Dosing advice

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Squalliesmom

Squalliesmom

Member Since 2015
Well, after a nervous day of testing every two hours or less, Squallie's pre-shot number was 203. I am afraid to give him 6-7 units tonight with his BG at that level; should I give him a lower dose and if so, how much would any of you recommend, or should I just skip tonight's dose and wait to see what tomorrow morning's numbers look like?
 
Sorry no one was up to give you advice, Lucy. What did you do?

He does seem to be gradually dropping in ranges so yes, I would be dropping the dose to match. A number close to 200 at night when it's hard to monitor is always a quandry. A chicken $&@#% dose is always an option - maybe half of the usual dose and a before bed check.

My theory with a new diabetic and the in and out insulins (vs the depot insulins) is that you can always raise the dose with the next cycle if you give too little.
 
Sue and Oliver (GA) said:
Sorry no one was up to give you advice, Lucy. What did you do?

He does seem to be gradually dropping in ranges so yes, I would be dropping the dose to match. A number close to 200 at night when it's hard to monitor is always a quandry. A chicken $&@#% dose is always an option - maybe half of the usual dose and a before bed check.

My theory with a new diabetic and the in and out insulins (vs the depot insulins) is that you can always raise the dose with the next cycle if you give too little.
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Thanks, Sue. I ended up just not giving him his shot. I just tested him a little while ago and he's at 319, after eating a little canned snack, so I'm glad I did what I did. We'll go ahead with the 7 units this am, and monitor from there, again.
 
If you haven't already given the 7 unit dose, Lucy, I'd be inclined to stick with the 6 if he was mine. If you've already given the 7 unit dose be sure to keep a close eye on the drop.
 
Critter Mom said:
If you haven't already given the 7 unit dose, Lucy, I'd be inclined to stick with the 6 if he was mine. If you've already given the 7 unit dose be sure to keep a close eye on the drop.
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I already gave him the 7 unit dose :-( So far he seems to be okay, eating everything in sight all of a sudden, though. Haven't tested him again, he goes to the vet in a couple of hours so unless things seem amiss with him right now, I'll probably wait till we get there and do the blood draw from his leg, ugh. I am buying her kit today, so now when I test my way and get a result I'm not happy with I can back it up with her method and talk to her about it! That will be a relief, don't like this cloak-and-dagger with her, but honestly I'm afraid she'll refuse to see him if she knows I'm doing something she disapproves of.
 
Hi Lucy,

I've just seen this. If you haven't tested Squallie since you posted your last message, can you do a test now, please? That sudden ravening hunger is a very strong signal that his BG might be dropping quite fast. It would definitely be safer to check.
 
Phew! Glad his numbers are OK.

It's very good that you got the test before going to see the vetty bean. The reading there may very well be influenced by stress and might therefore be higher as a result, but not reliable for basing dosing decisions upon.

If Squallie were mine, I'd really discuss with the vet stepping the dose back to an absolute maximum of 6 IU for the next cycle (or possibly less if his PMPS is on the low side). Again, check back here and ask for help with dosing this evening. (I won't be online but hopefully other members will be able to assist.)
 
Critter Mom said:
Phew! Glad his numbers are OK.

It's very good that you got the test before going to see the vetty bean. The reading there may very well be influenced by stress and might therefore be higher as a result, but not reliable for basing dosing decisions upon.

If Squallie were mine, I'd really discuss with the vet stepping the dose back to an absolute maximum of 6 IU for the next cycle (or possibly less if his PMPS is on the low side). Again, check back here and ask for help with dosing this evening. (I won't be online but hopefully other members will be able to assist.)
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I agree, I'd like to take it back down to 6. I will check back here tonight with his pre-shot number, thanks. I hope you get some sleep tonight!
 
Just back from the vet, she said his numbers are good if a little low and has reduced his dose to 6 units again, hooray! Obviously I will continue to monitor him (she wants me to use my new, expensive veterinary unit every other day-we'll see) and we'll just go from there. I am more comfortable with him at 6 units, his numbers seemed to be coming down and be more controlled before she put him up to 7 units.
 
Hi Lucy.

Sounds like a more productive visit today. :)

With regard to his numbers getting screwier on the higher dose, too much insulin can be just as problematic as too little insulin because the cat's liver can panic and produce more glucose thus driving levels higher.

Remember to post for advice if you get a low-ish PMPS. I'd also recommend getting a 'before bed' test in. Primarily this will give you some bit of an idea of how the cycle is going and whether Squallie is in OK numbers before you go to sleep. It will also help you start to build a picture of what his night time cycles are like.
 
Critter Mom said:
Hi Lucy.

Sounds like a more productive visit today. :)

With regard to his numbers getting screwier on the higher dose, too much insulin can be just as problematic as too little insulin because the cat's liver can panic and produce more glucose thus driving levels higher.

