Dosing Help

Kerri2455

Kerri2455

Member Since 2017
Hello
I don't know if this is the proper place to post but I am looking for advice on dosing.

Just general rules of thumb for how many units to give based on what the BG number is at testing.

Is there any information about this on this site? I checked under a few other areas within this forum and didn't see anything specific.

THANK YOU
Kerri & Oliver
 
Hi Kerri and good morning Oliver. Lantus is not dosed according to the pre-shot test blood sugar level. It is based on the lowest BG or the nadir. Finding the nadir is a process of testing mid-cycle, and seeing how that insulin is working for Oliver over a period of cycles (12 hours between shots). It is recommended to test at different times during the cycles, on different days, to get a big picture of the blood sugar levels between shots. It's also helpful to get tests in the nighttime cycle too, as you can, at least a before bed test.

You need to set up the spreadsheet and record the insulin and testing data. I did not go back through all of your previous threads and posts because there are over a hundred of them, so I do not know if someone told you to do the spreadsheet or not.

Even the last month of data would be very helpful for the advising members to review before offering any input on dosing. Without that data no one can tell you how to proceed.

If you need help setting the spreadsheet up and linking it to the signature, let us know. There are members who can help you.
Also, please add to the signature what kind of glucometer you are using to home test.

Read the stickies at the top of this forum. The stickies contain the information you need to provide effective insulin therapy with Lantus, the information about increasing and decreasing doses, plus the protocols used here are described.

Have you been consistently home testing Oliver since his diagnosis in December 2017? Has he been on different dosing during that time? What dose are you using now?

Is he on a low carbohydrate diet? Is he eating dry food? Please detail what (brands/variety) he eats, when and how much.
 
Hi and thank you! I don't have a spreadsheet as we don't test religiously as he started to hide from us and I was more concerned with him eating and getting insulin than testing. He's been good so far but last week, 1am on Thursday, we were on the way to the ER with an episode of hypoglycemia and when they tested him at the ER his BG was 40! I tested him that night before going and he was at 60 so we gave Karo syrup and then he ate like he hadn't eaten in a while and then he started walking in circles so off to the emergency vet we went.

So Sunday we did a curve and I didn't think to bring those numbers with me today and wish I had. I can post those when i get home.
Im embarrassed to say i don't know how to create a spreadsheet-I am not saavy with excel.

I didn't realize Lantus was not dosed according to BG levels or not the traditional way other insulin was dosed. I think my vet had him on too big a dose so we adjusted as I was told less is better (higher BG better than low BG). She had him on 3 units when he was testing in the mid 400's. I do recall his numbers on Sunday being mid 300 and the vet at the ER said to give 1 unit.

I feed him both dry (I know its horrible) and wet. I tried to get him off the dry but it wasn't working so well. I do feed the Dr Elsyes dry which is under 10 grams of carbs and I don't leave a ton out but we have 5 other cats and while they mostly eat their wet together in the AM there are two who don't eat until later so i leave wet and dry out. Canned food is Fancy Feast pate. Oliver also has issues with non diagnosed IBD and the only thing keeping him firm before he was diabetic was Royal Canin Satiety so i need to keep him on that and mix a small amount into the dry kibble so its like 3/4 Dr Elsyes and 1/4 Royal Canin which isn't low carb. Im at a loss as to what to do for his IBD as we tried other foods and he goes right back to pudding piles vs normal poop so the mixture seems to be good....We haven't had any issues since his initial diagnosis aside from last week.
The insulin does show it expired 8/2019 but i read that if refrigerated its still ok to use. I may just toss that vial to be safe.

I appreciate the info above and will post his numbers from his curve tonight.

THANK YOU!
Kerri and Oliver
 
Kerri, you can start a conversation with @Marje and Gracie. She can set up the spreadsheet for you and then all you will need to do is plug in the numbers. Don't be embarrassed about not being computer savvy, we all have different talents, and I was one that had to have it set up for me too.

But, it's really important for you to test, and I do know how difficult that can be. You are not the only one with issues on that front. But, as you just experienced with the rush to ER with the hypo, you know how important this is.

