Java and Lois, new here, diagnosed Oct., need better MO

[Lois and Java]

From Intro page:
My 20 year old DSH neutered male Java was diagnosed in early Oct. I have four months of data on notebook paper - date, time, BG, dose, notes, and vitamins. Java ended up in the vet emergency room for day and half. with a BG of 36 after the first two days of his vet-prescribed insulin regimen back in Oct. Vet prescribed 2 units bid, and what a crash.

I've been tracking everything ever since, but I don't feel like I have a handle on any of it, not really. I was at his vet for the 4th or 5th time yesterday asking for help. I came home not feeling like I'd gotten any and started Googling. I could kick myself for not doing this back in Oct. because I found this website right away.

I'm trying to work with your spreadsheet template*, since I have 4 months of data. I didn't know that I should do a proper glucose curve, though I probably could produce several from historical data, and am tracking Java closely today. He's very reactive, too many spikes high, and drops low, possibly/probably because I'm only dosing when he goes high? I look forward to learning more here and getting a better handle on it. My name's Lois.

*does anyone ever just convert the +1, +2 etc. in concrete time? 8 AM, 9 AM, 10 AM etc?

So! I've been doing testing for a proper BG curve since 4pm yesterday. Where to go to plot it on a computer? Excel? Google docs? Shodor.org? Or just do it on a piece of notepaper and photograph it? Word? Retired paralegal here, mathy stuff not my strong suit, though I'm proficient on Excel.

Insulin: ProZinc
Meter: Henry Schein vet meter, measured in mg/dL
Soon to become a backup. AccuTrack ordered, and should arrive in 3-7 days.
Feeding: free feed round the clock. Shares feeding area with healthy 5-year old.
Diet: Fancy Feast classic. Home cooked plain chicken. Eliminated dry food after diagnosis, tried adding back in after 4-6 weeks with bad results. Cut-up dehydrated chicken breasts available to provide alternative to dry kibble, for which he begs when feeling spry (he has to jump up on the dryer to do so, and he does).
Treats: for chronic dry stool, Feline Greenies Smartbites Hairball control, approx 15 per day. Definitely spikes glucose, definitely kitty crack. Might have to eliminate?

He's an old man, 20+, still enjoying himself inside and outside (makes his rounds every morning), eats well, if a bit picky sometimes. I worry about his weight, which seems to be holding steady. He'd lost a few ounces from Oct. at his last vet appt. about 3 weeks ago. It's the main reason I haven't picked up food - he's been a free feeder his whole life. But I'll do it if it helps.

We've gone through three more hypoglycemic episodes since the first one, very scary. Handled at home pretty quickly, he will eat, he will come get me if he doesn't feel well, if I don't catch. I've been testing in the AM, and throughout the day when home, and giving insulin any time his BG is over 250. He's really sensitive to the insulin most of the time, and sometimes not. I need to sit down and do some curves from last night/today's data, plus I have enough data from other days, maybe not every 2 hours, but lots of testing. My MO is flawed, it needs to work better for him, and for me - I can't be here to test him every few hours every day, and I like to travel, and need something my fabulous and responsible house/pet-sitter can handle.

I've been getting complete blood panels annually for 4-5 years, because of his age. He shows in the early stages of renal failure, although the values had barely changed annually for the past several years. I did sub-c fluids about once every 2-3-4 weeks for awhile, but stopped with vet's okay since it didn't seem to matter. Gave all the Ringers to the vet. He's always been a big water drinker.

 

[Larry and Kitties]

Welcome.
It is good that yo are home testing
Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Have the BG information in the SS allows others here to see what is going one so we can make suggestions.

One concern I have with free feeding is that you have another cat and could it be that Java is not eating the same about of food during each feeding cycle. If Java eats less then that could explain the low BGs

 

[Kris & Teasel]

Thanks for the extra info, Lois. Now more questions and comments:

So! I've been doing testing for a proper BG curve since 4pm yesterday.

You can lessen the burden of doing a curve by testing every 2 hours starting with the AM test and ending with the PM test 12 hours later. No need to plot a graph if you use our spreadsheet:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
There's help available to set it up if needed.

He's very reactive, too many spikes high, and drops low, possibly/probably because I'm only dosing when he goes high?

Some cats are very reactive ("bouncy" as we call them - mine is a prime example) but with careful, systematic dosing over time some of this can be smoothed out. Yes, you absolutely must be giving insulin regularly at 12 hour intervals if you have any hope of getting Java regulated or, even better, into remission.

does anyone ever just convert the +1, +2 etc. in concrete time? 8 AM, 9 AM, 10 AM etc?

No, we use these time designations because the members here are all over the globe in different time zones. Using actual clock time would be extremely confusing.

Henry Schein vet meter, measured in mg/dL

I'm not familiar with this meter. The pet meter mentioned here is the AlphaTrak. It's main selling point is that it gives BG readings that are close to what the vet would measure. The test strips are extremely expensive which is why most people use a human meter.

Diet: Fancy Feast classic.

Friskies and Fancy Feast pates are fine for diabetic cats, as are plain cooked chicken and freeze dried meat treats. You're giving quite a few high carb treats each day. If you eliminate them that would be best. There are other things you can use for hard stools.

giving insulin any time his BG is over 250.

He needs insulin at 12 hour intervals, even if the dose is tiny. There are procedures for weaning a cat off insulin if they've proven they're ready to go OTJ ("off the juice"). You don't know if Java is there yet until you test/dose/log data in a systematic way.

I can't be here to test him every few hours every day,

No need: AM/PM before shot then one other time mid day or before bed. More testing on weekends if needed.

I like to travel, and need something my fabulous and responsible house/pet-sitter can handle.

It's doable once you have a system in place.

 

[Lois and Java]

Thank you.
I begin my 24 hour glucose curve at 4 p.m. yesterday. The odd time is because test strips didn't arrive as scheduled, and I ran out, argh, and 4 pm is when I got them.

I'm an hour away from 24 hours, and he's gone up to 381. Dose now, yes? Should I have done at 328 - 2 hrs ago?

 

[Pati]

Hi Lois. Welcome. ProZinc is dosed every twelve hours so for example my cat is dosed at 6am and 6pm. How much you dose is based on the BG reading before each injection (AMPS - AM preshot and PMPS) and by how low that dose is dropping the BG midway through the cycle. If you go to the ProZinc forum there are some "stickies" at the top of the forum that have a lot of information.

 

[Kris & Teasel]

Thank you.
I begin my 24 hour glucose curve at 4 p.m. yesterday. The odd time is because test strips didn't arrive as scheduled, and I ran out, argh, and 4 pm is when I got them.

I'm an hour away from 24 hours, and he's gone up to 381. Dose now, yes? Should I have done at 328 - 2 hrs ago?

OK. Just looked at your graph. I see the BGs but no indication of when the insulin was administered. At 4 PM yesterday? When was the next dose? At 4 AM this morning? If you dosed 1 unit at 4 PM and 4 AM then the curve is showing quite a large drop between dose and nadir (lowest BG point). That can be an indicator that the dose is slightly high. However, until you have more data over several days at this dose with the insulin being given every 12 hours, it's hard to be sure.

 

[Lois and Java]

The units are in brackets at the bottom. I gave him 1 unit at 4 pm yesterday, and 2/3 unit at 3:45 am today. I gave him 1/2 at 3:15 pm because I had to leave for about 1.5 hours.

I've not been dosing BID so I'll need to work this schedule around to 8 am, pm somehow.

I thought I'd give him a break and test him every 4 hours the rest of tonight and middle of the night. Sound okay?

 

[Kris & Teasel]

The units are in brackets at the bottom. I gave him 1 unit at 4 pm yesterday, and 2/3 unit at 3:45 am today. I gave him 1/2 at 3:15 pm because I had to leave for about 1.5 hours.

I've not been dosing BID so I'll need to work this schedule around to 8 am, pm somehow.

I thought I'd give him a break and test him every 4 hours the rest of tonight and middle of the night. Sound okay?

I think you can stop testing for now. I understand your dosing. Based on that small bit of data, your graph is showing that your kitty's BG has responded properly to the two different doses - ie., the nadir value was higher when you gave 2/3 u than when you gave 1 u. Are you using U40 syringes with half unit marks? How did you measure 2/3 unit?

I recommend that you set up a testing/dosing schedule that you can stick too as much as possible. I also recommend that you pick a reasonable dose and stick to it for a few days, test AM/PM before injecting plus one other test midcycle or before bed. If you can get U40 syringes with half unit marks it'll be much easier to do dose fractions.

