Should I increase Juno's dose?

Status
Not open for further replies.
Tininha & Juno

Tininha & Juno

Member Since 2014
Hello everyone,

Juno's BG values have been really high in the past days and it seems he's loosing a bit of weight. I have been giving him 1 unit of Levemir in the morning and another one in the evening. Last week was a bit tough for him. I had to travel abroad and he had to come with me. He's a difficult cat to deal and nobody else besides me can read his glucose values and give him the shots. So for a few times he also didn't have the shots (since I was away for a couple of days because of my work) and I think that his blood sugar got a little out of hand. He also keeps having the asthma attacks.

I have finally regular syringes that some of you advised me to buy, and my question now is if I should increase his dose?

Thanks,
Cristina
 
I'm wondering if the skipping of shots actually means you need a decrease to 0.75 units. I did a post on Lantus and asked them to come take a look.

The way Levemir and Lantus both work best is with as much consistency as you can possibly do. Shot times almost exactly 12 hours apart and food with similar carb levels.

Dose adjustments are based on the nadir - the lowest glucose level between shots. This is roughly +7 to +9 for Levemir, although cats can and do vary in the timing of the nadir, even from day to day.
 
Thank you BJM. Besides the lack of shots, I also couldn't find Ziwi Peak food, and I had to give him Purina md canned food. His BG shoot up after that. It's difficult for me to check his BG during the week between the shots, but now that I'm back home I'm doing everything again as much consistent as I can. My problem is that I have to travel usually every 2 months and I'm worried how that will affect Juno's diabetes.
 
Hi Cristina - as BJM says, we make changes in dose based on the nadir instead of the preshot. Although the "typical" Levemir nadir may be +7 to +9, I've seen a lot of variability. Neko's is typically from +9 to +12, although I've sometimes seen it as early as +6 or as late as +15. What this means for me, is that occasionally I have to give insulin at nadir which can be a lowish number. From the data you've got, it looks like Juno may like to nadir later too.

Before making recommendations on changing the dose, I'd like to see a few more tests in the +6 to +11 range. Any chance of getting some tests in the next few days around then? And keep in mind that often cats will go lower at night. Mine does that a lot. You've now been able to give Juno his 1.0 shot 8 cycles in a row consistently, which is great. That means the depot is full and we can get a good idea of how this dose is working once we see those late cycle tests. The 72 you got for the PMPS on March 4th has me thinking that either this is a good dose, or maybe a reduction is needed. Normally if we see a green number like that 72, we hold the dose a bit. If he is getting numbers under 50, we lower the dose by .25U.

As lastly a question on food. Which Ziwipeak are you giving? Some of them are zero percent carbs. We noticed that some cats do a little better with "some" carbs, maybe the 3-5% carb level.
 
Thank you Wendy. If Juno cooperates, I can try to test more tomorrow, but during the weekdays is more difficult. He really hates to be pricked in the ears and he keeps biting me, shaking his head and complaining out loud when I have to test.

He's eating Ziwi Peak mostly lamb canned food. He loves this food, but he's not very fond of other two flavours. This is one of the wet foods he actually eats. Before he was diagnosed with diabetes he used to eat only Royal Canin kibble and he wouldn't touch any wet food.
 
Are you giving Juno treats after testing? That does seem to help them accept it more. And put some topical pain relief on the poke site afterwards. In the US they use Neosporin with Pain Relief. It eases the pain and helps heal.
 
Can you hire a trustworthy pet sitter, a vet tech, or a college student interested in veterinary science, teach the person how to test, then have them come in maybe once a week and test mid-cycle? This also gives you a backup person if you can't get home on time, or in an emergency.
 
Hi Wendy, Juno is not very fond of treats. I bought some for him in low carbs but he doesn't touch them.

PS: I'm living in Europe.
 
Hi BJM, that's almost impossible thing to do with a cat like Juno. He doesn't like strangers and he usually hisses at them. It gets worse with vet tech people... When he was diagnosed with diabetes he had to stay two days at the vet clinic he got really worse in the clinic. He was too stressed and the vets couldn't approach him even with some sedation...
 
Systematic desensitization can work. It takes time, though.
It is positive reinforcement plus tiny steps moving towards desired behavior.
 
We don't have Neosporin in Canada, here it's called Polysporin with heal fast formula. You want some first aid gel with antibiotics, pain relief and assists healing.
 
