Pls advise? Vet wants to double the dosage.

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SarahL

Member Since 2013
Hi all -- my regular vet is out with the flu. The other vet in her office, who I don't know, is advising that I go from 1 unit BID to 2 units BID after looking at his blood sugar readings. Miko has been on 1 unit BID since 7/18/13 PM, and I've only had the glucometer since yesterday -- you can see on the spreadsheet link in my signature that his blood sugar seems to be all over the place and strangely tested lower in the vet's office yesterday +6 past AM dosage than he did today at home with me, and also tested higher pre-insulin than even his initial diagnosis had determined.

Anyway, I'm looking for some advice from you all -- I know he needs to come down, but I'm so scared of giving him too much insulin. What do you guys think? If I'm lucky my regular vet will be back on Friday, but she isn't in today or tomorrow. I'm also scared to double the dosage tonight because if it was too much I'd be asleep. I work at home so could monitor him better tomorrow. I'm going to do another blood sugar in about an hour before his evening insulin.

Sorry to have so many questions -- this is just all new to me and a bit scary. Thanks so much.
 
Personally, I'd stay with 1 unit until you can see your regular vet. I would never follow the advice of a vet who had never treated my cat specifically who was basing dose advice on numbers that came from tests at the vet clinic. Does your kitty enjoy going to the vet? Most cats don't, and they get all stressed out, which makes their blood glucose numbers higher temporarily. That's most likely what the vet saw.

You just got the glucometer yesterday? Then I would stay at 1 unit every 12 hours, and test before every shot. I'd also try to get a test around 6 hours after either the AM or the PM shot, and maybe a test or two just at random times, like before you go to bed at night. Collect all of that data, and then when you can see your regular vet, share those numbers with her, and see what she thinks.

Another good idea - when you take him in to the vet, test him just before you leave the house. Then see what kind of number the vet gets just a few minutes later. You might see "vet stress" in those numbers.

Bottom line? Trust your gut instincts when it comes to dose. If you aren't comfortable with it, don't do it.
 
you can see on the spreadsheet link in my signature that his blood sugar seems to be all over the place and strangely tested lower in the vet's office yesterday +6 past AM dosage than he did today at home with me, and also tested higher pre-insulin than even his initial diagnosis had determined.
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The missing piece of that puzzle is that you don't know what his number was at shot time yesterday morning. If it was much lower than the 514 you saw this morning, then it would make sense that the +6 number was lower. It's really hard to form an opinion based on just three numbers on a spreadsheet. But as you continue to collect data, it will begin to make sense to you. And we can help you make sense out of it.
 
I think that making a dose change is easier for new diabetic caregivers like yourself. if you can give that increase when you will be home to monitor. It gives you more of a comfort level, helps to reassure you if you can be around to monitor.

We recommend that you always get a test before each shot. You want to take away food, 2 hours before the pre-shot tests only. Giving your cat food in the rest of the cycle is just fine.

1U to 2U is a pretty big jump. Many vets are not familiar with the Lantus Tight Regulation protocol and either start the dose too high or increase in larger increments than the protocol recommends. We normally do 0.25U increases. I would not increase the dose that much. With more tests, as Carl recommended, we could tell you more.

You should probably be testing the urine for ketones with those high numbers.
 
Thank you SO much, Carl and Deb. I can't even tell you how much I appreciate your help. I do work at home, which has been such a godsend with this, so would be comfortable upping his dose tomorrow when I am around and awake to watch him, but I like the slow increases of .25 and .50 much better instead of jumping to 2 units. I'd probably even be comfortable doing a .25 increase tonight as his numbers have been so high, but the idea of doubling it really scared me especially since his numbers were so different today than yesterday and there's so little other info to go on. Of course I'm also terrified of how high his numbers are.

I didn't realize I shouldn't let him eat two hours before the pre-shot tests, so that's really good to know. I think all he had before this morning's was a couple Halofreeze-dried treats.

I just got ketone strips today after poring through this incredible forum and the shopping list you gave me, Deb, and just am waiting for a urine capture success with the box. It's challenging but I'm trying to implement some of the tips from the ketone testing tip sheet, and have a litterbox made up of his favorite materials (shredded cloth!) as well as several aluminum boats strategically stationed in his favorite corners of the litterbox. My vet hasn't been able to get a urine on him since diagnosis and if I even approach the box while he's in it he bolts.

