New Member, Need help with dosing

GuppySeaweed

GuppySeaweed

New Member
Hello! Guppy was diagnosed early this year in February when he was in DKA, and has been on 2 units of Glargine twice/day since his diagnosis. His dose was lowered by the internist we work with to 1 unit for two weeks in late July, but was raised again after consistently high BG and increased PU/PD symptoms.
I was recently advised by someone who used to be an active member on this forum to restart using the SLGS method and go from there, as his BG has never been consistent: could be around 230 mg/dL for a few days and then go up to 500 mg/dL. I need help figuring out where to begin and how to do this safely. I have just set up a SS, but have not yet started recording data. Thank you in advance!
 
Hello and welcome to you and sweet Guppy. You've dealt with a lot with the DKA and pancreatitis.

We can help with dosing, but will need to see some blood sugar values in the spreadsheet. Let us know if you need help knowing how to enter the data.

The SLGS method is just one of two methods we use here, and we don't recommend restarts (also called resets). They can do more harm than good, especially with a kitty with a history of DKA. I'd suggest sticking with the 2.0 units if that is what you are doing now, and gathering data for a few days. Check in each day and we can help you figure out what needs to happen next with the dose. Test his blood sugar in the AM and the PM, just before you give insulin. That will tell you if it's safe to give insulin. Also find some time in between shots in the AM and the PM if you can, so we can see how low 2.0 units is taking him. We determine how to change the dose based on how low it takes him. If you don't work on the weekend, a curve (testing every 2 hours for 12 hours or every 3 hours for 18) will be really helpful to see how he's using the insulin.

If you see a shot before the test (we call it the preshot or PS) that is below 200, post here for help deciding what to do.

A couple questions from me. First, are you using syringes or the pen to inject the insulin? Second, are you home testing Guppy for ketones? WIth a DKA history and high numbers, testing for ketones will help keep him safe. You can get urine test sticks at human pharmacies for that.
 
Wendy&Neko said:
Hello and welcome to you and sweet Guppy. You've dealt with a lot with the DKA and pancreatitis.

We can help with dosing, but will need to see some blood sugar values in the spreadsheet. Let us know if you need help knowing how to enter the data.

The SLGS method is just one of two methods we use here, and we don't recommend restarts (also called resets). They can do more harm than good, especially with a kitty with a history of DKA. I'd suggest sticking with the 2.0 units if that is what you are doing now, and gathering data for a few days. Check in each day and we can help you figure out what needs to happen next with the dose. Test his blood sugar in the AM and the PM, just before you give insulin. That will tell you if it's safe to give insulin. Also find some time in between shots in the AM and the PM if you can, so we can see how low 2.0 units is taking him. We determine how to change the dose based on how low it takes him. If you don't work on the weekend, a curve (testing every 2 hours for 12 hours or every 3 hours for 18) will be really helpful to see how he's using the insulin.

If you see a shot before the test (we call it the preshot or PS) that is below 200, post here for help deciding what to do.

A couple questions from me. First, are you using syringes or the pen to inject the insulin? Second, are you home testing Guppy for ketones? WIth a DKA history and high numbers, testing for ketones will help keep him safe. You can get urine test sticks at human pharmacies for that.
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Thank you for the advice! I will definitely start getting some values on the spreadsheet so you can see what's going on. I use syringes to inject, and do not test for ketones currently. I'm assuming the urine test strips are the way to go? How often should I be testing? He was tested for ketones in August before they determined the pancreatitis, luckily it was negative, but of course it would be helpful to do at home. The internist I work with advised to just keep an eye on his symptoms and weigh him every week or so as he only recently started gaining a little. I do test his BG before each dose, and was planning to do a curve on Monday:) I should check back in on the main forum, starting a new thread? or on this thread?
 
Tips to catch and test a urine sample. Some people get a BG meter to test for ketones, especially if recently seen. Ketones can go from trace to high in a day. I'd test when he's in high number and/or lethargic and not eating.

Good to hear you are using syringes. Are you using ones with half unit markings? We typically make changes by 0.25 units at a time, we eyeball that. Cats are sensitive to small changes.

Since you just started this thread, you can carry on with it so people have some history. On this forum, we ask people to start a new thread if it's getting long or been a longer period of time.
 
Welcome to FDMB!

If you have test data that is stored in your meter, you can include that on your spreadsheet. We suggest a minimum of 4 tests per day. You want to get a test before giving insulin so you know that it's safe to give a shot. You also want to get at least one test during both the AM and PM cycles so you have an idea of how low the insulin is bringing the numbers. That will also tell you if doses need to be raised or lowered.

