Toby's PMs up to 503

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Peg and Toby

Peg and Toby

Member Since 2014
Started Toby on 2.5 units last night. He was in the 300's most of the day not much different from the 4.5 units and 5 units
that he was on before. Then tonight he was up to 503 at +12. I posted his numbers from last night and this morning in my spreadsheet. Wondering if his body has to get used to this new dose before I see any reduction? I tested for ketones and they were negative. I'M worried because he has been high for quite a while now. Peg and Toby
 
I agree, that isn't a good number. It's hard to know whether it's connected to the low number yesterday and the 17 hours between shots or if the dose is too low.

This is where you have to go with your gut. You could increase to 3 units or keep with 2.5 for one more cycle. I think I'd increase and monitor, in case he has a surprise for us.
 
Already gave 2.5 units tonight. What do you mean by he could have a surprise for us? Will monitor and if he's still high in the morning I will increase to 3 units. Peg and Toby
 
Because he had a weird cycle yesterday, and it's hard to tell how that is impacting his current numbers, I don't know what to expect. That's why I said surprise., I hope his numbers calm down tonight.
 
Toby's numbers went down some last night. Gave him 2.5 units again this morning. Will monitor bg and check for ketones.
If he was yours would you keep the dose the same for a few more cycles or would you increase? I know when I ncrease the dose it takes a week to see any difference. Don't know if it is the same for a decrease. Peg and Toby
 
It's one of those Every Cat is Different things. It's been three full cycles which is enough for some cats but not all, to adjust to a new dose. He did go down to a yellow overnight. Hard to figure out a pattern yet. Maybe get an out the door test his am and another one if you can later in the cycle before you decide about tonight.
 
Posted Toby's Numbers for today. They seem a little better than yesterday not so high tonight. ketones were negative again today. Would you try 2.5 Units again tonight and see hoe it goes tomorrow? Peg and Toby
 
Definitely a better cycle. We don't know yet whether he might need a little more (he looks like he has room to drop) or if he is a cat that takes a few days to settle into a dose (in which case he may continue to drop with this dose). It's a guessing game, but as long as he is negative for ketones and seems normal, maybe hold the dose a little longer?
 
Toby's preshot this morning was 461. Didn't get any numbers through the night . I thought I'd give him a break guess I should of tested. Don't know if this has anything to do with his numbers but he caught and ate a mouse last night. Sometime around 2AM. Gave 2.5 units this morning will test today and see how it goes. Peg and Toby
 
Hi Peg! I'm with Sue. Upping the dose some tonight if still high is what I would do for my cat. :-D
 
Just Tested Toby At 10.00 AM He Tested over 600 on the meter relion Prime should I give him more insulin? He got his shot at 6.00AM this Morning He was 461. This will be his +4 reading. Peg and Toby
 
I Didn't know what to do so I gave him 1.5 Units at 10.30 AM . Hope it brings him down. Tried to put the 911 icon on my post
but only came up on my inside post. Hope I did the right thing. I was scared because this was the first time he's ever been this high. Just hope I didn't do anything to mess him up. Peg and Toby
 
You'll just need to watch him today. Is that 6.5 units altogether? If so, that is a big jump in dose. And you will have two points to watch - 6 hours after the first shot (because the full amount is in by then) and 6 hours after the second shot. And you really shouldn't shoot until at least +11 after the second.

It is possible that he did shoot up and needs more. Whenever you get a number that is very unusual like that, take a second reading just to be sure.

For next time: To get the 911 on your thread, go back up to your first post on the thread and edit that one, adding the icon.
 
Sue, he got 2-1/2 Units this Morning at 6AM and 1-1/2 Units at 10.30AM So he has 4 Units this morning. I did take the bg twice.
Do you think I should have waited until tonight before I gave him any insulin? Do you think his bg could of gone way down last night chasing the mouse? Wish I had tested last night. He is acting alright but haven't been able to catch him for ketones yet. He's not doing any excess peeing. Peg and Toby
 
Sue, Just posted Toby's Numbers for the afternoon. Look a lot better Than this Morning. Do you think upping it to 4 Units is to much or would you try 3 Units First? Peg And Toby
 
I wouldn't shoot until you are at least 8 hours from the second dose. You just can't be sure how the second dose will affect him, when added to the first. How much will it mess up your schedule to wait 8 hours from that second shot?

At this point, it's not clear whether he is still dropping.
 
Sue, Just tested Toby and bg was 324 he has already started back up. He has't eaten for 3 Hrs before his preshot test.
It is 6.00pm here this is the time I usually give him his shot. Is it okay where he is already going up? what would you give 3 or 4 Units. If I wait 8 HRs from last shot it will throw me off by 4-1/2 Hrs . Peg and Toby
 
Thanks Sue for your quick reply. Am going crazy trying to figure this out. Doesn't seem like he follows any pattern. Keep thinking I will never get him truly regulated. Peg and Toby
 
Patience. :-D You are doing the important stuff - testing to keep him at safe levels, using a good insulin and feeding him the good stuff. It all takes a while to work together in his body and it takes you a while to figure out the sugar dance. (someone once said that you are trying to dance with them, but they are the only ones hearing the music. :mrgreen: )
 
Posted Toby's bg was 382 this morning so I went with 3 Units. Will test again at +6 and see if it has come down any. That should be when he is about peak. Will take a few days to see if this dose works for him. Got up and checked on him last night but didn't take any bg after 9.00pm. Kind of feels like I'm using him for a pin cushion. He's so good about everything
though. Peg and toby
 
Sounds like a good plan, Peg. We have to remember he has taken him several days to react to a dose and drop. It sure looked like 5 was way too high and but maybe wasn't doing it. It may be his "best" dose is somewhere between 4 and 5. But the only safe and sure way to tell is work your way up.

I say "best" because that may prove to be a good choice until one morning when he decides to change it up. :mrgreen:
 
Got Toby on 3.5 units for 2 Days now still getting high numbers. His numbers don"t seem to be getting any better. Will hold this dose for a few more days to see if it makes a difference. The day I gave the 4 Units when he was in the 600's he went down in the 200's. Wondering if this is a better dose? I know it takes time so trying not to be inpatient and go slow. I'M wondering if this insulin last long enough for him because he seems to always to be a lot higher at the end of his cycle. I know he should be higher at the end but not as high as he is . Wondering if lantus would be better? Has anyone been on BCP PZI and had to change over? Peg and Toby
 
Just a check - you are rolling the PZI thoroughly before drawing up the shot, right?
 
Gave 3.5 units last night he was up to 465 this morning. Will try 4 Units today. Yes I roll the insulin before I give it. I free feed him ff classics. I stop about 3 hrs. before his shots. He is always hungry because he's not regulated. Do you think his feeding routine has anything to do with his numbers? This is the way I've done it right along and we had pretty good numbers before. Like I said I.ll try 4 Units today to see if I get any better results. Thanks for your replies it helps to have someone to talk to. Peg and Toby
 
Your spreadsheet starts at 4 1/2 units. How did you arrive at that?
Your low PMPS of o 8/16 suggests that 5 units is too much.
The 8/19 increase at +4 suggests that 4 units is also to much.
Have you tried 1 unit?
 
No I have not tried one unit. The vet that diagnosed him a year ago started him out a 2 Units. That seemed to work good. He
would start out in 200's and go down into 100's. He's On Prednisolone for inflammatory pancreatitis 2.5mg twice a day. Have tried repeatedly to wean him off on this only to have his bg go way up. He gets really sick running a fever and not eating at all. Have to syringe feed him and put his dose of pred. back up till he comes around. My vet. would have me do a curve come to her office look it over and decide what we should. After each increase we would wait two weeks before we did another curve. That's how we got to the 4.5 and 5 units She thought we should do 4.5 AM and 5 PM because he was always higher in the morning. At this point not sure what to do thinking about asking vet. about changing to another insulin. Yet I know some cats never get regulated on steroids. I know he is on quite a high dose of steroids . Just was hoping we could do something to get his numbers better. Peg and Toby
 
I don't know. Peg. I think I'd try the 4 units and see. I'm not sure how insulin and prednisolone work together , but it may mean things continue to be variable: that one dose may work for a while and then not work?

The trouble with switching to Lantus or Levemir is that they are depot insulins and you need to hold the dose. You can't vary as easily, so I don't know how easy it would be to adjust to compensate for the steroid. I'd suggest reading some posts (and the stickies) on the Lantus TR forum and maybe post there and ask specifically for using a depot insulin with steroids. Maybe it would work fine.

And you might post here asking about diabetes + steroids. I know we have people who cope with both.
 
Steroids like pred raise BG/require higher insulin dose. Since you are giving the pred twice daily that should even out the effects,
 
If you will be doing the steroid on a daily basis, you may be OK with a depot insulin.

If, however, it is pulsed or alternate days, the glucose will go up with the dose and down as it wears off - a bit of a roller coaster. It will take a lot of effort to use a depot insulin well with this as you will be adjusting the dose frequently OR, you might need to use a booster insulin such as R when the glucose spikes up from the steroid. Using a booster can get complicated quickly, plus it means more injections and testing.
 
He's been on steroids for a over a year now . He has to take them everyday. Wish there was some way to take him off them but, the vet. and I decided if he was going to have any quality of life it was better to keep him on them. We even tried to reduce his dose a tiny bit at a time but, he can,t take it. He doesn't act sick just bg levels are way to high. Posted on relaxed Lantus to see if anyone had a cat on pred and insulin. Will post on this forum to see if anyone is dealing with the same thing.
Would like to thank everyone for their help. Peg and Toby
 
Our general view is that you treat other conditions as needed and adjust the insulin around it.

Since the steroid dose is daily, a depot insulin should work without too much complexity so long as you can stick to the 12 hour schedule fairly religiously. An early shot acts like a dose increase due to more overlap; a late shot acts like a dose decrease due to less overlap.
 
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