+3 223 (.5u) New ProZinc user, Advice appreciated

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Wren

Wren

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Hello all,

I've been posting in the Feline Health Main Forum here, but some more expertise from ProZinc users would be very helpful.
(Previous Thread Link Below):
http://www.felinediabetes.com/FDMB/...ed-post-1st-blood-test-x.158275/#post-1686587

My vet told me to give 2 units of ProZinc 2x a day which I now see was way too much! Micah was in the 300s + 200s yesterday. You can look at his SS but his +11 is 48. I will retest at +11.5 to see how he's doing, but I don't think I will be giving him any insulin at his PMshot time. If you have any advice please let me know.

Thank you,
Karen
 
Wren said:
My vet told me to give 2 units of ProZinc 2x a day which I now see was way too much!
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Karen, you probably just saw what I wrote on the other thread about stress hyperglycemia ...

We want to get Micah's #s up to a reasonable level and make certain it stays there on its own for at least a couple of hours (without any more steering) before you can really relax tonight. No, you definitely do not want to dose him at all this cycle.

And tomorrow, at his usual morning pre-shot test time, you need to post that # here on ProZinc with "AMPS # & Dose Advice Needed" in a brand-new thread at that time. Not only will you not shoot if the number is below 200 tomorrow, but even if it is, I'm wondering whether you'd be much better off starting out at 0.5 unit. As you can always increase a dose next cycle, but you can't "unshoot" a dose of insulin that's too high; at that point all you can do is steer, like you're doing right now.
 
And the small amounts of higher-carb food are important too, because the honey or Karo syrup will bring the BG number up faster, but the food helps the blood glucose stay up longer ... and that's what's needed here: A good, safe BG # that comes up and sticks.
 
Hm is dry food okay then? He prefers the wet but I can give him a small amount of dry before his meal of wet food.
 
If that is all you have. Best would be gravy off a high carb food. But if not, then a few pieces of dry food. And I think I'd be tempted to add a tiny amount of honey also.
 
Ok so his +11.5 is 56, which is back up a little from 48. Should I still put honey on the kibble? It's Purina One Sensitive Systems kibble.
 
I am glad he is moving back up. Maybe we can skip the kibble and just give him a teaspoon of regular food. Then plan to retest in 20 minutes. (It is most likely at this point in the cycle, he will be going up, but we want to make sure he doesn't drop down again.
 
I would add a few drops of honey to the kibble. Kibble is pretty high-carb, but we do want to make sure he gets up to above 70-75 at least.

Oh, good! Sue's back!!! (And I agree with her post above, btw.)
 
Sue and Oliver (GA) said:
I am glad he is moving back up. Maybe we can skip the kibble and just give him a teaspoon of regular food. Then plan to retest in 20 minutes. (It is most likely at this point in the cycle, he will be going up, but we want to make sure he doesn't drop down again.
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Should I add honey to a teaspoon of regular food?
 
I'm sorry: Has he already had some honey?
Because if he has, maybe just the food this time around to see how he's doing in 20 more minutes ...
 
Since he's risen to 56, I'd be a little more cautious about adding more honey if he's already had some before this; would like to see how the food does.
 
@Robin&BB No I haven't given him any honey yet. Just a tiny bit of wet food and gravy around +11 when he went down.

I'm going to copy&paste what you wrote to respond better here from the other thread.
"The good news is this, Karen: We know that Micah needs significantly LESS insulin than 2 units. One of the things that can happen at the vet visit is "stress hyperglycemia" - some cats really stress out going to see the vet (some cats get really stressed just by riding in a car, like mine does:rolleyes:).
It is not unheard of for a cat to spike a BG# more than 100 pts higher during a vet clinic visit than the cat would at home where he or she is more calm and relaxed. This is why home-testing is such a smart thing to do!;) (And I am SO glad you're doing it.:bighug:)"

I am debating between going down to .5 or 1 unit of insulin. Micah was actually extremely relaxed and at home at the vet's. It was very peculiar. Meowing nonstop the whole car ride there, but I let him out on the bench while we waited (and we waited for 40 minutes) and he just laid down and relaxed like he was at home. Little dogs barked and walked by and he was totally calm. I don't get him lol!
 
