General questions concerning diabetes.

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Pika and Shellz

Pika and Shellz

Member Since 2023
Hello!! I have some general questions that I’m hoping can help others with these questions as well.

#1. What signifies a dose decrease? Is it one or two test that are lower in a cycle.. like in slgs the 90 mark and in TR 40 or 50s? (these are all human meter numbers)
But like today with me I gave insulin with a low number and he did drop to 73 on the AlphaTRAK.. on a human meter it could have been closer to 50-40s. So does that signify a .25 reduction.. but it all was because I gave insulin when he was only 103.. and that was 12 hours apart. I’m trying to be consistent (I have issues with consistency for his insulin dose cause I get scared of low numbers but here I am)

#2 what is the difference between pet meters and human meters? I know human meters read a lot lower than pet meters.. and I was on a human meter (libre sensor) but I noticed about a 30 point difference between that and my AlphaTRAK (human 30 points lower than alpha, yes I know I was on a human meter and now im not and I know that human meters are all cheaper and most people use them for their pet)

#3. How does the insulin work when shooting low? I know it depends on the insulin you use. But when he isn’t in range I get those huge drops fast.. but when he is in range I see more of this flat slow drops... so that gets me lost and makes me worried about giving full dose at low numbers. (ya I can’t see too much since I’m off the sensor and just doing poke test)

#4 what are signs of your cat’s pancreas sputtering/trying to kick in?

#5 bouncing.. what is it and why does it happen? And how does it affect regulation?

#6 how can I tell if my cat is regulated? Is it when the symptoms of diabetes starts to go away or is it if his numbers stay between 240 and 70? I know all the numbers here are for human meters but there is a lot of us using pet meters as well. That is why I asked question #2.

#7. How fast is too fast to be waking down the dosing scale and what does that mean? And how often do people give decrease then have to actually increase again?

#8 how do we know we have the correct dose? Cause I don’t want to be sliding up and down the dosing scale I want to stay consistent cause I’ve seen that is what works best.

#9 do you ever stop getting questions, and actually “figure it out”


Thank you all. I’m sorry these questions are super basic and I know they have been answered in many other post so they are super repetitive.
 
Hi and let me see how many of these I can answer for you:

#1) a dose decrease happens anytime your cat registers a bg under the threshold for the dosing protocol you’re following. So once only and every time. You’re following SLGS so anytime your cat goes under 90 on a human meter, sorry I’ve never used a pet meter and don’t know the equivalent. Any reason switched to a pet meter? @Bron and Sheba (GA) would probably know what that number is.

#2) there’s a difference but there’s also a variance within meters even from human meter to human meter. The advice is pick one either pet or human and stick with it because comparing gets crazy

#3) you want to shoot at lower numbers because the goal is to keep them in the blues and greens for as long as possible since that’s when their pancreas can heal. Yes, you get a huge drop fast because you shot at a lower number but you can avoid that with food. The idea is if you shoot low, test again in 2 hours so you can manage the drop with food. That 73 you got today wasn’t such a huge drop so good job in managing that. Did you give LC food at +2?

#4) those lower preshot numbers and dose decreases

#5) @Bron and Sheba (GA)

#6) I believe regulation is when your cat is staying as much as possible in those blues and greens and you’re not having to do constant dose adjustments. But someone will correct me if I’m mistaken

this is all over got for you. You’ll never stop asking questions I don’t think. I can answer a lot of them and yet here I am dealing with a cat going into remission and I found myself asking a lot of questions again because that was all new to me!
 
Ale & Bobo & Minnie (GA) said:
Did you give LC food at +2?
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I didn’t give LC I did HC the gravy lovers Fancy feast. I actually called my vet to ask them about my 73.. and I was told to give some carbs to boost him and watch him. I liked the human meter (libre sensor) cause it never let him get too low. I did my few test with the sensor and alpha and it was close to 20-30 point variance (human being lower)

so did he earn a reduction and I just didn’t give it to him? Or did he not cause I gave his full dose when he was only 104 when his shot was due?
 
Pika and Shellz said:
bouncing.. what is it and why does it happen? And how does it affect regulation?
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From the Basics
  • 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).
Bouncing is frustrating but very normal and common in newly diagnosed cats. Some cats bounce for just a short time and others bounce all the way to remission.
Pika and Shellz said:
#7. How fast is too fast to be waking down the dosing scale and what does that mean? And how often do people give decrease then have to actually increase again?
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If you are following a dosing method you should be OK. Some cats though, race down the dosing scale, but most go down at a slower pace. Others don't go down and need to stay on insulin for life.
When a cat earns a reduction, sometimes it doesn't work out and you have to go back up in dose.
Pika and Shellz said:
how do we know we have the correct dose? Cause I don’t want to be sliding up and down the dosing scale I want to stay consistent cause I’ve seen that is what works best.
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You will know you are on the correct dose when your cat is in great numbers. If you follow a dosing method, that is the best way to 'get there'. However insulin needs change so you may have to go up and down sometimes. Don't take reductions unless they are earned.
Having a SS and keeping it updated with lots of BG tests is the best way to achieve good results. The BGs will tell you when to increase, decrease or stay on the same dose...and following a dosing method
Pika and Shellz said:
do you ever stop getting questions, and actually “figure it out”
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There will always be someone new wanting to ask questions and as every cat is different (ECID), one size doesn't fit all so there are many ways to figure it out.
 
Under dosing protocol on the spreadsheet you wrote vet. We use either SLGS or TR. under the SLGS protocol, your cat earns a 1/4 reduction every time it goes under 90 so you’ve got a few reductions you didn’t take. He should be at 2.25 now and you can start on that tomorrow but you want to hold the dose for 7 days unless another reduction is earned. Vets dose by the preshot numbers while we dose by the lowest they go at any cycle.
 
