Help with dosing

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ceecee

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I need some guidance, suggestions, ideas, please. My kitty has used bcp pzi for years. His numbers are high today at +4 with his regular dose, maybe a tiny bit more. There are other things going on with him right now, drops for eye problems.
Thank you,
ceecee
 
It'a hard to guess what might be going on.

Sue can help you set up a ss, if you could fill in the last few weeks maybe the numbers will tell us something.

Welcome to our group!
 
Yes he does have eye infections that he is getting drops for. This is the 3rd day of drops and his numbers are have gotten high. I did not want to give him too much pzi at +8. I did give him .5 units more than usual and it went even higher at +4! I will post the numbers in my next post.
Thank you for your help,
ceecee
 
Before you get a spreadsheet up you can post your numbers like this.

AMPS - xxx AM Pre Shot
+1 - 1 hour after shot
+2 - 2 hours after shot
+3 -
+4 - bg xxx
+5 -
+6 - bg xxx
+7 -
+8 -
+9 - bg xxx
+10 -
+11 -
PMPS - xxx PM Pre shot

Since we are all in different time zones posting the numbers by how many hours since the shot will let us know where you are in the 12 hour cycle.
 
Ok, I am trying to figure how to post these simply. Until then, I have been giving 1 unit at +8 if the bg is over 150. It has been working well for quite some time (years) until past 2 days. I have been giving him eye drops for 3 days, maybe that is part of it? His numbers were in the 100's 3 days ago. 300's and 400's yesterday and today.
ceecee
 
You might post the name of the eye drops on Health and see if anyone has had experience with them. Some antibiotics raise bg levels. It certainly would make sense if they are the problem, with the time frame.

How old is the insulin?
 
Any type of infection in the body can rise BG. Medication can do the same.
One concern with being in the 400's is ketones. You might want to get some ketone test strips @ Walmart or the drug store & test.

Are you get any other readings? Maybe since the numbers are running a little high try to get some mid readings. To see how low the insulin is taking the BG. If its not lowering the BG then maybe raise the dose some?

Also, how old is the bottle & how low is the insulin in the bottle? If its getting old it won't work well.
 
Thanks Rob. I start my count after the shot. Been giving eye drops these days, hmmm. I will give this a go with what I have:

5/30/2013
6:30am +9.5 190 fed ff (always 1/2 can)
7:30am +10 300 gave 1 unit
12:00pm +4.5 128 fed ff
3:30pm +9 113
6:00pm +11.5 166 gave 1 unit fed ff
11:00pm fed ff

5/31/2013 (at the vet from 8am until 12)
12:00am +6 48
5:30am +11.5 121 fed ff
11:30am +17.5 266 gave 1 unit fed ff
5:00pm +5.5 449 fed ff
7:30pm +8 448 gave 1 unit
11:30pm +4 476 fed ff

6/1/2013
6:30am +11 385 gave 1.5 units fed ff
11:00am +4.5 405 fed ff
1:00pm +6.5 439
2:30pm +8 414 gave 1.5 units
4:30pm fed ff
6:30pm +4 584!
 
The last few cycles have been really odd, in terms of dosing and times. A couple of things - we really like to try to stay on a 12/12 schedule and not shoot early or late. It can really mess up the numbers. Also, we try not to feed them in the 2 hours before the shot, as food can raise the levels and we want a number that is not food influenced. He certainly has had some decent numbers on one unit. His numbers have been higher the last two cycles but you have been shooting early which can cause a lot of bouncing around.

I'd suggest you start clean. Give one unit when he is over 200 at shot time, at least 2 hours after food. (If he is under 200, wait 20 minutes without feeding and retest. You want to be sure the number is rising and that he is over 200. ) You've been doing a great job getting midcycle numbers so continue doing that whenever you can. Give the next shot 12 hours after the first - one unit if he is over 200 and 2 hours after eating, or before he eats. Then let's see what his cycle looks like. I think that will give us a much clearer picture of how the insulin/dose is working for him.

Sound doable?
 