Thank you, thank you, thank you. <3 <3 <3
 
A 1u increase is huge for a cat. Maybe print out the Lantus Tight Protocol and the Insulin Depot information to give to your vet so they at least know what you are doing and why. I've been fortunate that my vet is on board here in this forum and with the Lantus protocols plus she has a diabetic cat of her own.

But, truth be told, I always investigate stuff, and I actually found this site before getting the "official" diagnosis and consultation of FD. If my vet did not seem informed on Lantus, AND prescribed it, we would be having a serious chat.

But, that is me :-D Good luck
 
Hold the new dose for a few days to let the depot build up ( unless he drops under 50 in which case you reduce). The protocol link provided above will help advise when to change dose -usually at the 3-5 day mark.

Wendy
 
Just an FYI - insulin syringes mark half units or greater, so you will need to eyeball a 0.25 unit increment.

The increase in glucose level at the vets can be from 100 - 190 mg/dL, unless your cat htinks he owns the place and is very confident there.
 
Thank you so much to all of you -- I am just so grateful for this board and all of your help.

Strangely, he tested lower at the vet's office on the same glucometer on Wed than at home Thursday.

But I totally failed at this morning's ear test -- kicking myself right now. After reading how some people say there's less bruising and red spots by doing hand pricks, I abandoned my alphatrak pen and went in by hand because his poor little ears are already covered in red spots... in retrospect it was a really dumb move to try today right after inching up his dose, and I was utterly unsuccessful. It seemed to bother him much more than using the pen, I guess because the pen is fast and powerful and I am slow and nervous by hand, and by the time I switched over to the pen my window was already gone and I was at risk of traumatizing us both :(

So I will try again with my alphatrak pen at +6 after some grounding meditation exercises so I have the right game face to bring :)

I was able to successfully catch some fresh urine from him in my little aluminum boats last night and he is still ketone free, which was a huge relief. I'm guessing I should try to ketone test daily while his numbers remain so high.

Purrs and gratitude to you all.
 
Its definitely a process not an event!
Maybe try practicing the freehand on an apple to get a feel for it.
Or use the pen if you prefer - that's OK too.

Hang in there; it does tend to become more routine and less time consuming as your experience increases.
 
You WILL see red spots and maybe a bit of bruising the first few days, even a couple of weeks of testing. After that, you'll start noticing much less. Be sure to hold firm pressure on the stick for 20-30 seconds to help it start clotting and stop bleeding. That will help with the bruising. All a bruise is is leaked blood between the skin layers. I test all my 'civies' (non-diabetics) every 2-3 months, they all have a red spot for a week or so afterward.

SO glad you didn't raise a whole unit at a time! That's a lot of increase for a cat....KT, 2 years diabetic, responds literally to changes by drops. Dakota,, 2 years diabetic but just joined us 2 months ago. He isn't quite that sensitive, his increase/decreases are usually by .25 units. He and I are just learning HIS dance so took a while for me to figure out he needed full changes.

BIG HUGS!!!
 
Thank you so much, everybody -- the moral support and advice is the best thing in the universe right now. My little guy just tested at 499 on the AlphaTrak2, +6 after AM dose. Boo.

I'm so worried that his blood sugar is still climbing after a full week on insulin -- even though it seems to me he is acting like he is feeling slightly better than those last few days before the vet appointment. Maybe that's just because he's been getting all the TLC in the world right now.

And then right after the reading I dropped the whole open vial of expensive AlphaTrak2 test strips on the floor where they spilled merrily all out behind the cat tree. So guessing they are no longer usable. I guess it's just one of those days! I ordered a human Arkray glucometer set to arrive on next Wed., but it looks like I'll be picking one up at the pharmacy tonight. What girl hasn't always dreamed of owning three glucometers? :)
 
The strips should be fine - just pack them back up.

As regards his numbers, we dont have enough data to know if he is in fact still climbing.. Its only been 3 days of testing and he just came off the kibble .. patience! :)

But if he is rising, we will increase the insulin when its time - soon likely. Meanwhile hold the same dose (unless he drops under 50) and let the Lantus depot build up. Lantus needs time to build up in the cats system before you see its real effects. And that applies to dose changes too.

Can you get a before bed test ( 2-3 hours after PMPS)? Many cats drop low at night - if the before bed test number is more than 50 points lower than PMPS he is likely to drop lower during the night.

Keep testing for ketones.

Wendy
 
SarahL said:
So I will try again with my alphatrak pen at +6 after some grounding meditation exercises so I have the right game face to bring :)
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Yes indeed, meditation exercises, deep breathing, a walk around the block, a piece of chocolate. All these and more are good ides to use when this sugardance has you stressed out and you think you can't take it anymore.