This is a link to the forum where we have information on glargine. The sticky notes at the top of the board will give you background on the insulin as well as on our dosing methods.
 
Wendy&Neko said:
Tips to catch and test a urine sample. Some people get a BG meter to test for ketones, especially if recently seen. Ketones can go from trace to high in a day. I'd test when he's in high number and/or lethargic and not eating.

Good to hear you are using syringes. Are you using ones with half unit markings? We typically make changes by 0.25 units at a time, we eyeball that. Cats are sensitive to small changes.

Since you just started this thread, you can carry on with it so people have some history. On this forum, we ask people to start a new thread if it's getting long or been a longer period of time.
Click to expand...
I do currently use syringes with half unit markings, but bought a new brand that I didn't realize does not until they came in, but I can buy others with half units. I will buy ketone strips today to have on hand, thank you!
 
Sienne and Gabby (GA) said:
Welcome to FDMB!

If you have test data that is stored in your meter, you can include that on your spreadsheet. We suggest a minimum of 4 tests per day. You want to get a test before giving insulin so you know that it's safe to give a shot. You also want to get at least one test during both the AM and PM cycles so you have an idea of how low the insulin is bringing the numbers. That will also tell you if doses need to be raised or lowered.

This is a link to the forum where we have information on glargine. The sticky notes at the top of the board will give you background on the insulin as well as on our dosing methods.
Click to expand...
Good to know! I am seeing that some of the information I was initially given on glargine (like rolling to mix) was incorrect, so it's a little overwhelming having to relearn a lot, but I'm happy to be put on the right track. I will start testing more often during the day/night. I work full time during the day and have considered a timed feeder during the day as I've noticed his BG seems more controlled when I can feed him more frequently throughout the day, but have another cat and am concerned that I won't actually know whether Guppy's getting another meal or not. I have also heard of freezing wet food cubes to thaw during the day so they can have a snack later.
 
There are pet feeders that are microchip controlled so that only a particular cat gets it. I've heard of people doing something innovative like putting the food in a box that has a doorway only big enough for a smaller cat, if the smaller cat is the one that needs the food. Or if the smaller cat is eating high carb food you don't want Guppy to eat.
 
Wendy&Neko said:
There are pet feeders that are microchip controlled so that only a particular cat gets it. I've heard of people doing something innovative like putting the food in a box that has a doorway only big enough for a smaller cat, if the smaller cat is the one that needs the food. Or if the smaller cat is eating high carb food you don't want Guppy to eat.
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The only thing with the microchip feeders is that I only feed wet (both cats get the same food). They have their own eating placements in the kitchen, so I may just try two automatic feeders in each of their spots and see how it works out on days that I'm home. Luckily they both eat FF classic pate so I'm not particularly worried about Guppy getting into Seaweed's food
 
I started Guppy's spreadsheet on Saturday and took as many readings as I could on Saturday and Sunday, and am currently in the middle of doing a curve. I know it isn't much information yet, but I will continue checking in here and updating as I go. I also asked my vet about scheduling a dental in the next month or two, as his teeth have a lot of built up tartar, and I'm hoping that could help get his BG a bit more under control. Thank you for the help already given, and I've already learned a great deal going through the forum and looking at other spreadsheet examples.

I understand if it's not enough data yet, but if you're able to give insight on Guppy's current dose it would be appreciated!
 
Great job on the testing so far! The only thing I'd recommend is to try to get a second test every night. It doesn't have to be in the wee hours, but if you can get a before bed test, say 2-3 hours after the preshot, that'll tell us a lot. On a cycle where kitty is planning to drop a lot, that +2 or +3 will be quite a bit lower than the PMPS value. So far, from what I can see, 2.0 might be a bit low a dose, but I need to see a few more days of data to see if those highs are from bouncing.
 
Wendy&Neko said:
Great job on the testing so far! The only thing I'd recommend is to try to get a second test every night. It doesn't have to be in the wee hours, but if you can get a before bed test, say 2-3 hours after the preshot, that'll tell us a lot. On a cycle where kitty is planning to drop a lot, that +2 or +3 will be quite a bit lower than the PMPS value. So far, from what I can see, 2.0 might be a bit low a dose, but I need to see a few more days of data to see if those highs are from bouncing.
Click to expand...
Yes! I was planning on getting more night time tests tonight, last night I tested when he happened to wake me up. Unfortunately I think I missed a little and poked through the other side but I guess we'll see how his numbers go. Thank you for the insight so far!
 
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