7/29 Toeby AMBG 140 , +3 = 140, +6 = 196, PMPS 178, gave 0.25 units, +3 = 43. +4=50

Yesterday's thread: https://www.felinediabetes.com/FDMB...-insulin-4-137-pmbg-113-no-shot-3-128.232789/

Toeby's BG this morning was 140
I will not be giving him insulin and will try for a +3 hr test

 

Sorry to ask what you've probably already posted...why no insulin? 140 is high enough to give comfortably. Is there something else going on with Toeby?

 

Hi Sue,
I've been following the SLGS guidelines which suggest that below 150, you do not give insulin.
The last time I gave him insulin on Sunday July 26th a tiny bit of insulin brought him down to normal levels.

There is nothing else going on with him that I am aware of, or that the vet found when I took him in a month ago with symptoms that did not suggest diabetes to me (throwing up, diarrhea, and vocalizing). He was diagnosed as "pre-diabetic" or that we caught his diabetes "very early" (the vet's description).

I'm going to be perfectly honest here, I really don't understand the science of this, but I take it the "start low, go slow" guidelines are to give his body a chance to adapt to diet changes and any effect the insulin shots may have had on his pancreas?
Any input is welcome.
Laura

 

I just wanted to add to the post above that he has dropped below 50 on me on 3 different days, and more likely 4 days (the first time he went low I used outdated strips I had on hand).
So, I think his body really responds to the insulin - I'm not sure if I've found a "comfortable" place yet...

 

+3.5 hours he was still 140

I gave them some fresh-picked catnip and he threw up a leaf piece, but I am attaching a picture taken right after this below.
He had just said hello to the mailman through the picture window, and has his tail in the air, bright-eyed.
I mean, he looks like he's feeling okay?
By all means, if he should be getting insulin, he'll get it.

 

It looks like he needs insulin tonight based on his +6 test... he's acting like he's not feeling great again, we're a little worried about him.
I supposed if his blood sugar levels are rising, it would make him feel sick?

 

@Chris & China (GA) just wondering if you are around, as we talked yesterday?

I have emailed his spreadsheet off to the vet clinic - the vet who diagnosed him is on vacation but another one is going to look at it....
He clearly is not feeling well this afternoon, but it looks like his blood sugars are up.
I'll likely have to give him insulin tonight, I guess 0.25 units would be the way to go?
The vet may call me back today, or she may not... who knows... and who knows if she will agree with what I am doing...

 

Yeah, looks like he needs a little something. I think .25 is a good place to start

 

PMPS 178, which was down from +6 hours, but he didn't eat this afternoon, he slept
Gave him a lean quarter unit
Vet has not called as of PMPS time.

 

I see...that makes sense - so it would be very helpful if you'd put that on your SS. I should have put it all together this morning - it's in your signature - but it was early...and I looked at the SS. He does look like he's feeling well but I have to say, you can't judge blood sugar levels from a cats appearance unless they're really in trouble - and by then it would be nearly too late - and most likely would require an emergency trip to the vet. He does seem to be very sensitive to the insulin and it looks like Chris has given you some good advice for starting with a very small dose.

You may want to investigate using calipers since they're a lifesaver when it comes to measure small doses consistently. These are great - easy to use and lightweight: https://www.harborfreight.com/hand-...rs-micrometer/4-in-digital-caliper-63710.html

I know you're just getting your feet wet with all this, but using calipers changed my life - and saved Luci's

 

Hi again Sue,
Wow, this is interesting - not sure how you use the calipers, but maybe you could drop me a description?
I'm using BD 3/10ml syringes with half unit markings as his vet started him on a half unit b.i.d.
My biggest challenge when I am trying to approximate a quarter unit, like today, is jiggling the black rubber/silicone end of the plunger to the right place... for whatever reason, these syringes do not have the smoothest gliding motion - they're kind of 'balky' or 'sticky'. I'm not sure if that is particular to the BD brand, or all small syringes...
I have read the material available on the board, with photos, of doing smaller doses.
I wish there was a smaller barrel syringe that could be adapted for use so that the volume of insulin in the barrel took up more space, if that makes sense.
A quarter unit is probably 1 or 2 mms on these syringes.

As far as getting my feet wet, I have to say, today was a rough day, which I am sure everyone goes through, but I feel like I am fumbling in the dark, and it upsets me when he is obviously not feeling well, like this aft.
I tell myself I am doing my best, trying to educate myself, following instructions and suggestions, and primarily being responsible, but I felt lost today.
I don't want to appear needy or greedy, but I sure look forward to every response I get on this message board.
The vet clinic is annoying too... sometimes bigger is not better, I think.
Hopefully tomorrow is a better day.
Some time if you have a minute, let me know how you use those calipers... I may I have something similar here in the house already.
Thanks
Laura

 

Here's lots of information on Dosing with calipers

 

Thanks, Chris!

 

Make sure you move the plunger up and down a few times before trying to put insulin into the syringe. That lubricates things a bit. Another issue with the BD's, besides bubbles , is that I found the zero marking very inconsistent. At times there was as much as 1/3 of a unit below the zero line. So I pushed the plunger in to see how far it went, and used that as my zero line.

I hope Toeby feels better soon and doesn't keep you up tonight.

 

Well, Toeby looked brighter just now, came over and was talking to me, but because I gave him insulin tonight for the first time since Sunday, I thought I should check him before I go to bed.
A little over 3 hours since he got 0.25 units, he is at 43.
Preshot was 178.
I just gave him some gravy Fancy Feast and a few kernels of the dry DM.
I will check him again in a half hour or so to be sure his blood sugar is going up.
I'm not freaking out by any means, but this is worrisome...
Tomorrow I will have to study the caliper method.

 

Thanks Wendy... at BG 43 he seems positively chipper, good appetite, scarfed down the gravy FF..

These syringes are mass produced and disposible... i don't put a whole lot of faith in the accuracy for minute doses of insulin, but you gotta do what you gotta do, with what you have.

 

He sure is making this interesting, isn't he?

May have to practice your 0.1 dose

 

Interesting...?
Is that what we call it here?
LOL
Little bahstid.... he was feral... I didn't know his parents... I doubt he knew his dad... can I call him that?

Well, yes, I sense 0.25 is not the answer... what the h-e-double hockey sticks am I going to give him in the morning?
I guess if he is above 150, try for the 0.125 or the 0.1 or the "drop" again...
I do have the leave the house tomorrow... I think that's legit for diabetic cat owners to have a life?

 

+4 hours he is 50... gave him some more gravy FF (trying not to give him too much at once to avoid upsetting his stomach)

 

A life? What is this "life" you speak of? Is it anything like the "sleep" I hear about occasionally??

Time to come up now Toeby!! Those sharks out in that deep water have pointy teeths!

 

I think I'd dry the "drop" dose next, if you have to give insulin again. Up some more please Toeby!

 

LOL
That gave me a smile this morning, thanks!
Well, we're retired now, and our traveling plans are mostly kiboshed thanks to Covid-19 so I shouldn't complain too much.. we're home a LOT.

@Wendy&Neko I gave him his insulin before checking this (dumb, I realize now), but I gave him more than a drop but less than 0.125 units, I hope... the black rubber stopper was deffo LESS than the half unit line, and just a hair's breath above the "zero" line, and yes, I realize that the drop level is where you drive the plunger in hard and then take the pressure off to pick up just a drop.
I have to leave the house shortly but will try to get a reading at 1.5 hours.
Thanks for all your support.