Just changed from Caninsulin to PZI

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sweetcherrypie

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Hi,
Yesterday I started my cat on PZI having been on Caninsulin for 1 year. I changed at the suggestion of a lot of helpful people on the FDMB. My cat Carbonel was having large swings in her blood sugar readings on the Caninsulin. This was not helped by a recent change from canned Hills M/D to a high protein food canned food called Bozita.
My vet suggested starting Carbonel on 2 units of PZI once a day based on her weight of 4.5 kg's ( the highest it has been since dropping to 3.8 when she was diagnosed). I only started her with 1unit which I think was a mistake. I have looked at the details of PZI and see it is a longer duration Insulin and that it is slower to peak as well but I think 1 unit is not enough. I did not take a reading of her blood sugar when I started the new Insulin yesterday, knowing that her blood sugar was way up on account of her visit to the vet. However after receiving 1 unit at 11.30am her blood glucose level was 11.2 four hours later. I checked again at 7.30pm and it was 12.4 and it was 15.3 when I tested again in the morning. Today after her 1 unit at 8.00am (her usual time for Insulin) at 1.30pm her blood was 13.2 and at 7.30pm it was 14.7. She is clearly not well and as I am going to be feeding her at 8.00 pm I am not sure whether to give her more Insulin now, or to wait and give her 1.5 units of Insulin in the morning or give her the 2 units the vet suggested. Can anybody help me with this please?
Thank you
Carol and Carbonel
 
How much Caninsulin was she getting?

PZI will never work as a once a day insulin. Early on, you probably won't even get 12 hours of coverage. Are you willing to shoot twice a day against your vet's instructions?
 
Hi Terry and Lucy,
Thanks for your response. Carbonel was on 1 1/2 to 2 units of Caninsulin depending on blod sugar reading. I can give Insulin twice a day, I am past her 8pm slot and have now fed her. Should I give her another unit now?
 
Hi Terry
Thank you! I have just given her 1 1/2 units as it was more than 12 hours since her last jab. This is really stressing me out! nailbite_smile I am having problems with the new syringes as well. The needle is 8mm long and it is difficult to see whether the syringe has Insulin in it! If it wasn't for the massive bubble I would not know whether I was giving anything!!
Anybody else have a problem with large bubbles adhering to the plunger? This must affect the dosage. A swift flick or 2 does not get rid of it. :cry: The needle length for the caninsulin was about 12mm and the the increments easier to see.
Regards
Carol and Carbonel
 
Weird...Caninsulin and PZI are both U-40 insulins. Your vet should have given you the same syringe.

You can use U-100 syringes if you prefer. If you get the ones with 1/2 unit marks, each 1/2 unit = .2 units of insulin. Or 1 unit = .4 units of insulin. So to give 1.5 units of insulin you would pull the insulin up to the 3.5 unit mark (that would equal 1.4 units of insulin actually).

Edited to add: I twist the plunger as I pull the insulin up into the barrel. That generally keeps the air bubbles out. Sometimes I have to shoot the insulin back into the vial and do it over though. As long as you don't pull the syringe out of the vial, there's no problem shooting it back into the vial and starting over.
 
Hi Carol, welcome!!! ((((hugs)))) yes it can be really stressful! hang in there! :-D

On the syringe question, are you using a U100 insulin (some PZI's are U40, some are U100)? I'm guessing b/c I think 8mm are the short needles on the U100 syringes. I actually like the short needles better, but have found some brands get more airbubbles than others. I have been really happy with the Monoject's from Hocks.com. I tried some Walmart brand and had problems with air bubbles. They also make them with 1/2 markings, which helps with the dose.

Can you post if the insulin & syringes you are using are U100 or U40? That will help people give you the best info. I know they make a variety of syringes, some people prefer certain length needles and have found options that work for them, so hopefully we can help you find what works best for you.
 
