? BG 365 AMPS, does no food always mean no shot?

Piers has been on 1 unit caninsulin at 12 hour intervals for about ten days. He's a bit of a sicker-upper so I wait about 30 mins after breakfast before his shot, to make sure his food is in him.
He can also be a picky eater so again I am cautious about his shot. Following the rule 'no food, no shot'.
He seems to be doing ok but still drinking and peeing too much. My vet plans to test for fructosamine in about another week.

This am his BG reading was 365. Tested before breakfast. He ate his breakfast (and I think he had been drinking a lot of water) then threw everything up about 20 mins later so I held off the insulin.
Finally ate a small meal at 7.50 so insulin at 8.30.
So my schedule is now 'off'by 2 hours.

I am wondering whether - given the high bg reading - I could/should have injected him (maybe only 0.5 of a unit) on schedule or whether waiting was better? Obviously had his BG numbers been closer to a correct range/with a different insulin, I would not be asking this question.

If anyone has time to look at my weekend readings and has any comments, I would be grateful. Plan to share them with my vet and request his readings/dosages from when he was admitted the other week. to clarify, I am in the UK but my glucometer is giving the US(?) mg/dl measurements.

It seems to me that he is on a pretty even keel but is still too high on his BG readings, not sure if waiting a further week for fructosamine test is best for Piers - seems to be in potential renal damage zone ATM?

thank you in advance.

 

If you ever decide to give a token dose on a higher BG level without a proper meal I wouldn't do it unless you can monitor closely... Your spread sheet doesn't show very many days on insulin so this might be a dosing plan to wait on until you get more data. Even more so if he's a picky/reluctant eater.
Is this a normal occurrence with him? Or do you think it was just from too much water and food in his belly? If it's a common thing you could try feeding in a larger dish so he can't eat too fast and possibly limit his water half hour before and after meal? I'm not sure if that would be an idea that could help (don't want to cause any dehydration) so if anyone knows better please feel free to correct me if I'm wrong!

 

My vet initially was adamant - no insulin without food. Categorically, no variation. After a couple of months when I presented them with evidence of testing they were happier for me to have more control but even now I would be very reluctant to give a full dose on no food. I would have to be sure I was around to monitor and test the BG regularly as I have no way of knowing at the moment how fast acting the insulin is without food. I know how she reacts with food in her but without it I have no data.

does he eat little and often and if he does that is he still sick? Is the morning a problem because he has gone so long overnight without eating? Mine are on four meals a day so if she misses the meal coming up to shot time it isn't a huge deal as she will have had some food within the last 6 hours. I would still monitor her though. I think the key to knowing how safe it is is to have a lot of testing data.

There is really no knowing the right answer as to whether you should have injected or waited or given a less dose - you do whatever feels right at the time and knowing you can deal with the consequences. The fructosamine test I thought was only done after a month or so on regular dosing otherwise it may not be accurate. I could be wrong on this though. In any event, if you are testing regularly you know how high/low the numbers are and have an accurate picture to present to the vet to decide on dosing.

What food are you using - I know it's difficult to change if they are picky but it could be that the food is keeping him higher than you would like. I could see the difference in numbers within 48 hours of switching Sky. I still had to increase her insulin a little to bring her down into a better range but now she is there I rarely have to go over 1 unit.

You are doing very well with the testing and at least you have a vet that has started you on a nice low dose - we see so many posts (mine included) where vets put them on a very high level of insulin and don't suggest testing. He does seem to be doing okay - his numbers go back to a similar point at each 12 hour test but they could do with being lower at each main test. That is something that will come gradually - it's a marathon not a sprint. Slowly and safely is better than overloading kitty with insulin in my view.

I think you may have to adjust your injection time tonight to compensate for the late one this morning -I'm sure I read somewhere that you should stick to 12/12 where possible but not to have 2 injections within 10 hours. If you moved your evening one to an hour later then by tomorrow/Wednesday you could be back on 12/12.

Good luck

 

Is this a normal occurrence with him? Or do you think it was just from too much water and food in his belly?
He's been a bit of a breakfast regurgitator all his life. It's just a bit more pronounced now he is also drinking too much.

does he eat little and often and if he does that is he still sick? Is the morning a problem because he has gone so long overnight without eating?
Yes, he eats often, but sometimes almost nothing and sometimes a lot. And you could be right that he is getting hungry overnight, as he ate ravenously at breakfast - also last night he seemed really hungry, so got 2 small meals 7.30 and 9 pm.

Because he's picky and I have dropped feeding any dry kibble (they only got a small amount) I am now having to explore other wet foods than normal, and must admit I am not being too insistent on the low carb foods - it's just whatever he'll eat for now. As everything is new to us, I am having to get a grip on things one at a time. Hope to make progress on this front though.

Thank you both

 

If you notice the sickness more in the morning it could be worth getting an automated feeder so you can set it up for him to eat through the night. Once his diabetes is more controlled his water drinking may slow down.

I understand it can be overwhelming everything that you suddenly have to think about and consider when you get the diagnosis. Once you get to grips with the testing and injections I would have a look at the food and see if you can see any patterns in numbers and food.

@Elizabeth and Bertie has an amazing food resource that you can have a look through when you get time to possibly give you options. I have found it invaluable.

http://www.felinediabetes.com/FDMB/...-including-link-to-low-carb-food-list.137376/