? Now that I have syringes..what dose should Cassie get?

Abby and Cassie

Abby and Cassie

Member Since 2020
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Today I'm doing a glucose curve (using the alpha trak for the vet to see). But regardless of what the vet says I know Cassie needs a dose reduction. I regret even bringing the vet up to date on Cassie's situation because I realize now they really don't know what they're talking about. Cassie goes in tomorrow for a checkup on her teeth and to discuss dosing, but I wanted to know what everyone else here thinks Cassie should go to. I'd like to do the SLGS method because it fits my schedule better I think, so I'm guessing with that method in mind I would go slow and start with 1.75?

But if the vet surprises me tomorrow and tells me to start at 1 unit/1.5, should I jump that far back and then slowly work my way up if my data tells me? I don't want to listen to the vet if they say to continue 2 units/increase. I'd like to start her new dose tomorrow night and stop seeing these crazy numbers. :arghh: Thank you all so much, you've been a light in the dark.
 
Yes, 1.75 units would be the new dose. I was lucky, I showed my vet the dosing protocol and Neko's spreadsheet, and after a couple weeks of spreadsheet update (and our long history together), she was fine with me doing the dosing. Not that she didn't suggest things at the beginning (like different doses at night which works for the Caninsulin we were originally on and she was more familiar with). Many people here have learned to "smile and nod their head" when it comes to dosing suggestions from the vet.

I hope you'll watch her closely today. That's 96 might prove an interesting cycle. I'd get a +1 and a +2 to start - since it's your lowest yet shot.

By the way, you do test plenty for TR.
 
Wendy&Neko said:
Yes, 1.75 units would be the new dose. I was lucky, I showed my vet the dosing protocol and Neko's spreadsheet, and after a couple weeks of spreadsheet update (and our long history together), she was fine with me doing the dosing. Not that she didn't suggest things at the beginning (like different doses at night which works for the Caninsulin we were originally on and she was more familiar with). Many people here have learned to "smile and nod their head" when it comes to dosing suggestions from the vet.

I hope you'll watch her closely today. That's 96 might prove an interesting cycle. I'd get a +1 and a +2 to start - since it's your lowest yet shot.

By the way, you do test plenty for TR.
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We're supposed to be doing it every hour and it's already 79 at +1 (again using dumb alphatrak!) so honestly if it keeps dropping I'm just gonna call and explain that I know this isn't good for her and I want to stop. I'm definitely gonna do the smile and nod thing! LOL. They really are a sweet veterinary practice, but I'll stick to using them for things like surgery or a dental cleaning.

I think technically I'm on TR right now but once I start up working again I don't think I'll be able to do it. Though I have been teaching my mom everything so she's my star pupil that could take over, LOL.

EDIT: I'm calling now, actually. This is gonna go way too low.
 
My very experienced vet internist also let me handle diabetes and he handled everything else. I did send him the spreadsheet every few weeks. Sometimes I would forget and when I would go there he would comment.
 
Wendy&Neko said:
You could technically go as low as 68 on the AT, but since Cassie is dropping so much so early, I think a couple tsps MC or a drizzle of HC is in order to help slow the drop.
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Okay just got off the phone with the vet. What a surprise, they said to feed food and bring to ER if it drops below 60. :rolleyes: Ay ay ay. I'm giving her some of her normal pate for now and will check up on her to see if she needs some more.
 
Tonight I'd like to start 1.75, I'm not waiting for the vet's permission. I know in my heart and from all of you it's the right thing to do.
 
How long do I hold the 1.75 dose for? On the SLGS page it says to hold it for a week. What happens if she drops too low again? Do I have to still do it for a week and monitor a lot or do I reduce it by another .25 immediately the next cycle?
 
105585720_210567353331161_2279208309377934343_n.jpg


Does this look like 1.75? My reading glasses won't be here til tomorrow so I have to eyeball it with my normal eyes. Sorry the image isn't the best!
 
So vet called back and said do not give insulin tonight. And tomorrow morning if pre-shot is above 180 (on the alphatrak) to give 1 unit. What do you guys think? She also said I COULD give 1.5 tomorrow morning but she recommends starting with 1 in the morning.
 
Please keep testing, the gravy could wear off and the numbers could drop again.

