Dosing advice please

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Sue484

Sue484

Member Since 2015
Hi. Please see link I started this morning.
Spreadsheet question
Can you look at Frankie's curve today and advise on a possible dose for tonight and tomorrow? He only started on a low carb wet food diet only last night.
 
Just read through your other thread. One thing you need to know is that we've had members who've experienced that having their cat eat literally 3 pieces of dry food - 3 crunchies - could raise their cat's blood sugar by hundreds of points.

So it is very possible that Frankie will need significantly less insulin after the crunchies are completely worked out of his body. Are you committed to getting rid of the dry food entirely? That would mean that Frankie can't even clean up a crunchie or two that the other kitties have left.

About the dose - what is your availability to monitor those cycles after the shot is given?
 
Tonight for possibly 4 hours. Tomorrow all day but not straight after evening shot. Tuesday only one during the day about 6.5 hours after. Yes the dry food is definitely on it's way out. He sneaked a couple today and it didn't raise it so that's good as I have a cat who only eats dry and turns his nose up at everything else so I have to work on him first.
 
And do you have 2 more hours or so before pmps? I'd like to see where he is then. He is pretty likely to bounce.

My thought at the moment is to maybe drop to something like 3u and see how he does with that without the dry food. The trouble is always that you never know what a cat is going to do after a shot, so it's not like I can say that you'll for certain be able to stop testing after 4 hours tonight. You might be able to, but there's no way to know.

I'd like to get opinions on a "restarting dose" for him from some others as well. I can check back in with you when it's his shot time. Let me know how long that will be when you post next.
 
I've just fed him about two teaspoons of food. In about an hour and 20 mins I will take pmps.
 
ok - i'll check back then and see where he is.

I wouldn't feed any more from now until we figure out what you can shoot tonight unless he drops below 68, but if he does go under 68, then just give him low carb. If he's below 58 then you'll probably have to give him a little bit of gravy or high carb.

yes, I know she's using an AT.
 
Won't feed him any more but he's going mad trying to open a pouch of food at the moment. I feel so cruel.
 
Punkin had acromegaly, which means he was starving all the time. It is hard to not feed them when they are like that. Give him an extra bit of loving and get the food hidden so he isn't torturing himself with it.
 
He's been mithering me for food since 3pm. Took the latest test 10 minutes ago and it was 5.6. That food worked!!
 
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It is really amazing what the switch to wet food can do for a cat.

I don't have as much experience as some of the other members, but if it were me and Sammy had a PS in the low 100's after the switch, I would consider decreasing the insulin dramatically, especially if you have limited ability to test over night or during the work day. I see that @julie & punkin (ga) suggested 3u, and that is probably a good starting point, but if I was in your shoes I would want to decrease down even further because I know I would be REALLY nervous to shoot that much insulin without data on how he will react with the new diet. That is just me and I do tend to freak out a bit, and sometimes make the wrong decisions, but we all have to feel comfortable with what we are doing, and not just do something because someone makes the suggestion.
 
I think I will have to see how high he is in the morning if he is that it. But let's see what the experts here say first.
 
Marje is thinking 4.0u - partially because of his neuropathy. Wouldn't want to make it worse by sending him up into high numbers.

I'm thinking 3.0u, mainly because you can only test til +4 tonight. But, if he heads back into low numbers after his shot then you'll have to monitor until he comes up. That could happen no matter what you shoot - we don't have any way to know. With Lantus, often shooting a normal number like this you can have a flat cycle, but your situation with the dry food leaving is a little bit different than a cat that's already been on canned low carb, has arrived at the "right" dose appropriately and the cat is then getting the regular dose.

You can also drop the dose lower tonight, see what happens in the next cycle and come back tomorrow with a "new normal" for the dose. He's not dropping, though, so I'm not sure if I would do that or not.

There isn't a clear path to just say "do this and then this" when a cat has had a higher dose but the circumstances have changed and you need to somewhat restart the dose.

You've got quite a bit of experience with him, even though the Lantus is relatively new to you. You know his history and how he "works." The choice is up to you, but those are some things to think about. What do you think you'd like to do?
 
I will feed him again at +4 so hopefully that should see him through the night. I usually wake at some point in the night so can test then but can set my alarm for every 3 hours if necessary. I'm thinking 2.5 dose tonight but have no experience of having these low figures EVER even though he has been diagnosed a year. If he had this number on Caninsulin I would not shoot.
 
I think that's a reasonable decision. With Lantus, there is the depot to consider. A larger dose can influence as many as 6 cycles after it's been reduced, likely lessening as the time goes by. That means that this morning's 5u dose can still likely help control BGs tonight and even tomorrow or the next day.

If you decide to go ahead and shoot, please get a +1 and a +2 to make sure he's not heading lower right away so you can intervene if he does. That's a good rule of thumb any time you shoot a number that is lower than you've shot before. I'll look back in on you in an hour and see if you need help.

Feed him with his shot and decide when to feed him next based upon his blood sugar tests. It can help to keep doling out low carb food every hour or so to help sustain his blood sugar and keep him flat.
 
11.8 at +9. Any ideas for his morning dose in 3 hours? Should I go with your thoughts at 3 units?

It's exciting to see him in the normal range. It was scary at first but @Elizabeth and Bertie was right. There is hope for his legs after all!
 
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If you're home tomorrow (which you mentioned earlier you would be) I'd go to the 3/4u that we talked about above. He's looking pretty good on the 2.5u tonight, but it's very likely that tonight's numbers are still being "helped" by the 5.0u dose that he had yesterday morning.
 
by the way, if you post in US numbers you'll find more people will feel comfortable helping you. We use US numbers as the common language here and while there are some people that are familiar with mmol, most are not.

You can start a new post when you get the amps.
 
Yes he is rising slightly now helped by his food at midnight. I think I will go with 3 or 3.5 depending on how much more he goes up in the next few hours. Thanks @julie & punkin (ga) good to know there's someone always here. Do you mind checking in on my boy tomorrow and give me your thoughts on tomorrow's numbers?
 
I do usually add the US numbers in brackets, but it's 4am and I've not had much sleep!!! I'll remember in future.
 
You must be exhausted! I knew you'd been up a lot when I saw all those tests there.

I'm on the west coast of the US, so it's 8:30pm for me. I'll be at work tomorrow and have an appt afterwards, but I'll look in on you when I get home. There are lots of people that can help you besides me, of course. It does help to keep updating your subject line so people see the latest info, or if you have any questions, from the main page. Most people keep updating that throughout the day, then if there are any questions folks looking at the main page will see and open your thread.
 
Thanks for that. I've started a new thread this morning. Are you in California? I went there last year and loved it.
 
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