Luther dosing

[Amanda Davies]

Hi, it’s been a while since I’ve been on here as we were lucky to get Luther into remission back in March 2019 (diagnosed in October 2016, he also has IBD and Pancreatitis - both managed via diet alone - raw fed). Luther is 13 this Christmas. In early November Luther had a UTI which caused his pancreatitis to flare up and came out of remission with his diabetes, with high glucose levels (blood testing and ruins testing). The vet was hopeful that once the UTI and pancreatitis calmed down he would go back into remission. Our vet is pro raw feeding, home testing, TR etc so it’s been really easy to work with her over the years.

Luther’s current readings are high, we have used the same insulin scale as last time - worked through with our vet, but it doesn’t seem to be enough this time around and would appreciate some help in adjusting it. I’ve attached his current spreadsheet and insulin scale we are using. Luther is on prozinc u40 0.5 unit needels. Based in UK using alpha trak.

grateful for help and advice on dosing.
Luther -spreadsheet
many thanks

Amanda

 

[MrWorfMen's Mom]

Hello and welcome to FDMB. Sorry Luther as relapsed and you are back at the sugar dance.

I have to be honest with you that I am not a fan of using sliding scale dosing for a cat that is not regulated. It's very difficult to really see what any particular dose is doing when it changes sometimes day to day or even cycle to cycle. Sliding scales are based on pre-shot readings and all those really tell you is whether or not it is safe to give insulin. Pre-shot readings should not dictate dose as they are not always a true representation of BG levels due to other biological phenomenon that occur in diabetics. We generally find most kitties do better with consistent dosing.

With ProZinc the lowest point in each cycle usually occurs sometimes between +4 and +7 post shot although some cats will reach the low point earlier and some later. It is really important to figure out how low a dose is dropping BG to ensure safety and make appropriate dose adjustments. Our cats have a tendency for BG to drop even lower at night so it's also important to grab some night time tests. Ideally if you can grab a +2 or +3 post shot at night and then test again every night before bed, you'll get some good data to see what Luther is doing overnight. Without the nighttime data, you are really only seeing half the picture.

Right now I'd recommend you hold the dose at 1.5u and get some mid cycle tests to see how low BG is dropping for a period of 3 days. If BG is still too high, then dose can be increased and we recommend increases of 0.25u at a time so as not to bypass the best dose. It's better to gradually and systematically increase the dose until you get Luther better regulated then if you choose, the sliding scale can be revised and used.