Mia & Monica - High BG numbers and dosing help

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MonicaT

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Starting a new thread again as the last one has gone (way) over the posting limit!

Current updates on Mia: has been pretty stable in her BG numbers for a while, with blue numbers (and sometimes even green numbers at AMPS and PMPS) and throughout her cycles, but has recently been having some yellow numbers both during AMPS and PMPS. Couple of times the last couple of days she has has entire cycles that have not gone down below yellow numbers.

Haven't seen any changes in her behaviour, she is still cuddly, playful, purring etc. Have been experimenting with different food flavors (still same type of wet food she has been on since diagnose) to see if any of them increase her BG more than others.

This all seems to have started after we tried manipulating her cycles with some high carb foods and treats when she was going low into lime green numbers. Have not given any high carb or treats for several weeks now though.

Previous threads:
Part 3
Part 2
Part 1
 
Starting a new thread again as the last one has gone (way) over the posting limit!

Current updates on Mia: has been pretty stable in her BG numbers for a while, with blue numbers (and sometimes even green numbers at AMPS and PMPS) and throughout her cycles, but has recently been having some yellow numbers both during AMPS and PMPS. Couple of times the last couple of days she has has entire cycles that have not gone down below yellow numbers.

Haven't seen any changes in her behaviour, she is still cuddly, playful, purring etc. Have been experimenting with different food flavors (still same type of wet food she has been on since diagnose) to see if any of them increase her BG more than others.

This all seems to have started after we tried manipulating her cycles with some high carb foods and treats when she was going low into lime green numbers. Have not given any high carb or treats for several weeks now though.

Previous threads:
Part 3
Part 2
Part 1
This is good news, always remembering that stability in BG numbers, Low Low Carb foods and consistent cycle is the answer, and it goes without saying testing, instead of manipulating with High carbs, you may test give 1/2tsp of low carb, continue this protocol every 1/2 hour until safe numbers, unless of course, 50 under, 1ml of Karo, a quick fix, retest in 1/2 hour then continue hiking up BG with LC food, I personally avoid High Carbs at all costs, at most 1/2tsp of HC gravy FF, is sufficient to get to safety, I learned the hard way!! but it has been a blessing:bighug::bighug::cat::cat:
 
This is good news, always remembering that stability in BG numbers, Low Low Carb foods and consistent cycle is the answer, and it goes without saying testing, instead of manipulating with High carbs, you may test give 1/2tsp of low carb, continue this protocol every 1/2 hour until safe numbers, unless of course, 50 under, 1ml of Karo, a quick fix, retest in 1/2 hour then continue hiking up BG with LC food, I personally avoid High Carbs at all costs, at most 1/2tsp of HC gravy FF, is sufficient to get to safety, I learned the hard way!! but it has been a blessing:bighug::bighug::cat::cat:
@CORKY Hi! Not sure I understood your reply here..

What exactly are you referring to as good news? The issue the last couple of days is that she is having higher than usual numbers, she hasn't had pink numbers since way before we switched from caninsulin to Lantus.

Regarding manipulating with high carb wet food, this was done after a suggestion from a forum member who had done that with her kitty instead of using high carb treats. But again, we haven't done this for a couple of weeks now. I just mentioned it because I feel like these high numbers started showing up after we tried doing that for a couple of cycles.

Our issue right now is where are these high numbers coming from, what's causing the sudden increase and how long do we wait before we increase dose
 
@CORKY Hi! Not sure I understood your reply here..

What exactly are you referring to as good news? The issue the last couple of days is that she is having higher than usual numbers, she hasn't had pink numbers since way before we switched from caninsulin to Lantus.

Regarding manipulating with high carb wet food, this was done after a suggestion from a forum member who had done that with her kitty instead of using high carb treats. But again, we haven't done this for a couple of weeks now. I just mentioned it because I feel like these high numbers started showing up after we tried doing that for a couple of cycles.

