Need insulin advice ASAP!-moved to HEALTH

Moved to HEALTH forum, seehttp://felinediabetes.com/FDMB/viewtopic.php?f=3&t=1080&start=0
PLEASE REPLY IN THAT FORUM!!!!


Fred, 9 yrs. DX 12/24/09. Been on ProZinc (1u) @ 12 hours for the last 8 days and I've been home testing about 3-5 times per day.
His numbers in averages run like this: AMPS: 368; +3 267; +4 234; +7 335; +8 213; +9 368; PMPS 395; +2 383; +3 241; +4 280; +8 236; He and his sisters have only received Binky-approved wet food since DX.

Today I tested at 6am: AMPS 336; then +6 it was 76. It worried me that the test was wrong, so I waited an hour and tested again. +7 was 87.

Now I'm not sure what to do and it's the weekend and the vet can't be reached -- I'd have to take Fred downtown to the Emergency Vet. Here's my question: If I test Fred at PMPS and his numbers are under 100 or even around 150, should I give him his 1u of ProZinc or skip it? He's acting fine, eating constantly, not drinking or peeing very much, still thin.

Please give me your advice quickly. I have one hour til test time!

Thanks so much

Kathleen & Fred dancing_cat

 

Re: Need insulin advice ASAP!

Hi Kathleen,

Looks like good news to me, a breakthrough, yay!!! (Assuming he is feeling well, etc.)

Most of us using PZI have a "no shoot" #. If you are new to things you might want to start with 200. As people get more data, typically they will reduce the no shoot to 180, and then 150 with more data. With PZI, that is generally the cutoff, unless you have A LOT of data to support shooting at lower #s (some of us here do that - don't follow our example!!!).

If you get a # below your no-shoot, then keep retesting until you get a shootable #. Based on how things look, you might want to retest in 1/2 hour, or an hour.

I will try to stay around on the board to check for your messages. Feel free to post the PS and ask for advice before making a decision. You may also want to post on Health - not too many here on PZI right now.

If you are really unsure what to do and don't get replies, you can always skip the shot (assuming he dose not have ketones), or shoot a reduced dose. Then you can get some data off that, which will help you fine-tune for the next time it happens.

[edited: reported thread to Mod to be sure it gets eyes on it. Thanks for linking to Health Sarah!]

 

Re: Need insulin advice ASAP!

Does Fred have any other conditions besides diabetes (hyperT, pancreatitis, etc.)? Without knowing more information, and not really having much data, I would suggest that your "no-shoot" number is set at 200. This means if his BG is below 200, you do not shoot. Does he have ketones? If he has ketones, you don't want to reduce insulin much, but you also can't risk him hypo'ing.

I am going to post the link to this on Health to get more eyes on it. Let's wait and see what others think.

 

Re: Need insulin advice ASAP!

Thanks for getting back to me so quickly. I'll test Fred again in 30 min. He's already hungry -- again!!

The vet says we probably caught this early. He has no ketosis or other problems that she could detect from the blood work. He has been fine since DX. His only symptoms were weight loss, drinking and peeing more in the last month. When he got lethargic one day, I took him to the vet and got the shock of my like.

The vet was thinking of increasing his insulin to 2u when I talked with her before New Years. His numbers were then in the 300's. She didn't say what she would advise if his numbers went lower. That's why I was sort of blown away and not sure what to do when I got those readings today.

I'll go with your no-shoot advise and test until about 10pm EST, but I won't be able to check through the night -- have to sleep some time! Will he be in trouble or will his numbers just go up if he doesn't get his shot at 6pm? They've been up before, but I'd like to think the ProZinc is the reason for his low numbers.

I'll send the PMPS in about 30 minutes. Please look for it then. Thanks.

 

Re: Need insulin advice ASAP!

Kathleen--I have no experience with ProZinc although I used PZI Idexx for several years.

What concerns me is the test numbers you are posting. Generally, with every insulin, you expect to see a U-shape response. You've got 2 days here where he went up at +7 on one day before dropping back down and then the next day he was dropping through +8. Something seems a little odd. Generally when you get a funky number (like the +8 213), it's a good idea to retest. What kind of glucometer are you using?

A drop from 336 to 76 is too steep, as long as you are getting good test data. If you feel sure your glucometer is working properly, then I would reduce the dose slightly tonight assuming you get another ~300 preshot. If you get a surprisingly low preshot, post on Health and see what others think.

How was the diagnosis made.....fructosamine or office blood test?

Terri

 

Just tested Fred with ReliOn glucometer, lancets and strips. The reading at PMPS was 234. So, I think I should give him his 1u shot. The original tests were done in the Vet's office (don't know the type) and his initial reading was around 400. I once got a 516 reading early on and another in AMPS at 415, but since then it's been around 235-375, except for two days ago when I got a 177 at PMPS. That's why I got worried with the really low readings.

I'll wait a few minutes to hear from you before I shoot. Thanks for your prompt replies. I was a little panicked!! laptop_smiley

 

Since that PS is quite a bit lower than this morning [ETA: and this morning's drop was awfully steep], I would consider shooting a reduced dose. Let's see what others say.

Check around on Health too - sorry the posts got confused like this. I'm not sure what forum I'm on!!! Guess I should go read the FAQs, ROFL.

 

Given the wonky numbers you posted earlier, I would reduce the dose slightly. Is the ProZinc U-100 or U-40?

 

The ProZince is U-40, which does not give me 1/2 doses. I have been giving him 1u every 12 hours. I could try to put in only 1/2 U, but it will be a guess-timate. You thoughts? laptop_smiley

 

Please understand the numbers I posted on his hourly readings were AVERAGES of those taken over the last 7 days. Not actually readings done today. I just wanted you to see the AVERAGE ranges he has been getting. I don't have my spreadsheet up to send out, yet.....just so much to get my head around.

Here are his numbers for just today: AMPS:336; +6 76; +7 87; PMPS 234. Does that help?

 

I would guesstimate - with the U-40 syringes, I've guesstimated 1/4, 1/2u or 3/4 units before. It's far from exact, but in the short-term it works well enough. For those of us with longer-term need for small doses, we use U-100 syringes and a conversion chart to do it. Don't worry about that at this point though - I'd just guesstimate for now and see how things go.

 

OK, now I understand what you were saying. The hourly averages really don't have any meaning here unless you just like fiddling with the numbers.

Do you know that you can shoot U-40 insulin in a U-100 syringe? If the syringe has a 1/2 unit mark (Walmart's syringes do), then each U-100 mark = .20 units of insulin. It sounds though like you are using U-40 syringes so I'd just eyeball a 1/2 unit or a little bit more tonight to be safe.

In general, I like Lucy's peak values to be about 1/3 of her preshot. With big drops like you got today, you run the risk of rebound. Are you familiar with the concept of rebound?

 

Thanks for clarifying that. Yes, it is very overwhelming for a while! You are doing great, and I'm glad you could post today. Hopefully we are helping. Let us know how things go tonite. Although it can be scary, it's great that you are seeing some nice #s. :RAHCAT