low blood sugar

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Phyllis

Phyllis

Member Since 2012
My diabetic cat has been testing a little high on almost all ear prick glucose test. He's on 5 units of lantus. I checked earlier and he was a 60...it's now been 6 hours after injection of slightly more than 5, maybe 5.3, and he was at 40. I gave him about a half TBSP of Karo syrup and am getting ready to test again...it's been about 15 minutes. I will definitely check more often and before I feed and inject. Any tips on how long it takes to get back up to normal? I understand lantus reaches peak at about 6 hours??? I've never had him go this low and he's been diabetic over a year now. Thanks.
 
It's hard to say when nadir is because it can be different for every cat, and it can also change with the same cat. Not knowing your history, it is hard to say when you'll be up again. Keep testing every 20-30 minutes and feed or give Karo depending on the numbers. You want to see two tests with rising numbers without food influence before you will know you are in the clear. I am at work, so can't stay with you. If you could change your subject line with some ?? or possibly use the 911 icon, you can catch the eye of someone who can help for a longer duration. We will have lots of questions.
 
EVery cat is different (ECID) but that much Karo will probably bump him up in about 20 minutes and keep him there a while. We usually only give a drop or 2 and it will last about 2 hours. When you got the 60 you could have given him a little extra of his regular food, that might have slowed his big drop.

:roll: You can probably expect a big bounce from this too.
 
I would love to think this could signal a remission, but probably not. I am getting ready to check again...thank you!
 
Reading just now on Nonnie was 89 so I feel better. He has eaten some treats and I just gave him some wet food with gravy. I'm still not sure why the sudden drop after most tests recently have been high. Plus he has been drinking more water lately, hence I thought his dose might be too low. Will probably take him to vet to have blood work done...want to check kidney function, etc.
 
I should also add that I have 18 indoor cats, thus it's hard to control his diet...they all get 1/2 can Fancy Feast in AM and PM. Plus dry food out continually...includes Hills Optimal Care, Hill's Tarter Control, and Purina Smartblend Vibrant Maturity. Plus they all get Temptations and Party Mix treats daily. They range in age from 8 mos to 17 years. Nonnie is about 12. Anyone have any suggestions? His numbers lately have been in the 250 - 350 range....it's weird to have such a low number today, but I checked meter by testing me and it seems fine. Has anyone ever found that not mixing the insulin properly (I roll it between my hands...never shake) could be an issue? I use it past the 28 days recommended on the bottle for disposal as I keep it refrigerated all the time and have not had problems. With a reading this low, I'm fairly sure it's still working. Any suggestions are greatly appreciated.
Thanks
 
Hi Phyllis,
Welcome to the TR lantus forum.
I would like to invite you to join our little community.
We all support each other with the trials of FD.

It is possible you are seeing a breakthrough dose ...
It would help if we could get you started with a spreadsheet to track the numbers and learn the patterns.
It is likely you will find there are even more lower numbers happening somewhere during the cycle.

5 units is a high dose for most cats .
We increase dosage in small increments. ( 0.25u at a time) Most vets increase in whole units which is too much, too fast.
I would be very interested in how you got to 5 units so quickly.

any number less than 50 ( such as 49 ) earns a dose reduction.
Dosing amounts are determined by the lowest number in each 12 hour cycle.
 
With Lantus, you shouldn't roll it either. It does not need mixing and motion can damage it over time.
Most of us make a small nest on the top shelf of our fridge... because even being in the door is too much shaking.
But since you are getting low numbers, your bottle seems to be doing fine.


I would stop giving those treats you mentioned right away. Those are high high carbs.
I think they are part of what made my cat diabetic. I was giving them like dry food. ( my cat isn't that big on dry food)
You will want to boil chicken or buy freeze dried treats. You can give the dog ones and buy it in larger bags.

If you truly can't afford/ convert all your kitties to wet food....
I would like to suggest the best dry food out there. ( although we don't like the stuff here)
Young Again
It seems expensive but it includes shipping and they don't eat as much because it doesn't have any filler in it like
the kinds you buy at the local stores.
The reasons you want to get your kittes on wet food as much as possible is here. www.catinfo.org
 
When we learned he was diabetic, he had pancreatitis... not sure which came first. We are lucky to have Upstate Vet. Specialists here in Greenville, SC, within 15 minutes of home. He was there for about a week, and they got him on lantus as they said that was most likely to put him in remission if that was going to happen. They started him on 4 units and I kept a spread sheet for several weeks and he seemed stable. We went up to 5 after taking him to the vet a few months ago and also emailing the specialist with his numbers at that time. I was not familiar with what was a high or low dose. But they did say that with glargine or lantus there was less chance of overdoing it than with what I used years ago on another cat. And I was wrong....Nonnie has been diabetic for going on 2 years. I am starting a spreadsheet now with today's readings. I am retired so I am here most of the time. I looked at your spread sheet and don't quite follow it. I understand the timing but the numbers at top 400-500, 300-400, etc. What do they mean. Is there an example of a blank spreadsheet available somewhere? Thank you for your help.
 