Please read through this info from Chris & China (GA):

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
**********
Sandi & Whisper also responded to a new member that is having trouble testing and I thought it was good advice:
And Lou mentioned a "rice sock" -- that would be great, and you might even find that you can just sit with Daj on the couch with the warm rice sock and rub his head with it. Whispy LOVES it -- I give him an all over body massage with it, starting on his ears and then rubbing it all over his body. Because, you know, I'd do absolutely anything for one of my kitties! If Daj likes it, that'd be a great way to desensitize him to using it to warm up his ears. At first I didn't exactly fuss with his ears, just rub it gently all over his head, but do make sure it isn't too hot, make sure after you heat it in the microwave that you could let it lay directly on your wrist without burning. Surprisingly, I find that I have to use the rice sock more in the summer when we have the A/C on than in the winter (but we do heat with a woodstove, so it is usually pretty toasty in here in the winter). So don't think that because it might not feel "cold" inside that using it to warm the ear isn't necessary.

If you need more responses and suggestions about easing the testing process, you could start a new thread in the Main Health forum. Kerri, I have read so many posts about problems with testing all over this board, you are not the only one, believe me! You should have seen DH and myself when we first began, utter chaos and dysfunction (Laurel and Hardy meet the Keystone Cops). It's just the only way you are going to know it's safe to inject and what dose Oliver should be getting.

I know you want the best for Oliver, and you are trying. Please don't give up.
 
I can do the spreadsheet for you if you will send me a PM. I’ll need some info from you.

Are you on Facebook? There are two IBD groups there that could really help you. You might want to start reading at IBDkitties website to get some basic information. The diet you are feeding him is really not good for IBD kitties even though it might be keeping his stools firm. Because most commercial foods include gums and/or caregeenan, we are seeing so many cases of IBD.

Rather than overwhelm you with more info about FD, it’s best to let what Lou (Idjit’s Mom) relayed, get the SS going, and go from there.
 
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Idjit's mom said:
Kerri, you can start a conversation with @Marje and Gracie. She can set up the spreadsheet for you and then all you will need to do is plug in the numbers. Don't be embarrassed about not being computer savvy, we all have different talents, and I was one that had to have it set up for me too.

But, it's really important for you to test, and I do know how difficult that can be. You are not the only one with issues on that front. But, as you just experienced with the rush to ER with the hypo, you know how important this is.

Please read through this info from Chris & China (GA):

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
**********
Sandi & Whisper also responded to a new member that is having trouble testing and I thought it was good advice:
And Lou mentioned a "rice sock" -- that would be great, and you might even find that you can just sit with Daj on the couch with the warm rice sock and rub his head with it. Whispy LOVES it -- I give him an all over body massage with it, starting on his ears and then rubbing it all over his body. Because, you know, I'd do absolutely anything for one of my kitties! If Daj likes it, that'd be a great way to desensitize him to using it to warm up his ears. At first I didn't exactly fuss with his ears, just rub it gently all over his head, but do make sure it isn't too hot, make sure after you heat it in the microwave that you could let it lay directly on your wrist without burning. Surprisingly, I find that I have to use the rice sock more in the summer when we have the A/C on than in the winter (but we do heat with a woodstove, so it is usually pretty toasty in here in the winter). So don't think that because it might not feel "cold" inside that using it to warm the ear isn't necessary.

If you need more responses and suggestions about easing the testing process, you could start a new thread in the Main Health forum. Kerri, I have read so many posts about problems with testing all over this board, you are not the only one, believe me! You should have seen DH and myself when we first began, utter chaos and dysfunction (Laurel and Hardy meet the Keystone Cops). It's just the only way you are going to know it's safe to inject and what dose Oliver should be getting.

I know you want the best for Oliver, and you are trying. Please don't give up.
Click to expand...
Thank you, I will reach out and see if i can get a spreadsheet made. I can test him AM and PM and more than once PM but its daytimes I cant as I work 8-5. But i can certainly add an AM test, we have been as of Sunday been doing PM tests. I guess though not knowing what the other numbers are since we use lantus that wont help with the amount of insulin to give but its a start.
I do have freeze dried treats he likes-primal nuggets and he also has some sensitive stomach treats too-he loves ANY treat and he's pretty good about coming to us its just us who need to read the signs that he's about to run under the bed and get to him before that happens type of thing. LOL

THANK YOU!!!
 