Our issue right now is where are these high numbers coming from, what's causing the sudden increase and how long do we wait before we increase dose
Apologies, I misunderstood, it takes several cycles to notice results on BGs patience is a virtue I will tag Sienne and Suzanne for you, they will be able to advice you on dosing concerns, all cats are different and react differently to dose increases or decreases, I know we want to see immediate results due to our frustrations, I’m one of them as well :bighug::bighug::cat::cat:
@Suzanne & Darcy
@Sienne and Gabby (GA)
 
Apologies, I misunderstood, it takes several cycles to notice results on BGs patience is a virtue I will tag Sienne and Suzanne for you, they will be able to advice you on dosing concerns, all cats are different and react differently to dose increases or decreases, I know we want to see immediate results due to our frustrations, I’m one of them as well :bighug::bighug::cat::cat:
@Suzanne & Darcy
@Sienne and Gabby (GA)
@CORKY Oh ok, no worries :)

Yes definitely confused about what's causing higher numbers suddenly when we aren't seeing any other changes, or have changed anything in terms of diet etc.

As you can see from her SS she hasn't had these higher numbers for quite a while
 
you can keep the same Title (Post) up to 50, then do a continuation
You are definitely with a much better insulin, as well as ProZinc, give you baby time to adjust 2-3 cycles, by then I have already tagged Suzanne ProZinc and Lantus expert,, , every increase/reduction without her guidance, I will not lift a finger!!! she has been my Corky's guardian Angel, and I don't say that lightly:bighug::bighug::cat::cat:
 
Hi all!

@Bron and Sheba (GA) @Suzanne & Darcy @JL and Chip @Sienne and Gabby (GA)

Haven't posted for a while as Mia has been doing good, with numbers being pretty stable in blues and greens. For several cycles she even had the exact same numbers at +4 for several cycles in a row. However the last couple of cycles her numbers are all over the place, so looking for some advice.

During her evening cycle on the 13th, while feeding preshot, she and our other cat got their usual wet food and ate as normal. However maybe 10minutes later Mia vomited everything back up, and 5 minutes after that our other cat also vomited everything back up. So we are worried that there was something wrong with the food. Could that end up causing higher numbers?

The same evening she also had a smelly poop, which was not completely watery diahrrea, but liquid/soft.

After that she has had yellows and pinks during preshot, where yesterdays am cycle didn't even bring her down into blue numbers. Yesterday's pm cycle got her down into blue. But this morning her preshot was even higher than yesterday morning in pinks again.

At what point should be consider increasing the dose? And is there anything else we should be concerned about or consider taking her to the vet to get some tests done?
 
It's certainly possible that you had a bad batch of food. It's also possible that both kitties have a stomach virus of some sort. It's hard to know for sure but whatever it is, it affected both of your cats. I would give this a few days to work itself out since it looks like Mia's numbers are coming back down. You don't want to decrease the dose if Mia is back into greens. The higher preshot may be be a bit of a bounce.
 
It's certainly possible that you had a bad batch of food. It's also possible that both kitties have a stomach virus of some sort. It's hard to know for sure but whatever it is, it affected both of your cats. I would give this a few days to work itself out since it looks like Mia's numbers are coming back down. You don't want to decrease the dose if Mia is back into greens. The higher preshot may be be a bit of a bounce.

@Sienne and Gabby (GA) Hmmmm yes I don't see that it could have been anything else than the food since they both vomited withing 15min after eating. And haven't vomited since.

So will keep an eye on her and if the numbers keep on going down I will take it as the food being the reason for the increase in BG numbers.

Her last green numbers as you can see in the SS were 2 days ago, so she has soon been 24 hours in pink, yellow and blues.
 
Mia's numbers aren't going down during today's PM cycle. 15.4 at preshot and has been 16.4 at both +2 and +4.

I'm so confused about what's going on with her numbers lately.

We were doing so good for such a long time with just blues and greens and now numbers are all over the place.
 
Mia had a high preshot number again this morning. She is now on her 6th cycle with no greens, where the last cycle kept her in yellows..
 
