Starting insulin

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smiley747

smiley747

Member Since 2015
hi, so i'm both crying over my recently departed molly and trying to figure out this insulin thing - yaay me! lol
so, i started the insulin today. Only one unit a.m. and then one unit p.m. I have some questions.
1) How long does it take for the cat to respond (IF) the prozinc insulin is going to work? (I realize she is on a small starting dose, just dont know how long it takes to get results even if on the correct dose..like is it instant..days, weeks)

2) she normally eats at 7ish a.m. during the week. and then dinner at 5:45 ish. I can not see her waiting until 7 pm to eat dinner. she will drive me crazy. Is it bad to give the shot too early or worse to give it too late? I will be honest, I cant check her blood each and every time she eats right now.

the vet wants her on the 2 units a day for a week and then do a curve. Is one week enough time to figure out the dosing? I can not afford to keep bringing her back for a curve every week. I know i can do the curve at home, but since i'm overwhelmed at this time...i want to let the vet handle the initial work.
 
smiley747 said:
hi, so i'm both crying over my recently departed molly and trying to figure out this insulin thing - yaay me! lol
so, i started the insulin today. Only one unit a.m. and then one unit p.m. I have some questions.
1) How long does it take for the cat to respond (IF) the prozinc insulin is going to work? (I realize she is on a small starting dose, just dont know how long it takes to get results even if on the correct dose..like is it instant..days, weeks)

2) she normally eats at 7ish a.m. during the week. and then dinner at 5:45 ish. I can not see her waiting until 7 pm to eat dinner. she will drive me crazy. Is it bad to give the shot too early or worse to give it too late? I will be honest, I cant check her blood each and every time she eats right now.

the vet wants her on the 2 units a day for a week and then do a curve. Is one week enough time to figure out the dosing? I can not afford to keep bringing her back for a curve every week. I know i can do the curve at home, but since i'm overwhelmed at this time...i want to let the vet handle the initial work.
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I think your one unit dose is much safer than 2 units. It is much better to increase slowly. Once the insulin is shot - if it is too much - you have a hypo situation. Can you move up the am shot to get them 12 hours apart? That is the best schedule. It is not a good idea to continually shoot earlier or later.

The first question: Every cat is different. Some cats get a diet change and a few weeks of insulin and immediately start dropping and go into remission. (One of the reasons we highly recommend home testing. Shooting blind is a very scary situation). Some cats take 3-6 months before levels start dropping. Some cats are on insulin for years.

I have to say one of the ways to get a cat well regulated and then headed to remission is to have a daily handle on his levels and be able to adjust the dose to address them. If you know a dose is working, you continue it. If he is higher and flatter, you know to increase. If he dips too low, you back off the dose. I know it feels overwhelming, but knowing whether he is too high, too low or just right gives you confidence and peace of mind.
 
Can you leave out some food for a third meal during the day? Then she could wait until 7 for dinner. Some people freeze a serving of wet food and then leave it in an automatic feeder. Then during the day it will defrost and the timer will open and she'll have a fresh lunch.

A curve after one week may or may not help... If she gets really stressed at the vet then the numbers won't really reflect how she's doing at home. I know you're not able to test her a lot right now. What are the problems with testing? Maybe some people here can help.
 
Her insulin has INCREASED to 414! 2 units a day total of prozinc. Her numbers have never been this high. Insulin can RAISE her BG????
 
You mean her glucose has increased, right?

It could be bouncing.
Bouncing happens when the glucose drops very rapidly, it drops to an unfamiliar number, or it actually drops below normal numbers. Compensatory hormones release stored glucose (glycogen) to bring the glucose back up in response to the perceived threat. This elevated glucose response may last up to about 3 days.
 
When was she 414? The lowest point of a cycle is usually 5-7 hours after the shot. The other complication is if this is a number from the vet, it can 100+ points higher than at home.
 
@Sue and Oliver (GA), do you think Smiley should lower the dose to 0.5? Or am I overreacting to the 414? I know when Marshmallow had high numbers it was because her body was compensating for going too low after getting insulin.
 
Are you testing at home? fantastic! So is it 11 or 12 hours since the last shot? Do you have any other numbers?

