? 3/10 | Zot | AMPS 98, +2 80, +4 70, +8 85 (Dosing Question)

ThisIsAllForZot

ThisIsAllForZot

Member
Yesterday's: 03/09 | Zot AMPS 153, +2 72, +4 77, +7 72, PMPS 82, Stall 1: 89, Stall 2 : 107 | Feline Diabetes Message Board - FDMB

Zot is loving the 100% canned pumpkin in his food today! Was a little iffy yesterday when offered with a snack. I think he's in love now, and it makes my life easier hehe.

The 100% coconut oil I believe is helping quite a bit to heal his ears up quick too from lots of tests.

Stocked up on more syringes, test strips, HC wet food, wanted MC but the shelves were basically empty. Spent quite a lot of time in the cat food aisle. I was trying to find a HC pate wet food, as Zot will only eat the gravy from anything that's not pate. He's quite picky when it comes to wet food I guess. Had to settle for a couple flaked FF and a HC friskies can!

Thank you so much for everyone who has assisted me so far in making decisions that I feel comfortable with, and are good for Zot. He is a thriving little sugar kitty right now :)

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bluesunshine said:
woah! It's been a bit since I looked at Zot's SS. Look at him go!!
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He's chugging along! :) How has Bell been doing lately? I mean, I see Bell's numbers, but I mean more so how is she feeling?
Zot has pretty noticeable changes in his personality from dropping 300 to greens/blues, and I love seeing him get the zoomies and feel good. I wonder if you experience the same thing?
 
Stephanie, He IS doing so well. I bet that baby is going to be in remission so soon. Then, you'll be able to put your savings toward that dental issue, and not feline diabetes, and then he's going to be so good!
 
Marielle said:
Stephanie, He IS doing so well. I bet that baby is going to be in remission so soon. Then, you'll be able to put your savings toward that dental issue, and not feline diabetes, and then he's going to be so good!
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Do you think so? I hope so! Yes, I'm really hoping to get his dental issue taken care of soon. If he does go into remission, I don't want the abscess and infection to come back and take that away from him potentially. <3
 
ThisIsAllForZot said:
Do you think so? I hope so! Yes, I'm really hoping to get his dental issue taken care of soon. If he does go into remission, I don't want the abscess and infection to come back and take that away from him potentially. <3
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I'm certainly not an expert, but he is responding so well to the insulin. I mean, the next step down is a drop of insulin. And, wait. He went below 90 today...and last night. And you're following SLGS. Do you have some dosing advice for his next shot???
 
START LOW, GO SLOW (SLGS)

The Start Low, Go Slow Method (SLGS) with Lantus, Levemir, or Biosimilars for Diabetic Cats has been adapted from the FDMB's original 5 Steps to Regulating Your Diabetic Cat. Adaptations were necessary to accommodate the action, nuances, and exceptions of the newer Lantus, Levemir, and their Biosimilars insulins.

Requisites when following the Start Low, Go Slow Method:
  • Learn the signs of and how to treat Hypoglycemia and prepare a Hypo Toolbox.
  • Test regularly for ketones and know about Diabetic Ketoacidosis (DKA).
  • Use a meter calibrated for humans, not a pet-specific meter. Reference numbers given are for measuring blood glucose with a human meter.
  • Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
  • Most kitties are easier to regulate when fed small meals throughout each cycle. Others adapt well to free feeding.

Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
 
Marielle said:
@Bandit's Mom, does Zot need a reduction??
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Marielle said:
I'm certainly not an expert, but he is responding so well to the insulin. I mean, the next step down is a drop of insulin. And, wait. He went below 90 today and last night. And you're following SLGS. Do you have some dosing advice for his next shot???
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Yes, I was confused about this, as he has already gotten a reduction every other day or the last 2-3 days in a row almost. I just wasn't sure if it could reduce down any lower. I meant to ask today, but I spaced it.
 
