Need help with curve and questions

[Mel and Oreo]

Hi Everyone,
I have just done a second curve. I am sending it to my vet, but I trust your input.

Caninsulin 2 units twice daily

5:10am 414 before food/insulin
5:30 fed Oreo
6:09 400
7:12 387
8:10 fell asleep missed alarm
9:09 218
10:08 200
11:10 178
12:08 131
1:10 106
2:15 97 (nadir)
3:09 130
4:50 142
5:00 fed Oreo
5:34 205 ( 34 min after food)
6:12 293 ( 72 min after food)

Vet said if approx 288 after food only give 1.5 units, if 360 or more give 2 units, and if 252 or less 30 min after food do not give the shot. So I gave 1.5 units.
At 6:36 am the next morning I tested Oreo 30 min after food and he was 291 so I gave 1.5 units again.
At 5:38 pm that night I tested Oreo 30 min after food and he was 383 so I went back to 2 units.
Now this am he measured after food at 6:02 am 297 so I went back to 1.5 units.

It has become a seesaw between 1.5 and 2 units. I can try 1.75 units, but I have the 40 unit per ml syringes so would probably be easier with the 100 unit syringes.

My vet says to test after food, that the test before without food just tells you that the insulin is still working from the last dose. She says that once he eats the glucose goes up and without the insulin it won't be used up and will stay high. What I read on here is that you test before food and even stall and not give food to see if the number rises and if not, not to give insulin or reduce dose etc.. Is my vet totally wrong telling me to test the blood sugar 1/2 hour after he eats? I am afraid Oreo will go to low. Thank you BJM for the chart, but if that is for tests given before food I am not sure what to do when the vet is saying to test 30 min after food. Is caninsulin different?

 

[Sue and Oliver (GA)]

With Canninsulin, the approach is to test and feed, then give insulin. Because Canninsulin can drop the levels fast, the thought is to have food in the cat to smooth out the drop. And if the cat is not going to eat, you would be more cautious about giving the insulin because he might drop low.

Your curve looks pretty good. That is a late nadir, especially with Canninsulin. And a very long drop - from the 400s to the 90s can't feel very good. But he didn't seem to bounce for pmps which was good. If you can keep him in the 200s at preshot and double digits(but above 40 ) at nadir, he would be doing very well.

One thing to remember is that when you test at preshot, you test before feeding, that is the number to base your dose on. The number more than 15 minutes after feeding can be higher because of food, so you wouldn't want to give a higher dose based on that number. You can give the shot later, but base the dose on prefed numbers. Does that make sense?

 

[Mel and Oreo]

I was basing the dose on before food numbers and then my vet told me to base them on 30 minutes after feeding. This really worries me.
For example on the curve at 4:50 pm he was at 142 before food. Then I fed Oreo and 34 minutes later he was at 205 and then at 72 min after food he was at 293 and vet said if around 288 30 min or more after food give 1.5 units.
If I base it on pre food at 142 then from the info I see on the site he would not get insulin at all? Is this correct?

 

[Sue and Oliver (GA)]

What we usually say to new diabetics is not to shoot a preshot under 200 but to wait 20 minutes, without feeding and retest. If the number rises and is at 200, then you can shoot. If you are using Canninsulin, at that point I would probably reduce the dose from the one the night before, because the previous dose would have given me a preshot too low to shoot.

We factor out the food rise and try to base the dose on " true" numbers, not influenced by food.