Robin&BB said:
Since he's risen to 56, I'd be a little more cautious about adding more honey if he's already had some before this; would like to see how the food does.
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Ok I will just give him a little bit of wet food by itself then and test again around the PMPS time.
 
Well, this drop down into hypo territory is a clear indicator that 2 units is way too much for him. We'll know more when you get that preshot # in the morning ...

As for the steering when he's too low, it's something of a balancing act. You want to bring that # up and keep it up, but you don't want to overload him with carbs to the point that he's spiking a really high BG # from too much added honey or syrup. And although you need a fast-hit like Karo or honey if that # isn't rising enough/ quickly enough, overdoing it can make it difficult to determine later whether it's his own system working or whether it's the effects of too much added glucose.
 
I was smiling at the irony here, Karen, as I was writing all of the above --- because lately I've been having to steer my own kitty a LOT out of low #s.
(And would you believe she is only on 0.05U of Lantus? And I used to have to steer her on 0.10U of ProZinc when we were on that, too.:p)
 
Robin&BB said:
I was smiling at the irony here, Karen, as I was writing all of the above --- because lately I've been having to steer my own kitty a LOT out of low #s.
(And would you believe she is only on 0.05U of Lantus? And I used to have to steer her on 0.10U of ProZinc when we were on that, too.:p)
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Wow that seems like nothing! I guess you probably have to use the u100 syringe instead of the u40 one then right?

I won't be able to monitor while I'm at work tomorrow either so if he's high enough by the morning I think I will give him the lower dose of .5u to be safe.

Edit: I was going to give it about 7 more minutes around 7:15EST since I just gave him a little food.

I am also trying grab a bite to eat between tests for myself lol.
 
Wren said:
I won't be able to monitor while I'm at work tomorrow either so if he's high enough by the morning I think I will give him the lower dose of .5u to be safe.
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Assuming that you see a pre-shot # of 200 or more, I'd say that would be the smartest route. But I would also leave out a frozen "puck" of the canned food when you leave for work, so that it's thawed out by the time he night need it. (Is Micah your only kitty in the house?)
 
Wren said:
Wow that seems like nothing! I guess you probably have to use the u100 syringe instead of the u40 one then right?
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Ha, yep! U100s. It's a real eyesight-wrecker of a dose, that's for sure!;)
(Btw, Lantus is always dosed using U100 syringes; ProZinc users need to use a conversion table to dose with the U100 syringes, though.)
 
I agree. Most likely he will be high. After 24 hours since his last shot and probably a bounce, his amps might be high. But I would still reduce the dose. My thinking is that you want less insulin in his body than the dose that gave you a hypo number at the end of the cycle.

A bounce is when his body perceives a lower number than he is used to (like his number tonight) and it releases extra sugar. So his number bounces and is higher than expected.
 
Wren said:
Micah was actually extremely relaxed and at home at the vet's. It was very peculiar. Meowing nonstop the whole car ride there, but I let him out on the bench while we waited (and we waited for 40 minutes) and he just laid down and relaxed like he was at home. Little dogs barked and walked by and he was totally calm. I don't get him lol!
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Makes me wish they could TALK to us ... but even "happy" excitement can cause a spike in BG#s; that's the trouble - you just never really know for certain. (Unless it's Bat-Bat. She's so nasty at the vet's office that she has to be stuffed in the "gas box" before anybody can even examine her ... but is as calm as can be here at home. Kinda embarrassing!:facepalm:)
 
Glad to see you made it over here Karen!!

I'm good for getting people started, but if they're using ProZinc, it's always best to move over to the Insulin support group for that insulin so you get the best advice possible

Just for the future....You should keep some "Fancy Feast Gravy Lovers" food in the house at all times...The "gravy" part is high carb and usually just a teaspoon or two of the gravy is enough to get them back above 50 where we want them (without filling them up so they won't want to eat later if we need them to)

When you use the Gravy Lovers types of food, just pop the lid and press it back down and squeeze the gravy part into another bowl and just feed that gravy part. It's messy but it works!!

I'll be checking in with you and Micah now and then, but mostly, since you're here with the ProZinc experts, I'll leave the dose advice to them!! I do agree the .5 would be safest for Micah at this point too..especially with him going this low, this late in the cycle....especially if you can't be home to test.

Welcome to the Sugardance!!

Edited to add...if you haven't see this Conversion Chart here it is....It's for using U100 syringes instead of the U40 that you usually use with ProZinc so you can give smaller doses
 
Wren said:
Good news! Micah went up to 91 at his PMPS time! That was just giving him a teaspoon of normal food, no honey.
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Yessssss!!! That's the kind of news we LOVE to hear. So you need to write "skip" in the "U" column on your SS (since he's definitely not getting a dose tonight;)) and I'd say you should go ahead and feed him what he normally gets for his evening meal. Then as long as he eats it all, check him @ +1 just so you can see that he's staying up there.

(If he doesn't eat it all, check him again in another 1/2 hour. I'm just being extra cautious here ...)
 
Great! Avoiding giving honey is good as it will add to those high bounces. Anytime you can just give regular food and steer the number is good. Chris is exactly right - gravy lovers fancy feast is a necessity for your hypo kit.

Nice job bringing him up. You survived your first hypo!
 
And you will also want to get a +2 before calling it a night on the testing. (And then - woo-hoo! - you'll be able to get a good night's sleep!:D)

P.S. We're all so proud of how well you did this, btw!:bighug:
 
Yay!! Thank you everyone for the help getting him back to a normal number. If you had told me that I would be getting blood from Micah's ear this many times in a day last week I wouldn't have believed it! I gave him the rest of his can of food with some extra water and will test him again at +1 and +2.

I'll also pick up some of the Gravy Lovers Fancy Feast tomorrow when I go to the pet store.
 
Umm.. is my monitor broken!? Micah just bounced up to 267 at +1, skipping the PM insulin! This is good right?
 
Well, now we get some idea of how fast he bounces. Somehow they bounce right away, sometimes a few hours later, sometimes the next cycle.

Yes, I imagine it's a bounce. To be sure, you might retest and make sure it was a good number.
 
Wren said:
Umm.. is my monitor broken!? Micah just bounced up to 267 at +1, skipping the PM insulin! This is good right?
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If you get a test that seems out of place try doing another one. Sometimes a strip is off or the blood sample was too small for a correct reading
 
Hi Karen

Great job with catching that low and steering Micah back up to better numbers today. I'm glad to see all is going OK.

Tip:

Make a note of when, how much, and which type of food you gave while Micah was running low in the Remarks column for today's line on your spreadsheet so that you have a record of the effect of the food on Micah's BG. It's always helpful to have information like this to refer back to.


Mogs
.
 
I retested and got a 266 so it looks like it really did bounce back up! Thanks @Critter Mom I will type in some notes right now.

Do you all think I should do .5units or 1 unit for the AM insulin shot if Micah is still above 200?
 
I'd still be inclined to do the 0.5 unit. Because you can always increase the dose later, when you can be home to monitor. Better to "start low, go slow" after an episode like this one.
 
P.S. In all the hubbub today, I forgot to tell you ... that I think Micah is a really strikingly handsome boy.:)
 
Hi Karen! Sorry I wasn't around today...looks like I missed all the activity! Since Sue and Robin had things well in hand, I pretty much wanted to stop by and welcome you to our forum!

Just to let you know, we are a fairly small forum. If you ever run into an emergency situation, post both here and on Health to be sure some eyes can be on it. We will definitely help if we're here, but we're not always, and there is usually someone on Health. :)
 
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