? Need Help with Morning Dosing

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Andrew Cat

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At 8:00am the BG was 180 and we did not dose. We fed him and an hour later the reading was 484.

How should I handle this situation should it happen again tomorrow with a low morning reading?

When the morning reading is so low it seems crazy to jump to such a high number within a short time.

If someone could take the time to check Andy's spreadsheet, it would be sincerely appreciated.
We had a similar situation happen on 10/06...

Thanks so much
Sheryl
 
Sheryl - I looked at the spreadsheet and have a few questions:
Did Andrew just start on insulin on 9/24? Are you using Prozinc? Do you have a human meter, or an AT2? What is Andrew eating?
 
I actually started him on the 25th . Yes, I'm using Prozinc and the relion meter. He us eating Fancy Feast Turkey/Giblet. Initially I was using the wrong scale, on 10/01 changed to a lower dosage.
 
Has Andy been eating the FF for awhile, or is that a new food? I think it's pretty normal for BG to rise after eating, so when Andy is low and then you feed him and test an hour or two later, the higher number is a pretty normal response. If this is a new food for him, and he's just transitioning from a higher carb food, that might be why his numbers are inconsistent, too. Especially with him being so new to the insulin, I think you're dong the right thing to not shoot, but the thing is figuring out how to get numbers that allow his dose to be more consistent.

I'm curious if starting at a lower dose, and keeping it more consistent might help him get better numbers? When I started, my vet said to give 1u twice/day, and then do a curve on the fifth day. I think some people even start at .5u twice/day. The goal is to get two shootable numbers/day and it looks like you're shooting in the morning, but not able to shoot most evenings, which might mean that the dose is too high, or it could mean that it's lasting too long. You're right to not give him a dose when his numbers are low, it's just a matter of figuring out what dose gives you two numbers that you can shoot.

Hopefully the experts will be on soon and can give you a more definitive answer about what to do.
 
When he was initially diagnosed the vet recommended changing diet only without insulin for one month,he recommended Royal Canin
wet/dry. I changed him to Fancy Feast Turkey/Giblet so he has been on the wet diet for about two months. Started insulin late September. Before that he was on dry food only.
 
Hi Sheryl! When you get a number under 200, you want to stall WITHOUT FEEDING for 15 to 20 minutes and retest. That way, you get a test that isn't food influenced. You want to be sure the number is rising and see if you can get it over 200. That way, hopefully you don't have to skip.

If he was mine, I think I'd restart at 1 unit tomorrow morning. He's going to be high since no insulin tonight (probably). But starting at 1 unit and keeping it there for a few cycles might help. Often, if you start at higher numbers, you miss the perfect dose. Looking at his SS, I'm seeing that you're not consistently getting 2 shootable numbers a day. It's important to get those so that the insulin is able to work constantly in his system. What do you think about starting over at 1 unit? It might help get 2 shootable numbers and we can go from there. :)

You're doing great at testing, by the way! I'm usually around in the morning...around 5:15 or so Central Time. Just in case you need early morning help.
 
Hey Sheryl. Just checking...are you using U40 syringes? Andrew has some really interesting numbers. I find it interesting because on 9/28 and on 10/5 he did not receive an AM shot and then at nadir he was in the 300's and then he was too low to shoot at PM. On 10/4, he did not get a PM shot yet he was high later in the cycle and then too low again to shoot on AM. Interesting....
 
Andrew is interesting....I waited until 9:00am this morning when his B/G was 220 before dosing...tried to give him around .05 ....using U40 at this time.
It's unfortunate that most vets have such a different approach to treating....I'm trying to find a vet within a 2 hour driving distance to oversee his care that will follow low carb/wet food approach and that has been a challenge. I'm so clueless.....having to rely on information from others on his care for such a serious problem is worrisome.
Just venting.....I'll check his B/G again at 2:00pm and see how the lower dose is working...Thanks....
 
Andrew IS interesting. Amazing that he went up to 515 and then went down on his own to the 200s and surfed along all cycle. I think I might try to get .5 on my syringe and dose that for a few cycles (as long as he is over 180-200) and see if he settles down. It seems like he doesn't need a whole lot of insulin..

Sometimes you can use a magnifying glass and find that 0.5 line on a syringe and mark it with a permanent marker or tape and use that syringe as a sample.
 
Next time you need syringes, you may want to try the U100. You can buy them at Walmart and it is the ones with the orange cap 31 gauge. You can get your doses to 0.2. You will need to use the Conversion chart

If you are looking for a vet, have you seen the vet interview questions? You probably could ask them over the phone w/o scheduling an office visit. @BJM has the questions I think in her signature.
 
Hi Sheryl - just wanted to say what a handsome guy Andy is -It's so hard when you first start out, because the cat can bounce all over the place. I am told that things eventually settle down (still waiting for that to happen myself) You can find lots of help on this board - you might have better luck finding a vet if you can find a feline only practice -I realize that those are mostly in larger cities though
 
Hi Sheryl, just a thought, perhaps if you can't find someone in your driving distance, you can cultivate a relationship with a knowledgeable vet that you could email you SS to and have phone and email consults. I am thinking of doing that with an internist vet that is 1 hour from me and the ophthalmologist vet that Bubba sees at that practice told me that the diabetic patient's correspond daily via email about their cats with the internist.
 
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