Thanks Sue and Jenn,
There are 6 different kinds of drops, round the clock with 4 of them. The insulin is fresh. I asked the eye vet about these effecting bg's, I thought she said they wouldn't. It must be what is happening. And the stress....even though he is so great with it all! Got to lower these. He is not getting many kitty cat naps in either.
Ceecee
 
Thanks for looking Sue. I will look over your post and try it. I have been doing it that way for while, it worked until this eye thing. And this past week HAS been especially odd. He goes in Monday for the surgery so I hope to at least see it lower tomorrow.
Ceecee
 
Hoping you see some better BG numbers too.

Consistency is important. When Baxter gets off schedule his numbers can be nuts & it takes a couple of cycles before he is back to what we know.

Also, rest is important for diabetic cats, just like it is in humans.
Just a idea....Research the board for pre & post surgery or make a post in the health board asking. From what I can remember surgery can make numbers crazy & ask about giving insulin & what to expect with BG #'s.

Keep us updated.
 
Thank you all. His amps is 60. Jenn you are right about rest it is so important. He got a bunch of restful hours, left alone. I will read up on the pre and post surgery posts. Ceecee
 
Assume no insulin this am? Has it been a full twelve hours since the last shot? If so, a dose reduction is in order for the next shot. That low of a number in the am means either a very long cycle or very low numbers overnight.

I like the idea of seeking advice on the Health for presurgery prep. I'd be nervous about giving insulin before the surgery if he is dropping that low on one unit.
 
Good morning Sue,

No insulin this am. Last was 12:30 am 1 unit.
6:30am +6 60 fed ff
8:30am +8 98
9:30am +9 149

Thank you so much,
Ceecee
 
I am confused. So your 60 is not am amps? A morning prehot number would be 12 hours after your midnight shot or noon today. So your amps is coming up at noon? He might be up to 200 by then. If not, remember to wait without feeding 20 minutes and retest.

Sorry, I missed that midnight was your shot. Used to seeing amps numbers every morning when yours was really a midcycle.

Amps is the morning preshot number 12 hours after the last shot
PMPS is the evening preshot number 12 hours after the amps
Nadir is the midcycle number. 5-7 hours after the shot
 
So you have a full cycle - noon to midnight, before surgery? Let's see where he is at noon. I think the general advice is to cut the usual dose in half before surgery so the cycle from midnight would be the one you would be cautious about? What advice did you get for presurgery insulin and food?
 
Hi Sue,
So very nice of you to do this. I will look at it. It is noon now and I will get his bg. It was 12:30am should I wait the extra 30 min? Instructions say no food after 8pm, no water after midnight. Diabetics, the vet said for him do not give ANY insulin, bring syringes and insulin and enough food for several meals.
Ceecee
 
So he would have 12 hours with this next dose until you have to stop the food? I will watch for your number. - 30 minutes early is okay. I think I would be tempted to dose, but maybe a reduced amount. My thinking is that it would be at least 6 hours without insulin and 18 hours since his last dose before surgery if you gave him a shot now? They can get him insulin and food after surgery.
 
And I put this on the health board also:
no food after 8pm. His regular vet has been having me give subq fluids with b vitamins 60ml. He got some on Friday. Not sure if I should give today, not confident in ANY of what that vet told me now.
 
The 108 looks good...it's within normal feline BG 80-120. I wouldn't give any insulin.
If it were me I would put off feeding & insulin as long as possible. I would chase the BG...meaning testing every hour & catching the BG rise.
If you can't put off feeding... test now, feed. Then test again in 30-45 minutes...trying to catch the rise before the food kicks into the BG. If you can't catch the rise & the food kicks in...which is about 1 hr or more then give a reduced dose...you don't want to dose on food induced BG.
 
Jenn,
Read this too late. Fed at 12:30. His bg @ 1:30 is 169, 1 hour after eating. Thanks for being so patient with me.
Ceecee
 
The 169 some is probably from the food. Which is still a good number. cat_pet_icon

Keep us updated.
I really hope the surgery goes well tomorrow. :YMHUG:
 
It is Jenn. How often should I test from here? I am so glad you all are here, today especially. Love that kitty on you reply!
Ceecee
 
I have also been wondering what to do about feeding today. He is smaller than his usual right now. I usually feed him 4 times a day, 1/2 can ff. He would normally eat again today at 5-6ish, then at bedtime. No food after 8pm tonight. Is it better that he not get 4 meals today?
Ceecee
 
Sorry I missed you. I would think smaller meals until the 8pm time would be good. Be nice if he didn't bug you about food and maybe he'd be full by then.
 
