New Member 03.02.21 - looking for dosing guidance

[catladybob]

Before I start, I just wanted to thank you all here for taking the time to help. My cat will be 19 at the end of this month. She was originally diagnosed around 2015 and went into remission twice. Both times only took a few months and she was on 1 unit max during these times. Her diabetes came back in May 2019 and hasn't left. I have not been checking her sugar at home. I was taking her to the vet every 2 weeks and adjusting her doses as per the vet's instructions. The week before Christmas, she had a weird episode that I thought was neurological. She was smelling the floor frantically and walking over things like they weren't there. I picked her up and her head was swaying. It all ended on its own in less than 2 minutes. Her vet says it was most likely a hypo event but that it was odd that it ended on its own. He lowered her dose to 2 units [ she'd been on 4 twice a day up until this time. Her bg was 115 during this visit. ] A few weeks later I started with the Freestyle Libre sensor. The vet's current instructions are to give her .5 unit when her sugar is under 350 and 1 unit when it is above. This does not seem right to me. With .5 unit, her bg shoots up - sometimes on 1 unit as well. 2 units brings her down too low and makes me afraid to give her next dose which raises the bg again and starts the cycle over. The link to her spreadsheet is below. Thank you in advance for taking the time.

https://docs.google.com/spreadsheets/d/1gNxZ7C1ED4bLJOP2skFVS06gZATO1idOSC2Y1MYeFrA/edit?usp=sharing


Thank you,
Anne

 

[Ann & Scatcats]

Hi. That was sucha pretty mainly good yellows, blues and greens bg spreadsheet she has.
Compliments!

Off the bat, the 1.5 unit BID seemed to bet the right one that set her back on blue and green track.

As she is 19, Super Senior, does she have any other ailments?

 

[catladybob]

Thank you for the response. No other issues, thankfully. I forgot to ask, at what point do we worry about ketoacidosis? She does sit in the 300’s sometimes and has hit 400. Should she be tested for ketones right when she’s in the 300’s? How long does it take for DKA to set in? Is it always obvious or could she be experiencing it right now and I don’t know it?

 

[Bron and Sheba (GA)]

. I forgot to ask, at what point do we worry about ketoacidosis? She does sit in the 300’s sometimes and has hit 400. Should she be tested for ketones right when she’s in the 300’s? How long does it take for DKA to set in? Is it always obvious or could she be experiencing it right now and I don’t know it?

It is always a good idea to test your kitty for ketones if he/she is unregulated, that way if ketones do appear you have heads up and can catch them early.
If your kitty is not eating, or is lethargic or vomiting or generally unwell, I would test for ketones as well.
Ketones can form if there is not enough insulin and not enough food and maybe kitty has an infection or an inflammation and if left, can lead to DKA
Ketones will appear before DKA so if you are testing for them and are aware of what to look for you, should be ok.
A DKA kitty is unwell, not eating, lethargic, may be vomiting

Lantus works best if you give the same dose for both cycles. If you chop and change, you will mess up the depot.