As for tonight’s dose, it depends if you want to follow SLGS or the vet for dosing. There is a decent chance Cassie will bounce and be higher by PMPS, in which case you really do want to give insulin. Per SLGS, your new dose is 1.75 units. We don’t determine how to dose the cat based on the preshot value, but rather the nadirs.
 
Wendy&Neko said:
Please keep testing, the gravy could wear off and the numbers could drop again.

As for tonight’s dose, it depends if you want to follow SLGS or the vet for dosing. There is a decent chance Cassie will bounce and be higher by PMPS, in which case you really do want to give insulin. Per SLGS, your new dose is 1.75 units. We don’t determine how to dose the cat based on the preshot value, but rather the nadirs.
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Don't worry I'm still testing every hour! I just gave her a bit more HC food since she dropped by 6 points at her +5. I think they're thinking Cassie is in remission, which isn't true at all based on my data if I understand correctly. I really don't feel comfortable skipping her dose so I don't think I will.
 
At the same time starting with 1 unit sounds appealing to me, but I don't know if that's the newbie in me speaking. Starting lower makes me comfortable so I don't have to stress as much about those low points. But then I run the risk of getting ketones if I understand correctly?
 
Not all cats get ketones. However, if you do decide to lower the dose, I would strongly recommend you test at least daily for ketones. Insufficient insulin, with ketones in the picture is a dangerous combination.

At this point, you could try feeding just low carb. A couple tsps LC can help them surf or maintain these nice haling green numbers, plus it is getting later in the cycle so the insulin isn’t as strong.
 
Wendy&Neko said:
Not all cats get ketones. However, if you do decide to lower the dose, I would strongly recommend you test at least daily for ketones. Insufficient insulin, with ketones in the picture is a dangerous combination.

At this point, you could try feeding just low carb. A couple tsps LC can help them surf or maintain these nice haling green numbers, plus it is getting later in the cycle so the insulin isn’t as strong.
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I hope my baby isn't prone to ketones. I feel like either path is super scary! I can't wait til I get the perfect dose for her, or she goes into remission. :( I will start doing the low carb food now!
 
Have you been testing regularly for ketones to date? Always a good plan when you are seeing high numbers. As is putting the kite on test results in the spreadsheet, so we stop asking about it. ;)
 
Wendy&Neko said:
Have you been testing regularly for ketones to date? Always a good plan when you are seeing high numbers. As is putting the kite on test results in the spreadsheet, so we stop asking about it. ;)
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Just for the past 4 days I've tested, but only by sticking it into the fresh urine in the litter so I don't know how accurate it is (comes out negative each time). I made another post here and I'm going to try to do what somebody recommended on the post to get a more accurate result. Cassie pees in a very strange way so she makes it difficult hahahah.

So I should put down when I test for ketones and what it comes up with? Do I write it in the remarks section or is there a test results part I'm missing specifically for ketones?
 
I gave 1.75 tonight. I had a really, really hard time getting the air bubble out tonight. My sister-in-law (who is a human nurse) says it's not a big deal if there is a small air bubble in the syringe, and that usually the amount in the needle makes up for it. But how true is that for kitties? We want the dose as accurate as possible right? Do I HAVE to get that air bubble out? It's hard to describe its size, next time I'll take a picture of it.

I tap it as hard as I can, I draw extra air, I really don't know what I'm doing wrong. It's so frustrating. I wasted so much. I was hoping with the syringes I'd save more insulin by not having to expel 2 units like I did with the pen, but I have wasted so much more than I ever have with the pen. :(
 
Draw extra air in, tap to try to join the bubbles on top. Bubbles like to go together. The bigger ones are easier to expel. Some brands of syringes are worse than others for bubbles,
 
Wendy&Neko said:
Draw extra air in, tap to try to join the bubbles on top. Bubbles like to go together. The bigger ones are easier to expel. Some brands of syringes are worse than others for bubbles,
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I'll try that some more. :( Maybe I'm not drawing enough air and tapping hard enough. Hopefully I'll get the hang of it. I'll also buy a different brand of syringes next time to experiment!
 
Abby and Cassie said:
I'll try that some more. :( Maybe I'm not drawing enough air and tapping hard enough. Hopefully I'll get the hang of it. I'll also buy a different brand of syringes next time to experiment!
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I've found that if I draw the dose reeeeeaaaally slow, the air bubble is minimal. Good luck! Looks like you're getting the hang of the sugar dance. :)
 
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