Stripes may be in trouble. He was doing so good for past day with BG levels between 55 and 172 (after typically being over 200). He was at 91 when I gave him his normal insulin dose of 2 units Humulin at 6:30 pm ( I realize I probably shouldn't have given the dosage...). Three hrs later he was at 30 and since then levels have been around that but down to 26 at 11:10 p.m. (testing every 1/2 hr). So . I have let him lick Karo syrup off my fingers and rubbed it on his gums. I don't have high carb Fancy Feast (only the pate which is carb low). What else should I try to feed him?? He's sleepy but not showing the other serious signs other posts have listed. Humulin is faster acting so hopefully he'll rebound faster, too?? Now it's been almost 5 hrs since I gave him his dose and my past tests have indicated his sugar levels start coming up after 5-6 hrs....Any help would be much appreciated! I am almost always dealing with high numbers. I will monitor thru the night if needed. Advice???
Stripes has Low BG - worried!!
- Thread starter lsweanor
- Start date
- Status
kittycat88
Member Since 2013
Courtney and Kismet
Member Since 2012
Hi There, Even though your cat nadirs around +5/+6, you will need to continue to monitor very closely over the next few hours to make that his numbers are rising safely. Here are the instructions for how to handle low numbers. The thing to do is to test every 20-30 minutes, and continue to feed a little bit of HC (or 1/2 tsp LC with a drop of karo in it) until the numbers get above 50. Once he is above 50, don't feed and test in 30 minutes. If he has come up some, that's a good thing. The goal is to get two consecutive, rising, non-food influenced numbers.
This is from the Tight Regulation Lantus Group:
DON'T PANIC! or HOW TO HANDLE LOW NUMBERS
First, try to not panic. Post to the Lantus Insulin Support Group or on the Health Board. Make sure your subject line indicates you are concerned about a possible hypo and/or add the 911 icon to the first post in your condo. People who are experienced in dealing with low numbers will be there to help. After posting, remember to refresh your browser periodically to see if people have replied.
It’s important to recognize that just because your cat may be experiencing low BG numbers doesn’t mean that your kitty is critically hypoglycemic. Many cats will have low numbers and never have symptoms. It’s important, though, to bring those numbers up into a safe range. ALWAYS make sure you have a stock of test strips, high carb (HC) canned food that contains gravy and is over 15% carb such as Fancy Feast grilled, marinated, or Gravy Lovers varieties (see Janet & Binky's Food Chart for a full list of options), and/or a simple sugar solution such as Karo/corn syrup, honey, maple syrup, etc.
If your cat is experiencing symptoms, especially if those symptoms are severe, you need to rub Karo syrup, honey, or maple syrup on the gums or, if symptoms are very severe, administer rectally and get your cat to the nearest 24-hour emergency facility. Take the bottle of syrup with you to administer on the way if necessary. (Note that it is rare that we see episodes of symptomatic hypoglycemia with Lantus and even rarer to see severe symptoms. But, you need to know what to do should they occur.)
The symptoms to be concerned about include but are not limited to:
staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
disorientation (yowling, walking in circles, etc.)
twitching
stupor
convulsions or seizures
coma
If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)
Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.
This is from the Tight Regulation Lantus Group:
DON'T PANIC! or HOW TO HANDLE LOW NUMBERS
First, try to not panic. Post to the Lantus Insulin Support Group or on the Health Board. Make sure your subject line indicates you are concerned about a possible hypo and/or add the 911 icon to the first post in your condo. People who are experienced in dealing with low numbers will be there to help. After posting, remember to refresh your browser periodically to see if people have replied.
It’s important to recognize that just because your cat may be experiencing low BG numbers doesn’t mean that your kitty is critically hypoglycemic. Many cats will have low numbers and never have symptoms. It’s important, though, to bring those numbers up into a safe range. ALWAYS make sure you have a stock of test strips, high carb (HC) canned food that contains gravy and is over 15% carb such as Fancy Feast grilled, marinated, or Gravy Lovers varieties (see Janet & Binky's Food Chart for a full list of options), and/or a simple sugar solution such as Karo/corn syrup, honey, maple syrup, etc.
