trying to figure out rebound dosages

Thanks everyone for so much help that I have recieved. Georges blood sugar was as low as 46 and as high in the 500's many thought he was rebounding. So I gave him a few days without insulin. Just took his numbers and was 370. I gave him 5 units, what he has been on for a long time, and did well for a bit. Please tell me how to follow this now he is clean of hummilan and I am starting over again at 370.

I hate taking his blood, so so hard. Been trying some of the advice I was given, I got a tiny bit better at it...thanks Kim

 

Got no responses, just took his BS and is 127 now, that is with a 5 unit injection this am...what do I do now?

 

It's great that you learned to home test.

How did you arrive at giving 5 units? Have you given any thought to changing insulins? Have you put a spreadsheet together, so that others can follow the BG progress?

It seems to me without seeing all the numbers that a spreadsheet can provide, that 5 units could be too much insulin for this cat and the fact that you are using one of the shortest acting, harshest insulins - Humulin N is not the best choice.

I highly recommend that you visit the Insulin Support Forums and learn about the other three insulin choices - Lantus, Levimer or Prozinc. Any of those insulins will be better and easier to manage than N.

Read the stickies at the top of each section so that you can learn more about each insulin choice. If you were to ask me which do I recommend, I recommend Lantus or Levimer over prozinc. Mainly because both have been on the market longer than prozinc, there is an established protocol of use and a method to follow (Tilly's Protocol), where prozinc is still very new and doesn't have an established protocol.

Also, what kind of foods are you feeding your cat? dry? wet? low carb? This too is critical in the managing of diabetes.

Now, if you need help navigating to the sites here are the links:

How to create spreadsheet and link to your account

Lantus ISG

Levimer ISG

PZI/Prozinc ISG

Nutrition and Diet links

 

Hey Kim so glad you are here and that I found you again on here Glad you are going to get help..... LOL Kath :mrgreen:

 

Here is Kim's earlier post: viewtopic.php?f=28&t=17702

Kim, it seems like George is all over the place with bg levels. I agree with Hillary that he is getting an awful lot of insulin and a harsh insulin that is more difficult to regulate with. We would be better able to help you if you would post and give us the bg levels you have gotten over the past few days, with the amounts of insulin given.

Try to post something like this:

amps bg number amount of insulin given (amps is the morning bg level before insulin is given)
+5 bg number (this would be the number you get at + 5 hours after the morning shot - it could be +3 or +8, whatever time it is)
pmps bg number amount of insulin given (pmps is the evening bg level before insulin is given)

I really think you are flirting with disaster. He has had some really lows lately and you are still giving a lot of insulin. Give us some more data to work with so we can give you better advice. I am afraid he will crash before you get this straightened out.

 

Kim it is hard to get this down but once you get the numbers BG in here on his spread sheet . Things go so much better.So please one step at a time got to help your little one...So do as they say and they will be able to help you. They have helped me so much and Trey is doing so well So come on get on board girl LOL Kath :mrgreen:

 

But, if he is at 126 at your usual pm shot, don't shoot. You should have 200 as a no shoot number. If I were you, I would not give insulin tonight, but get your data up for the board and get some advice on dosage.

 

Hi Kim,

I understand testing is difficult at first. I've been testing Tandy twice daily for several months now and she still puts up a terrific fight and there is no comforting her afterward.

You said George is clear of hummilin, does that mean you have switched insulins? If so which one are you using now? I am usually hesitant to offer advise on dosing, but if you have changed insulins, remember always start off with a low dose. I have read many posts from others with far more experience advising to start off low dose such as 1/2 - 1 unit then slowly raise the dose until you fine the correct level George needs. This usually means doing an at home curve, but that will give you an accurate picture of how George's system is reacting to the dose.

Tandy's story: Hopefully this helps, I know it is a little backwards to the advise so many, but for about a month my vet was taking an active role in Tandy's home care. When Tandy first went on insulin she was prescribed 5 units 2x a day. I never even gave her the first dose the day I took her home because she went hypo on the dose she got at the vet. Talk about scary, I spent a very en-easy night on a chair and got next to no sleep. Since she wouldn't eat I had to force feed her with a syringe for almost two weeks until her appetite kicked in. With the vet practically holding my hand, she would call me for Tandy's BG numbers then tell me how much to give. Tandy's dose was cut to 2 1/2 units then to 1 unit and finally 1/2 unit. I did three separate curves on Tandy in the space of two weeks. I know that not everyone has access to a vet who so compassionate and is willing to take such a personal interest in the welfare of their clients after office hours are over. But if it had not been for her taking such an active role in Tandy's initial transition period I would have started with a much lower dose and worked my way up as so many others here have suggested. Tandy has been OTJ for a little over a month now. We will keep our fingers and paws crossed that George achieves the same result.

Best of Luck,
Terri

 

Let's see if this helps, Kim. I have put down what I think has happened. You can copy it and paste it in your posts with any corrections. It will help us get a picture of what is happening.

6/20 580 7 U Humulin
+6 46

6/21 amps 246 6 Units Humulin

6/22 pmps 50 no insulin given

6/26 370 5 Units humulin

6/27 +? 127

I know you are struggling to get bg numbers. But we need to see some kind of pattern.

 

Terri, what I meant was I skipped his shots for a few days to get him clear of rebounding. When I took it was 350ish I think, I gave him a five unit shot when I saw this. This morning I gave him a four unit shot and tonight when I took it his bg was 127, I did not give him his shot. I am learning from all of you. I was killing my poor cat before.

Sue I am just learning this is all so overwhelming, I feel guilty for what I have been doing. I will start a spread sheet, I will change his insulin, call the vet tomorrow to get something else. I did not know 200 was a no shot, thanks for the info and help.

Kath thank you for all your support and concern.

Hillary, I just kept giving George more insulin every week until I got his BG down in the first few weeks. I was not taking his BG regurlary, because it was so difficult.

I started him on fancy feast. I read the champion wet food label and saw no grain in it, I bought some of them. thanks everyone Kim

 

Kim what works with our Trey is 1/2 cup rice in a sox warm 20 seconds in microwave then hold on his ear for count to 30 Wrap :mrgreen: :YMSIGH: him in big towel can not get away so stays put while you prick his ear. Grab the metor and its done Don`t forget treats after Hope this helps LOL Kath

 

Sue 6/27 amps 4 units
no pmps bg 127

 

That all sounds good, Kim. A spreadsheet would be nice, but for now, you can use put the numbers you have in the format I gave you.

You aren't killing your cat. You have been doing a great job getting bg levels when it has been difficult.

Fancy Feast sounds good. That may be bringing his numbers down. It would be great if you could get on one of the longer lasting insulins.

For us to help, we have to know what has been happening, in terms of bg levels and insulin given.

The 127 12 hours after the shot with a short lasting insulin is indicative of too high a dose. Glad you aren't giving a shot tonight. But don't be surprised if in the morning, you have a high number. It can be rebound or the 12 hours without insulin. I would not give 4 units in the morning. Try to take a bg reading before you give insulin in the am and then come on asking for dosage help.

 

amps 243 how much do you think I should give him this am. Going to call the vet and get a new insulin this am

 

I gave him 2 1/2...do most of you use lancet by itself or with the pen?? I am off to work any feed back is greatly appreciated. You guys are saving Georges life. Kim

 

Considering how low he went yesterday, and no insulin last night, that is a pretty decent number. I would give one 1/2 unit this morning to be super safe, and check at +3 and +6 if possible. Since you are going to the vet and off N, it can be a token dose. And remember, he may be higher at the vet than at home because of stress from the car ride, the smells and noises. But, get more opinions - put N dose advice needed in your topic line. (Although you may get no takers - so few people here use N)

Have you done some reading on the other types of insulin? Lantus, Levemir and PZI are slower acting and longer lasting. All three are good insulins and cats have been regulated on them. Vetsulin has quality control problems and isn't being used anymore: http://www.fda.gov/AnimalVeterinary/new ... 188752.htm but some vets are still prescribing it. I think everyone here would urge you not to use it. You might go to the Insulin Support Group forum and print off the stickies on the tops of each of these insulin pages and take to your vet: viewforum.php?f=5

With all the low numbers you have had, I sure hope your vet will start on a low dose - .5 or 1 unit twice a day.

Good luck at the vet. It will be good to start over with the insulin now that you are hometesting.

Oops too late - saw you gave him 2.5 Will anyone be around to check on him today? If not, please put down some food so he can bring himself up if he goes too low.

 

We did use the lancet with the pen but just not working as good as free hand get blood easier. We do use the lancet holder but leave cover off our is free style came with the meter... Wish I could help more>>>> ;-) :mrgreen:

 

Kim where do you live I am in Canada PEI Just wondering ....Hope you leave him lots of food out ......LOL Kath

 

Sue, thank you....I am only going to call the vet for a new insulin. I am home now and will check. He just walked by me and looks good, but he does not show too many symptoms according to his numbers other than when his numbers where very high.

Kathy I live in northern NJ, thanks for such wonderful support...Kim

 

Glad you are home with your baby. Send :mrgreen: ;-) Angels to keep him company while your were gone now they will be there to watch and help you both Hugssssss LOL Kath

 

Where in NJ are you? I may be able to recommend a vet or two.

 

Thanks Kath

Hillary, I live in Ringwood, NJ

Georges BG is 197 tonight, should I give him 1 unit, because it will only rise in the am....thanks Kim

 

I find it hard waiting for someone to respond so put dose advice in where you have your heading trying to figureout Remove that and put his BG what hour+ and dose advice ..You will get help faster.What insulin are you using now Is he eating better Prayers and Angels and I lite a candle for him George will be ok just ask and they will help here ok chance your heading LOL Kath :mrgreen:

 

197 is a shootable number.

there is a member who is not far from Ringwood, she hasn't been on the board in a while, but if you need a vet recommendation, I can contact her and ask her to look here - her name is Virginia and Smokie.

 

Kim hope all is going good with you Prayers and Angels coming to your house LOL Kath ;-) :mrgreen: