Indy Dose Increase - Go back to 1 unit?

MissLiner

MissLiner

Member
Hi all,

I am so happy I found this board! A few years ago my vet told me Indy had diabetes, did a 1-day curve, told me to give him 1 unit once a day, and sent me on my way. My bad for not researching this on my own! Over the past year it became clear that he was not controlled at all. It took me a while to be able to bring him in (I won't bore you with the details, but no $$ and other quite serious life-happenings). When I finally could, we saw a different vet in the practice and she was like "well didn't he tell you x, y, and z?" (he being the other vet, and xyz being everything important you need to know with a diabetic cat). Well no, he didn't.

So I'm doing my best to make up for this horrible lapse in cat parenting. After starting home monitoring, we added a second dose almost immediately. I monitored for about a week, though I missed a couple of days as I was travelling and my husband hasn't learned how yet. We had a couple of blues, but nothing to write home about (edit: or are those blues exactly right and he was at the right dose, I was just expecting too much?).

Just started with 1.5 today on advice of the vet, but now I'm wishing I asked you guys first. His numbers have barely budged all day! I know patience is needed, and I'm not rushing to make any changes, but did I do the right thing or is this too big of a raise?

Thanks,
Caroline

PS I know I need to do some mid-cycle night tests, working on it!
 
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Update: his numbers finally started coming down at the end of the cycle! Now I really don't know what to do about the second dose, please help!
 
Hello and welcome to FDMB.

Normally we suggest dose adjustments in increments of 0.25u at a time however a half unit increase is not overtly aggressive. As long as BG doesn't drop any more by PMPS and you can monitor a bit tonight (get a test at +2 or +3 and before bed) then you should be fine to give the 1.5u dose. If BG at +2 or +3 is lower than PMPS, then a little more testing might be needed as that often suggests it could be an active cycle. Our kitties have a habit of going lower at night than they do during the day so those night time tests are really helpful to determine dosing and to keep kitty safe.
 
Thank you so much! I've been reading up like crazy, but it will take a while to get a feel for all of this. I appreciate you taking the time more than I can say.
 
With the lowest point in the cycle being at the end of it (+11), I tend to think you may end up having to go to 1.25 soon. Do you have syringes with 1/2 unit markings?
 
FurBabiesMama said:
With the lowest point in the cycle being at the end of it (+11), I tend to think you may end up having to go to 1.25 soon. Do you have syringes with 1/2 unit markings?
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I don’t but was just looking at ordering some - or even trying the U-100 option. I’m really uncomfortable just eyeballing it, especially as I won’t be the only one injecting him.
 
MrWorfMen's Mom said:
Hello and welcome to FDMB.

Normally we suggest dose adjustments in increments of 0.25u at a time however a half unit increase is not overtly aggressive. As long as BG doesn't drop any more by PMPS and you can monitor a bit tonight (get a test at +2 or +3 and before bed) then you should be fine to give the 1.5u dose. If BG at +2 or +3 is lower than PMPS, then a little more testing might be needed as that often suggests it could be an active cycle. Our kitties have a habit of going lower at night than they do during the day so those night time tests are really helpful to determine dosing and to keep kitty safe.
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Thank you so much! I am so glad I kept with the 1.5 dose last night, his BGs are much more stable now than they were (short time, I know, but still encouraging!). I can also finally see a change in his behavior, not drinking as much water, not as hungry, out and about more. My poor man, so happy to see him feeling better!!!!

PS I'm not sure any spreadsheet has ever brought as much joy as this one, I just want to stare at it all day.
 
Hello again - Indy was at 208 PMPS, I stalled for 20 mins and got 214, then 20 mins it was 198, 20 mins more and now 224. Deciding whether to skip his PM shot or give him a low dose? And wondering if I should lower to 1.25 tomorrow, or do I need to stay the course for a few more cycles first, and just skip shots if he stays low? TIA
 
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Sorry just seeing this now. I see you gave 0.5u last night and Indy's BG dropped to 68 which is the lowest you want BG to go with your pet meter. Any time BG drops below 90, Indy earns a dose reduction of 0.25u.
I would immediately reduce the dose to 1.25u but if you don't feel comfortable eyeballing that dose, then reduce to 1.0u until the syringes with 1/2 unit markings arrive.
 
MrWorfMen's Mom said:
Sorry just seeing this now. I see you gave 0.5u last night and Indy's BG dropped to 68 which is the lowest you want BG to go with your pet meter. Any time BG drops below 90, Indy earns a dose reduction of 0.25u.
I would immediately reduce the dose to 1.25u but if you don't feel comfortable eyeballing that dose, then reduce to 1.0u until the syringes with 1/2 unit markings arrive.
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Thanks MWMM! Yeah, I was worried when he went so low so early, and tested him like crazy, gave him some high-carb treats. He’s high today, but I see why you guys say better high for a day than low for a minute! Scary.
Gave him a little over 1 unit this morning, on the conservative side of 1.25. The new syringes should be here soon.
 
Indy had another borderline PS this morning - gave him a token dose because I didn’t have time to stall for a higher reading. I’m wondering if I should just go back to 1 unit for now, and I can raise by .2 increments when I get the U100s. Do you guys think that’s the right action?

Also, am I doing the right thing just editing the title slightly and keeping to the same thread for all of this?
 
Your pre-shot this AM wasn't that low that you needed to reduce quite so drastically ;)but you have to do what you are comfortable with. Next time pre-shot is in that vicinity, perhaps try a reduction of 10 or 20% or in this case down to 1u instead of dropping quite so low. It's amazing what a small change in dose can do.
Having the U100 syringes and being able to finesse doses in smaller increments will certainly give you more control.

It's entirely up to you if you want to start a new thread each day or not. While we don't want the threads getting too long (once you get to page 2 it's getting long), this forum is not so formal that we have rules about how you post. If you do decide to start a new thread daily or every few days it's a good idea to provide a link to your previous thread to maintain continuity for anyone helping.
 
Thanks for the feedback! I figured I was over correcting this morning, but I’m still spooked from when he dropped so much after a .5 dose, when his PMPS was only 25 points below what it was this morning. I’ll get there. It’s scary to think I was giving him insulin all this time without monitoring at all. I guess it was well below what he needed, so hypoglycemia wasn’t really the danger at hand, but still!
 
Once you start testing you'll never want to give insulin without testing again. Yes folks do it all the time but I'm sure a lot of cats aren't feeling well because of it or worse because of going too low and bouncing and repeating the pattern. Even a small dose of insulin could cause a hypo event. Testing is really the only way to keep kitty safe and healthy.
 
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