 

[Lois and Java]

I guess my mistake is not sticking with one unit? At 6:45 he's at 254. And I have to leave cuz I have theater tickets.

 

[Kris & Teasel]

I guess my mistake is not sticking with one unit? At 6:45 he's at 254. And I have to leave cuz I have theater tickets.

Maybe 1 u is the good dose right now, maybe not. You need to gather data systematically to know for sure. Start with 1 u BID for a few days.

 

[Lois and Java]

Hi, thank you for your comments. Since starting to post, I've continued taking very regular readings and graphing them. I also took some historical data and graphed it. They're pretty crude hand-drawn things. I took all the day that to my vet yesterday and we took a look. His observation is that Java is very reactive to insulin, a little bit causes a big drop. But then it goes back up. I'm attaching photos of my charts.
This is 1/25 to present 1/28.

 

[Lois and Java]

2 of 4 -- 1/22 and 1/23

 

[Lois and Java]

My vet's suggestion is, continue using the ProZinc, starting today, dose one unit every 8 hours, and track his BG every 3 to 4 hours. Do that all weekend, including today Friday. Thoughts? Feedback? I appreciate having experienced eyeballs looking at this!

My constant worry is HG of course. Plus he seems to be getting more hind leg neuropathy. He still begging for dry food and treats, which I'm not giving him. That's a really hard one for me, because it really spikes his BG, but boy does he ever want it. When he was first diagnosed, I eliminated all dry food, and he was doing great without insulin, or having it very rarely. Until I let him start with one sixth cup of MD Science Diet. It's been difficult ever since. I'm not giving him the dry food regularly, maybe that's the problem? Curious to know what you think although my main concern is whether or not every 8 hours is good idea or not.

 

[Lois and Java]

I'm still reading more here. I am wondering, because I have food down 24 hours a day, if I should instead start over as if new, taking food up 2 hours before a dose, and doing the PIZ every 12 hours today and this weekend instead of every 3 hours.

Among other things, this would enable me to use your spreadsheet. I have too much variation right now to adapt my historical data to your spreadsheet without modifying the SS.

Should I be posting in the prozinc thread?

 

[Larry and Kitties]

You are getting good reductions with the ProZinc. However, you are getting very large swings.
How much (compared with total for the one shot cycle) food does Java eat right away after the shot?
Maybe changing to Lantus or Levemir will help reduce the swings

 

[Lois and Java]

Sorry I didn't notice earlier that two of us had gone sideways. Here they are again, right side up.

 

[Lois and Java]

I'm really not sure. Maybe this is my problem with the swings, not having better regulation on his food? He grazes on his own, and if I am testing him, it's near the kitchen/their food, so he will eat after testing, sometimes right before it while I'm getting the kit together. My guess would be can and a half of Fancy Feast classic spread out over a day, plus cut up dehydrated chicken breasts from Trader Joe's now and then.

 

[Lois and Java]

My immediate concern is, do I go forward with Fri, Sat, Sun, with 3 shots of one unit per day, or should I back off that and do one shot every 12 hours? If I do the 8-hour plan, he will be due for a shot in about 1.5 hours.

He got a shot at 7:30 am; his BG was a whopping 466. His BG at 12:30 pm was 156.

I think I'm answering this myself, unless it really Skyrocketed in the next hour and a half, I wouldn't want to give him another unit because he likely would go into hypoglycemia.

 

[Zoey & Carol]

I've been reading your thread and since no one has answered yet, I'll give you my 2 cents. Zoey has been on ProZinc for 2 years, so I have some experience. I would definitely not give a shot if his BG hasn't gone up a lot.

 

[JanetNJ]

My vet's suggestion is, continue using the ProZinc, starting today, dose one unit every 8 hours, and track his BG every 3 to 4 hours. Do that all weekend, including today Friday. Thoughts? Feedback? I appreciate having experienced eyeballs looking at this!

My constant worry is HG of course. Plus he seems to be getting more hind leg neuropathy. He still begging for dry food and treats, which I'm not giving him. That's a really hard one for me, because it really spikes his BG, but boy does he ever want it. When he was first diagnosed, I eliminated all dry food, and he was doing great without insulin, or having it very rarely. Until I let him start with one sixth cup of MD Science Diet. It's been difficult ever since. I'm not giving him the dry food regularly, maybe that's the problem? Curious to know what you think although my main concern is whether or not every 8 hours is good idea or not.

