Need Dose Opinions Updated

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I know most of you have been concentrating on my low numbers but, my Momma is more concerned with my high ones - especially with the one this morning that was Over 600 which makes three close together. She's trying to decide whether to increase my dose tonight .25, .5, or a whole unit. She's threatening to stick me again later to see what my number is then. Yeo-o-o-w! I'm eating my food, and drinking lots of water (I especially like her glass), and I was running around outside again 'til she made me come in (it's raining). That was after I had to scream for her 'cause I got my toe stuck on an old board. Help her decide so that she doesn't give me too much stuff.

See below!!!!!
 
Re: Mugsy needs opinions

I would advise against raising the dose since you do not have too much data. Are you testing at pre-shots and not filling in the ss? It is very important to get those pre shot numbers.
You should also be testing for ketones with such high numbers.

Without anymore spot checks it is hard to say why the numbers are so high. Could be a bounce. Is Mugsy getting into any dry food or any higher carb food?
See what others have to say.

Could you also remove the 911 from your subject and just put "dose help or advice." Thank you. :smile:
 
11/4 Mugsy +600 & +600 Updated

Help, please. Should I increase his dose .25 or .5 or 1 u ?? With this many high readings, I know he needs to have a higher dose but, I'm not sure how much is safe. His current dose has been 1 u. Opinions please. (see SS and earlier post by Mugsy)

Third successful test today 5 pm - OVER 600 AGAIN :!:

You people still sure I should reduce the dose ????? I'm afraid to put him at more risk if he's hyper not bouncing from lows. :?: nailbite_smile
 
Re: 11/4 Mugsy +600 & +600

What time do you shoot, 7:30 eastern time? Unfortunately most peeps are at work now, check back an hour or two before your next shot time. or try a PM to one of the more experienced members. Sorry I can't advise, but I'll bump you up the list.
 
Re: 11/4 Mugsy +600 & +600

Sally and Mugsy said:
Help, please. Should I increase his dose .25 or .5 or 1 u ?? With this many high readings, I know he needs to have a higher dose but, I'm not sure how much is safe. His current dose has been 1 u. Opinions please. (see SS and earlier post by Mugsy)
sally, i have to ask...
--- are you testing before administering every shot?
--- are you doing any evening spot checks?
--- were any bg tests done on 11/1 & 3?

if the answers to these questions are "no"... i would reduce mugsy's dose immediately for the sake of safety.
he may be dropping very low and then bouncing very high. increasing the dose without enough data can be very dangerous.

otoh, if you haven't entered all the data you've collected on mugsy's ss, please do so and forget what i said above.
we'll have to take another look once you've recorded all the data.


ps - i've merged both of today's threads. :-D
 
Re: 11/4 Mugsy +600 & +600

So you switched to Lantus from Vetsulin about a week and a half ago, and after a couple of seemingly BLUE days, the numbers are really whacky now. I know you've been having trouble getting readings, but it's hard to see what's going on without more data. Is he still bouncing around from the 53 on 10/27, or is he solid BLACK all the time? Very glad to see negative ketones. Could your Lantus be damaged/bad now? Did you drop it or shake it?

Weird... :?

MJ&Donovan
 
Re: 11/4 Mugsy +600 & +600

1. All information is recorded...just got lucky today getting blood.
2. Did a control check on the meter to be sure it was working right and strips are new, also.
3. He did not get into anything he shouldn't
4. The Lantus is new, has been very carefully handled, and is kept at 40 degrees.
5. He is showing textbook signs of Hyperglycemia appetite, thirst, urination...vomiting may be caused by grass eating. He is not lethargic, however.
6. His shots are given at 8 am and 8 pm. The 2nd reading was within a half hour of +6 hours (possible nadir).
7. This is the 12th day since starting Lantus. He has had readings over 500 5 times in the past 10 days but, only one day showing normal numbers.
8. His infection is gone, injury healing nicely, and the only stress is from testing.

Have I missed anything? Protocol calls for an increase of about .5 with a nadir above 300 and consistant high readings. That's why I'm asking.
 
Re: 11/4 Mugsy +600 & +600

Sally and Mugsy said:
1. All information is recorded...just got lucky today getting blood.
2. Did a control check on the meter to be sure it was working right and strips are new, also.
3. He did not get into anything he shouldn't
4. The Lantus is new, has been very carefully handled, and is kept at 40 degrees.
5. He is showing textbook signs of Hyperglycemia appetite, thirst, urination...vomiting may be caused by grass eating. He is not lethargic, however.
6. His shots are given at 8 am and 8 pm. The 2nd reading was within a half hour of +6 hours (possible nadir).
7. This is the 12th day since starting Lantus. He has had readings over 500 5 times in the past 10 days but, only one day showing normal numbers.
8. His infection is gone, injury healing nicely, and the only stress is from testing.

Have I missed anything? Protocol calls for an increase of about .5 with a nadir above 300 and consistant high readings. That's why I'm asking.

thank you for answering all the questions.

are you missing something? yes.

lantus/levemir dosing is based on nadirs. how low is this dose taking mugsy? all we know for sure is the current dose has dropped him to 53. we have NO idea if he has dropped lower. although the high numbers suggest it's very, very possible mugsy has dropped even lower. after having looked at spreadsheets for the last several years, i would say there's a real good chance mugsy has dropped lower than 53. if he didn't, it doesn't matter. when a dose drops a kitty that low (53), you certainly don't want to increase the dose. kwim?

combine the above with not enough data collected and you have a recipe for a disaster. i strongly urge you to drop the dose to 0.5 unit bid. in the meantime, test before every shot and get at least one mid-cycle spot check every cycle.

if you're having trouble with hometesting, please post for help on the Health forum. if you post your city & state, perhaps someone lives close enough to you to come over to show you some tips and tricks.


from the Tight Regulation Sticky at the top of the forum:

WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR...

  • Kitty should be monitored closely the first three days when starting Lantus or Levemir.
    Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
    More monitoring may be needed.
  • It will be necessary to test kitty's blood glucose levels multiple times per day. <---------------
  • Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
  • Feed a high quality low carb canned or raw food diet.
  • Feed small meals throughout the day. Some kitties adapt well to free feeding.


i know you're trying and i applaud your efforts (it will get easier), but until you are able to test multiple times a day, a Tight Regulation Protocol is not something you should attempt to follow... for the sake of safety. we're concerned. we just don't want anything to happen to mugsy.
 
Re: 11/4 Mugsy +600 & +600

I have to agree with everything that Jill posted. There's a very good chance that Mugsy is getting low numbers during the PM cycle and bouncing into high numbers. Without test data you will never know and there is no way to keep Mugsy safe without testing.

In fact, this is what I posted in Mugsy's condo on Monday:

Sienne & Gabby said:
Can I gently prod you into getting pre-shot tests? And PM spot checks?

Here's my reasoning. You are seeing some blue and green mid-cycle numbers. Pre-shot tests tell you whether it's safe to shoot. If you look at the subject lines displayed on the Board, you'll see people posting when they have low pre-shot numbers. If you don't have a pre-shot test, you could be shooting on a mid-green, and Mugsy's +3 could be a 30. You need to have confidence in what you're doing and test strips and a meter will give you the confidence to make decisions as to whether it's safe to shoot. Mid-cycle checks tell you whether Mugsy gets a dose reduction or an increase. That black number looks like a bounce -- but the question is how low was the number Mugsy bounced from.

Without PM checks, you are losing half of your data. Many cats have lower numbers during the PM cycle. It's quite possible that Mugsy had a low number during those PM cycles when the AM check showed a 500+ number.

Pre-shot tests are essential as are at least one test per cycle.
 
Re: 11/4 Mugsy +600 & +600

Sally I am sorry if this all sounds scary and maybe even a little harsh but please know that we have nothing but good intentions to make sure Mugsy is safe.
Everything Jill said is correct and the protocol only works when you have enough data to support using that protocol.

Mugsy may be reacting very well to the Lantus and I know to you it appears his numbers are too high which I agree they are too high but I don't believe they are high because he needs more insulin I really believe he is high from too much insulin and you are seeing some very big bounces.

If you have trouble testing please post on the health forum for help. I know how hard it is to test because when Putty was first dx it took two of us to test him but I knew it had to be done for his safety. Once he was used to the testing he was very cooperative.

We are all here to help you so if there is anything we can do please just ask. We want to make sure Mugsy is safe and healthy and that you become comfortable testing.
 
Re: 11/4 Mugsy +600 & +600

Sally and Mugsy said:
Third successful test today 5 pm - OVER 600 AGAIN :!:

You people still sure I should reduce the dose ????? I'm afraid to put him at more risk if he's hyper not bouncing from lows. :?: nailbite_smile

This is the question from another thread that Sally just started but I reposted it here.


To answer the question.....YES we are sure you should reduce the dose. He is at more risk not knowing what his numbers are and without many tests we cannot be sure he is safe at the dose he is on.
Are you testing for ketones?

There is a greater risk for him being at very low numbers than high numbers which is why you need to reduce.
 
Ketone tests all negative (strips fresh - litter ph neutral). From 9:30 am through 5 pm all bg tests >600.

PS - MY blood pressure is way up thanks to all of this Hope I hold on. Cross your paws for both of us.
 
Re: 11/4 Mugsy +600 & +600

Miriam and Putty said:
Sally and Mugsy said:
Third successful test today 5 pm - OVER 600 AGAIN :!:

You people still sure I should reduce the dose ????? I'm afraid to put him at more risk if he's hyper not bouncing from lows. :?: nailbite_smile

This is the question from another thread that Sally just started but I reposted it here.


To answer the question.....YES we are sure you should reduce the dose. He is at more risk not knowing what his numbers are and without many tests we cannot be sure he is safe at the dose he is on.
Are you testing for ketones?

There is a greater risk for him being at very low numbers than high numbers which is why you need to reduce.
i agree with miriam 110%!
there's only one way to know for sure how low a dose is taking him and that's to get serious about testing before EVERY shot as well as getting mid-cycle spot checks.

yaaaaaaaaaaaaaaaaaay for no ketones!!!
 
Okay - I'll go for .5u.

Believe me, I am serious about testing - there's just NO point recording every UNsuccessful try! The larger lancets are on the way and that's what I need to get blood from a rock called Mugsy. :roll: Today was a fluke!

Just check the SS, which I will do keep updated. As a matter of fact, I have a written log, the FDMB SS, a personal Vetsulin SS, personal Lantus SS, and special Curve chart. The last ones are my own design. Most of all poor Mugs gets poked a lot more than he should have to be in spite of the results.

Ps: I am using Ambesol on his poor, sore feet. It takes away the pain for a while but, won't hurt him.

Good night
 
I did some searching too - I'm a little concerned about it too - have you tried polysporin? (regular strength)
most people on the board use that (or polysporin) on the ears if testing is done on the ears (can't be licked off)

check it out just in case.
 
Re: 11/4 Mugsy +600 & +600

I checked your spreadsheet - it looks like you reduced the dose tonight. THANK YOU!!!!! You simply do not have enough data for us to recommend a dose increase, and with the data you do have we are concerned that Mugsy might be getting too much insulin.

You can't increase the dose in response to the 600's because you don't know WHY he is in the 600's. It's a lot like when I was recently diagnosed with hyperthyroidism, and despite my begging, my doctor wouldn't prescribe medication for me until the tests had been done to show WHY my thyroid was overactive. Some of the treatments would have been dangerous if the condition had certain causes, so I had to be sick for a little longer. Mugsy might have been high for days, or he might have been very low yesterday or the night before. It is impossible to tell from the data you have, but because he has been in the 50's (or lower) in the past, we have to assume it is possible that he went there again. If you can keep getting preshot tests and midcycle tests over the next few cycles, we will have a much more clear picture of what is going on.

We do know what the possibilities are, and that is why we are not able to make dosing recommendations without data. We're not trying to be critical, but we have to put the cat's safety first.
 
I wish you the best of luck with your new dose and to becoming a pro at testing...it will come, we've all been there. :roll:
Please heed the advise given about the anbesol being toxic to cats. I hope you have a nice night :-D
 
Yes, I did reduce the dose. Yes, it's Anbesol. Sorry, was getting tired and rushed. He does not lick it off but, I can assure you from prior experience it seems to do no harm. My last cat was crazy about the stuff and would attack anyone to get at it. She sure licked enough of the stuff with no adverse effects. I have been trying all day to get a new reading but, so far no luck in spite of all the poking. Will post if I get a reading. I'm waiting impatiently for the new lancets.
 
http://www.fanciers.com/cat-faqs/health-care.shtml

(From Norsworthy, 1993:)

Medications that cats should NEVER be given:

* Acetominophen (=tylenol, paracetamol) (1 tablet can be fatal to an adult cat)
* Benzocaine (the topical anaesthetic) (available in spray and cream forms--- Lanacaine and several hemhherrhoid preparations have lots of benzocaine)
* Benzyl alcohol
* Chlorinated hydrocarbons (like lindane, chlordane, etc.)
* Hexachlorophene (found in pHiso-Hex soap, among others)
* Methylene Blue (used to be used for urinary infections, many cats cannot tolerate it)
* Phenazopyridine (used in combination with sulfa as AzoGantrisin: fine for humans, deadly for cats)
* Phenytoin (=Dilantin) often used for seizures in other species
* Phosphate enemas (including Fleet (tm) enemas): may be fatal


http://www.petfinder.com/pet-care/pain- ... friendly=1
Pain Medication Poisonous to Cats
Charlotte Means, D.V.M., ASPCA National Animal Poison Control Center

...Local anesthetics like lidocaine, tetracaine, benzocaine or pramoxine are found in many topical antibiotic ointments and suppositories made for people. Products that contain these local anesthetics may include the phrase "plus pain relief" in the product name. Concerned guardians often apply these topical medications to their cat's cuts or abscesses, not knowing that the local anesthetics can be absorbed through the skin or ingested during grooming. Cats are at an increased risk for toxicity because of their unique hemoglobin structure, which is easily damaged by the anesthetic. In large amounts, seizures, tremors and cardiac arrhythmia can occur. Before deciding which antibiotic ointment to keep in your cat's first aid kit, ask your veterinarian for recommendations and dosage guidelines. ...
 
In case WCF wasn't clear, benzocaine is the active anesthetic in Anbesol. It really doesn't sound like Anbesol is a product that should be used for cats.
 
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