Need dosing help

PatJ

PatJ

Member
Could anyone give me advice on dosing my cat tonight, because I've missed the last two nights because the night before I kept waiting for his numbers to go up and then it was too late, and last night he was so low that I didn't give him anything . The trouble is that he has started to go low lately (which is good) but he stays much lower than usual at his PMPS when he should be going higher again and I'm getting a bit paranoid about what to give him when he's low. Could he be on too high a dose of insulin or perhaps it's too low? I really don't know and would be so grateful for any comments. Thanks for any help.
 
It looks like his dose needs to be reduced. Try 2.75 u or 3 u tonight, whichever you're most comfortable with. Get a +2 this evening.
 
Thanks for replying. I think I'll try 2.75 because I feel a bit safer giving him a lower dose, although because he went back down from 6.1 to 5.6 I've fed him so I'll have to wait till 10.0 clock tonight now, but hopefully his numbers will have gone up quite a bit. Is it all right to keep him on 2.75 for a while, because he's been really quiet for the last couple of days and it's probably because of my dosing or lack of it for two nights. Thanks Kris.
 
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PatJ said:
Thanks for replying. I think I'll try 2.75 because I feel a bit safer giving him a lower dose, although because he went back down from 6.1 to 5.6 I've fed him so I'll have to wait till 10.0 clock tonight now, but hopefully his numbers will have gone up quite a bit. Is it all right to keep him on 2.75 for a while, because he's been really quiet for the last couple of days and it's probably because of my dosing or lack of it for two nights. Thanks Kris.
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Yes, try to avoid no shot as much as possible. It's worth trying 2.75 u for a few days to see if it helps the high/low PS problem. Those big ups and downs likely make him feel off and that's why he's been quiet.

We'd love to see a photo of William in your avatar box. :)
 
I guessed it was the ups and downs that were affecting him and I feel so bad for him so I'm glad you said to drop it a bit. I'll get a photo of him as long as it will transfer from my phone. Hope so!!
I've just tested him and he's got twenty minutes to go before shot time and he's now at 9.6. In the unlikely event that he doesn't reach 10.0 at least, is it still all right to give him the full 2.75?
 
PatJ said:
I guessed it was the ups and downs that were affecting him and I feel so bad for him so I'm glad you said to drop it a bit. I'll get a photo of him as long as it will transfer from my phone. Hope so!!
I've just tested him and he's got twenty minutes to go before shot time and he's now at 9.6. In the unlikely event that he doesn't reach 10.0 at least, is it still all right to give him the full 2.75?
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I'd try the 2.75 u. That 9.6 is close to 10 and it's these experiments that teach you where the boundaries are.
 
Thanks for that info. Thankfully, he's at 13.2 now so sorry for bothering you for nothing but I'm glad you told me that for future reference.
 
Sorry to keep on, but William has had four hypo numbers in four days and although the rest of the numbers today are the best he's had, he goes very quiet and he's not so enthusiastic about eating any more, although he does, thank goodness, but I've had to change his food, which I've read can affect them. Do you think that these low numbers will go away soon, or is his insulin in need of adjusting? I'm really worried about the way he goes down so quickly and these hypo numbers are scary but is this all par for the course when their numbers are getting better? I would just be so glad for your opinion, if you wouldn't mind. Thanks very much.
 
Every time he gets a lime green number, you need to lower the dose right away. Why don't you try 2u tonight and see how he does? He'll likely be high tonight because of that low number today, so don't worry about the numbers, reduce the dose anyway.
 
Don't ever be sorry about asking questions! That's why we're here. We want to help you all like folks helped us when we got here.

I agree that you want to go ahead and reduce to 2 units tonight no matter how high he is. :)
 
Good advice from the others. Yes, if you get a lime green in any cycle reduce by at least o.25 u for the next shot. Post here for help.
 