Well...about testing for the rest if the day...you don't have to worry about any hypo situations which is positive because there isn't any insulin in the system.

What did the vet or the health board say about giving insulin? How many hours before surgery? I know for humans it's about the same no food or insulin after 8pm for am surgery the next day.

If that is the case then.....I would have a feed time about 6:00-7:00 really trying to hit the 7 & give insulin @ that time as well. That way tomorrow after his surgery the vet would give insulin & it won't be to much after the 12hr window. Instead of the 24 hr without if you were to stay on the 12:00 time schedule. His shot times are going to be Willy Wonka...but we can always help you get back on the schedule that works best for you.

I wouldn't starve him. Just feed as usual...keep in mind give the food sometime about 2 hrs. to wear off the BG. Say you are able to push the food back til 7 no food after say 4. Then test, feed & insulin ( if needed or okay'd).

I might try to get a test in around what would be a +6 just to see a rise or decline. It would also, help @ the 7pm feeding & test. Also if you need to give insulin at that time to.

Hope all of this makes since if not just tell me & I can read word all of it.
 
Just got another round of eye drops in him then tested. 2:30pm 196bg So you think feed him that last 1/2 can ff a little before 8pm? Not sure how often to test right now, it is +14 since last shot. Thank you for being here, friends! Today is.................................................!
breathing,
Ceecee
 
BTW, he is getting really long cycles with nice numbers. If and when you shoot again, I'd lower the dose and ask the vet to give the lower amount, if needed.
 
If you can put off feeding him til 8 I would & giving insulin. I am with Sue about lowering the dose.
The 196 is partially food most likely. As long as you have test results then its really helpful for us to help you. It will also help your vet tomorrow...so take those numbers with you.
Don't stress yourself out about testing you are doing a great job :RAHCAT & his numbers are pretty good.
 
Awww, cheer kitty!
So, no food until almost 8 and the whole ff can? Or 1/2 in a bit and 1/2 at 8 or just 1/2 at 8? Thank you for holding my hand today! :dizcat
Ceecee
 
If you send me your email by private message, I can send you a copy of the spreadsheet so your vet will have your most current numbers.
 
Jenn, just reading through your previous post about insulin before surgery. Are you saying to maybe wait from now test and feed a whole can of ff at 7? The vet wrote do not give him any insulin the morning of surgery. Still not sure about giving him the subq fluids w/b vitamins tonight. I want him as strong as possible.
Ceecee
 
Got a bg of 335 @ 4:15pm. That is a little more than +15. Now, how much insulin? .5u? Then ff, all of the can? or 1/2 now, 1/2 at 8pm. Then still question the 60ml subq. It is sodium chloride w/b's.
Ceecee
 
Yes, I'd do .5 and the food is up to him - if he will eat a few smaller meals, that is probably best. If you can get a test in at +3 and +6, that would be wonderful. If not, he should be fine.

I would be very firm with the vet tomorrow and tell him you have been getting low preshots - well below 200 - and you want him to give .5 regardless of his number, as you know any higher number will be partly due to the stress of being there and post surgery.
 
Sue, I gave him .5 and fed. I will see if he wants another 1/2 just before 8pm. I will tell anyone who will listen about the reduced insulin and write it down with the vial. They said they check the bg 3 times while they are there. It would be great if they would call. But who knows what happens past those doors. Many of the pets humans in the waiting room said they had diabetic pets.
Ceecee
 
Positive thoughts for surgery in the morning. :YMHUG:

Make a post tomorrow if you can to let us know how everything went.

Have a good day. cat_pet_icon
 
We are HOME!!!! Surgery went well and the vet said after the anesthesia wore off kitty popped up and looked around. YEA! Let the healing begin! She gave me his bg #'s and they looked good. He ate there and they did not give any insulin. He has eaten since we have been home, bgs below 100. Thank you again for the support this weekend,
Ceecee
 
I didn't see anyone ask but may have missed it.

Do the eyedrops have steroids in them?
 
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