? Should i increase dose for am, please advise

Discussion in 'Feline Health - (The Main Forum)' started by mary hornbeck, Dec 17, 2017.

  1. mary hornbeck

    mary hornbeck Member

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    Sep 22, 2017
    he everyone, I am sorry for this late post. I did a 10p BG reading tonight and it was 81 so I gave him 1/2/can of fancy at 6p it was 350, please refer to SS. I am wondering if he will go lower by his next BG read about 6a, please advise for am
     
  2. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Those numbers
    81
    97
    151
    are pretty much fine. He could have gone lower, so it was good to give him the food. I dose Leo a little less in the evening because he doesn't eat much after PMPS +4hrs.

    I would probably give him 2U in the morning. Especially if he has a good appetite and is eating well during the day. You might consider the reduced dose at night, like I'm doing.
     
  3. JanetNJ

    JanetNJ Well-Known Member

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    Perfect numbers last night.
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    If you're am bg is over 320 stick with 2 units. If it's under (like 280-320) then reduce it slightly to 1.75. 250-280 try 1.5
     
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  5. mary hornbeck

    mary hornbeck Member

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    Hi janet- marmalades BG per SS was 279, should I try 1.5?
     
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  6. JanetNJ

    JanetNJ Well-Known Member

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    Yes! Great preshot! Keep it up, marmalade!
     
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  7. JanetNJ

    JanetNJ Well-Known Member

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    Make sure to test around +4 to make sure it's not too low
     
  8. mary hornbeck

    mary hornbeck Member

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    K. Thank u, see u around 10a
     
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  9. JanetNJ

    JanetNJ Well-Known Member

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    Why did you only do 1.5 at pm? That should have been 1.75
     
  10. mary hornbeck

    mary hornbeck Member

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    I was going by the numbers that u posted the other day, I misread, now what should I do since I screwed it up. That’s what happens when I post at 6 am and am not really awake. How do us think this will affect his AMPS the next morning? Hopefully I won’t have a bounce
     
    Last edited: Dec 19, 2017
  11. mary hornbeck

    mary hornbeck Member

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    The more I post numbers the more I get confused
     
  12. JanetNJ

    JanetNJ Well-Known Member

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    I think you are misunderstanding what a bounce is. A bounce is when a cat goes too low and releases stored glucose causing the next preshot to be high.

    It's not screwed up, just may stay a little higher this cycle. No biggie. Next time its 280-320 try 1.75.
     
  13. mary hornbeck

    mary hornbeck Member

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    Imgave him the 1.5 units at 6, how can I correct this to accommodate for the 1.75/units? Or is it to late?
    janet I’m so sorry, should I give him any additional insulin given number I just posted
     
  14. mary hornbeck

    mary hornbeck Member

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    When u say cycle; you mean for a 24 hour period?
     
  15. mary hornbeck

    mary hornbeck Member

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    If it’s okay, can u be on the look out for me in the am, I just want to make sure I am dosing correctly. I know that I am being repetitive but that’s one of my worst qualities
     
  16. mary hornbeck

    mary hornbeck Member

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    So if his bg requires a different dose age in the am I should still ge by the number guidelines that were previously posted, how does that work?
     
  17. mary hornbeck

    mary hornbeck Member

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    I guess what I am asking is that is it common to administer different units in the am and pm. For example an am may be 3 units and a pm maybe 2 units, does situations like that happen
     
  18. JeffJ

    JeffJ Well-Known Member

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    Here is a summary of Janet's recommended dosing. Corrections welcome. I agree with the recommendations.
    over 320 - 2 units
    280-320 - 1.75
    250-280 - 1.5
    adding
    under 200 - no dose

    If BG = 197, that is close enough. A single kibble would probably take Marmalade up to 220.
     
  19. Critter Mom

    Critter Mom Well-Known Member

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    If you've given a smaller than normal dose then you need to wait until the next regular dose time before giving any more insulin.

    The same rule goes if you mess up the injection - a 'fur shot' as they're called here. You wait until the next regular dose time to give insulin again because there's no way of knowing how much insulin did/didn't get into the kitty.


    Mogs
    .
     
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  20. JeffJ

    JeffJ Well-Known Member

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    Yes, some people provide different AM and PM dosages. Leo eats almost nothing after 9pm. His daily doses are:
    AM - 4.5 units, sometimes 5.0 units
    PM - 2.5 to 3.0 units

    And we sometimes get a BG = 102 for AMPS. But it cranks up high after his first breakfast.
     