You're doing good. Look back to where you were one week ago. Now look at where you are today and all you've learned about how to help your diabetic cat and the progress. Pretty neat huh?

Just wait, it gets even better and easier.
 
Thank you, all. Would it be dangerous to try 1.5 tonight instead of 1.25? I hate that he's creeping over 500. He's been on 1 unit BID since 7/18, and then last night I smidged up to 1.25 as best I could.

What's so weird to me is he tested at his lowest, 338, at the vet's just on Tuesday when he was in a stressful place and had been getting just that small pinch of kibble with each insulin injection for the past 5 days since he was diagnosed (before then he was all raw). Then that night I switched to healthier treats and started testing at home (using neosporin + pain relief on the ear), and now his numbers are even higher than his initial diagnosis and higher even since his five day check in at the vet on Tuesday.

The only thing I was thinking is that the vet tech did use rubbing alcohol on the ear when he was showing me how to do it. I just read on one website that rubbing alcohol can get into the blood sample and make the reading inaccurate -- is that true? Could that have given an inaccurate lower number? That would make much more sense.

I know I need more information and the process has to go slowly. It's just scary to think he's maybe getting worse on insulin, even if it's a low dose. Unless the vet tech botched the reading by using rubbing alcohol and Miko's blood sugar was actually higher than reflected, which would totally suck but actually make this make more sense.
 
It's really hard to know what is going on. We don't have those pre-shot tests. Even though the dosing changes are based on the nadirs, you want to always get those pre-shot tests so you know if the number is high enough to even give the insulin.

I would recommend holding the 1.25 dose for the full 6 cycle minimum and getting those pre-shot tests.
 
Hey, he's not getting worse on insulin.. You don't have the data to know that. Plus meters vary by 20% so in fact these numbers are similar.

Hold the course and the dose.. You don't want to skip past the ideal dose by increasing too fast.
 
Thanks, all! I'm feeling a little panicked about my kitty today -- can you tell? -- so I really appreciate you keeping me on course and facing in the right direction. I better go find some chocolate :)
 
Thank you, KPassa! SO much better. <3

Miko's numbers stopped climbing today and backed a teensy bit down, which thrilled me to no end/ And he drank water like a champ and flushed out the ketones that to my horror started last night -- he's such a good boy!!! I keep realizing how much my worry adversely affects all the things that I have to do with him, so as much as I'd like to eat french fries and panic, probably choosing yoga and the like for whatever free time I can scrap together is a choice that serves us both much better :)

And I'm really grateful for how well he's taking all of this. I can't believe that this was a cat I couldn't even put Advantage on or do a nail trim for most of his life, and now he not just tolerates the ear tests, he's leaping up to the test table and meowing for them! Well, for the accompanying Halo treats and kisses, really, but still... I still am struggling with the head shakes at the critical juncture post-prick (and with my nervousness blowing the endeavors), but I feel entirely lucky that he is such an amazing kitty and to have the support of awesome people like you and everyone else here. My vet has been very sick and out since last Saturday, and having this board and the awesome people on it to help has just been incredible.

I'm keeping my fingers crossed that we keep heading down into at least the pink in the very near future. Thank you so much for asking :)
 
If you can get the blood droplet on a clean fingernail, you can test it from there.
 
Can you get a before bed test in tonite? I am thinking a dose increase to 1.5 or even 1.75 omorrow night if you don't see any new colours like yellow and blue but without a night test we can't be sure he isn't dropping low at night.. Many cats do.
 
Wendy&Tiggy said:
Can you get a before bed test in tonite? I am thinking a dose increase to 1.5 or even 1.75 omorrow night if you don't see any new colours like yellow and blue but without a night test we can't be sure he isn't dropping low at night.. Many cats do.
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I will try to do so -- we've been on a winning streak so far today. is the best time as close to +6 as I can get it? We just went back in the black -- his PMPS is 512. :(

Thanks for the fingernail advice, BJM -- I may need to try that.
 
Wendy&Tiggy said:
We don't have a lot of data for any time , and cats nadirs (lowest points) can vary, so how about a PMPS +4 or a+5?
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Oh! I didn't realize their nadirs could vary. I will do my best tonight. If he's still in the red and/or black +4 / +5 tonight and for his AMPS tomorrow, should I push up to 1.75 for his a.m. injection? Thank you so much for all your help and advisement with my little pumpkin.
 
You want to wait 6 cycles so it would be tonite. And I think 1.75 since he is so high.

