What dose for what #'s?

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Meridith and Zeke

Meridith and Zeke

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I have just started monitoring Zeke. I am really confused on what dosing for what #'s and when to not give a dose. Any and all help on this will be much appreciated!
 
Kudos for home testing Zeke! Just peeked at Zeke's SS and I think the dose needs to be lowered! On the 25th Zeke's BG was 69 at +6 on a dose of 2.5u. With fast acting Novolin, I would try to keep Zeke's BG from dropping below 90 so you allow some wiggle room to deal with low BG numbers. Right now I think Zeke is coming out of a bounce and wonder just how low he might have gone last night on the dose of 3u with a pre-shot of 124. I would not recommend using a sliding scale until you get more data to see exactly how Zeke is reacting. Does Zeke have any history of DKA? If not, based on the drops you are seeing, I would drop the dose back to 2u and hold it there for at least 6 cycles providing that your pre-shot readings are high enough (300 or higher) and your mid cycle tests are not taking BG below 90. If pre-shot is lower than 300, post for assistance. I'd test at +3 post shot to see where Zeke is heading and then you can use food to steer him if he is dropping quickly.
 
Meridith and Zeke said:
I have just started monitoring Zeke. I am really confused on what dosing for what #'s and when to not give a dose. Any and all help on this will be much appreciated!
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When you were first diagnosed did the vet start at 1? I agree your dose is too high.

If Zeke were my cat I would start over from scratch. I'd do a few days at 1 or 2 units and see what happens. If it is not enough I would raise it by no more than half a unit at a time.
 
@MrWorfMen's Mom
No history of DKA. He was diagnosed after a drastic weight loss over 1 1/2 weeks time. So drop to 2u? And by cycles, is a cycle a day or 12 hours? I can test at +3 tonight but during the day tomorrow I will probably be out of town and my daughter can't test by herself since he still isn't liking it so well. We have also started a small meal around peak time during the day because having problems getting him to eat enough. How will that affect his #'s and insulin during the day?

@JanetNJ
The vet started us a 1u. We were on that a couple weeks then he raised us 1/2u a week until we were at 2 1/2u last week and the new vet said to go to 3u.
 
Meridith, the problem with vet numbers is that they are often if not usually elevated due to stress. Our felines generally get pretty worked up at vet appts. Good to know the dose was increased gradually although we usually adjust doses by 0.25u rather than 0.5u when increasing or decreasing as small changes can cause big changes in BG and it's quite possible to skip over the ideal dose even with half unit adjustments.

Yes I'd drop the dose to 2u or if you prefer take it back to 1u although I don't think you need to go back that far unless readings indicate it in the next cycle or two. A cycle would be 12 hours....each day has 2 cycles.

I would probably drop the dose tomorrow morning to 1u if your daughter cannot test on her own just to be on the safe side and you really haven't honed in on the ideal safe dose for Zeke yet. We all have lives and sometimes we have to compromise to meet both our and our kitty's needs.

The meal early in the cycle, before peak action is reached, provides more food for the insulin to work with and slows the drop down so there is less of a dramatic drop all of a sudden which can cause a bounce. It's something that you can experiment with a bit timing wise now that you are testing because your goal is to keep Zeke in the best numbers possible for as long as possible in each cycle without having him drop too low.
 
@MrWorfMen's Mom
I think we will do the 2u. Zeke was actually eating better when he was at that dose. He was eating 2 1/2 cans of FF 2 times a day when raised to 2.5u and he decided he wanted to only eat 1 can a meal. We have him eating about 1/2 to 2/3 a can of friskies for dinner and breakfast and the mid meal we are trying 1/2 a can. Also trying different flavors to see if we can find one he likes a lot.
 
Wow, just checked out your spreadsheet. (I know we were talking food the other day, lol.)
Your numbers are way lower than mine.
(Again, I'm pretty new to this too.)

