with FBM. I think I'd like to try to hold 2. 5 and see what that gets you.
 
Ditto. I’d stay with 2.5. Little takes longer than 4 cycles to see what really going on. I would not increase based on the 71 this week
 
I am glad to hear that from all of you. I did give him the 2.5u tonight. I am so nervous about leaving him alone during the day now. My supervisor wanted me to take a later lunch but I told her I had to come home and check on him since his numbers were lower before the shot. I gave him the full dose and I was nervous about not being here to do a test at +2. I don't know what I would do if I was not able to come home during my lunch.
 
I know the stress this creates. I can promise it gets easier once you know the patterns but even still there is always worry that’s the mom In us. Better to shoot lower dose if you are concerned than risk and worry about hypo. Hugs to you and Giz:bighug::bighug:
 
Thank you Lisa. I did a BG reading at +3 and his numbers are so high now. The first reading I got 436. I did another because I couldn't believe my eyes and it was 493. Is this a reaction to the low number in the previous cycle? I hate when he gets this high, because he looks so miserable and there is nothing I can do for him. I logged the average of the two to his SS in case you are wondering why it reads 465. I pray that this does not get much higher tonight. I really don't want him to develop DKA. I will check his ketones in the morning. Is this a bounce? I know it will level out in the next couple of cycles, but I really hate this disease!!! Do I need to worry that a hypo episode will happen in the next couple of cycles?
 
My guess is that it's a bounce. I wouldn't worry too much...that's really to be expected with the lower numbers.

I know DKA is scary and I'm not going to lie and say it's not something to watch for, but remember...DKA usually happens as a result of not enough insulin + not eating enough + an infection. It can happen without all 3, but it's something I would be concerned about more if Gizmo just stopped eating. And yes ketones can develop with higher numbers BUT Gizmo isn't just consistently sitting in them. He's going lower and then bouncing back up. So he DOES spend time in lovely, healing numbers. I would say for ketones, test for them but don't WORRY about them. He's really not a cat that I would be overly concerned about ketones with right now.
 
Thank you Rachel for explaining how DKA usually starts. Gizmo does have an appetite. Unfortunately he is staring at me waiting to be fed because I am stalling since his PMPS number was 129. Do you have any advice on dosing. He had a big drop from his AMPS number to the +5 reading, but he has only dropped 5 points since then. I don't know if I should give him his full dose. I believe I was told before that if his numbers are low around 120-150 that you want to give a token dose. I have no idea how to determine what a token dose would be for him. I am hoping someone will read this by the time I am done stalling so I know what to do tonight. I really wish I could figure this out on my own, but I am not quite there yet.
 
I just did another test 30 minutes after the first and it is 139, but I don't know if that if from the freeze dried chicken that I gave him after his test.
 
Nah, it's not likely the freeze dried chicken would actually affect him at all. 139 is basically the same as 129.

I'd probably drop his dose to 1 unit. Then you just want to be sure to get some tests in. And of course, make sure he eats.
 
Thank you so much. He is ready to eat. We have a spot that we do his testing and then he gets fed in the same spot. He has just been laying there for the last 45 min letting me test him and expecting food. I feel so bad when I have to stall. I will be sure to get a test at +2 and a couple more through out the night. Thanks again.
 
Haha yeah they know when it's feeding time. I used to have to take a walk or a long shower if stalling was going to happen!

Remember if you get into a bind at all tonight you can post on Main and there will probably be people on. I don't think this dose will overdo it, but you just never know. Most likely it'll be fine, but sometimes it's nice to have others to talk to if you need it!
 
I did one more test before I fed him. It was 151. I don't know if this is from stress of being hungry or not. He was starting to search for any crumbs on the floor around where his food dish is usually at. He is eating now and is so grateful to be fed. :)
 
I hope I won't have to post any emergencies tonight but I am grateful to know that someone will be there. It looks like he is done eating so I am going to go give him his insulin. I can't say thank you enough.
 
I think you just had a dose that lasted longer than usual. It happens. His level is coming up on its own so don’t freak out tonight. Just get a +2 or 3 so you can relax. :bighug:
 
I agree. I think it's really unlikely you'll have an emergency, but I always mention it at night anyway just like a disclaimer. :)
 
Thank you. Do you know what I can expect tomorrow morning for the AMPS number? I am trying to be proactive. If it is low again do I give a token dose again? I am assuming if it is above 180-200 I would give the regular dose.
 
Really there's no way to know, although we might have a better guess after you get your next test. My hunch is that he'll be quite high in the morning since the dose was so reduced, but he might surprise us. He is showing some hints that he might be getting ready for a lower dose.
 
I just did his +2 reading and it is 246. He did just get done eating some of his food. So I am assuming his number will be high in the morning so I will give him his usual dose of 2.5 u.
 
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