Djamila, Rachel and Kris, I know I should have dosed him last night but I didn't because of these hypo numbers and I couldn't wait any longer for a reply because it was nearly midnight, but this morning I saw your replies and I just want to say a big 'Thank you' to you all. Where would I be without all this wonderful help? This morning he wasn't as high as I thought he might be - 16.8mmol/L. I gave him 2 u today but I wondered afterwards if that was only meant for last night? or should I carry on with 2 u to avoid these hypo numbers? Thanks again
 
Not sure if you got a reply from me because it seems to have disappeared. Just in case you didn't, it was to thank you all, Djamila, Rachel and Kris for replying and for your invaluable help. I asked if it was all right to keep him on 2 u or was that just for last night( which I didn't give him anything because of the hypo numbers, I know that I should have done, but because of the time zones it was nearly midnight here, so I couldn't stay up any longer and didn't see your messages till this morning. I always worry in case not enough insulin is as bad as too much and I'm not clever enough yet to dose him without asking. He wasn't too bad (for him) this morning at 16.8mmol/l. I've only given him 2u today. Do you think that he should have had more? Again, thank you all for your help. Apart from the hypo numbers and looking at yesterdays numbers, I'm beginning to think that there's light at the end of the tunnel at last!
 
How about continuing the 2 u for today just to take a bit of pressure off of you. The dose might have to go up a little but that can be done in 0.25 u increments later.

It would be helpful if you add your general location to your signature text - time zone or similar. That way we can take that into account when posting.
 
I agree with Kris. Stick with 2 for now and let's see what happens. It is hard when we're all in different time zones, I know. We've had folks on here before that we've had to work around the time zone issue with, though, so we can help you too. We just sometimes have to give advice differently in more like "what if" scenarios since we're less likely to be on when you are dosing.
 
He's dropped from 18.0 to 7.1 in a little over 2 hours and two hours later another hypo number!!! I've just got him back to 6.2 with high carb and honey, but WHAT IS GOING ON WITH HIM?????? I think he's definitely out to get me!
Could he slip back to another hypo number before this cycle is finished or do you think that will be all for today? I gave him 2 units this morning, so tonight I'll drop it even lower. What would you recommend? I'll set the alarm for every two hours tonight and see what happens. Oh joy!!!

Apparently, our time zone is with Paris, but we are one hour in front of England, if that's any help. Thanks as always.
 
Well, the good news is that his pancreas is taking up more responsibility, which is great! It does make it stressful for you though. The lime green didn't hit until mid-cycle, so let's drop back to 1.5u or 1.75u now (whichever you are more comfortable with is fine). One suggestion I would have is that next time, if it's around +6, just give him regular food instead of honey - the honey is kind of hard on their systems and is best reserved for symptomatic hypos, very low numbers, or early in the cycle.
 
Thanks Rachel, He's had another hypo number today and I gave him 2 u this morning. I don't know why this should be happening, but will lower the dose again tonight and fingers crossed.
 
Thanks Djamila, Is his pancreas really on the up? That's really good news. Is that why he could be having all these hypos? That's now his fifth in as many days.Sorry I'm a bit thick,but what is a symptomatic hypo and what is a very low number, would that be one or under? When you say give him regular food do you mean his usual food or regular high carb? I must admit that he shows no sign of being IN a hypo, just that his numbers are scarily low!I think I'll drop to 1.5 tonight, and hope that he stays higher. Thank you all so much for this help.
 
Symptomatic hypo is when they are low and they are not acting normal. They might seem disoriented, have trouble walking, lethargic, etc. Most of the time when our cats hit lime greens they are extra hungry, but other than that they will seem just fine. If they go really low though, they'll start acting funny. And what counts as "really low" can vary some from one cat to the next. In general, I would say anything in the 30's (low 2's on your meter) or lower you want to take a little stronger action to bring them up (high carb food). 40's are really still pretty safe, but you don't want to ignore them - a snack (low carb food) and further monitoring is definitely in order.

In general, if the lime green happens near the nadir, giving regular low-carb food is all they need to start rising since the insulin should be starting to wear off anyway. If it happens early in the cycle, they still have several active hours of insulin left so that's when they might need higher carb food. I tend to think of honey or karo as a last resort - generally only if the kitty isn't able to eat themselves, or if you don't have any high carb food in the cupboard. If they can eat higher carb food on their own, they don't really need us stuffing them with short-acting sugar.

