Dosing help..need advice URGENT

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Catdaddy87

Catdaddy87

Member Since 2017
Hi guys. Once again Sam is keeping things interesting. Decided to do a curve today and see if her insulin is still working and the correct dose.

-Fed her Purina DM dry this morning at 7 am and she tested at 245 BG
-Gave 1 unit of Vetsulin at 7:30 am
-Sam vomited between the injection and +4 BG
-BG at 148 at +7
-BG at 91 at +10

I planned on giving her her insulin at 6:30 to get back on the work schedule for the rest of the week but I think 91 is way too low for a full 1 unit even after she eats.

I assume she is dropping so low since she vomited earlier in the day and doesn't have enough food in her system to slow the insulin's drop?

Is it better to give a half dose or quarter dose than none at all to try and keep her pancreas happy?
 
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Yong said:
Indeed 91 is too low for full dose. Post your PMPS tonight and someone should be able to help :). I don't want to give advice when I can't stick around :bighug:
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Thanks Yong. 91 was pretty much her PMPS it was at 10.5 hours. I need to give her the injection at 6:30 pm Central to get her back on our work schedule. Or I could wait until 7:30 and retest then she could get the insulin earlier tomorrrow morning.
 
You could test again at 7:30 your time and see if her BG rises enough for a shot. If her BG is still low I would skip shot and wait until morning. That's just what I would do if she were my cat,
 
Lisa and Smoky said:
You could test again at 7:30 your time and see if her BG rises enough for a shot. If her BG is still low I would skip shot and wait until morning. That's just what I would do if she were my cat,
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What level would you say would be high enough? She already ate so I know it will be higher
 
I see that the 91 was at the end of the cycle so it doesn't appear she dropped too fast. You don't have a lot of data just yet so I would err on the cautious side. Could you test her and post BG? You said she had already eaten so her BG will be higher. I would give either a reduced dose or skip shot for tonight depending on her BG. Its hard to give dosing advice without knowing her current BG.
 
I use cansulin. Canada's version of vetsulin. Once I started feeding Charlie high protein she is only getting micro doses now. The #s I've seen are good early on. Just not enough info. Before I tested at +3 +4+5 ect... Charlie might have been slightly hypo. she ate alot during the day. Then was not hungry at night.
 
Clark said:
I use cansulin. Canada's version of vetsulin. Once I started feeding Charlie high protein she is only getting micro doses now. The #s I've seen are good early on. Just not enough info. Before I tested at +3 +4+5 ect... Charlie might have been slightly hypo. she ate alot during the day. Then was not hungry at night.
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Smoky reacted in this same way when he was on vetsulin
 
Her BG at exactly 12 hours from injection is now 72. Plus she ate a little middle range carb food. Going to syringe feed her some Hill's A/D and make sure she doesn't go lower.
 
72 is a good #. That's a normal BG Reading. Does she like wet food at all? Charlie has improved so much since going to high protein.
 
Clark said:
72 is a good #. That's a normal BG Reading. Does she like wet food at all? Charlie has improved so much since going to high protein.
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She is super picky and seems to like the A/D but will only eat it off of my finger after I syringe feed her some. It's like she doesn't realize its food until I put some in her mouth. Even then, she wont eat it out of a bowl. :(
 
Did you try feeding her some wet food off a dish raised slightly off the floor? When smoky was nauseous I gave him wet food off a flat plate a few inches up from the ground. Is there a chance she might be nauseous?
 
Catdaddy87 said:
Her BG at exactly 12 hours from injection is now 72. Plus she ate a little middle range carb food. Going to syringe feed her some Hill's A/D and make sure she doesn't go lower.
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Wow, interesting. By now the canisilun is out of her system, so you don't have to worry about hypo, but you do need to make sure she's eating enough. If she's still of eating tomorrow id bring her in and have her tested for pancreatitis or some other reason for her lack of appetite.
 
At the end of 12 cycles, Caninsulin (Vetsulin) should be out of her system. Congrats on your first NS :). Definitely want to get a before bed test though to see how she's doing on her own.
 
Yong said:
At the end of 12 cycles, Caninsulin (Vetsulin) should be out of her system. Congrats on your first NS :). Definitely want to get a before bed test though to see how she's doing on her own.
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Yea I know the insulin should have run out at 12 so that's why I was worried she might be going lower and possible hypo.
Got her to eat a syringe and a little more of A/D. Just checked her BG and she is 126. I feel like I can sleep now. I will check her BG in the morning and go from there.
 
Clark said:
How long has it been that way? Not eating well
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She developed some ulcers I her mouth that seemed to be the reason she stopped eating a few weeks ago. I have a thread about all of that if you are interested. She hasn't eaten 100% like she used to since but I figured that was because BG was better regulated and her mouth was still not 100%
 
Sorry that should have said "At the end of 12 hours" lol. I was thinking 12 hours in a cycle and being tired combined them. Glad you can get some sleep, I'm going to do the same! 126 isn't bad for a couple hours and eating :). If she gives a similar PS tomorrow morning, you may want to give a reduced dose.
 
Yong said:
Sorry that should have said "At the end of 12 hours" lol. I was thinking 12 hours in a cycle and being tired combined them. Glad you can get some sleep, I'm going to do the same! 126 isn't bad for a couple hours and eating :). If she gives a similar PS tomorrow morning, you may want to give a reduced dose.
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Lol. No worries. I understood what you meant.
Yea, I thought 126 with food and no insulin was pretty good! Thanks!
 
Catdaddy87 said:
Yea I know the insulin should have run out at 12 so that's why I was worried she might be going lower and possible hypo.
Got her to eat a syringe and a little more of A/D. Just checked her BG and she is 126. I feel like I can sleep now. I will check her BG in the morning and go from there.
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A cat with no insulin in their system can't hypo. :)
 
Andrew, that's really not that bad considering her NS last night :). Since it's probably a slight bounce, may have been better to slightly reduce her dose this morning. BUT I think you already gave her insulin, so can you get a mid cycle to see how she's doing? :smuggrin: It's what I meant last night but I clearly see I had a couple miscommunications :p
 
Yong said:
Andrew, that's really not that bad considering her NS last night :). Since it's probably a slight bounce, may have been better to slightly reduce her dose this morning. BUT I think you already gave her insulin, so can you get a mid cycle to see how she's doing? :smuggrin: It's what I meant last night but I clearly see I had a couple miscommunications :p
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The issue is because of our work schedule, I test and feed Sam before I leave for work and my wife gives her the shot before she leaves. That all takes place at 5:30-6:30 am. I get home first which is usually about 5 pm. It's difficult to get mid day because I have to miss work to go home at lunch and do it. I may try today since she may be bouncing just to get a data point for the SS. Thoughts?

She did eat the AD out of her bowl this morning after I held up to her to smell for a few seconds. Hoping that means she will start eating it on her own.
 
Catdaddy87 said:
The issue is because of our work schedule, I test and feed Sam before I leave for work and my wife gives her the shot before she leaves. That all takes place at 5:30-6:30 am. I get home first which is usually about 5 pm. It's difficult to get mid day because I have to miss work to go home at lunch and do it. I may try today since she may be bouncing just to get a data point for the SS. Thoughts?

She did eat the AD out of her bowl this morning after I held up to her to smell for a few seconds. Hoping that means she will start eating it on her own.
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It's good you guys can work as a team to do the shot schedule! Mid day numbers may not be possible often, but if once or twice a week you could get a +4-6 at night that might help, and if anyone is home weekends, so checks and curves then. :). If he gets a shot at 5 pm and you could get a 10 pm test before bed that would be good.
 
JanetNJ said:
It's good you guys can work as a team to do the shot schedule! Mid day numbers may not be possible often, but if once or twice a week you could get a +4-6 at night that might help, and if anyone is home weekends, so checks and curves then. :). If he gets a shot at 5 pm and you could get a 10 pm test before bed that would be good.
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Yea, weekends are the only time we can do curves. I try to give her her shot at around 6:30 pm to try and keep them at 12 hours apart. I know I have a little wiggle room with the Vetsulin
 
Sam's numbers are higher than normal today. I assume she may have eaten some of her dry food within 2 hours of me doing her +5 test.

My wife accidentally fed her at 5 instead of waiting until 6 so her PMPS was after she had eaten so it was higher naturally. Just can't seem to get a good routine going.:banghead:

On a side note, Sam ate her AD from the bowl on her own both AM and PM, ate her dry food during the day, and drank from her brand new water fountain. At least she is cooperating with the food now and drinking water on her own again.
 
Catdaddy87 said:
Sam's numbers are higher than normal today. I assume she may have eaten some of her dry food within 2 hours of me doing her +5 test.

My wife accidentally fed her at 5 instead of waiting until 6 so her PMPS was after she had eaten so it was higher naturally. Just can't seem to get a good routine going.:banghead:

On a side note, Sam ate her AD from the bowl on her own both AM and PM, ate her dry food during the day, and drank from her brand new water fountain. At least she is cooperating with the food now and drinking water on her own again.
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It's OK to feed before mid day tests, just no food 2 hours prior to the preshot test so the number is not food influenced to make sure it's high enough to shoot.
 
Can you give fancy feast classic as amid day meal instead of the dry? Because unless it's Young Again or Dr Elsley's it's high carb.
 
Catdaddy87 said:
The issue is because of our work schedule, I test and feed Sam before I leave for work and my wife gives her the shot before she leaves. That all takes place at 5:30-6:30 am. I get home first which is usually about 5 pm. It's difficult to get mid day because I have to miss work to go home at lunch and do it. I may try today since she may be bouncing just to get a data point for the SS. Thoughts?
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Ah I wasn't 100% sure if you might be off today too ;). Looks like you went home at lunch to get a test and she's spending a little time on the trampoline, as expected. So no need for a full curve every weekend but definitely use those days to get more mid cycles and during the week you can try to get some before bed tests (usually between +2 and +4).

There was a discussion to getting a note system down to communicate between two caregivers but I can't find it and I'm sure you and Cassie can figure something out on your own :smuggrin:.
 
JanetNJ said:
Can you give fancy feast classic as amid day meal instead of the dry? Because unless it's Young Again or Dr Elsley's it's high carb.
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I'm waiting on some more Dr. Elsey's to come in tomorrow. All I have is Purina DM right now.
 
Yong said:
Ah I wasn't 100% sure if you might be off today too ;). Looks like you went home at lunch to get a test and she's spending a little time on the trampoline, as expected. So no need for a full curve every weekend but definitely use those days to get more mid cycles and during the week you can try to get some before bed tests (usually between +2 and +4).

There was a discussion to getting a note system down to communicate between two caregivers but I can't find it and I'm sure you and Cassie can figure something out on your own :smuggrin:.
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I normally text her from work and let her know Sam's BG before I fed her and if she should get insulin or not.
 
Catdaddy87 said:
Sam is at 148 this morning and ate some Hill's AD before I left. I'm thinking half of her normal insulin or less? @JanetNJ @Yong
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If you aren't going to be home to test I would say either skip or do just 0.25. I think 0.5 might be too much... That's a really low preshot that you have no data for
 
JanetNJ said:
If you aren't going to be home to test I would say either skip or do just 0.25. I think 0.5 might be too much... That's a really low preshot that you have no data for
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Thanks Janet! I was thinking .25. It just seems like she is bouncing the last two days and I don't want to skip completely and lose any ground. The bouncing is from having too high of a dose correct?
 
Catdaddy87 said:
Thanks Janet! I was thinking .25. It just seems like she is bouncing the last two days and I don't want to skip completely and lose any ground. The bouncing is from having too high of a dose correct?
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generally yes. You could try 0.75 when the preshots are in the 200's.
 
JanetNJ said:
generally yes. You could try 0.75 when the preshots are in the 200's.
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Thanks. You and many others here have been so much help. I don't think I could have done a good job with Sam with just the vet.

I feel like Sam is getting close to being regulated with her diet and minimal insulin. I think I will try and step down to .75 when her pre shots are in her normal range of 200-240.
 
Catdaddy87 said:
Thanks. You and many others here have been so much help. I don't think I could have done a good job with Sam with just the vet.

I feel like Sam is getting close to being regulated with her diet and minimal insulin. I think I will try and step down to .75 when her pre shots are in her normal range of 200-240.
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I agree.... Sam is doing well!
 
Just seeing my tag, Andrew :oops:. Is there a chance for grabbing a test at lunch today? Would be nice to see how she's doing with 0.25U on your lowest PS yet :cool:.
I like the idea of trying the lower dose of 0.75U when she goes back above 200 PS range ;)
 
My wife is actually home sick today so I will try and get her to test at +6. She is late on giving her insulin though. Sam ate at 5:30 and she is giving the shot at 7:30.
 
Try to have her give Sam a little snack, like 1-2T of some wet food since she last ate 2 hours before shot. I know you're still trying to get her off dry so if she absolutely won't eat the little bit of wet food, give 1T of dry food. Hope your wife feels better! :)
 
Yong said:
Try to have her give Sam a little snack, like 1-2T of some wet food since she last ate 2 hours before shot. I know you're still trying to get her off dry so if she absolutely won't eat the little bit of wet food, give 1T of dry food. Hope your wife feels better! :)
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Well, wife is still miserable and in bed so Sam didn't get a shot. Just going to have to wait until this afternoon to get her insulin.
 
I would just wait until her PMPS schedule otherwise you will mess it up and have to go on another new schedule. Could use this morning's NS to get you back on 06:30/18:30 schedule tonight.
 
Yong said:
I would just wait until her PMPS schedule otherwise you will mess it up and have to go on another new schedule. Could use this morning's NS to get you back on 06:30/18:30 schedule tonight.
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That's the plan. She hasn't eaten since this morning and her BG at +6 of feeding is 219. Seems pretty good without insulin.

Whats your thoughts on afternoon dosage?
 
Definitely not terrible without insulin since yesterday morning :). If she stays above 219 for her PMPS, I think you're OK to try the 0.75U. If she's lower (<200), go ahead and post as soon as you get the test and don't feed right away. Are you CST zone? I will try to hop on as soon as I get my boy set up. If you're testing at 18:00 your time, that's the same time I'll be getting my boy's PMPS :)
 
Yong said:
Definitely not terrible without insulin since yesterday morning :). If she stays above 219 for her PMPS, I think you're OK to try the 0.75U. If she's lower (<200), go ahead and post as soon as you get the test and don't feed right away. Are you CST zone? I will try to hop on as soon as I get my boy set up. If you're testing at 18:00 your time, that's the same time I'll be getting my boy's PMPS :)
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She got 1 unit of insulin last night but none this morning. Will do. I am in the CST time zone. I will be testing about 18:00. I will post here. Thanks so much!
 
Catdaddy87 said:
She got 1 unit of insulin last night but none this morning. Will do. I am in the CST time zone. I will be testing about 18:00. I will post here. Thanks so much!
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Ah right, I was thinking the other night with NS :). Ok, yes you're test will be happening about same time as mine but it will be 19:00 here ;)
 
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