Red's dose after falling out of remission | Page 2 | Feline Diabetes Message Board - FDMB

Red's dose after falling out of remission

Suzanne & Darcy said:
I don’t even bother to move the furniture to see the skin. I just lift and shoot. The needle goes in under the skin and that’s all that matters.
Click to expand...
This has helped me. I give the injections better, not great yet, but much better.

How do we know we're at the correct dose of insulin? Red's numbers still seem to be high at .5u dose. Even when he doesn't eat for hours, his numbers do not come down. I don't want to rush this, but is there a BG level or reduction we should be trying to achieve when giving insulin?
 
Well, we could try increasing the dose to .75 units, but he dod have a nadir of 87 on the .5 unit dose already— although it seems to just be that particular day 10/5. Do you recall a reason why he was lower on that day? Not eating?
 
Normal feline BG is between about 50-120. So he has room to go lower if you are able to keep getting the BG tests and would be okay following the Modified ProZinc Method (and he is not eating dry food.) I know we were hoping this steroid shot would wear off and he would get back to normal, but he may need for us to be a little more assertive with his dose so we can get his numbers down.
 
Suzanne & Darcy said:
Well, we could try increasing the dose to .75 units, but he dod have a nadir of 87 on the .5 unit dose already— although it seems to just be that particular day 10/5. Do you recall a reason why he was lower on that day? Not eating?
Click to expand...
I went back to my notebook that I keep, and Red was eating fine that day because he had the Mirtazapine the night before. On 10/5 I do have a note my husband said he may have given Red just a hair above .5 unit, but not as much as .75 units. If that was the case, could that have caused the 87 BG? It makes sense now looking back because he has been no where near that BG level since. So maybe Red should be on a slightly higher dose than .5 right now? I think I'd like to try going up to at least a .6. or do you think I should try .75 units? It will be 3 weeks this Friday since he had the steroid shot. Red never eats dry food. He's the only cat I have and he only eats low carb pates ever since being diagnosed.
Thank you for your guidance!
 
I would try the .75 unit dose and see if we can get his numbers down, including the preshot numbers. We have a better chance at getting him back into remission that way. You test enough to keep him safe. When you get a green number just feed him a snack of LC pate and monitor. You do not need to give HC (food/gravy/karo/honey) unless he goes below 50. If he does, give a small amount of HC and test again in 20 minutes to make sure his BG is rising.
 
Could you please change your signature to MPM instead of TR? TR is for Lantus users. MPM is for ProZinc users. Not a big deal since I knew what you meant, but I don’t want others to be confused.
 
Suzanne & Darcy said:
I would try the .75 unit dose and see if we can get his numbers down, including the preshot numbers. We have a better chance at getting him back into remission that way. You test enough to keep him safe. When you get a green number just feed him a snack of LC pate and monitor. You do not need to give HC (food/gravy/karo/honey) unless he goes below 50. If he does, give a small amount of HC and test again in 20 minutes to make sure his BG is rising.
Click to expand...
I gave .75 this morning, and I'll be monitoring him. He ate good so we'll see where he is with the next test.

I laughed when I read you don't bother to move the furniture 😄 but I knew what you meant!
 
Marie & Red said:
@Suzanne & Darcy
Do I keep him at .75 for the PM shot seeing he dropped to 56 BG? It seems he is liking between .5 and .75 right now.
Click to expand...
1) Did he eat at +2? His nadir is awfully early.
2) I see that the small amount of low carb food kept him surfing in green. Did you test again another 30 minutes after that? Don’t stop testing at least hourly until you are sure he’s stable in green or rising.
 
Suzanne & Darcy said:
1) Did he eat at +2? His nadir is awfully early.
2) I see that the small amount of low carb food kept him surfing in green. Did you test again another 30 minutes after that? Don’t stop testing at least hourly until you are sure he’s stable in green or rising.
Click to expand...
He didn't eat much at +2, about 1/3 - 1/2 small pate packets. He did eat a lot at +3.5, after testing at 56 BG.

