Is Duke dropping too fast... Con't

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teetee (UK) said:
He's down to 6.1 mmol/L (110 mg/dl). Should i give him a little high carb food?
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@JanetNJ - If Tee's in a position to monitor intensively, would it be better in future when around this BG level/point in the cycle level to try low or medium carb to steady numbers/keep them in the safe range? (Trying to learn a little about situations like this for kitties on Prozinc.)


Mogs
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JanetNJ said:
Yeah

I think we hit the higher carb stuff too quickly.
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That's me panicking Janet. My thinking was that Duke was at 6.1 mmol/L (110 mg/dl) at +5 and his nadir is about +8 i reckon. He had dropped 12.7 mmol/L (228 mg/dl) at +4 and then another 3.7 mmol/L (66 mg/dl) in 1 hour from +4 to +5, still roughly three hours to his nadir so i was thinking he's going to drop lots more as he approaches his nadir.
 
JanetNJ said:
Another option would be to try a "fat" 1.... Just over the one line but not quite 1.25.
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For his PMPS injection tonight i will give him a fat 1 unit and in the morning i will give him a another fat 1 unit and see how he goes.
What do you think?
 
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teetee (UK) said:
Ok @JanetNJ will do, i gave him a fat 1 unit (about 1.125) this morning.
I really appreciate your help.
Thank you.
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Ok. I'm pretty sure you're probably going to have to go back to 1.25 in a couple days though and just keep a close eye. Lol. He never really did come down too low. That little bit extra just reallymade him drop fast but I wonder if after a day or two on that dose if it would smooth out a little.
 
Yea i think your definitely right Janet. Looking at his BG results it does seem like he struggles with any change in his dose, regardless of the amount.
Do you think it would be a good idea to leave him on this dose until Monday, by doing that it will let him get used to this new 1.125 and then increase to 1.25.
 
teetee (UK) said:
Yea i think your definitely right Janet. Looking at his BG results it does seem like he struggles with any change in his dose, regardless of the amount.
Do you think it would be a good idea to leave him on this dose until Monday, by doing that it will let him get used to this new 1.125 and then increase to 1.25.
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Maybe leave him on this dose through tomorrow and then we can up it again sunday if he needs it and you will be home to monitor. It looks like he may run higher at night.
 
Sounds good Janet, hopefully this time i won't panic when he drops :). I was expecting a bounce today but his numbers have been pretty stable and fingers crossed the same tomorrow.
 
hi, I'm Angel's mum Cassandra, also from uk. We're back after a long silence due to a few upsetting life events, as Angel now has ckd. Not sure if it would help if you looked at Angel's last spreadsheet when he had his 'blip', the link is in my profile. He'd been diagnosed in 2014 on insulin for a few months and then in remission. until that month in 2016. Since then he's been in remission partly I'm sure due to an ultra low carb diet. He was on prozinc and I was confident enough to adjust the doses slightly according to his blood sugar. Fingers crossed for Duke. xx
ps I was feeding Angel Felix as good as it looks and Gourmet Gold chicken pate, but now he's on a renal diet and I just hope he doesn't become diabetic again
 
Hi Cassandra thanks for that, sorry to hear about Angel and the ckd. We had a cat with ckd a few years ago that we tried with a renal diet, Hill's kd but she refused to eat it point blank so it went back to the vets for a refund.
How did you achieve such fine dosing such as 1.10, 1.20, 0.80, 0.85 etc?
Food wise we feed duke a max of 3% carbs in his food so the Felix agail and the Gourmet are too high in carbs for him.
Tee.
 
teetee (UK) said:
Hi Cassandra thanks for that, sorry to hear about Angel and the ckd. We had a cat with ckd a few years ago that we tried with a renal diet, Hill's kd but she refused to eat it point blank so it went back to the vets for a refund.
How did you achieve such fine dosing such as 1.10, 1.20, 0.80, 0.85 etc?
Food wise we feed duke a max of 3% carbs in his food so the Felix agail and the Gourmet are too high in carbs for him.
Tee.
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I'm going to guess she's using u-100 needles with a conversion chart.
 
JanetNJ said:
Oh! Interesting numbers so far today.
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Yes very interesting Janet. The only thing i can think that's happening is that he had a smaller calorie breakfast this morning. He had about 25% less calories this morning compared to yesterday, also on the 7th he had about the same 25% less, both times his numbers dropped fast, whereas more calories yesterday kept his numbers up and not dropping as fast. The amount of food is roughly the same but a lot less calories. Could this be the reason because his dose is exactly the same. Also he started with lower numbers this morning than yesterday morning.
 
teetee (UK) said:
Yes very interesting Janet. The only thing i can think that's happening is that he had a smaller calorie breakfast this morning. He had about 25% less calories this morning compared to yesterday, also on the 7th he had about the same 25% less, both times his numbers dropped fast, whereas more calories yesterday kept his numbers up and not dropping as fast. The amount of food is roughly the same but a lot less calories. Could this be the reason because his dose is exactly the same. Also he started with lower numbers this morning than yesterday morning.
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It's more the carbs then the calories. I'm glad to see these numbers though
 
Oh darn, that huge fast 78% early drop is setting him up for a high, hard bounce. Please keep it down Duke!

Following Prozinc SLGS dosing method that 79 (4.4) on an AlphaTrak - Duke earned a dose reduction to 0.75u.
 
Oh no!!! please no bounce.
I was going to ask that question about his dose for tonight, what should i do, keep it the same, or drop it.
 
Dosing and dose changes are based on the nadirs or lows Duke gets on a particular dose. Take the reduction, regardless if Duke bounces from todays low or not. Hold the dose and wait for the bounce to clear. That was a strong reaction to the insulin early in the cycle today. We want to keep Duke safe.
 
@Shelley & Jess did you find any answers for this https://felinediabetes.com/FDMB/threads/trying-to-figure-out-dosing-for-gizmo.239917/#post-2701127 because i'm sure that i went into his muscle this morning, purely because the needle seemed to have more resistance going in. Could that affect the fast drop in numbers?
Also this.
https://felinediabetes.com/FDMB/threads/trying-to-figure-out-dosing-for-gizmo.239917/#post-2701967
https://felinediabetes.com/FDMB/thr...4-5-67-5-60-5-5-64-7-105.238419/#post-2677515
 
Hi Teetee, yes I had a pretty accurate needle and I just got as close to those measurements as possible. Duke looks like a sweetie, I have 2 black and white 6 year olds brother and sister who both adore Angel. Fingers crossed here for no bounce xx
 
teetee (UK) said:
@Shelley & Jess did you find any answers for this https://felinediabetes.com/FDMB/threads/trying-to-figure-out-dosing-for-gizmo.239917/#post-2701127 because i'm sure that i went into his muscle this morning, purely because the needle seemed to have more resistance going in. Could that affect the fast drop in numbers?
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That thread was more a question of resistance shooting in fat. Doesn't look like we got a definitive answer in Gizmos thread and the article Deb posted made my brain glaze over - that's as far as I got with any further research. I think Debs reply in that thread is the take away though, when shooting in the scruff, an area generally thicker and more fatty for most cats.
Deb & Wink said:
There has been some anecdotal reports from various members, that shooting into the scruff can slow absorption of the insulin. But it's thought that does not really impact the overall BG levels much. But it can delay the onset.
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Whether you get the low number early in the cycle or later in the cycle, it's still a low number.

From what I understand, injecting in the muscle hurts. Did Duke react to the shot, flinch, give you a dirty look? Not sure who to tag to try and answer this one!
 
SweetAngel said:
Hi Teetee, yes I had a pretty accurate needle and I just got as close to those measurements as possible. Duke looks like a sweetie, I have 2 black and white 6 year olds brother and sister who both adore Angel. Fingers crossed here for no bounce xx
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What sort of needle/syringe. @JanetNJ suggested you used a U-100 syringe and converted.
Thanks, yes he's a nice and so placid cat, big softy he is.
Tee.
 
Shelley & Jess said:
That thread was more a question of resistance shooting in fat. Doesn't look like we got a definitive answer in Gizmos thread and the article Deb posted made my brain glaze over - that's as far as I got with any further research. I think Debs reply in that thread is the take away though, when shooting in the scruff, an area generally thicker and more fatty for most cats.


Whether you get the low number early in the cycle or later in the cycle, it's still a low number.

From what I understand, injecting in the muscle hurts. Did Duke react to the shot, flinch, give you a dirty look? Not sure who to tag to try and answer this one!
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No reaction at all Shelley, the injections never bother him at all, but as you say a low number is a low number. Luckily he didn't go too low and held quite good today. Just hope there is no big bounce.
 