The only dry food that is ok for diabetic cats are Evo cat and kitten in the purple bag and my favorite Young Again Zero carb food available at Youngagainpetfood.com.

Unregulated cats are often hungry all the time. You can give several smaller meals of ff throughout the day, but NO FOOD two hours before the preshot test.

Instead of the hairball treats which are super high carb, try adding a bit of plain pumpkin to his food.

Every 8 hours is not a good idea. We will help you find the right dose for every 12 hours.

The spreadsheet is great... Download Google Sheets to get going with it. There are a few ss experts on here that can set it up for you if you are really struggling with it.

 

[Lois and Java]

Thank you so much for your comments. I feel very emotional about it all suddenly, I can see his mortality looming as the slight drag in his hind legs gets a little worse. I'm so grateful for other people to talk to, so happy-crying relieved for your knowledge. I have felt that I'm doing it all wrong and terrified that what I'm doing is making things worse for Java, not better, even with regular consultations with the vet.

His BG was 383 at 4 pm. He just ate a bunch - I have to get used to quanifying this for myself, about 1/2 - 2/3 can FFC -- pulling up dishes now and will test him at 8, just 30 minutes behind 12 hrs. From last shot.

 

[JanetNJ]

Thank you so much for your comments. I feel very emotional about it all suddenly, I can see his mortality looming as the slight drag in his hind legs gets a little worse. I'm so grateful for other people to talk to, so happy-crying relieved for your knowledge. I have felt that I'm doing it all wrong and terrified that what I'm doing is making things worse for Java, not better, even with regular consultations with the vet.

His BG was 383 at 4 pm. He just ate a bunch - I have to get used to quanifying this for myself, about 1/2 - 2/3 can FFC -- pulling up dishes now and will test him at 8, just 30 minutes behind 12 hrs. From last shot.

Is he getting vitamin b 12 for the neuropathy? You are doing great.... You have lots of people here to help you.

 

[Lois and Java]

Yes, Jarrow B-Right, B vitamins, methylcolbamine + Pantethine+P-5-P, info obtained from Tanya's kidney cat website, excellent website. Someone was curious about my meter; Henry Schein is a medical, dental, and vet supply company. The strips are close to $1 per strip, come in packets of 50. The Henry Schein salesman gave a starter pack (including 25 strips) to my vet, who gave it to me in turn. I ordered an AlphaTrak earlier this week, so the Henry Schein will be back up. I'll look into the human type if (no, when!) Java is stabilized.

I just ordered a bag of Young Again Mature food. He craves kibble, and also the fiber treats I mentioned above (Greenies hairball relief). I got some pumpkin and tried it today, he ate a little bit. I don't want to let him get constipated for days. Besides the Greenies, pumpkin, there are tubes of Cat Lax and similar. Is there anything else for cat constipation?

I'm feeling less anxious. His reading at 8 was 385, and I tested him, fed him, and waited a bit before giving him 1 unit. He also seems better than he did during the day, not sure if it's the prism of my mood or not. Next to do: start using the spreadsheet. I couldn't use it with the irregular schedule I'd been on, not without re-doing it to add columns, which would necessitate re-doing the programming for the color coding - super nice feature. But now that I'm starting a twice a day schedule, it'll work great. Thanks for your feedback and help, very much.

 

[JanetNJ]

Yes, Jarrow B-Right, B vitamins, methylcolbamine + Pantethine+P-5-P, info obtained from Tanya's kidney cat website, excellent website. Someone was curious about my meter; Henry Schein is a medical, dental, and vet supply company. The strips are close to $1 per strip, come in packets of 50. The Henry Schein salesman gave a starter pack (including 25 strips) to my vet, who gave it to me in turn. I ordered an AlphaTrak earlier this week, so the Henry Schein will be back up. I'll look into the human type if (no, when!) Java is stabilized.

I just ordered a bag of Young Again Mature food. He craves kibble, and also the fiber treats I mentioned above (Greenies hairball relief). I got some pumpkin and tried it today, he ate a little bit. I don't want to let him get constipated for days. Besides the Greenies, pumpkin, there are tubes of Cat Lax and similar. Is there anything else for cat constipation?