Hi Joanna and Terry,
The syringes are U100. Still no shift in her BGL this morning after increase to 1.5. Her blood does not seem to drop much at all, a couple of pts and thats all! Is this normal?
Thanks for the hugs I need them :smile:
Carol and Carbonel
 
I am having problems with the new syringes as well. The needle is 8mm long and it is difficult to see whether the syringe has Insulin in it! If it wasn't for the massive bubble I would not know whether I was giving anything!!
Anybody else have a problem with large bubbles adhering to the plunger? This must affect the dosage. A swift flick or 2 does not get rid of it.
Click to expand...

Hi Carol,

I use the U-100 BD Micro-Fine demi syringes (orange top) and find they are great. If I get an air bubble I also shoot the insulin back into the vial and withdraw again, usually this does the trick. - as long as you don't withdraw the needle inbetween. I was told by a vet NOT to flick the syringe after insulin is drawn up in it as one needs to treat insulin with care. So I am guessing that if you have airbubbles and if you are flicking the syringe, both could be interfering with the dosage?

All the best

Kay
 
It takes a while to see a response. Keep bumping the dose up by .2 units every 3-4 days until you see a peak value in the low 100s.
 
That bit I can help you with-yes :-D

Some users do a sliding scale, but you need to see how Carbonels gets on with it first. Then you need to ensure it's an experienced PZI user ex0plaining how to do it to you.

The twisting of the syringe works (you are using the conversion chart if your PZI is a u40 aren't you?)to prevent airbubbles. Check the instruction booklet on the PZI about pushing air back into the vial. It was ok to do this with Caninsulin but a big no no for example with Lantus. Other people just drew extra insulin into the syringe and squirted the excess down the sink.

Just as an added check-check your batch number between vial and glucometer matches and maybe do a control test as well. Just one more thing to discount out of the equation in terms of numbers not dropping.Not always unusual to not get a drop in numbers so don't panic either.Insulin looks ok? stored at right temperature?

Carbonel putting on weight is a good sign :mrgreen: Monitor her peeing, pooping, playfulness, preeening.

Have you had chance to ask in tech forum for help with spreadsheet?

Try not to stress, your doing everything you can and Carbonel loves you for it :mrgreen:
Remember chocolate for you, maybe even a glass of wine.
 
Hi Carol,

You just want to make the increase once a day. Since you started the 1.5 last night, you'll bump up to 1.8 on Wednesday night.

Terri
 
since no one mentioned it, I was wondering if you push the plunger back and forth a few times to spread the lubrication around inside before you pull in the insulin.
I push it back and forth and then depress the plunger all the way, then inset into the vial with it still depressed. That helps if there is no air in the syringe when you insert it. If you let go and then slowly pull the insulin out, you should be able to see any bubbles and express them easier.

Here's the link from the Tech Support forum for creating and attaching Spreadsheets: viewtopic.php?f=6&t=18207

I used Vetsulin too but switched to Levemir. I am not sure about PZI at all but hopefully an experienced person will come along if you put "dose question" in the title of your post. I wish you well and hope you can get some help with the dosing! :mrgreen:
 
Thank you everybody for all your help. :-D I will try your trick with the syringe Pat, thank you. I will also have a look at the spreadsheet info. I am noting down everytime I test at the moment and will try to transfer it on to a spreadsheet soon Kay :oops: . Carbonel is starting to improve having a happier demeanour and lower blg readings, whew :smile:
Best regards
Carol and Carbonel
 
Thanks again for your advice,
I am still having problems with the airbubbles! :roll: Am I not supposed to draw up more than enough and squirt the rest back in the bottle, without withdrawing the needle of course? Tried twisting, tried pushing the air into the vial before loading syringe and I always get a bubble.
With regards to spreadsheets I need a tutorial and I do not have a computer brain. It will take me ages to learn how to do it and I will learn eventually, but it is not going to happen overnight! Sorry!
Carbonel is still not regulated but she is getting lower numbers now. However this bubble thing is making it difficult to be consistent. I also made the mistake with the dosage night before last and she had a reading of 3.2 the following evening. :shock: I have listed her blg's below.

Time units blg
-----------------------------------------------------------------
8.30am 2 15.0
1.45am 11.8
8 pm 10.0
------------------------------------------------------------------
8am 2 14.5
------------------------------------------------------------------
8am 2 14.6
2pm 13.2
8pm 1 13.1 I know, this was stupid, should have been .2
-------------------------------------------------------------------
8am 1.5 10.4
8pm 0 3.2
-------------------------------------------------------------------
8am 1.5 13.3
2pm 12.3
7pm 7.2 Checked early as I am going out at 7.30pm
I don't know where to go from here. Should I have given her 2 units at breakfast this morning and what should I do this evening? Help! Sorry I cannot seem to highlight numbers in colour for the last 2 days and whilst I have opened the digits up, the submitted piece shows them closed up! :roll:


Carol and Carbonel
 
OK, I'm going to tackle the conversion!!!! If anyone knows, can you glance through & confirm I got it right? I multiplied everything by 18, gosh I hope I remembered that right!!!

Generally the format is:

AMPS BG Units
+n BG
+n BG
PMPS BG Units

Where +n is hours since last shot. We are "internationally challenged" here :lol: sorry - so I think everyone converts to US style BG#s. I believe there is an international version of the spreadsheet that does the conversion - you might want to post on Tech for help with that.

AMPS 270 2u
+5.25 212
PMPS 180 no shot
------------------------------------------------------------------
AMPS 261 2u
------------------------------------------------------------------
AMPS 263 2u
+6 238
PMPS 236 1u
-------------------------------------------------------------------
AMPS 187 1.5u
PMPS 58 no shot
-------------------------------------------------------------------
AMPS 239 1.5u
+6 221
+11 130
 
Ok, so for my comments:

1) I think your dose is too high. When the next PS is lower than the midcycle #, which you are seeing several times, that can be an indicator the dose is too much. I'm seeing that in several places, and all of it looks to me like too much insulin, even on the 1.5u. I would drop down to 1u and get some data on that. [ETA: 2/x day that is. I think why 1u looked like too little before was if you were shooting SID. With BID, it's double the amount in a 24 hr period, so 2u 1x/day is equivalent to 1u 2x/day, although with 2x/day they will usually respond a lot better.]

2) On airbubbles, the best solution I found is to switch to a different brand of syringes. I like the Monojects. Back when I used some that were bubble-prone, what I did was draw up a little more insulin than the dose. Then hold the syringe with the needle upwards over the sink, flick it a couple times with my finger to get the bubble to the top, and then move the plunger to the dose I actually wanted, which would get rid of the bubble. It worked reasonably well for me, though I have found using the syringes that are designed differently is a lot easier.

I got confused about your comment
I also made the mistake with the dosage night before last and she had a reading of 3.2 the following evening.
Click to expand...
You meant that you meant to shoot 2u the night before but shot 1u instead? That shouldn't have anything at all to do with the 3.2 reading the next evening, so I'm not sure I understood you right. I think the 3.2 was because the 1.5u was too high a dose on the AM shot that day.

Hope that helps!!! You may want to start a new topic each day with the #s you are seeing, and any questions you have. Sometimes on these longer threads with a more generic title, people don't realize there are immediate questions, so might not read the new posts right away... And always if you have any kind of emergency, post on Health where there is more traffic.

Keep us posted how things are going!!! It's nice you are seeing some good #s.
 
Hi Joanna,
Thanks for your advice. I had to go out last night so I never gave Carbonel any Insulin.
Her BLG was 250 this morning so I gave her 1.5 units at 8am. I am out all day today and have a feeling based on what you are saying that this may have been too much again. I will try to get back for 7pm this evening and hope she has not gone too low. Her BLG seems to be peaking very late about 12 hours after her jab, but I can't be sure until I have done a full blood glucose curve.
Sorry about the incorrect format, I will use the correct form and convert before posting in future. It is all taking a while to sink in, sometimes I feel as if I am reading morse code. :? Panicking does not help either!
What I meant with regards to the 3.2 (65 ) reading was that I thought that by giving her 1 unit instead of .2 or .5 the previous evening, I had precipited the drop the following day. Maybe it does not work that way. What is PS, please?
I will take your advice on posting, thank you. :smile:
Carol and Carbonel
 
Hi Carol,

PS means Pre Shot, so AMPS is the morning pre shot bg# and PMPS is the evening pre shot bg#.

The good news is that everyone here was new at one time. We all understand how overwhelming the learning can be in the beginning and we all have experienced the panic, we still do sometimes. So ask questions whenever they come up.

It is recommended here that you start with 1 unit twice a day 12 hours apart. That way you can gather data (do a curve) on how 1 unit works in your kitty so you can make informed decisions on how to proceed.

It's great that you are home testing, you have already mastered one of the hardest parts of this. Things will start getting easier and will become routine in the near future.

When you start a new post each day you can put the date (8/14), Carbonel, AMPS bg# in the subject line. That way people can see at a glance where you are starting each day.

You're doing great, welcome to the club.

Robin
 
Yeah, a late peak/late drop is often a sign the dose is too high. I wouldn't worry about doing a full curve - personally I would go ahead and reduce the dose on the next shot, and then keep testing (as you are) for a nadir every few cycles and see if those improve. What you want is a U-shaped curve, and I don't see that in your #s. If the #s are all flat, with the +12 (next PS) about the same or higher, that is usually from the dose being too low. If they are flat but the +12 is a lot lower, like you are seeing more often than not, that can mean the dose is too high.

Don't worry about getting all the terminology right, it takes time for it all to make sense! :)
 
Re: (14/8) Carbonel AMPS 14.9

Thank you Joanna and Rob,
Your trick with the syringe works a treat Joanna, thanks so much! :-D I now feel at least that I am giving the dose in the syringe and not the dose minus bubble!
I am trying to go in reverse now. So, I gave Carbonel 1/2unit of Insulin last night as her PMPS was 234 in the hope that her BG would be lower this morning, but it was a whopping 268 so I still gave her 1 1/2units. I had intended to cut the insulin back to 1u this morning and increase the evening jab to 1u. I will do this over the next few days hopefully. Is that okay do you think? I feel like I get all this advice and then I do something totally different to what is advised. I guess this has something to do with the delay in response( I will post on the diabetic health site in an emergency) and the unpredictable nature of all this. I do wonder whether the shorter needle (8mm) is affecting the absorbtion of the Insulin, perhaps I am not getting it past the fat layer. The Caninsulin needle was 12mm . Carbonels fur is quite thick and long and I don't find it as easy to feel the syringe piercing the skin either.
Carol and Carbonel
 
Hi Carol,

I'm guessing that you are in Europe or Canada, Joanna and I are both in the US so we do have a time zone delay. Definately post in Health in an emergency, there is alot more traffic over there on a daily and nightly basis.

I looks like the 1/2 unit on the PMPS of 234 wasn't enough. In looking back it looks like 1 1/2 might be a little too much. If I were you I would stick to 1 unit every 12 hours and let that settle in and gather data. Once Carbonel gets used to the 1 unit you will be able to see her patterns.

Try to not react to each bg# (unless it's crazy high or something, which Carbonel isn't), I'm still learning this lesson, try to stick to a dose until you have given it enough time to tell you if it is working or not.

If you're not sure that the needle is getting through the layer of fat you can try a longer needle and see if that gives you better #'s and then you'll know if it was or not.

You're doing great, have a good day.
 
Great to see you've had some new eyes and help.

I can't remember for sure whether you can get longer needles with 1/2 unit markings.

For everyone else-In Europe, despite mine and others best efforts, it seems you can only get BD needles without a script and you don't get a script from the vet that the pharmacies will accept (this is what I was told in Boots)

Carol-if you don't smell insulin after giving the shot, then it is probably going in under the skin. The other hing you could do is when you next go to the vets, ask if they can shave a smallish square that you can then use as the area for shots. Just rotate where you shoot within it to prevent the skin thickening and this causing pain for Carbonel.

Hope the 1u twice a day does the trick :mrgreen:
 
I agree trying 1u 2x/day seems like a logical step. You probably are getting the insulin in, especially since your #s do suggest a good response. With the short needles, I always sort of press the whole syringe up against the bit of skin I pull up, to be sure it's really going in all the way, and hold that a couple seconds before I pull the needle out. And then feel his fur there for wetness. I remember at first it was disconcerting b/c you don't really feel it going in the way you do with the longer/bigger gauge needles, but if there's nothing on their fur/skin, it probably went in just fine is my guess. Bix is short hair so I don't worry much, but if it were longer, I'd probably try clearing a little patch and then poking in there...
 
