I need quick advice about dosing

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twinkiefreekitty

twinkiefreekitty

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Briefly, my life is completely upside down this week - I am going to explain why just so people don't think I'm being lazy by not researching how to get the dosage right for Winny. I have a disabled daughter who is having wall-to-wall meltdowns and I cannot fathom how to access appropriate care for her, I made 20 calls today so far. My dad died last month and I'm spending a lot of time skyping my mother to keep her company while she grieve. I had a 2 level fusion spine surgery a few weeks ago which has caused inflammation and severe pain (can't walk, sit, stand for more than 5 minutes) and have to wait 4 weeks for the "emergency" steroid shot. I cannot take painkillers because I have to be able to drive my daughter to the ER if she needs to become an inpatient

It's very stressful for everyone, including the cat. And unfortunately, our cat is not top priority this week. It's very important that Winny gets better, not just for his sake or because I love him dearly, but my teenage son thinks that not following the vet's orders is going to kill the cat and it'll be my fault. Vet said 2u once a day. I'm doing 1u twice a day as suggested by many of you here.

I don't have time to learn how to do the spreadsheet right now. I got up at 3 this morning so I could learn how to do the glucose testing. Could someone please tell me if I am on the right track.

I was giving Winny 1u at 12 hour intervals straight after he ate (1 can FF twice a day). We've been doing that for about a week and he was showing some signs of feeling better, but only for a few minutes at a time. For instance he started playing his favorite game albeit very weakly.

Yesterday and today his back legs seemed to get much worse to where his paws weren't just sliding on the floor but he was down on his hocks and only able to take five steps at a time. He cannot jump. He was also very hungry and I have been feeding him every 6 hours (1/2 can FF each time). Last night his pee was sticky again, as before we started insulin. I have had to carry him up and down the stairs and to his food bowl. I'm not supposed to bend or carry more than 10lbs.

This morning I did the glucose test and it was 330
I gave him slightly more than the usual 1u for his morning dose
This afternoon, 6 hours after the first shot, he was at 189

I don't have any other test numbers because my daughter's behavior has taken precedence over reading the meter instructions and watching the youtube demos. I've learned how to do it now. I am testing him before he feeds at both shot times plus at the six hour mark. Are those the right times to be testing?

Should I continue to give him slightly more than 1u? I don't know enough about this to know if I should give him more or less. I know he should be between 70 and 150. I'm worried mostly because of the sticky pee and the increased weakness in his back legs.

The environmental stress is now gone for a few days, the house is quiet, so I'm not sure if stress caused the deterioration or if I'm not giving the correct dose. I really don't want him suffering on top of everything else that's going on.
 
We understand. You have to take care of yourself first, or you will not be able to take care of your cat... or anyone else for that matter. However, I don't feel comfortable giving dosing advice without a lot of information to go by.... I'm sure you understand. The choice is ultimately yours, in the end... it is your cat, and your decision. Your testing times are good, but I personally would try to get one or two more tests in there, especially at the 4-6 hour mark. The more info we have, the better. :smile:
 
What kind of insulin are you using?

I'm glad the house has quieted down for a few days. We'll help you with your cat. I'm glad you are learning to test.
It seems you are doing a good job so far.
 
twinkiefreekitty said:
...I know he should be between 70 and 150...
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Not exactly - for the moment, you're looking for those numbers only at the lowest point of the cycle, until your life calms down enough you can put more attention on this.

Because you have so much on your plate, please keep the dose at a consistent 1 unit every 12 hours, whatever insulin you are using.
If you can get the time to test 5-7 hours after insulin, great - that will tell us a lot about how the insulin is working.

I couldn't find a mention of what insulin you are using in your previous posts. The kind of insulin makes a big difference in how the dose is adjusted. Lantus and Levemir doses are adjusted based on the nadir - the lowest point in the cycle.

If you have been giving the insulin for 5-7 days AND it is Lantus, Levemir, ProZinc, or PZI, posting some mid-cycle tests (yeah, in your copious spare time!), will let us give you some feedback about the dose.

Could you maybe get an experienced pet sitter or vet tech to stop by some days and test mid-day for you? Then you could focus more on some of your other responsibilities without worrying as much about Winny.
 
twinkiefreekitty said:
This morning I did the glucose test and it was 330
I gave him slightly more than the usual 1u for his morning dose
This afternoon, 6 hours after the first shot, he was at 189
Click to expand...
If you are not able to be sure that you can be around to watch him, then I think you should go back to the exact 1 unit twice a day until you have more data. Think of this as data gathering. I'd rather you err on the side of caution.
Really, I think you're doing good, with all that you have going on. Hugs.

Just be sure to always have plenty of test strips, and some High Carb food stashed away somewhere, if needed, and some Karo syrup, and the hypo instructions taped to the inside of your cupboard or pantry where they won't get lost in an emergency.
 
Sometimes cats will bounce to higher numbers when they have gone into a bg range that they are not used to.

I am not the best at explaining this; but the liver has stored glucose and other hormones in it, that it will spill out into the system, if it "thinks" the cat is getting too low (not necessarily too low, per se, but lower than what it is used to). This is what we call a bounce.

Keep up the good work.

For now, just write the times and how much insulin you gave, and maybe how much he ate during the day, and when you are able to, try to dabble with getting a spreadsheet up. The spreadsheet is what will help us to help you in adjusting the dose, to eventually get your cat into better numbers and better health. Hang in there :YMHUG:
 
This may or may not help explain the whole "bounce/liver/glucose" thing. It's something I posted in PZI a while back when I was trying to figure out how it all works....