I find it helps to nose around and peak at other people's spreadsheet. (Not to emulate their dosing, but to better understand.)
I know you recently started home testing. There was a learning benefit for me to do the curve with my Fabby.
The every 2 hours got her more of the salmon treats and more incentive to put up with my testing and learning...
It also showed me the cycle she is supposed to go on with our insulin. (Vetsulin is a fast acting one like your Novolin.)
So perhaps if you can get in a curve this weekend?
For my cat she tested at 450 at diagnosis. She's been about there at AMPS with fluctuations +/- 100 roughly.
Our big goal is remission.
We'll settle for well managed.
But out short term is just stability...
Remission to me means her body goes back to managing her glucose correctly and she doesn't need insulin anymore, though she will always stay on low carb now.
Well managed means insulin dependant, but that our numbers stay consistent and I don't have to test 4x a day. (Just 2x before insulin).
Stable means consistency in numbers and hopefully trending downward.
Right now Fabby seems to be bouncing. I'm getting really low numbers then really high numbers.
I'm happy when the numbers are blue on the spreadsheet. The optimum goal is to stay around 120.
Other key numbers I remember are:
below 60 = hypo need food/sugar immediately.
Below 200 = do not give insulin. (Skip dose)
High numbers can be worked with, low numbers = attention necessary immediately.

Check out my spreadsheet just for info. Then check out the spreadsheet of others (and make sure to see a couple that are in remission like JanetNJ's cat).

For comparison I'm only on 1.25 units 2x a day, and my numbers are way higher than yours. (Considering changing to 1.5 soon... The jury is still out.)
And you're already double what I am in insulin.

Also, I think it's a real good idea you get more food in Zeke at the nadir time especially if he's dropping into the 60's. (Like we discussed on your other thread.) But, personally I'd be worried about the nadir that happens when you're sleeping.
I saw on your spreadsheet that you don't always dose 3 units at night. It seems like that would be a good indicator that 3 units is too high in general... But I'm new. That's not fact or experience speaking, just gut talking... So listen to these other folks on that portion as they have the experience.
 
@AlphaCat
Yeah, we are lowering the dose and I will probably see if we can do a curve on Monday or Tuesday. He is still fighting us on testing so I don't want to stress him too much. I'm hoping his appetite will pick up with the lower dosing.
 
Those extreme drops in BG may very well be making Zeke feel unwell. Our extra sweet furkids get used to being at elevated numbers and then think something is wrong when they hit even normal numbers initially so if we can slowly but steadily ease them back to more normal numbers, I think it's not only easier on kitty but also on us, their caregivers.;) On the other hand, appetite is quite often a sign of how well BG is being controlled but both high and low BG will often cause them to be ravenous. Has Zeke been on Friskies since he started insulin or is that a more recent change?
 
I'm able to keep my treats in my glucose kit. Fabby associates the glucose kit with treats and extra petting. My curve within the first week of testing helped the association stick. Since I feed her after every test now I don't always treat anymore, but her association is still there so if I pick up the kit she comes running.
Perhaps you can keep treats in your kit and do some fake outs... (Don't actually test, but break out the kit, give extra love and treat.) I always try to massage her ears for a minute before I poke them. Both to simulate the blood flow and to have her not angry with me every time I touch her ears. (Because the association is good and pain.)
After my curve and with me testing 4x a day her ears were getting a little rough. I got the Neosporin + pain relief and I use that on both ears each time I test (Even though I only poke one ear.) It's helped so much! There's no more swelling, and she's not griping at me as much during the process.
Good luck on your potential curves!
 
Meridith and Zeke said:
@MrWorfMen's Mom
I think we will do the 2u. Zeke was actually eating better when he was at that dose. He was eating 2 1/2 cans of FF 2 times a day when raised to 2.5u and he decided he wanted to only eat 1 can a meal. We have him eating about 1/2 to 2/3 a can of friskies for dinner and breakfast and the mid meal we are trying 1/2 a can. Also trying different flavors to see if we can find one he likes a lot.
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Sounds like a good plan.
 