Nice numbers today! the fat 1 brought him down nicely. Did you have to steer at all to get the number up from the green? If not I would keep the dose the same. If you did maybe drop it to a regular 1 u.
 
JanetNJ said:
Nice numbers today! the fat 1 brought him down nicely. Did you have to steer at all to get the number up from the green? If not I would keep the dose the same. If you did maybe drop it to a regular 1 u.
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No steering at all Janet, he was 4.4 mmol/L (79 mg/dl) at am +3 and i fed him a mini meal with 8%carbs at his normal time at +4 and then all i did today was just keep my eye on him. From the 4.4 mmol/L he just rose up steadily to his PMPS at 21.2 mmol/L (382 mg/dl)
 
Do you think you're going to follow MPM dosing protocol from now on? (You certainly test enough to follow MPM safely) If so, quick housekeeping chore, can you change your dosing method from SLGS to MPM on your spreadsheet please - that way anyone following (especially for those new members that may be reading) aren't confused by what Janet is recommending. Thanks!
 
Shelley & Jess said:
Do you think you're going to follow MPM dosing protocol from now on? (You certainly test enough to follow MPM safely) If so, quick housekeeping chore, can you change your dosing method from SLGS to MPM on your spreadsheet please - that way anyone following (especially for those new members that may be reading) aren't confused by what Janet is recommending. Thanks!
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Hi Shelly, i have changed my spreadsheet to MPM.
I decided to keep Dukes dose at 1.00F because i'm convinced that i hit a blood vessel, vein/muscle that caused the insulin to disperse through his body way too fast.

I read this on a diabetic site.
When insulin is produced by the pancreas, it is released in small amounts in response to blood glucose levels over the course of several hours. Injecting insulin just under the skin simulates this response most effectively and safely because the insulin works gradually.
When insulin is injected intravenously, the effect is immediate but very short-lived. Instead of the insulin being gradually absorbed into the circulation from tissue, it is immediately available in the bloodstream. This results in abnormally high insulin levels that can cause a rapid drop in blood sugar levels

I'm 100% convinced this what happened to Duke and why he dropped to 4.4 mmol/L (79 mg/dl)
 
JanetNJ said:
A much smoother drop today. I like seeing those blues
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Hi Janet
He's doing well today,yea. He's going back up now but at least it's steady compared to yesterday. I decided to keep Duke at a fat 1.0u because i'm 100% convinced that yesterday i injected into a blood vessel causing the very fast drop. I did quite a bit of reading about it on various diabetic sites.
 
teetee (UK) said:
Hi Janet
He's doing well today,yea. He's going back up now but at least it's steady compared to yesterday. I decided to keep Duke at a fat 1.0u because i'm 100% convinced that yesterday i injected into a blood vessel causing the very fast drop. I did quite a bit of reading about it on various diabetic sites.
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I agree I wouldn't lower it. In the even bg I might even push it to 1.25. He seems to run higher at night.
 
teetee (UK) said:
Hi Shelly, i have changed my spreadsheet to MPM.
I decided to keep Dukes dose at 1.00F because i'm convinced that i hit a blood vessel, vein/muscle that caused the insulin to disperse through his body way too fast.

I read this on a diabetic site.
When insulin is produced by the pancreas, it is released in small amounts in response to blood glucose levels over the course of several hours. Injecting insulin just under the skin simulates this response most effectively and safely because the insulin works gradually.
When insulin is injected intravenously, the effect is immediate but very short-lived. Instead of the insulin being gradually absorbed into the circulation from tissue, it is immediately available in the bloodstream. This results in abnormally high insulin levels that can cause a rapid drop in blood sugar levels

I'm 100% convinced this what happened to Duke and why he dropped to 4.4 mmol/L (79 mg/dl)
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Thanks for sharing Tee!
 
Duke's BG numbers have been consistent today albeit a little higher than yesterday, still a lot higher AMPS than PMPS, so tonight i have upped his dose to slightly 1.25u from a fat 1.0u because as @JanetNJ noticed he seems to run higher at night.
 
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Thanks Cassandra, i've upped his dose a little bit tonight so i'm up for a few hours yet just to make sure he does not drop too far.
 
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