Dosing guidance for Baby ILa

Baby ILa's Momma

Baby ILa's Momma

Member
Hi! I gave a rundown under my introduction on the initial forum. I added all of the info and labs that I have. I clearly need guidance on dosing, tracking etc. I am beyond grateful that Baby is still with me. I have been reading like a maniac and trying to balance and test on my own. My Vet and the ER doc has not been much help at all. Baby almost didn't make it and I know it was due to mismanagement of Insulin and not testing! Please help me as I am in need of advice moving forward. I have been off from work since Friday afternoon and I am off until Wednesday or until I can help get Baby in a safe space. She was definitely in bad space until I started taking her readings at home. Not at the urgency of my Vet. They didn't even say a word about it. Just order the insulin and give 1 unit click two times a day and see you in 2 weeks. I took it upon myself to give her fluids, insulin, and monitor her. She pulled through it all. I am horrified that I did not educate myself and realize that she needed to be tested at home immediately when she started the insulin. I know that this would not have been so awful for her. She was so very sick. She is eating and drinking again,using her litter box and trying! so am I.
I am feeding her the Royal Canin Glycobalance wet and dry food. She didn't eat or drink for 3 days!! so when i was able to bring her numbers into range she was eating and drinking on Sunday Sept. 8th. I let her eat every hour for 3 hours a small amount which was probably bad and what drove her number sky high. I have her on a 2 day schedule now. I have been checking before the administration of the insulin, feeding her then giving her 1 "click" 1 Unit dose at noon and at midnight. I do need to get her on a 6 am 6pm schedule. I need advice on the best way to do that as well.

Thank you kindly!
Lauri
 
Here's the link to your Feline Health post for more details: https://felinediabetes.com/FDMB/threads/new-and-introducing.293859/ Sorry for the fire hose of information you got. I'll try to keep it simple in the beginning.

First, well done you on being a great advocate for your cat. :bighug::bighug:

You did get the information about using half unit marked syringes. Our Syringe Info Sticky Note has the names of some brands that come in half units in the US. Your local Walmart Relion brand is one such syringe.

Food - you don't need to feed "special" diabetic food from the vet. Any low carb wet food will do. We aren't great fans of dry food for any cat, much less a diabetic one. There are some die hard kibble heads though, and we recognize that. This food chart has a lot of the foods available in pet food stores or supermarkets. You want something under 10% in carbs. What was she eating before the diabetes diagnosis?

Ketone testing is going to be your friend since she was recently DKA. You can get ketone testing sticks, such as Ketostix, at most pharmacies. Tips: Tips to catch and test a urine sample If you think it'll be difficult to get her in the litter box, there are ketone blood test meters.

Regarding insulin dosing, is she only getting one shot per day?
 
Baby ILa's Momma said:
I have been checking before the administration of the insulin, feeding her then giving her 1 "click" 1 Unit dose at noon and at midnight. I do need to get her on a 6 am 6pm schedule. I need advice on the best way to do that as well.
Click to expand...

you can move her shot times over the next few cycles. You could shoot 15 minutes early per cycle OR 30 minutes early per day until you're back to 6 AM and 6 PM
@Baby ILa's Momma
 
Wendy&Neko said:
Here's the link to your Feline Health post for more details: https://felinediabetes.com/FDMB/threads/new-and-introducing.293859/ Sorry for the fire hose of information you got. I'll try to keep it simple in the beginning.

First, well done you on being a great advocate for your cat.

Regarding insulin dosing, is she only getting one shot per day?
Click to expand...

You said you are giving one click two times a day. I think that means you are using a pen that only gives whole units and giving insulin twice a day. With the low bg today on a pet meter I hope you can get the syringes and reduce to .75. Since feeding dry you need to reduce if the bg is under 90 so .75 should be the new dose.
 
Wendy&Neko said:
Here's the link to your Feline Health post for more details: https://felinediabetes.com/FDMB/threads/new-and-introducing.293859/ Sorry for the fire hose of information you got. I'll try to keep it simple in the beginning.

First, well done you on being a great advocate for your cat. :bighug::bighug:

You did get the information about using half unit marked syringes. Our Syringe Info Sticky Note has the names of some brands that come in half units in the US. Your local Walmart Relion brand is one such syringe.