Welcome to Lantus Land.

My best guess is that Nonnie wasn't eating the dry food. The dry food that you're feeding is very high in carbohydrates which will drive your cat's blood glucose (BG) up. The likelihood of remission for a cat that's eating dry food is low. It's why we try to encourage people to transition their diabetic cats to an all canned food, low carbohydrate diet.

One of the basics of the Tight Regulation Protocol is that your cat is not eating dry food. The protocol is aggressive with it's approach to dosing and for a cat on dry food, it's not a safe approach. You may want to take a look at the Start Low Go Slow approach to guide your dosing. There are a number of people here who follow this approach.

You may also want to take a look at this link on handling low numbers.
 
OK....have now read Dr. Pierson(?)'s long article on diet. I have a mixture of cats...some finicky, some not. Some prefer wet food, some dry. All will eat wet food...so I guess I am lucky on that count. I use only Fancy Feast, feeding 1/2 can AM and 1/2 can PM each. But with 18 cats, I can't control their intake very closely. I do leave it out and it's usually all gone within 2 hours...as they go back and nibble. Since they all eat wet food, do you recommend just taking up the dry food totally or maybe having just one bowl for a while (upstairs and downstairs as I have one cat who does not go downstairs ever) and then at some point take it up completely? I do have 2 cats that are quite overweight and they tend to eat a lot of anything. Perhaps I should start feeding at noon also? Or is that too much? I'm hesitant to try making my own as it's a lot of food for 18 cats. I suspect you are right that if I cut back and slowly eliminate dry food, Nonnie's numbers will go down. Will also move the Lantus from the door to the top shelf of fridge. I'm really not a crazy cat lady....most of my cats found me except for the 3 Maine Coon mixes that I fostered from Humane Society and then adopted. The two males have already had PU surgery due to blockages...the surgeon said their urethras were very small and thready....it was touch and go with both during surgery in finding enough good tissue to suture to the new opening. I'm now thinking that dry food did not help that situation.
I can afford to feed as much wet food as I need to...that is not an issue. I appreciate the group's concern and suggestions....
 
I forgot....I have another question. My husband and I NEVER go anywhere overnight because of Nonnie and the lack of someone who can inject him...or figure out which cat to inject (his sister is also gray tabby, just heavier). Anyone have experience or opinion about missing one PM and one AM dose, or should I board him with vet which will really stress him out...
 
well if you think they will gladly give up the dry.... I would figure that one out. It's beneficial for all of them.
I researched pet foods and truly they have only been around for about 100 years.
I think the last decade has been an explosion of high carb/filler foods and gimmicks to get people to buy one brand over
another. All to the detriment of our pets. We feed them easy junk just like we do ourselves.
It's become a prepackaged processed food kind of world.

But especially for the diabetic cat and the fat cats ( who are in danger of becoming so) , take away the dry food.
Diabetics benefit from having smaller meals more often. ( just like they tell humans to eat smaller meals more frequently)
I can see that being difficult with a herd ....or rather a clowder of cats. :lol:
But if you could take Nonnie into another room and give her food separately.... that would help her.

And yes we do sometimes have to skip a dose or two.... it happens.
Since his numbers aren't way high, it would be okay.

I don't trust vets to monitor with diabetes. They tend to not be there at night and have no staff there either.
 
I think being on wet food is the best for all your cats, and if they all like wet the transition shouldn't take long, maybe a week. Feeding an extra meal is a good idea, especially for a diabetic. It evens out the food load and the demand for insulin.

DRy food can cause so many problems for so many cats, diabetes, kidney failure blockages!

FF pates aren't bad foods for a diabetic, w/ 18 cats to feed you can save money and feed better quality w/ larger cans. (Although there is some concern that the 12oz cans have a lining that can be considered problematic.) Look on the sidebar to the right on Dr. Pierson's site, she has a list of nearly all the wet foods available listing their carbohydrate % and Phosphorus levels (important for CKD cats.) We try to stick w/ foods that are 10% or lower in carbohydrates. Most of us try to stay around 4 or 5%.

