Level at 90 before food, do we skip insulin again?

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Kelley & Bender "Bub"

Kelley & Bender "Bub"

Member Since 2020
We are still very new at this and learning how to deal with fluctuating glucose levels.

Bub gets 1unit of Lantus every 12 hours, 9am and 9pm. We are also trying to slowly wean Bub off of prednisolone, which we believe caused his diabetes in the first place. Over the weekend Bub seemed nauseated and "out of it", which the vet said could be because of the reduced prednisolone dose. On Saturday he vomited and refused to eat - And since he refused to eat, we skipped his insulin shot all Saturday and one dose Sunday morning. We finally got him to eat Sunday evening and were able to resume his dose.

This morning, Monday, his AMPS was 150 and he ate his breakfast, so we gave him his regular insulin dose. He does not seem nauseated today and is acting healthy, even chasing our other cat around and playing with his toy tennis ball.

Tonight however his level dropped to 90 before food. We let him eat, and we are considering skipping his dosing tonight because of the low level, but I'm worried since we skipped most of the weekend as well. Should we give him a reduced dose, wait an hour and test again even though he has had some food?
 
I'd skip. 90 on an AT2 is too low to shoot without having slowly worked your way down, and you'd have to monitor possibly all night if you shot.

Even if you skip, you should really get another test in tonight to see where he goes from here-- he might still be going down. Plus, it's hard to figure out what is going on with Bub without more data in the spreadsheet. I suspect he wants a little less insulin than 1.0U, but you aren't catching his nadirs (lowest points) so it's hard to say for sure...
 
without a lot of evening data, I’m going to say skip it as well. You need to pick a dosage protocol like SLGS which means anytime he goes under 90, he gets a .25 reduction. But you need more testing data a midday test if you can and an evening +2 every night would be very helpful.

I agree with Nan, he likely needs a reduction down to .75 maybe
 
Thanks for the help, all. We tested him again about an hour later and he was at 128 after eating a little bit. We've had trouble getting him to eat enough in general lately. We suspect this is due to his IBD issues and weaning off of prednisolone. So maybe he's not eating enough food to counteract the insulin? We'll talk with our vet about reducing, he's only been on insulin for less than a month so we're still figuring out what's best for him. Thank you again you have all been such help!
 
Just keep in mind we recommend .25 dose adjustments while vets will usually do 1 unit or .5. At such a low dose, I’d really go for the .25 adjustments. and as I mentioned above, we dose by the nadir here while vets will usually dose by the preshot numbers. The problem with that is you don’t know how low that dose is taking your cat in a cycle and it could be too low like you experienced yesterday.

Minnie has IBD too. Have you discussed budesonide with your vet? There’s also a great IBD probiotic called Visbiome. A few of us here give it to our IBD kitties. What kind of food is he eating? Novel proteins? Minnie is also on and anti nausea to help her eat, ondansetron
 
Aleluia Grugru & Minnie said:
What kind of food is he eating? Novel proteins?
Click to expand...

We were giving him Fancy Feast Classic, but he stopped being interested in that, so we've had to try all sorts of extras to entice him--mostly cheeses. We just ordered some probiotics and Fancy Feast Kitten for the extra calories. It takes a lot to get him to eat enough for about the last week. Our vet suspects that his IBD may be lymphoma since we just started weaning him off prednisolone and he started to lose his appetite and seemed like he could be having an upset belly (although, it hasn't seemed like his belly is upset yesterday and today.) So this complicates switching steroids. We wanted to get him off the steroids completely, but since he started to have problems after dropping the dose of prednisolone, our vet doesn't think he'll be able to go off of it.
 
Has your vet not brought up budesonide? It’s a localized steroid for the GI tract that shouldn’t affect his bg levels. Minnie is on it now. Also, he needs to be on anti-nausea probably daily. Nauseated cats won’t eat. And then once that’s controlled you can try novel protein like ziwipak pet food has. Tagging @Wendy&Neko whose cat had both!
 
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