Need help with dosing. Thank u

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Deb14

Member Since 2015
Hi need help for my kitty. Possible bounce ?? Vet told me to stop insulin on Jan 7 afternoon dose. I did and she's getting high reading even after giving her small amounts. Need to know if can give her another unit but how much.? Last time insulin was 9:30 1/8 unit and 12:39 1/4 unit. Now that the blood sugar is 179 at 4:17 not sure what to do. The vet advised me not to give does unless it's 125(that's too high isn't it especially on a cvs meter)..From reading here it says 70 on human meter and 100 on alphatrak. Am I understanding it correctly.

Thanks so much hope to hear back soon
Debbie

Jan 5th, Thursday evening
Bs. 280. 4:00 pm
Bs. 279. 10:05 pm
........Insulin 10:15pm, Hair over 1/2 unit 10:15 pm.....
Bs. 207 11:10 pm

Jan 6, Friday
Bs. 48. 2:09am
Bs. 46 3:15am
Bs. 56 4:20am
Bs. 64 10:04am
Bs. 72 11:17am
. ..Insulin 11:55am .....1/2 unit
Bs. 166 1:42pm
Bs. 53 4:28pm
Bs. 41 5:54pm

Jan 7, Saturday
Bs 75 12:21am
Bs 79. 1:13am
Bs 114. 3:30am
...Insulin 3:45am ......1/4 unit
Bs 87 6:00am
Bs 68. 8:00am
Bs 59. 10:00am
Bs 78. 2:15pm
Bs. 76. 5:30pm
Bs. 83. 9:45pm

Jan 8, Sunday
Bs. 91. 1:06am (krill given 2 hrs before a few drops causes sugar to rise)
Bs 131. 8:36am
....insulin 9:30 1/8 unit
Bs 150 12:14pm
...... Insulin 12:39. 1/4 unit...
Bs. 145 2:09pm
Bs 179 4:17pm???? Insulin or not ??? Concerned its high at 179 or do I wait. , just retook it, it's ok now 126. Should I give next dose when it starts to go up . The last 2 doses were given at 8:36 am 1/8 unit and 12:39 1/4 unit. Thanks so much!

Debbie
 
I would not recommend giving any more insulin at this point! Most insulin is dosed twice daily at 12 hour intervals. What type of insulin are you using?
 
It would help us to help you if you could answer a few questions:
1. When was your kitty first diagnosed, and how long on insulin?
2. What type of insulin are you using?
3. What dose has your vet recommended, and how frequently?
4. Does your kitty have any other health concerns?
5. What are you feeding your Kitty?
 
Squalliesmom said:
It would help us to help you if you could answer a few questions:
1. When was your kitty first diagnosed, and how long on insulin?
2. What type of insulin are you using?
3. What dose has your vet recommended, and how frequently?
4. Does your kitty have any other health concerns?
5. What are you feeding your Kitty?
Click to expand...

1. Diagnosed 18 mths ago. Started with 2 units and was tapered to 1 unit then again to just a few drops. I followed your website protocol tight regulation. Her diabetes was caused steroid use. Went in remission this past July 2016. After remission monitored bs every week to ten days. Numbers between 100 -125 . Had one with 140 back a month or two ago. Last bs reading were 125 dec 24, then Jan 5, 280. Noticed Increases eating/drinking for just a few days. Vet did a test similar to an A1c which showed her sugars were up for 1wk to ten days. Her tests showed BUN and creatinine and stage 2 renal failure or possible dehydration. Need to retest in 10 days. Is it normal for blood sugar to just rise like that from 125-280 in just 10 days. I'm hoping she didn't get into anything that caused kidney damage plants, medication. We are very careful and we don't leave sweets around. She was never sick just the increased water/ food for a few days.
2. Lantus
3. This time 1/2 unit twice a day. since she's been off insulin for 6 mths
4. She had ibd that resolved after steroids (which she is NOT taking anymore) .
But now doc is saying her BUN and creatine are increased didn't give me total but said could be in second stage kidney disease or extremely dehydrated. Her urine was also clear. Could renal failure cause a rise in blood sugar.
5. Eating raw food
Hope this helps thanks so much for all your help.
Debbie
 
