Higher BG Today. Raise dose?

Hi all,

Relative newbie here still trying to figure out BG testing and how to interpret results. Wondering if someone would help me with some advice on dosing and have a look at Butters’ spreadsheet please (link in signature)?

Based on her BG numbers and feedback here, I lowered Butters’ insulin dose over the last two days from 2 u Caninsulin 2x daily to 1.75 and then last night to 1.5. I dosed at 1.5 again this morning. But her BG numbers are higher today than yesterday. I also noticed that she visited her water bowl three times this morning and was getting quite beggy for some food at around +9. Since starting Caninsulin, she had not done these things.

I know I stressed her out a bit during the AMPS. But besides that, I am not sure why her numbers are higher than yesterday.

Also maybe worth noting that I am working with u100 needles with full unit markings only, and u40 insulin so getting exact accurate 1.5 doses are a bit of a challenge.

Do you think I should go back to dosing at 1.75? I am not confident that I will be able to get a PMPS reading today. Her poor ears aren’t producing much blood yet and are all red and spotty. I wonder if they are sore and need a break.


Previous thread about butters: http://www.felinediabetes.com/FDMB/...gly-against-home-testing.230292/#post-2578716

 

I can't help much so wait for more experienced people, but I believe it is recommended to hold a dose for 6 cycles (so 3 days) before switching doses.

The name Butters is adorable! I love that.

Also heating up the ear before testing helps a lot! You can use a sock with rice or put a washcloth with warm water on it in a sandwich baggie. I know some people can use a paw pad to get blood as well if you think her ear needs a break.

 

@JanetNJ

You need expert advice

 

I am so confused by the different forums and threads. I just posted to the Caninsulin group because I actually got a PMPS test done but it is slightly low! 196. i believe the instructions are to post the concerning number to that group and wait for advice, so that is what I have done.

I have no idea why her BG readings seem to be all over the place.

 

The Caninsulin board is not always terribly busy. It's helpful to post on Health and in the insulin forum.

Actually, Butters numbers aren't that surprising. What you're seeing is a bounce. When Butters dropped to 70, her body wasn't used to seeing normal range numbers. As a result, her pancreas and liver panicked. When that happens, a stored form of glucose and counterregulatory hormones were released. This causes the spike in numbers. It can take a few days for the bounce to clear.

Given that Caninsulin can yank numbers down, I cannot emphasize enough how important it is to get PM tests. Many cats drop into lower numbers during the PM cycle. Please get a test before you turn in for the evening every, single night (aka a "before bed" test).

Generally if you see a lower that usual pre-shot number, with Canisulin, you have 3 choices:

• Do not feed your cat and stall. Re-test in about 20 min and see if numbers are heading up. If you see a rise in numbers, shoot. If they are about the same, you can continue to stall.
• You can shoot a reduced dose of insulin.
• You can skip the shot entirely.

Without knowing in which directions numbers are heading, you might want to consider stalling.

 

Ok thanks for replying with your guidance. I stalled for 20 minutes and the number is 229, so definitely heading up.

She is now eating. Should I give a full dose or lower it?

When I can do an evening "before bed" test, what would I do with that information? Is this to make sure she is not hypo? Does a "before bed" test have to be a certain number of hours after giving insulin?

 

I'd give the full dose of you can test later. If your nervous maybe do 1-1.25

 

I did approximately 1.25. How many hours after her evening insulin would I want to test? But more importantly, what am I looking for? A certain range? Like, making sure she is not in the light green range?

I am going to feed her some more in a couple hours. Hopefully that also helps.

 

With Caninsulin, it's best to aim for numbers >100, roughly speaking. Definitely, you want to stay away from light greens! Any time you go under 90, that calls for another reduction. Butters technically did not earn another reduction today, but I agree it's always better to go a little conservative [edit with a necessary caveat: unless a cat is just out of DKA or known to be ketone-prone, then the question must be considered in more detail] if you have any qualms and/or aren't sure that you can monitor throughout a cycle.

Caninsulin hits quickly, in the first couple of hours, but usually peaks and starts to decline in action after 4-6 (note "usually"! never any guarantees of anything here lol!). So you'd want to act more aggressively to low numbers in the beginning of the cycle (when the insulin is just getting started) than later (when it's probably making one last stand).

Feeding around +2 is a nice insurance policy-- whatever she ends up doing, it will likely make it a slower and shallower drop to have some more food coming on board right when the insulin is revving up .

 

Around

90-130 is a great range. If she is getting close to the 70's give reg food. If it's light green you wanna break out the high carb stuff.

 

Actually, with Caninsulin, if it's early in the cycle and you get a 90, I'd give a teaspoon or two of medium or high carb. Like Nan pointed out, Caninsulin can act rapidly and drop numbers early in the cycle. Some of this will get easier as you get more. used to how your cat responds to insulin.

 

Thanks all for your advice on how to keep Butters safe. I am hanging onto all of it.

I started a new thread here because something strange happened with Butters today: http://www.felinediabetes.com/FDMB/threads/butters-possible-hypo-episode.230445/