Food - you don't need to feed "special" diabetic food from the vet. Any low carb wet food will do. We aren't great fans of dry food for any cat, much less a diabetic one. There are some die hard kibble heads though, and we recognize that. This food chart has a lot of the foods available in pet food stores or supermarkets. You want something under 10% in carbs. What was she eating before the diabetes diagnosis?

Ketone testing is going to be your friend since she was recently DKA. You can get ketone testing sticks, such as Ketostix, at most pharmacies. Tips: Tips to catch and test a urine sample If you think it'll be difficult to get her in the litter box, there are ketone blood test meters.

Regarding insulin dosing, is she only getting one shot per day?
Click to expand...

Hi! thank you so much!! I am trying for sweet Baby. I know it is not her time to go and I know I found you because you are all so on point! I am so grateful.
Ok! I have the syringes. I used a syringe tonight for her evening dose of 1.25. If i understand correctly I should increase is small increments and hold for 2-3 days? Her numbers have been riding too high since 9:30 am yesterday morning. I will order a ketone blood test meter. I already know I won't catch it mid stream. lol. I appreciate that tip!
I will get a low carb food. As far as dry I can transition off of it. Before her diagnosis I was giving her blue wilderness wet and dry food with treats. Temptations. I know those are super bad. i don't feed them that anymore. I do have another cat too. Little Girl.
Regarding insulin dosing, Baby has been getting 2 shots per day since August 24th. Her diagnosis was the 20th and it took me that many days to get approval for the script. I did not monitor at home until Sept 8th. She did not have insulin for 24 hours when she was at the ER/Vet on 6/7th. They kept her insulin and they were closed so i could not get it. Thank goodness my husband takes the exact same Insulin so i took one of his pens and started her back on Insulin the evening of the 7th ( 1 unit) . That is when i started giving her subq fluids, ordered the monitor for overnight delivery. I was determined to try to bring her back. She was losing weight so fast and could barely walk. So awful.
 
Diane Tyler's Mom GA said:
@Baby ILa's Momma
Wanted to be sure you read tiffmaxxe post above about reducing the dose to 0.75 units
I also posted above on how to move your shot times to 6 AM and 6;PM like you want to do above
Click to expand...

Thank you! yes, I did! she is running too high and has been since 9:30 am yesterday at 311. I increased her dose by .25 for a total 1.25 for her evening dose. Thank you for the suggestion on how to move the shot times. I will start that tomorrow. I am supposed to fly out to West Virginia on Friday to Sunday. I am probably going to cancel my trip. I am too worried about Baby and her recovery as we try to get her regulated. My hubby is out of town until Saturday night. If he were home I would be more comfortable leaving. He is a diabetic too! So he understands the goal.
 
So glad you found this forum! This is an amazing group with TONS of knowledge. One thing I will warn you about is going on other sites (fb) and listening to additional information. I did that in the beginning and it's just not a good idea. Stick with the people here. They are definitely a better source of information. It can be overwhelming. There is a LOT of information and you will forget and mess up and have to reread and have people tell you again... but it's OK. We've all been there and some of us are STILL there. Keep asking questions. :)
 
Baby ILa's Momma said:
I already know I won't catch it mid stream. lol. I appreciate that tip!
Click to expand...
Hi Lauri, welcome and great job asking questions here. You will find lots of great information and a very helpful community.
One thing I do to test urine for ketones is I let Ivy pee in her box and as soon as she’s done (before urine has a chance to sink into the litter) I swoop in with the test stick and dip it right into the puddle of pee (you have to be really fast) and I can catch a good reading on the ketostix.
Takes some practice but usually works well for me.
Just thought I’d share that with you.
:bighug::bighug::bighug:
 
tiffmaxee said:
You said you are giving one click two times a day. I think that means you are using a pen that only gives whole units and giving insulin twice a day. With the low bg today on a pet meter I hope you can get the syringes and reduce to .75. Since feeding dry you need to reduce if the bg is under 90 so .75 should be the new dose.
Click to expand...
Hi Elise Lauri shot 1.25 units last night and this morning ,I asked her to fill in the numbers for last night. She posted about this above. Post #7 Shouldn't she have given 0.75 like you said
@tiffmaxee
 
Lauri -

I'm not sure you're interpreting how the spreadsheet is used. AMPS is your morning pre-shot test (AM Pre-Shot) and PMPS is the PM Pre-shot test result. The "U" column is for the dose. All of the test data from the morning goes in the columns between the AMPS and PMPS. The "plus" numbers (i.e., +1, +2, etc.) refer to the number of hours after you gave your cat a shot. So you +6 is six hours after the insulin dose.

You need to get tests both during the morning (AM) and evening (PM) cycles. A cycle is a 12-hour period between each shot. If you don't have test data during the evening, you're missing half of your data and that's how your spreadsheet currently reads. The +times also give us a picture of how the insulin is working.
 
Heather82372 said:
So glad you found this forum! This is an amazing group with TONS of knowledge. One thing I will warn you about is going on other sites (fb) and listening to additional information. I did that in the beginning and it's just not a good idea. Stick with the people here. They are definitely a better source of information. It can be overwhelming. There is a LOT of information and you will forget and mess up and have to reread and have people tell you again... but it's OK. We've all been there and some of us are STILL there. Keep asking questions. :)
Click to expand...


I am staying right here!! I have had more help in less than 24 hours here than I have had since day one of the diagnosis. I am most definitely overwhelmed! I have to go back to work at some point. I am supposed to go tomorrow and I am super stressed about that. This site and all of you are amazing and I am beyond grateful to be here. Yes! Talk about the mess ups!! . She was super low this morning at 57 so I have her sugar water and retested 30 min later and he was at 213. I am trying to get this right for her. Thank you for your kind words of encouragement.
 
Staci & Ivy said:
Hi Lauri, welcome and great job asking questions here. You will find lots of great information and a very helpful community.
One thing I do to test urine for ketones is I let Ivy pee in her box and as soon as she’s done (before urine has a chance to sink into the litter) I swoop in with the test stick and dip it right into the puddle of pee (you have to be really fast) and I can catch a good reading on the ketostix.
Takes some practice but usually works well for me.
Just thought I’d share that with you.
:bighug::bighug::bighug:
Click to expand...

thank you so much for your kind words and helpful tips. I need them all!! Baby usually won’t go if we are anywhere near her. lol I ordered the monitor and it will arrive any moment. I am off work one more day today so I can focus on her. It has been a rough 4 days. I actually did get to sleep at 3 am after I tested her and woke up at 8:30 am. Both of the cats were right next to me. And yes. I was on the floor with Baby all night. I am that cat woman. ❤️
 
Diane Tyler's Mom GA said:
Can you fill in your spreadsheet for last night.
Click to expand...
I updated it before I went to bed at 3:30 am. Let me know if you don’t see the updates. I am getting ready to add this morning. She was low at 57 I have her sugar water and retested 30 min later. She was at 213. I will retest her at 11:30 before her insulin is due at noon.
 
Sienne and Gabby (GA) said:
Lauri -

I'm not sure you're interpreting how the spreadsheet is used. AMPS is your morning pre-shot test (AM Pre-Shot) and PMPS is the PM Pre-shot test result. The "U" column is for the dose. All of the test data from the morning goes in the columns between the AMPS and PMPS. The "plus" numbers (i.e., +1, +2, etc.) refer to the number of hours after you gave your cat a shot. So you +6 is six hours after the insulin dose.

You need to get tests both during the morning (AM) and evening (PM) cycles. A cycle is a 12-hour period between each shot. If you don't have test data during the evening, you're missing half of your data and that's how your spreadsheet currently reads. The +times also give us a picture of how the insulin is working.
Click to expand...
Ok. I am just filling it out wrong. Sorry. I will try to do better. Thank you for explaining. I appreciate your help
 
Diane Tyler's Mom GA said:
Hi Elise Lauri shot 1.25 units last night and this morning ,I asked her to fill in the numbers for last night. She posted about this above. Post #7 Shouldn't she have given 0.75 like you said
@tiffmaxee
Click to expand...

Hi. I have not given a shot this morning. I have her on a noon and midnight schedule which is a mess in itself. I must be misunderstanding? I read if she was running high too often and she was the last 2 days that you are supposed to increase by .25 and hold for 2-3 days. In reality when I pulled the insulin with the syringe since there isn’t a like for .25 you eyeball it so I was more conservative. So it may have been barely passed 1 unit. Correct me if that is the wrong thought process. I appreciate your guidance. Thank you!!
 
