HELP ASAP - PMPS 8.7 ~ 157 - which is usually his nadir!!!

[.:. in.active .:.]

We are still on Caninsulin so his PMPS usually falls on AM+11, today I was out so I checked it at +11.5 and he gave me a 8.7 mmol/L - 157 mg/dl ... WHICH RANGE WAS HIS NADIR ONLY A FEW DAYS AGO!

Currently stalling, seeing if he hits close to 14 mmol/L - 252 mg/dl [AlphaTrak], but even he does WHAT DOSE DO I SHOOT?
His numbers are all over the place, and his nadir was a nice 5.2 mmol/L - 94 mg/dl today.

What on earth is going on with this cat???

 

[.:. in.active .:.]

Stalled for 20mins, he gave me a 10.9 mmol/L - 196 mg/dl. Couldn't stall again, boy was hungry.
I'll check 20mins after food again, although BG likely be raised, even though he's fed 0% carb Sheba.

DO I SKIP THE DOSE COMPLETELY? Or do I shoot since he was rising, just reduced and later? HELP!

Edit:
Did a wee after eating - glucose still present (high)
Food+20mins 13.3 mmol/L - 239 mg/dl

 

[.:. in.active .:.]

The general guidelines for making dose changes are:

• 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

SOMEONE PLEASE! DO I SHOOT THE 3.5IU STILL?

 

[.:. in.active .:.]

AM+11.5 8.7 mmol/L - 157 mg/dl
stall
PMPS 10.9 mmol/L - 196 mg/dl
stall + fed
FOOD+20' 13.3 mmol/L - 239 mg/dl
FOOD+1 17.7 mmol/L - 319 mg/dl
FOOD+2 22.2 mmol/L - 400 mg/dl
FOOD+3 N/A shot at FOOD+2

If numbers don't start to drop by FOOD+3 on their own, I guess I'm shooting a reduced dose then...

 

[Red & Rover (GA)]

The 10.9 was okay to shoot if you could test. The numbers were rising.

Given meter variance, that 196 US is close enough to 200 US.

(I doubt I'd show the cycle to the vet, though – might be an argument against a better insulin.)

 

[.:. in.active .:.]

We are approaching FOOD+2 (will update number in the above post)
He is super active and happy, more than he has been since Dx. Shall I shoot now or wait and see if numbers drop by FOOD+3?
And do I hold the dose? If you look at the data, his numbers/pre-shots are all over the place
Edit: Shooting now isnt an issue re: time, in fact, more sustainable holding a 12hr cycle with a 10am-10pm cycle than the previous 8am-8pm one.


Note taken re: vet. Sheet is shared with her too tho, so I may have to temporarily delete or alter data for the upcoming 2 days

 

[.:. in.active .:.]

Shot. Held it.
So are you saying, as long as the number rising after stalling, even if it hasn't reached the threshold, I should go ahead and shoot (the usual dose, as long as it has a corresponding nadir)?
Mind that I'm using an AlphaTrak so that 10.9 likely have been an 8 on a human meter...

When in doubt, ask the Forum or your vet for advice BEFORE dosing your cat.

• The proper sequence for dosing insulin is: Test/Feed/Wait (30 – 30 min for Caninsulin/Vetsulin and an hour for N/NPH)/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle. NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT/Ask for help number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.

 

[Nimi S]

Hi @evedroid
I know nothing about Caninsulin. But based on your Monday condo, I think you were supposed to lower your 3.5U dose to 3.25U and hold it for some time.
You may want to revisit that condo to recheck any dosing advice you may have missed. (Since from your SS, it looks like your dose went from 3.5 to 3.0 and back to 3.5 again )

Quoting part of your Monday condo:

I’m sorry I didn’t mention the new dose he should be on now. It is 3.25 units as he dropped under 5 (90) on 3.5 dose.

The beginner's guide to Caninsulin/Vetsulin mentions the following regarding Changing the Dose:

Hold the starting dose for at least a week UNLESS

• your cat won’t eat or you suspect hypoglycemia
• 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 (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:

• 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
• HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.


Hope someone experienced comes along to offer dosing advice going forward

 

[.:. in.active .:.]

I'm pre-vet visit. There is no such thing as quarter-dosing with Caninsulin in the UK. Not officially, anyway. If they see I do 0.25 on a u40 insulin, I'm toast. So it's either 3iu or 3.5iu
Given his nadir was (just about) above 5 mmol/L today, I held it.
He always sleeps with me, and well... I don't sleep, so I can keep and eye on him.
Thank you though

 

[Bron and Sheba (GA)]

There is no such thing as quarter-dosing with Caninsulin in the UK. Not officially, anyway. If they see I do 0.25 on a u40 insulin, I'm toast. So it's either 3iu or 3.5iu

Eve, this is simply not true. We have had plenty of caregivers in the UK who increase and decrease in 1/4 unit increments
If you look at the caninsulin dosing method, it clearly says to go up or down in 0.25 unit increments.
Two days ago you asked for advice and I recommended you reduce the dose to 3.25 unit. When a cat earns reduction, you don’t increase the dose 24 hours later. If you increase the dose as you did, you will run into trouble again with low BGs.
We are very happy to help you but you need to read the dosing method and follow it, if you want to get your kitty into better BG numbers.
Nimi gave you excellent advice.

 

[.:. in.active .:.]

"My Way Or The Highway". As always.

ECID obviously only applies to old, experienced members' cats.

 

[.:. in.active .:.]

And let's not forget only getting replies to get corrected or when it's thought the poster is in the wrong.
Not when something is actually urgent or when the person has less trivial questions. Unless one kisses certain asses, of course.
Looking at own accords and admitting mistakes is also unheard of here by so called experienced members.

Let me deactivate, so everyone is happy.
My cat is happy, because he continues to live.
I'm happy because I don't get constantly ripped a new one.
And of course, the old members of the forum are happy too, because "they were right again, as always."



FYI:

You can go back to 4 units and see how he goes.

Had I listened to that, and have gone back to 4iu when the topic first came up, he would've gone hypo overnight, or worse...

You said..."The human insulin is 2.5 times stronger than the pet."

That this statement was incorrect.

This is just simple math. 100÷40=2.5 --> LOL

 

[Sienne and Gabby (GA)]

Where is your spreadsheet?