Another thing that I have repeatedly read here is about "liver panic" and how when the BG goes to low, the liver will dump "glucagon" into the blood to raise the BG. Well,the liver does dump stuff, but not Glucagon. It turns out that glucagon is actually produced naturally by a part of the pancreas called " the islets of Langerhans" (which to me sounds like a wonderful destination for a cruise or vacation, doesn't it?).

Here's a good explanation of what takes place in the blood, pancreas, and afterwards the liver when BG rises or falls:
http://bloodsugardiabetic.com/diabetestreatment/insulin/how-the-body-regulates-blood-sugar/
Blood Sugar Levels Rise

If blood sugar levels increase (e.g. after a meal), the beta cells of the islets of Langerhans in the pancreas produce insulin. The insulin has an effect on various organs of the body, increasing cell permeability to glucose and increasing enzyme activity in the cells allowing the glucose to be taken up and stored.
The liver and muscle tissue converts glucose to glycogen and stores it. This helps reduce the levels of sugar in the blood. In addition, the breakdown of fats in fat cells is inhibited, so that glucose will be used preferentially for energy.

Blood Sugar Levels Fall

The alpha cells in the islets of Langerhans of the pancreas product glucagon. Glucagon is “antagonistic” to insulin, basically having the opposite effect on the organs of the body. Glucagon increases the conversion of stored glycogen into glucose in the liver and muscles thereby increasing blood sugar levels.
Glucagon also increases the uptake of amino acids and glycerol into the liver so that more glucose can be synthesized.


The importance of glycogen as stored energy

Since all of the cells in your body require a continuous supply of energy, it is important that your body stores excess “energy” eaten during meals so that it can be used when food is less plentiful. Excess glucose is converted to glycogen by the mechanisms we saw above.
Glycogen is stored in the liver and the muscles. When your body is active, energy requirements increase and stored glycogen can be converted to glucose to be used as energy. If stored glycogen levels get too low however, cortisol is secreted from the adrenal cortex, and this stimulates the conversion of proteins and fats into glucose so energy levels can be maintained.
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So what does the glucagon do?
Glucagon and Insulin
Glucagon increases the amount of glucose in the blood by accelerating the rate at which the liver converts stored glycogen into glucose and releases it into the blood. Insulin decreases the amount of glucose in the blood by transporting glucose from the blood and into the muscle cells. It also stimulates the conversion of glucose back into glycogen so that it can be stored.
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It makes the liver dump glycogen, coverted into glucose, into the blood so that it can show up in your next PS reading!
And what happens when there is too much insulin? It does exactly what we don't want it to do:
Other Effects
Insulin also has a few other important roles in the body. Insulin facilitates the storing of excess glucose in the form of glycogen in the liver. Elevated levels of insulin also cause the liver to make more fatty acids. Insulin inhibits the breakdown of fat in adipose tissue for energy. Insulin also allows cells in the body to take up more amino acids, so that they can make more proteins
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In balance, that's a good thing, and in a non-diabetic, it would do so in amounts that made sense in the body. But if insulin is excessive, and it cause the liver to store more glycogen, then when the BG goes too low, and the pancreas puts out glucagon, and it makes the liver dump the glucose from the glycogen, then the pancreas (and the insulin) is sort of working against itself, isn't it?

So, what does this all mean? It means Carl is trying to learn junk. Look, y'all, I don't have a sugarkitty on insulin at the moment. I'm here because I want you all to be able to say that too. Diabetes is just a freaking disease, and it doesn't need to kick our collective butts. No, some kitties will never "get there". But that doesn't mean they don't have a chance at it. What the hell is so special about Bob, or Kitten, or Scout, Cello, Harry, Curt, Stinkyboy, Sev's Kitty, or any other furry that has gone OTJ? Nothing. It just happened. Not by itself of course, don't get me wrong. The beans had something to do with it, this Forum had a tremendous bit to do with it, but it can happen to any of us or any of our kitties.
I just want to learn all I can about it, which is why I'm doing all this "research". It's why I'm still around.
Well, that, and to show off my pics when I get a good one!

Too tired to continue tonight.

Carl

P.S. I haven't read the whole thread, but a discussion on this topic took place on the old board too. It was on page two I think, of my google search. But so cool that FDMB discussions get hits on Google!
http://www.felinediabetes.com/phorum5/r ... 616,675616
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Carl
 
Thank you guys so much. I'll come back and read the bounce information later today.

I'm sorry it sounded like I was whining yesterday. It's just a lot of emergencies to try to resolve all at the same time.
 
You do what you can, when you can.

You have a lot on your plate - any outside help you can get will help with your stress!

This may give you a technique to help keep going and maybe reduce your stress a tiny bit:
 

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I am wondering- it seems like he only gets 6 oz of food each day and that is only at shot time. Is that correct?

Does he act starving all the time or try to steal your food? (Sorry, more worry).

My Sneakers eats around 9-12oz per day, and at the beginning she was getting 15-18oz. Until the insulin starts working and they start getting the needed nutrients out of it they will eat a lot. She also grazes through the day (1 oz at a time, every two hours) with her biggest meals (2-3oz each) at shot time. She sometimes eats less than that as well, depending on how active she was during the day (or not- lazy is her "thing").

Once I started upping her food she stopped wanting mine :lol: .
 
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