? Sally, dose advice

http://www.felinediabetes.com/FDMB/...ka-amps-91-6-326-pms-253.197771/#post-2213104

Haven't posted for awhile trying to let dose of .25 twice daily have some time. Sally had dka end of June because we tried her off of insulin for a couple of days till I found ketones in her urine. We have been afraid to lower her dose because of ketones, although they didn't appear till she was off insulin. She has been getting very high bounce numbers very often now and a couple of days she had hit 80's and a 50's reading just the other day. Are we crazy to lower her dose to .125 now? She at least had some decent numbers when we did that dose before.
If you didn't know she's diabetic there would be nothing to indicate it. Her coat is good, she's bright and her activity is normal. We add water to her food because she hardly drinks.
Issue with syringes:we've been using Monoject and I love them because they have been pretty consistent quality. Last week I noticed when drawing up that the zero line on the syringe was lower on the barrel than I remember it being. We discarded that one and have been checking them all because that obviously affects the dosing. A little experiment proved that to me. Then I second guessed myself on a couple of syringes that were a little dubious to me and used them and that is where we are now with the 50's reading yesterday. There appear to be a lot of syringes likevthat that I have found. So my thought is now that Sally may have gotten .5 or close to it instead of.25. The .5 was too high for her a couple of months ago. We were worried the .25 may be to much too because of the bounces. She still has not remained consistantly in even the 100's since doing her current dose. She was more consistant when she had .125 twice a day or even .25 or .125 once a day.
Forgive the rambling post I'm just lost once again. We admittedly are terrible at night tests so I'm sorry there isn't much there to go on.
I know there are no standards for either syringe or insulin quality. It will just be a matter of wasting money on the syringes I don't use I think. But how to manage these doses? We can test enough probably to catch the 60's and 50's if they happen but what kind of damage is happening to her kidneys/liver with the bounces? Is she better off to be in a range of 100's and avoid the big bounces? We have been doing urine strips daily. We have been feeding breakfast and dinner and a meal in between each meal but a few hours before the preshot tests.
I hope this post can make some sense. To be honest I'm not even sure sometimes of what I'm asking. I'm looking for reassurance and direction maybe even chastisement! but I know it's not a simple answer. I'm really starting to go mad. I feel as though every decision we've made has been the wrong one.

 

That 56 on the AT yesterday says Sally earned a reduction. I would try the 0.1 unit, for her safety. Any chance of making it a habit to get a night time test in, just before you turn out the lights? With half the data missing, it's really hard to see what is happening with the current dose. She is obviously going lower at night, then bouncing. On July 3rd, you shot with a preshot of 61. That's not safe to do. With the AT, never shoot below 68 and since you are following SLGS, you shouldn't be shooting with any preshot below 90.

As for inconsistent syringes, that is very common. Some of us use calipers to measure the doses. Here is a post on Dosing with Calipers.

 

I'm sorry that dose of 61 I left in the wrong spot! It was the 122 we shot. I had forgotten to change it. I thought that dose in the 50's would get a reduction but we were afraid to lower it since the ketones. But then that situation was caused by our taking a stupid chance and stopping the insulin.

 

A lot of us use calipers because of the markings being so off from syringe to syringe. There can easily be as much as .25 of a unit off from syringe to syringe, maybe more. If you don't want to fool with calipers here's what you can do. Find a syringe in the box that when you apply a little pressure on the barrel, the top of the plunger should be even with the zero line. When you find that syringe, use it as your sample and draw out your dose with colored water, coffee , or tea, something that will show up that you can use as a comparison to draw up another dose in another syringe.

Taking her off the insulin was premature and I am glad she is okay now after the DKA. Remember, a DKA can happen when there is not enough insulin + in appetence, and a systemic stress or infection.

Also, you have to get some night time testing in. She could be going lower and bouncing back up in the AM. All the data you can get is good info to understand how low the dose is taking her.

Since you are using a pet meter, the 56 earned a reduction for now.

 

Whew! Glad it was just a spreadsheet typo! The 50's is a little low to keep the same dose.

 

Yes I know sorry about that we never changed it she was newly home from the hospital and I was late for work. The ER doctor was also having us do a sliding scale to dose and at first we were scared to do anything else till we got our bearings that day. She wanted us to do .5or .25 depending on preshot. So that 61 was with a couple of .5's in the depot.

 

That's a great idea to measure. I liked the Monojects because the zero line is thin not like the BD's and Ulticare. Even with a magnifying glass it's hard to see .25 or less on those with the thick lines.