I'm feeling less anxious. His reading at 8 was 385, and I tested him, fed him, and waited a bit before giving him 1 unit. He also seems better than he did during the day, not sure if it's the prism of my mood or not. Next to do: start using the spreadsheet. I couldn't use it with the irregular schedule I'd been on, not without re-doing it to add columns, which would necessitate re-doing the programming for the color coding - super nice feature. But now that I'm starting a twice a day schedule, it'll work great. Thanks for your feedback and help, very much.

I'm so glad you're feeling better. Knowing you aren't alone makes this journey easier. I'm sure your cat picked up on it.

Cats can also be given Miralax for constipation but I don't know the dosage. The pumkin had worked for several of my cats in the past... And I know it doesn't spike bg. Try the pumkin, add a little extra water to the wet food and see how he does over the next few days. If it's not enough than look into the Miralax. I also find my cats drink more since I bought a few cat drinking fountains. Santa brought it for Christmas. Heehee


I'm glad you are giving young again a try.... It really is fantastic. Did you get the mature one? It's low in phosphorus too for kidney health.

I'm glad you are going to try the spreadsheet....it really makes it easy for us, and you, too assess what the numbers are doing in a glance.

If you could also set up a signature with info like date diagnosed, food you're feeding, and type of insulin that would be great.

 

[Lois and Java]

testing signature and spreadsheet.

 

[Lois and Java]

Do I keep adding to "my thread" now as I have questions? I have more questions and some worries.
1. I'm worried that Java is constipated. The greenies hairball relief treats really helped with his hard stools. He comes inside to use the litter box even if he's been outside for his morning rounds, and he hasn't had a good poop in a couple of days. He had some pellets yesterday and this morning, there was a dried poop elsewhere that had clung to his butt and dropped off. I gave in to my worry yesterday and gave him 7, but it's actually a half measure, a dose being 14, so that was dumb of me now I see.
2 &3. I thought he was holding his own with weight, but now he's not, he's losing weight, and the hind leg neuropathy seems worse. I sprinkle a little bit of the Jarrow B on nearly every bowl of food, but should I try the injectable kind? I gave him some MD last night also. He wasn't eating after testing at 8:30, and I knew he'd eat that.
Then 4, this morning, he was at 410 at 6 AM, but he'd had a shot at 9:15 PM, so I took up his food, went back to sleep, woke up later than usual, tested at 450 at 10 AM and waited some more for him to eat, so he got a shot at 10:45. Could I have given him 1 unit at 6 AM?

 

[Kris & Teasel]

It's great that you've set up the spreadsheet and put in all the data you've collected so far. If I understand it correctly, on 01/23, 01/24, and 01/28 you gave only one dose a day. On 01/27 you gave a different dose in the AM and PM even though the BG numbers preceding the dose were in the same range.

Most cats do best with a very consistent insulin dosing routine, ie., two doses a day 12 hours apart (or close to that) with the same dose given AM and PM. After you've collected a large body of data on your cat's responses to a dosing regimen it's possible to deviate from this slightly but you're not there yet. Your SS shows considerable variation in dose timing and wildly fluctuating BG numbers. It's difficult to tell if a 1 unit dose is too high or not.

I suggest the following:

1. choose two times 12 hours apart that you know you'll be available at home to give your kitty his insulin and stick to those times (plus or minus 0.5 hour is OK)
2. choose a safe dose and stick to it for 3 days to evaluate its effect. I suggest a 1 unit dose for now if you can monitor him for the next 3 days
3. test prior to feeding and injecting (no food for at least 2 hours before) in the AM and PM
4. test in the mid section of the 12 hour cycle - eg. at +4, +6 and +8 to determine how low this dose takes him
5. feed only low carb wet food and perhaps try plain canned pumpkin (not the pie mix) for his constipation - a teaspoon added to a wet food meal
6. feed a larger breakfast, small lunch, larger supper and smaller bed time snack.

All these suggestions are aimed at structuring your routine so that insulin dosing can be figured out without a myriad of other confounding factors. Are you willing to try this?

 

[Kris & Teasel]

My vet's suggestion is, continue using the ProZinc, starting today, dose one unit every 8 hours, and track his BG every 3 to 4 hours. Do that all weekend, including today Friday. Thoughts? Feedback? I appreciate having experienced eyeballs looking at this!

