insulin dosing

Hi, I'm reposting this from the introductions page as I meant to post it here....
I’m pretty new to this only about six Weeks since my cat Buddy was diagnosed. Trying to figure out and regulate his dosing I’m not at home testing yet but he’s getting fructosamine testing At the vet twice per month. She lowered his dose for two units to one when it look like he was remitting. However he had high fructosamine Reading again and the dose increased back to two. My concern is when dose increased again his water consumption did not decrease and has actually increased again recently. I’m curious how long it takes To regulate as it’s only been six weeks so far. He goes for another test next week so I can tell this to the vet.
Thanks for any feedback and support.

 

It can definitely take a lot more than 6 weeks to regulate, but the fructosamine test is not going to give you enough information alone. If the dose is not high enough that test will show high but if the dose is too high and causing bouncing and kitty is spending a lot of time in high numbers that test will still show high. Testing at home before every shot and mid cycle tests will tell you more specifically if a dose is working. It will also reduce the chance of life threatening hypo if you’re giving too much. The fructosamine is more of an average. You need those daily constant checks to know what’s really going on.

 

Hi Buddy’s human, I saw in your introductory thread you asked about meters. I’ll answer here since this is the best forum for questions. If you’re in the US and have a Walmart nearby, you can pick up a Relion Confirm or Micro, not sure of the price, but they are affordable. The meter I use is the Relion Prime. It’s cheaper, but uses a larger blood drop so some don’t like it. You will also need a supply of test strips and lancets size 26-28 gauge. If you’re not in the US or near a Walmart, pick a meter that uses a small amount of blood and check the price of the matching strips as that will, over time, be the biggest expense.

 

Thank you. I’m near a Walmart and these are human meters right that I can find in the pharmacy? I’m still concerned about his water consumption. He is pushing 3 cups of water per day this is up from 2 cups when he was first diagnosed

 

Yes human meters. Be sure to pick up extra test strips and the 26-28 gauge lancets too. The extra water consumption is probably due to unregulated diabetes. We’ll know more when you start testing

 

Have you been able to get the supplies?

 

Here's my new member info handout:
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It would help us if you set up your signature (light grey text under a post). Here's how:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

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Here's the basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

1. BG goes low OR lower than usual OR drops too quickly.
2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
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Some of this will make more sense later but read it over a few times. Ask lots of questions.

 

I will most likely go to Walmart this weekend to get suppplies and will look at the spreadsheets in the meantime

 

@JanetNJ has a great shopping list for testing supplies