Marje and Gracie said:
I can do the spreadsheet for you if you will send me a PM. I’ll need some info from you.

Are you on Facebook? There are two IBD groups there that could really help you. You might want to start reading at IBDkitties website to get some basic information. The diet you are feeding him is really not good for IBD kitties even though it might be keeping his stools firm. Because most commercial foods include gums and/or caregeenan, we are seeing so many cases of IBD.

Rather than overwhelm you with more info about FD, it’s best to let what Lou (Idjit’s Mom) relayed, get the SS going, and go from there.
Click to expand...
Hi
I am a member of the IBD group but when we had the ultrasound done and cat scans done (he had an anal polyp needing removed) they wouldn't definitively diagnose with IBD. Im just assuming that's what it is as whatever he eats, if not high protein like the Royal Canin Satiety Forumla, it runs right through him. Even straight fancy feast does that...…..Ive tried SO many foods and he loves them all but they don't love him. So to fix that issue i mix the two foods but make sure he eats some of the satiety (wet and dry) daily to keep him regular.

Ok, how do i PM you? Ill click your name and see if that's how i do it...….THANKS!
 
Kerri2455 said:
Hi
I am a member of the IBD group but when we had the ultrasound done and cat scans done (he had an anal polyp needing removed) they wouldn't definitively diagnose with IBD. Im just assuming that's what it is as whatever he eats, if not high protein like the Royal Canin Satiety Forumla, it runs right through him. Even straight fancy feast does that...…..Ive tried SO many foods and he loves them all but they don't love him. So to fix that issue i mix the two foods but make sure he eats some of the satiety (wet and dry) daily to keep him regular.

Ok, how do i PM you? Ill click your name and see if that's how i do it...….THANKS!
Click to expand...
Ever try to switch him very slowly to a balanced raw diet? So many people say their cat won’t eat raw but I’ve found they don’t transition slowly enough or in the proper way. I’ve never had any issue getting my cats to balanced raw but it takes time and patience.

BTW, no one can dx IBD by ultrasound and I don’t know what you mean by a “cat scan”. IBD can only be dx by biopsy. However, it does make sense that if the symptoms are there, treat it like IBD.
 
I did try frozen raw and he refused but he seems to like the freeze dried raw like primal or stella and chewy's BUT wont eat it rehydrated only dry which isn't good.

No biopsy don't but the vet did an xray and ultrasound and we have had cat scans done as we thought he may have a tumor in his anal cavity which turned out to be a polyp they removed. But seems the only type food he can tolerate is the high fiber stuff...……. We have gone through quite a bit of foods which nothing seems to help so i mixed them thinking part high fiber but then also low carb for diabetes.
 
I have an IBD (non-diabetic) kitty. One of the issues your vet may not have mentioned is that you may need to use novel proteins. IBD is much like an allergy to proteins that you have been feeding Oliver. I had fed Gizmo a diet of canned food that was entirely poultry. I switched him over to either lamb or pork. I do use a raw diet. I've also fed him ZiwiPeak (either lamb or venison).The good thing about ZiwiPeak is that there are no gums or caregeenan in its ingredients. They also make a freeze dried like that is fine for IBD cat. I use the venison as a treat for Gizmo. He also gets a daily probiotic. The probiotic can help to prevent diarrhea.

The website I've relied on for general information, particularly for info on supplements and dealing with flare ups is Raw Feeding for IBD Cats. They also have a Facebook page.

@Marje and Gracie - can you check on the IBD kitties link you provided. It takes me to a "web name for sale" page.
 
Sienne and Gabby (GA) said:
I have an IBD (non-diabetic) kitty. One of the issues your vet may not have mentioned is that you may need to use novel proteins. IBD is much like an allergy to proteins that you have been feeding Oliver. I had fed Gizmo a diet of canned food that was entirely poultry. I switched him over to either lamb or pork. I do use a raw diet. I've also fed him ZiwiPeak (either lamb or venison).The good thing about ZiwiPeak is that there are no gums or caregeenan in its ingredients. They also make a freeze dried like that is fine for IBD cat. I use the venison as a treat for Gizmo. He also gets a daily probiotic. The probiotic can help to prevent diarrhea.

