Josie 42 at 6+ today (Now 141 at +11)

[Holly and Josie]

I haven't been on the board much this week because one of my other cats, Mittens, has been sick with a nasty virus. Between taking care of him and keeping him away from the other cats, I haven't had much time to be on here. And luckily, Josie's numbers had actually become somewhat stable (for her.) She's mostly been hanging out in the low to mid 200's for the past few days. Until today...

We had gotten really off track with Josie's dosing schedule and we were trying to get her back on her normal noon and midnight schedule. Today, thanks to a late showing by Mr. P we were able to push her shot up to 11am. Almost back to our normal time. She was at 249 and we gave her .75.

Immediately after my husband have her the shot, I began to worry. By giving her the insulin at 11am, there would be no one home between +3 and +6, when Josie often goes low. (Particularly during the day.) I was nervous, but when my husband tested her right before he left at +3, she was at 233, I figured there was nothing to worry about. I assumed she'd stay flat like she had been the past few days.

When I got home at +6, I felt a sense of urgency I can't explain. Instead of putting my stuff up like normal and testing her 10 or 15 minute after getting home, I ran up my stairs, threw my bags on the table and grabbed the meter. After a couple of tries I managed to get some blood and the glucometer confirmed that my earlier worries had been justified. 42!!!

I think I managed everything OK. I gave her a tablespoon of high carb food and tested her 15 minutes later: 56. I began feeding her low carb food and she moved up slowly...64; 70; 89. At +8 we were at 129. At +9, 157. Not too bad.

But I'm still kind of at a loss right now. I really genuinely thought at 233 at +3, I had NOTHING to worry about at +6. I only thought she could drop so low at that point. I feel like I kind of lost my safety net. There is no more "well, if she's at this now, she couldn't possibly get down to that then." Apparently all bets are off.

But my primary concern is her shot tonight. How the heck much insulin should I give her tonight. As it is, she's only on .75 units. And with the U40 syringes, I don't know how we'd give less than .50. Is that too much? Does anyone have any opinions/advice?

 

[Catannc]

Re: Josie 42 at 6+ today (157 now)

I think Mr. P came for a visit today, you're gonna need some u-100 syringes. You can eyeball smaller doses on u-40 for now though, I found it pretty easy to shoot 0.33ish by eyeballing 2/3 down from 1u.

 

[Sue and Oliver (GA)]

Re: Josie 42 at 6+ today (157 now)

I do think, once the pancreas enters the picture, things are harder, Holly. But don't lose sight of your lovely low numbers and low doses.

If she were mine, I would dose very conservatively when I wasn't going to be around. And when I was able to monitor, I would be a little more daring.

Let's see what others think. Maybe if she is above 200 at preshot, .5?

And I think it is time to buy some U100 needles. :mrgreen:

 

[Holly and Josie]

Re: Josie 42 at 6+ today (157 now)

I think Mr. P came for a visit today, you're gonna need some u-100 syringes. You can eyeball smaller doses on u-40 for now though, I found it pretty easy to shoot 0.33ish by eyeballing 2/3 down from 1u.

Oh, that's a good idea! I never thought to use the 1 unit marking as a guide. I was just looking at the syringe and thinking "I can't even see where half of .50 would be!"

 

[Grayson & Lu]

Re: Josie 42 at 6+ today (157 now)

You've heard the terms "a skinny .5" or a "fat .6" With the U40s you can take a sharpie or pen and mark half units on the barrel of the needle. Then you can shave off just a sliver, or add it on to make it fat or skinny.

Let's see where she's at closer to shot time. Some of her number is likely to be the high carb food, so my guess is that you'll reduce what you'd normally give her at whatever level she's at. I expect there will be some others with more "near hypo" experience that will be able to advise you on how to select the best dose.

 

[Holly and Josie]

Re: Josie 42 at 6+ today (157 now)

I do think, once the pancreas enters the picture, things are harder, Holly. But don't lose sight of your lovely low numbers and low doses.

If she were mine, I would dose very conservatively when I wasn't going to be around. And when I was able to monitor, I would be a little more daring.

Let's see what others think. Maybe if she is above 200 at preshot, .5?

And I think it is time to buy some U100 needles. :mrgreen:

Oh yes, it is much harder! The thing is, .75 is the right dose most of the time, I think. But when the pancreas enters the picture, it's too much. WAY too much today. So it's like, what do I do, under dose her most of the time to account for the times when her pancreas might decide to work? But I think you kind of hit the nail on the head, when I'm not around, be conservative. I absolutely should have had my husband give her .50 since neither of us would be home. That would have been the smart thing to do. And I considered it... after she'd already had her shot!