@MrWorfMen's Mom
The move to friskies is more recent. We were feeding one of the higher carb FF's since we were never told on that, just to feed FF. The change to friskies was mainly on trying to find a food he would eat and that is what we were feeding our other two and although he was eating his, he always seemed to want theirs more. As we have learned more on the foods, we are also working on getting them all to eating better carb ones though they hate pate. Not every time but most times they are all eating the flaked with tuna and tuna with egg. Which seems to be mostly pate.
Slowly lowering the numbers does make sense. It is amazing how little vets tell u and how wrong much of the info is that they do.

@AlphaCat
What we have started doing is having either his treat (even when we are about to feed) or his meal ready to give him immediately after. Will also try giving him a treat without testing to see if that helps him associate it with good.
 
Even a change in the % of carbs between higher carb FF and the lower choices will make a difference. I can tell the minute my girl pilfers a tiny bit extra food or worse yet gets into the kibble her younger brother gets periodically as a treat now. In the past, a drop of 7% in carbs in her dry food didn't seem to make any difference at all. Admittedly I am dealing with a fairly rare secondary condition but it suggests to me that carb sensitivity can not only be different for each cat but possibly also for different food types in my world.
 
@MrWorfMen's Mom
I'm hoping I can find that balance for Zeke soon. We have been at this for almost 6 weeks now and I feel like we are really just now getting started. I know we really need to stay below 10% carb, but what is a safe give when it comes to giving him food that he will eat?
 
Meridith and Zeke said:
Correction, she said post if lower. Too easy to get confused, that mean I should do only 1.5u to keep him from dropping too low?
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At 269 2.5 got her down to 69.... Not hypo but low. If you are awake and want to steer you could do that again. I'm more inclined to recommend 2-2.25 so you have more of a buffer.

If you are feeling like being more conservative the go with 2.
 
Thank you @JanetNJ. After dosing him too high last night because of confusion, want to make sure I'm getting things straightened in my head first. Much rather be cautious then send him into hypo like I almost did last night.
 
Sorry! I took a quick break to get some grub and tidy up and just now saw your message but I see you were in good hands with Janet. I agree with giving 2u tonight and checking Zeke at +3. Post if you have any questions at +3. I'll probably be up 'cause one of my all time favourite movies, Mr. Roberts is on TV. :)
 
@MrWorfMen's Mom
His +3 is 213. We had to do it a few minutes early because of the storms that came through. Lots of surges so didn't want to try testing him by flashlight lol. Right after we tested him, lightening struck behind the house next to us hitting a power line and then in front of the same house hitting a tree! Then the storm was over lol. Fun night in the okie state! :D
 
Just checked Zeke's SS and saw the 213. That's a decent but not extreme drop so if you are off to bed, give him a snack now to keep him dropping slowly.

We've had rivers of rain here lately but no storms that even come close to what you folks have been enduring. I feel for ya! Glad the lightning didn't strike the house and the tree didn't get uprooted and hit anyone's house. Stay safe!
 
Thanks, he already has had a snack of chicken. These storms have been nuts lately. Luckily no huge twisters so far this year *knock on wood* and we are almost outta our storm season. Should start slowing down soon thankfully.
 
We've been getting rain day in and day out to the point where lakefront properties are sandbagging and praying and some neighborhoods have had pumps going for weeks now trying to keep their homes from flooding. The Toronto Islands which are a tourist destination have been shut down completely and the folks who live on one of those islands have a ferry standing by in case they have to be evacuated. The amount of rain has been crazy. We are expecting some thunder storms tomorrow overnight. Hopefully nothing too severe! Well, I'm going to call it a night. Sweet dreams Meridith & Zeke!
 
Yeah, with all these storms, been a lot of flooding. We don't see it so much where we are at but could really tell when we were down by Talahina last weekend for an event at the Choctaw Capital.

