Dosing Question

Need dosing help. My cat diagnosed a few months ago ( onset result of a Depo Medron shot) is not stabilized at all. Came home from an 8 day stay at the vets 16 days ago (to help what looked like an IBD issue and to get insulin level) . Since then glucose values up and down, they got too low so per vet we changed from 3.5 unit Lantus to 2 units 2 days ago. No chart your format but since we switched to 2 units: Wed a.m. 367, 2 unit givens, Wed p.m. no test, 2 units given, Wed midnight (midpoint) test 65, Thur (today) a,m, test 72 double checked with different brand of strip 92, so no shot given. What do I do? I was thinking of testing at 11:30 and if low give 2 unit shot then and then I am on an 11:30 schedule each day. (Note I will not be home today no matter what between 4:30 p.m. and 11:30 p.m. so no shot can be given then.) My vet has not been very helpful thru this (but they are great about other stuff). Note- I have a problem testing ALL the time 'cos the cat bites- hard and deep. Sometimes I try and it fails. Other times he's great.

Update- my vet said to retest at 11:30 a.m. and call him.

 

Not a lot of info to go on, but sounds like the current dose is still too high. If you give your shot at a different time, that does change your shot times since the next shot would be due 12 hours later.

 

Yes, I do know I would be on a different 12 hr schedule. Thanks. My life has become just one big juggling session over the last few months. I am really hoping this is the beginning of the pancreas starting to work well again! (Never ever will I get a cat another Depo shot- I've been lucky with my other cats in the past.) Interestingly- the cats is still on half a high carb food for what looked like IBD- I have been transitioning him to FF chicken pate. I suspect as I go further the insulin need will lessen even more.

 

Here is a link to the spreadsheet so you can get it set up: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

You just have to link it - all of the formatting is already done for you.

The high carb food is also a factor in the wildly swinging numbers you're seeing. Carbs make it difficult to get stability throughout the cycle. As far as the IBD, a probiotic is a powerful tool in getting that under control. It takes a little time to build up in their system, but if given consistently can make a world of difference. S. boulardii is a popular one around here that has had good results. This one is also good: https://www.chewy.com/animal-essentials-plant-enzyme/dp/49372 Many vets recommend fortiflora - that one tastes really good, but hasn't been found to be as effective in helping with the IBD.

 

O.K. I put info in from when he came home form 8 days at the vets. My vet wanted 6 hr #'s and didn't care what I did otherwise. 2 vets at office- 1 good but new and we didn't agree on treatment for this, other vet old, like a God to me and he's helping me now when I call.

 

Also- IBD, his stool is great now, has been on the new diet, need to stabilize insulin and then see if he has food allergies. Have been keeping him just on chicken based for now. Note- at times very difficult to test. If in doubt try harder but at times 4 ear holes and not enough blood ( I warm and massage, right size lancet, use tip of ear) or lots of growling etc. I judge a lot by his behavior. When his glucose gets high he's always trying to get food. Now that it's low he's not. Also- water consumption pattern changes.

 

My two cents based on looking at your Excel (?) spreadsheet:

• 2 u is too much because it dropped him to 65 at +6 last night and he was only at 72 this AM
• try 1.75 u (eyeballed) or 1.5 u if you have syringes with half unit marks
• using our spreadsheet (Djamila linked it above) makes giving advice a lot easier for us
• do the best you can with testing, etc. Getting a pre shot test and at least one in the 4 to 7 hours after a dose is your goal.

 

Kris &- I thought I did attach the spreadsheet in the posting. Did I do it wrong? New count 145 18 hours after his last 2 unit shot. Called my vet- he said test again in 6 hrs (I'll be here until 4:30 so will do it then) and if it's above 250 give him 1 unit. He said he thinks the cat is coming off of insulin. I did feed him his normal mid day meal to keep things consistent. (4 ears holes to get 1 count.) Am attaching sheet again.

 

Sorry! I wasn't clear. I saw your Excel spreadsheet. I was referring to the special automatically colour coded one we use here. Check out a few to see what I mean. Each BG range has a colour so we look for the scattering of hues to quickly assess.

Sounds like your vet wants to wait until the BG is at a certain level before dosing. Our advice would be to give an appropriate sized dose IF the pre shot test number is high enough. How how that is depends on which insulin you use, how much reference data you have and how well you know your kitty's responses (calm vs dramatic). We also give small dose fractions. It wouldn't be 2 u or 1 u. It could be 2 u, 1.75 u, 1.5 u, 1.25 u or 1 u.

 

When I look at it it is color coded but my colors are different. I did do a download and save on the link one. I'll have to start from scratch but probably will not have time until after Xmas Eve so won't expect dosing help for him until I have it.
Is there a chart or something that will tell me the parameters. My vet does not want me fooling around with the dosing by myself. I do not feel comfortable doing it either. Isn't there some written guidance based on the insulin you are using. I CAN go down by 1/2 units but my syringes don't have 1/4 marks, and they'd be a best guess. Because my problem started with 1 Depo shot which the vet says sometimes plays havoc with the pancreas he feels the pancreas might have corrected itself and no insulin at all might, just might, be needed. (I should be so lucky!) My main priority is not to dose too high. His behavior will tell me if the dose is too low.
Thanks for your help!

 

You have to do what you're comfortable with. You don't want BG to drop below 68 as measured on a pet meter like the AlphaTrak if that what you use. The cutr off is 50 on a human meter because they read lower.