There is no way to know what is happening yet. It could be that he dropped low in the middle of the cycle and has bounced up. When their body perceives a lower number than it is used to, it can release extra glucose and then the next number is higher.

It's only one number and we don't really know what it means. What would you think about reducing the insulin to one unit (our suggested beginning dose) and, if possible, set the alarm for 5-7 hours from now and get a test. Then you'll know how low the insulin is taking him and whether the dose needs to be reduced or not.
 
I thought it should increase no? Her last shot was 12 hours prior. Yesterday it was higher Also than normal. Was usually 250 without insulin
 
If she was lower without insulin, then it is very likely that the dose is too high and is causing the bounce I was talking about. If she was 250 at the vet, it is quite possible that she is getting too much insulin. Many cats are 100 points higher at the vet. We advise new diabetics not to shoot under 200.

Was the number yesterday at home or at the vet? What was it?

This is really difficult. If she were mine, I guess I'd give the one unit and get some numbers in the first 2 hours to see where she is headed IF you can also get a nadir in that 5-7 hour time frame. I wish it was daytime so it'd be easier to get some tests in. I know the 400+ is scary but it is hard to know what it means.
 
No she was 343 at vet. About 250 usually at home. Yesterday after starting insulin she was 345 at home. Today 414 at home. Thought insulin was supposed to help her
 
It will. It is not, however, instantaneous, any more than becoming diabetic was instantaneous. This means you have to be patient and persistent in following the guidelines for your insulin.
 
An annoying but truthful saying here is "This is a marathon, not a sprint." You have to get the data that tells you how the insulin is working, how low it takes her.

So was 354 her morning pre shot number?

It sounds strange, but high numbers can be caused by too much or too little insulin. The only way to find out which is to get those numbers in the middle of the cycle.
 
Wondered about you overnight. Did you get any numbers?

I hope today you'll be able to get a number 5-7 hours after the shot. It will help you figure this out.
 
For your peace of mind, you may have to set the alarm at night for somewhere in that 5-7 hour range after the shot, and get a test in. (Or if you are a person of a certain age like me, you might be up then any way? )

Robin had a great analogy for the data from preshots and the data from the nadir. She likened it to putting together a jigsaw puzzle - the preshot numbers give you the edges, but they can't really help you see what picture you are making. The mid cycle numbers are the middle pieces. That mid cycle number will show you how low the dose is taking her. If she is too low mid cycle and then bounces back up, the dose needs to be lowered. If she is high and flat, then you might look at an increase.

Other numbers that will help you fill out the puzzle are an "in the door" test after work and a before bed test at night.
 
Smiley, breathe and breathe again. Insulin will help. You just began. It's scary now but guaranteed you will think nothing of it in short time.

People here will help you. You are not alone.
 
okay so i'm super confused. her gluc this evening at 5:45 p.m. was 109 only !!! and dinner time (just now - 8:30 p.m.) it is only 145. ( my husband injected her this morning and he gave her one unit and 1/4 instead of 1 unit- yes, i've told him he can not guess lol) I came from the vet's office who told me to increase the dose to 2 units twice a day. Had I done that without checking, I'm sure i could have had a problem. So, she went from being way higher than ever to almost ideal numbers overnight. She is eating now. I read that new diabetics should not be injected if under 200. Should I check her bg gain and if so when??? and then inject or not inject at all? It's not possible for me to wake up later. i'm exhausted.
 
If you can wait another 20 minutes without feeding, and it rises to 200, then you could shoot BUT A REDUCED DOSE. If she was 109 at +9, she might have been quite low at +6.

I am guessing she has been dropping low mid cycle and bouncing back up. I definitely would not give more than one unit and I would probably reduce to .5.

If you skip tonight, she is likely to be high tomorrow BUT I WOULD STILL LOWER THE DOSE. YOU don't want to shoot the same dose that probably took her very low.

I will be so glad when you can get some mid cycle numbers and figure out what is really happening. And I am so glad you are testing. Yes, 2 units would have been a scary dose.

We need to get you a spreadsheet. When you want advice shooting a dose, we need to be able to see her history of doses and numbers so we can help. I can make you one - just send me a private message by clicking on my avaitor.
 
Sue and Oliver (GA) said:
If you can wait another 20 minutes without feeding, and it rises to 200, then you could shoot BUT A REDUCED DOSE. If she was 109 at +9, she might have been quite low at +6.

I am guessing she has been dropping low mid cycle and bouncing back up. I definitely would not give more than one unit and I would probably reduce to .5.

If you skip tonight, she is likely to be high tomorrow BUT I WOULD STILL LOWER THE DOSE. YOU don't want to shoot the same dose that probably took her very low.

I will be so glad when you can get some mid cycle numbers and figure out what is really happening. And I am so glad you are testing. Yes, 2 units would have been a scary dose.

We need to get you a spreadsheet. When you want advice shooting a dose, we need to be able to see her history of doses and numbers so we can help. I can make you one - just send me a private message by clicking on my avaitor.
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Pls send spreadsheet. I will wait and check again u guess.
 
This morning pre shot pre food at 7:45 a.m. was 255. My husband will give her 1/2 unit just to be safe. I'm at work now. I have to pick up my step daughter after work and then a bunch of other things. I hope to be able to get the spreadsheet going soon.
 
255 is good. I know it is confusing but what most likely happened is that she was getting too much insulin so she dropped low in the middle of the cycle and then bounced up high for the preshot. Now that she is getting less insulin, she is staying in lower ranges because she isn't bouncing. Weird that too much insulin can look like too little, but it works that way.

See our conversation about your spreadsheet.
 
Sue and Oliver (GA) said:
255 is good. I know it is confusing but what most likely happened is that she was getting too much insulin so she dropped low in the middle of the cycle and then bounced up high for the preshot. Now that she is getting less insulin, she is staying in lower ranges because she isn't bouncing. Weird that too much insulin can look like too little, but it works that way.

See our conversation about your spreadsheet.
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I understand. So, he gave her only 1/2 a unit. Is that a good idea for now? I will not hold you to it without complete info. I'm waiting on vet to reply.
 
O.5 should be a safe dose, and for now, that is what I would shoot for (pun intended). If she is not bouncing, we can guess that she is not dropping low mid cycle, but that is a guess. Once you see how low that dose takes her mid cycle, then you can adjust it. If her pre shot tonight is high or under 200, then likely the dose is too much.
 
Just to give an update. This morning 7:45 her Bg was 257
Husband injected slightly more than 1/2 unit. At 9 a.m.

At 2 pm her Bg was 339

6 Pm 290

She will be eating in a couple hours. So i was able to get one "mid cycle" number. It looks like she's NOT dropping too low middle of the day.

Vet replied that she recommends still 1 unit am and 1 unit pm
 
Hmm interesting. Looks like a flat cycle (meters have a 20% variance so the numbers aren't that far apart)

What did your vet think about the 145 pre shot? That was the number that said to me - reduce
 
Sue and Oliver (GA) said:
Hmm interesting. Looks like a flat cycle (meters have a 20% variance so the numbers aren't that far apart)

What did your vet think about the 145 pre shot? That was the number that said to me - reduce
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She wasn't concerned because she said Brandy weighs 12.5 pounds and so she could get up to 4 units at her size, she said. I gave her 1 unit this morning at 7:30 ish before work.
I am still trying to manage the spreadsheet thing - getting there. We have a lot going on in our house at the moment.
 
We have found that weight makes very little difference in dose amounts. Dogs can be dosed by weight, but not cats. We have 15 pound cats getting the same dose as 7 pound cats and both are doing well. I would want to base my dosing on the blood glucose levels you are actually getting at home.

I'd give the one unit a few more cycles, hopefully getting a midcycle number in there. Then, if an increase is needed, we suggest increasing by .25 or 0.5.
 
Sue and Oliver (GA) said:
We have found that weight makes very little difference in dose amounts. Dogs can be dosed by weight, but not cats. We have 15 pound cats getting the same dose as 7 pound cats and both are doing well. I would want to base my dosing on the blood glucose levels you are actually getting at home.

I'd give the one unit a few more cycles, hopefully getting a midcycle number in there. Then, if an increase is needed, we suggest increasing by .25 or 0.5.
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Good information - as usual! I tell you, If it weren't for this site and all the nice people sharing their knowledge - it'd be A LOT harder. I was telling an animal rescue lady about you guys last night
 
I will check her with the 1 unit and be VERY conservative with any kind of dose adjustment to be on the safe side.
 
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