Dosing advice!

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FatMax'sMom

FatMax'sMom

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My cat was 300 preshot this am so I gave 3.5 units (when he had been on 4), the only kibble he had in the last 24 hours was while I was at work..

I just checked him and he's at 228 preshot..should I stay at the 3.5?

My vet said normal range for diabetic cats is 100-300.

Please help
 
We generally consider a cat regulated if they are in the mid 200s at preshot and lower 100s and double digits at nadir (but not below 50 on a human meter, 68 on a pet meter). We think a cat is in remission if they range from 40-120 for 2 weeks, without insulin.
 
Wow, ok..maybe I will check our other cat once the strips get here.

What do you think of the accuracy of human meters, or cheaper meters than Alphatrak 2? The vet said she has found the Alphatrak 2 to be the most accurate..but it's not cheap
 
The AlphaTrak is the most accurate, but for many people, the cost of the strips is prohibitive. So they use human meters which work fine, as we are generally looking at the patterns of an individual cat. If you decide on the pet meter, be sure you have extra strips. If you have an emergency and have to use a lot of strips to keep your cat safe, you won't be able to run to the store and get some.
 
FatMax'sMom said:
Wow, ok..maybe I will check our other cat once the strips get here.

What do you think of the accuracy of human meters, or cheaper meters than Alphatrak 2? The vet said she has found the Alphatrak 2 to be the most accurate..but it's not cheap
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Alpha track runs higher than a human meter. If a cat hits 40 on an alpha, it's probably in trouble. Human meters run quite a bit lower. My cat is currently in remission and I use an Alphatrak . Her average the past couple of weeks is around 118. The lowest I've seen her go is 71. She also hits the 140's but comes back down without insulin.
 
Thank you for the info. I got the strips yesterday..but I have not yet gotten the control solution. Doing a curve today as best I can. Today if the first day where he has had no kibble..he doesn't seem to mind. I've slowly been giving him more canned since last week. Hoping that it helps him to get OTJ
 
He was hungry this morning bit still no kibble for him! See picture
 

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Could anyone look at my spreadsheet and tell me if I am doing the right thing by reducing his doses? It's scary not being sure of yourself.

Thank you!
Heather
 
I would keep your doses the same. The cycle on 9/23 was beautiful! No numbers too low, just beautiful blues and a nice pmps. It looks like they caused a bit of a bounce for the pm cycle, but he came down for this am. I like 3 units for above 350 and 2 units for the yellows around 250. You might reduce the 3 on days when you won't be around to monitor and the 2 units if your preshot is in the 200 range. So for now, it looks good. Remember that these doses are subject to change - it's all about the data and the dose can go up and down. As Woodsy's Mom said lately - it's not that you find the perfect dose and stick with it. You find a good dose for a cycle or two and plan to adjust as needed.

Have we given you these ranges: In general, we consider a cat regulated if they are in the mid 200s at preshot and lower 100s or double digits at nadir, but not below 50 on a human meter and 68 on a pet meter (those ranges are approaching hypo territory). Regulation is the first goal. Then you continue to finesse the dose and lower the numbers a little.

Looking good!
 
FatMax'sMom said:
Could anyone look at my spreadsheet and tell me if I am doing the right thing by reducing his doses? It's scary not being sure of yourself.

Thank you!
Heather
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No need to go so much less. Pinks are high numbers and she didn't drop too low. Stick with 3 for a while. Her number raised because her body is not used to the blue numbers yet. Give her a chance to regulate a bit more.
 
Sue and Oliver (GA) said:
I would keep your doses the same. The cycle on 9/23 was beautiful! No numbers too low, just beautiful blues and a nice pmps. It looks like they caused a bit of a bounce for the pm cycle, but he came down for this am. I like 3 units for above 350 and 2 units for the yellows around 250. You might reduce the 3 on days when you won't be around to monitor and the 2 units if your preshot is in the 200 range. So for now, it looks good. Remember that these doses are subject to change - it's all about the data and the dose can go up and down. As Woodsy's Mom said lately - it's not that you find the perfect dose and stick with it. You find a good dose for a cycle or two and plan to adjust as needed.

Have we given you these ranges: In general, we consider a cat regulated if they are in the mid 200s at preshot and lower 100s or double digits at nadir, but not below 50 on a human meter and 68 on a pet meter (those ranges are approaching hypo territory). Regulation is the first goal. Then you continue to finesse the dose and lower the numbers a little.

Looking good!
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I agree.
 
Yep, I think Sue nailed it! You're doing great...don't worry about not being sure of yourself. None of us were either. Quite frankly, even when I got to the point where I felt comfortable making my own decisions about my cat, I still asked for help! I just said "this is what I think I should do, what do you think?" so that I would be sure my logic made sense. :)
 
Sue and Oliver (GA) said:
I would keep your doses the same. The cycle on 9/23 was beautiful! No numbers too low, just beautiful blues and a nice pmps. It looks like they caused a bit of a bounce for the pm cycle, but he came down for this am. I like 3 units for above 350 and 2 units for the yellows around 250. You might reduce the 3 on days when you won't be around to monitor and the 2 units if your preshot is in the 200 range. So for now, it looks good. Remember that these doses are subject to change - it's all about the data and the dose can go up and down. As Woodsy's Mom said lately - it's not that you find the perfect dose and stick with it. You find a good dose for a cycle or two and plan to adjust as needed.

Have we given you these ranges: In general, we consider a cat regulated if they are in the mid 200s at preshot and lower 100s or double digits at nadir, but not below 50 on a human meter and 68 on a pet meter (those ranges are approaching hypo territory). Regulation is the first goal. Then you continue to finesse the dose and lower the numbers a little.

Looking good!
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Thank you..I was just concerned he would drop too low because of not having any kibble at all. I truly appreciate the advice!
 
Rachel said:
Yep, I think Sue nailed it! You're doing great...don't worry about not being sure of yourself. None of us were either. Quite frankly, even when I got to the point where I felt comfortable making my own decisions about my cat, I still asked for help! I just said "this is what I think I should do, what do you think?" so that I would be sure my logic made sense. :)
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I am going against my vets wishes..about adjusting doses without her ok, but I'm going to go by what the numbers tell me..
Thank you!
 
You guys are so right..because of me giving him only one unit the other day I feel I've messed him up :( (see ss).

The good thing is he is drinking and urinating like normal..as of now. Also, before he was dx, he had slept in bed with me every night for over eight years..when he started to sleep on the bathroom floor I knew something was up. He hadn't been sleeping with me until just this past week..when i got him off of the kibble and his numbers were in the blues.

Does this mean I probably won't ever get him OTJ? I was hoping that feeding him only low carb canned he would get a lot better :/

Hoping for better numbers tomorrow
 
No, you tried something and learned something. This is a process - a marathon, not a sprint. He had a lovely cycle a few days ago; he'll get there again. Be happy about those numbers.

There are no promises about remission, but if I were you, I'd be encouraged. He has responded well to the insulin and the diet.

Have you looked at other people's spreadsheets? They may be helpful and you'll see how they're doing. Everyone is at a different place in this sugar dance, but you just keep plugging along, with some days more encouraging than others.
 
Thank you for saying that Sue..I felt so bad. I will take a peek at some ss's...I have looked at a few. I want to try to keep track of when he eats vs. how his numbers react..but it could be a challenge as I know things change. I just got the PerSafe5 and I REALLY hope it works for us. He ate out of it today..but I was only testing it out..so I am hopeful. I hope the other cat doesn't eat it all before he gets to it.

I am very happy about the numbers he had the other day
Thanks again!!!
 
I hit snooze too many times this morning but would still have had time to give shot..however his AM number was 153 so I didn't give him a shot..blood was checked 30 minutes later than normal. Hope I did the right thing..surely he will bounce now.
 
I think skipping is fine. Join the club - almost every PZI cat got a lower amps this morning. You can shoot earlier than usual tonight if it doesn't mess up your schedule.
 
Almost every PZI cat had a too low to shoot amps this morning. Is the moon full? (More likely it is that you are all in similar places in this dance and things are falling into place.) No problem if you can't shoot early. He is likely to be high but I wouldn't increase the dose.
 