The website I've relied on for general information, particularly for info on supplements and dealing with flare ups is Raw Feeding for IBD Cats. They also have a Facebook page.

@Marje and Gracie - can you check on the IBD kitties link you provided. It takes me to a "web name for sale" page.
Click to expand...
Thank you! Fixed....sorry; tried to do it from memory :p:woot:
 
Sienne and Gabby (GA) said:
I have an IBD (non-diabetic) kitty. One of the issues your vet may not have mentioned is that you may need to use novel proteins. IBD is much like an allergy to proteins that you have been feeding Oliver. I had fed Gizmo a diet of canned food that was entirely poultry. I switched him over to either lamb or pork. I do use a raw diet. I've also fed him ZiwiPeak (either lamb or venison).The good thing about ZiwiPeak is that there are no gums or caregeenan in its ingredients. They also make a freeze dried like that is fine for IBD cat. I use the venison as a treat for Gizmo. He also gets a daily probiotic. The probiotic can help to prevent diarrhea.

The website I've relied on for general information, particularly for info on supplements and dealing with flare ups is Raw Feeding for IBD Cats. They also have a Facebook page.

@Marje and Gracie - can you check on the IBD kitties link you provided. It takes me to a "web name for sale" page.
Click to expand...
Hi
Thank you- I haven't tried novel proteins yet so that's a possibility. I really don't want to feed lamb though, I cant get past the fact its a baby and we don't eat lamb either so i may need to find another protein. Venison I may have tried and it was too rich for his tummy. i looked for Ziwipeak freeze dried treats/food at my local Petco last night and they didn't have it so i can order from chewy. I need something for him to entice him for testing as both last night and this AM he tried to hide from us.
We have tried probiotics but he knew something was in his food. Tried Metamucil and other things too at the vets suggestion and he wont eat the food. :( Thanks for the info above on the raw feeding.

Kerri
 
Marje and Gracie said:
Thank you! Fixed....sorry; tried to do it from memory :p:woot:
Click to expand...
I entered Oliver's numbers, or those we have, into the spreadsheet. It doesn't make sense to me...….he was low last night -174 so we were too worried to give him insulin and then this AM he was over 400. Should we have given him maybe 1/2 a unit? I don't understand how much to give based on the numbers. He seems to be high in the AM and then low in the PM so maybe we need just one dose in the AM and no insulin at night? My testing isn't so great. Im working on that.
 
Kerri2455 said:
I entered Oliver's numbers, or those we have, into the spreadsheet. It doesn't make sense to me...….he was low last night -174 so we were too worried to give him insulin and then this AM he was over 400. Should we have given him maybe 1/2 a unit? I don't understand how much to give based on the numbers. He seems to be high in the AM and then low in the PM so maybe we need just one dose in the AM and no insulin at night? My testing isn't so great. Im working on that.
Click to expand...
Did you test him before you decided to not give insulin because, from the SS, it looks like you decided no insulin and then tested two hours later and got a 174.

Typically, you want to test, feed, and shoot within about 15 minutes and close to 12 hours apart. By “close” I mean generally 15 minutes. There are times when we need to vary that but I don’t want to throw too much at you now.

Because you are doing Start Low Go Slow (SLGS), at least until he’s off dry and you can decide further, we ask that you don’t give insulin if he’s below 150 as long as he’s never had diabetic ketoacidosis (DKA). If he’s 150-200 and until you get a little more experience and data, we ask that you stall the shot without feeding and post here and a member will walk you through the options depending on where his BG is and how much data you have on him. By data, I mean tests and also how he responds to the carbs in the food you give him.

Lantus is given twice a day; there are rare circumstances where we give it once a day and that’s usually for cats that are on a drop of insulin, about to go into remission, but just need a tiny bit of support. There are times when his BG might be too low to shoot....any time he is below 90 on the AT (since he’s still eating dry, then you are following SLGS), but we have ways to deal with that as well (stalling a bit) to give his BG a chance of rising to a safe number to shoot.

I understand he’s a little difficult to test. Besides the other info given, here are some Testing and Shooting Tips that might further help. I’ve found one simple thing that most new testers do is forget that the bevel of the lancet must be up so you are poking with the sharpest end.