Hi Joanna, Kate, Rob,
Thanks all!
Tried changing Carbonels insulin to 1 and 1, morning and night but have not got there yet! Carbonel had a massive crash this evening so I have layed out her bg# for the last 2 days and perhaps you can tell me what to do next. Sorry!
15/8
AMPS 268 1.5u
PMPS 191 .5u
16/8
AMPS 207 1u
PMPS 47 no shot
Thank you
Carol and Carbonel
 
Good call on not giving the insulin.

I would keep testing her until you start getting rising bg #'s to make sure she is safe and feed her, make sure she's eating.

A 47 is a bit low but not really hypo low, but you don't want her to go any lower so keep testing her to see where she goes from here.

If she starts going lower, feed her some high carb food with gravy maybe or if she goes scarry low rub some honey on her gums.

Please keep posting her bg's, and if you can get some spot checks at like +3 or +6 and post those for us.
 
Hi Rob, thanks for responding,
Carbonels okay! :shock: She was eating and was okay in herself, just rather hungry. I checked her again 4hrs later and
it was 205 :o Not sure what to do in the morning. It seems as if giving the extra at night is precipitating the lows.
Carol and Carbonel
 
Hi Carol,

I'm really glad she's ok.

The 205 4 hours later is her liver dumping suger from the lower 47, she probably hasn't see those lower numbers for a while, her body thought she was in danger so it is trying to protect her. So don't panic, ok?

I tend to be on the conservative side, so if I were you I might go with maybe .5u or .75u IF you get a shootable bg# over 200. Others might have a different opinion, but that's good, than you can decide what you are comfortable with.

Please keep us posted.
 
When you say crash, do you mean the 47 & acting hungry, or was she really sick & stuff?

On the dose, it looks to me like the 1u is still too high. Here are some notes on what I see in the #s:

15/8
AMPS 268 1.5u
PMPS 191 .5u
16/8
AMPS 207 1u -- > PS is about the same as PMPS from the night before, which suggests a good holding dose (i.e. PS #s aren't rising much, so could indicate the 0.5u was a good dose)
PMPS 47 no shot -- > indicates the 1u was too high a dose

I would pull back to no more than 0.5 BID, and I would probably wait to shoot on anything above maybe 180. It is looking to me like her pancreas may be trying to work, and that is always good news. A bit scary though, because it seems like her body is protecting her from the insulin, and that can backfire as a repeated pattern.

I would go conservative on the dose at this point - you haven't seen a U-curve yet, so it's hard to know what's going on. Seems like the doses keep being too high though. If you can, I would try to shoot 0.5, or even less if you prefer, and like Robin said, get a +3 and a +6, and if you can a +9 too and of course the next PS at +12, to give you a better picture what is going on. Even if you can't get all those #s in the same day, if you can get one here & there it will help fill out the picture.

If you have a crisis too, remember you can post on Health where there is more traffic. Just be sure to mention you use PZI, and I would post the full history of her #s (you can probably copy & paste from here), and maybe link to this thread too. Her #s are a bit unusual (no problem, just different than the patterns often seen), so I'd just want to be sure people get the full picture in giving you advice.

Another thing you might want to do is experiment with a food test if you get a PS around 200 or below. With that, you don't give the shot but go ahead and feed them, and then test in a couple hours and see where their BG# is. If their pancreas is working, sometimes it will bring their #s down on their own. If the # hasn't come down, then you go ahead with the shot. If the # has come down, then you may want to shift to really tiny doses like 0.2 if the #s do get back over 180 or so.

Of course that only works if your schedule can accomodate it!!! I mention it b/c I'm starting to wonder if she's trying to go OTJ. If her body has been protecting her from doses too high, that would result in higher #s that are artificially high in protest to the insulin. If she got that 47 off of 1u.... hmmm, makes me wonder what you might see if you held off on a shot and fed & retested. You don't want to skip shots of course if she does need the insulin, but at the moment I'd say all you really know is that 1u is too much insulin for her. If you can experiment with lower doses or something like the food test and get more spot tests in, hopefully that will give you a better sense of what her #s really are & what her insulin needs are.
 
