Skipping a Dose

[Bluuberry]

Hello everyone!

Thank-you for all your kind comments on my previous post! I’m happy to report that Bluu is doing well on caninsulin so far!! Almost too well if that’s even a thing lol

After visiting the vet on Friday to learn how to check his blood sugar she made the decision that we should reduce the number of units (he was low at the vet, 3.1 about five hours after his dose!). So now he’s on 1.5 units every 12 hours and my gosh the difference in him is amazing. I can just tell he’s feeling so much better (and no more litter box accidents!!!)

I wasn’t expecting improvements so fast but it’s really amazing to see. I’ve been keeping a journal of his blood sugars which I check prior to giving insulin. Checking the blood sugars is a bit of a learned skill I’ve determined but Bluu’s been so patient with me while I get it right.

Now onto the subject at hand. Today is the first day I’ve been checking his blood sugar (I gave up last night as both he and I were too stressed from me completing bungling it). This morning he tested 16.1 so I gave him his full dose. I wasn’t going to test him this evening, but decided to anyway and to my surprise he was 11.6! This was really surprising to me!

My vet had instructed me that if he’s below a 12 I should skip his dose. I figured maybe I had checked too soon so waited half an hour and checked again and he was down to 9.3 which was even more surprising! He’s had a completely fantastic day overall as well (he cuddled with me for the first time since Monday). I’m feeling more confident in having skipped his dose, but does anyone have any ideas what this could be? There’s no way he’s regulating already, right? What could have made such a drastic difference in his blood sugar this morning versus this evening?

His diet hasn’t changed much and he’s eating and drinking pretty normally (I’ll be making the transition to wet only pretty soon).

I’ll be following my usual routine with him tomorrow and then reach out to my vet as well on Monday to talk about what’s going on, but just wanted to ask anyone’s experience with this. I feel like it’s good news, but given that his diagnosis is so new can’t help but feel a bit anxious.

 

[Basic's Mom]

Hi

Here is your previous post. You're asked to include a link to your previous post for continuity.
https://felinediabetes.com/FDMB/threads/new-member-newly-diagnosed.285488/


In your previous message, Ale provided you with a link. The link is also listed below. You need to set up a spreadsheet when you have a free minute. It is wonderful that you've kept a log to be able to see Bluu's progress. However, someone helping you here can't see it and in order to advise you, they'll need to see his numbers. His spreadsheet is an online journal. You will need to use a world spreadsheet. It will automatically convert your numbers for those helping you as the forum doesn't use mmol/L. While I can easily multiply your numbers by 18, in an emergency no one will have time to do that.
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Did you say that he was 3.1×18=55.8 at the vet?

How often are you testing him at home?

If you can't figure it out the spreadsheet, let someone know so we can help you.

In the meantime, can you please give the numbers you do have for Bluu in the last couple days?

I have these numbers so far:

1/12
AM preshot (AMPS) ?
+5 55.8 (at the vet)

1/13
AMPS 16.1×18=289.8

I'm not sure when 'this evening' is.
11.6×18=208.8
(If it was PMPS, you have no idea what his numbers were today if you didn't test in between. It is okay. You are new to this, but this is why it is important. You see the previous day when at +5, he was 55.8, at the vet. He could've been that or even lower today. Cats are usually stressed at the vet and stress raises blood glucose. Your cat isn't regulated yet. I would think his number would've been much higher. That number is most likely from his insulin hitting him hard and fast. See previous post for links regarding the insulin you use and a cat's response to it. Also, because his insulin is so fast acting, I'm very curious what his numbers are at +1-3. You may be very shocked.)

Possible skipped PMS
+.5 9.3×18=167.4

Please be very careful changing his diet to all low carb. This will change his bgs and could do so drastically. Therefore, changing his insulin needs.

Please never ever give him insulin without checking his blood glucose. If he was 40 at shot time and you didn't know and gave him his insulin, it could be very bad. Monitoring his bg is the only way to keep him safe.

I'm glad he is feeling better. It is a wonderful to see after they've been sick.

 

[Bluuberry]

Hi

Here is your previous post. You're asked to include a link to your previous post for continuity.
https://felinediabetes.com/FDMB/threads/new-member-newly-diagnosed.285488/


In your previous message, Ale provided you with a link. The link is also listed below. You need to set up a spreadsheet when you have a free minute. It is wonderful that you've kept a log to be able to see Bluu's progress. However, someone helping you here can't see it and in order to advise you, they'll need to see his numbers. His spreadsheet is an online journal. You will need to use a world spreadsheet. It will automatically convert your numbers for those helping you as the forum doesn't use mmol/L. While I can easily multiply your numbers by 18, in an emergency no one will have time to do that.
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Did you say that he was 3.1×18=55.8 at the vet?

How often are you testing him at home?

If you can't figure it out the spreadsheet, let someone know so we can help you.

In the meantime, can you please give the numbers you do have for Bluu in the last couple days?

I have these numbers so far:

1/12
AM preshot (AMPS) ?
+5 55.8 (at the vet)

1/13
AMPS 16.1×18=289.8

I'm not sure when 'this evening' is.
11.6×18=208.8
(If it was PMPS, you have no idea what his numbers were today if you didn't test in between. It is okay. You are new to this, but this is why it is important. You see the previous day when at +5, he was 55.8, at the vet. He could've been that or even lower today. Cats are usually stressed at the vet and stress raises blood glucose. Your cat isn't regulated yet. I would think his number would've been much higher. That number is most likely from his insulin hitting him hard and fast. See previous post for links regarding the insulin you use and a cat's response to it. Also, because his insulin is so fast acting, I'm very curious what his numbers are at +1-3. You may be very shocked.)

Possible skipped PMS
+.5 9.3×18=167.4

Please be very careful changing his diet to all low carb. This will change his bgs and could do so drastically. Therefore, changing his insulin needs.

Please never ever give him insulin without checking his blood glucose. If he was 40 at shot time and you didn't know and gave him his insulin, it could be very bad. Monitoring his bg is the only way to keep him safe.

I'm glad he is feeling better. It is a wonderful to see after they've been sick.

Hello!

So sorry I’ll definitely get a spreadsheet up when I’m able. He gets insulin at 9:30AM and 9:30PM, so his pre-shot was just barely prior to 9:30PM. I apologize about the numbers, I’m using a human glucometer and this is how it’s set up for me.

As far as numbers go, yes he was 3.1 at the vet at around 2:30PM-3:00PM on 01/12. I did not test him that evening after about 5-6 failed attempts because I was so anxious and he was so stressed from me poking at his ears.

Today @ 9:30AM he was at 16.1 so received his regular dose of 1.5 units of insulin.
He drank and ate regularly throughout the day and I made sure he ate in the half hour prior to what was supposed his second dose of insulin for the day (just a bit of wet food).
I checked just prior to 9:30PM and he measured at 11.6 so I skipped his dose per my vet’s instructions.
I checked again at 10:00PM just in case I was too early after his mini meal at 9:00PM and he measured at 9.3

I have read that when starting treatment the numbers can fluctuate a bit while they’re getting settled with it, could this be the case here? He’s been on insulin less than a week. I plan to do inbetween testing I’m just running low on test strips until payday (his diagnosis came inbetween pays sadly) and don’t want to run out at the pivotal meal times.

 

[Basic's Mom]

The majority of us use human meters. I don't see a location on your profile. Are you in the US? What type of meter do you have? I may be able to look up how to see it for mg/dL.

I understand how much this disease can set one back especially at diagnosis. I'm hopeful you have a human meter that the strips are fairly inexpensive. Most human meter strips are much cheaper than pet meters. Let me know where you are located, even if I don't have a link, someone will provide you with a supply list for your country, if we have one.

No need to be sorry for anything at all. You are trying your best. All of us will keep reminding you of this until you are testing often. It isn't to hound you or stress you at all. We just want to keep Bluu safe and this is the only way to ensure this.

There's a lot of things that could be happening with his numbers. One of them is, Bluu's body could be used to high numbers. When their bodies are used to high numbers and they get low, like he did at the vet, his body starts releasing hormones to help raise those numbers because the body feels threatened. This is known as bouncing and it can take a while to clear. Another thing it could be, as explained to you previously, this insulin doesn't have a 12 hour duration in cats, like the some of the others do. You may always see his numbers climbing and falling on this insulin.

Please keep in mind, some cats never get regulated. I had placed unnecessary pressure on me and my cat regarding regulationnand remission. While it is wonderful to think about both, it isn't possible for every cat. Focus on keeping him under 300s, then 200s, etc. Don't put undo pressure on either of you. There is enough stress with this disease. We don't need to add more to us or our cats.

Did you get a hypo kit set up? This is a priority.

Let me know if you need help or have other questions.

 

[Basic's Mom]

At the top of the page, click on your name. To the left of the menu that popped up, click on personal details and add Canada to location. Don't forget to save your information. People won't keep asking you your location if the info is filled in.

 

[Bluuberry]

The majority of us use human meters. I don't see a location on your profile. Are you in the US? What type of meter do you have? I may be able to look up how to see it for mg/dL.

I understand how much this disease can set one back especially at diagnosis. I'm hopeful you have a human meter that the strips are fairly inexpensive. Most human meter strips are much cheaper than pet meters. Let me know where you are located, even if I don't have a link, someone will provide you with a supply list for your country, if we have one.

No need to be sorry for anything at all. You are trying your best. All of us will keep reminding you of this until you are testing often. It isn't to hound you or stress you at all. We just want to keep Bluu safe and this is the only way to ensure this.

There's a lot of things that could be happening with his numbers. One of them is, Bluu's body could be used to high numbers. When their bodies are used to high numbers and they get low, like he did at the vet, his body starts releasing hormones to help raise those numbers because the body feels threatened. This is known as bouncing and it can take a while to clear. Another thing it could be, as explained to you previously, this insulin doesn't have a 12 hour duration in cats, like the some of the others do. You may always see his numbers climbing and falling on this insulin.

Please keep in mind, some cats never get regulated. I had placed unnecessary pressure on me and my cat regarding regulationnand remission. While it is wonderful to think about both, it isn't possible for every cat. Focus on keeping him under 300s, then 200s, etc. Don't put undo pressure on either of you. There is enough stress with this disease. We don't need to add more to us or our cats.

Did you get a hypo kit set up? This is a priority.

Let me know if you need help or have other questions.

You’re so kind!! I’m located in Canada and I’m using a OneTouch Ultra 2 that was donated to me by a diabetic relative as well as some strips she had. A container of 100 will run me about 85.00 CAD. Canada doesn’t seem to have a lot in the way of generic options based on what’s available in my province (Ontario).

And yes absolutely! Remission would be a dream and his vet is feeling optimistic about it but my main focus right now is just making sure he stays healthy. I’m definitely over anxious about his health in general because his diagnosis has come only just over two months after his brother had to be put down due to aggressive mouth cancer. I’m sure he’s annoyed by me checking on him when he’s trying to get his well deserved naps!

I did also absolutely make sure I had supplies in easy access in the event of hypo episode. My hope is it never happens, but I totally understand how pivotal it is to have on hand.

 

[Wendy&Neko]

I'm glad you reduced the dose. With our Caninsulin dosing methods, we reduce the dose any time they go under 5.0 (90). If you are going to be short on test strips, I might even be tempted to lower the dose a bit more until you can get more test strips, especially if he's lower yet tomorrow morning. That spreadsheet will really help us give better suggestions on dosing.

As an aside, the Freestyle Lite test strips can often be obtained for $75 for 100, and some places will throw the meter in for free. There is also the Bravo meter, though strips are only available on line so you generally have to shop in advance so you don't run out. Some people also find really good deals on eBay on test strips.

 

[Basic's Mom]

I have a dedicated box for my hypo supplies (it can be a shoe box or Amazon box) with all of my supplies marked (as suggested) and instructions printed. Never become complacent while handling diabetes. We are inject a hormone into them that could kill them if we don't pay attention. I can't stress that enough. It isn't to scare you, it is to make you aware of the reality of the dangers.

I am so sorry for your recent loss. It is never easy. I'm sure Bluu misses his brother too.

While my cay may get annoyed sometimes if I've had to test a lot, he also knows he's getting a low carb treat. Make sure you are giving positive reinforcement while testing regardless if the testing is successful or not.

I'm sorry the cost is so high in your area for strips. I'm not sure if you're close to the border, but I've seen people discuss picking up supplies here.

 

[Ale & Bobo & Minnie (GA)]

Great news that he’s feeling better!

I think I may have mentioned before, but I just want to mention again and make sure you understand that with caninsulin you need to test, feed and wait at least 20-30 minutes before giving the shot because of how fast action an insulin it is. You said you test close to 9:30 and give the shot at 9:30, so when are you feeding him? The other thing to note is that for the preshot tests, you want to withhold the food for at least 2 hours before you test so the number you get is not elevated or food influenced and you know it’s safe to give the regular dose. It doesn’t matter for the other tests, only for the preshot tests since those are what you go by to decide if it’s safe to shoot or not. Are you doing that?