My constant worry is HG of course. Plus he seems to be getting more hind leg neuropathy. He still begging for dry food and treats, which I'm not giving him. That's a really hard one for me, because it really spikes his BG, but boy does he ever want it. When he was first diagnosed, I eliminated all dry food, and he was doing great without insulin, or having it very rarely. Until I let him start with one sixth cup of MD Science Diet. It's been difficult ever since. I'm not giving him the dry food regularly, maybe that's the problem? Curious to know what you think although my main concern is whether or not every 8 hours is good idea or not.

Dosing every 8 hours is rarely used because it's an unsustainable schedule for most people. it also requires a lot of extra testing to be sure the dose is safe to give. It's better to try to make every 12 hour dosing work for you.

 

[JanetNJ]

Pumkin or a 1/4 teaspoon of Miralax could help the constipation... And make sure he's drinking enough.

Good job getting the ss and signature going!

 

[Lois and Java]

Java drinks a lot of water already, he always has, though he increases with high BG.
How do you dose a cat with Miralax?
I gave him plain pumpkin in food the afternoon of the 28th.
And gave him as much CatLax as I could - maybe a half inch - at 6 AM today.
My error in the spreadsheet, now corrected. He had insulin AM and PM but not at the same time, because I was holding off because he didn't eat much in the AM.
Will need to institute feeding hours. I tend to follow him around with bowls saying, Eat! Eat! and he doesn't always.

 

[JanetNJ]

Java drinks a lot of water already, he always has, though he increases with high BG.
How do you dose a cat with Miralax?
I gave him plain pumpkin in food the afternoon of the 28th.
And gave him as much CatLax as I could - maybe a half inch - at 6 AM today.
My error in the spreadsheet, now corrected. He had insulin AM and PM but not at the same time, because I was holding off because he didn't eat much in the AM.
Will need to institute feeding hours. I tend to follow him around with bowls saying, Eat! Eat! and he doesn't always.

I think most people just mix the miralax in with the food.
for the pumkin you can put a teaspoon in each meal.

 

[Lois and Java]

1. >> choose two times 12 hours apart that you know you'll be available at home to give your kitty his insulin and stick to those times (plus or minus 0.5 hour is OK)

This AM, BG at 410 at 6 AM. Should I have dosed him then, because it was high, and close enough to 7-7:30 AM, and he'd eaten something? Instead of waiting until 10 AM?

How much does he need to eat? Yes, I will have to change feeding patterns, this isn't working, the time keeps creeping as I wait for him to be hungry, then wait 30-45 minutes after he's eaten to shoot.

Today, starting BG at 450 at 10 AM. 1 unit at 10:45 (waiting for eating, then 30-45 minutes). BG at 12:30 was 349. Right now, 4:40 pm, 159. That's interesting, I thought it would continue to go up. He just ate some pumpkin and FF, drank water, back to nap some more. I'm off my goal of 7:30-8:00 AM and PM, so at what point do I go back?

 

[Kris & Teasel]

This AM, BG at 410 at 6 AM. Should I have dosed him then, because it was high, and close enough to 7-7:30 AM, and he'd eaten something? Instead of waiting until 10 AM?

If you tested at 6 AM and there was no food in him for at least 2 hours beforehand, then that is a valid test number to decide on dose. You should then have fed him some low carb wet food - doesn't have to be a large meal - and injected his insulin right then while he's eating or immediately after he finished. Identical routine at 6 PM (no food for at least 2 hours before that test as well).

How much does he need to eat? Yes, I will have to change feeding patterns, this isn't working, the time keeps creeping as I wait for him to be hungry, then wait 30-45 minutes after he's eaten to shoot.

A small meal is sufficient with ProZinc or PZI because it's slower in onset than some of the shorter-acting insulin. Something like 1/4 or 1/2 can the size of a Fancy Feast can would work.

Today, starting BG at 450 at 10 AM. 1 unit at 10:45

Should have happened at or shortly after meal given right after 6 AM test.

I'm off my goal of 7:30-8:00 AM and PM, so at what point do I go back?

Why not take a bit of liberty just for today and wait until 7:30 - 8:00 PM to test. Don't let him eat anything beyond 5:30 PM. Tomorrow morning you can test at 7:30 - 8:00 AM and you'll have established your schedule going forward.

You have to get a structured routine going and stick with it in order to make good dosing decisions. If he likes to graze on low carb food through the day, that's fine. Just take all food away for the 2 hours prior to AM and PM tests.