So Mia finally had a blue preshot number for this evenings cycle after several cycles of pink and yellow, but just did her +2 half an hour ago and she's up in yellows again!

I'm so confused and literally have no idea what I have changed! Why does her BG keep on going up in the evenings but during the day her cycle is normal with a nadir at +4 or +6. She is getting the same food, the only thing we do is switch around flavors regularly, but again those flavors are the same she had been getting since diagnosis
 
If you squint your eyes that 104 could be real close to a green and maybe was at +7.
It must be real hard to measure such a teeny tiny dose. Could the dose be inconsistant by a little tiny bit? I think I would give it another day.
 
If you squint your eyes that 104 could be real close to a green and maybe was at +7.
It must be real hard to measure such a teeny tiny dose. Could the dose be inconsistant by a little tiny bit? I think I would give it another day.
Hi @Dyana which 104 number are you referring to?
Regarding doses I am using a caliper to keep the dose consistent.
 
Are you drawing in more insulin than you need then squirting out the excess? I’m also wondering about slight variations in the dose — any chance you’re getting air bubbles sometimes?

Did the higher BG numbers correlate with a new batch of food?

How are both of the cats feeling now after the bout of vomiting and soft stool?

Lantus is dosed based on the low numbers and you had a 49 just a few days ago, so given that and the recent vomiting/soft stool (which can sometimes have lingering impact for a few days depending on the cause), I might hold tight a bit longer.
 
Are you drawing in more insulin than you need then squirting out the excess? I’m also wondering about slight variations in the dose — any chance you’re getting air bubbles sometimes?

Did the higher BG numbers correlate with a new batch of food?

How are both of the cats feeling now after the bout of vomiting and soft stool?

Lantus is dosed based on the low numbers and you had a 49 just a few days ago, so given that and the recent vomiting/soft stool (which can sometimes have lingering impact for a few days depending on the cause), I might hold tight a bit longer.
Hi @JL and Chip ! Thanks for replying :bighug:

Yes when I draw insulin I always draw a little more than necessary, flick with my fingers on the syringe to get bubbles to the top and then squirt out the excess. Haven't seen any air bubbles as I am always checking it against a really bright light while also measuring with the caliper.

The higher numbers aren't necessarily a match for the new batch of food. As this started quite some days later.

Both cats seem fine again thankfully! Have kept the can from the food they puked from in order to check batch numbers of the same flavor as we have more cans of that same brand and flavor.

Yes it's the recent lime green that has had me wondering if I should wait a little longer before increasing her dose. Would you say another couple of cycles? Or is there a specific time after a recent lime green you suggest I wait?
 
So, Mia finally had a "normal" pm cycle yesterday evening where her numbers actually decreased after insulin at both +2 and +4 before starting to increase again at +6.

This mornings preshot number was yellow, the first am preshot lower than pinks in 5 days now. Just did her +2 test and it has gone up now! Got a feeling she has just decided to switch from increasing numbers in pm cycle to increasing numbers in am cycle now...:(

Will be testing again at +4
 
Looks like I will be increasing the dose in the morning. Would appreciate advice on what dose to increase to from her current 0.1u and what that looks like on the syringe.
 
From the TR dosing sticky:


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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
 
From the TR dosing sticky:


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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
@tiffmaxee

Yes I have seen this, but seeing this is the first time I have had to increase her dose past 0.1 I don't know what a dose like that would look like on the syringe. I don't want to end up increasing too much.

Increasing by 0.25 units on a 0.1u dose means her new dose would be 0.35u?
 
@tiffmaxee

Yes I have seen this, but seeing this is the first time I have had to increase her dose past 0.1 I don't know what a dose like that would look like on the syringe. I don't want to end up increasing too much.

Increasing by 0.25 units on a 0.1u dose means her new dose would be 0.35u?
No. Her dose will be .25. Do you have syringes with half unit markings? You will need to eyeball .25. It’s easier if you have the half unit markings but if not you can do it with what you have. I’m glad you asked about the dose as .35 would be too much. The smallest dose we can give us a drop dose. From there you go to 0.1 and then to .25. I hope this helps.
 
No. Her dose will be .25. Do you have syringes with half unit markings? You will need to eyeball .25. It’s easier if you have the half unit markings but if not you can do it with what you have. I’m glad you asked about the dose as .35 would be too much. The smallest dose we can give us a drop dose. From there you go to 0.1 and then to .25. I hope this helps.
@tiffmaxee oh ok, I just assumed since it's 0.1 now and I am supposed to increase with 0.25, that I would add the two measurements together.

Ok so increasing to 0.25u. I use 0.3 ml syringes, with half unit markings. So compared to the 0.1u she is currently getting, a 0.25u would be between the first line and the half unit marking?

I use a caliper, any advice on how to change the current measurement to 0.25u?
 
@tiffmaxee I don't have a measurement for 1 unit since Mia has never gotten 1 unit before. I only have a measurement for the 0.1u she has been on, which on the digital caliper I am using, we measured to 1.35mm.
 
Are you using any of the syringes in the link I gave you? If not I would eyeball .25 and let let be your new dose. I do want to add that I wanted you to hold the dose the extra cycle because you never reduced when the bg fell under 50. Once you start the new dose if the bg falls under 50 you would decrease back to 0.10. If possible always get another test if the bg is under 50. That 49 did make sense given the previous readings though.
 
@tiffmaxee No, none of those syringes, the ones I am using are called Insumed Pic Solution. Ok, but generally, apart from that I am using a caliper, where should I be aiming for the 0.25u dose to be on the measuring lines?

Yes, I never reduced after her last lime green number, as I felt pretty confident that it was a one off and not because she needed a dose reduction. She hadn't eaten enough during her meal at shot time, which is why she ended up dropping just a little too low. I always test 20-30min after she has a low number, but I am always unsure of how to add those tests into the sheet without making a complete mess of the SS.
 
I found even with the best of syringes the lines could be off which is why I started using calipers. I would pick a used syringe that seems to be the most accurate and use that as my guide. Going forward you could then ignore the lines and go with calipers. You won’t be doing a full .25 increase so I would just adjust the calipers to what you feel is closest to.25 and go from there. When I started using them my syringes were in the list. You can change your subject to say caliper help if this won’t work for you and see what others say.
 
@tiffmaxee yes that's exactly the same reason I started using a caliper too! So frustrating!

Ok, will just have to give it a go I guess. I'm just trying to figure out how much more a 0.25u dose is compared to the 0.1u. That's why I'm asking about the measuring lines on the syringe, just to have several guidelines to go after
 
@tiffmaxee I don't have a measurement for 1 unit since Mia has never gotten 1 unit before. I only have a measurement for the 0.1u she has been on, which on the digital caliper I am using, we measured to 1.35mm.
If for 0.1u you’re setting the calipers to 1.35mm, then doubling that caliper mark would be 0.2u, would it not? (I’ve not used calipers before but assume this should work). I believe this would be the math:

0.1u —> 1.35mm caliper mark
0.2u —> 2.7mm
0.25u —> 3.375
0.5u —> 6.75mm

The 0.25 dose should appear visually to be half way between the zero line and the 0.5 line on the syringe.

I’m glad you’re double checking the dose and where to draw on the syringe. After your early drama with incorrect syringes and being given dosing in mm rather than units, it’s good to be cautious.
 
@JL and Chip

Yes, that is what makes sense to me too, that I would be doubling the measurements on the caliper. But it also kind of sounds alot to double it.. @tiffmaxee can you confirm if this is the right way to do it since you have used calipers too?
 
I would also draw what you think is 0.25u and then use the caliper to measure. If it’s around 3.3mm to 3.4mm (ish) on the caliper measure, then you’re on the right track. You can use colored water in a syringe to experiment. Let me know what you find out.
 
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