Hi again,

Yesterday, I tested almost 6 hours after giving him the first shot and his values were 299. This is a very high number to be in between the shots, isn't it? Yesterday's and today's values pre-shots were once again very high (around 450). His back legs are starting to show that he's loosing weight, even tough he's eating very well. It worries me that the lost of the weight is because of too little insulin, and he keeps having asthma attacks probably because of a respiratory infection. I also tested for ketones today, but thanks God it was negative.
 
Is he on any medication for the asthma?

I would definitely try and get a test midday and one before bed (2-3 hours after PMPS) like the other Wendy said, you need more data to see how well this dose is actually working - pre shot tests just don't give you enough data..

wendy
 
Thanks Wendy. No he's not being medicated for the asthma. The asthma attacks started around the time when he was diagnosed of diabetes. I will try to test more today.
 
Cool - just to be clear what we are looking for here is a bounce i.e. With the phenomenon called "bouncing" and somogyi, what happens is the cat will drop low (like hypo or even just under 100) for a few hours and then bounce and sit high for up to 72 hours.

That means you can easily miss the low if you aren't testing enough and assume the cat is high all the time and assume the dose is too low... when in fact the bouncing indicates the dose is too high!
 
Oh I see what you mean... I just tested him (7 hours after the first shot) and his blood sugar is now 407. I will test him a bit later.

I have one question. If the amount of insulin is enough he shouldn't be loosing weight, isn't that right? He's eating a lot but his back legs have become weaker in the past days. In the first weeks with insulin, he actually has gained a little bit of weight.
 
Given he is high I wait now till pre shot and get a test then. And then try and get a test 2-3 hours after his pre shot test.

As soon as you see anything pink, yellow, blue etc I would start to test more often.. wanna catch that low!

Wendy
 
http://www.fritzthebrave.com

Asthma can be fatal very quickly. Even if it increases the insulin dose, get him on meds asap.
There is an inhaler mask for cats - AeroKat - to reduce the amount of oral steroid required.
 
I'm going to follow your recommendation, Wendy.

Tomorrow, I'm going to talk with the vet to see what we can do about the asthma attacks. I still think the asthma attacks are caused by the fluid he has on his lungs, but the vet should know better than me. The vet is also probably going to recommend me to give him a larger dose of insulin.
 
Well its lower than it was. Seems to be dropping. Lets see where his PMPS is at - he might drop further. Then get a before bed test

this is good info - we should be able to judge dose if you keep getting tests in like this for couple of days.

Wendy
 
Thanks Wendy. The pre-shot value was 376. I will test him again in a few hours.

I'm also thinking about one more thing. I'm keeping the Levemir FlexPen outside the fridge as in the Levemir website it is said to keep it once it has been opened. Yesterday, I was reading another site about feline diabetes regarding the usage of Levemir and Lantus insulins, and this website says to keep the Levemir cartridge in the fridge. The cartridge has now a bit more than one month. Do you think that might be also an issue? I mean if the insulin has lost some of his power because it has been outside of the fridge. I'm worried that can be the reason why it started to loose some effect.
 
When Levemir was submitted to the FDA, they'd only tested it for 1 month. That isn't the same thing as saying it won't last longer.

Refrigerated, to slow degradation, it may last up to 6 months.
 
Did you buy a pack or just the one pen? If I were you I would try a new fresh pen as the old one may not be effective any more.

With a new one, best to keep it in the fridge (closed or open) as it will last up to six months as BJ says.

Today can you get an AMPS +8 and a PMPS +7 or so?


Wendy
 
I have a pen. Yesterday, I talked with the vet about the FlexPen and also Juno's high blood sugar during the past week. He told me the pen should be stored outside the fridge and that he will give me a new one only when this one finishes. I asked him if he was sure about the efficiency of the insulin, and he said that it's still fine. He also advised me to increase Juno's dose to his initial recommendation of 2 units of Levemir (as I had changed the dose to 1 unit after a few days Juno started the insulin).

I really don't know what to do. Yesterday I gave him 2 units after the vet recommendation, but then I keep worrying if he's actually under the somogyi effect that you mentioned before, and today I gave him again 1 unit in the morning. Today his values around +8 were 373.
 
When did you give him 2 units ? I don't see it on the sheet? I do see you had a blue last night its a shame you didn't get more tests in because he may well have dropped lower.