So, a sample schedule might look like:

• 7:30 AM - test BG (no food 2 hours before)
• feed a small meal
• inject insulin while eating or right after

__________________________________________

• maybe try structured meal time mid day to train better eating habits
• allow to graze if he insists
• try to get a mid day BG test or two if you can

__________________________________________

• 7:30 PM - test BG (no food 2 hours before)
• feed a small meal
• inject insulin while eating or right after.

Many people use automated pet feeders for overnight feeding of snacks. They allow food intake overnight and you can set timing so there's no food available for 2 hours before the AM test.

 

[Lois and Java]

Thanks! I tested at 8, BG 191, which I think is too low for him to have a dose. He ate about tablespoon of food. I'm guessing pull food up again and test again at 9:30 to 10?

I'm glad to hear I don't have to wait so long after he eats food to give him an injection. It was in the faQ's to wait 30 to 45 minutes after eating.

 

[Kris & Teasel]

I'm confused. You have a bunch of data on your SS for today, January 30/17 and it's only AM. Is there a mistake on the date? I see you're in California so it's only around 6 AM your time right now. When are you going to begin the 7:30 AM and 7:30 PM dosing schedule? I'm willing to help as much as I can but it would be easier if you had more of a structured system in place.

Re waiting 30 to 45 minutes to feed: that's for users of fast acting insulins like Novolin, Vetsulin, etc. PZI is not one of those.

 

[Kris & Teasel]

Thanks! I tested at 8, BG 191, which I think is too low for him to have a dose. H

Too low to have a dose when?

 

[Lois and Java]

Hungry cats woke me up, 6:40 here. I pulled up food at 4:45 am, about 2 hrs ago. His Bg was 137 then at 4:45 am, it was 125 at midnight.. Yes I must have filled out wrong lines going to look on laptop bigger screen.

 

[Lisa and Smoky]

It would be good for example if you could put how many hours after each test or before and after feeding cats. I saw that you do that in your spreadsheet but it would be easier if you put that info in your posts as well. I get it since I am in the US but was thinking of our international members.

 

[Lois and Java]

I was off by one day all along I guess. 6 am to 5 PM is on AM side; 1 PM to 5 AM is on the PM side. I tested Java at 4:45 AM, he was 137. It's now 7 AM, I test him again.

 

[Lisa and Smoky]

I meant putting in hours since shot,
+1, +2, +3 instead of actual clock times.

 

[Lois and Java]

I saw that the SS doesn't assign hours to the +1, +2, hours, and found it too big a task to tackle when starting with historical data before I was trying twice a day only. Okay, heat on, more clothes on, let me test the hungry boy.

227 at 7 am. I would guess 1/2 a unit?

 

[Lisa and Smoky]

You have to do what works best for you.
The reason the SS doesn't assign hours is because members are all over the world and have different clock times where they are.

 

[Kris & Teasel]

I saw that the SS doesn't assign hours to the +1, +2, hours, and found it too big a task to tackle when starting with historical data before I was trying twice a day only. Okay, heat on, more clothes on, let me test the hungry boy.

227 at 7 am. I would guess 1/2 a unit?

Try 0.5 u and enter both that preshot BG and the dose on your SS. I think Lisa has explained the +1, +2, etc. time designations we use. Feed now and inject as he eats or right after. I suggest testing at +2, +4, +6, +8 today to see how that dose is working.

 

[Lois and Java]

>> I meant putting in hours since shot,
+1, +2, +3 instead of actual clock times.

I get that I'll have to start doing that to conform to the norm here, though I'm obviously finding it hard to do (and don't think it makes sense to not use actual hours of the day - it's just like time zones, everyone has a 7 AM whether you call it +1 or something else).
I'm pretty new here and I have four months of data that's only date/time/BG/units/notes -- I wasn't trying to stick to 1 shot in AM, 1 shot in PM until a few days ago. I'm transcribing notes from paper to this spreadsheet, and I think the +1 system will work better if it's the only record I keep, instead of going back and forth. I'm trying to get with it here, I'm sorry.

I think I should feed these hungry cats. Java had 1/2 unit of insulin at 10:45 PM, not yet 12 hours ago.

 

[Lisa and Smoky]

No need to apologize Lois, we were all new here at one time. I've not been here that long yet, just a month before you. There is a lot to learn and it takes time to catch on and get everything going. It's great that you are home testing Java so soon. It took me over a month to really start to test on a regular basis. You are doing an outstanding job taking care of your boy.

