What is the lowest safe BG reading before I shouldn't give Tigger's dose?

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vbc2000

vbc2000

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I am so worried about putting my boy in a hypo state. At what number do I not give him his dose (5 units)? For example, if his reading is as low as in the 140's pre-shot, should I give it to him? I'm so not confident in my ability to adjust as is needed.
Thanks,
Stephanie
 
Hello Stephanie!!
5 units is a really high dose. My buddy Lou went into a hypo state on 3 units, and then he did really well on 1 unit afterwards. Obviously every cat is different. I think the general rule around here for those just starting out is not shooting if the preshot BG reading is below 200 until you have more data to know how your Tigger will react to insulin. I know there are others on here with much more experience than I, but what I've learned through this experience is trust your gut and always err on the side of caution rather than pushing full speed ahead. Also, please make sure you read and print off the guidelines for treating hypoglycemia (http://www.felinediabetes.com/hypo-emergency.htm). I used it for Lou and was able to stave off a bad situation before it could turn deadly.

Best of luck to you!!
Amanda
 
Thank you for your reply Amanda. We've been at this since late April, starting at 1 unit twice a day and going up from there. He was at 4 units for a long time and just recently went up. He had a home curve done at home Wed. as the sreadsheet shows. He is not eating well. They actually want me to go up to 6 doses but that was not my vet who said that since mine is away. I am leary to do that and am planning on doing another curve on Wed. and talking to my regular vet. He is just not stable and I'm not confident in my ability to know what to do. Maybe when I am, I'll feel better.
 
Since I have a feeling Tigger's dose is too high, I might suggest not giving his regular dose 5.0U if his pre-shot test is less than 300. I know you're new to the home testing but that +3 reading of 141 today stresses the importance of knowing the AMPS and PMPS numbers with no food eaten 2 hours prior.
Has Tigger ever had ketones?
If not I really think we should try to reduce his dose. Do you have any BG numbers from previous doses that you could enter on the SS?
 
Hi Stephanie

Previous Condo - we usually link the previous day's discussion for continuity.

Tigger is on prednisolone every other day. Did you move him to the night or still giving him his pred during the day?

Is he still getting some dry food as well?
 
Important notes to the discussion though. That pred once a day can bounce numbers all over the place, I think it is an important note to keep track of while we are trying to figure out Tigger's story.
 
Yong said:
Since I have a feeling Tigger's dose is too high, I might suggest not giving his regular dose 5.0U if his pre-shot test is less than 300. I know you're new to the home testing but that +3 reading of 141 today stresses the importance of knowing the AMPS and PMPS numbers with no food eaten 2 hours prior.
Has Tigger ever had ketones?
If not I really think we should try to reduce his dose. Do you have any BG numbers from previous doses that you could enter on the SS?
Click to expand...

I do have the numbers but at home and I'm away for the weekend. We have not done ketone at home and have to ask about at the vet.. When I get home Sunday, I will update the SS.
 
Tracey&Jones said:
Hi Stephanie

Previous Condo - we usually link the previous day's discussion for continuity.

Tigger is on prednisolone every other day. Did you move him to the night or still giving him his pred during the day?

Is he still getting some dry food as well?
Click to expand...
He is getting 1/2 his usual pred. Dose at night after eating at my bed time. A couple of hours after his last mean. Only other food he gets besides twice daily wet food at shot time is treats which help him eat his meal and a few in between meals but we try to keep it down to only a few a day so as not to affect his numbers too much.
 
Without data be very cautious about dosing at lower levels..... DEFINITELY no 5 units. I agree with Yong if the preshot is under 300, reduce the dose. Keep collecting data. I am still concerned that the doses were raised too quickly in whole units and you may have skipped the ideal dose.
 
JanetNJ said:
Without data be very cautious about dosing at lower levels..... DEFINITELY no 5 units. I agree with Yong if the preshot is under 300, reduce the dose. Keep collecting data. I am still concerned that the doses were raised too quickly in whole units and you may have skipped the ideal dose.
Click to expand...

I guess I don't understand about missing the correct dose. Here's more info. At one unit we were still bringing him in for weekly vet testing and the level after 2 weeks was still in the high 400's so he was raised to 2 units. Then his next test was 2 weeks later at the vet and it was in the high 300's so he was raised to 3 units. A week later his BG was 292 so he was raised to 4 units, again testing at the vet. He stayed at 4 units for a number of weeks because his vet readings were a bit all over...once 262, once 363 and I really began getting concerned about stress hyperglycemia. So at that point I got a meter and he was still running high 300's often. The first curve will be put in the spreadsheet but he didn't get below the mid 300's. The vet determined he wasn't "Somogyi'ing out" and raised him to 5 units. His levels and appetite have varied a lot but the recent curve is hopeful but not low enough so once he is more stable on food, they want to raise him to 6units 2x day. He has steadily gained weight since starting on the insulin and his drinking and peeing is drastically reduced. So something is working..just not regulated yet!
 
vbc2000 said:
I guess I don't understand about missing the correct dose.
Click to expand...
Maybe these Spreadsheets will help see how increasing by whole units can "miss" the working dose. Even though said working dose can change up on ya ;). These kitties were increased by whole units as well.
Cloud (trapnurse / Novolin N) is another, started 5-7U and now down to <0.25U: https://docs.google.com/spreadsheet...944PDuAFBUrl0AQElhLyHLStxw/edit#gid=361360320
Abby (megmonger / Vetsulin), started on 7.0U https://docs.google.com/spreadsheets/d/1L3L6oePa-ADJ7sts2ke2OtwvJLOh-oOzraDqiJ1vPyE/pubhtml
Sammy (Sammy's G-ma / Vetsulin) is another one, started 8U and is down to 2.0U now: https://docs.google.com/spreadsheet...FoCpwOpU5qoYrOiX3nGiZ_NNMM/edit#gid=736012511
Leo (Cyrstal & Leo / Vetsulin) started on 5.0U and is down to 0.25U now: https://docs.google.com/spreadsheets/d/1rrdWEJs9aWoUwnDINXYAS4iSAs_eq_5-eOMZfilldKw/pubhtml
 
Yong said:
Maybe these Spreadsheets will help see how increasing by whole units can "miss" the working dose. Even though said working dose can change up on ya ;). These kitties were increased by whole units as well.
Cloud (trapnurse / Novolin N) is another, started 5-7U and now down to <0.25U: https://docs.google.com/spreadsheet...944PDuAFBUrl0AQElhLyHLStxw/edit#gid=361360320
Abby (megmonger / Vetsulin), started on 7.0U https://docs.google.com/spreadsheets/d/1L3L6oePa-ADJ7sts2ke2OtwvJLOh-oOzraDqiJ1vPyE/pubhtml
Sammy (Sammy's G-ma / Vetsulin) is another one, started 8U and is down to 2.0U now: https://docs.google.com/spreadsheet...FoCpwOpU5qoYrOiX3nGiZ_NNMM/edit#gid=736012511
Leo (Cyrstal & Leo / Vetsulin) started on 5.0U and is down to 0.25U now: https://docs.google.com/spreadsheets/d/1rrdWEJs9aWoUwnDINXYAS4iSAs_eq_5-eOMZfilldKw/pubhtml
Click to expand...

Wow, thank you. Alot to mull over and discuss with the vet.
 
Maybe a bit of bounce back is happening with Tigger. My vet is very good, I'm hoping she will be receptive.
 
vbc2000 said:
I guess I don't understand about missing the correct dose. Here's more info. At one unit we were still bringing him in for weekly vet testing and the level after 2 weeks was still in the high 400's so he was raised to 2 units. Then his next test was 2 weeks later at the vet and it was in the high 300's so he was raised to 3 units. A week later his BG was 292 so he was raised to 4 units, again testing at the vet. He stayed at 4 units for a number of weeks because his vet readings were a bit all over...once 262, once 363 and I really began getting concerned about stress hyperglycemia. So at that point I got a meter and he was still running high 300's often. The first curve will be put in the spreadsheet but he didn't get below the mid 300's. The vet determined he wasn't "Somogyi'ing out" and raised him to 5 units. His levels and appetite have varied a lot but the recent curve is hopeful but not low enough so once he is more stable on food, they want to raise him to 6units 2x day. He has steadily gained weight since starting on the insulin and his drinking and peeing is drastically reduced. So something is working..just not regulated yet!
Click to expand...
When too high of a dose is given the cats body will sometimes over compansate by releasing stored glucose raising levels, making it look like it's not enough insulin.

Also were these dose increases done after a few curves (testing every 2 hours for 12 hours) or were they based on a single reading?
 
JanetNJ said:
When too high of a dose is given the cats body will sometimes over compansate by releasing stored glucose raising levels, making it look like it's not enough insulin.

Also were these dose increases done after a few curves (testing every 2 hours for 12 hours) or were they based on a single reading?
Click to expand...

The adjustment are after curves. Isn't the bounce back called the Somogyi effect? They've been watching for that.
 
Definately get all those numbers on Tigger's SS, it really helps those here help us. I have been at this also since April and even when things are going smoothly and not posting much, I have had them post about him getting blues etc because they do follow our progress to give us help and pointers when needed. We don't have the best of vets in our area so we are lucky to still have our Zeke. READ READ and then READ some more here on the boards and elsewhere. The more you know, the more comfortable you will feel with making adjustments when needed. :) Eventually we will all get there and our kitties will feel so much better!

BTW, not sure if you have Dollar Tree's in your area, but if you do the ladles they sell are perfect for gathering urine for ketone tests! They are are flatter then most ladles so makes for easy slipping underneath their booties when urinating. lol Of course we used red glittery nail polish to put Zeke's name on his ladle and it is hanging on the wall near the litter box so there is no accidents of us using it!

Almost forgot, what I have to do to make sure Zeke eats enough at his meal times (he is a grazer normally) is add a decent sized spoon of tuna to his bowl. 99.9% of the time he will just gobble it up! Also give him a small pinch of it for his reward after a test so he now hops right onto the cabinet where I test, the moment I pull out the tuna container from the fridge lol.
 
Meridith and Zeke said:
Definately get all those numbers on Tigger's SS, it really helps those here help us. I have been at this also since April and even when things are going smoothly and not posting much, I have had them post about him getting blues etc because they do follow our progress to give us help and pointers when needed. We don't have the best of vets in our area so we are lucky to still have our Zeke. READ READ and then READ some more here on the boards and elsewhere. The more you know, the more comfortable you will feel with making adjustments when needed. :) Eventually we will all get there and our kitties will feel so much better!

BTW, not sure if you have Dollar Tree's in your area, but if you do the ladles they sell are perfect for gathering urine for ketone tests! They are are flatter then most ladles so makes for easy slipping underneath their booties when urinating. lol Of course we used red glittery nail polish to put Zeke's name on his ladle and it is hanging on the wall near the litter box so there is no accidents of us using it!

Almost forgot, what I have to do to make sure Zeke eats enough at his meal times (he is a grazer normally) is add a decent sized spoon of tuna to his bowl. 99.9% of the time he will just gobble it up! Also give him a small pinch of it for his reward after a test so he now hops right onto the cabinet where I test, the moment I pull out the tuna container from the fridge lol.
Click to expand...
I love the nail polish as well!

I will be calling the vet tommorrow but I think Tigger has pancreatitis. He isn't eating well still.
 
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