The best way for us to help you is for you to always get a preshot test. During the a.m. cycle, if you work, try and get a +2 or an out-the-door test and then an in-the-door test. In the p.m. cycle after his preshot test and insulin, we suggest a +2 and a before bed test.

He’s high today because you didn’t give insulin last night. 174 is a very safe number; it’s possible he went a bit lower before he headed up. Once you are able to get a few more tests and your weekly curve, we can have a better idea as to the best dose for him.

Could you please add “SLGS” in your signature block so everyone will know right off that that’s what you are doing? Yesterday when I revised the signature block, I didn’t realize you were still feeding dry as that wasn’t included in that info so we need it to say “canned food & dry diet”. It doesn’t matter if he’s only getting a small amount of dry....it is what it is :) If you are able to get him off it, you can change it later. If you run out of room in the signature block, you can delete the website for Dr. Lisa...we all pretty much know it by heart ;)

Let us know your questions.
 
Marje and Gracie said:
Did you test him before you decided to not give insulin because, from the SS, it looks like you decided no insulin and then tested two hours later and got a 174.

Typically, you want to test, feed, and shoot within about 15 minutes and close to 12 hours apart. By “close” I mean generally 15 minutes. There are times when we need to vary that but I don’t want to throw too much at you now.

Because you are doing Start Low Go Slow (SLGS), at least until he’s off dry and you can decide further, we ask that you don’t give insulin if he’s below 150 as long as he’s never had diabetic ketoacidosis (DKA). If he’s 150-200 and until you get a little more experience and data, we ask that you stall the shot without feeding and post here and a member will walk you through the options depending on where his BG is and how much data you have on him. By data, I mean tests and also how he responds to the carbs in the food you give him.

Lantus is given twice a day; there are rare circumstances where we give it once a day and that’s usually for cats that are on a drop of insulin, about to go into remission, but just need a tiny bit of support. There are times when his BG might be too low to shoot....any time he is below 90 on the AT (since he’s still eating dry, then you are following SLGS), but we have ways to deal with that as well (stalling a bit) to give his BG a chance of rising to a safe number to shoot.

I understand he’s a little difficult to test. Besides the other info given, here are some Testing and Shooting Tips that might further help. I’ve found one simple thing that most new testers do is forget that the bevel of the lancet must be up so you are poking with the sharpest end.

The best way for us to help you is for you to always get a preshot test. During the a.m. cycle, if you work, try and get a +2 or an out-the-door test and then an in-the-door test. In the p.m. cycle after his preshot test and insulin, we suggest a +2 and a before bed test.

He’s high today because you didn’t give insulin last night. 174 is a very safe number; it’s possible he went a bit lower before he headed up. Once you are able to get a few more tests and your weekly curve, we can have a better idea as to the best dose for him.

Could you please add “SLGS” in your signature block so everyone will know right off that that’s what you are doing? Yesterday when I revised the signature block, I didn’t realize you were still feeding dry as that wasn’t included in that info so we need it to say “canned food & dry diet”. It doesn’t matter if he’s only getting a small amount of dry....it is what it is :) If you are able to get him off it, you can change it later. If you run out of room in the signature block, you can delete the website for Dr. Lisa...we all pretty much know it by heart ;)

Let us know your questions.
Click to expand...
Thanks for all this...…..We feed everyone (we have 9 animals total) once we are home from work which is about 5:30. So we tested him 2 hrs after his feeding but he didn't eat all that much. Maybe he had eaten before we got home or wasn't interested at the time but that 174 was a few hours after he ate a little for us. I was worried if he was at 174 and we gave insulin he may drop lower and i thought 70-130 was the normal range and was just worried he might drop too much. After last weeks scare im super nervous.

Im going to get some different canned food, something with a novel protein- i looked at Duck which had too many carbs so maybe ill have to use Venison/Rabbit (hate to do that too). UGH......so many small yet important things to work on.

Ill update my signature line.

Ill keep up with the testing and try to work out an AM/PM test and shoot routine. Thanks for the support!!
 
Kerri2455 said:
Thanks for all this...…..We feed everyone (we have 9 animals total) once we are home from work which is about 5:30. So we tested him 2 hrs after his feeding but he didn't eat all that much. Maybe he had eaten before we got home or wasn't interested at the time but that 174 was a few hours after he ate a little for us. I was worried if he was at 174 and we gave insulin he may drop lower and i thought 70-130 was the normal range and was just worried he might drop too much. After last weeks scare im super nervous.

Im going to get some different canned food, something with a novel protein- i looked at Duck which had too many carbs so maybe ill have to use Venison/Rabbit (hate to do that too). UGH......so many small yet important things to work on.

Ill update my signature line.

Ill keep up with the testing and try to work out an AM/PM test and shoot routine. Thanks for the support!!
Click to expand...
You’re welcome! Thank you for updating the signature block.

If you feed at 5:30 when you get home, what time do you usually shoot? I just want to be sure it’s recorded correctly in his SS. And, you should have a two hour window, generally, between feeding and his preshots so the PSs are not food influenced. That’s not to say that we never feed within that two hours; there are instances where we need to.
 
Kerri --

It's hugely important to test BEFORE giving a shot. The pre-shot test tells you whether it's safe to give your cat insulin. If you look at either Marje's spreadsheet (SS) or mine, you'll see there were times when we had to stall before shooting. What you're doing is what we refer to as "shooting blind." It makes me very nervous. We want you to keep Oliver safe and testing before you shoot is the best way to do that.
 
Hi
So the "preshot" that's actually testing or giving the insulin? Im a little confused by the terminology. We feed at 5:30 but have not been testing until after he eats and its usually a few hours after that we test.
So i understand we should test and then feed...… then test again before insulin is given???

Ill take a look at the other spreadsheets.... There is so much work involved here- LOL. I assume this is a daily thing the test, feed, test and give insulin or would it be just until we know he's on a dose that works for him? I want to think its going to be forever which means we need to probably push everyone's food schedule back a bit but we also do have food out for the cats on the counter since we have 6 cats total and they are not all on the same feeding schedule and two wont eat wet food. SIGH.
 
both spreadsheets are amazing, WOW! Hats off to you both for taking such wonderful care of your babies. I will try to follow suit.
 
Kerri2455 said:
Hi
So the "preshot" that's actually testing or giving the insulin? Im a little confused by the terminology. We feed at 5:30 but have not been testing until after he eats and its usually a few hours after that we test.
So i understand we should test and then feed...… then test again before insulin is given???

Ill take a look at the other spreadsheets.... There is so much work involved here- LOL. I assume this is a daily thing the test, feed, test and give insulin or would it be just until we know he's on a dose that works for him? I want to think its going to be forever which means we need to probably push everyone's food schedule back a bit but we also do have food out for the cats on the counter since we have 6 cats total and they are not all on the same feeding schedule and two wont eat wet food. SIGH.
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The preshot (AMPS = a.m. preshot; PMPS = p.m. preshot) is the test you do within 15 minutes before giving insulin. You should always do this test. We’ve had members wake up to an AMPS of 40. You can only imagine what would have happened if they had shot without testing.

Since I don’t know your shot time, I’ll give you an example. Let’s say you are on a 6 a.m./6 p.m. shot time.
  • “in general”, it’s best to withhold food two hours before so you aren’t shooting a food spike (again, there are exceptions if numbers are running low)
  • between 5:45 and 6, test followed during the same timeframe with feeding and shooting insulin; most here feed while shooting so kitty’s attention is on food and not the shot.
If you can please let me know what time your regular shot time is (even though you skipped last night) and what time you got the 174 last night, I can help you with the SS.

Yes, this is exactly what you need to do, plus other tests during the cycles as you can, as long as he is on insulin. We can help you with things like moving the shot time around if another time is better, when to test during the cycles, etc.

Most of us have had to deal with having other cats that are non-diabetic (we call them “civvies”).

It would be really helpful for you if you read the stickys at the top of this page. Lots of great info; we are always happy to take questions.

Also....Sienne and I were testaholics but that doesn’t mean you have to be. Some cats are much more predictable than ours were and don’t have to be tested as much. If you look at other threads (“condos”) and SSs, you’ll see what I mean. There is a lot to be learned here just from reading other condos and looking at other SSs.
 