Heres the protocol :

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 (blue,green) before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300(yellow) increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 (pink, red, black) increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.
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If he doesnt come down on 1.75 I am thinking we will need to get you over to the tight regulation board so that more experienced eyes can look at him.

Wendy
 
Wendy&Tiggy said:
You want to wait 6 cycles so it would be tonite. And I think 1.75 since he is so high.

Heres the protocol :

"General" Guidelines:

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 (blue,green) before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300(yellow) increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 (pink, red, black) increase the dose by 0.5 unit.


If he doesnt come down on 1.75 I am thinking we will need to get you over to the tight regulation board so that more experienced eyes can look at him.

Wendy
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Thank you, Wendy -- I had also read this here-- http://www.tillydiabetes.net/en_6_protocol2.htm
However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU.
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I'm also much much more comfortable increasing his injection now in the day when I can monitor him better. I have about 15 minutes to decide.

But like the dumb dumb I am, I've further compounded the issue. I had to switch to the ReliOn Micro today -- I had one Alphatrak strip yet and I was hoping to compare but I didn't get enough blood and ruined the strip. So all I know is that he had a 387 on the ReliOn for AMPS today and I have no way of knowing how that compares to his other numbers on the AlphaTrak.

I had done a control test using the AlphaTrak control solution on both last night night and I got a test 141 on Alphatrak and test 99 on ReliOn, so it seems the ReliOn runs lower. Is there a rule of thumb to compare them both without good data from both? I could cry that I messed up my last AT test strip -- too much pressure.
 
We know the AlphaTrak reads higher than human glucometers. Think of it as reading temperature in Celsius vs Fahrenheit. Freezing is 0 degrees Celsius and 32 degrees Fahrenheight. Both are correct. Stick with 1 meter, note it in your signature (bold it if AlphaTrak), and enter the numbers you actually obtain (no adjusting)

Here are some glucose reference ranges used for decision making using a human glucometer:

< 40 mg/dL
- Treat as if HYPO
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s; if not on insulin, this can be safe.

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
We know the AlphaTrak reads higher than human glucometers. Think of it as reading temperature in Celsius vs Fahrenheit. Freezing is 0 degrees Celsius and 32 degrees Fahrenheight. Both are correct. Stick with 1 meter, note it in your signature (bold it if AlphaTrak), and enter the numbers you actually obtain (no adjusting)
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Thank you so much, BJM -- I also looked through a bunch of user posts and saw it is very common for differences to be even larger between the two units with high sugar present. I hope it was the right decision -- I just went ahead and gave him the 1.75 dose and will be watching him like a hawk. No one seems to sell ALphaTrak strips by me but I will call every vet office and pet store -- if I can find I will get so I can compare soon.

The one nice thing about the ReliOn Micro being lower is that even if it doesn't mean anything different, it spares me the heart pains that come when his numbers all show up in black and red on his spreadsheet!
 
Hi there :-D

You're doing fantastically! In case you don't know: sometimes when you make a dose change (increase or decrease) it may not show up/affect for a few cycles.
 
So... I rustled up some AlphaTrak2 strips and did a +2 comparison, and the ReliOn Micro came in very close but slightly _higher_ than the ALphaTrak2.

That being the case, I'm wondering if the 387 he got this morning on the ReliOn meant he had responded to the .25 bump -- I mean no matter what meter, he's obviously still very high, so maybe going from 1.25u to 1.75u after only 2.5 days was still a good move? I hope I didn't make a dangerous mistake that I may not realize for another day or two. Wishing I had listened to Wendy's sage advice now :(

Or maybe tonight I should back off to 1.5u?

I'm sure this would be confusing to me on a good day, but with all the strange anomalies (lowest tests in vet's office, higher readings on the AlphaTrak2, me having to switch glucometers midway) I am really struggling. Thanks so much for all your help, everybody.
 
Patience!

And an additional glucometer note: The FDA allows meters to read within 20% of what a lab test would get. That means, that any test actually represents a range of values +/- 20% around what you got.
Ie
200 -> 160 to 240
300 -> 240 to 360
400 -> 320 to 480
If the ranges around 2 tests overlap, they may be considered the same value and the overlap area is likely where the lab value would lie.
 
Stay at your new increased 1.75U dose for a minimum of 6-10 cycles unless he drops under 50 on the Micro (80 on the Alphatrak).

We want to see Miko down under 200 at the lowest point or nadir. He is no where near that yet.
 