Lisa and Smoky said:
It looks like the majority of the time period you listed your kitty was too low to be given insulin. Have you decided on a no shot number in which no insulin would be given?
Click to expand...
Yes I thought with the tight regulation that number was 70 on a human meter and 100 on an alphatrak. Which I have both , but misplaced the alphatrak since she was in remission. The vet got concerned with the low numbers and wanted me to wait till 125 and reduce dose to an 1/8 unit. Which I did at 9:30am and it kept rising, so I gave another dose at noon time of 1/4 unit. It still increased but finally started to drop in early evening. Kinda scary. Cause she was in remission for 6 mths after being on insulin for a yr. hoping she doesn't have renal failure don't understand she's on a good commercial raw diet. Water avail always. Weird how her bs was perfect at 125 on dec 24th. Then to rise to 280 in ten days seems odd. Her labs were off high BUN and creatine. Vet said either 2nd stage renal failure or dehydration. Need retake tests in a few wks. I'm so scared love this kitty more than life. Look forward to hearing from you thanks so much deb
 
I can't imagine how scary that must be for you having your kitty come out of remission. I'm new to the sugar dance myself, Smoky was only diagnosed four months ago. I'm not that experienced yet to give much advice. There are other more experienced members who know more than I do about feline diabetes.
I see that you are using Lantus for your cat. I would suggest also posting on the Lantus forum as there are many other members who can help you. I am sending hugs for you:bighug::bighug:. You are in the right place, these folks are wonderful on this board.
 
Lisa and Smoky said:
I can't imagine how scary that must be for you having your kitty come out of remission. I'm new to the sugar dance myself, Smoky was only diagnosed four months ago. I'm not that experienced yet to give much advice. There are other more experienced members who know more than I do about feline diabetes.
I see that you are using Lantus for your cat. I would suggest also posting on the Lantus forum as there are many other members who can help you. I am sending hugs for you:bighug::bighug:. You are in the right place, these folks are wonderful on this board.
Click to expand...
Hoping ur kitty is doing well. Thanks so much yes I'm a wreck . I will take ur advice and also post in the lantus forum. Take care hugs to you as well my friend
 
Deb14 said:
1. Diagnosed 18 mths ago. Started with 2 units and was tapered to 1 unit then again to just a few drops. I followed your website protocol tight regulation. Her diabetes was caused steroid use. Went in remission this past July 2016. After remission monitored bs every week to ten days. Numbers between 100 -125 . Had one with 140 back a month or two ago. Last bs reading were 125 dec 24, then Jan 5, 280. Noticed Increases eating/drinking for just a few days. Vet did a test similar to an A1c which showed her sugars were up for 1wk to ten days. Her tests showed BUN and creatinine and stage 2 renal failure or possible dehydration. Need to retest in 10 days. Is it normal for blood sugar to just rise like that from 125-280 in just 10 days. I'm hoping she didn't get into anything that caused kidney damage plants, medication. We are very careful and we don't leave sweets around. She was never sick just the increased water/ food for a few days.
2. Lantus
3. This time 1/2 unit twice a day. since she's been off insulin for 6 mths
4. She had ibd that resolved after steroids (which she is NOT taking anymore) .
But now doc is saying her BUN and creatine are increased didn't give me total but said could be in second stage kidney disease or extremely dehydrated. Her urine was also clear. Could renal failure cause a rise in blood sugar.
5. Eating raw food
Hope this helps thanks so much for all your help.
Debbie
Click to expand...

Lantus should be dosed twice daily at twelve hour intervals. It is a depot insulin, which means it builds up a reserve, the "depot", which causes it to be absorbed slowly, helping kitty's blood glucose levels to stabilize with consistent dosing. Your vet should give you a "no shoot" number.

There can be any number of reasons for blood glucose to rise; contraband food, stress, pain, infection, certain meds, all can have an effect on BG. Have you spoken to your vet about restarting insulin and, if so, what dose did he/she recommend? I don't usually like to give dosing advice, but if it was my kitty I would probably start her back on a very low, 2x daily dose and see how she responds. You can always raise the dose if you find it isn't enough. We suggest raising by 0.25 increments, and holding the dose for at least 3-5 days. From the sticky Lantus & Levemir - Tight Regulation Protocol:

"GENERAL GUIDELINES:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers."
Was your vet unable to determine if your kitty was dehydrated? You can get a rough idea of dehydration by trying the snap-back test: pull up a pinch of skin at the scruff of the neck, if it snaps back into place quickly kitty probably isn't dehydrated, or not much; if it slowly sinks back down into place she is dehydrated. You can also check her gums, if they are tacky/sticky she may be dehydrated. I am surprised your vet didn't give fluids if he/she thought dehydration was an issue.

If you can post a copy of her blood test results, we have a couple of people here who are very good at reading and interpreting them who may be able to give you a better idea of what's going on.

