Insulin SID dosage??

[tigertail]

Hi there!

Looking for some advice/support and I was recommended this website. Some background info in addition to the profile in my signature...

Recently, I switched my cat to canned food (Nutro). I took my cats off of dry food and kept them on canned C/D before gradually switching to a low-carb food to try them on. I was initially told by my vet to give insulin twice daily, but to not give the insulin if my cat's blood glucose is below 12mmol/L.

The past couple of days, his morning blood glucose has been high (20-19mmol/L) and in the evening it gets low (4-6.4mmol/L). So basically he has been getting 2 units once daily (in the morning). My vet doesn't seem to have a problem with this...

I have been told that insulin works over 12 hours so it would make sense to keep the dosage twice daily and just lower the number of units. Not really sure what to do! Thanks in advance.

 

[BJM]

No insulin works 24 hours. It would be better to give 1 unit every 12 hours rather than having the glucose swing high half of the day, risking organ damage from the elevated glucose, diabetic ketoacidosis from breaking down fat because glucose can't be used without enough insulin, or hepatic lipidosis from fat breakdown overloading the liver.
I'd switch to doing that. Also, dose adjustments are made based on how low the glucose goes. It should remain above 50 mg/dL on a human glucometer and above 68 mg/dL on a pet meter when following a Tight Regulation protocol and slightly higher (90 mg/dL) for other guidelines.

 

[tigertail]

No insulin works 24 hours. It would be better to give 1 unit every 12 hours rather than having the glucose swing high half of the day, risking organ damage from the elevated glucose, diabetic ketoacidosis from breaking down fat because glucose can't be used without enough insulin, or hepatic lipidosis from fat breakdown overloading the liver.
I'd switch to doing that. Also, dose adjustments are made based on how low the glucose goes. It should remain above 50 mg/dL on a human glucometer and above 68 mg/dL on a pet meter when following a Tight Regulation protocol and slightly higher (90 mg/dL) for other guidelines.

Right. Makes sense. He's already lost a lot of weight so I'm really trying to avoid that now. I'll give the 1 unit twice daily a try and monitor his BG throughout the day tomorrow to see how it goes. Thank you for your reply!

 

[Squalliesmom]

Hi, welcome to FDMB!

I'd like to invite you to use our spreadsheet to track Lilo's BG numbers, dosages, and insulin reaction patterns. It's nowhere near as difficult as it may sound, lol, and is one of the most valuable tools you will have for fighting this disease! It also helps us to answer your questions and give you assistance, when we can look at this information at a glance, all in one place. Just follow this link:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you're not very tech-oriented (like me!) there are lots of people here who can help you get your spreadsheet set up, just sing out.

Let us know how Lilo does with the split dose! You are right, it doesn't make sense to only give it once a day, it really does need to be administered twice daily, at 12-hour intervals.

 

[tigertail]

Thank you, Squalliesmom!

So this morning, his blood glucose is at 8.4mmol/L (151.2 mg/dl) after eating about 15 minutes ago... This is after 24 hours of no insulin. Could this mean that he no longer needs insulin or do I still need to work out a new dosage?

Once I get this sorted, I'll work on a spreadsheet!

 

[BJM]

Not quite. You've been dosing 2 units every 24 hours. Typically, the dose is gradually reduced as testing shows it is approprate.

When your pre-shot test is < 200, we suggest you wait/stall 30 minutes without feeding and re-test. If rising or above 200 mg/dL it is often safe to shoot.

Now you're going to switch to either 0.5 or 1 unit every 12 hours. Based on your mid-cycle tests around +5 hours post-shot, you'll evaluate if the dose needs adjustment.

In your other post, you indicated you are using Lantus. We have 2 sets of guidelines for using Lantus: Tight Regulation and Start Low, Go Slow. These are described at the top of the Lantus forum in sticky posts along with other useful info on Lantus.