  21. JanetNJ

    JanetNJ Well-Known Member

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    A cycle is 12 hours
     
  22. JanetNJ

    JanetNJ Well-Known Member

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    Don't shoot more. It's really not a huge difference.
     
  23. mary hornbeck

    mary hornbeck Member

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    tha
    nk u so much Jeff, this is easier for me to read as much as janet posted it for me.
     
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  24. JanetNJ

    JanetNJ Well-Known Member

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    Let's see what the numbers so tomorrow. I may revise that scale to increase on some of those numbers.
     
  25. mary hornbeck

    mary hornbeck Member

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    what is a good time to post given marmalade eats at 6a? I tend to,panick when stalling until I hear from someone
     
  26. mary hornbeck

    mary hornbeck Member

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    Did my mistake prompt a revision
     
  27. mary hornbeck

    mary hornbeck Member

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    Waiting to hear from someone is really hard for me as I am not the type of person who works well kind being in limbo, so I apologize if I sound impatient. I am not as nervous when I have a “game plan” in advance, if that’s possible with nature of diabetes
     
    Last edited: Dec 19, 2017
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  28. mary hornbeck

    mary hornbeck Member

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    i never knew that doseage could be different, my vet only made any insulin changes at .5 for atnleast a week, now I see where I made my mistake,
     
  29. JeffJ

    JeffJ Well-Known Member

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    "Waiting to hear from someone is really hard"
    Ha ha. Don't panic. Really we are trying to get Marmalade regulated. It will be a week or so. Even with accidental low doses, you are doing good. The dose wasn't that low.

    There are 2 dangers in diabetes:
    - hypo, under 50, which can kill. I assume you read about it by now. If not, there is hypo info in the lantus subforum
    - hyper (high), not as dangerous daily

    With insulin dosing we are trying to bring the BG out of the high numbers. Over time, high BG causes glucose toxicity and other bad stuff. But a few high BG numbers in a one month period, doesn't have much effect on the cat (or human). Well, in humans it actually seems to make them friggin cranky. At least with the dude I used to know.

    One thing you can do in your spare time is read some of the FAQs. I read them multiple times when I was getting started. Maybe there are some super smart people that just memorize them the first time thru.
    .
     
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  30. mary hornbeck

    mary hornbeck Member

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    just to be on the same page as everyone the “rule of thumb”would be to give insulin per these numbers no matter what
     
  31. JeffJ

    JeffJ Well-Known Member

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    For me, the AM posting is irrelevant. I'm on CST and not fully cognitive until 9:30am. :D
    Janet will be up and at 'em by then.
     
  32. mary hornbeck

    mary hornbeck Member

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    I am definately not a number person which bites me in the butt, all the time
     
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  33. JeffJ

    JeffJ Well-Known Member

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    Those numbers are for your cat only. Each cat has their own insulin needs. Janet has customized the dose for the current period.

    Example: Leo gets 3.0 to 5.0 Units to keep him regulated. His insulin demand is different.
     
  34. mary hornbeck

    mary hornbeck Member

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    Sep 22, 2017
    I will post by 6 am so would my window still be half an hour after AMPS or PM
    PS stand to give insulin while waiting to hear from someone? How long does it take to hear back from someone? Should I start a new thread when I post tomorrow am?
     
  35. JeffJ

    JeffJ Well-Known Member

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    You can just dose based on the recommended sliding scale that Janet provided. Typical protocol for daily routines is:
    - test BG
    - dose
    - food immediately

    I usually dose Leo after he starts chowing into his breakfast or dinner.
     
  36. mary hornbeck

    mary hornbeck Member

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    That’s pretty much what I do too
     
  37. mary hornbeck

    mary hornbeck Member

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    If marmalade is really Hungary in the am he won’t let me dose after testing his BG, I have to shoot while he is eating​
     
  38. JeffJ

    JeffJ Well-Known Member

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    Sounds good. That is a good method to test and dose.
     
  39. mary hornbeck

    mary hornbeck Member

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    I am so hoping that he is still in the yellow tomorrow am, now I’m worried that he will bottom out by the am
     
  40. JeffJ

    JeffJ Well-Known Member

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    With the lower dose you provided (1.5U), he will likely be fine.
     
  41. mary hornbeck

    mary hornbeck Member

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    Marmalades BG this morning was at 307, go to 1.75 units?
     
    Last edited: Dec 20, 2017
  42. JanetNJ

    JanetNJ Well-Known Member

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    Yes. If it's not enough then going forward we can do 2 at this preshot. Let's see what happens.
     
