Dosing advice - updated spreadsheet

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Blues Brothers

Blues Brothers

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Hi all,

I'm hoping for a little advice since I keep messing around with Jake's doses depending on how high his pre shots are and whether or not I will be around to keep testing him. This is difficult with work getting in the way. Anyway, I'm hoping someone with some experience under their belt can let me know if I'm on the right track. Also, I don't get why his levels go down so low sometimes when his pre shots are high. He is also an IBD cat. I believe it's on my signature, but he is on budesonide in the AM as well as his insulin.

Thanks in advance for any help.
 

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Hi there. It looks like the bouncing PMPS numbers are most likely a result of the big dose changes (IBD can shift numbers, but not usually that randomly. With my kitty it tends to cluster the higher numbers when he doesn't feel well). The low dose in the morning is wearing off faster which causes those higher PMPS numbers. Then the higher dose at night is giving you lower AMPS numbers. I think I might recommend trying 0.75u for both AM and PM for a few cycles and see if things don't start to even out a bit. If you're getting numbers that make it difficult to want to stick with that, then post before you shoot and see what folks around here think (if there is someone around) because that amount is a bit of a guess - it may not be right on the money, and it might take a few days to get it right.
 
Djamila said:
Hi there. It looks like the bouncing PMPS numbers are most likely a result of the big dose changes (IBD can shift numbers, but not usually that randomly. With my kitty it tends to cluster the higher numbers when he doesn't feel well). The low dose in the morning is wearing off faster which causes those higher PMPS numbers. Then the higher dose at night is giving you lower AMPS numbers. I think I might recommend trying 0.75u for both AM and PM for a few cycles and see if things don't start to even out a bit. If you're getting numbers that make it difficult to want to stick with that, then post before you shoot and see what folks around here think (if there is someone around) because that amount is a bit of a guess - it may not be right on the money, and it might take a few days to get it right.
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Thanks Djamila. I was thinking about 0.75 units. I would need u100 syringes and do a conversion, correct?
 
You can also take an old syringe, eyeball where 0.75u might be, and set the syringe. Then use that to compare against in drawing the doses. It isn't as important to be exactly 0.75u as it is to be consistent.

It's also an option to get u100's and do the conversion. I used up all of my u40's, and then got u100's and have been doing the conversion for most of the past year. It makes it easier to make smaller changes in dosing, but it's also just fine to keep using the u40's.
 
Djamila said:
You can also take an old syringe, eyeball where 0.75u might be, and set the syringe. Then use that to compare against in drawing the doses. It isn't as important to be exactly 0.75u as it is to be consistent.

It's also an option to get u100's and do the conversion. I used up all of my u40's, and then got u100's and have been doing the conversion for most of the past year. It makes it easier to make smaller changes in dosing, but it's also just fine to keep using the u40's.
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We’ll try with the ones I have. Thank you!
 
Hi again,

If I can request more advice... Jake's spreadsheet is attached (please note, I switched from a pet meter to a human meter on 12/7/17 since the pet meter died). At what point would I not dose at all? My inclination right now is to do 0.75 units if he's at 130 or higher at pre shot, 0.5 if he's 100-129, and 0.25 if between 80-99. Does this make sense? Do I have enough info to go on this?
 

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Jake is looking good! I would be very cautious shooting under 100 if you aren't home to monitor. Most people don't shoot below 120 or so, but you're getting data that Jake can handle it and just flattens out (my kitty does too), so I think you can do it with reasonable safety at least for now - again assuming you're monitoring to near his nadir. Do you leave food out for him? Thta's the other thing that can help when shooting on those riskier numbers like this.

Is there any chance I could talk you into getting rid of the lime green background when you post his SS? It's really hard on my eyes and I see green squares for a while after I look at it. ;)
 
Djamila said:
Jake is looking good! I would be very cautious shooting under 100 if you aren't home to monitor. Most people don't shoot below 120 or so, but you're getting data that Jake can handle it and just flattens out (my kitty does too), so I think you can do it with reasonable safety at least for now - again assuming you're monitoring to near his nadir. Do you leave food out for him? Thta's the other thing that can help when shooting on those riskier numbers like this.

Is there any chance I could talk you into getting rid of the lime green background when you post his SS? It's really hard on my eyes and I see green squares for a while after I look at it. ;)
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Sure, that's just how someone sent me the spreadsheet setup. Okay, that sounds good - I won't shoot under 100 if I can't monitor. I do leave food out.
 
Djamila said:
I don't know if this would be at all helpful to you, but here is the link to the spreadsheet most of us use:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

The color coding happens automatically when you type in a number, and it's stored in Google Drive so you don't have to share the link to your file. The way you're doing it is fine, but wanted to offer just in case.
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Thank you for all your help. I’m struggling a little with the spreadsheet, but I’ll get it eventually. Also, Jake was at 93 at AMPS and 96 at PMPS today so he didn’t get any insulin. He was on 0.5 units for 3 days prior (preshots were all under 130).
 
Blues Brothers said:
Thank you for all your help. I’m struggling a little with the spreadsheet, but I’ll get it eventually. Also, Jake was at 93 at AMPS and 96 at PMPS today so he didn’t get any insulin. He was on 0.5 units for 3 days prior (preshots were all under 130).
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If you are having trouble, someone could set it up for you. @Chris & China
 
That's great! Go Jake!!!

As for the spreadsheet, please don't let it be a stress. It's fine to keep using the one you have. Especially this close to the end of the year it's not worth struggling with it. If you want to revisit at the new year (we usually start new pages with each year) we can get someone to set it up for you. And if not, no worries.
 
Yep, I'm with Djamila. If you'd like, we can get you one set up for the new year (we have folks who set them up for people all the time...trust me you're not alone in that!). Until then, you're good to keep the one you've got.
 
"Share" is the blue button in the top right corner. A box will pop up and you'll want to make sure it's set for "anyone with link can view"
 
Thanks everyone for all your help. I have a 12-hour curve. Do I need to give him a little insulin or is he good with these numbers? I’m so hoping this continues on for the long run of course, but if he can go without insulin December 26-29, I will be ecstatic since I will be out of town and I will likely be able to leave him with family instead of boarding him! I just don’t know if I should give him 0.25 when he’s over 100 at this point. Thanks again! I couldn’t have done it without you. His vet would still have him on 2 units right now...
 
Hmmmm....honestly, it's a tough call. He hasn't been diabetic for very long, and the likely cause has now been removed (steroid)...I think I would suggest that you keep monitoring pretty closely and if he goes over 120, resume shots.

There is an argument to be made for continuing to dose him a bit lower than that since he's just barely skimming the top of the healthy numbers (50-120) which is why I'm hesitating a bit about what to recommend, but since it's his first diagnosis, short term, and no more steroid, I think I'd lean toward just continuing to skip doses and be watchful.

Hopefully a couple other folks will chime in with their thoughts too. He's kind of in a gray area.

As for vacation, I think you can confidently leave him with family. He's low enough to be fine for a few days and I imagine he'll be happier and less stressed there than being boarded!
 
Djamila said:
Hmmmm....honestly, it's a tough call. He hasn't been diabetic for very long, and the likely cause has now been removed (steroid)...I think I would suggest that you keep monitoring pretty closely and if he goes over 120, resume shots.

There is an argument to be made for continuing to dose him a bit lower than that since he's just barely skimming the top of the healthy numbers (50-120) which is why I'm hesitating a bit about what to recommend, but since it's his first diagnosis, short term, and no more steroid, I think I'd lean toward just continuing to skip doses and be watchful.

Hopefully a couple other folks will chime in with their thoughts too. He's kind of in a gray area.

As for vacation, I think you can confidently leave him with family. He's low enough to be fine for a few days and I imagine he'll be happier and less stressed there than being boarded!
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Thanks, this sounds like a plan. I will keep testing him at his preshot times and try to do another curve next Saturday. Thanks again for all your support!
 
He's looking good! I agree, I think he can stay with family safely. That'll be less stressful for him AND for you I'm sure!
 
Thank you! He’s being much more playful than usual. I’m so glad he’s feeling better.
 

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