Help with dosing!

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Mitzelplik's Mom

Mitzelplik's Mom

Member Since 2015
Good morning and HELP!
After a missed dose 3 nights ago and very high numbers for 2 days, I spoke w/ the vet about raising Mitz's dose from 2.5 units to 3 (ProZinc) but I just checked her BG and got 144 (AT) so now I have no idea what to give her and I need to leave to leave for work. I don't really want to skip it altogether because her BG skyrocketed after the last missed dose. I have a message in to the vet too.
Thanks!
Joan
 
from the prozinc protocol
Low Preshot Numbers
The general recommendation for new diabetics is not to shoot a preshot under 200, but to wait 20 minutes (without feeding as food raises blood glucose levels) and retest. If the number is rising and above 200, then a shot can be given with perhaps a little less insulin given.
 
I don't know what dose to recommend if you are going to be out all day. Can you retest now? have you feed?
 
Hi Joan,

I'm guessing you may have already left for work by now,
but if not you may wish to read this info extract from the general FAQ's here:

"Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?

A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines. Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise. In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine..."

"...Keep in mind that these are general guidelines, and they should be personalized to your own cat's reactions to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then your experience should be your guide."
http://binkyspage.tripod.com/faq.html#glucose

I have to say that if it were my kitty, and I wasn't going to be able to test, and I had no data about how he might respond at that preshot, I would skip the shot.

Edited to add: The blood glucose numbers in the FAQ extract refer to tests done with human glucometers, not the AT.
.
 
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Thanks everyone for the input. I finally heard back from the vet and she recommended the normal 2.5 units, which I was not at all comfortable with. Mitz has done OK with that in the past but it was at a time when her BG was under better control and she's been such a roller coaster lately. I ended up giving her 1.5 after she'd eaten a little. I didn't think to re-test. My husband will be home til 11:00 but he can't check her blood sugar. Mitz is a nibbler and free-feeds on wet food thru the day. I also left her some dry Stella & Chewy's which she loves. I'm feeling pretty confident that she will be fine but I may try to leave work early anyway.
 
Chances are that she will be just fine, Joan. But I understand that it's always a worry when we have to give a shot and then go out, especially if we're shooting lower preshots.

I did look at your spreadsheet and at the high numbers that followed the missed shot. And I do wonder if there was some factor in addition to the missed shot that caused the high numbers. It wasn't just that the numbers rose (which you'd expect in the circumstances) but they also stayed high and 'flat' and unresponsive to insulin for, what looks like, about three cycles. And then, with the next shot, Mitz's body suddenly responded really well because you then got a lower than expected AMPS the next morning.
(There are a number of things that cause spikes like that in my own cat, including furballs and constipation; where his numbers seem to get 'stuck' and then suddenly get better again as the problems clears.)
Just thinking out loud...

Do update us about how Mitz is when you get home.

Reassuring hug to you,

Eliz
 
Hi Eliz,
Yes, I wondered that too. The only thing I can think of is that she was very vocal right after using her box a couple of times on Tuesday so I increased her dose of D-Mannose yesterday in hopes of warding off another UTI. Maybe that was just coincidence though because when the last UTI hit, her BG numbers were actually looking good. Another possible factor is that we are near the end of the current ProZinc vial. But we haven't opened the new one yet so last night's shot wasn't new insulin. I'm very confused by it all!

I will definitely post an update when I get home.
Thanks again - for the thoughts and the hug :)
 
Just got home and checked Mitz's BG: 466. I'm thinking I should go ahead and try 3 units. She's due for her next dose in 2 hours.
 
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