Nah - he probably needed the increase. I didnt like those reds either. I would hold this new dose for at least 6 cycles unless you see a drop under 50.

Dont stress on the meters - he is probably high no matter what meter you use and the relion is good.

Wendy
 
Thank so much. This is such an amazing community full of such caring and incredible people. Thank you all.

Back in the 500s for last night's PMPS and today's AMPS. Boo :( I never knew diabetes could be such a roller coaster ride. I'm definitely working on the patience lessons I need to learn.
 
Sorry if I asked this before but

1. No access to dry food or anything like that? Does he go outside? Do you have dog food or anything in the house he could get to
2. Any signs of infection. Teeth, ear, UTI
3. Any concurrent medications?

Wendy
 
Wendy&Tiggy said:
Sorry if I asked this before but

1. No access to dry food or anything like that? Does he go outside? Do you have dog food or anything in the house he could get to
2. Any signs of infection. Teeth, ear, UTI
3. Any concurrent medications?

Wendy
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No to all of the above. :( No access at all to any dry food. He's indoor only. My dog and other cat eat raw food, too. Miko has no signs of any infections including any in his blood panel taken on 7/16, and he's not on any medications or anything. He's still negative for ketones. I feel like someone is secretly pouring sugar in his food. Or that my insulin is broken. Or that my meters are all broken.

:(

I'm really hoping maybe this is a bounce because he was in the 300s yesterday which was the lowest of all my at home tests yet.

I also really do wonder if maybe he's got some other underlying issues, because he's so not the typical suspect in most ways. He is an older neutered male, possibly part burmese or siamese, but other than that he was on a 100% raw food diet and was always so lean and athletic and active before diagnosis. My vet wanted to get him stable before doing any x-rays, but it just doesn't make sense that his BG is still so high after he's been on insulin for 10 days. It seems like it should at least be coming down a teensy bit. Hopefully that's what 300s I saw yesterday were -- I would scientifically be the happiest person in the universe if I could safely get him to at least the 200s.
 
He could be a high dose cat or have a high dose condition. My Tiggy is on 8 right now, some cats are up to 40. Not that mike will get there but am just saying you may just not have reached the right dose.

I would like to see a few more PM tests though. We should be sure he isn't dropping low at night before Increasing again so can you always get a PMPS +2 or 3? If that test is lower than PMPS then we might be dropping low at night every few days and triggering a bounce. If it is lower than pmps you will want to set the alarm for a +5 to +7.

Wendy
 
Wendy&Tiggy said:
so can you always get a PMPS +2 or 3? If that test is lower than PMPS then we might be dropping low at night every few days and triggering a bounce. If it is lower than pmps you will want to set the alarm for a +5 to +7.

Wendy
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Thanks! 40 units -- holy moley. That sounds like you'd need a bazooka to inject!

My vet had told me that AMPS and PMPS would typically be the highest numbers I'd see, because insulin would be lowest. It sounds like you are saying that +2 or +3 can or should be highest instead?
 
It depends some on the cat and whether you meal feed or free feed and the cat nibles. When you meal feed it is more likely you'll get a food spike around +2. If your cat grazes or you provide mini meals, there'll be less of a spike. Mini-meals may be at shot time, +2, and +4. If needed (scarfer kitties), spreading the food thinly across a plate slows the cat down, too.

Also, a very carb sensitive cat may spike more than one which is less sensitive.
 
BJM said:
It depends some on the cat and whether you meal feed or free feed and the cat nibles. When you meal feed it is more likely you'll get a food spike around +2. If your cat grazes or you provide mini meals, there'll be less of a spike. Mini-meals may be at shot time, +2, and +4. If needed (scarfer kitties), spreading the food thinly across a plate slows the cat down, too.

Also, a very carb sensitive cat may spike more than one which is less sensitive.
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Ah, that makes sense, thank you. I do feed frequent meals, but Miko tends to eat three larger meals -- one after his AM injection, one around midday, and one after his PM injection.

I have now been trying to take food away about 2 hours before AMPS and PMPS... so when I've withheld food two hours before AMPS and PMPS I have seen that spike on +2. My vet hadn't told me that I should withhold food before AMPS and PMPS.

I feel like I'm in diabetes college :) So much to take in and so many variables...
 
Its complicated and every cat is different but you will get there.

Normally insulin is at lowest at preshot. And so normally preshot is highest. However there is also a phenomenon called bouncing which is what I am looking for here. Bouncing is very common, extreme bouncing is called somogyi (not as common). I am looking for either. ..

