Had to stall & skip last night, helped ty 💕 | Feline Diabetes Management Board

Had to stall & skip last night, helped ty 💕

LisDiedrich

LisDiedrich

Member
Hello!

Dexter is 5 days back on insulin and he is at 116 (on a relion strip) @ +10 & still looks like he’s heading down. Here is his libre graph. We have two hours til next shot but am I skipping under 200 or? This is on .25U PZ. Thank you!! 🙏💕
 

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Let's see where he's at at 11.5 and then again at PMPS. If he's below 150 at PMPS, stall, DON'T feed and re-test in 20-30 minutes. Use that time to post here and edit your subject line to something like "STALLING...NEED HELP!"....when you get somebody, you can go back and edit it to the usual format.
 
Chris & China (GA) said:
Let's see where he's at at 11.5 and then again at PMPS. If he's below 150 at PMPS, stall, DON'T feed and re-test in 20-30 minutes. Use that time to post here and edit your subject line to something like "STALLING...NEED HELP!"....when you get somebody, you can go back and edit it to the usual format.
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92 ten min before shot
 

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OK, you can continue stalling if you can get off schedule (and he'll let you since I'm betting he wants his dinner) or you can skip tonight but expect him to be high in the morning.

Since you don't have syringes with half unit marks yet, I'm not sure if he got more than 0.25 this morning. From the picture I saw, it looked like it could have been 0.5.
 
Chris & China (GA) said:
OK, you can continue stalling if you can get off schedule (and he'll let you since I'm betting he wants his dinner) or you can skip tonight but expect him to be high in the morning.

Since you don't have syringes with half unit marks yet, I'm not sure if he got more than 0.25 this morning. From the picture I saw, it looked like it could have been 0.5.
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Ok thank you! I am unable to get too far off schedule so going to feed & skip. But what # would I be looking for before I shot if I was able for future?
 
LisDiedrich said:
But what # would I be looking for before I shot if I was able for future?
Click to expand...

No particular number exactly but you do want to see his numbers going up without the influence of food. That's why we tell you when you stall, don't feed. We want to know which direction the BG is going....if you feed, you don't know how much of an effect that has on his BG and how much is because of the last shot wearing off.

From the Prozinc dosing methods:

How to handle a lower than normal preshot number when following SLGS:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin once you have data and understand your cat’s cycles. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.
 
Hi Lis, I noticed on your SS that your new vet took Dex off insulin. What was his/her rationale for this? I've never heard of this approach before.
 
Hello! She was not 100% convinced he had diabetes off the initial fructosamine when he was constipated & diagnosed from other vet & wanted to make sure. The first couple nights he randomly hit below 200 on his own but now has been in mid 300s. We are coming up on a week no meds now and after she looks at his #s we will go from there.
 
Hi again! Lis, I'm not an expert here, and I'm not encouraging you to go against the advice of your vet, but Dex is clearly seeing consistent numbers in the diabetic range. If he were my cat, I would be worried about him not getting insulin, especially since he's had ketones before.

I'm going to tag a couple of people who are much more experienced than me to get their feedback.

@Sienne & Gabby (GA) @Wendy&Neko
 
I really think Dex needs insulin. His numbers the past few days have been uncomfortably high. He's basically had one day where his numbers were in the blues and greens and even then, a lot of the cycle was over 120.

What concerns me is that with numbers in the 400+ range and no insulin, you are looking at risk factors that contribute to DKA. If you are going to follow your vet's advice and continue to withhold insulin, please test for ketones.
 
I'll pile onto the idea that Dex looks like he needs insulin. Unfortunately with holidays, you might not be able to talk to/see a vet except an emergency vet for a few days. Please test for ketones, for his safety.

Which Purina Pro Plan are you feeding now? Except for the DM, they are all too high in carbs to feed a diabetic cat. The DM is OK carb wise, but ingredients aren't the best.
 
He sure looks like he needs insulin. He’s way too high. Are you testing for ketones? Test strips would also show if there’s sugar in his urine. Did your vet run a fructosamine test? It would give a range of his bg over the last couple of weeks.
 
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