I think a reduction tonight is a good idea. And again, don't worry if the PS number is high tonight. Go with the reduction anyway.
 
Thanks Djamila, There's a few things there that I didn't know; I thought that all hypo numbers were dangerous. Don't feel quite so paranoid now; I'm going to reduce it to 1.50 tonight as you suggested. Thanks so much for all that information.
 
When they drop below 2.7, you want to take it seriously, but they aren't in danger right away. We use the lime green numbers to remind us to "take action". When I first started I was sure Sam would just fall over dead when he hit a lime green. :rolleyes: Then I looked at some of the old spreadsheets where the lime greens didn't start until 40 and I realized that there is a little built in safety buffer there. Again, you don't want to get complacent about them - you do want to make sure to give a snack and monitor until the numbers come back up, but there's no need to panic as long as you're doing your part.
 
By the old SS, she means like mine. Take a look if you feel inclined...it's been years now since Gypsy passed but I keep it linked so people can research if they want. Back in my day (man I sound like an old person talking about "these kids today" now!) 40 was where lime green started...I think they raised it to 50 so we could take action BEFORE it got unsafe.
 
Sorry Djamila and Rachel, My post just disappeared. Don't know what I pressed. Just wanted to say thank you for the reassurance about the hypo. Having said that I've just tested him two hours after he was 8.8mmol/L and I gave him 1.50 units and he's already gone down to 6.9 mmol/L! It's now a foregone conclusion that he will drop down to 2.something in a couple of hours or so.. I'll have to keep setting the alarm through the night now. Can I just ask you if the hypo can come back in the same cycle? Thank you both very much.
 
There's a chance he'll stay steadier and not dive...sometimes they "surf" which is always nice - especially at night. Can you stay up a little longer and get another test in an hour?
 
Hello Djamila, I kept getting up with the alarm till 3.30 this morning and I've got his results on the spreadsheet, but I was so afraid of not hearing the alarm that I didn't wait for him to take a dive to a hypo number,( but I think that he might have done because of his past cycles,) so I fed him, and when he went back up to 5.4mmol/L I went back to sleep. I wanted to ask you if I should keep him to 1.50 -he seems to be doing on well on it, but if he has another hypo number shall I give him 1.25 u and also, at what number is it all right to give him a PMPS now that his numbers are going down. Thanks for your help!
 
Woo hoo! Excellent progress, Pat! :D

Right now the 1.50 u dose looks very good. If he drops to a lime green number reduce to 1.25 u for the shot after that. So far you're seeing that giving the full dose on a PS near 9 is working well.
 
Thanks Kris, I'm so chuffed! I thought that he was one of those cats who would always stay high. Plus, he seems so much brighter this morning and Djamimla says his pancreas . I'm just waiting for his next test which could well be a lime green number and I know one swallow doesn't make a summer, as they say, but yes, Woo hoo!!!
 
Well, William has been to Hypoland again and he's due for his PMPS very soon, and his numbers are still low, so if it isn't much above 7.0mmol/L ( which I don't think it will be at the moment ) is it still all right to give him 1.5 u now that it's a lower dose, or should I wait until it's gone up to a higher number? Thank you.
 
I think going with a no shot tonight was the right decision. Tomorrow, if he's higher again, you can try 1u. Given what he did during his nadir today, I wouldn't do 1.25u right now. It seems like he's on a mission to reduce his insulin, so I would err on the side of caution and lower a bit more. Go little pancreas! Keep up the good work! :D
 
I've just tested his BG and he's gone down from 5.9 to 5.6 and it's time for his insulin so am I best to leave it tonight, unless he goes up in the next hour, because every time I have to stall, it makes him that much later for the next day and as he's still so low I'm really worried about another hypo in the night - they seem to be inevitable at the moment -
 
I tested him this morning for the AMPS and he's at 4.3mmol/L with no insulin last night!!! What have you done to my cat??This is the best result he's EVER had!! but if he's much higher tonight should I still only give him 1.0 u just in case there's another hypo?