His morning amps was 390. He is starting to eat better already, ate a full can without any coaxing or bribing, shredded parmesan works great when we have to. We are working on getting him more used to the test by giving him treats when it is opened up. At least he doesn't run into hiding anymore lol. Last night he even sniffed of the kit as I was pulling things out for his test lol
 
Great to hear he is eating better and getting more compliant with testing. Bribery works wonders! Less extreme up and downs are likely making him feel better even if his numbers still need to come down. Slow and steady wins the race in this game. I know you are going out today (hope the weather is good for you) but if you can grab another test before you go, it will tell you what he is up to and let you determine how much food to leave out or have your daughter give Zeke later on.:)
 
Will do! Hubby helped with the test this morning and Zeke definitely struggled more, so possible this amps was a little high because of stress. Was his first time helping. Now if I can get our fat boy to loose weight lol. He is about 20 pounds and almost as wide as he is long! He only eats the same amount as my little 10 pound one, but not a drop of weight coming off. Maybe over time that will change.
 
Yep. A little testing resistance could certainly cause a bit of stress elevation in BG.

I know all too well the struggle to get them to lose weight even when they don't seem to be an out of control eater. I stupidly thought my efforts to slim my girl down were starting to pay off and then realized she was losing too fast in comparison to my efforts and that's when I found out she was diabetic. She managed to regain everything she had lost and then some and now we are once again on the weight loss treadmill. In the early days, I wouldn't be too concerned about his weight. Just try to keep him steady and not gaining. When he gets a little more regulated and you have a better idea how he is reacting to insulin, you can ease back on his calories gradually. An unregulated diabetic can't get the nutrients out of the food and as a result, tend to have big appetites sometimes to the point of being continuously ravenous.

Have a good break today! :)
 
The fat boy isn't my diabetic kitty lol. My diabetic should be closer to 18 with his build. The fat boy should probably be closer to 12 or so. We had to keep him in a small room when I had to stay at my mother's for a bit because of a dog and so he went from a high energy kitty to overweight quickly.
 
OH! LOL! I was kind of wondering how Zeke had managed to maintain his weight so well but they are all unique individuals and often don't follow the rules! I think the trick is in getting them to exercise along with reducing calories. Unfortunately, some, like my girl, are not much into the play thing. Mine goes on short forays of running around the house like she's possessed periodically but she'd have to do her laps a lot more frequently to make it count toward calorie burning! As for interactive play, her attention span seems to be very short!:rolleyes:
 
Lol. Our one that is nicknamed demon child is the one that daily has to run back and forth across the house and loves doing spinners in my bedroom lol. The fat boy is actually starting to want to play. Before he wouldn't.

Zeke was 302 at +2 so dropping good.
 
Love the nickname demon child. My Menace got her name for good reason too! She may not be an overly active girl but when she gets going, she's great at finding lots of mischief to get into! :cat:

Zeke is looking good with no big surprises! Now you can have a "relaxing" time out today. :)
 
It's renaissance time for us, hubby and I go every weekend when possible. Lasts 6 weeks hehe. My demon child is also called gremlin too because he makes gremlin noises lol. Our fat boy Max is the only one who makes "normal" cat meows lol. Zeke is full of silent meows and very weird sounding ones when he is following his food bowl lol. Demon (Grayson) "talks" to us and does is gremlin noises. Then we have our hotdog who is the referee! She doesn't like Max and Grayson playing at times so stops then.

Here at Ren fest so I'm our till this evening! Have a great Sunday!
 
Meridith and Zeke said:
It's renaissance time for us, hubby and I go every weekend when possible. Lasts 6 weeks hehe. My demon child is also called gremlin too because he makes gremlin noises lol. Our fat boy Max is the only one who makes "normal" cat meows lol. Zeke is full of silent meows and very weird sounding ones when he is following his food bowl lol. Demon (Grayson) "talks" to us and does is gremlin noises. Then we have our hotdog who is the referee! She doesn't like Max and Grayson playing at times so stops then.

Here at Ren fest so I'm our till this evening! Have a great Sunday!
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Huzzah!
 
Zeke is 185 tonight, so not giving his dose. How could he be at 390 this morning, then that low tonight? He has even been getting treats of chicken today, and he had a can of FF. Hopefully we can have him stressing less soon so we can get his curve going. Would hate to have seen what tonight would have been if we had still been doing 3u.
 
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