How low is too low to give a dose?

savnbinx

savnbinx

New Member
Hi y'all. First time posting (I originally posted in the Lantus forum but I think I'm supposed to post it here). Binx was diagnosed in December and we've been mostly dealing with high glucose numbers this entire time. We started out on 1 unit of Lantus twice a day, and after several curves we are now up to 3 units. His numbers were steadily staying in the 300s until we got up to 3 units.

Now Binx's numbers are bouncing around a lot. Usually in the 200s, but often in the 300s still and sometimes in the 100s. For example last night it was 327 and this morning it is 146. Big fluctuations. My vet has been so horrible about advice that I've actually recently switched to a new one. But I'm hoping to find some advice here too.

My question is what's too low to give him his dose? I've skipped it a couple of times in the past month when it got down to 98 and 104. But is 146 too low? My old vet said that his target range is 150-250. So I'm hesitant giving his shot with anything below that, especially since 3 units is a big dose. But I also don't want these skipped doses to be messing him up either.

I plan on doing a new blood curve next weekend to send to the new vet and see if it's time to lower his dose.

Any advice would be appreciated but please be gentle with me! I've been afraid to post on here and be bombarded with messages saying I'm doing everything wrong. Nothing against this website in particular, just that the Internet is so mean these days that my social anxiety is at an all time high! Thanks in advance.
 
Welcome to FDMB! :-)

Sorry you've had to deal with a bad vet - many of us have been there and know how upsetting that can be! We can help you with dosing.

What food does Binx eat? Is he on a low carb diet? Do you use a human or pet meter?

We are very data dependent here. We have a spreadsheet we use to track test data which helps us understand how a cat is doing on a dose and to give dosing advice accordingly. Here's the sticky on setting up a spreadsheet, but I can set one up for you in a minute, so let me know if you need help with one.
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

In addition to the spreadsheet, it would be a big help to us if you can set-up your signature? It's basically a summary of the information we need about your cat to give you advice. The spreadsheet and signature are the things we look at when asked for advice. It saves us asking you the same questions again and again especially when the question is time critical like stalling or low numbers. It also saves you the effort of giving us the information every time you post!

Here's how you can set-up your Signature:
  • In the Menu, under your user name, click on Signature.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • DKA or other recent health issue (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
  • There is a limit of two lines. You may separate info with commas, dashes, | etc.
  • Be sure to click the 'Save Changes' button at the bottom.

It's normal for a newly diagnosed cat's numbers to be all over the place. We call it bouncing as well!
"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)."

We follow 2 dosing methods here - Tight Regulation (TR) and Start Low Go Slow (SLGS). With TR, you can shoot any number over 50 (with a human meter) and with SLGS, any number over 90. Lantus is very good at giving flatter cycles when you shoot low.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

 
savnbinx said:
Hi y'all. First time posting (I originally posted in the Lantus forum but I think I'm supposed to post it here). Binx was diagnosed in December and we've been mostly dealing with high glucose numbers this entire time. We started out on 1 unit of Lantus twice a day, and after several curves we are now up to 3 units. His numbers were steadily staying in the 300s until we got up to 3 units.

Now Binx's numbers are bouncing around a lot. Usually in the 200s, but often in the 300s still and sometimes in the 100s. For example last night it was 327 and this morning it is 146. Big fluctuations. My vet has been so horrible about advice that I've actually recently switched to a new one. But I'm hoping to find some advice here too.

My question is what's too low to give him his dose? I've skipped it a couple of times in the past month when it got down to 98 and 104. But is 146 too low? My old vet said that his target range is 150-250. So I'm hesitant giving his shot with anything below that, especially since 3 units is a big dose. But I also don't want these skipped doses to be messing him up either.

I plan on doing a new blood curve next weekend to send to the new vet and see if it's time to lower his dose.

Any advice would be appreciated but please be gentle with me! I've been afraid to post on here and be bombarded with messages saying I'm doing everything wrong. Nothing against this website in particular, just that the Internet is so mean these days that my social anxiety is at an all time high! Thanks in advance.
Click to expand...
@Sienne and Gabby (GA)
@Diane Tyler's Mom GA
@Bron and Sheba (GA)
 
We consider normal blood glucose range as 50 - 120 and that is our target range. We look for a cat to be tightly regulated so the diabetes doesn't have other consequences for your cat's health. For a caregiver who's new to managing their cat's diabetes, we suggest that you post and ask for input if your pre-shot test numbers are in the 150 - 200 range. We can help you puzzle through what the best option is. (A lot can depend on which insulin you're using and/or the dosing method, as well.) Most vets are cautious about when to refrain from giving a shot because most of their clients do not home test or they are very concerned that your cat will have a hypoglycemic event and blame the vet. The other issue is that vets are not in the office 24/7. Our membership is worldwide so there's usually someone who's around. I'm in the US, as is Diane and Booma (Bandit's Mom) is on the other side of the globe as is Bron and Sheba.
 
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