We normally are on a 6:30 AM and 6:30 PM injection time.

The 174 reading was last night at 7:30 after the normal 5:30pm feeding time. Oliver ate last night but not a lot- we gave him a can of FF pate and he ate maybe 1/4 of it but he may have munched on the dry food shortly before we got home. We feed AM at 6:30 and PM at 5:30 but could push the cats food to 6:30 but the dogs eat once a day so they get fed once we are home. Its a juggling act but my husband and I will need to figure a schedule out that works for us and the cats.
It does make sense he was high this morning considering nothing given last night. Will see this evening when i get home what his BG reads......and then will feed and dose from there.
 
If you normally test, feed, shoot at 6:30, and the 174 was a 7:30 pm test, then could you please move it to the “+1” box after the PMPS and U columns?

Were you able to get an AMPS today or you just shot at 6:30 and then tested before you left for work at 7:30 so at one hour after you gave his morning shot, he was at 457? IF, by any chance, the 457 was right before you gave the shot, then you would put it in the AMPS column as 457 @ +24 since it was 24 hours since you last gave insulin.

We always record numbers based on the last time insulin was given. Let me know if you don’t understand, and if it’s ok since I have editing rights, I can fix it for you so you can see what it looks like. Thank you :)
 
Ok tomorrow I’ll have to fix as it’s too hard on my cell.....

tonight before eating he was at 427. FYI. He hid from us too so it was very hard to get the test and then he wouldn’t eat so I’m hoping he will and we will probably give 1 1/2 units....

If you want to correct the spreadsheet feel free but I can do it in the AM too.

thank you!!
 
I am posting this here because Kerri PMd me to let me know Oliver isn’t eating well and she’s still had some trouble testing. She is taking him to the vet. She also asked in the PM if he needed insulin just once a day perhaps.

@Kerri2455 to respond to your PM: the only time we shoot insulin just once a day is if the dose is down to a drop and the kitty is still dropping into lower numbers but, on either side of the lower numbers, is above 100. Oliver still needs insulin twice a day based on what you have on his SS. It’s “possible” that the reason you see really low numbers is that you’ve give a higher dose the cycle before; with Lantus, a dose can affect subsequent cycles.

However, dosing him as you’ve been doing is going to really mess with the Lantus depot and so you can’t see what any particular dose does for him when you change it so much or don’t give insulin. The other thing that makes it difficult to tell how much insulin he needs is the lack of tests. I understand he hides from you but it’s really important to keep him safe that you find a way to block under the bed so he can’t hide. We’ve had many, many, many cats here who did not like testing, at first, but with diligence and patience, they start to be fine with it and some even eventually run to their testing towels at test time.

Are you testing his urine for ketones? This is really important. With no dosing information for large gaps, I don’t know if it means you gave no insulin (10/30 - 11/8) or not. For any day that you gave no insulin, please put “0” or “NS” in the Units column so we know. The more data you have that you can fill in, the better and the more we can help you.

If he were my cat, I’d absolutely make sure I close the bedroom door well before AMPS and PMPS, get those tests in, and start back religiously with giving 0.5u twice a day and get at least once mid cycle test in during the day and one before bed at night. That’s just four tests a day starting out. It’s going to be difficult for us to help you if you can’t provide us with some info so we know he’s safe at a dose. If, at any time, he drops below 90, reduce his dose to 0.25u twice a day. The reason why I’m suggesting this dose is because I’m concerned that with him not eating and a possible dental issue, he could be prone to developing ketones and DKA.

It would also help if you can post daily. Here is the information for posting for this subforum. Please let us know if you have questions. We are here to help you and Oliver.
 
Thank you! I did give insulin on the days we didn't test. I have tried to stick with 1 unit unless his numbers were high 300's to mid 400's so i will update the spread sheet.
I will do my best to corral him both AM and PM for shots but daytime my husband and I both work and cant get home to test so I can test him when i get home and before bed, three tests a day.

I didn't realize even below 90 he would still need insulin. What are the normal range numbers for a cat without diabetes?

THANKS for the guidance! I really appreciate it and I a sorry to not provide more info, i am trying to get better.... its a work in process between my husband who thinks its crazy to do so many tests and Oliver who says NO THANKS! LOL.
 
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