Bouncing:

When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
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Yep. Feline Diabetes for the Caregiver 101, 5 quarter hours with extended lab experience!!!

Try the food smearing to slow him down a tad. Also, as you get control, he should be less ravenous because he'll be able to use the food.
 
can we get a PM test between +5 and +8 tonite? He may have a late nadir and we want to know before another increase to 2.25.

Wendy
 
BJM said:
Yep. Feline Diabetes for the Caregiver 101, 5 quarter hours with extended lab experience!!!
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It really is. And right now I feel like we're failing every test :(

Wendy&Tiggy said:
can we get a PM test between +5 and +8 tonite? He may have a late nadir and we want to know before another increase to 2.25.

Wendy
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Wendy, I'm going to try to. Although I think it's unlikely he is having any lows. I have my doubts he's even made it into the 300s.

When I first got the ReliOn I was pushing in the strips, checking the code, and then pulling them out until I was ready to push them back in. I didn't realize on that second push it so often reads a different code than marked for the test strips until yesterday. So I'm not even sure that any of his two dips into the 300s were correct. I want to cry. He just got a 530 for a +7. It's breaking my heart to see his levels this high and I'm so worried about him.

Is this a common occurrence when cats first go on insulin for them to be so high and so seemingly unresponsive?

How does it work -- would his BG be even higher without it? Does the insulin in their bodies typically act like a light dimmer, inching along? Or does it usually not show any results until it's delivered at an appropriate dose, like an on/off switch?

I know/hope it will help eventually, but I'm just wondering if it's helping at all right now. It's scary to think his BG could be even higher without it, but it seems to be having no effect at all. It seems like nothing is really 'normal' or 'average' with diabetes (or really anything for that matter), but I'm just wondering if there's other kitties who stayed so high for so long and what happened with them.
 
Its ok - you probably just havent hit the right dose yet.. patience. His BG would likely be the same or higher without it.. and the insulin is in his system which is helping him feel better and process food.

Here is an example of a recent red and black cat that just found the right dose .. i am not saying you will end up on 8 units but it shows what happens when the right dose is reached.. Look at his SS... you can see they started testing a bit more often to see if Charms was dropping low at any point - in his case he wasnt (doesnt mean Miko isn't though)

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=101127

I am thinking you might want to start posting on the same board as them. Its called tight regulation http://www.felinediabetes.com/FDMB/viewforum.php?f=9 and is "staffed" by very experienced dosing members. I post there every day for my cats too and there is a great sense of community. Its a specific protocol which has a high success rate for remission- make sure you read the stickies on there too.

Heres how to post
Every day ( or as often as you want/need/are able) you open a new thread/post . We call them "condos"
- The subject has the date/cats name and BG readings ie 07/29 Miko AMPS 493 +7 530 Add a ? icon if you have a question. You can update your subject as you get a reading, or whenever is convenient

- The contents of your post have a quick update on how Miko is feeling as regards the 5Ps ( peeing. pooing, preening, playing and purring) and any questions - plus a link to your previous post ie : Today Miko was in a good mood, playing and eating well. But do I need to increase the dose again?

For your first post include "newbie" also in your subject so everyone can welcome you!

Wendy
 
Wendy&Tiggy said:
Its ok - you probably just havent hit the right dose yet.. patience. His BG would likely be the same or higher without it.. and the insulin is in his system which is helping him feel better and process food.

Here is an example of a recent red and black cat that just found the right dose .. i am not saying you will end up on 8 units but it shows what happens when the right dose is reached.. Look at his SS... you can see they started testing a bit more often to see if Charms was dropping low at any point - in his case he wasnt (doesnt mean Miko isn't though)

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=101127
Click to expand...
Click to expand...

Thank you SO much, Wendy -- I can't even tell you how much better this makes me feel. To hear that the insulin may be helping him process food and feel better is heartening in and of itself, and looking at Charms' spreadsheet gave me so much hope. I'm glad other red and black kitties have found their way into the yellows, blues, and even greens! I will join that other board soon. A million thanks to you.
 
Check out the board first, read its stickies etc so you understand where they are coming from when they (we) give advice etc.

And you are more than welcome to post here too

Wendy
 
Take a look at the link to Secondary Monitoring Tools in my signature. Your cat is more than a glucose number :smile:

Other indices of improved control include less hunger, less thirst, fewer/smaller pee pools in the litterbox, and weight gain. Also look for playing, purirng, and other behaviors that may have waned due to the diabetes; they may pick up. Tracking those may give you some additional insight into how he's doing.
 
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