If you do increase I would go to 1.25 at the most and work up slowly as I am also worried about bouncing.

Wendy
 
He told me the pen should be stored outside the fridge and that he will give me a new one only when this one finishes.
Click to expand...
The advice from your vet to store the pen outside the refrigerator is because that is what the manufacturer recommends, because the pen has positive pressure in it. When humans use the pen, they use pen needles tips and the dial-a-dose feature to have the pen 'squeeze out' the insulin.

Because we do not use the pen needles with the pen, but instead use a regular insulin syringe, the pressure mechanism in the pen is not used. Because our cats need tiny changes in doses, we do not use the dial-a-dose feature either. That pressure mechanism is the only reason the manufacturer says not to store them in the pen. We don't use that, so storage in the fridge will make the insulin last longer.

I asked him if he was sure about the efficiency of the insulin, and he said that it's still fine.
Click to expand...
Is it older than 42 days?
The manufacturer also recommends tossing out the insulin pens after 42 days. If you can afford to buy a new pen every 42 days, then keeping it outside the fridge would be ok. If you are trying to save some money, then keep it in the fridge to extend the life of the insulin which degrades with exposure to light and to heat.

The manufacturer never tested beyond 42 days to see if the insulin would last longer. That is why they say to throw it out after 42 days. Our experience here, has shown that with refrigeration, you can get much longer use out of the insulin.

Since we want to make those pens last as long as possible, we recommend storing them in the refrigerator. If you do that, they can last for months and many members here use their insulin pens to the last drop.

Direct from the manufacturers website: http://www.levemir.com/Levemir/StorageTravel.aspx
How to store unopened Levemir® (insulin detemir [rDNA origin] injection):

Unopened Levemir® FlexPen® and Levemir® (insulin detemir [rDNA origin] injection) vials should be kept in the refrigerator at a temperature range between 36° to 46°F (2° to 8°C).
•Do not freeze Levemir® FlexPen® and Levemir® vials or use if frozen
•Keep unopened Levemir® FlexPen® and Levemir® vials in the carton to protect from light
Click to expand...

How to store Levemir® (insulin detemir [rDNA origin] injection) while in use:

Levemir® FlexPen®
Once in use, Levemir® FlexPen® should be kept at room temperature, below 86°F (30°C), for up to 42 days. That means you can use Levemir® FlexPen® for almost a month and a half without refrigeration.
•Do not store a Levemir® FlexPen® that you are using in the refrigerator
•Keep Levemir® FlexPen® away from direct heat or light
•Be sure to throw away a used Levemir® FlexPen® after 42 days, even if there is insulin left in the syringe

Vials
Once in use, vials should be kept in the refrigerator or at room temperature below 86°F (30°C) for up to 42 days.
•Keep vials away from direct heat or light
•Throw away an opened vial after 42 days of use, even if there is insulin left in the vial
•Unopened vials can be used until the expiration date on the Levemir® label, if the medicine has been stored in a refrigerator
Click to expand...
 
I gave him yesterday morning the 2 units (by mistake I had written 1.5 in the spreadsheet). I wished I could have tested him once more time yesterday, but I have been too exhausted and sleepless because of my work and Juno's illness.
 
Thanks for the information, Deb. I'm using the pen needles tips as the vet advised me to do. That's the reason why I'm not giving him half unit doses. I have bought regular syringes, but I'm worried I cannot measure it precisely and give him to much dose. The pen is not older than 42 days. I started using it on February 10th, so I still have a few more days to use it. I can go to the pharmacy and buy a new one if they sell me one without a prescription.
 
I'd encourage you to try using the syringes. They are way more accurate than the pen tips. Cats can be very sensitive to small changes in amounts of insulin. A one unit or even half unit change will easily bypass the good dose. My Neko is on Levemir and I notice a difference in her numbers with a .125 (or 1/8th) unit change. For cats new to diabetes, we recommend changes in .25U amounts. The way that I manage to keep consistent and find those tiny in between doses is with a good light, a white background, a magnifying glass and digital calipers. Here is a post on dosing with calipers.

I've used my Levemir cartridge as long as 77 days by keeping it in the fridge. That meant using it to the last drop.
 
The syringes allow 1/2 and 1/4 unit dose changes which is important in cats who react to small doses.

I have seen other users switch from pen tips to syringes and get better control..

Wendy
 
It was way too difficult, but I managed to order some syringes at the pharmacy. Tomorrow I'm going finally to pick them up. Apparently the pharmacies here only sell the 1ml capacity syringes, and some of them only sell he insulin pens. Anyway, I bought the 0.3ml Micro-fine syringes. I hope these are good enough for cats.
 
The 0.3 mL syringes are the smallest they make. They are made for human children but work well with our cats too.

Good job on searching out those smaller syringes over there in Denmark. Hopefully, these will help you to measure those tiny doses more accurately.
 
The .3ml syringes are perfect!!

Since you skipped the shot last night, and shot 2 units this morning, I think I'd just stick with the 1 unit until you got the syringes.

You don't want to "skip over" the best dose for Juno, and when you go up in whole units, you may just do that.

The protocol for Levemir says this:
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Considering his nadir's, I think you could go up to 1.5 and then hold it for at least 3 days and get as many tests in as you can. It's also important for you to get more in during the PM cycle if you can. Without seeing more tests in that cycle, it's like looking at a puzzle and only seeing the edges...it makes figuring out the whole picture more difficult.

Hopefully more will chime in with some advice soon, but that's what I think I'd do if Juno were mine.
 
Thank you Chris :) I will test him more during the weekend. I also want to see how his numbers are during the night. Wendy mentioned about the "bouncing" phenomenon and I have been reading a bit about that. I'm concerned that can be the case with Juno. I read somewhere "A typical rebound pattern, most often seen with long-acting insulins, is a high, flat, unresponsive blood sugar over a period of days." If that is the case, should I still give him 1 unit in the evening or skip the shot?
 
I really don't see Juno in a bounce at all at this point.

Bouncing happens when the blood glucose number EITHER goes lower than the cat's body is used to, or drops a lot quickly (like going from 400 to 250 in 2 hours)

When our kitties first start this journey, they've already been diabetic for an unknown amount of time, and their body has become accustomed to living at those higher numbers. If the number drops lower than it's used to, the liver thinks there's something wrong and kicks into gear, releasing hormones and stored sugar to bring it back up fast. This is a leftover survival mechanism from when cats were wild and times were hard.

The liver doesn't understand that these new lower numbers are good! The more time Juno spends in lower numbers, the more his liver will re-learn what it's like to be at those numbers, and the bounces will be less high, and clear faster. Bounces can take up to 72 hours to clear though, so when we know they're bouncing, we don't want to increase their dose because as they "clear the bounce", they can come down fast and if we'd also increased the dose, they might go back into a hypo state and start the whole process over again. That 72 hour period is what you're thinking of when you read "high, flat, unresponsive blood sugar over a period of days"

We want them to spend as much time in "normal numbers" (50-120) as possible since cats have a unique ability to "heal" their pancreas, but the liver panics and causes a "bounce". They're frustrating, but I'm told they don't do as much damage as being too high from non-control, and they will eventually clear and with enough time and better control, the liver will calm down too.

Does that help explain what bouncing is?

For the 2nd part of your question, we always want to give a shot every 12 hours. The only time we might suggest you not give one is if you get a pre-shot of 50 or below, and then, depending on how Juno's data has shown he responds, we may suggest you shoot even that low. It's one of those ECID (every cat is different) situations. If you're concerned about a Preshot number that's lower than you're used to shooting, we'd want you to Stall, DON'T feed, and post and ask for help so we can help you through those first few times when you're shooting a lower number.

We have a "shoot low to stay low" saying here and that means that you DO want to learn how your cat responds to both insulin and food so you CAN shoot lower and lower numbers...which will keep him in lower and lower numbers....and those lower numbers are the ones that can allow the pancreas to heal.
 
Wow!! Thank you so much, Chris. People here are amazing, very helpful and I've been learning so much about feline diabetes in this forum.

I finally got the 0.3 ml syringes!! I'm so happy. Now I see what you meant about the half unit marks. It's much easier to measure those tiny doses. I will give him 1.5u for at least 3 days as you suggested. I will try to test him more after the second shot, but he's not at all happy with all the testing I did last night. He puts himself in what I call his defensive position - he starts rolling on the floor on his back with his four paws up and bared fangs - and you can imagine how my hands look today. :-D
 
Happy Caturday Tininha and Juno!!

On the testing, here's what we tell a lot of people to try.

The edge of their ears don't have many pain receptors..Less that our fingertips do, but cats usually just don't like having their ears fooled with. It's not so much that you're poking, it's that you're fooling with their ears they object to.

Decide on a "testing spot" that you have easy access to those ears, and room for the testing equipment. As many times a day as you can, take Juno there and just give his ears a quick rub (even a second or two if that's all he'll allow) and then give him a yummy treat (low carb of course) or if he's not real food motivated, a nice petting, brushing, belly rub...whatever he'd really look at as a "reward" for allowing you to fool with his ears.

The more you can do that, the less he'll associate that place with anything but the reward, and when you DO have to poke, you'll just be "fooling with his ears" again..but by then, he'll be used to that and shouldn't care..as long as he gets his "treat"!

Great that you got the syringes too! They'll make it SO much easier for you to measure correct doses now instead of using the "dial a dose" on the pen!

I'd like to invite you over to the Lantus Tight Regulation Board too. I understand you're using Levemir, but both Lantus and Levemir are dosed the same way, and you'll get lots of experienced eyes there to help advise you going forward with Juno. There are others posting in Lantus Land that use Levemir too. You can also continue to post here in Health if you prefer.

On the Lantus board, each day we start a new post (we call them condo's) with the date, cat's name and the AMPS number. As the day goes on and you get more tests, you can edit that first subject line and add the new test results. For example, today's condo for China looks like this: 3/15 China AMPS 336,+6 246

In the body of the post, you'd give the WCR (Whole cat report). How Juno is feeling, how's his appetite, are the 5 "P's" in place? (Purring, playing, preening, peeing and pooping) along with anything else you feel might help people get to know Juno better. You can also ask questions here. When you have time, it's a big help to read other people's condo's too, since that may bring up questions you hadn't even thought of to ask.

You also want to put the link to the prior post in the body of the new one, so it's easy for people to go back and see what was said earlier. Just copy the link, click on the URL tab, and "paste" it.

I'll continue to watch for you here, but if you decide to move to the Lantus board, just say you're posting over in Lantus Land!
 
Hi Chris! Thank you for the testing tips. I have been trying everything that I have been reading here about the ear testing, but sometimes Juno is just impossible, and he does not cooperate at all. It's not just Juno's fault. I'm also quite clumsy with the testing too, but I guess I'll get better with practice.

Thank you for the invitation to the Lantus board. I will try to go there too. I have been with hectic work schedules, but as soon as I get some extra free time I'll post also there. For now I am just going to have a look at the posts. I just had a quick look at some posts (including yours :)), and wow I am amazed how people here are so experienced in feline diabetes. Thank you once again for the help.
 
Hello there!

Juno's morning pre-shot today is 121. Yesterday, I couldn't give him the morning shot and in the evening I gave him 1.5u, and his high values came down during the evening very quickly. Should I give him 1.5u or decrease his dose or just skip the shot? I've been reading here we should skip shots when the pre-shot number is lower than 200 for a newly diagnosed kitty.

Thank you.
Cristina
 
What we say is that the first few times you get a pre-shot below 200, you stall, don't feed, and ask for help.

There are several problems with me advising you anything this morning though. First, I can't stay online to help, so if you decide to shoot, you need to make sure you have plenty of test strips and some high carb food to feed Juno if he drops below 50.

Next, you can go ahead and retest...IF you haven't fed and the number has gone up, it's probably fine to shoot, BUT, since you've kept changing his dose so often, it's REALLY hard to tell you how much to give.

It's VERY important that we find a dose you CAN give, every 12 hours without having to skip because of low pre-shot numbers. Lantus and Levemir are "depot" insulins that require consistent dosing to be able to see what any particular dose will do. You've skipped and changed doses so many times, it's just impossible to know how any particular dose is going to work with Juno.

My advice, given with the understanding that you WILL NEED to test at least at +2 (and preferably sooner, like +1), and possibly every 15-30 minutes IF he drops below 50 would be to try giving a 1 unit dose and see how he does.

If you can't be around to test, it's safer to give no shot, or just a "token" shot of (for example) .5 unit just so you're giving some.

I'll try to check back with you to see how you're doing
 
Thank you Chris. Since I'm not going to be around I decided not to shot. I checked his values 2 hours after the pre-shot time and they were 182. He ate a little bit, not so much though. I was thinking perhaps giving him the 0.5u you said, but then I decided not to shot. Perhaps it wasn't the best thing to do... But I didn't want to take the risk since I'm not able to test him every 2 hours.
 
You don't necessarily need to be around to test every 2 hours, but when you shoot lower numbers for the first several times, you do need to try to get at least a +1,+2 and +3 or +4

Getting a +2 is what I call my "crystal ball" test, since it can really give you a pretty good idea of where they are going later in the cycle. If the +2 is lower than the Pre-shot test, it's a good idea to plan to get other tests in, or at the very least, leave some extra food down so if they drop low, they can get some food to eat. Most cats will get hungry if their blood glucose goes low, so leaving food down if you can't be home to test is an extra "safety valve"

We need to find a dose that you'll be able to give every 12 hours. Right now, you've been changing dose too often, or skipping doses, and there's just no way Juno will ever get under better control that way.

Since you skipped this morning, you can change your schedule if you like, so decide what time would work best for you to be able to be home to test/feed/shoot every 12 hours, and if at all possible, also get at least a +2 every cycle...better yet a +2 and a +5 through +8...sometime in the mid-cycle. I had to change to getting up to test/feed/shoot at 6am (and I HATE mornings) but it allows me to get a +2 on both the AM and PM cycle, as well as usually a mid-cycle test during both the day and night (and I can usually go back to sleep...LOL)

Let's try giving Juno 1 unit...every 12 hours and get as many tests in as you can. Let's see how he does after getting a consistent dose every 12 hours for at least 6 cycles. IF he were to drop below 50 at any time, we'd reduce to .75, but it's really important for you to try to be consistent so we can really see how Juno does when the Levemir is given correctly.

What do you think?
 
I will do my best, Chris. I'm very busy with work the whole March and that's why I couldn't test him today. In a regular month I can test him more often during the weekend, but during this month is not so easy. Dealing with Juno's illness has also not been easy, and I'm too exhausted.

I read your post after the evening shot, so I gave Juno 1.5u. Should I keep the 1.5u dose or change it again to the 1u dose as you said? I should have given the morning shot even with the low number, as his values shoot up again like crazy... When you say 6 cycles, you mean 3 days, isn't right? I had given him consistent doses of 1u for 6 consecutive days, but his values were still very high with that dose...
 
Yes, you had given 1 unit for 6 cycles (and yes, that's 3 full days) but you were only testing at Pre-shot. When there's no data in between, we just have no way of knowing if they're going lower in the cycle, and then bouncing back up at Pre-shot.

Lantus's nadir (the point at which it's working it's best) is usually around +6, but can be as early as +4 and as late as +10, and it can change from cycle to cycle. Only through testing can you start to learn where Juno is actually getting his best response (usually anyway)

Since you skipped again this morning, the cycle count has to start all over again. 1.5 has been causing you to skip too many times, so it's important to try a different dose that WILL let you give it every 12 hours without having to skip

Since he was bouncing tonight, the 1.5 won't hurt him..especially since he bounced into the 500's, but I'd really consider dropping it back to 1 unit tomorrow morning...or even 1.25 unit

If you get a pre-shot you're uncomfortable shooting, please just "stall", don't feed, and post and ask for help. Edit your first post's subject line to say something like "stalling, need help!" so people who are scanning the board can see you need help. IF you happen to be on at a time when nobody else is available to help you, Re-test every 15-20 minutes and see if he starts to go up. If he does, you can go ahead and shoot whatever dose is scheduled for that time. (or if you're still concerned, you can shoot a smaller dose just so you're not draining the depot any more than necessary and then restart the correct dose at the next Pre-shot time)

Remember, when you shoot, and when the insulin actually starts working are about 2 hours apart usually. You can also leave down some food if you can't be around to test after+2. Most cats will eat when their blood glucose drops.
 
Thank you Chris. His values today morning were 413 and I gave him 1.25u (or approximately 1.25u). The doses are so tiny that it is difficult to be sure that I am giving him exactly 1.25u. Let's see how he behaves with that dose for the next days. During the day is not easy for me to test, but as soon as I get home I start testing him. I will try to test him during the night too.

Juno has always preferred to eat small amounts of food during the day, so I always leave him some extra food when I am away. I also read that eating small amounts of food can also be good for healing the pancreas.

Have a nice day!
Cristina
 
Status
Not open for further replies.
Back
Top