 

[Lois and Java]

I'm going to start a new section on SS with the +1 and see how that goes.
Java's been tested 45 times since the afternoon of 1/24, as I've gone about making curves and trying to get into a 1 AM, 1 PM shot schedule. He's a very tolerant cat!
In all sincerity, how would someone keep track of that using just the +1 system? I know I need to know that I started at 7:30 AM, as I go about my day.
Anyway, the good news is, look at that! Lots of blues and yellows on the spreadsheet! I am thrilled with the spreadsheet, it's a terrific tool. (I just need times is all, but I'll try with the +1 and see how it goes.)

 

[Lois and Java]

Oops, I think we crossed.
Yeah, my vet sent me home with insulin and needles after diagnosis, on a Thursday afternoon, and his recommendation to give him 2 units BID nearly killed Java. I took Java to the vet ER around 11 pm the day after, Friday, when he started walking around in circles, stumbling. OMG so scary. I had a test kit by Monday, that my vet gave me, but ever since that day, I never tried to stick to a 1 AM/ 1 PM shot, which was a mistake. I went to the vet with all my paperwork 4 or 5 times asking for help, more guidance, and he didn't pick up on the lack of 1 AM, 1 PM and obviously I didn't either. And with all my data, I'd never done an actual curve until the ones I posted above.

I've stuck Java so much, last night I had a flashlight under his ear, and it looks bruised, he's been stuck so much in one area. I'm not trying to torture him, it's the only place on either either where I get a good drop right away. I need to try harder in other places. Don't have a microwave, will have to find an alternative to the rice sock.

 

[Lisa and Smoky]

Try filling an old medicine bottle with hot water and using that to warm up his ear.
You don't really need to test him every two hours every day. That's usually just done on days you would do a curve for 12 hours. I did one on Smoky about once a week when I started, now I do one every two weeks.

 

[Lisa and Smoky]

If you want to you could start another thread asking about home testing tips and how to prevent and treat ear bruising. The links in FAQ's helped me out a lot when I first started. My vet also gave my cat a high dose to start with, it turned out to be far too much. I'm glad I found this site when I did and have since changed vets. My old vets solution was to just keep giving him higher doses of insulin.

 

[Kris & Teasel]

Oops, I think we crossed.
Yeah, my vet sent me home with insulin and needles after diagnosis, on a Thursday afternoon, and his recommendation to give him 2 units BID nearly killed Java. I took Java to the vet ER around 11 pm the day after, Friday, when he started walking around in circles, stumbling. OMG so scary. I had a test kit by Monday, that my vet gave me, but ever since that day, I never tried to stick to a 1 AM/ 1 PM shot, which was a mistake. I went to the vet with all my paperwork 4 or 5 times asking for help, more guidance, and he didn't pick up on the lack of 1 AM, 1 PM and obviously I didn't either. And with all my data, I'd never done an actual curve until the ones I posted above.

I've stuck Java so much, last night I had a flashlight under his ear, and it looks bruised, he's been stuck so much in one area. I'm not trying to torture him, it's the only place on either either where I get a good drop right away. I need to try harder in other places. Don't have a microwave, will have to find an alternative to the rice sock.

I feel bad that you were sent home with so little direction from your vet. Unfortunately it's a common story here. What we do here is often different from what the vet might say but it's tried and true and geared to getting a cat regulated if possible but keeping him/her safe above all.

I think you'll get the hang of the +1, +2 time designations as you use them. It's quite adaptable too. So - if you dose at 7:30 AM, say, and then do a BG test at 10:30 AM, you'd enter the result in the +3 cell on the SS because that test happened 3 hours after the dose. If you test at 10:45 AM you can enter it in the cell as "x" BG at +3.25 and the cell will enlarge to accomodate the extra text. Then you should go to the paint can in the tool bar at the top of the SS to colour in the cell according to the range that BG value fits in.

Aside from people here on the forum being all over the globe and giving actual clock times creating confusion, we look at a dose's action profile based on time after the dose was given. For example, we might expect to see the dose onset at two hours after administration (entered under +2 on the SS) in some cats and we look to see whether nadir has been reached about 6 hours after (+6 on the SS). All of this would be harder to understand at a glance if we were reading clock times on your SS and having to say, "Hmm ... let's see ... dose was given at 7:30 AM and the BG was tested at 12:30 PM, so that's 5 hours after ..."