URGENT: Help with insulin dose!

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fsu_slp

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My cat was diagnosed with FD in June 10, 2014. We had her off insulin for two weeks because I had a faulty meter that read much lower than what her actual BG was. Fast forward to new vet in July, she has been prescribed 1.0 unit x2 a day ever since. I moved recently and just changed vets. She asked me to perform a BG curve and I recently did so (8/23). I do notice she urinates a vast amount (like three-four tennis size amounts) and drinks usually a lot in one or two sitting (not a lot in frequency).

The new vet recommended she go on 2 units x2 a day but I was not comfortable with that and currently trying 1.5 units x2 a day.

With tonight's reading, should she be given 1.0 or 1.5 units?
 
Sorry you didn't get help last night. This is a very small forum. If you need urgent help, post on Health where there are more eyes.

In general, we suggest Increasing by .25 or .5, not whole units. Looking at her spreadsheet, she has had some variable readings. The curve day was strange - much higher numbers than you usually see. Overall, the one unit seems to be bringing her down to mid 100s at midcycle, which is a nice drop. But she could drop lower safely. (we consider a cat regulated if they are in the lower 200s at preshot and in double digits at midycle, but not below 40 which is approaching hypo territory.)

If she were mine, I'd increase by .25 on a day I could monitor and see where she is. I would urge you not to shoot without a number. Especially with her varied levels, she could surprise you some morning with a low preshot and need a lower dose that morning. You could also use a sliding scale - giving one unit on a yellow preshot and 1.25 on a pink. The other thing that could be working here, for your pink preshots in the am is a bounce from overnight. Some cats go lower at night. You might wake up some night and test to see. If she does drop low at night, then her body may perceive that as a number lower than she is used to and release extra glucose, causing the next reading to be higher than normal.

Have you seen the protocol we put together for ProZinc?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077

If you regularly post her with your numbers, we'll watch for you and reply.


BTW. Do you use the AlphaTrak meter? If so, please include in your signature. I am basing my advice on human meter numbers. AlphaTrak meters tend to run 30 points less, so your numbers would be in a lower range if that is the case.
 
Hello! Sue seems right on the money to me (as always!). Posting numbers daily always helped me. Over time, I was able to better control my cats dose alone but it took time. Posting numbers here gets people to tell you their thoughts and why. You might try it. It's super helpful.
 
Thanks Sue! I decided to administer 1.0 unit last night since I didn't want to stay up all-night worrying (plus this is my first week of grad school)!

I booked marked the protol and just put in my signature that I use Relion Confirm :)

I am using U-40 1/2 cc syringe so may have to get the U-100 to better monitor the .25 and .5 doses. Is 3/10 or 1/2 cc recommended?

Also Rachel, I looked at your cat's GB chart and was wondering what made you decide from administering 3.0 units x2 a day to 1.0 units suddenly? (Mid December of 2013)
 
Well, I was on 2.5 units based on the vets advice. As I moved her dose up, her numbers never got better. Finally, Sue suggested I back off and try 1 unit...basically starting over since I never went that low and might have skipped over the ideal dose. It worked sonewhat. Each time I lowered her dose her numbers would be lower for a few days. I often wonder what would have happened if age had lived. I think her numbers were high partly because of the cancer (which we didn't know about).

Anyway, starting over at 1 unit helped me see what she needed which was less insulin. I don't know why it worked but there you have it!
 
U-100 insulins have 100 units per mL
U-40 insulins have 40 units per mL
Thus, a U-40 insulin is 40% of the concentration of a U-100 insulin.

If you multiply the marking on a U-100 syringe by 0.4, you will get what the dose of a U-40 insulin of that same volume would be.
0.4 * 0.5 = 0.2
0.4 * 1.0 = 0.4
0.4 * 1.5 = 0.6
0.4 * 2.0 = 0.8
 
As Rachel did, I did as well, back when Grayson was on ProZinc. I called it his re-boot! Turned out he had Acromegaly and was insulin resistant, so it wasn't the insulin that was the problem, just that he needed LOTS more to give me movement, as well as carry over "shed" (reserve tank), which is why I ultimately switched.

I, too, agree w/ Sue's recommendation. Most normal diabetic cats respond well to even the slightest increases, particularly if they are eating low-carb wet food. I have a foster that came in April on 9u of NPH, dry food, and having seizures. He's now doing great on .5u and low-carb food. Coat looks amazing, numbers quite good (only problems stem from my schedule and eyes at getting the small doses precise!), and no seizures. Sometimes that re-boot is the best thing for a kitty.

Good luck!
Lu-Ann
 
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