Need Insulin Dosage Help!

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suwannee79

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My little man George has a BG of 392 right now - my dilemma is this:

He had a fructosamine test done Monday that came back on Tuesday with a result of 268 so the vet told me he appears to be producing his own insulin and to stop giving him insulin for right now but to obviously continue checking his BG before feedings. The next day (yesterday) he had BG over 300 all day so I called the vet and she told me to go back to giving him insulin at 0.5 units twice a day unless his BG was 225 or lower, then don't give him insulin.

This morning his BG was 225 so I didn't give him a shot but my husband just checked his BG before feeding him dinner and it came back at 392!

My question is: Do we just give him the 0.5 dose or should we give him 1 full unit to bring it down?

Also, is there a blank version of the BG spreadsheets people have or do I just try and save someone's and fill it with my info?
 
Go with the .5. You would expect the number to be high with no shot this morning, but don't overreact to it. If you give .5, that should drop the number to something closer to the "don't shoot line" in the morning.

In the Tech Support Forum, there are instructions on how to set up a spreadsheet. You will need an account on googledocs, and it will be blank, but pre-formated to match the ones you see here.

http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Carl
 
Spreadsheet

Stick with the lowest dose. And keep a good eye on him, maybe a mini-curve of every 3 hours, or make sure he's oK before you crash for the night.

Also, to help him stay more level, you might take half of his food and freeze it. Put out both the frozen and the fresh at the same time. As the frozen thaws, he can nibble on it, rather that eating all of it all at once. Its a "several smaller meals" tactic to control the rate of food going in so it does so more evenly.
 
That means that he isn't quite ready for "no insulin at all", but pretty close to that point! Your vet gave you good advice to reduce to .5, and not to shoot below 225 too.

Carl
 
Depending on how stable he can be at the 0.5 dose, you may want to invest in some U-100 syringes for smaller doses.
There is a conversion chart, but the math is pretty straighforward
0.4 * U-100 syringe mark = dose
so,
0.4 * 0.5 U-100 syringe mark = 0.2 units
0.4 * 1.0 U-100 syringe mark = 0.4 units
0.4 * 1.5 U-100 syringe mark = 0.6 units
 
Thanks so much, sticking with the .5 dose!

I am slightly confused now though about when to shoot and when not to shoot - if he's low in the morning and then really high at night is it still ok to not give a shot in the afternoon?

Going to do the spreadsheet now so I can get a better idea of what he's looking like and calling the vet tmw for sure!

Oh and BJM, I try and give him half his food prior to the insulin and the other half a few hours later but I like the idea of freezing that second half so that if some reason I can't be there in person to give him the food later he can still eat between meals :) And we actually have a ton of U-100 needles from when a previous vet switched him to Humulin N temporarily so I would love to find a use for those, especially with 0.5 unit being difficult to see on the U-40s.

Thanks for the help!!
 
If you skip the AM shot, it depends on what you want your normal shot times to be. You can shoot in the afternoon, but then that would become your new starting point, and the next shot would be 12 hours from that point.
Or you can do what you did today. Skip AM and wait till the normal PM time.
If this keeps happening, then what you would do is reduce the dose from .5 to less than that. The goal is to be shooting a dose that allows you to shoot every 12 hours. If .5 doesn't allow for that, then you find a lower dose that will. If the numbers just keep getting better, then eventually you don't need to shoot at all. :smile:

Carl
 
suwannee79 said:
...Oh and BJM, I try and give him half his food prior to the insulin ...
Click to expand...

But the first half of the meal is AFTER the glucose test, right?

Ideally, the test should reflect a somewhat fasting level of glucose, roughly 2 hours worth. If it doesn't, you may overcorrect and give too much resulting in a "no shoot" level, or possibly a hypoglycemic episode.

The optimal dose is one you can give every 12 hours without changing.

Of course, that presupposes your cat has read "How To Be A Feline Diabetic" and is following the rules!!!
 
BJM said:
Of course, that presupposes your cat has read "How To Be A Feline Diabetic" and is following the rules!!!
Click to expand...

You know, I'm not sure he's read that haha :-D And as far as the pre-shot glucose tests they are before he eats.
 
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