Ale & Bobo & Minnie (GA) said:
Under dosing protocol on the spreadsheet you wrote vet. We use either SLGS or TR. under the SLGS protocol, your cat earns a 1/4 reduction every time it goes under 90 so you’ve got a few reductions you didn’t take. He should be at 2.25 now and you can start on that tomorrow but you want to hold the dose for 7 days unless another reduction is earned. Vets dose by the preshot numbers while we dose by the lowest they go at any cycle.
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did he just earn another reduction this morning? At +1 with his 84? Even though I gave his insulin when he was 108?
 
Pika and Shellz said:
did he just earn another reduction this morning? At +1 with his 84? Even though I gave his insulin when he was 108?
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Yes. So his pm dose will be 2 units. It seems you may have found the breakthrough dose and now his numbers are coming down. You can kinda see now how he’s the one dictating the dose not the vet or even us and that’s what you want to see

I’m really hoping he can hold the back to back reductions, but I think what we’re seeking is his pancreas is kicking in. Looking good!

@Bron and Sheba (GA) should she start posting on the Lantus/glargine forum?
 
Make sure to get a +2 or +3 since you shot a lower amps. Btw, congrats on giving the full dose with a lower amps! Are you giving snacks to keep his numbers from going down too much?
 
Ale & Bobo & Minnie (GA) said:
Make sure to get a +2 or +3 since you shot a lower amps. Btw, congrats on giving the full dose with a lower amps! Are you giving snacks to keep his numbers from going down too much?
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I actually can’t today cause I had to leave for work after his +1. And I am trying my hardest not to be super worried. But I did give him a scoop of gravy to counter the insulin as I was walking out and that was right after +1 so i know he will keep dropping. My neighbor at +2 gave him another scoop or two of gravy.. and she will go over and check on him at +3 then at +4 probably some treats. I will be home at +7.5

but I’m really trying not to worry. He is free fed so I know he has access to food at all times he just isn’t eating like he was with higher sugars.
 
Got it. Hopefully this will happen again on a day you’re home because it’s good to get some tests in and see how his bg is reacting to the food. Good job on getting him snacks and food throughout the day!
 
Your cat was eating more when his blood glucose (BG) was higher because all of that glucose coming from what he was eating was floating around in his bloodstream and not getting into the cells. All food breaks down into glucose. It's how food is metabolized and gets into our cells. Insulin helps transport the glucose into the cells. If your kitty isn't producing insulin or the BG numbers are high, the glucose isn't getting into the cells efficiently. Once you start seeing better numbers, your cat won't be as hungry because the glucose is going where it's supposed to go!

Looking at Pika's spreadsheet, he clearly hit his "good" dose. Nice looking shift from those 200 - 300s to 100s and below.
 
Sienne and Gabby (GA) said:
Looking at Pika's spreadsheet, he clearly hit his "good" dose. Nice looking shift from those 200 - 300s to 100s and below
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It got a little scary for me when he was getting into the 70s at +2 and I’m leaving for work (I’m on a pet meter and not supposed to go under 72 according to my vet under that I can start to expect to see some symptoms of hypoglycemia) But yes we found that break through dose and started going down the dosing.

yea I know I did a full .5 reduction but he was being a little too low for comfort. I will hold this 1.5 for a few days and see how it goes before I increase to 1.75.. getting 70s on that alpha made my vet uncomfortable as well. Especially since I haven’t been able to monitor him. I got really freaked out seeing some SS and how cats are seizing when they get too low.. I look at others sheets to get confidence then I saw some with actual symptomatic hypo and I got scared and didn’t want that. But I’m going to stay consistent with 1.5 for 5 days then I will increase if I don’t see a dip below 150.. but he had a perfect curve yesterday. With 180 150 185..
 
I’m not sure if the pet meter 72 is equivalent to human 50 but that’s the take action number. Sienne would know. I have noticed vets are way more uncomfortable with lower numbers than we are here and I find those lower numbers for Bobo is what kinda if “jump started” his pancreas. Not saying you want to risk a hypo but you shooting at that lower amps the other day was a good thing. You’re doing great and putting on your big girl pants for Pika so let’s see what the 1.5 will do. Def hold it for a few cycles so we can gauge it and you can give it a chance to work. We’ve all been there :cat:
 
That 51 is pretty close to 50 so I’d give him some food and retest in 30 minutes. Can you add it to the ss? Where are you at in terms of timing from the shot? And he just earned another reduction down to 1.25 :bighug:
 
Ale & Bobo & Minnie (GA) said:
That 51 is pretty close to 50 so I’d give him some food and retest in 30 minutes. Can you add it to the ss? Where are you at in terms of timing from the shot? And he just earned another reduction down to 1.25 :bighug:
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Umm I was leaving for work when I tested so I gave some honey and Gravy lovers. My husband is home with him and gave more carbs around 1pm. (He doesn’t test him not comfortable doing that yet) we were at +2.5 when he hit the 77/51.

but this is why I was so what is the conversion. And I’ve been thinking I’m in a form of TR..
 
Gravy lovers is good. Honey is good to bring it up fast but also wears off quickly. I don’t know that you are. With TR you’d only decrease once he goes below 50 in a human meter so todays bg would not have earned him a reduction. It’s a bit scarier because you have to get numbers in the 40s before you decrease the dose.
 
I’m not a TR I’m SLGS cause I don’t want to push him to the edge. I like to have some safety since I’m gone most the time. But he is the one who keeps going low numbers on me and keeps needing a reduction. I’m happy he is doing so well but it’s scary.
 
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