We also have many members who can advice re: kidney disease, as it seems to go hand in hand with FD so frequently. Just post for help with kidney issues. Here is a link for a really great site that can provide you with tons of info on kidney disease:

http://www.felinecrf.org/index.htm

Hope this helps.:)
 
It looks like you may have been following a different version of Tight Regulation that was developed by Dr. Elizabeth Hodgkins instead of the Tight Regulation Protocol we follow here

The "rules" are totally different .....Our Tight Regulation Protocol has been published in a veterinary journal and was written by Drs. Roomp/Rand

The Hodgkins TR was first developed for use with ProZinc insulin and has been "twisted" to be used for Lantus

Now that being said, we do know there are other dosing methods out there and the one that's best is the one that works for YOUR cat.....but I'd really suggest for your cats safety, you read our version of TR and compare it to the "rules" you've been following

This is our Tight Regulation Protocol....the link to the actual protocol is at the bottom of that page
 
Squalliesmom said:
Lantus should be dosed twice daily at twelve hour intervals. It is a depot insulin, which means it builds up a reserve, the "depot", which causes it to be absorbed slowly, helping kitty's blood glucose levels to stabilize with consistent dosing. Your vet should give you a "no shoot" number.

There can be any number of reasons for blood glucose to rise; contraband food, stress, pain, infection, certain meds, all can have an effect on BG. Have you spoken to your vet about restarting insulin and, if so, what dose did he/she recommend? I don't usually like to give dosing advice, but if it was my kitty I would probably start her back on a very low, 2x daily dose and see how she responds. You can always raise the dose if you find it isn't enough. We suggest raising by 0.25 increments, and holding the dose for at least 3-5 days. From the sticky Lantus & Levemir - Tight Regulation Protocol:

"GENERAL GUIDELINES:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers."
Was your vet unable to determine if your kitty was dehydrated? You can get a rough idea of dehydration by trying the snap-back test: pull up a pinch of skin at the scruff of the neck, if it snaps back into place quickly kitty probably isn't dehydrated, or not much; if it slowly sinks back down into place she is dehydrated. You can also check her gums, if they are tacky/sticky she may be dehydrated. I am surprised your vet didn't give fluids if he/she thought dehydration was an issue.

If you can post a copy of her blood test results, we have a couple of people here who are very good at reading and interpreting them who may be able to give you a better idea of what's going on.

We also have many members who can advice re: kidney disease, as it seems to go hand in hand with FD so frequently. Just post for help with kidney issues. Here is a link for a really great site that can provide you with tons of info on kidney disease:

http://www.felinecrf.org/index.htm

Hope this helps.:)
Click to expand...


Thanks so much. Yes much help. My vet mentioned dehydration because of the labs the next day bun and creatine were elevated. guess the urine was clear too. He told me the bun and creatine could possibly get normal once kidneys weren't aggravated by high blood sugars. But he also said 2nd stage failure is possible as well. Won't know till her bloodwork in 10 days, gosh I'm praying her kidneys are ok. I'll get in touch the the kidney group as well. Looks like her numbers are still coming down its now 101 a 1/2 ago. My vet says 125 or no less than 100 to shoot, but they are basing it on a alphatrak. He didn't know there's a difference between human and alphatrak. I will keep an eye on here and will prob dose when I see it stops going down and starts rising. Not sure how much . 1/2 unit originaly caused her nadir to be 41. Might be a long night again . But she's worth it. Thanks so much appreciate all your help.
 
Chris & China said:
It looks like you may have been following a different version of Tight Regulation that was developed by Dr. Elizabeth Hodgkins instead of the Tight Regulation Protocol we follow here

The "rules" are totally different .....Our Tight Regulation Protocol has been published in a veterinary journal and was written by Drs. Roomp/Rand

The Hodgkins TR was first developed for use with ProZinc insulin and has been "twisted" to be used for Lantus

Now that being said, we do know there are other dosing methods out there and the one that's best is the one that works for YOUR cat.....but I'd really suggest for your cats safety, you read our version of TR and compare it to the "rules" you've been following

This is our Tight Regulation Protocol....the link to the actual protocol is at the bottom of that page
Click to expand...


Thanks so much I read over the protocol by Drs rooms/rand I can't seem to find the magic number it shoot at. I see the nadir info ( which my kitty is like 5 hrs after preshot, but don't see anything about what number after 12 hrs ? Is it 70, 80'or 100 on a human meter . Thanks much hope to hear from you
 
All I can tell you is what I learned on here myself. Below 50 on a human meter and below 68 on a pet meter puts the cat into a hypoglycemic episode or " hypo" which is dangerously low blood sugar. You probably already know this needs to be treated right away to bring BG back up.
My no shot number is 150 but Smoky is on prozinc which is an in and out insulin. I'm using a bit of a sliding scale with him right now as I base his dose on both his nadir and pre shot numbers. I hope this helps you out.
 
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