Hi Joanna and Rob,
Carbonels bg was 342 this morning! Is it not possible that as this PZI is supposed to have a 12-36hr duration that the jab in the evening is still in her system the next morning ? Was the reason why we abandoned the 2 units a day because her bg# was consistently high and this could be too much Insulin? I gave her 1 unit this morning and then had to go out. So I could not do the food thing you suggested Joanna. 8 hours later her BG# was 250. 12 hours and it is 286. What does OTJ mean please?
Carol and Carbonnel
 
Hi Carol,

A cats metabolizism is much faster than a human. The insulin dose is only in their system for about 12 hours. If you only give 1 injection a day it will be out of her system in 12 hours and than she won't have any for the other 12 hours.

If you split the 2 units that your vet told you to give once a day into 1 unit every 12 hours she will have insulin in her system for the whole 24 hours.

The 2 units at one time is too much insulin for her as you have seen because she crashes and could die and than she goes high because she hasn't had any insulin for the last 12 hours.

I still feel that you should try 1/2 unit (.5u) every 12 hours to try to stabalize her.

If this doesn't answer your questions, please ask again and I'll try to better explain. Ok?

Sorry, I missed the OTJ question, it means Off The Juice (insulin). This is when they have non diabetic bg's from diet change to low carb food or clearing up any other medical issues that cause their bg's to be high.

Robin
 
Hi Robin,
If you look back at Carbonels bloods her numbers weren't shifting at 2 units once a day. It was only when I introduced an evening shot that her bloods plummeted.. This Pzi is for cats, so why does the info state that it has a duration of 12-36 hours if it doesn't? I will try the 1/2 a unit twice a day but feel that the effect of this insulin is accumulative and that the evening shots are causing the crashes. Having said that I can't be sure of anything, although one thing is certain, I am finding this all extremely stressful.
Carol and Carbonel
 
Hi Carol,

It is very stressful. It was stressful for everyone of us when we got here because we were all scared and overwhelmed.

PZI is a medium lasting insulin. I know they say long lasting but most of the PZI's lasts anywhere from 10 to 14 hours (every cat is different) and it is not accumulative like Lantus or Lev. Lantus and Lev are much different insulins.

Carbonel bg's for today look pretty good.

AMPS 342
+8 250
PMPS 286

You can see how the insulin is working, AMPS 342 1unit, +8 250 she dropped 92 points and this is probably around her nadir, PMPS 286 she's going back up 30 points (the insulin is wearing off) but she hasn't gone all the way back up to 342. That is how it is supposed to work, and it starts all over again with the next 12 hours.

I think that what you see as accumulative is that the insulin is working and bringing her bg's down so that the 1 unit starts to become too much insulin as she becomes more stable without the wild swings from going without insulin for 12 hours.

Does that make more sense?

Knowledge is power. Keep asking questions whenever you have them. We'll help however we can.

Take a look at Harley's SS in my signature, to see what his patterns look like within each 12 hour cycle.

Take a deep breath, your doing great.

Robin
 
Hi Carol ((((hugs)))) yes it is very stressful!!!!!!!!!! Her #s are pretty good though, so you can feel good about that! She is well positioned to do really well, it's just a matter of getting things sorted out so her body can use the insulin most effectively.

PZI typically peaks (at it's strongest) somewhere around 4 - 8 hours after the shot, with many cats seeming to get their nadir (lowest point in cycle, when insulin is at its peak) around 5 - 6 hours after the shot. Then the PZI will start wearing off and though it is still in their systems a little, it's not helping them much to keep their #s down, and it taxes their pancreas to try to do the work itself (if the pancreas is working at all).

The idea with 2 shots a day is that the second shot is kicking in before the 1st has totally worn off. So it's not that you are giving the 2nd shot when the 1st is at peak or anything, you are giving the second shot with the hopes of catching them before the 1st one has completely worn off. With some insulin still in their systems like that, then you can keep the #s steadier, with some overlap between any two shots, rather than letting one shot wear off 100% before giving the next.

I think of it sort of like taking Tylenol when you have a headache. If you take it every 4 hours you feel pretty good. If you wait 8 hours before taking the next dose, if you're like me at least, the headache will come back, you feel miserable for a while, then the next dose kicks in and you feel better again. I have heard that before with pain management in general - if you can get the pain under control it takes less medicine to keep it under control, vs. if the pain comes back you will need a higher dose of painkillers to get the pain back under control.

So when you switch from SID to BID shooting like you did, the idea is to get the same amount of insulin in a 24 hour period, only spread out so it gives more hours of coverage. So if you were previously giving 2u of insulin once a day, the idea would be to switch that to 1u 2x/day. So instead of getting maybe 8 decent hours after the one shot, and the insulin starts to wear off, you have the hopes of getting 8 decent hours after each shot, with only a few hours between times where there is not as much insulin in their system.

For cats that get better duration on PZI, longer than 8 hours (which it looks to me like she probably does), you can luck out and really keep their #s better overall, with not much rise in #s between shots. Because of that though, you need a lower dose per shot. If the insulin is completed out of their system, like in SID, then you'll likely need more insulin per shot to get to better #s, vs. if it's not 100% out of their insulin, you can think of the next shot as like a booster - just giving them enough insulin to keep the #s good.

So the idea of the insulin being cumulative is right, that's exactly the goal in getting them well regulated. You want to take advantage of that effect. Why they say 12-36 hours is beyond me - sounds like a sales pitch maybe? I haven't seen any cats do well on SID dosing. Some cats need that once they have been on insulin a while and their pancreases are clearly working, then it can give them extended duration. But I haven't seen it in cats just starting on insulin.

The crashes (by that you mean the low PSs you sometimes see?) to me look like the effect of a single dose that was too high, causing a late break to lower #s. If you lower the dose a bit what you should see is lower #s in the mid-cycle, around +6, and then a rise to the next PS.

If that doesn't make sense, just keep asking questions!!! The more you understand what is going on, the easier & less stressful it will be for you.
 
Hi Joanna and Rob,
Thanks so much for taking the time to explain all that to me. I feel a lot better now. Carbonels AMPS was 220 this morning and I gave her 1/2 a unit last night and the same again this morning, as you suggested Rob. I think I will keep her at this for the next few days and then do a blood glucose curve on Friday. Even though I am stressed whenever I speak to you guys, I am really pleased that Carbonel is now behaving more like her old self, she is talking to me more and her coat is much better as well. Thank you. :smile:
Thanks again for all your patience with my questions.
Carol and Carbonel
 
Hi Carol,

Very nice AMPS.

I'm glad you are feeling better about all of this. There is a very steep learning curve in the beginning but once things start falling into place it gets easier and easier.

Carbonel's "whole cat report" is just as important and informative as anything else. "Carbonel is now behaving more like her old self, she is talking to me more and her coat is much better as well." That gives you a picture of how she is feeling overall. See what a great job you're doing?

Don't forget, we're all in the same boat here. Keep asking questions. It's the only way.

Robin
 
Hi Carol,
I'm so sorry I have'nt posted any greeting or offered any help here. Robin and Joanne and the others are so great about being 'right there for you'. I wish I would have been here. I'll make it a point of checking in with you now. And to echo, it is always very stressful in the beginning...but it is true, this becomes rather rote for most of us in a relatively short period. after a while you will probably be able to go 2 may 3 whole minutes without thinking about your cat :lol: and a normal routine will set in.
Very happy to have you join us here on the island. PZ-Island.
Neighbor to Lantus Land...but more tropical.
 
Hope things are going well today!!! Wondered if with your next update you would be ok with starting a new thread? My internet is terrible and keeps choking on this one as it's gotten longer.... If you like, post every day in a new thread with updates as to her #s and how she is feeling. At some point too it would be good to set up a spreadsheet - it's pretty easy, there are instructions over on the Tech forum & we can help answer questions too. It will help you get the best advice if we can all see the #s history...

have a great day!!!!!!
 
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