If he's getting better, it's all down to you girls. You're just so clever. Thank you so much!
 
Wow! William is doing GREAT! I don't think I would go any higher than 1 unit right now considering what he's done so far. :) Even if he's higher, remember that's due to no insulin in his system...but you don't want to overreact to that and give extra insulin since that could bring him pretty far down again...make sense?

It's actually down to you that William is doing so well too! Remember we can only advise. You're doing the hard work of giving him shots/testing him/making final decisions. It's hard taking care of a diabetic kitty, and you're willingly doing all that work to keep him healthy and safe!
 
Thanks Rachel, I might be giving all his shots, etc., but without advice from you girls I would be absolutely floundering and I can't tell you what a relief it is to have found this forum. I'd sooner take advice from you about diabetic cats than from my vet and that's the truth. I'll give him one unit tonight and hope he doesn't bounce to another hypo! Do you think he should stay on 1 u for a while or is it too early to tell? He certainly seems a lot brighter since his insulin has dropped down. I suppose time will tell! Many thanks again.
 
Yay! Go William! Sometimes after a round of low numbers like this, a cat will stay low on their own for a couple of cycles and then start rising again, so don't get our hopes up too high just yet, but that AMPS is certainly a good number to wake up to!
 
Every time I send a message, I get something that says I have to be logged in (which I am, or I have to send a valid message) and my message disappears and I don't know if it's gone or not. I just replied to say 'thank you' and will wait and see what happens with the low numbers before getting too excited! Sorry, Djamila, if you've already got it.
 
Kris, As long as he doesn't go back up the ladder as quickly!! Ha! Ha! He's at 13.5 at pre-shot. I gave him one unit and fingers crossed it wasn't too much. Should have checked first.:oops:
 
Well shoot. Even though I said not to get hopes up, I totally had my hopes up that maybe he was going to stay low. Oh well. I think you did the right thing with the dose.
 
He was at 20.0mmol/L this morning and I really didn't know what to give him. I wasn't sure if it was safe to have upped it too quickly because he's had either no dose or low doses for the past few days and I wasn't sure if I should have gradually increased the dose or given him a higher one, so I just gave him 1.50, but it was probably wrong. If he's still staying high tonight should I increase it again? Say he's between 15.0 and 20.0 how much do you think I should give him? Sorry to keep asking, but I'm still quite clueless when it comes to dosing. Thanks Djamila.
 
What you did was reasonable. Figuring out a dose in these situations is a lot of guesswork. You might need to go up in 0.25 u increments going forward but that can be done every 3 to 4 cycles as needed. A "sputtering pancreas" (if that's what it is) can cause these fits and starts of good numbers with higher numbers in between.
 
He's now gone from 18.3 to 9.6 in about two and a half hours, so he's probably going to keep dropping for a while. If he goes low again tonight, should I give him less than 1.50 or keep to the same dose? If it wasn't for these hypo numbers that he's so fond of getting, I wouldn't worry half so much, but I would appreciate your opinion because I'm really not that confident at the moment about what to give when it comes to these low numbers. (If, of course, he gets any tonight!) Thanks Kris
 
If he's low tonight (but still high enough to shoot), you can reduce a little, but you do want to try to keep the dose as stable as you can.
 
I've just tested him again and he's gone from 21.7 this morning to 3.9mmol/L (less than two hours ago he was at 9.6) so I'm really worried about overdosing him. What in your opinion is the best dose to give him if he has a low number but high enough to shoot? Or even if he's a bit higher what should I give him, because he always seems to find his way down to the low numbers whatever he gets at the moment, and I just dread him going comatose in the night if I miss the alarm.

Thanks Djamila, I do appreciate all the help you're giving.
 
Oh now he's just messin' with us! :cat:

Let's see where he's at in a couple of hours when it's time to shoot. If he gets high enough, maybe try 1.25u.
 
In retrospect those pinks look like a short lived bounce from the AM green yesterday and now that bounce is "breaking" (ending) as we call it.
 
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