sam-cat - dosing - opinions on vet advice?

Hi - me and Sam would appreciate it if people could give any advice with Sam's dose. His BG has come down - which is good - but now it's starting to go too low at times - not so good.

Vets are saying to give him 2 units morning and night and I can't give him that at night when his BG is low. Think it might be going too low and then swinging higher in the morning? Wondering if the morning dose is too high now - even though it feels 'safe' to give it him when his BG is higher? Feels like I am losing the consistency with dosing.

Thanks for any help.

 

I think 2 u is too much. It leaves you with a PS at the next cycle that's too low to shoot that same dose on. When BG numbers are erratic like this I'm a fan of lowering the dose a little and giving the same dose both AM and PM until BG has settled somewhat. This can help to pin down the "good dose" range and maybe then you can go back to dosing differently AM and PM. Right now it's clouding the picture - in my opinion. I'd try eyeballing 1.25 u AM and PM for several cycles. Are you using U40 syringes? If you are, you can buy U100 syringes and use them with this conversion chart to allow a much larger range of dose fractions:
http://www.felinediabetes.com/insulin-conversions.htm
You can also do your best to eyeball 1.25 u on the U40s.

 

I agree with Kris. You want two shootable preshots so that the insulin is consistently in his system.

 

I agree with Kris and Rachel
@TempestsMum Tara can probably give you some links to buy the syringes as she is also in UK.

 

Thanks fo the advice - he was 11.9 this morning and gave him 1.25. See how things go on that.
Totally agree that 2.0 was too much - he seems to be needing less now.
Tess and sam

 

Hello Tess, If you are in the UK?I can send you some u100 syringes if you want to try them? If you feel comfortable with them I can tell you where to get them online. Just message me your address and I will post some out to you.

 

Thanks Tempestsmum - that's very kind of you, I will message you my address.

Further confusion.

Vet phoned to say that I should keep him on the 2 units. That I am getting the higher BGs as I reduced the previous dose. I need to go back and look at his spreadsheet but I don't think that's quite right? He said not to drop his dose as he's not stable.

But I think that I tend to go with the 2 units being too much and I think in the short term it is less risky to reduce the dose, than to keep going at 2 and risk him going down too low? The worst that can happen is that if 1.25 is too little then his BG would become higher and we would have to increase the dose after a good few cycles.

The vet said that his BG will not increase after it has been too low unless it has been a very acute drop. I don't think that is the case??

Vet said I was safe to give him 2 units as long as his BG is 10 and over and as long as he's eating he will be fine. I don't feel comfortable giving him 2 units and going to work all day??? He does have lunch on a timer but it isn't the same as somebody being physically there.

Vet got a link to his spreadsheet so if they look they will be able to see I am not following their advice. But then I need to do what seems the best option for Sam. Nobody has a crystal ball so going with the safest option and taking it from there seems to be the best plan.

Would be greatful for any advice
Thanks for help so far!

 

I must vehemently disagree with your vet. The 2 u dose it too high, you're absolutely right that if 1.25 u is too low you can increase by a tiny amount (up to 1.5 u) if necessary. Trust your instincts on this. He's your kitty and your goal is first and foremost to keep him safe. So many people here have gone through the same confusion and anxiety because their vet's advice is at odds with what we suggest.

 

For what it's worth, I disagree with your vet. I think you should lower the AM dose a bit, so that your PM dose can be more consistent. I wouldn't worry about your vet seeing that you're ignoring his directions. Sam is your cat, and you need to keep him safe.

 

I am with Kris and Djamila

 

That certainly has not been the case with the majority of kitties here. A drop into lower than "usual" numbers can trigger counter-regulatory responses in the body and cause a "bounce" into higher numbers. On August 8 (corrected) Sam had a drop of 58% within 3 hours and may have dropped lower later in the cycle. The last thing anyone wants is for their kitty to drop into hypo ranges. Not all kitties show signs of a hypo right away and quite frankly a hypo is much more serious than some slightly higher numbers.

I agree with the other members on dropping the dosing in order to keep the AM and PM dosing more consistent.

 

Thank you all. I agree with what you are all saying. And I do think that if it doesn't work the dose can be increased whereas if he goes too low that could potentially be very dangerous for him.

Today he didn't touch his timer lunch. Despite it being food He has always liked he said that it was inedible - and guess what I have just bought more of it...
BG 8.6 tonight so no way would I be giving him 2 units.

I don't suppose that the vet will be hugely surprised I don't follow their advice. Think he could tell I was a little less than enthusiastic!!!

I do think that Sam has responded well on a consistent dose and we are not managing to be consistent on 2.0. So dose has to be lower.

How many cycles should I keep him on 1.25 before potentially increasing? Know slow and steady but don't know what that really equates to?

Really appreciate the advice. I don't blame vets as they can't know everythi g about every animal but not going to blindly follow what they say either.

Thanks
Tess

 

It's hard to say for sure until you've gathered some data. Slow and steady is definitely best.

 

Thanks - I suppose it will become clearer with further doses and testing. It will be good just to get back to a consistent dosing - even if he does need small increases.

 

If the 1.25u is too low, we'll probably be able to see that pretty quickly. Just keep posting and people can chime in with their thoughts.

 

Thanks will do.

 

I wasn't around, but glad that you aren't going to be giving 2 units! That's definitely too much.