I actually got him back up to 3 units last night..from 2.5. Maybe I should stick with the 2.5, but I'll have to see what he reads tonight. He is losing more weight because of no kibble..he's very playful lately
 
Absolutely!! I've never seen him thin(ner) so it's very weird...I am hoping for a miracle that he can get OTJ someday. Thank you Sue for all of your guidance..it means the world
 
I got a PMPS of 225, so I only gave him .5 units. I only have 5 test strips left (again) even though I have ordered more on the 22nd. They are hung up in Chicago and ADW Diabetes is looking into what is going on. I ordered more from Amazon that should come tomorrow or Sunday. I thought that the Freestyle Lite strips were cheaper, but it looks like they have caught on and jacked up the prices on those as well. I am seriously considering a human meter because I am going broke!!

I have a question for anyone who is listening (Sue?), how do you know when to stop giving insulin (if the numbers are lower at pre-shot)? When Max had higher preshot numbers he at times would go down over 200 points! I know I have to look at the data that I have to see his trends, but maybe I just don't have enough info for these lower numbers. I am also going to look more at others ss's. Frankly I am so scared for his numbers to go below 100 I won't know what to do..as I've seen people giving shots at that number.

I need to update ss...thanks in advance!
 
So you want a gradual downward trend, requiring less and less insulin. He is in regulated numbers which is great (mid 200s at preshot and lower 100s or double digits at nadir, but above 68 on your pet meter.). So now you finesse. On a cycle you can monitor, increase by a smidge - maybe 2.25 on those preshots 250+. See what the nadir looks like - is it in safe double digits? Then use that dose for awhile in that range. If he is near 200, maybe lower the dose to 1.5/1.75 and se what the nadir looks like.

He is in very safe numbers. I think, if your goal is OTJ, you need to push a little. People do shoot at 180 but usually they are shooting tiny doses (like 0.2 etc) and close to remission. You have to do what you are comfortable with, on cycles you can safely monitor.

Have you checked the remission thread above? The spreadsheets there will give you an idea of how people worked OTJ.
 
I guess the low dose I gave him yesterday caused his numbers to rise today :( 384 on the AT2 just now...I am going to give him 2 units tonight..I also got a Relion Micro, which read 275 at 5:30pm. I am going to try to do a curve tomorrow for more data. Thank you for your guidance Sue. By the way, what does the GA mean? I tried to look it up..maybe I was looking in the wrong place, but I gather it means you lost your baby :(
 
So now you know 0.5 is too low for mid 200s. Remember - data gathering.

Yes, GA means guardian angel or gone ahead. It's a designation for kitties who have died. We got our Oliver OTJ and then a year later, he died of heart disease.
 
Yes..but isn't it true that it might not be the right dose today for that preshot number..but it can change if maybe he didn't eat that much that particular day, or if he keeps losing a bit more weight?

I'm very sorry about your baby..cancer sucks!! Two of my cats died from that as well..I swear by Chinese Herbal meds as an option as Max's tumor has shown minimal growth since taking them..when it had been growing every 4 months or so.
 
Right. But you can figure, unless he doesn't eat or something, at for the next few cycles, 0.5 is probably not enough. The ranges/doses aren't static, but usually make sense for one cycle to the next, at least.
 
I think I'm going crazy..if you wouldn't mind looking at the ss, yesterday had awful numbers..and I shot a little low as I couldn't monitor. I went up to 2 units this am..and tonight its a completely different story..how can it be like night and day? I know I upped the dose a little, but how could he be so low tonight? Sorry, this is new for me to have such a low preshot number. Thanks
 
FatMax'sMom said:
I think I'm going crazy..if you wouldn't mind looking at the ss, yesterday had awful numbers..and I shot a little low as I couldn't monitor. I went up to 2 units this am..and tonight its a completely different story..how can it be like night and day? I know I upped the dose a little, but how could he be so low tonight? Sorry, this is new for me to have such a low preshot number. Thanks
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Looks like bouncing to me.
 
I agree with Kris. That late 96 and the other low numbers caused a bounce this am, and this morning's number reflects 24 hours since the last shot. I like your reduced dose this am and hope it will get you better results tonight.
 
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