Hi there! I have a somewhat strange question considering my cat has been diabetic for a few years, but I'm just now really learning the appropriate way to care for him. Long story short he was diagnosed while I was on my honeymoon. When I got back he was already started on Novolin insulin and DRY purina DM food. Since that's what the vet suggested I didn't think anything about it. Over the next two years we continually had to up his insulin dose (due to the dry food I finally learned. I also was never encouraged to home test). Did some research and switched to wet food and started home testing and that helped dramatically. Recently, a couple weeks ago, switched his insulin to Prozinc and now I'm trying to find the right dose for him. My question is, if you're on a dose and start seeing good range numbers are you supposed to always give that same dose? For example, say the pre shot number is 171 do you still give the full dose or do you not give a dose? I ask because I read that you're supposed to have a no shoot number, but that was listed under the instructions for recently diagnosed cats. Since mine probably won't ever go into remission I didn't know if that applied. My line of thinking was "if this is the dose that got him to the good range numbers it makes sense that he needs that same dose to keep him in the good range numbers," but I also worry about him going too low. I hope that makes sense and I'm sorry I don't have a spreadsheet for you guys to look at, but hopefully you get what I'm trying to ask.
You should be giving a dose that keeps him in good numbers without him going too low, so knowing where his nadir numbers are is going to be as important as knowing his pre-shot numbers. You might be able to shoot the normal amount when he's 171, but you'd have to watch him and make sure he doesn't drop into hypo range. If you can keep him in a good range without going into hypo range, then keep giving that dose, but you should keep checking.
Great advice from Aslina & Alex! Yes unfortunately insulin needs can and do change over time. So if you find a dose that works for now, know that it might change in the future. Checking BG at home as you're doing now is the best way to find a good dose range and make sure that it is still a good dose. We'd be happy to help you figure out dosing if you'd like! If you get a SS set up and want us to take a look, feel free to post and we'll see if we can't help you determine what to do.
Here is a link to the spreadsheet if you want to get one started: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ You can see examples in our signatures (don't worry, the color coding happens automatically - it's super easy to use).
Thank you, so much! I’ll work on the SS today and get that uploaded. I just want him to feel good and I know all this up and down doesn’t. So thankful I found this forum.
Ok I got his spreadsheet updated as best as I could. After about a week at 1 unit my vet told me to increase to two units. I was very worried about making such a drastic change at one time, so I've been doing it slowly while monitoring his numbers as best as I can. I just don't know if I need to keep moving up to two units. Any advice would be greatly appreciated as I am so overwhelmed trying to figure it out on my own. My vet did say he needed dental work, but that she wanted to wait until his numbers were better. I've been reading that poor dental health can actually make normalization harder, so I've called to see if we can move forward with his teeth.
Spreadsheet is looking good so far! You may end up at 2u eventually, but definitely don't jump straight to that. You're doing a good job increasing slowly. Try to keep getting those middle of the day tests, and if you can get a before bed test in, that's good too since sometimes the night cycle is different from the day cycle. Stay on 1.5u for at least a few more days checking those mid-day numbers to find where George's nadir is (Alex's is at about +5.5, but George's may be anywhere from +4 to +8) and that's what you're going to want to be watching to make sure it doesn't dip into lime green. If he's still not getting low enough I'd try going up to 1.75 and then holding at that for at least a few days, maybe a week. Need to give them time to adjust to the new dose before increasing again so you don't accidentally speed through the right dose.
I agree with Asiina, with one minor adjustment - I think I would get a test or two tonight to make sure there isn't anything crazy happening during the PM cycle (as Asiina said, sometimes it's quite different from the AM cycle so it's important to monitor both cycles - at least a before bed test and anytime you get up to use the restroom or wake up for no reason). Then if all is steady there too, I'd move to 1.75, give it 6 cycles or so, and do the next increase. Unless George starts bouncing, there is no need to wait a whole week with these small increases. Of course if he does start jumping around you do need to go slower.