His tests today:
AMPS 183 BG - ate 2/3 FF can - rec'd .75 units
+2 135 BG - ate 1/3 FF petite packet
+3.5 56 BG - ate 1/5 FF beef/gravy and 2/3 can FF turkey
+4.5 66 BG - no food
+6 88 BG - no food
 
Okay. Thanks for the info. It helps.
He’s really doing ideal on this dose,
but if you feel a little uncomfortable with it at this point, I completely understand. And actually, since I believe we should (hopefully) see a little more waning of the effect of the steroid shot in the fourth week, we can try a dose that is between the .5 and the .75 units and see how it goes. This will give us some wiggle room if the steroid shot wears off completely and he starts staying in lower numbers. We can always increase back up if needed.

If you were using U-100 syringes you could actually draw a .6 dose, but you will have to just eyeball a “skinny .75” where the plunger is just slightly less than the (already eyeballed”) .75 units. We could call it a “fat .5” which might be easier to imagine— where the plunger is a little past the half unit mark but not as far as you would draw it to eyeball the .75. This is where using U-100 syringes allows for finer dosing.

Let me know how you feel about it. If he doesn’t do well on the dose, we can make alterations. Between 50 and 120 is where we want him to be if we want to get him into remission again, but there’s no rush — especially since we still potentially have the steroid at play.
 
Suzanne & Darcy said:
Okay. Thanks for the info. It helps.
He’s really doing ideal on this dose,
but if you feel a little uncomfortable with it at this point, I completely understand. And actually, since I believe we should (hopefully) see a little more waning of the effect of the steroid shot in the fourth week, we can try a dose that is between the .5 and the .75 units and see how it goes. This will give us some wiggle room if the steroid shot wears off completely and he starts staying in lower numbers. We can always increase back up if needed.

If you were using U-100 syringes you could actually draw a .6 dose, but you will have to just eyeball a “skinny .75” where the plunger is just slightly less than the (already eyeballed”) .75 units. We could call it a “fat .5” which might be easier to imagine— where the plunger is a little past the half unit mark but not as far as you would draw it to eyeball the .75. This is where using U-100 syringes allows for finer dosing.

Let me know how you feel about it. If he doesn’t do well on the dose, we can make alterations. Between 50 and 120 is where we want him to be if we want to get him into remission again, but there’s no rush — especially since we still potentially have the steroid at play.
Click to expand...
He startled me at 56. He's never tested that low before, even 3 years ago when he went into remission. I'm comfortable with him in the 60's, but 50's worry me a tad right now - especially it he gets to that level or lower during the night. He got there so quickly.

I'm using U-40 syringes, holds up to 12 units, with 1/2 unit marks. I believe I can get .6, going just above the .5, which I guess would be called the "fat .5". I call it a .5+ ☺️

I didn't know we were able to use U-100 syringes and I just ordered a box of U-40. I was searching for ones that had a small total volume and half units. If I can get .1 and drop dose, I know I can get .6! I will do that tonight.

Thank you!
 
U-100 syringes can only be used with a U-40 insulin like ProZinc if you use the special conversion chart that tells you how much to draw on a U-100 syringe to get the correct amount— otherwise the insulin would be underdosed or overdosed (without the conversion chart I mean.)

I look forward to seeing how he does on the .5F
 
What do you want your reduction point to be. With MPM it’s below 50. With Start Low Go Slow it’s below 90 (which I don’t think is going to help Red.). You indicated yesterday that you were okay with 60s. I see he dropped to 61.
 
If you want to do custom dosing and use a reduction point of 60, then please change your signature to say Custom Dosing, Reductions at 60. Or reductions at 59 (so below 60 would trigger a reduction.)
 
Also, he’s dropping too fast and hitting nadir too quickly. He either needs to eat more at +2 or needs to eat higher carbs (not higher carbs but something closer to 10 percent) to slow him down. If he’s not hungry at +2 then cut back on his breakfast so he will eat more at +2.

I hope I am communicating okay this morning. I am in a rush to get out the door. Have a vet appointment and still have to feed the cats before we leave.
 
