upped too much?

Sorry, I haven't been updating my google chart, but I do keep a notebook of all dosage times, food given, circumstances,(sinus headaches in bad weather, very hungry, etc)

Mouse had HI reading on the meter, have been giving her 1.25 units twice a day. I panicked, and gave her 2.25 this morning when I had the high readings.
Is this going to cause a crash? What should I look out for?

I gave her the shot at 8 am, when I get unusual numbers, I do two readings. This morning was HI/449. I checked her at 11:30 = 412. Not really a big drop, so far, so good.
I gave her wet food, small amount, with extra water. I usually add water, about 3TB for each 3oz serving, but for today, I'm giving more.
She has an appetite, so that's good. I only give a TB at a time when it isn't shot time. My cats, (siblings), can't handle more than 3oz at a time or they get indigestion. So, frequent, small feedings are the norm - no free range eating for them.

I did wrong by upping the dosage too much. Never got a HI before.
Should the dosage tonight be 1.75 if her numbers are back to her 200's? She surfs around 200's, bounces, but never into the 500s!

Added at 12:45....her reading was 351. Gave her another TB of low carb food with extra water. I had to prod her with a little fortiflora on the food, since watery food wasn't acceptable this time.

 

You should only increase .25 when increasing

 

I know the panic when you see those numbers, but basal insulins just don’t work that way so it doesn’t help with a lot and it really messes with the depot. I would strongly encourage you to monitor closely the next few cycles, you gave her almost a 100% increase, she could bottom out now or later, there’s just no telling. What were her nadirs like on the 1.25 dose? Any chance you could put in the values to your SS for at least the last couple of days so we can have a visual to see how she’s been prior to this?

As far as what to shoot tonight, there is no telling just yet, I would post closer to shot time, get a +10 and +11 if you can so that you can see if the number is rising or falling. It will have to be a game time decision. Does she have any history of ketones? Is she acting okay recently? Anything unusual that you’ve noticed?

On 4/16, my cat started out at almost 500 and her regular dose took her into the 50s. More basal insulin on demand won’t fix those one off high preshots, but if you fill in your data from the past few days we might have a better idea what is going on and can offer suggestions.

 

I posted numbers from 4/13/18 to today.
There was a 5:30 reading because she woke me up, purring, cuddling. She usually doesn't do that unless there's a drop in her numbers - it makes her hungry, so she wakes me up. I was shocked to see the numbers go in the opposite direction.

I never tested for ketones....I tried various box fillers, but she wouldn't cooperate.

She's acting normal today, appetite normal, normal box habits, (both cats pee a lot...big cats 17 & 14 pounds, Mouse being the 14 pounder)
Her nadirs started out late since I've been monitoring, but she has shifted to even later, almost overlapping the preshot. I give up trying to catch her nadir at night.

 

Thanks for filling those in, it really helps to see it in that format. Her +9 being higher than her AMPS makes me think you shot a falling number, whatever sent her up there in the first place, she was working it out and on her way down. Looks like everything is going okay so far this cycle, seems like she is on the rise again, but it only means you might be seeing the effect in tonight’s cycle or even tomorrow’s. She could break this high number and come down quickly and with little notice, so it’s great that you are keeping close tabs on her.

I’m glad to hear she is acting okay. I know it can be tricky to get urine ketones, cats being cat like and all. I hope if it’s not possible for you to test her urine for ketones that you would consider getting a blood ketone meter, it works just the same as a glucose monitor, unfortunately the strips are expensive. It is important though, you are going through the trouble to test her BGs (which is awesome) but ketone testing is very important too. You may be lucky that your cat never has ketones, but if she ever does, you will be glad you monitor it at home and can take precautions instead of waiting for an emergency situation that is extremely expensive to treat and doesn’t always end well, even with treatment.

I wouldn’t say her nadirs are late, I’d say they are all over the place, it’s no wonder you can’t find them at night. She is not regulated and spending almost all of her time above renal threshold, it can’t feel good and it’s damaging to her organs, including her heart and kidneys. She’s not getting enough insulin right now (speaking of the 1.25 not the panic dose from this morning). You should be able to get much better regulation with TR than you are getting. Maybe you can post more often and try to work some things out with the help of people here so Mouse can be in nicer numbers? I’m sure that would be a relief to you both.

I’ll check back around your +11 and see how it’s going. Glad it didn’t turn out to be a scary day, hope that continues to be the case.

 

What source/name of meter do you recommend? I saw one made by Abbot, no wonder you said it could be pricey, same company as Alphatrak! I'll get one, it's worth it.

Just tested at 5:30 = 297. She came into my room and begged for food. She usually does that when she's headed downwards. The begging turns into demanding as time goes on.

I've been trying to get her out of the high 200's for a long time now. If she goes lower, she bounces high, surfs, goes back down, starts again. No matter what the dosage, she seems to want to be in that 200s bracket. Sometimes switching foods brought her numbers to a good spot, but then, her body adjusted to it, and back go the numbers in the 200s.
I even have fooled her into thinking she's getting dry food by freeze drying fancy feast pate, and chopping it up. This is another reason why I put extra water into her wet food, so the freeze dried food doesn't do harm. The things we do for our pets......

