Seeking help with Maxs dosing

Katie & Max

Katie & Max

Member
Hi , my name is Katie . Max has been on insulin for about 3 years but I am new to trying to regulate him . I have just been sent this group from the Facebook page . Max has dropped from 4 units to now 1.75 in the last couple weeks as he started going hypo . I’m feeding him a raw diet now and I think that mite be helping his numbers …. I’m a bit confused on the rite dose of insulin based on his recent numbers and am hoping I can get some input from ProZinc users .
Thanks
 
I am glad you reduced the dose to 1.75 units after the lime greens of yesterday. I know he is a long-term diabetic, but you don't have a lot of data on his spreadsheet (more now, which is good -- good job!) Please be sure to get a test at every single preshot to make sure his BG is high enough to shoot insulin, and get some mid cycle tests in as you have been doing. When are you feeding him throughout the day? It's important for diabetic cats to eat small meals spread throughout the cycle to help stabilize blood sugar -- we just don't recommend feeding after kitty's nadir. It looks like Max's is about +5 so I would not feed him after +5 (except for very small low carb treat if you need to -- or if you are testing his BG because he should get a treat each time you test.)

Then you would hold this dose for 7 days as long as his BG is high enough to shoot the full dose and as long as he doesn't earn another reduction.
 
So I will test before each shot and then mid cycle about +5 ?

I am not feeding him at all during the day . Since being on a diet he is just getting Am and Pm food . At what time should I be giving him a small snack ? +4 ? And then plus + 8 ?

what is a nadir ? I believe I have read about that but has splipped my mind .

If his Bg drops to anything below 90 I reduce by 0.25 units , correct ?

Also what is the lowest dose that I do not give insulin ?

thank you so much for your help , I’m embarrassed to say it has taken me so long to start testing him like this . I hope I can help him get regulated now . Do you think it’s a good sign he is dropping so low and needing less insulin ?
 
Is he overweight? I would recommend dividing up the amount of food that you want to feed him during the day and then the evening. I would feed a good breakfast but save some for snacks. I would give a +2 snack and a +4 snack. +2 is a good time to get the first test since that is typically when ProZinc onsets (starts to kick in to lower the BG). Give him a low carb treat each time you do a test, of course. You can even feed him a small snack at +6 if you want to — the +5 was just an approximate time to cut off the food until PMPS (except test snacks). It’s not a hard and fast rule, but a guideline. He does nadir around those hours. The nadir is simply the lowest point in each cycle.
 
You are correct that if he tests under 90 that you would reduce the dose by .25 units. This is for the Start Low Go Slow method. The reduction point can be adjusted over time to a lower number as you gain data on Max (and some people choose to follow the MPM method which has different parameters.)
 
I would try to get as many tests as is reasonably possible for now - +2, +4, +6. You may not be able to do this every day, of course. But gradually you will fill in the checkerboard that is his spreadsheet and we will have an idea of how he is doing. Some days you may want to do +3 and +5 and then a little later on so we can see how long the insulin is lasting. Evening tests are important as many cats tend to drop lower at night. We usually recommend getting a “before bed” test to see if it looks like you may need to set an alarm to wake up and test a little later in the cycle. I would definitely try to give him the same snacks in the evening as in the morning. Many people use timed feeders for this.
 
I have to go pick up my husband whose car is in the shop, but I will come back later and try to answer more questions that I may have missed.
 
Thank you for all your help . It’s helped me understand a lot more . Yes Max is really over weight . He is about 19 pounds now . I’ve started feeding him raw food and I’ve noticed his numbers dropping . I’m hoping this helps him loose weight but not much luck . I have been following your suggestion and giving him small meals twice a day between am and pm feeds . Max bg seems all over the map . I’ve been trying to test at al different times and consistently . I do need to get more evening tests done still . He had a few lows today so I will try dropping him to 1.5 . It’s just weird cause sometimes he has highs still too
 
Katie & Max said:
Thank you for all your help . It’s helped me understand a lot more . Yes Max is really over weight . He is about 19 pounds now . I’ve started feeding him raw food and I’ve noticed his numbers dropping . I’m hoping this helps him loose weight but not much luck . I have been following your suggestion and giving him small meals twice a day between am and pm feeds . Max bg seems all over the map . I’ve been trying to test at al different times and consistently . I do need to get more evening tests done still . He had a few lows today so I will try dropping him to 1.5 . It’s just weird cause sometimes he has highs still too
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Yes. Do reduce his dose to 1.5 units. He earned the reduction today when he dropped under 90. It was a beautiful cycle though.
 
You should be pleased. The last few days he has had very good daytime numbers. He is making good progress. Be sure to always do a preshot test morning and evening so you can be sure it is safe to shoot the full dose.
 
Suzanne & Darcy said:
You should be pleased. The last few days he has had very good daytime numbers. He is making good progress. Be sure to always do a preshot test morning and evening so you can be sure it is safe to shoot the full dose.
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for max what would you say would be an unsafe number to give his full insulin dose . Anything less than 100 ?
 
Try to get a few tests tonight so we can see how he does on the 1.5 unit dose with his 144 preshot. I’m thinking this is the lowest preshot he’s ever had? Be sure give small snacks if you can tonight at +1 and +2. Test at least by +2. If it’s a lot lower than 144 then be prepared to monitor and feed as necessary. So for now, we can see how he does on this dose with this low of a preshot. If he’s really lower than that at this point in his journey (preshot I mean) you can consider a skip or a small token dose depending upon your ability to monitor him.
 
Yes 144 is his lowest pre shot he’s ever had . This is exciting ( but nerve racking ) that his insulin and Bg has gone down so much !

I’m just trying to be prepared for if he is lower then this next pre shot . If it’s lower then 100 I should skip a dose and continue testing ? Or does a token dose mean half a dose ?
 
Suzanne & Darcy said:
Try to get a few tests tonight so we can see how he does on the 1.5 unit dose with his 144 preshot. I’m thinking this is the lowest preshot he’s ever had? Be sure give small snacks if you can tonight at +1 and +2. Test at least by +2. If it’s a lot lower than 144 then be prepared to monitor and feed as necessary. So for now, we can see how he does on this dose with this low of a preshot. If he’s really lower than that at this point in his journey (preshot I mean) you can consider a skip or a small token dose depending upon your ability to monitor him.
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I wasn’t sure what to do this morning because he hit 91 last night . I gave him 1.25 this morning to be safe because I have to go to work this afternoon .
 
Today’s dose worked out really well for Max. But so did last night’s dose. I think if you are not going to be home at all then it’s safest to go with the lower dose, but if you are going to be at home then you can try the slightly higher doses. I’m talking about when he is having the lower than normal preshot tests, of course.
 
Hey Suzanne . I’m getting a little thrown off by Maxs recent numbers . He dropped below 90 in today but his pre shot numbers are above 200 so I didn’t think I should dip him any lower . What would you do ?
 
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