should I increase my insulin dose?

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kphowe

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Hello All,

Sorry I have not been on lately. But I changed Mya's diet from raw to wellness 4% carbs. She has been on this since Friday am feeding. It also has more calories and seems to hold her better between feedings. (she is not as hungry and searching for food).(she gets a whole can split in two 5.5oz total) I did a very long curve today and want a little advice. With the numbers I have, Ithink I should increase to 1.5u. Only did up to 11:30 pm as I have to get some sleep, need to get up at 5 am to get ready for work.
Thanks in advance, Karen and Mya
 
Hi Karen & Mya!
Good job on the curve. She had a good blue, but didn't hold it. She sky rocket up.
I'm not really one to give dosing advice.
I would see how she is going to do on the new food. So today is going on 3 days for the new food. I would wait maybe til tomorrow to consider a dose increase. Also, you want to make sure you are going to be around to test when you increase. You will want to ran test throughout the cycle.

Are you testing for ketones? She has some high numbers that could cause ketones.

Jenn & Baxter cat_pet_icon
 
Hi Karen,

I agree with Jenn, I'd hold the dose for a couple more days actually....and be testing to see if you'll need to decrease. You got a 300 point drop yesterday, that's over 60% so I wouldn't think you would want to increase. Mya's curve looks very similar to what we experienced here after switching to low carb wet, and 6 days in she needed a drastic dose reduction. Went from shooting 1u to 0.5u to 0.2u in the am and we were still getting 60% drops. I know the PS numbers suck, test for ketones, and I would wait it out a bit and keep testing BG to see if she's coming down from the food change.

Cathy
 
Hi Karen,

I'll third that, I would hold this dose until the bouncing stops and then you will probably need to decrease the dose once her liver stops reacting to the lower numbers and her PS's start coming down.

Great job on the curve.

Robin
 
Thanks for the response, I agree that I would not increase until I can be home to monitor her which would not occur until the weekend. So I will keep her at the 1.25u until then, and give her a few more days to adjust to the new food. As far as testing for ketones, I have not. I think that would be difficult as I have 2 other cats that use the liter boxes, and the litter absorbs the urine. I would have to isolate her and try paper instead (very little of course so it is not absorbed), and even then would it be accurate if I do not see her urinate? but check it later? I will if that is what I need/should to do, but I will need to order some stips.
Karen and Mya
 
Great job on the curve yesterday! Is there a way to get a number here and there, perhaps before bed in the evening, to help fill out Mya's picture?
 
Awesome curve!
I am with the consensus to hold the dose
especially beause of the food
Great job!
 
Nice looking cycle tonight, I def. would hold this dose and I think you might be lowering it in the near future...wouldn't plan on raising it this weekend at least. You're now seeing blues again, and the red PS's are bounces from the lower numbers. Once she's back in the pink for PS, you'll probably see her go lower on the same dose you are currently on, and may have to decrease. The one thing I see from the chart is that if she throws a 200ish PS I would not shoot 1u again. You did 0n 3/4, and 3/7 and ended up with her bouncing up 200 points at her next PS. If she gives you a low number, I would post on here so someone can advise you on a dose.
 
Nicer AMPS today, see that you reduced because she lost most of her breakfast. I am interested to see what that does to her PMPS, hoping it holds or drops a little from AMPS and she's done bouncing at the moment. I really think you should get some early opinions for a sliding scale, many people shoot a varying dose dependant on PS readings ( example, 0.5u 200-280, 0.75u 280-360, 1u 360+), and I think it might be useful to have an idea of what to shoot when you start seeing 200's again....probably going to need to be able to give 0.5-0.75 (or if you have u100 syringes it might be easier to shoot in 0.2u increments).
 
I was actually reading about a sliding scale last nite, and was wondering if it would be beneficial for Mya and me.

I was a bit nervous about dosing her at 1.25 this morning even though I fed her the other half of the can and she kept it down (at least until I left for work). I went with my gut on this one. I was also thinking that if she did vomit again I would not be there to make sure she did not drop to low. I did not think about leaving a little food for her until I was on my way to work.

I am keeping my fingers crossed that her pms are still as nice or nicer than this am. I also am hoping that her vomiting this am is not secondary to anything other than eating to fast. She does not seem to be acting any differntly.

Thanks
Karen and Mya :cool:

ok so when I got home and checked her sugar it was 365 wahoooo... :mrgreen: I did check it about 20min early, but even at that I dont think it would be much different. So going forward, I again only gave 1u. I will do some random checks again tonight. I do have one question. Has any cat ever become anemic from doing to many blood sugar checks? Reason I ask is that sometimes when I stick her I get just enough to fill the strip and other times Iget a larger blood drop.
 
No danger of too much blood loss from testing. Sometimes you may hit the vein directly instead of between the vein and the edge of the ear, and that will bleed a good bit. I used to use a cotton ball below the ear (in case I poked thru and hit my finger) and then I would just pinch Bob's ear for 10-15 seconds with the cotton ball to stop any more bleeding. The couple times I hit the vein, of course he shook his head so I had droplets all over the place. You can also rub a little neosporin on the poke hole and that helps heal as well as stopping the bleeding.

Nice job on the curve.

Carl
 
I feel you on the blood loss, first time I stuck my cat I tried it freehand and it was like a scene from Carrie. She bled for 20 minutes and ended up coated in cornstarch to her shoulders when I finally got the bleeding to stop. I'm sure you're doing a great job with her ears.

Nice PMPS, Carl is a good one to advise on sliding scales, BTW

Again it'll be interesting to see what her tests show tonight, wonder how low she's going?
 
Thank you Cathy and Carl,
Im glad im not the only one who has had some blood loss going on and yes my own as well, when I have gone through the ear.

Carl,
Do you advise on using a sliding scale for Mya? I would love your input. I am ordering some 100u syringes this evening, as I know they make it easier for smaller doses.

Karen and Mya
 
Well I got yellow this am. :-D Have not seen that in some time. When I checked her at +5 and +6 I saw that her numbers stalled. I was not able to check again as I fell asleep. So When I saw the 244 this am I thought I was seeing things, (I was still half asleep) and had to look at the meter again just to verify. I again went with my gut and gave <1 more around .75. (difficult to get a true number as Im using U40 syringes) I do think it is time to establish some sliding scale numbers and when not to shoot. I wish I could be home to test her randomly throughtout the day. But with a little prayer maybe her numbers will be good again tonight. I really need to get the 100u syringes in.(just ordered last nite).
Karen and Mya.
 
Good morning KP --

I also questioned how to catch Grayson in the litter box in a multi-cat household. Here's what I do:

I have a box up on a table that is an easier level to reach. The ketone test strips are closeby. There's nothing like a clean litter box to get a cats attention - whether they need to use it or not! Fortunately, Grayson is easily caught up in it. Sometimes I just need to run the scoop through it and he'll go in. If you have a sense of WHEN he uses it, you can anticipate it. Easier said than done. Yes, I've run around after him with a stick (strip) in my hand! :lol: Some people use a spoon or ladle. Grayson isn't thrilled when I just stick the strip in his stream, but once he's going, it's a moot point. If they don't cover the urine, sometimes you can test from the "pool' of clumping litter. Once it's absorbed, however, you're too late (you just get a muddy strip!). Others will use a box w/o litter, or one of the kind that has the tray inside that can be emptied, if your cat is really shy.

But the ketone test is HUGELY important - especially if your kitty is running high numbers. Check back on myposts on 2/23 and you'll see why it's so important to stay on top of them... you DON'T want to risk DKA - the testing is the insurance policy to head it off! A bottle of 50 strips is about $6 at Walmart. $10 at Walgreens. Best little insurance policy in a bottle! Please don't delay getting these!

Lu-Ann
 
kphowe said:
Well I got yellow this am. :-D Have not seen that in some time. When I checked her at +5 and +6 I saw that her numbers stalled. I was not able to check again as I fell asleep. So When I saw the 244 this am I thought I was seeing things, (I was still half asleep) and had to look at the meter again just to verify. I again went with my gut and gave <1 more around .75. (difficult to get a true number as Im using U40 syringes) I do think it is time to establish some sliding scale numbers and when not to shoot. I wish I could be home to test her randomly throughtout the day. But with a little prayer maybe her numbers will be good again tonight. I really need to get the 100u syringes in.(just ordered last nite).
Karen and Mya.
Click to expand...

My guess is yesterday am Mya had a pretty active cycle (no data to know for sure) but didn't get so low that her liver really panicked. Last night you had a kinda flat cycle after the active one, which seems to happen, but it held the numbers down for 12+ hours. ECID so don't know what she'll do this cycle, be great if she stayed yellow. If you for some reason get a high number, it will be a bounce, and you should stick with your reduced dose if no one is around up here (I know you shoot at like 5pm which is early) or post for help. She might see a green today, and if she does you'd expect to see a high PMPS, it sucks, but I wouldn't be shocked if she gives you one.

*I have a feeling she may be higher this evening, and it won't be an issue, but when do you normally depart and return from work? The way Mya is heading she may start giving numbers PS that aren't shootable (below 200) and you will have to hold her food an retest to make sure they are rising. Getting a +11 when you think she might be low will give you a heads up and more time to make a decision what to do if you are leaving the house shortly after 5 am. I'm just putting this out there cause yesterday it sounded like you had to refeed and run, if that's the case and it were a day where she didn't hit 200 before you had to go then you would have to skip, rather than wait around and see if she becomes shootable. If that's the scenario and you get home before 5pm every day, you may want to consider moving her shots forward about 30 minutes for a couple of cycles to give you more time to wait her out.
 
Hello Cathy,
My routine is get up at 5am, check Mya's sugar, prepare all the cats food (and dogs) feed them. I stand by and make sure they all eat and that Mya does not get into the other cats food because I feed them friskies and Mya wellness. then around 5:30 I give her her insulin. I have to leave the house by 6:10am.

I usually get home between 4:45 and 5pm. On occasion I have gotten home at 5:15 (traffic). I have to travel a ways to and from work. The first thing I do when I get in is check Mya's sugar. Then feed the gang and give her insulin about 5:30pm.

So I could check and wait a little in the am but only for about an hour.

I could also get up at 4 am and check at +11 like you suggested to have a heads up.

I guess I have one question. You had said that if she is too low to shoot to "hold her food" and re check her sugar to see if it is coming up. Is holding her food, to make sure its coming up on its own and not secondary to the food that I would have given her. (makeing sure she can self adjust) Im glad you mentioned that because my first response to a very low number would be to feed her re check sugar and then shoot if it is in good range.

Thanks
Karen & Mya
 
I figured there was a reason you were on a 5/5 schedule, as far as you having to get up earlier to get a +11 I would wait and see how she does today when you get home before depriving yourself of sleep. If she doesn't bounce tonight and happens to give you a yellow PMPS then getting up early may be a good idea, because then you have a +11 to compare your +12 to and confirm that -for example- +12 is 201 and +11 was 160 her +12 is a rising number. Yes, if she gives you a low number at +12 you would not feed (stall) and check in 30 minutes, if the number is within 20% (meter variance) you would continue to hold the food and check again at +13. For your schedule, that means if the number is not rising at +13 and at least 200 you will have to skip the shot, feed her, and she may be high when you get home. If you feed, the number you see is partially a food spike and makes dosing difficult unless you know how much Mya goes up just from food.

I am not experienced at this, but some people do feed and then shoot a very reduced dose if they can't wait around...maybe someone else can tell you how that works, I couldn't reduce as I was already almost shooting on the zero line.

If you look at Kitten's SS, we had to stall on 3/7 am (she ended up rising by +13 and I shot her), and 3/10 am (she was still unshootable at +14, I fed her, and her pancreas kicked in), just to give you an idea of what it looks like/how to enter data if it happens. 3/10 is good to look at to see what a rising number is not, +12 163/ +12.5 179/ +13 170/ +13.5 154/ +14 161. Now I could have seen that 179 and thought I could give a reduced dose (i was shooting at anything rising at 180+), but with the 20% error 163 and 179 are really the same number. So I waited, and when I saw 161 at +14 I knew she wasn't going to be able to get a shot, so I fed her. If I had just shot at +12.5 I wouldn't have known that her pancreas was working and that the tests results for that day were not caused by the insulin. Plus if the dose were large enough, she might have hypo'd. That evening she did come up, and I gave her 0.05u (my cat is really sensitive)-her last shot (ever hopefully). The next morning 3/11 when she threw a AMBG (if you're not giving a shot the PS changes to BG) of 136 I knew she wouldn't be coming up enough before I had to leave, so she got fed and she's been doing it on her own since.
 
ok so got 320 still not bad but I think I should stay at <1 and check her randomly tonight. I followed your advise and gave her the same dose as this am. I have to go out tonight, but my husband is going to test her at 7:30 and 8:30 if Im not back by then.
oh and I did manage to get some U100 syringes so I can dose lower.
 
Sounds good, probably bounced a little (she may have seen a green today!). I'm new to all this too, we were only diagnosed 2/9 but my cat had a very similar ss to yours (similar curves, just smaller doses) and I spent a lot of time pouring over ss of other microdosers trying to educate myself (there aren't a lot of people on here actively with microdosing cats because it seems most of them are in remission).

I would love for someone else up here...ahem....to chime in on dosing, but I'm watching your ss and will check in with you

I think holding the am dose is smart because if your cat is starting to get some P action she will be coming down in BG on her own in addition to the insulin, and the advice I've always been given is hold or reduce on a bounce. The question now is how long do her bounces last? I'm gonna look at your ss again and see if there's enough there to figure that out.

I do think you're going to be giving smaller doses in the near future, I think your numbers were all over the place before your latest diet change because your dose was a little high and you were seeing rebounding all over the place. I hesitated to jump in with my opinion, being a newbie myself, and I will say always go with your gut feeling above all else. Mya's looking like she wants to get regulated at the least, what you're trying to do is keep her below 250 for her to be considered regulated on insulin, at those levels symptoms should pretty much resolve. Who knows, she might go OTJ...I'm hoping she will!

*looks like she clears the bounce in 1-2 cycles, hard to tell because the dose was higher, the food was different. I would think you might have one or two flatter cycles coming up, my bet is just tonight. If you don't then awesome, and if her tests tonight show movement you might want to get a +11 or +11.5 in the morning because her insulin needs might be decreasing and you may need to reduce a little if her AMPS is closer to 200 just to be safe. Since you're not around during the day, we currently have no way of knowing how low she gets, I think she saw some lower numbers today but not too low or she would've given you a 400+ again. This weekend if you'll be around at least for a +6 that would give you a lot more to work with, a full curve would be great but just knowing how low she gets would be something. Stinks that her bounce cycles are during the pm when you're actually able to test, but that's a cat for you! Gonna find the link to the u-100 conversion chart and hopefull the pics of the needles and put them up here.
 
So My husband was unable to get a sample at +2 and +3. I just got a +4 of 272 this is what her +3 number was last night. So I think I will see 200's in the am. Maybe the bounce will only last this cycle. So I will lower my dose. Its funny you said to hang the conversion chart on my fridge, because I did that when I got home, I had also printed out a picture of the U100 syringe that I found on the internet (with and without half marks) So I too could see where to draw to. I am a very visual person. I did not use the U100 to shoot this evening, but in the am I will so I can give a smaller dose.

I want to thank you for helping me through this, even though you are new to this too. You have done a great job with your kitty. And your knowledge is great. I try to read up on this as much as I can in the evenings but Im also studying for a certification exam through work.
I hope you can continue to be in the honeymoon phase. And that is what Im hoping for too. Only Mya knows the answer.

I think that maybe we humans can learn a bit from diabetes in cats. I have been a nurse for many many years and treating a human was not this involoved. Maybe if we took the time to do what I have been doing with Mya more people could be regulated.

I will continue to be a bit sleep deprived tonight so I can see how she plays out. No rest for the weary :YMSIGH:

Hope to talk with you tomorrow.
Karen & Mya
 
You're welcome, I feel like an idiot sometimes thinking "maybe I'm wrong", and I don't help in most cases because I don't understand what's going on.

You're right, you might see yellow again tomorrow. Being that her bounce was rather small today (and if she had seen really low numbers I think she would have been higher than 400), you could hold at your current dose if you AMPS is about 240. It's only if it were closer to 200 that I would reduce, just to be safe because no one is home. On the weekend it'd be different because you could intervene if it ended up being too much. You kinda have to get an idea of what is a safe dose for a number, and what is a little more aggressive dose for a number. You shoot the safe dose when you can't be home or just have a feeling something isn't right, and you go a little higher when you are home and can test so you can get some greens in her life.

As for the sleep deprivation, I feel ya! The first morning she ended up skipping I ended up brewing sugar (the canisters are the same) rather than coffee, then walked around the house crying because I was soooo exhausted. But then an hour later it was like the best day ever, so it's worth it. I agree this is very involved monitoring, and I think that's why so many vets don't want to go through all this and just want you to shoot the same thing every day and let them do the testing. It's a lot of work.

Glad she's doing better!

*btw, the bounces will stop eventually as Mya gets used to seeing the lower numbers, what happens is their bodies are so used to having high BG that the liver panics when BG hits a new low...kinda like it thinks the cat is going to die from low BG. Once the liver realizes it's cool, the bounces stop til you hit a new low.
 
kphowe said:
My routine is get up at 5am, check Mya's sugar, prepare all the cats food (and dogs) feed them. I stand by and make sure they all eat and that Mya does not get into the other cats food because I feed them friskies and Mya wellness. then around 5:30 I give her her insulin. I have to leave the house by 6:10am.

I usually get home between 4:45 and 5pm. On occasion I have gotten home at 5:15 (traffic). I have to travel a ways to and from work. The first thing I do when I get in is check Mya's sugar. Then feed the gang and give her insulin about 5:30pm.
...Thanks
Karen & Mya
Click to expand...

Hi Karen...

I know it's hard to keep the schedule you have, commuting and all, and although I don't know if this is a good recommendation or not, it's worth a look. Angela doses Henry on a 14/10 schedule instead of 12/12. You may want to check out Henry's spreadsheet or PM Angela to see how she came up with her numbers. This might give you an alternative. I'm not certain why she doses larger in the shorter cycles, but haven't followed up on the post where I asked about that.
 
Grayson & Lu said:
Hi Karen...

I know it's hard to keep the schedule you have, commuting and all, and although I don't know if this is a good recommendation or not, it's worth a look. Angela doses Henry on a 14/10 schedule instead of 12/12. You may want to check out Henry's spreadsheet or PM Angela to see how she came up with her numbers. This might give you an alternative. I'm not certain why she doses larger in the shorter cycles, but haven't followed up on the post where I asked about that.
Click to expand...

I think the 14/10 is designed for a cat that is much more active and runs longer in one of their daily cycles, but I could be wrong..think I remember reading it somewhere. The 10 would be the less active cycle, and she may be shooting more insulin to compensate....that would kinda make sense.
 
Catannc said:
...I think the 14/10 is designed for a cat that is much more active and runs longer in one of their daily cycles, but I could be wrong..think I remember reading it somewhere. The 10 would be the less active cycle, and she may be shooting more insulin to compensate....that would kinda make sense.
Click to expand...

That may be the case for other who do the 14/10, but Angela gave an explanation for her decision on her thread. Apparently on a 12/12 the AMPSs were extremely higher than the PMPSs. By adjusting the times, she was able to bring the AMPS down. Makes sense when there's that much difference of preshots. Take a look at her ss if you get a chance.

I never cease to be amazed at the differences we all run into from one another. And thanks to the uniform-ish spreadsheets, we have the luxury of learning from others. Thanks to whoever had the idea to establish the template!!!
 
ok so no yellow today, but not a bad purple. I guess Mya is not ready to cooperate. I will stay with the same dose and see how this pm is. I would love to stay home as I am sooooo tired but not in my profession duty calls. LOL:) I will look at the other spread sheet when I get home and have more time.
 
Not bad, if she's purple tonight you might want to think about going back to 1 unit for 300+, start a sliding scale.
 
So Mya still does not want to play nice. she was 341 this pm. So I went back to 1u. I will try to do some checks this pm, but I am very exhausted and feel I need some good sleep in order to stay sane. As well as be able to continue to be dilegent with Mya in hopes of getting her regulated at the least. Not forgoing, with hope and prayers of getting OTJ.

I wish I had known about this forum a couple of years ago when I lost my beloved Sebastian. He was my very first cat that I had since he was 3 months old. I always fed him dry food, and at the age of 17 he was diagnosed with diabetes. He lived to almost 18, but lost alot of weight and went blind. He seemed as if he was suffering so I had to make that dreeded decision to put him to rest. Being on this forum makes me wonder if I could have done something different for him. (as in better regulation of his sugars) I did not check him like I now do with Mya. I did alot of just giving of the insulin and scheduleing curves to be done at the vets. This was what I knew to do. I know that he lived a good life as he did almost reach the age of 18.

When Mya was diagnosed I did some research and have learned alot, but still have alot to learn.
So I don't want to miss out on anything with Mya and give her the best chances I can possibly give.

Sorry for rambling and being sappy, but I still think of my Sebastian every time I see Mya. He was like my family and I still miss him to this day.
I guess the sleep deprivation is working on my emotions.

Karen & Mya
 
You need to take care of yourself so you can take care of Mya.

You can be as sappy as you want here because every one of us will understand.

Don't beat yourself up about Sebatian, he had a long happy comfortable loving life with you. What more would a cat ask for.

I looked at your ss and put together a very generic scale for Mya. Since it is so early in the dance the scale will need adjusting as her numbers come down.

Over 400 - 1.25u
350 to 399 - a fat 1u
300 to 349 - 1 unit
250 to 299 - .75u

Since you havn't really had many yellow PS and no mid cycle tests on the lower numbers that you shot that .75u is only a guess and we can adjust it when we see how it works.

Take care,
Robin
 
Ok So my batteries are semi recharged. Mya was a bit higher this am, but It may be stress related as after the +5 She and my other cat had gotten into a fight. (those too just can not get along) Or that I fed her wellness, but it was there newer version still same ingredients but higher in protein. Maybe she can not handle too much protein (as was noted when I had her on an all raw diet before the swithch to Wellness).

Robin,
Thanks for the SS, I used it this am and gave a f1. I will be able to do some checks today as I am off (will have to go out and may not be able to check all day) but may be able to get some randoms.

Had to go break up a fight again. I dont know whats going on between them. (this seems to be what happened when Mya was still hungry even after eating) that got better when I started her on the wellness as it has more calories. Now she seems to be hungry again and searching for food. Maybe this is the reason for the agression of the two cats (afraid of missing out on food).
I feed Mya 1 can(5.5oz) split 1/2 in am and 1/2 at pm feeding. Maybe I will start giving her a little bit more at each meal (not a whole can but maybe 3/4)
 
Morning
Just an fyi
the hunger can be because of the high sugars as the body can not absorb the proer nutrients
It will subside one th sugars start to come down(yes I know, no pressure there!)
It will happen, try not to worry too much(yes I know that is impossible!)
I hope you get some good numbers today
and have a great day!
 
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