 

I think there are only 2 meters, the one you found and this one that ADW currently has a special on. The strips are experience regardless of which one you choose, but you’re not testing for ketones as often as you would test BGs either so it’s not too bad.

https://www.adwdiabetes.com/product...MI__fY5e_O2gIVyIWzCh0apAK9EAQYAyABEgKixvD_BwE

Glad you know her patterns, I’d say between the begging for food and her number dropping again, she could be up to some funny business.

What you are describing is glucose toxicity. Mouse has decided those numbers are normal for her now and she’s going to be stubborn about changing them..but it can be done! With some guidance on the board, you’d basically need to keep on top of her dose and increase it every time it is safe to do so until you break it, get ahead of it, get her into lower numbers and keep her there.

You’re in good company regarding the things you do for your cat, I think most of us can relate, probably to the point of embarrassment.

 

question....I see all the time, people say, "high dose of 6", etc. Is that referring to the TOTAL for the day, or for each dose?

 

High dose of 6 in regard to what?

I think one of the issues with why Mouse's dose isn't going lower than 200 may be you are holding doses for too long. If numbers aren't where you want them, the longest you hold a dose is a week if you're following SLGS. If you're following TR and the kitty isn't in normal range numbers, you increase every 3 days if nadirs are mostly above 200 or 5 days if you're seeing mostly greens and blues.

 

I've seen remarks, where someone says their cat has high dosage, and they toss out a number, say, 6. I never know if they mean 6 units a day, or 6 units each shot time

 

They are referencing per shot, usually, so 6 units twice a day or 12 units daily.

 

289 at 7pm
She's getting hungry, which is normal. Mealtime is at 8pm.
Go back to 1.25 units, or something else?

Ok, thanks

It's shot time....297.....what number of units should I go for everyone?

 

I think 1.25 so long as you can continue to monitor her.

 

I'll certainly monitor her as long as I'm awake....if she should go low at bedtime, that's a different story.
Thanks!

 

As long as you can keep her safe, I would leave out food for her when you have to go to sleep just in case she drops later in the cycle. Hopefully you’ll have a pretty good idea of what she plans to do by then.

 

I always worry about her dropping during the night....there has been evidence of that happening in the past.
If her numbers aren't showing a trend downwards, I go to bed and I leave the freeze dried food (fancy feast turkey & giblets pate), in a food dispenser, goes off at 1,3,5am. If she gets voraciously hungry, a sign of low numbers, she grabs all the food. If normal, she waits for the next cycle.

 

That sounds like a great plan. I’m glad you have an auto feeder, it gives some peace of mind when you’re out or sleeping and it makes it easier to give frequent small meals. We have one too.

 

Interested to see where Mouse is at for AMPS, hopeful for something in a nice blue or yellow.

 

You got it! 278!

 

Yay! That’s a little nicer. I think tomorrow morning you should increase 1.5 units so long as you can get a few tests in the cycle. Let’s see if we can’t banish this glucose toxicity nonsense.

 

tested at noon = 279!
Should I start a new thread, for the glucose toxicity? I'm going to need advice as I go along, to get it right.

By a "few tests", more than one in between preshot times? How many? I'm willing to do what it takes.
Mouse is extrememly cooperative, even with callous scarring on her ears forming. I have a pad for her to jump on for testing, which she does when I enter the room. She gets into positon, purrs, puts her head up for testing. She insists on a kiss on the head when done, and of course, a snack as another reward. Does it get any better than that?

 

I’m glad she’s so relaxed about it all, Asia is too, having a patient patient makes this FD stuff a little easier for sure.

What we like to do here is create a new thread (we call them condos) for each day. Yours today would say “4/23 Mouse AMPS 278, +4 279”

You can edit the title as needed throughout the day to show your BGs at a glance, and also alert others that you have a question by turning on the ? icon in your title as well as a brief summary, something like this:

“4/23 Mouse AMPS 278, +4 279 Help with glucose toxicity”

Then each new day, you copy and paste the link from your previous day’s condo and put the link in your condo before you start typing that day’s post. That way, it’s easier for those trying to help to go through your history, also, it’s easy for you to go back and review advice given to you or things you wanted to revisit.

There’s no magic number of tests, we like to suggest preshots and at least one mid cycle test as a starting point. How much you test really depends on knowing your cat and her patterns, and what numbers you are dealing with that cycle. So if Mouse had an AMPS of 98, you might want to test more that day to make sure she doesn’t go too low. Get a test at +1 or +2 (wherever her insulin typically onsets) will give you a preview of perhaps what is to come. If the onset value is near or less than the preshot value, we say it’s likely to be an active cycles (a cycle you need to pay more attention to). If it’s a day where she is staying high all day, you might just get a test around her nadir and that’s it. If you know she has a pattern to drop fast at +4, you might get a +3 or a +3.5 so you could slow her down with food.

You’ve done a great job with testing so far, for tomorrow if you are increasing the dose, maybe try a +2 and then a couple more somewhere in the cycle. If for some reason she responds dramatically and drops to a low blue or a high green, you might need to test more. Let Mouse and the numbers guide you.

 

I just tested for Ketones with my new meter that I ordered from ADW the day you recommended it - thanks- My hands were shaking so much while testing that I wasted two strips! Held my breath the whole time also. She's had such high numbers, that I almost expected to be dialing the vet when I was done
It was:
0.1
I didn't realize that it takes a larger blood drop than for glucose & my Relion meter. I'll be prepared next time.

 

Yay! That’s negative. Yes, it does take a larger drop of blood, that’s probably why people use it as a ketone meter exclusively instead of using it for glucose and ketones.