Need to adjust dosage

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Shadow McFatto

Shadow McFatto

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So the vet wanted me to go with 2u in morning and 2 again at night because his pre test was between 300-350. Did that yesterday and bg dropped into the 40s both times. I think he has been bouncing and I need to drop. I only used 1.5 this morning but he wouldn't eat much so that may be why I had to give nutrical. I think I need to adjust my doses. My thoughts are 1u in morning and again at night. What do you guys think? I am scheduled to give in 1.5 hrs.
 
I think he's bouncing too. And I think you could try 1u and see how it goes for a couple of cycles. I think your instincts are right on the money.
 
One thing... see what you get in 1.5 hours. If it's lower than you expect, for instance.
 
Did I read that you had recently changed from dry to wet low carb? One unit could be okay. If it makes you a little nervous going into overnight, you could go down to 0.5. Depends on what you get for pmps. The likelyhood of a bounce is big - especially with the high carb given to bring him up.
 
I took him off the dry on Thursday or Friday entirely although he was mostly canned. I had been leaving him dry in the day just in case. Would it be safe to leave him YA while I'm at work tomorrow? I feel like I should leave him with something (as if he could tell his sugar is low and needs to eat), lol.
 
Yes, leaving out Young Again should be fine. Some people freeze the wet food and leave it out to thaw during the day. A silicone cupcake pan works great for this -fits a Fancy Feast can perfectly and pops out frozen pucks.
 
Actually, it seems many cats do know when they are low and will look for food, or demand that they be fed. I don't think leaving out YA is a bad idea.
 
OK, just took my pmps and we are at 274 which is better than it was yesterday so I think we are on the right track. I am thinking 1u tonight. What do you think?
 
Hmmm...it's hard to know for sure. I might go .5 if he was mine...but I tend to be pretty conservative. It might be too little, but should hopefully let you get some sleep. And we can always raise in a bit...just my thoughts though.
 
I think it depends on whether you want to test tonight. The 0.5 is safe but might not be enough. Giving it will likely give you an easy evening - though a test before bed is always wise. The one unit might be fine, but you need to ge that before bed test, and if he is heading down fast, be prepared to test and perhaps intervene over night.

The problem we have advising you on dose is that we have very little data yet, and the diet change is in the mix.
 
My opinion? I think I'd go with .5u and get a good night's sleep.

ETA - to clarify, sometimes it makes sense to be aggressive.Sometimes it's best to take a break. Your spreadsheet looks like you haven't had a break lately.
 
I went with 0.5. He ate, had a pee and ate some more. Maybe 1 oz of FF savory salmon so it should be low load. I will check him again in a couple hours. His little paw pads got pretty beaten up today. That reminds me, today he started reacting to the insulin needle. Anyone else have that? He jerks and I'm afraid I could end up shooting IM instead of subq.
I'm laughing right now because he's purring and kneading on my belly, lol.
 
Sounds good!

What size needle are you using? Some people like the 30/31 gauge needles; the 29 ones can hurt. Where are you shooting?

The standard here is to feed seafood once or twice a week with other meats fed more often. The thought is that you want to limit the mercury.
 
If you do shoot IM by accident, It's not a big deal.
More likely it would be a "fur shot" where all of the insulin doesn't make it in. If that ever happens, don't try a second time. You have no way of knowing how much got in or didn't.
 
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The needles are 29g. I shoot in the scruf of the neck. They came with the little sharps container prozinc kit from the vet. I will look for the smaller ones.
I bought a couple cases of FF in a variety. I will use something else tomorrow, I wanted to finish the can. (cheap skate) lol
 
Last night the +2 was 185 after 0.5u. The amps was 378 which is the highest it has been since coming home. I went with 1.0 this morning since he went so low yesterday on 1.5. I will check again before I leave for work in 1.5 hrs. I'm planning to leave out some YA today. Even though he was high this morning, it was the first time in several days that he has gotten in my face once he sees I'm awake so I think that's a good sign.
 
Sounds like it was too little insulin. That's okay! As Carl said, sometimes you need a break...the good nights sleep was worth it. Plus, better too high for a day than too low for a moment.

At this stage, it's all data collection. Now if you get a similar number, you have a good idea what that dose will do so we can adjust. Make sense?

I think 1 unit will be good. :)
 
Thanks! I almost feel like I am in control! I have Thursday and Friday off for some minor surgery. I should be able to get some good data on one of those days.
 
That is the best part of home testing. You feel like at least you know what is going on now and that you can keep him safe. Your job is to collect data, as Rachel says, and keep him in safe numbers.
 
So amps and pmps are a little high. I went up to 1u tonight and we'll see what the amps is. If still above 300 will probably go to 1.25 and see how that looks. He is eating more now that his lows aren't so low, I think maybe that's why his numbers are still high. Any thoughts?
 
Interesting...it's possible that his eating is helping soften the curve some, which is a good thing. I'd say, see where he is at tomorrow morning...can you monitor tomorrow? I'd increase for high numbers maybe IF you can monitor...I just want to make sure you don't see a steep drop! If you can't monitor, I wouldn't increase until you can.
 
I agree with Rachel. I think I'd give the one unit a few more cycles. Today, for example, you don't know whether there was a low number somewhere in the +3 to +12 time period.

It really doesn't work well to determine doses just on pre shot numbers. You need to know how low the insulin took him mid cycle. If he dropped low, he can bounce up to a higher pre shot. Increasing the dose could then make that drop lower and the bounce higher. If he is flat and in the 200s all cycle, then yes, an increase is a good idea.

Once you have that data, then you have the information you need to change the dose. Lots of people set the alarm for 5-7 hours after the shot at night and get a test, if they are not able to get tests during the day. That information can help you figure out the puzzle too.
 
I agree about not increasing until I can monitor him. I'm going to stick where we are at with 1 and 1 until I can. I can tell that even if his pre sticks are high, he is still feeling better than he was. He is following me around the house again.
How much of the FF should he be eating? He weighs about 8.5 lbs now but was probably 12-13 before this all started. I am lucky to get him to eat one small 3.3 oz can a day. I don't know think that I can get him to eat more.
 
Was he always a slower eater or does he seem less interested? If the former, you can leave it out for him to graze. If the latter, have you tried adding a little warm water and making it a little soupy? Sometimes they just aren't used to the texture. Some people have had success "dressing" it with Parmesan cheese or tuna juice or a favorite snack.

I think it's pretty average for cats to eat 2 cans of Fancy Feast daily - maybe a half a can more if they are underweight.
 
He just inhaled another half of a can! He usually asks to be fed every time I go into our bathroom where they feed. It was always kibble though so it's hard to compare. He seemed to like the canned until I think he started feeling bad. Could it be that after two weeks of that he needs to rebuild his appetite? He goes right after it when I put it down, just doesn't finish it lately. Maybe his stomach shrunk?
 
His appetite may calm down as you get the glucose under control because he will be able to use the calories from what he eats.
 
Shadow McFatto said:
He just inhaled another half of a can! He usually asks to be fed every time I go into our bathroom where they feed. It was always kibble though so it's hard to compare. He seemed to like the canned until I think he started feeling bad. Could it be that after two weeks of that he needs to rebuild his appetite? He goes right after it when I put it down, just doesn't finish it lately. Maybe his stomach shrunk?
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I think he probably needs more than one an a day. If he will eat more and he isn't overweight, I'd feed him more. Maybe try a different flavor than he was eating when he didn't feel well. Sometimes they associate not feeling well with whatever they were eating at the time.
 
One thing you can give him to entice him to eat is Bonita Flakes. I find them at a local Asian Market. I had no idea to look for so I just asked one of the cashiers. They come in little packets and basically they are shredded or very thinly shaved fish. I just put a pinch on top of their food. All my kitties love it.
 
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Yeay! Very excited! His bg was quite a bit lower this morning even after eating almost an extra can at pm+5! His appetite was great this morning and he ate a whole can of FF chicken! I left YA for all cats to munch while at work today. Excited to see his pmps! Thank you all for your advice which convinced me not to follow the vet blindly. I know we have a way to go here but he is acting so much happier and looking so much better, we must be
 
Yes! He follows me around screaming "Feed me Seymour"
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OMG! Road block! YA does not sit well with Luna! She had diarrhea this morning all over my bedroom! She managed to climb up the cat tree and poo on the wall!! I can't leave YA out during the day for Shadow without locking him up somewhere. Guess I'm going to have to find a silicone muffin mold to freeze some FF.
 
I feel like I should say, that our vet was absolutely wonderful. She worked hard to save him when he could barely stand. I just really appreciate the after hours help here with people who have been dealing so closely with this for so long.
 
OH dear! Well, she certainly gave you her reaction to that in a big way!

You can freeze the FF on a cookie sheet or anything it will sit on while freezing. It's just that it is so easy to pop out of the silicone. I can't remember where I got mine; it was long ago. Maybe others will have other ideas...
 
I use ice cube trays to freeze my food pucks. Then I have a big container in the freezer where I store all of them together. I think that container holds about 35 food pucks.
 
Appetite came back with a vengeance! He's eating 2 cans FF - 1am,1pm. He wants more but I'm afraid of his numbers. If he munches on it during thethe day will the insulin still keep him low?
 
It's a balancing act. If he is underweight, you can feed a little more. If he is overweight and inactive, then feed a little less. I'd say the average here is around 2 cans of Fancy Feast daily, for a normal cat who is fairly well regulated.

But he has to eat so you dose and feed the way that fits your schedule. If that's twice daily, then about 1 can twice a day. If you want to do mini meals, the cut the daily ration into as many meals as you want to give him.
 
Still trying to get his weight back up so I will put the frozen puck out tomorrow. I was just worried that his bg would get too high, I won't be around to monitor.
Does there seem to be an average amount of time before the bouncing stops? It certainly makes it hard to find thethe balance.
 
I used to feed Bob a half can of FF at each shot, and the other half can around 5-6 hours after his shot. So he got a total of two cans a day, in four equal meals. That worked well with my schedule since I live where I work, and home was never more than ten minutes away.

ETA- Polly eats the same amount on the same schedule, although she's not a sugar cat. I just feed her 4 equal meals because that's what works for me. And she eats much slower than Bob ever did.
 
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