I know, how many times do I have to say "But I only have the U40's... I truly need to get over my fear that we will miscalculate or misread the chart and overdose her. Because I think we'd get much more precise dosing if we used them.

I was thinking .50 if she's over 200. I think she will be there by the time she's ready for her shot and if she's not yet, I will just wait until she is!

 

[Holly and Josie]

Re: Josie 42 at 6+ today (157 now)

You've heard the terms "a skinny .5" or a "fat .6" With the U40s you can take a sharpie or pen and mark half units on the barrel of the needle. Then you can shave off just a sliver, or add it on to make it fat or skinny.

Let's see where she's at closer to shot time. Some of her number is likely to be the high carb food, so my guess is that you'll reduce what you'd normally give her at whatever level she's at. I expect there will be some others with more "near hypo" experience that will be able to advise you on how to select the best dose.

I have heard of the skinny/fat thing. We've done that before, but just eyeballed it. I think you told me about using the pen to mark the syringe before and I forgot about it. We'll do that tonight. That should help.

 

[Sue and Oliver (GA)]

Re: Josie 42 at 6+ today (157 now)

Most people keep the conversion chart right on the refrigerator where they look at it as they get the insulin out. After a while, you will get more comfortable, but still double check.

 

[Grayson & Lu]

Re: Josie 42 at 6+ today (157 now)

The U100s make the dosing much more accurate in my opinion. Even now that I'm shooting larger doses (3.4), I'm still using them.

You'll definitely want the conversion chart handy, but it's also easy to remember that every half unit mark on the syringe is an additional .2 units. You'll LOVE them!

 

[Holly and Josie]

Re: Josie 42 at 6+ today (157 now)

Wow, apparently Mr. P wants to hang out with Miss Josie tonight. 2 hours ago, at +9 she was at 157. Now, at +11 she's at 141. I have a feeling that if she gets a shot, it's going to be pretty late.

 

[Sue and Oliver (GA)]

Stressful but great news! Looks like Mr. p is definitely visiting you guys.

 

[Holly and Josie]

Stressful but great news! Looks like Mr. p is definitely visiting you guys.

Definitely great news!

Now, this might be a stupid question, but do you know if a cat can go hypo if they are 12+ hours past their last shot? I know a cat not on insulin can't, but I wondering about a cat who is on insulin, but whose shot should have already worn off? I wouldn't expect her numbers to suddenly crash again, but I figure I should be prepared.

 

[Sue and Oliver (GA)]

Well, I don't think I have seen that. They definitely can surf. I think, in theory, the insulin should be gone in 12 hours and the pancreas shouldn't push her into hypo numbers. But they do always surprise us!

Check Chewy's ss. Kim has been working with low doses and Mr. P.

 

[Holly and Josie]

Well, I don't think I have seen that. They definitely can surf. I think, in theory, the insulin should be gone in 12 hours and the pancreas shouldn't push her into hypo numbers. But they do always surprise us!

Check Chewy's ss. Kim has been working with low doses and Mr. P.

Yeah, that's what I thought. But then again, Josie does love to surprise me!

I'll go check out her spreadsheet now, thanks!

 

[Grayson & Lu]

Hey Holly -

Mine aren't hypo numbers, but early on, Grayson danced some marathons! His numbers stayed "unshootable" [my baseline to shoot is 250] in some cases as long as 24 hours.

The advice I got was that long cycles indicate too much insulin. We reduced down, and down, and down to .2 units. Then it clearly wasn't enough. Since Feb 23rd, the giant increases I've done have been due to ketones, so the numbers on my spreadsheet from that point forward will be confusing. But you may want to look at his earlier stats and how he responded.

Lu-Ann

 

[Grayson & Lu]

You may want to edit the subject in your first post to reflect NEED DOSING SUGGESTIONS etc to get the right eyes on it.

 

[Holly and Josie]

Hey Holly -

Mine aren't hypo numbers, but early on, Grayson danced some marathons! His numbers stayed "unshootable" [my baseline to shoot is 250] in some cases as long as 24 hours.

The advice I got was that long cycles indicate too much insulin. We reduced down, and down, and down to .2 units. Then it clearly wasn't enough. Since Feb 23rd, the giant increases I've done have been due to ketones, so the numbers on my spreadsheet from that point forward will be confusing. But you may want to look at his earlier stats and how he responded.

Lu-Ann

Interesting. I wonder if too much insulin is causing the unshootable pre-shots or if it's just that her pancreas is kicking in late? I had thought it was the pancreas, but maybe a lower dose would even things out.

I'll check out your spreadsheet!