ThisIsAllForZot said:
Yes, I was confused about this, as he has already gotten a reduction every other day or the last 2-3 days in a row almost. I just wasn't sure if it could reduce down any lower. I meant to ask today, but I spaced it.
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Let's get some advice from an expert on this. Go ahead and throw up your "?" in the title. I tagged Bhooma because I just saw her on the forum, but someone else might weigh in if she doesn't get around to you before your PM shot.
 
With SLGS, every drop below 90 is a reduction. Even back-to-back, unlike TR. The next dose would be a drop dose.

To measure a drop dose, push the plunger of the empty syringe in fully, keep it pressed and insert in the pen. Let go of the pressure on the plunger and it will draw a drop. When you insert the needle into Zot, push the plunger and count to ten if he will let you.

(I wonder if he had diabetes at all or whether the abscess was elevating his BG.)
 
Marielle said:
Let's get some advice from an expert on this. Go ahead and throw up your "?" in the title. I tagged Bhooma because I just saw her on the forum, but someone else might weigh in if she doesn't get around to you before your PM shot.
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Added the "?" to my title.

Bandit's Mom said:
With SLGS, every drop below 90 is a reduction. Even back-to-back, unlike TR. The next dose would be a drop dose.

To measure a drop dose, push the plunger of the empty syringe in fully, keep it pressed and insert in the pen. Let go of the pressure on the plunger and it will draw a drop. When you insert the needle into Zot, push the plunger and count to ten if he will let you.

(I wonder if he had diabetes at all or whether the abscess was elevating his BG.)
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I see. So if it calls for a reduction again, what then?

Yeah, I am unsure as to what's going on as well. I've had a lot of mixed opinions. He did have a BG reading of more than 500 after a Vet visit in October.
The infection cleared up somewhere between the 20th and 25th of last month. I don't know how long it would take for BG levels to elevate properly again after an infection has cleared.
He does typically have a some sort of stress reaction at the vet, which probably has caused at least some elevation between the 500 and 300 reading they got. The 300 reading was when they diagnosed him as a diabetic, in combination with the fact he was losing weight, I think 2-3lbs total from October to February, despite eating the same.

My Vet is unsure as well.
 
Also @Sienne and Gabby (GA) , If you don't mind: I know you mentioned him being in diabetic numbers still; obviously, I will continue with insulin just to make sure and be careful. I am just curious about your opinion as well.

I feel as though he either responds really well to insulin, or there's something else going on? Maybe he's just real lucky the last few days? I always value your opinion as well on things like this. So many people here are just chalked full of knowledge.
 
Marielle said:
Do you use vials or pens?
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Vials right now.

Bandit's Mom said:
The other option is that you follow TR and hold the drop dose (or even 0.10U) till he earns a reduction by staying a week in greens or dropping below 50.



Was a fructosamine test done?
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That may be necessary.

He just had Glucose testing, hasn't had a bloodworkup since October, and I am unsure if that was included.
Finances are a problem at the moment, but I can call and talk about pricing if it is necessary for him in this situation right now.
 
ThisIsAllForZot said:
That may be necessary.

He just had Glucose testing, hasn't had a bloodworkup since October, and I am unsure if that was included.
Finances are a problem at the moment, but I can call and talk about pricing if it is necessary for him in this situation right now.
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No no. Not necessary at all. I was wondering whether it was done at the time of diagnosis to rule out BG elevation due to stress or any infection/inflammation/other health issues.
 
ThisIsAllForZot said:
He's chugging along! :) How has Bell been doing lately? I mean, I see Bell's numbers, but I mean more so how is she feeling?
Zot has pretty noticeable changes in his personality from dropping 300 to greens/blues, and I love seeing him get the zoomies and feel good. I wonder if you experience the same thing?
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She seems to get sleepy and a bit lethargic when she is bouncing. Sometimes the large swings seem to make her feel yucky. The biggest difference I notice when she is in the low greens is she is super duper hungry. It is so good to hear that Zot is feeling good at the lower numbers!!
 
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