Ordering canned food online also is cheaper and you don't have to haul it home from the store. Click the "Shop" link on top of the page and FDMB will get a commission without costing you anything.
 
I'd see if you can find a vet tech from your vet's office that would be willing to give the injection. We've all had to skip a shot or given a fur shot. The only time there's a huge issue with skipping is if you have a cat that's prone to developing ketones.

I'm glad you got through reading Dr. Pierson's website. If you can afford to have all the cats on a low carb, canned food diet, I think you'd be doing yourself, Nonnie and the other 17 cats a favor. There's a good chance the overweight cats will lose weight and due to the moisture in the food (and most of us add water), your kitties will have fewer problems with their plumbing. Likewise, most of us feed more than twice a day. If you're around, feeding at shot times and at least one other time during each cycle, prior to Nonnie's nadir would be great. A lot of food all at once is hard on the pancreas whereas multiple small meals is easier on the pancreas. Had you given any thought to isolating Nonnie when you feed him?
 
Boy do we know about not getting away! It's bee four yraes since DH and I got away together!

Sometimes you can find a vet tech to pet sit. If you do have a sitter that can't monitor overnight you can have them give a lower dose while you are gone, better than totally skipping.
 
Welcome to LantusLand, Phyllis. You're in the right place to get advice on treating Nonnie. :-D :-D Around these parts, "crazy cat lady" is a badge of honor. :lol: :lol: :lol: We've never felt so normal.
Liz
 
Nonnie's glucose level was about 200 at 6pm right before I fed them so it did come up. He did not eat much, tho' and I had to go to class for 2 hours so I did not inject him. I will do a test in the am and adjust the level of lantus accordingly....then continue my spreadsheet... :? I was afraid tonight that even giving him 2 units would trigger another low level....rather be high than low.
 
Well...I tested Nonnie this am at 7 before feeding and he was around 500! I obviously should have given him something last night. I gave him 4 units and will recheck later. I suspect he is eating a lot of dry food at night and that may be what is causing the fluctuations based on all that everyone here has said. So...weaning them off dry food should help. Thanks for all your input and advice!!
 
A spread sheet will have the #s that you've tested on it, and will help others understand where Nonnie is going/doing, and they will be able to help you make the right decision. I hope that you can get that set up today. :-D
 
I have started a spreadsheet using the template most of you use. It will take time to get much data. Now I'm weaning them off dry. Does anyone have experience with Feline Pride cat food? I am reluctant to make my own with 18 cats. But this sounds like good quality. Any other brands any of you would recommend? Thanks
 
Feline Pride is good but not available here so I haven't tried it. We use Nature's Variety, I like it because several of the varieties are also very low phosphorus.

that 500 last night could also be a bounce from going lower than normal. When a cat experiences BGs that are lower that what has been usual the liver can "panic" and release glucagon and counter regulatory hormones. It can take up to 72 hours for these to clear the system. Bouncing can be caused by a fast drop even if the numbers are normal or even above normal.

Lantus needs consistent dosing. Remember that every time you change the dose the shed will adjust and you can see wonky numbers for up to 6 cycles.
 
Hi Phyllis!

Welcome to TRLLand!

I wanted to share with you that I too had Scooter on 5.5 of insulin. I removed the kibble from my house of 13 cats and within days he was OTJ. We are now entering our 3rd month off insulin. I was shocked because I was sure he was not eating kibble and he was. It sent his BG very HI.

You said in one post that getting Fancy Feast was not an issue for you. I recommend switching them all over to wet food only 4 times a day. It may be a life saver.

Also don't worry about figuring it all out the wonderful women here will guide you thru everything. You may feel like a graduate course is needed but just share here and they will help you. You are in great hands.

Linda
 
!

Thank you, Linda. That makes me feel so much better. 6 hours after injection, his numbers are still in the 400's but I will be patient after your response. I have weaned them now to one kind of dry food...Purina Smart Blend Vibrant Maturity after reading the labels...it has higher moisture content than all the Hill's I have and the first ingredient is chicken. I know dry is not good, but I'm weaning by only offering this kind and in smaller amounts, and adding a small meal at noon. At night the dry food comes up. Hopefully we'll be on all wet soon. I'm hoping this will keep Nonnie more stable.
Everyone is right...none of our vets or specialists say much about food or nutrition.
I'm encouraged after reading the last posts.
Thank you so much...I don't feel so alone with this resource!
 
Hi Phyllis:

I am not as smart as many on this board, so I don't give dosing advice, but I wanted to welcome you to LL. You will fine a lot of wonderful people here who have a ton of experience and knowledge, and lots and lost of empathy and support, which is really critical to helping YOU survive the FD journey. I am not exaggerating when I say the people here saved my kitty's life. If I had listened to my vet, he would be dead now (in fact, at one point soon after his diagnosis she recommended euthanasia because he had DKA and was very, very sick). We found FDMB and started following the advice of people here instead of our vet, and Cinco went from near death with a BG so high their glucometer couldn't read it to OTJ in less than three months. He was a stray I adopted and was used to dry food when we started, too. So you see, it can be done, and you are in the right place to help Nonnie, and in the process, help your other kitties stay healthy! Ask all the questions you want - you will get answers! :-D
 
hi phyllis!

welcome to Lantus Land from me too! i'm glad you found us.

i'm so glad Linda/Scooter posted, because she had a very similar arrangement to what you've got with a many-cat household. Scooter went from 5.5u per dose to zero in one day when all the dry food went away in the house and the carbs had cleared his system.

It sounds like you are home-testing - YAY! that's the hardest part of all of this, so if you're already mastered it you're ahead of the game. The important thing to note here is that as you remove the dry food carbs, Nonnie's insulin needs are going to go down. This means you've got to do a fair amount of testing to keep her safe.

We are a very data-driven forum. We "read" spreadsheets and can tell from the blood sugar numbers and the timing of those tests what is going on, so while it is a pain in the neck, getting numbers on the spreadsheet will really help us see what you need to do in terms of dosing.

For example, that 60 you got followed by high numbers is what we call a "bounce." it means that Nonnie has gotten used to high numbers and isn't used to normal low numbers. I'm wondering how he was started at 4u. There are plenty of cats that need 4units per dose, but most start somewhere around 1 or 1.5u per dose. if a cat's dose is raised in small increments, with at least 3-6 days in between dose increases, with either 0.25u or 0.5u per increase, then we can have confidence that they need that dose.

Sometimes a cat that has continuously high numbers has them because they are overdosed. the cat's body will release stored sugars and hormones to keep a cat alive. And of course, dry foods or high carb treats can send BGs high and keep them there even for a day or so after the high carbs have been removed. So . . . it's hard to know exactly what's going on with Nonnie.

When you can get the ss done, that'll help us see the picture more clearly. If you need help putting in the numbers, we do have people who can help you get it set up and then turn it over to you. Just say so. It's such a vital tool in handling dosing that we really need it.

Hope you'll ask away - we're all glad to help.
 
Can't tell you how much I appreciate this. I didn't put out new dry food last night and Nonnie's number this am was 170. I was at a loss as to what to give him, so I dropped it to 3, which may be too much, but he was high all day yesterday. I understand Lantus is longer acting than what I used to use years ago on another cat (PZI), and he ate well this am, so wonder how long to wait to retest. This is going to be very trial and error and he's already getting tired of me pricking that ear. Will have to try the other one today, tho it's been hard to get enough from that one. It has an old tear in it which may affect it. I do have the SS and am filling it in as often as I can, figuring anything is better than nothing.
I'll probably drive everyone here crazy with all my questions, but I do have one more. I understand that the 12/12 schedule isn't as critical as doing the injection right after he eats. I try for 12/12 but often it's an hour off one way or the other, for reasons beyond my control. What are your thoughts on that?

Thanks again!!!
 
Hi Phyllis,

That's great that you're getting your spreadsheet set up. Make sure you share it with us so that we can see what Nonnie's numbers are. There's a blue "share" button at the top right of the spreadsheet page. After giving permission to share it, you'll also need to put a link to it in your signature so that we can access it. (The signature is the stuff that appears at the bottom of every post. For example, my signature includes my name, food fed, etc.)

Here are more instructions for setting up the spreadsheet if you need them: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Here are the instructions for setting up the signature: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=486

If you have any questions about all of this, let us know!

Have a great day!
Shelly
 
Hi Phillis,
Just adding my welcome to all of the others. You have come to the right place! A little Neosporin with pain relief helps to heal the ear. I prefer the creme because it absorbs well, but many here prefer the ointment (don't let it get too goopy!). I always put the Neosporin on at bedtime so that it will help heal the ear overnight.

To answer your question about the 12-12 hour shot schedule. It has been found that Lantus works best if dosed consistently, every 12 hours. The reason is because it is a "depot" insulin that leaves some of itself in the body's "shed" or "depot". This is one of the reasons why it is considered a "gentle" insulin: because there are not the wild spikes and drops that one finds with insulins that are in the body and then gone when their efficacy wears out. Every change you make to the dose or by shooting very early or very late has an effect on the shed and it can take a while for things to settle down. So we all try to stick to the 12-12 schedule. If you shoot early the effect is like giving a dose increase. If you shoot late, a dose decrease.
I always figure that I have a window of about 20 minutes one way or the other with regard to shot time. (With PZI Vet, which I assume is the insulin you used in the past, you could figure on a window of about 2 hours, but that would be a big mistake with Lantus.)

Anyway, WELCOME to Lantus Land! It all gets easier as you go along.

Ella & Rusty
 
One stupid question re: SS. The AMPS and PMPS....what do those stand for? I'm assuming sugar level prior to feeding and injection?
 
That's not a stupid question at all, Phyllis. The AMPS is the morning blood sugar before you gave insulin. (AM = morning, PS = pre-shot). The PMPS is the evening blood sugar before you gave insulin (PM = evening, PS = pre-shot). The jargon here can be overwhelming at first, so always ask about it if you're unsure! :-D
 
and the ss is spreadsheet!

do keep asking - i actually didn't join FDMB for a few weeks after i found it because i could see the jargon and thought it was weird, but then i needed the help for my punkin, so i joined anyway. fortunately you pick it up fairly quickly.

fwiw - for what it's worth
btw - by the way

are other common ones.
 
I'm having trouble setting up the stuff at the right..picture, Nonnie's profile, ss, etc. Help. I have read the info that was in a link someone posted but can't seem to get it right. I got into my google account, but saw no where to click on googledocs, etc.
 
It's okay. We'll work on the picture and stuff a little bit later. Let's try to get your ss up and running. I'm not sure which browser you're using (it might make a difference), so I'll take a stab in the dark here. When you log in to Google, do you see a little box of square dots in the upper right-hand side of the Google page? Click on that. It will show you "Drive" as an option. Click on that. It should pull up a page that shows you your ss. Can you get that far?
 
Yes...I can get that far....It brings up the spreadsheet and a photo of Nonnie that I downloaded. Then I got a little further and thought I added it to my profile but nothing shows up.
 
Hi Phyllis,

I sent you a private message with some more instructions that I hope will help. I didn't want your thread to get lost on the board. (It's busy around here!) :-D

Let me know how I can help!
Shelly
 
hi phyllis! i think you've almost got it. I can click on the spreadsheet link but i'm getting the message that i need to request access.

on your spreadsheet, i think in the top right hand corner, there should be a place where you can publish it to the web and give access to everyone with the link. i can't see the choices on punkin's ss, but that's what i recall. if you choose those privacy options we ought to be able to see the ss.

give it a try and let us know when we should attempt to access the ss again.
 
Hi Phyllis,

I sent you some replies this morning via PM, but they're still sitting in my outbox. Let me know if you don't receive them soon, and I'll try again!

Shelly
 
hi phyllis!

yes! your ss is working - and wow, it looks like Nonnie is having a good response to the insulin. You're doing a super job of getting tests in.

one thing that will help you to know is that Lantus is a depot type of insulin, which means that when you inject it, some is used right away and some builds up in the body. that build-up is called a depot or shed. it's an important concept to understand, so much that Jill has a yellow starred sticky at the top of this forum page here. There are a few implications from using a depot insulin.

one is that a previous dose can still impact numbers as many as 6 cycles later. A dose reduction, in other words, can take a few cycles to show what the newly reduced dose is doing.

another is that changing doses frequently can cause wonky numbers, making it so you can't really see what a dose will do to his blood sugar numbers.

it's also a more gentle way of administering insulin, compared to earlier insulins. Sienne likens dose changes to moving a barge - it takes a while for the changes to take effect. earlier insulins were given with food, dropped the blood sugar and then were out of the body in a matter of hours. then the cat's blood sugar rose again and the process was repeated. we know that cats do best and feel better when their blood sugar is flattened out.

Lantus also is different from those other insulins in that the dose decision was based on preshot numbers in shorter acting insulins. People on the PZI group have a sliding scale - if you get x preshot then you administer y dose. We hold most lantus doses 6-10 cycles and re-evaluate to see if what it's doing unless the cat goes under 50.

All of that combines together for me to suggest to you that you hold his dose for at least 6 cycles unless he goes under 50. I'm not sure what dose that should be - can you answer the questions below and we can talk about it?

I saw you mentioned that Nonnie has been diabetic for more than a year. How long has he been on Lantus? What is the story of how you got to a 5unit dose, ie, what kind of increments was his dose adjusted in (1u? larger or smaller?)
 
oh, and never roll or shake Lantus. there is nothing to mix up. it's a clear liquid - that's another thing that makes me think you've used some other insulin. Here's the link on Lantus/Lev - Info, Handling & storing

You may find the video on how to draw a dose helpful as well. Even if you've been doing it for a while, something in here might be different than what you've been doing.

[youtube]u4KtK_skpmQ[/youtube]
 
Thanks for the video and all the info....I went back and found all Nonnnie's paperwork from when he was diagnosed and I'm working on his profile so I can provide as much info as possible. Hopefully this will help. The specialists who treated him got him started and leveled out on the original dosage and hopefully I can include all that. I am learning a lot. Thank you!!
 
The other point I would add is that Lantus dosing isn't based on your pre-shot number. You base the dose on your cat's nadir -- the lowest point in the cycle. If the BG test numbers fall below 50, the dose is reduced.

Just out of curiosity, how much does Nonnie weigh and is this a good weight for your kitty? (There is a weight based formula that allows you to calculate the initial dose.) Unless you have a tiger cub at home, a starting dose of 5.0u is HUGE. Most cats start out on a dose of 1.0u (give or take).
 
I have Nonnie's profile done but having trouble getting it to show up on website. Can someone help? No rush..I'm off to the Humane Society where I volunteer on Mon. afts. Thanks so much~
 
hi phyllis!

you put in the profile just like you did the spreadsheet link for Nonnie.

Go to the User Control Panel on the top left of the page.
Choose "Profile".
Choose "Edit Signature" along the left side of that page.
Click on the URL button
add the info i've described in color in the appropriate place, including the = sign. [url=paste address for profile doc here]Name it something like Nonnie's Profile here[/url]

Phyllis, I want to suggest that you go back up in this thread and reread what i posted earlier about not changing doses often. You're getting set up to have wonky numbers by changing your dose at every shot or two. Lantus doesn't change that quickly. I think you're looking at the preshot numbers and just deciding Nonnie needs more or less insulin from those.

Lantus dosing is based upon the LOW point that a dose gets a cat to.

That's a huge difference from the older insulins, but that's how it works. If you can stick with a dose for 6-10 cycles, you will very likely stop having the high highs and low low numbers. cats feel crappy when their blood sugar is zooming up and down and Nonnie will thank you for helping him get stable numbers. this is pretty important!

I think I would go to 2.0units and stay there - at least 6 cycles and then let us look at him and see if he needs adjusting. so regardless of any high numbers you see, stay with 2.0unit doses. if he gets below 50 we'll reduce his dose.

And thanks for mentioning that Linda - we open one new thread (condo) every day for each cat. That helps keep things manageable on the forum.
 
For those who have been helping me, I think we are making progress with Nonnie. If you look at his SS, his numbers are much better and he's still only on 2 units. I'm keeping him there for a few more days and then may be asking for opinions on what to do next. He may just stabilize here. Thanks again.
 
Hi Phyllis,

Nonnie's looking a bit more stable - today's numbers are great! Just to confound you though, cat's don't usually get stable on a dose. The dose usually needs adjusting regularly. Cats tend to settle into a dose and then it either becomes too much or not enough. ohmygod_smile i think they do it to mess with us! :lol:

The other factor that can have an effect on the dose needed is that cats are unique in their ability to have their pancreas heal and begin producing its own insulin again. When the cat is kept in normal blood sugar numbers, 50-120, the pancreas will sputter back on. that means we have to reduce the insulin we're shooting so that the total is the just right amount needed.

One more tip - anytime you shoot a preshot number that is lower than you've shot before, it's a good practice to get a +1 and a +2. If the cat is still going down, you want to know it.

Right now he's got 5 cycles at 2.0, so according to the guidelines, you would wait 10 cycles before increasing the dose. Unless you see a number under 50, in which case you would reduce the dose by 0.25u.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

So I hope you'll keep posting so we can give you a hand. Most people post every day or every couple of days.

Is it getting any easier yet?
 
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