Help with deciding not to inject tonight

http://www.felinediabetes.com/FDMB/threads/unregulated-glucose-levels-with-lantus.214346/

Mimi is now on half unit every twelve hours. Her PMPS is usually higher in the 400s range and half unit bring her way downm sometimes to 50s. PMPS is 296 right now and I am afraid she will drop while I am asleep. I am thinking of waiting and testing her around 5am. She has been grazing all day and her values have been in the 200s all day, which is also unusual for her. Any suggestions would be appreciated. The Vet told us to wait until tomorrow at 5am but I would love to hear what the forum thinks because I trust you more!
Mimis SS is up to date.
Thanks!

 

Reading back on your posts I can see Mimi had high levels of ketones and was in hospital for three days. Did she have DKA or just high ketones?
Either way it is not wise to skip insulin doses with ketones/DKA in the very recent picture.
How is her appetite today? Is she eating and drinking well?
Yesterday she dropping to 66 in one cycle and 54 in the next cycle. Using the alphatrak 2 meter, that warrants a reduction in dose. With ketones /DKA in the picture it is really important that Mimi is getting her insulin dose, is eating well, drinking well and her infection is being treated and is resolving.
I think you should reduce the dose of insulin to 0.25 units so you can shoot both cycles. The 0.5 units is sending her too low and you are risking a hypo.
I would also test at least daily for ketones in the urine. If you don’t have a bottle of Ketostix, I would go out and buy a bottle from a pharmacy or Walmart today. Do not leave it.
Also make sure she is eating well.
Could you put in your signature that she was hospitalised with ketones recently please?
She is only a couple of weeks into the feline diabetic journey so it will take longer than this to get her regulated.
Great you are testing the BSLs and feeding low carb.
Keep asking questions and please keep us posted how she is going

 

MIMI AMPS 539 +2 343 +6 167
Ketones are negative and she is grazing and feeling ok and we are back on the 5am and 5pm schedule.
I have learnt so much already in the past week, thanks to all this information and I feel I am learning to manage and recognize Mimi's needs. I even slept last night.
I want her off the Veraflox now as I read it can be given to cats for 7 days max and the vet said to do it for 30 days! I never heard of that. I will ask the vet tomorrow.
I hope Mimi continues to eat so we don't have to force feed her anymore. This forum is a life saver!

 

Mimi has high AMPS this morning because you skipped last night. I see you gave 0.5 units this morning. That dose has twice taken her into hypo territory. Unless you are going to feed her higher carb food to keep her BSL a bit higher, I think you need to reduce the dose to 0.25 units.
Also I would suggest you keep testing this cycle because Mimi could drop lower.
The vet probably wants her on an antibiotic longer than 7 days to make sure the infection has gone. This is really important because we don’t want ketones to reappear.
Im glad she is eating well on her own. That’s progress

 

We just tested her. Her PMPM is only 124 so we cannot give her another shot. We will retest at 7pm PST and see. 0.25 is going to be so hard to measure. We already struggle with 0.5 with the bubbles taking space and we often have to try a couple of times before getting the syringe ready..
I think that we will try tonight because there is no way I can give her half unit unless she is in the 400s.

 

Lantus dosing is based on the lowest point in the cycle... the nadir.... not the Preshot. Skipping shots and changing the dose is not how Lantus works well. If you reduce the dose to 0.25 unit you should be able to shoot each cycle.
Try using a magnifying glass to get the 0.25 units.
Try and always get mid cycle tests in to ensure she is safe

 

Mimi barely ate today and she was tired but her values were ok and her BG is now at 207 so I am not comfortable giving her a shot as we go to sleep. We see the vet tomorrow morning and I will make sure we retest her urine for ketones and infections.
I do think 0.25 each time is probably the way to go. I feel like we take one step forward and two back each cycle..

 

Vet is taking Mimi off the Lantus and putting her on Glipizide 2.5mg twice a day. He thinks that the tablets might be better for her way to remission. Her last shot was at 4.30am this morning. I have read Glipizide is not very effective, but vet says she might be producing her own insulin and so we should try it. I am inclined to try 0.25unit twice a day as was suggested by the forum. It is just that we can't seem to be able to be confident about the tiny dosage. We have a magnifying glass now, but it is still hard. Any tips on that and thoughts on Glipizide very much appreciated.

 

I would not use Glipizide. It is not good for diabetic cats. It will stress the pancreas more.
I would continue the insulin.
I will tag @Wendy&Neko @Marje and Gracie for input about this.

 

See my answer on your post on the Lantus forum http://www.felinediabetes.com/FDMB/threads/lantus-v-glipizide.214438/