Remember to post for advice if you get a low-ish PMPS. I'd also recommend getting a 'before bed' test in. Primarily this will give you some bit of an idea of how the cycle is going and whether Squallie is in OK numbers before you go to sleep. It will also help you start to build a picture of what his night time cycles are like.
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Much more productive! I will get a "before bed" test tonight. I always get a pre-shot pm test so I will test him again 2-3 hours later, as well. Thanks! I appreciate the encouragement more than you can know!
 
Critter Mom said:
I have a wardrobe's worth of brown trousers. (Keep 'em next to the patience pants. :rolleyes:)
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Lol, I'm getting a good start on a very similar wardrobe! He's still only at 205 at his pre-shot test, once again I'm afraid to give him 6 units, I think that'll drop him too low a few hours up the road.
 
More questions on dosages! My vet lowered Squall's dose to 6 units but at his pre-shot test his BG is still only 205. I'm really afraid if I give him 6 units he will drop too low later on tonight. Don't know what to do - again.
 
If he hasn't eaten much, if he were mine I'd be quite conservative about dosing tonight. Can you stay up through the cycle if he goes low? How do you feel about a dose of 5 units?


@BJM - if you're around, maybe you could suggest something for Lucy, please?
 
Critter Mom said:
If he hasn't eaten much, if he were mine I'd be quite conservative about dosing tonight. Can you stay up through the cycle if he goes low? How do you feel about a dose of 5 units?


@BJM - if you're around, maybe you could suggest something for Lucy, please?
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I can stay up most of the night with him, if necessary. I think conservative is good! I'm okay with 5 units, or lower if need be.
 
My thinking is that there's a possibility Squallie's BG might still be influenced a little by the vet trip, and he also hasn't eaten much. Thirdly, there is always the possibility of a little bit of carryover from the 7 unit dose given this morning. Add to that the possibility that Squallie might run lower at night (many cats do), a slightly lower dose might be better.

Generally, 200 is the no-shot threshold when people don't have much data gathered. Given that you can stay up to monitor, if he were mine I'd try the 5IU dose. Assuming all goes OK through nadir (he seems to really get a bang for his buck on the Vetsulin!), I'd make sure that there was enough food left out for Squallie to graze on (higher carb if necessary) when it came time for me to get some bit of sleep.

Hope that helps. You may hear from BJ if she's on the board.
 
Okay,I just tested him again and his BG is now 281. I feel a whole lot more comfortable giving him 5 or 6 units at 281. probably go conservative and give him 5 tonight.
 
Critter Mom said:
My thinking is that there's a possibility Squallie's BG might still be influenced a little by the vet trip, and he also hasn't eaten much. Thirdly, there is always the possibility of a little bit of carryover from the 7 unit dose given this morning. Add to that the possibility that Squallie might run lower at night (many cats do), a slightly lower dose might be better.

Generally, 200 is the no-shot threshold when people don't have much data gathered. Given that you can stay up to monitor, if he were mine I'd try the 5IU dose. Assuming all goes OK through nadir (he seems to really get a bang for his buck on the Vetsulin!), I'd make sure that there was enough food left out for Squallie to graze on (higher carb if necessary) when it came time for me to get some bit of sleep.

Hope that helps. You may hear from BJ if she's on the board.
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Thanks ! That's pretty much my exact plan for tonight. his BG has come up to 281 so I feel better about his shot than I did at 205.
 
Okey dokey. I'm off to my leaba. Hope everything goes OK with you two. Remember to post if you get stuck. If something does come up and you don't get an answer to your post on the Feline Health board, try asking for help on the Lantus board - there tends to be more footfall there and there are experienced members who should be able to assist you. Remember to use the 911 icon for your thread title should you have an emergency (gets eyes on your thread faster).

Blessings for a good night to you both.



Mogs
 
Critter Mom said:
'Tis a bit of a white knuckle ride at times. ;)
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Oh yes, so I am discovering! He just ate a little bit (maybe 1/8 cup) dry so I guess I consider that a win, lol.
Critter Mom said:
Okey dokey. I'm off to my leaba. Hope everything goes OK with you two. Remember to post if you get stuck. If something does come up and you don't get an answer to your post on the Feline Health board, try asking for help on the Lantus board - there tends to be more footfall there.

Blessings for a good night to you both.



Mogs
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Thanks, same to you and Saoirse, sleep well!
 
It looks like he can drop about 28 to 32 mg/dL per unit of insulin, over about 6-8 hours based on the last 2 days.

So using that to estimate, he might drop about 140 to160 mg/dL on 5 units, which could take him down from his pre-shot of 205 to around 45 to 65 mg/dL, give or take.

Its just an estimate based on how he did yesterday and today.

You may need to steer him a bit, with some medium or high carb food.
 
BJM said:
It looks like he can drop about 28 to 32 mg/dL per unit of insulin, over about 6-8 hours based on the last 2 days.