Baby ILa's Momma said:
Hi. I have not given a shot this morning. I have her on a noon and midnight schedule which is a mess in itself. I must be misunderstanding? I read if she was running high too often and she was the last 2 days that you are supposed to increase by .25 and hold for 2-3 days. In reality when I pulled the insulin with the syringe since there isn’t a like for .25 you eyeball it so I was more conservative. So it may have been barely passed 1 unit. Correct me if that is the wrong thought process. I appreciate your guidance. Thank you!!
Click to expand...
This is from the SLGS sticky

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit


As @tiffmaxee said you should have shot 0.75 because she dropped under 90.
She could be bouncing

And here is an explanation on bouncing
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
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Diane Tyler's Mom GA said:
This is from the SLGS sticky

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit


As @tiffmaxee said you should have shot 0.75 because she dropped under 90.
She could be bouncing
Click to expand...
Yes. That was on Sunday the very first time I tested her and before I found you. Otherwise she has not dropped below 90 since Sunday. She was super high from 9:30 am on Monday until this morning at 9:45 am. Ranging from 311 upwards of 500’s. Based on that info I should have increased by .25 since she was above 150. Am I understanding this correctly? Thank you for helping me navigate.
 
Baby ILa's Momma said:
I updated it before I went to bed at 3:30 am. Let me know if you don’t see the updates. I am getting ready to add this morning. She was low at 57 I have her sugar water and retested 30 min later. She was at 213. I will retest her at 11:30 before her insulin is due at noon.
Click to expand...
@Sienne and Gabby (GA)
@Wendy&Neko
@Bron and Sheba (GA)
@Bandit's Mom
@Suzanne & Darcy

Hi Ladies I don't know what else I can tell Lauri
Lauri's shooting times are noon and then midnight. She wants to try to get to 6 AM and 6 PM schedule. I explained how to do that above. It will probably take forever to get to that. I guess that's the only way to do it correct? Or skip a shot
I don't know what else to tell her .
Elise did tell Lauri to decrease to 0.75 since Baby dropped under 90

Lauri just explained why she increased from 1 unit to 1.25 above because I asked her why she increased

Yes. That was on Sunday the very first time I tested her and before I found you. Otherwise she has not dropped below 90 since Sunday. She was super high from 9:30 am on Monday until this morning at 9:45 am. Ranging from 311 upwards of 500’s. Based on that info I should have increased by .25 since she was above 150. Am I understanding this correctly? Thank you for helping me navigate.

She is following SLGS so she went by what the sticky says
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
 
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Take a look at some of the rest of our spreadsheets to see how we fill them out. There is room on the spreadsheet to show both the AM and PM cycles each day. You don't need to have one line per cycle.
 
Baby ILa's Momma said:
Yes. That was on Sunday the very first time I tested her and before I found you. Otherwise she has not dropped below 90 since Sunday. She was super high from 9:30 am on Monday until this morning at 9:45 am. Ranging from 311 upwards of 500’s. Based on that info I should have increased by .25 since she was above 150. Am I understanding this correctly? Thank you for helping me navigate.
Click to expand...
She was most likely bouncing from the 38. You don't typically want to increase during a bounce. @Wendy&Neko always tells me to put my "Patience Pants" on. ;)
 
Are you now giving 1.0 units in the morning and 1.25 units in the PM? That's what the spreadsheet looks like.

By the way, this thread is getting a little old. This forum is very busy, and it helps us help you if you follow a few guidelines for posting and subject lines. Thank you. Next time, please start a new thread. POSTING GUIDELINES PLEASE READ
 
@Baby ILa's Momma
Hi Lauri how is it going trying to move your shot times to 6:AM and 6 PM


When posting on the Lantus board we like members to do a new post every day like this
Date Baby AMPS BG number and any additional tests after that and you can continue with his PMPS BG and any additional tests after that
To add those additional tests tap on the word Thread Tool to the right then tap on Edit Title add those tests and tap save.
When you do a new post every day we ask you to link your previous days post to your new one in case members need to let ok at it . I'll tell you how to do that below



To link your previous posts
Your previous days post will always be in the URL all the way up top ignore where it says insert or cancel I'm just trying to show you where your previous days post will be
Just ignore where it says insert and cancel
Just copy your previous days post and then paste it when you do your new post





Like I said
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it




austin-logo-240.jpg



you can start a new post on the Lantus board tomorrow and link this post to it
 
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