Process of finding new dose.

[Amy Dobson]

Hi,

I've been giving Murphy 1.5u caninsulin BD.
But his BG has been pretty much spot on 21 before the last three injections I've given him.
My vet wants me to wait until Monday to do a glucose curve at home to see if the levels settle. Then I've to email him the curve info on Tuesday and take it from there.
Is it usual to wait this long until changing doses when your cat has just been diagnosed?
I'm concerned as he's just had DKA and his numbers are still clearly high (they were a bit higher).

Thank you in advance,

Amy.

 

[Larry and Kitties]

It is standard practice to wait at least three days (6 shots) before changing a dose. However, in your case with DKA and the insulin you are using a shorter time may be prudent. However. without past history of BG at various times I can't make a recommendation.

Many of us here record our BGs and other information in a spreadsheet that can be viewed by other. Here is how to create that spreadsheet.
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

 

[Sue and Oliver (GA)]

Are you getting ketone tests? They are the best way for you to stay on top of possible ketones which lead to DKA episodes. You buy the same ketone strips that humans use (inexpensive and available at the drug store) and stick them into the cat's urine stream. If he won't let you do that, we have other ways.

Daily blood testing is vital but ketone tests are also vital when a cat has had DKA.

 

[Elizabeth and Bertie]

Hi Amy,

It may be that Murphy is still in high numbers all the time. Or it may be that he is dropping during the insulin cycle and then rising high again by the 'preshot' test. (And high numbers can also be caused by a phenomenon called 'bouncing' or 'rebound', whereby the blood glucose swings up high in response to a previously low number).

But before increasing the dose it's important to see how low this dose is dropping him.
Sometimes, people who only routinely test twice a day (ie. just before giving insulin) see high numbers and think that the numbers are like that all the time. But those 'pre-shot' test numbers are only part of the picture.

Blood glucose levels can be erratic when a cat first starts on insulin. But that is no reason not to test. And at the very least you may be able to reassure yourself that the dose isn't actually too much.
(1.5 units doesn't seem a bad starting dose. But we have occasionally seen folks here whose cats needed absolutely tiny doses, less than a unit.)

I know that you're not really keen to do more testing until you do your curve. But even doing just one or two more tests could be useful.
Caninsulin/Vetsulin can often have it's lowest number of the cycle around 4.5 - 5 hours after the shot (but 'your mileage may vary', and it could be earlier or later for Murphy). Is it possible to get a test say, 4 hours after the insulin shot..?

And I do second what Sue said above about the importance of ketone testing. For a cat whose been diagnosed with DKA this is absolutely vital.

Eliz

 

[Amy Dobson]

Hi Eliz,

Thank you. Am shattered! Just up to put more eye drops in his eyes - my poor boy has a corneal ulcer in each one, so I'm putting in alternating antibiotic and lubricating drops around the clock.

His curves in hospital consistently showed that he reached the Nadal point about 6 hours after injection, so I'll test him tomorrow around midday.

Ill check his urine too. The vet thinks it's extremely unlikely he'll have ketones in his urine this quickly as his blood was ketone negative only a couple of days ago.
Is your experience different to this? I do have ketostix.

Thank you all, your advice is invaluable.

 

[Amy Dobson]

He's probably on the right dose as he dropped to between 4 and 6 in hospital. He had neutral for a couple of days in addition, but by the time he came out, this was just on caninsulin. Ill definitely check tomorrow.
I feel most sorry for him with his eyes though. He just wants to scratch and he can't stand having the drops. And is so bored of his collar - though he much prefers the ones I've made him to those horrific plastic ones.
Here he is

 

[BJM]

He may appreciate it if you do a bit of Mom Cat grooming since he can't reach to do it - some combing or brushing, then take a warm, damp washcloth and swap him down a bit.