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  43. mary hornbeck

    mary hornbeck Member

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    K, thank u. I will test after work around 12/1
     
  44. Juliet

    Juliet Well-Known Member

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    I am the same. Don’t worry. Someone will respond.
     
  45. JanetNJ

    JanetNJ Well-Known Member

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    No we just need to see what her numbers are like. We don't have data at how she responds aThe this preshot. Even for myself I'm constantly reevauating what dose to give my cat based on how she responds the previous few days.
     
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  46. mary hornbeck

    mary hornbeck Member

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    Should I continue to test as much as I have been or is it okay to test at the AMPS and PMPS intervals
     
  47. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The amount of testing can vary depending on where you are in trying figure out a dose. When you try a new dose it's a good idea to do PS of course but also a mid cycle in the day and a bedtime test at night. If you're seeing some nicer numbers with these you might want to do a curve at that dose on a day off to get a fuller picture.
     
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  48. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Hi Mary,
    mid cycle data is very useful to assess the dose effectiveness. If possible it is best to test as you have.
     
  49. Chris & China

    Chris & China Well-Known Member

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    Just adding my 2 cents.....we usually Test/Feed/Shoot

    You don't want to shoot and then find out that kitty won't eat!!

    With Vetsulin, we usually test (to make sure they're high enough for insulin), Feed (to make sure they eat a normal amount), wait 15-20 minutes and Shoot.

    Since Vetsulin can hit "hard and fast", it's important that there's food on board.

    With the longer acting, gentler insulins, it's not as important that they eat a certain amount....the "onset of action" isn't for 2-3 hours so you have time to get the cat to eat more, but with Vetsulin, they really need to eat a pretty normal sized meal first.
     
  50. mary hornbeck

    mary hornbeck Member

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    Hi , do I still have window to give insulin at 7 instead of 6, I had to run out and get test strips, do I still have my window, please help panicking
     
  51. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    +1 hour is fine. Go ahead. I do not dose if it is +1.5 or more. And at that point, I dose just a little less. You could do a smaller dose like 1.25 to feel safer.
     
  52. JeffJ

    JeffJ Well-Known Member

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    I have responded to a lot of threads this week. You can get very inexpensive test strips online. I think the Relion strips are cheap already. Just saying.
     
  53. Chris & China

    Chris & China Well-Known Member

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    Yes, you're fine....Vetsulin has a little more flexibility with dose times
     
  54. mary hornbeck

    mary hornbeck Member

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    Yes they are very affordable for unfortunately Walmart is the last place I wanted to be tonight
     
  55. mary hornbeck

    mary hornbeck Member

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    Could I do a curve starting at 6a through 6p? It’s a thought. Maybe after the holidays when things calm down
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    When you decide to do a curve you test BG at AM as normal and then every 2 hours until the usual PM pre shot. When I do/did them, I'd feed lunch right after one of the curve tests so there would be a gap of two hours with no food before the next curve test.
     
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  57. mary hornbeck

    mary hornbeck Member

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    Could u set up the times given marmalade eats at 6a and 6p, thank u
     
    Last edited: Dec 20, 2017
  58. mary hornbeck

    mary hornbeck Member

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    Jeff, with marmalade insulin being an hour later I just noticed that I,put it in the +1 column of PMPS. Should I change it and put in the regular PMPS column?
     
  59. JeffJ

    JeffJ Well-Known Member

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    That is up to you. I usually put notes and deviations in the right column, like you have been doing.

    281 is a good reading. I hope Marmalade is starting to feel better with this insulin therapy.
     
  60. mary hornbeck

    mary hornbeck Member

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    Yes I think he is feeling better but he is still scratching his ear a little bit.overall he is more active and his coat even feels softer. I am very glad that I decided to take the plunge. I’ll just make s notation. I am so tired and am in desperate need of down time, thank god thevweekend is almost here
     
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  61. mary hornbeck

    mary hornbeck Member

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    BG 247 this morning, would it be to give 1.75 units, per dosing scale?
     
    Last edited: Dec 22, 2017
  62. JanetNJ

    JanetNJ Well-Known Member

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    If you follow the dosing scale that would be a 1.5. But, if you will be around to test you could try 1.75.
     
  63. mary hornbeck

    mary hornbeck Member

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    PMPS BG 228, would that be 1 unit or the same at 1.5?
     
  64. JanetNJ

    JanetNJ Well-Known Member

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    Let's cut the difference and try 1.25? Can you get a test at +4
     
  65. JanetNJ

    JanetNJ Well-Known Member

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    Loving these numbers today.
     
  66. mary hornbeck

    mary hornbeck Member

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    Hi janet, I was thinking 1.25 also. I am also loving,these numbers, maybe we can get marmalade into remission eventually that is. I can defiantly do a +4 tonight. Marmalade is still scratching occasionally so I’ve decided to cut out the fish out and stuck with mainly chicken and beef classics fancy feast.
    * I also bought some friskies pates tonight, would I be going backwards if I wanted to try it for a day to see if the scratching stops, I welcome any thoughts
     
  67. JanetNJ

    JanetNJ Well-Known Member

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    Try it
     
  68. mary hornbeck

    mary hornbeck Member

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    Just did BG @ 10 was 214
     
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  69. JanetNJ

    JanetNJ Well-Known Member

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    Not bad. Next time its over 200 let's stuck to 1.5. I don't think the 1.25 was quite enough.
     
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  70. mary hornbeck

    mary hornbeck Member

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    Hi folks:
    I need some direction because my daily routine has changed today and I will be working at marmalades normal meal time which is 6 pm. I know I have asked this before but wanted to what is best for him. I have two main questions:
    * so fat today marmalade has had 2 3oz. Cans of fancy feast. One at 6 a and 1 at 3p.
    * should I get another reading on him just before I leave at 3?
    * should I double up on his food when I get home around 10 and do insulin then per janet’s sliding scale? I’m not sure my daughter who is 13 can get a reading on him.
    * should I have my daughter feed him at 6, then when I get home around 10 I can give him another can of food and do his insulin?

    * SS just updated
     
    Last edited: Dec 23, 2017
  71. mary hornbeck

    mary hornbeck Member

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    Janet can you please post marmalades sliding scale again, I will get confused. Thank y. You have 250-280 1.5 units. Thank you again
     
  72. JanetNJ

    JanetNJ Well-Known Member

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    Yes I know, but I think when it's 200-280 lets keep it at 1.5
     
  73. JanetNJ

    JanetNJ Well-Known Member

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    so the insulin will be four hours late tonight? are you going to adjust it back gradually over the next few days? I would let her feed him at 6 if he's hungry.
     
  74. mary hornbeck

    mary hornbeck Member

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    Yes insulin will be 4 hours late. I don’t think that my daughter would be able to get a reading on him at his 6p feeding time
     
  75. mary hornbeck

    mary hornbeck Member

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    How should I adjust it back over the next couple of days? Should I just skip his 6p dose tonight permhis latest number on SS?
     
  76. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Four hours is a big change to compensate for time wise. Skipping the evening dose is simplest.
     
  77. mary hornbeck

    mary hornbeck Member

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    off to work, I’ll post when I get home. I’ll just skip the 6insulin and feed him when I get home.
    k
     
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  78. JanetNJ

    JanetNJ Well-Known Member

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    I agree, I'd just skip with it THAT far off.
     
  79. mary hornbeck

    mary hornbeck Member

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    Janet. Ugh to my surprise the missed dose of insulin this past Saturday only affected his BG this morning, Sunday, a little bit. I was almost in the yellow this morning. Oops was in the yellow (AMPS) and purple in the evening at his PMPS. Not bad
     
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  80. mary hornbeck

    mary hornbeck Member

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    oh man, just realized that I as supposed to give marmalade 2 units at his
    PMPS, how will the morning numbers be affected by this
     
  81. JeffJ

    JeffJ Well-Known Member

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    Vetsulin does not have a residual effect like the other insulins (Lantus, Levemir, Prozinc). Maybe the BG will be a bit high.

    It might be a good idea to jot down the current sliding dose "chart". When I had Theresa doing dosing, we had written instructions posted next to the insulin supplies.
    .
     
  82. mary hornbeck

    mary hornbeck Member

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    After looking at janet’s scale 320 and up is 2 units, I am good. He was just under that insulin doseage
     
  83. Critter Mom

    Critter Mom Well-Known Member

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    Occasionally one can see evidence of some carryover of Vetsulin effect into the next cycle. (It can be quite subtle.)


    Mogs
    .
     
  84. mary hornbeck

    mary hornbeck Member

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    Do u think by looking at his SS he could possible go into remission
     
  85. JeffJ

    JeffJ Well-Known Member

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    The 300's on the AMPS and PMPS are pretty high. I don't have the remission definition. But a cat should be completely under their renal threshold, 100% of the time. For Leo, his renal threshold is 180-200. Over that threshold, he gets excess glucose in his blood that gets filtered out by the kidneys. Under that threshold the external symptoms are more obvious - a lot less water ingested and normal amounts of urine.
     
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