So using that to estimate, he might drop about 140 to160 mg/dL on 5 units, which could take him down from his pre-shot of 205 to around 45 to 65 mg/dL, give or take.

Its just an estimate based on how he did yesterday and today.

You may need to steer him a bit, with some medium or high carb food.
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I just tested him again half an hour ago and he was at 281; I feel a little safer giving him 5 units at that level. Or am I fooling myself?
 
I'm estimating based on 2 days of numbers. I think 5 units will be OK; I just wanted to give you some possibilities to help you decide.
I took the pre-shot - lowest number tested and divided by the units to get the approximate drop per unit for each of the 2 days.
 
BJM said:
I'm estimating based on 2 days of numbers. I think 5 units will be OK; I just wanted to give you some possibilities to help you decide.
I took the pre-shot - lowest number tested and divided by the units to get the approximate drop per unit for each of the 2 days.
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Okay, thank you. and thanks for explaining the math, that makes sense. Does it help to continue to get numbers every 2-3 hours for a few more days, to really see where he is headed with his dosage?
 
The more data you can get, the better a picture you will have of how the insulin interacts with the glucose levels.
That said, also take a look at my signature link Secondary Monitoring Tools as your cat is more than a glucose number!
 
Stayed up with Squallie most of the night last night to try and get some night-time numbers for him. He was at 339 this morning pre-shot, I gave him 6 units and will test him again around lunchtime. Poor guy has had enough testing for a while, he runs when he thinks someone's gong to pick him up to do another test :-( Wish he could understand I'm doing this because I love him and want him to be well.

And just a funny aside-I mentioned previously that my vet wanted me to buy a veterinary testing kit from her, and to have me do blood draws from his leg for testing-I went ahead and bought it yesterday, it's an AlphaTrak, complete with lancets and instructions on how to prick the ear to test! Now I just wonder who's crazier; her, for wanting me to do these blood draws, or me, for actually buying the kit when I have a perfectly good ReliOn I'm already using, lol!
 
:D

I use my Alphatrak for testing (but I've got severe PTSD and it made a huge psychological and emotional difference to me to be able to see actual pet-calibrated readings - I have much greater peace of mind. I have a human meter as a backup.

Squalliesmom said:
Wish he could understand I'm doing this because I love him and want him to be well.
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Kitties are smart. He'll make the connection. :)

You did great getting the PM cycle numbers. Very interested to know what his nadir will be today on the 6 units.
 
Critter Mom said:
:D

I use my Alphatrak for testing (but I've got severe PTSD and it made a huge psychological and emotional difference to me to be able to see actual pet-calibrated readings - I have much greater peace of mind. I have a human meter as a backup.



Kitties are smart. He'll make the connection. :)

You did great getting the PM cycle numbers. Very interested to know what his nadir will be today on the 6 units.
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I don't mind using either the AlphaTrak or te ReliOn-as long as I know what the numbers on each unit mean. I was just greatly amused that my vet made me learn how to do blood draws from his leg and frowned greatly upon my suggestion to test his ear, only to unpack the Alphatrak and be greeted by instructions for testing the ear, lol.

I'll keep posting his numbers to his speadsheet; I'm still not entirely sure ow to "read" his spreadsheet, tho'.

I really hope he does come to understand-the trip back to the vet yesterday was a nightmare for him, too, and I know he was terribly stressed when we got there (it was absolutely stinking hot and humid yesterday and my Jeep has no air conditioning, I was terrified he would have heat stroke before he got to the vet's) and the return trip was just as bad, for the same reasons. He is the most patient, long-suffering, cooperative sweet guy, and he never gives me a hard time (I have a Bengal it would be absolutely impossible to ever get a shot into, much less test, praying he never gets anything like this!) I just hate for him to think I'm causing him pain and not know why!
 
Critter Mom said:
I have visions of you pointing at the Alphatrak manual and going: "Nyah, nyah, ni-nyah nyah!" :p
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Lol, pretty much on the mark! Just tested him again at +4 hrs, his BG was 157. It took me forever, two of my other kitties decided to "help" and the new girl, who no one else is sure about yet, wanted to get in on the after-test treat action!
 
Giving treats or a favorite food at test time might help him feel better about it too. Sounds like you're doing great!

Which I see you are already doing :). (Should have refreshed the page before I posted.) Maybe a little competition and peer-pressure will help.
 
Mitzelplik's Mom said:
Giving treats or a favorite food at test time might help him feel better about it too. Sounds like you're doing great!

Which I see you are already doing :). (Should have refreshed the page before I posted.) Maybe a little competition and peer-pressure will help.
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Lol, thanks! Btw, love your kitty's name, we once had a horse we nicknamed Mitzelplik! Not a name you see too often!
 
Don't forget beans need treats, too. Saoirse says, "You can haz truffelz"...

iu
 
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