? Help! PM dosage advice needed

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Jena4277

Jena4277

Member Since 2017
hi. Cat tested 174 20 Min ago. Today I upped her Insulin by .25. Tested her just now 20 Min later and it is 164. I’m going to feed her dinner and test in an hour or so to see what it is. Last time this happened I didn’t shoot and at +3 she was in the high 300s. I want to shoot tonight so I will see how she’s is doing in a bit. Sound ok?
 
I'm not versed enough for dosing advice sorry :( Hoping to bump this and someone better with prozinc can help you out!
 
Sarah Smith said:
I'm not versed enough for dosing advice sorry :( Hoping to bump this and someone better with prozinc can help you out!
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THanks. I most likely will give reduced dose if she isnt going up enough. This forum doesn’t get that much traffic compared to them Lantus one...
 
@Rachel @Kris & Teasel what do u think if u have time?

I want this 1.25 dose to work and on the first day she’s too low...how frustrating. I don’t want to have to stall everyday. Im going to retest her soon
 
It’s 254 an hour and 10 min after the 174. Im going to wait another half hour and shoot the whole 1.25. She didn’t eat very much yet so I think it’s ok.
 
I know I'm late to the party, but maybe this will be helpful sometime in the future: The 174 was most likely high enough to take the whole dose. It's hard to be certain since there isn't a lot of PM data, but based on the AM data, and the follow-up tests that show she was rising, she most likely would be just fine. When you know that the previous dose has worn off (the numbers are rising), and you are near to 200, it's most often fine to stick with the regular dose.
 
Djamila said:
I know I'm late to the party, but maybe this will be helpful sometime in the future: The 174 was most likely high enough to take the whole dose. It's hard to be certain since there isn't a lot of PM data, but based on the AM data, and the follow-up tests that show she was rising, she most likely would be just fine. When you know that the previous dose has worn off (the numbers are rising), and you are near to 200, it's most often fine to stick with the regular dose.
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Thats what I was thinking. Oh man I missed it.
 
Just seeing this now. Did you give 1 u? It shows beside, not in, the dose cell on your SS. I also don't see the 254 and 236 info on your SS.
 
Oh so sorry! I'm just seeing this too. I was at the park taking a walk when you posted. Looks like you gave 1 unit. I think that was fine...she probably would have been fine with the whole dose too. But this way you can get some good data on what she does on a 1 unit dose at this number. All data is good data!

So sorry again...we'll know when to check in on you next time!
 
No prob. I will try to get her twice tonight but I may fall asleep lol.

@Kris & Teasel Idk how to show the extra shots when they r within the hour on the spreadsheet. I don’t have a pc just my phone so it’s hard to read if the cells are overcrowded.
 
Jena4277 said:
OK. also she is at 102 three hours in. She usually rises and she has eaten about half a can already so I am a little worried but not yet. I will check her in an hour
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This drop is a sign that you might see dark green at nadir. Maybe try to control her drop by feeding 1-2 tsp regular low carb food every 30 minutes or so.
 
Kris & Teasel said:
This drop is a sign that you might see dark green at nadir. Maybe try to control her drop by feeding 1-2 tsp regular low carb food every 30 minutes or so.
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@Djamila @Kris & Teasel it’s 81 now and she may get lower. She ate a half hour ago a lot of wet with some cheese on it and she still tested 81 25 Min later. I gave her 2 temptations treats as a safety precaution bc I have to go to bed and unless I wake up cannot test her anymore as I get up at 4:45am for school and need some sleep.
 
It looks like the 81 was at +5, so she was probably fine at that point, plus the regular food may not have fully kicked in yet. So all that to say, I hope you sleep well! And hooray for a nice safe green!
 
@Rachel @Kris & Teasel @Djamila
I was able to come home an hour early and grab a 10.75ish test. It is 422. Is this a bounce? I gave her 1.25 this morning on a number in the 300s. Do u think she’s went low today? I think to still shoot the 1.25u later and monitor...what do u think?


On second look her number this morning might as well have been 400 it was 392. I should stay with this 1.25 dosage still correct?
 
Rachel said:
I think you’re seeing a bounce. Hard to know for sure but what you’ve got indicates she probably stayed high and flat today after that low last night. Not uncommon or unexpected. I’d stick with your dose for now...don’t want to adjust on a bounce cycle. :)
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Thanks!
 
Hi! So this morning she was in yellow and I just tested her and she is yellow again. My only concern is that she might be going too low during the day but I won’t be able to tell until Saturday when I can curve. If I see a high number tomorrow it’s probably another bounce right? How does the bouncing game work - if she keeps showing numbers all over the place like she’s has been I will have to reconsider the dose? Hopefully today’s data stays consistent and I don’t have to worry!
She had some diahrea today. I have been sprinkling cheese on her food. Perhaps too much. I will keep an eye on it. I don’t want her getting another UTI
 
Jena4277 said:
Hi! So this morning she was in yellow and I just tested her and she is yellow again. My only concern is that she might be going too low during the day but I won’t be able to tell until Saturday when I can curve. If I see a high number tomorrow it’s probably another bounce right? How does the bouncing game work - if she keeps showing numbers all over the place like she’s has been I will have to reconsider the dose? Hopefully today’s data stays consistent and I don’t have to worry!
She had some diahrea today. I have been sprinkling cheese on her food. Perhaps too much. I will keep an eye on it. I don’t want her getting another UTI
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The two yellow PSs are good. If you can get a +2 and a +4 this evening that would be good data for today. Stay with this 1.25 u dose for now. Chances are if she had dipped low mid day today her PMPS would be quite a bit higher.
 
She sure is! I do think you're seeing some minor bouncing...and as Kris says, it's only been 2 weeks. She might need some time to settle into the new insulin before she calms down. The good news is you're seeing some beautiful and healing numbers mid cycle, which means her pancreas has time to rest and heal. I know it's tough, but be patient! I think you'll see things get better soon.
 
THANKS! Just wanted to make sure I was kind of on the right track. She must not feel so hot bc of the bouncing :confused:
 
Please forgive me if we've already talked about this, but which type of Fancy Feast are you feeding her? Also, what kind of treats does she get, if any? Are there other pets in the house that eat anything different? And is she taking any meds for the arthritis or any other health issues? Anything for the neuropathy? Just looking for any factors that might be contributing to the bouncing. It's most likely just as Kris and Rachel said - she's new to the insulin and needs some time to settle - but might as well check on everything else while we're at it! :)
 
Djamila said:
Please forgive me if we've already talked about this, but which type of Fancy Feast are you feeding her? Also, what kind of treats does she get, if any? Are there other pets in the house that eat anything different? And is she taking any meds for the arthritis or any other health issues? