Need dosing advise - Upping dose? | Feline Diabetes Message Board - FDMB

Need dosing advise - Upping dose?

McKenzie LaPray

McKenzie LaPray

Member since 2025
We were 2 hours late for his PMPS, due to a wedding. Didn’t get to test him but once today due to being busy for said wedding. (Feeling guilty right now!) Got home and he was at 393 and ketones 2.2. We fed then shot! He’s eating, drinking, and using the bathroom normally. Im thinking it’s time for a slight increase to 2u. Can someone look at his spreadsheet and let me know your thoughts?

Thanks in advance! Hoping to get back on my testing game as his ears have been giving me trouble. They’re getting scabby 😞
 
I’m sorry that I was tied up all day and didn’t see this. I am trying to get caught up right now and answer everyone’s questions.

I do agree with the increase to 2 units. He has been on the 1.75 unit dose long enough with mostly yellow nadirs.
 
I’m sorry to hear about his ears as well. They should not actually be getting scabby. Are you holding/applying pressure for a minute after you do the test? Are you alternating ears and pricking up and down the outer edge of the ear so that you aren’t pricking in the same place each time? Holding the lancet at a 45 degree angle?

You can put a little coconut oil on his ears.
 
Suzanne & Darcy said:
I’m sorry to hear about his ears as well. They should not actually be getting scabby. Are you holding/applying pressure for a minute after you do the test? Are you alternating ears and pricking up and down the outer edge of the ear so that you aren’t pricking in the same place each time? Holding the lancet at a 45 degree angle?

You can put a little coconut oil on his ears.
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Yes. We are doing all of the above! I just put coconut oil on, we will see how they look in the morning! I’m sure one of our other cats will lick it off, lol!
 
Suzanne & Darcy said:
I’m sorry that I was tied up all day and didn’t see this. I am trying to get caught up right now and answer everyone’s questions.

I do agree with the increase to 2 units. He has been on the 1.75 unit dose long enough with mostly yellow nadirs.
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Good morning! I just tested Stoney, 3 times, (his ears are still giving me a hard time), 81, 77, and 70. I’m going to stall for 30 minutes, test again. We haven’t been able to keep on a true schedule for at least 2 weeks. :( I hope he goes up to a better number for me to feed and shoot. Poor guy is hungry.
 
When you test, do you go in with the lancet at an angle, preferably of about 45 degrees? I've found this makes a big positive difference, rather than jabbing directly from above.
 
McKenzie LaPray said:
Good morning! I just tested Stoney, 3 times, (his ears are still giving me a hard time), 81, 77, and 70. I’m going to stall for 30 minutes, test again. We haven’t been able to keep on a true schedule for at least 2 weeks. :( I hope he goes up to a better number for me to feed and shoot. Poor guy is hungry.
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He’s now at 55, which is great considering his numbers lately, but I don’t think I can stall any longer. Him and the other kitties are hungry (have to feed all at the same time or else 😅). I’m going to feed, then test again 30 minutes later.
 
It’s weird. I had a funny feeling last night that when we had talked about the increase that he was going to now show us a thing or two. They like to do that when we threaten an increase! So instead of an increase he has earned a reduction to 1.5 units. Congratulations, Stoney!
 
McKenzie LaPray said:
He’s now at 55, which is great considering his numbers lately, but I don’t think I can stall any longer. Him and the other kitties are hungry (have to feed all at the same time or else 😅). I’m going to feed, then test again 30 minutes later.
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Tested, he’s at 71. Will test again in 1 hour, at +3. Thinking we are skipping this dose, because there is no way I can give his PM dose at 11:30pm our time.
 
Suzanne & Darcy said:
It’s weird. I had a funny feeling last night that when we had talked about the increase that he was going to now show us a thing or two. They like to do that when we threaten an increase! So instead of an increase he has earned a reduction to 1.5 units. Congratulations, Stoney!
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Haha! When we were first diagnosed and I saw a green #, I freaked! Now I am happy with them! We will reduce to 1.5 and now maybe we can get him back on a semi normal schedule :)
 
Suzanne & Darcy said:
It’s weird. I had a funny feeling last night that when we had talked about the increase that he was going to now show us a thing or two. They like to do that when we threaten an increase! So instead of an increase he has earned a reduction to 1.5 units. Congratulations, Stoney!
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Just tested him again at +5. He is at 367! I’m not sure a reduced dose is a good thing…. 🫩 we are going to continue with 1.75 tonight then increase depending on # for the AM shot. I don’t feel comfortable increasing over night because I won’t be able to monitor him.
 
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We cannot adjust the dose based on preshot numbers. In order to prevent hypoglycemia, we must take into account the nadirs. He has just had low green nadirs. Now, the problem here is that we can’t completely trust the Libre readings in low numbers, but if it’s all we have then we have to base dosing decisions on that. The Libre tends to read excessively low in the low numbers. This is why we recommend having a backup human handheld glucometer to check the lower green Libre readings. I have seen a Libre 50 be well over 100 on a human glucometer.
 
Suzanne & Darcy said:
We cannot adjust the dose based on preshot numbers. In order to prevent hypoglycemia, we must take into account the nadirs. He has just had low green nadirs. Now, the problem here is that we can’t completely trust the Libre readings in low numbers, but if it’s all we have then we have to base dosing decisions on that. The Libre tends to read excessively low in the low numbers. This is why we recommend having a backup human handheld glucometer to check the lower green Libre readings. I have seen a Libre 50 be well over 100 on a human glucometer.
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Oh he is no longer on the Libre! He broke the last one before we even got home. He has been on the human meter since Friday October 10! Thought I took that off when I removed it from his spreadsheet. Whoops! Been rough over here.
 
Also, it’s a good time to talk about bouncing. High numbers do not always mean more insulin is required, and we must be careful. It’s quite likely that the pink numbers you are seeing now are a bounce. A bounce is where the cat’s body reacts to lower numbers that he is not used to being in anymore… since becoming diabetic. It’s a protective mechanism where the cat’s central nervous system perceives either a steep drop in blood glucose or simply the cat being in lower numbers — and releases adrenaline, cortisol, glucagons and growth hormone, all of which create insulin resistance and can keep numbers high for up to six cycles (the bounce). Bounces don’t have to last that long, but in some cats they will. Over time, many cats will start to clear the bounces more quickly. When the bounce does clear, the BG numbers will come back down and give us an accurate picture of what a dose is doing for the cat.
 
Suzanne & Darcy said:
Also, it’s a good time to talk about bouncing. High numbers do not always mean more insulin is required, and we must be careful. It’s quite likely that the pink numbers you are seeing now are a bounce. A bounce is where the cat’s body reacts to lower numbers that he is not used to being in anymore… since becoming diabetic. It’s a protective mechanism where the cat’s central nervous system perceives either a steep drop in blood glucose or simply the cat being in lower numbers — and releases adrenaline, cortisol, glucagons and growth hormone, all of which create insulin resistance and can keep numbers high for up to six cycles (the bounce). Bounces don’t have to last that long, but in some cats they will. Over time, many cats will start to clear the bounces more quickly. When the bounce does clear, the BG numbers will come back down and give us an accurate picture of what a dose is doing for the cat.
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I have been trying to understand what a bounce was since joining the forum back in September. You just explained it beautifully! Now that I know this, I will report back tomorrow morning with his numbers and if we skip, then go forward with a reduction only if he earns it. Thank you, Suzanne, for everything!
 
McKenzie LaPray said:
Oh he is no longer on the Libre! He broke the last one before we even got home. He has been on the human meter since Friday October 10! Thought I took that off when I removed it from his spreadsheet. Whoops! Been rough over here.
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Okay then since you are using a human meter (thank for updating the spreadsheet and signature) that is even more reason why we need to reduce the dose, according to the dosing protocol, (regardless of bounce numbers or other high fluctuations.)
 
McKenzie LaPray said:
I have been trying to understand what a bounce was since joining the forum back in September. You just explained it beautifully! Now that I know this, I will report back tomorrow morning with his numbers and if we skip, then go forward with a reduction only if he earns it. Thank you, Suzanne, for everything!
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I’m so glad it helped! Bouncing is sooo frustrating. You see all the high numbers and it just seems like you should increase the insulin, but if you do and then he clears the bounce, his numbers can come crashing down.
 
Suzanne & Darcy said:
I’m so glad it helped! Bouncing is sooo frustrating. You see all the high numbers and it just seems like you should increase the insulin, but if you do and then he clears the bounce, his numbers can come crashing down.
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Luckily we only have him the 1.75 and did not increase to 2, so he is at his normal dose for the evening :) should be stable overnight! I’ll be up for the next few hours to be able to test him again. He was at 304 when I tested him a few minutes ago at +3.
 
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