If your cat is experiencing symptoms, especially if those symptoms are severe, you need to rub Karo syrup, honey, or maple syrup on the gums or, if symptoms are very severe, administer rectally and get your cat to the nearest 24-hour emergency facility. Take the bottle of syrup with you to administer on the way if necessary. (Note that it is rare that we see episodes of symptomatic hypoglycemia with Lantus and even rarer to see severe symptoms. But, you need to know what to do should they occur.)
The symptoms to be concerned about include but are not limited to:
staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
disorientation (yowling, walking in circles, etc.)
twitching
stupor
convulsions or seizures
coma
If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)
Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.
Courtney and Kismet
Member Since 2012
Additionally, it would seem that Stripes has earned a reduction. I am not a dosing expert, but I will see if I can alert some more experienced members to come take a look.
Please update this thread whenever you get the next test.
Also, how many hours are you since shooting? What have his numbers been?
PMPS-- 91
+3--- 30
+5 = ?
Please update with any other tests you've gotten
Please update this thread whenever you get the next test.
Also, how many hours are you since shooting? What have his numbers been?
PMPS-- 91
+3--- 30
+5 = ?
Please update with any other tests you've gotten
o.k., I just got a reading of 35 (11:59 pm). Last reading was 26 about 1/2 hr ago. One hr prior to that the number was 30. I got him to eat a little (not as much as I'd like) and have given some more Karo (rubbing on gums). I will keep trying to feed until I get numbers above 50, is that right? I have some dry food but he's not at all interested in that.
Courtney and Kismet
Member Since 2012
Don't feed dry food, it takes too long to clear their system and won't kick in as quickly as wet food.
Feed another 1/2 tsp of LC (low carbwet food) with a drop of karo or honey and test again in 15 minutes.
Feed another 1/2 tsp of LC (low carbwet food) with a drop of karo or honey and test again in 15 minutes.
Is he on Humulin R or Humulin N? I have not used "N" before but understand it has a longer duration than "R". I've only used "R" as a bolus to Gracies basal insulin so my experience withit is also limited.
Do you always give him the same dose or do you change it depending on his preshot?
This is some very good info on Humulin.
When a kitty gets into hypo range numbers, they can possibly have an insulin sensitivity. While Humulin is a shorter acting insulin, it could still have residual effects. I'm not sure what to tell you about dose tomorrow. In the morning, If he's low like he was when you shot tonight, I'd skip and call my vet.
I would suggest you change the subject line to "need Humulin help". And hopefully the folks who have used it will pop in.
In the meantime, stay on top of the testing until you see him coming up and staying up for a couple hours without food.
Eta: just saw your note. Please put a good portion of karo on his gums and continue testing every 20-30 minutes. Don't use the dry food....it takes forever to get in his system and then takes a long time to get out.
Do you always give him the same dose or do you change it depending on his preshot?
This is some very good info on Humulin.
When a kitty gets into hypo range numbers, they can possibly have an insulin sensitivity. While Humulin is a shorter acting insulin, it could still have residual effects. I'm not sure what to tell you about dose tomorrow. In the morning, If he's low like he was when you shot tonight, I'd skip and call my vet.
I would suggest you change the subject line to "need Humulin help". And hopefully the folks who have used it will pop in.
In the meantime, stay on top of the testing until you see him coming up and staying up for a couple hours without food.
Eta: just saw your note. Please put a good portion of karo on his gums and continue testing every 20-30 minutes. Don't use the dry food....it takes forever to get in his system and then takes a long time to get out.
Courtney and Kismet
Member Since 2012
Does this look right?
Recap
PMPS-- 91 (6:30 pm)
+3--- 30
+4.2- 26 (11:10 pm)
+5.5- 35
Recap
PMPS-- 91 (6:30 pm)
+3--- 30
+4.2- 26 (11:10 pm)
+5.5- 35
Courtney and Kismet
Member Since 2012
Great! The Karo can wear off very quickly, though, so you don't want to become complacent. Will he eat yet? Can you offer a little bit of LC to see if he will eat? I think it would be a good idea to try to get him a little bit higher before you two rising tests. So if you can, get him to eat about 1/2 tsp of food and test in 15.
If you can't get him to eat, then hold off giving anything and wait 30 minutes and test again, but watch him very closely for any signs of hypo. ok? Please post and let us know what you're doing as far as feeding or waiting.
If you can't get him to eat, then hold off giving anything and wait 30 minutes and test again, but watch him very closely for any signs of hypo. ok? Please post and let us know what you're doing as far as feeding or waiting.
Super. Please keep doing what you're doing. If you can get him to eat Low carb food with karo, that is best as it gives some food to hold the numbers up. Please do not get complacent even if his numbers rise.
It's really important that his BG stays up without karo or food before you go to sleep.
If his numbers come back down,I would consider taking him to the ER.
It's really important that his BG stays up without karo or food before you go to sleep.
If his numbers come back down,I would consider taking him to the ER.
I will continue to test every 20-30 min. and will stay up all night if need be. I'm not sleepy at all from this!!! Thank you all so much for being there; it helps so much!! I will try feeding a little more but not sure he'll take it. He has shown more awareness, cleaning some of the karo off his fur.
Is he acting alright? Responsive.....
I'd like to see one more test ....but need to get to bed soon.
I'd like to see one more test ....but need to get to bed soon.
Courtney and Kismet
Member Since 2012
Recap
91 PMPS (Humulin N)
30 +3
26 + 4.6
35 + 5.2 hrs post
55 + 6 hrs post
61+ 6.5
Did you feed any LC or karo after +6?
91 PMPS (Humulin N)
30 +3
26 + 4.6
35 + 5.2 hrs post
55 + 6 hrs post
61+ 6.5
Did you feed any LC or karo after +6?
Yes...please let us know last time you gave food or karo.
I'll be up for another 20 minutes and will check in. Im glad he's up but if you've been giving him very much karo, he should be up alot more than that.
I'll be up for another 20 minutes and will check in. Im glad he's up but if you've been giving him very much karo, he should be up alot more than that.
Yes. Fed another 1/2 tsp or so LC food with drop of Karo about 5-10 min before testing. So I need to take at least 2 more samples without food to see if his levels stay up, right? He is being so good about all the ear pricks (and my hands have been a little shakey). I am good to stay up all night monitoring. But that mention about not going up much with the Karo worries me. How much is a good amount of Karo?
1/2 tsp is a good amount. Do you think you've given that much?
You want to wait 20 mins after you feed to test. It usually takes 20-30 minutes for the carbs to hit the BG and bump it up.
Gosh..I'd be thinking he'd hit his peak and really start to climb.
Just post, ok? I'll catch the number.
You want to wait 20 mins after you feed to test. It usually takes 20-30 minutes for the carbs to hit the BG and bump it up.
Gosh..I'd be thinking he'd hit his peak and really start to climb.
Just post, ok? I'll catch the number.
Courtney and Kismet
Member Since 2012
Hi Linda, Just popping in to say that I have to go to bed now, but just keep doing what you're doing. As long as you stay on top of the testing and karo-ing as needed, Stripes should be just fine. If he were to drop signifigantly lower, then it might be wise to take him to the ER as Marje suggested.
You're doing a terrific job.
As far as dosing tomorrow, change the subject line of your original post to ask about dosing for Humulin N so that people with experience with it can come help you out. If you don't get a response, it might be wise to skip the dose until you do.
Have a great night, and here's to hoping that Stripes continues to rise.
You're doing a terrific job.
As far as dosing tomorrow, change the subject line of your original post to ask about dosing for Humulin N so that people with experience with it can come help you out. If you don't get a response, it might be wise to skip the dose until you do.
Have a great night, and here's to hoping that Stripes continues to rise.
Great! Please be sure you read Courtney's post.
Think you'll be ok now? I would like to see him up about 50-60 more without food. I can set my phone to alert me when you post if you'd like me to stay with you until he's way up.
Think you'll be ok now? I would like to see him up about 50-60 more without food. I can set my phone to alert me when you post if you'd like me to stay with you until he's way up.
O.k. 194 at 2 a.m. I think he's good (now wondering if he'll be over 500 when I test in the morning... poor guy is up and down like a yo-yo). Anyway, I think I can safely go to bed. Thank you all again. I was really scared. I will run this all by our vet in the morning.
Good job and good night. Someone does need to help you with the dose.
Courtney had posted you were dealing with low number over on the Lantus board last night. I just want to add a link to some additional information. This is a post on handling low numbers. It may be useful to print out or bookmark.
If no one has already mentioned this to you, you may want to discuss switching insulin with your vet. While some vets still prescribe Humulin N for cats, it is no longer a recommended insulin for the treatment of feline diabetes. The American Animal Hospital Association (AAHA) published guidelines for the treatment of diabetic dogs and cats. They recommend either Prozinc or Lantus for treating cats. Humulin N is very harsh and drops numbers much like you saw last night. It can be very scary. It also dose not have the kind of duration you need to stabilize Stripes blood glucose levels.
If no one has already mentioned this to you, you may want to discuss switching insulin with your vet. While some vets still prescribe Humulin N for cats, it is no longer a recommended insulin for the treatment of feline diabetes. The American Animal Hospital Association (AAHA) published guidelines for the treatment of diabetic dogs and cats. They recommend either Prozinc or Lantus for treating cats. Humulin N is very harsh and drops numbers much like you saw last night. It can be very scary. It also dose not have the kind of duration you need to stabilize Stripes blood glucose levels.
Sue and Oliver (GA)
Member Since 2009
I also wanted to say that he may, indeed, be high this morning. But that is likely to be because of the extra sugars he got last night, and rebound from lower numbers than his body is used to. He earned a dose decrease. Until you can explore other insulin options, I would reduce the dose and monitor carefully.
Just an update. Stripes was at 328 when I tested this morning a half hr after he ate 1/2 can FF pate (a normal feeding is about 1-1.25 cans). Not being sure what to do (vet not open yet), I gave 1 unit of Humulin N (normally gets 2-2.5 units) and checked him again 1.5 hrs later. His reading was 322. I have called the vet and she says to go ahead an lay off the insulin for the rest of the weekend and we'll re-assess Monday morning.
Sue and Oliver (GA)
Member Since 2009
This might be an excellent time to ask your vet about another insulin. You can say you want a milder one that won't give him such extremes and ask her for a prescription for Lantus, Levemir or ProZinc.
If, after a full cycle without insulin, he is in the 300-400 range, I would consider giving a small dose. I wouldn't want him to run in high numbers for a whole weekend.
If, after a full cycle without insulin, he is in the 300-400 range, I would consider giving a small dose. I wouldn't want him to run in high numbers for a whole weekend.
Courtney and Kismet
Member Since 2012
Hi Linda, hope you got some sleep and that Stripes clears the bounce soon. I agree with Sue, depending on his numbers, you might want to give a token dose so that way you don't lose momentum. Sending good vetty vines for Monday.
Lantus is the only insulin I have experience with, but I highly recommend it. We have many members who use it or Levemir, so either of those insulins would be good choices.
Have you gotten any more tests today?
Lantus is the only insulin I have experience with, but I highly recommend it. We have many members who use it or Levemir, so either of those insulins would be good choices.
Have you gotten any more tests today?
The vet recommended leaving him alone, not testing again until Monday morning... and just watching him. But I can't help myself. Too scary. Tests I've taken: 328 this morning 1/2 hr after giving 1 unit Humulin; 322 at 1.5 hrs post, 83 at 5 hrs post, 328 at 9 hrs post. I did give him some food at 5 hrs post and at 6 hrs post (ate very little first time, but seemed hungry for maybe 2 tbsp at 6 hrs post). I was worried because he hasn't eaten much today, but i know I should probably have gotten the food in him prior to the numbers climbing back up. If he's pretty high at 12 hrs, I may break down and give him 1 unit (like I did this morning). We will definitely have a serious conversation about insulin when I talk to the vet Monday. thanks so much for your concern and support. He is a really good boy and very loving and I so want to get him feeling better!
SierraNevadan
Member Since 2013
lsweanor said:
My cat Louie has been on Novolin N (same thing as Humulin N - just different manfacturers) since being diagnosed 3 weeks ago and my vet recommended a high starting dose, 2units to start. I'm glad I found this board and cut that way back and started testing myself because even with a reduced dose I had some scary lows (40-55)
This is how I dose Louie's Novolin N (She is on all low carb wet, weighs 12 lbs 2 oz)
Under 180 = NO INSULIN AT ALL
180-220, = scant 1/2u (maybe about 1/3, a shade under .5 on the syringe
200-250 = full 1/2 unit (.5)
She has not been over 240 preshot since bringing her home from the vet (where she was 380 on the cat meter, but non-fasting)
With this dosage she drops in the 70s as her lowest by hour 4-4.5 which I feel comfortable with.
For Stripes, I would just give him a maximum of one unit if his starting glucose is around 300 or better, but I really think you could drop back to 1/2 unit and watch him on that for a few days. If he needs more, you could gradually add .25 u at a time. His higher number this morning might be a rebound number and he really is trending to lower preshot numbers. You said his preshot glucose has been 200 or less a couple times this past week and only 91 when you gave him his usual 2u...obviously that was too much. I also wouldn't dose him at all at 172. It's possible his pancreas is starting to kick in and make some of his own insulin so you want to encourage that and not suppress it by adding outside insulin...obviously, if his BG is higher, you want to supplement him since he's not making enough on his own.
91 is a GREAT number, normal range and it's best to let numbers like that ride insulin-free and see where he is in 12 hours.
I would not give him any insulin at all if he is under 180-200. At 200-250 I would give him only 1/2 unit MAXIMUM and test him starting at +2.
You see how low he went at +5? on one unit? 83. Humulin/Novolin will give a huge drop between +3 and +4. It's likely he could have been lower than 83 earlier.
The critical time to test is when he's falling and the insulin is most active, hours 2-6, after than you can expect his glucose to rise, but that is safe zone and you can rest and sleep ;-)
You did great dealing with his hypo, isn't it scary? That's why you should always err on the side of giving him less, rather than more.
C
Carl & Polly & Bob (GA)
I got a PM from Marje last night asking if I was awake and could help out, but I was fast asleep when all this was going on. I'm very happy people were here to help you handle that adventure.
Given the numbers you got today.... I can understand and agree with wanting to shoot if he's high again later tonight.... but it looks to me that 1u is the very highest dose you might consider. Normally, I think N is a 6-8 hour duration insulin with a nadir around +3 or +4. Today's cycle would seem to put the nadir in the +5 or so time frame. And I wouldn't want the number going any lower than that 58 you saw. That's a lot of drop from a little insulin.
I did a lot of this :shock: :shock: when I saw the 2u dose on the green PMPS last night! You catching that 30 at +3, in my opinion, saved your cat's life, or at least avoided a trip to the ER last night. I was a pretty aggressive doser with PZI with my cat Bob. I shot 1u on a green number a couple of times. And he dropped to the 40s a couple of times. But 2u of PZI on a 91 would have probably dropped him like a rock.
Sorry I wasn't around last night and thank goodness you caught the low numbers and got some great help dealing with them.
Given the numbers you got today.... I can understand and agree with wanting to shoot if he's high again later tonight.... but it looks to me that 1u is the very highest dose you might consider. Normally, I think N is a 6-8 hour duration insulin with a nadir around +3 or +4. Today's cycle would seem to put the nadir in the +5 or so time frame. And I wouldn't want the number going any lower than that 58 you saw. That's a lot of drop from a little insulin.
I did a lot of this :shock: :shock: when I saw the 2u dose on the green PMPS last night! You catching that 30 at +3, in my opinion, saved your cat's life, or at least avoided a trip to the ER last night. I was a pretty aggressive doser with PZI with my cat Bob. I shot 1u on a green number a couple of times. And he dropped to the 40s a couple of times. But 2u of PZI on a 91 would have probably dropped him like a rock.
Were those preshot numbers? If so, what dose (if any) did he get the previous couple of days?
Sorry I wasn't around last night and thank goodness you caught the low numbers and got some great help dealing with them.
Deb & Wink
Member Since 2013
With the NPH type insulins (Humulin, Novolin), it's also important when you feed. Since these insulins have a very quick onset, short duration 5-6 hours, and then very steep climb, you do not want to be feeding any food in the last half of the cycle where the insulin is gone and feeding is only going to raise the BG numbers higher.
These insulins also require food on board at least 30 minutes before you shoot. I've seen some recommendations to wait 1 hour after feeding. That 1 hour clock starts when you put the food down, not when the food is finished.
So unlike Lantus or Levimir, the order is test, feed, shoot.
Here is a decision tree that covers some of the scenarios in dosing the N insulins. It is not complete by any means and needs some tweaking still. I devoloped this when we were helping Yo Hon (Becki and Rags) The number of units will need to be adjusted for your cat.
This is an example of a decision tree. It's something most of us can do in our heads by now. We don't even consciously think about it. This is an example of the sort of the steps that you could follow in deciding how to manage the blood glucose testing cycle.
Beginning of each pre-shot cycle
Test
If BG reading <200? Go to step A
If BG reading 300 up to HI? Go to step B
If BG reading < 300? Go to step C
Step A - BG < 200 pre-shot cycle
don't shoot, need to retest in 30 minutes
30 minute timer starts
30 minute timer goes off
test
rising number? Go to a1
Falling number? Go to a2
a1 rising number- steps on <200 pre-shot cycle
30 minute timer starts
Feed 1 can FF
30 minute timer has gone off
Has he eaten about 1 can?
ok to shoot 1.5u
a2 Falling number - steps on <200 pre-shot cycle
30 minute timer starts
30 minute timer has gone off
Test
Rising number?
go back to step A1 and follow the steps
falling number?
Go back to step A2 to start over
Step B - BG under 300 pre-shot cycle
30 minute timer starts
Feed 1 can now
30 minute timer has gone off
Has he eaten about 1 can?
ok to shoot 1.5u
ok to feed more after shot
pull up food at +2
no food until start of next pre-shot test cycle
Step C - BG 300 to HI pre-shot cycle
30 minute timer starts
Feed 1 can now
30 minute timer has gone off
Has he eaten about 1 can?
ok to shoot 2u
ok to feed more after shot
pull up food at +2
no food until start of next pre-shot test cycle
This is a working draft and is by no means complete but it can give you some idea of the steps in dosing N.
These insulins also require food on board at least 30 minutes before you shoot. I've seen some recommendations to wait 1 hour after feeding. That 1 hour clock starts when you put the food down, not when the food is finished.
So unlike Lantus or Levimir, the order is test, feed, shoot.
Here is a decision tree that covers some of the scenarios in dosing the N insulins. It is not complete by any means and needs some tweaking still. I devoloped this when we were helping Yo Hon (Becki and Rags) The number of units will need to be adjusted for your cat.
This is an example of a decision tree. It's something most of us can do in our heads by now. We don't even consciously think about it. This is an example of the sort of the steps that you could follow in deciding how to manage the blood glucose testing cycle.
Beginning of each pre-shot cycle
Test
If BG reading <200? Go to step A
If BG reading 300 up to HI? Go to step B
If BG reading < 300? Go to step C
Step A - BG < 200 pre-shot cycle
don't shoot, need to retest in 30 minutes
30 minute timer starts
30 minute timer goes off
test
rising number? Go to a1
Falling number? Go to a2
a1 rising number- steps on <200 pre-shot cycle
30 minute timer starts
Feed 1 can FF
30 minute timer has gone off
Has he eaten about 1 can?
ok to shoot 1.5u
a2 Falling number - steps on <200 pre-shot cycle
30 minute timer starts
30 minute timer has gone off
Test
Rising number?
go back to step A1 and follow the steps
falling number?
Go back to step A2 to start over
Step B - BG under 300 pre-shot cycle
30 minute timer starts
Feed 1 can now
30 minute timer has gone off
Has he eaten about 1 can?
ok to shoot 1.5u
ok to feed more after shot
pull up food at +2
no food until start of next pre-shot test cycle
Step C - BG 300 to HI pre-shot cycle
30 minute timer starts
Feed 1 can now
30 minute timer has gone off
Has he eaten about 1 can?
ok to shoot 2u
ok to feed more after shot
pull up food at +2
no food until start of next pre-shot test cycle
This is a working draft and is by no means complete but it can give you some idea of the steps in dosing N.
Courtney and Kismet
Member Since 2012
Hi Linda, just wondering how the vet visit went today and how Stripes is doing.
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