Have you rechecked his AMPS? Do you have any food with a few more carbs than the FF pate?

If he’s still at 130, I would just give .5 for this cycle because he has such a propensity to drop early in the cycle (which is why I was suggesting feeding something in the 7-9 percent carb range to try.)
 
Suzanne & Darcy said:
Have you rechecked his AMPS? Do you have any food with a few more carbs than the FF pate?

If he’s still at 130, I would just give .5 for this cycle because he has such a propensity to drop early in the cycle (which is why I was suggesting feeding something in the 7-9 percent carb range to try.)
Click to expand...
He doesn't eat much at any meal. He's a light eater.
I will give him .5 this morning.

Thank you!
 
Marie & Red said:
He doesn't eat much at any meal. He's a light eater.
I will give him .5 this morning.

Thank you!
Click to expand...
Well then I would go with the slightly higher carbs to help him.

Having said all that, his AMPS this morning is almost within the normal range for cats. That is definitely progress. It’s probably the fattened dose that helped him to get there, but it’s still really good news. We hopefully will see his AMPS and PMPS come down below 120 (and hopefully even lower) as the steroid shot wears off (I am still hoping).
 
I'll check the carb content of the meals I have. I usually buy by the case. I do have a couple med carbs on hand.
He actually went down to 56 yesterday after the AM shot. It's 3 weeks since his steroid shot, so hopefully that's going to help.

Good luck at the vet appt!
 
Our goal should be to keep him in that 50-120 range as much as we can so his pancreatic beta cells can continue to heal from the steroid. Then hopefully his pancreas will take over!
 
Marie & Red said:
I'll check the carb content of the meals I have. I usually buy by the case. I do have a couple med carbs on hand.
He actually went down to 56 yesterday after the AM shot. It's 3 weeks since his steroid shot, so hopefully that's going to help.

Good luck at the vet appt!
Click to expand...
Oh yes. I know about the a.m. 56, we talked about that yesterday and that’s why you reduced from.75 to the .5 F for the p.m. cycle. So that is why I was talking about the p.m. cycle where he had 61.
 
Suzanne & Darcy said:
Oh yes. I know about the a.m. 56, we talked about that yesterday and that’s why you reduced from.75 to the .5 F for the p.m. cycle. So that is why I was talking about the p.m. cycle where he had 61.
Click to expand...
Almost all of the food I have at home is low carb, in the range of 2-4% Guess I'll go shopping for some a little bit higher.

Are there any toppers I can put on his food to increase carbs a little? I have sprinkled parmesan cheese on his food when he wouldn't eat, but that's low carb too but it got him to eat. Would Churu's help, either on top of his food or separate? I used to give him 1/2 tube of Churu when my other cat needed it for her meds. I haven't given any to Red since he fell out of remission.
 
Here’s a food list of foods appropriate for diabetic cats— but these are lower phosphorus foods so also appropriate for cats with kidney disease (which Red does not have, but lower phosphorus foods are good for senior kitties anyway because they are easier on the kidneys.) I am not sure about the carb percentage of Churus
https://www.bizave.com/foodlists/CKD Diabetes Food List.pdf

Some of the Weruva foods are also available at local pet stores like PetsMart, Petco, and others… so that you can just buy a few cans and not a whole case.
 
Suzanne & Darcy said:
Here’s a food list of foods appropriate for diabetic cats— but these are lower phosphorus foods so also appropriate for cats with kidney disease (which Red does not have, but lower phosphorus foods are good for senior kitties anyway because they are easier on the kidneys.) I am not sure about the carb percentage of Churus
https://www.bizave.com/foodlists/CKD Diabetes Food List.pdf

Some of the Weruva foods are also available at local pet stores like PetsMart, Petco, and others… so that you can just buy a few cans and not a whole case.
Click to expand...
Thank you! I haven't seen this list yet. I do have some Weruva cans at home. Of course the ones I purchased are like 0-2% carbs!
 
You must log in or register to reply here.
Back
Top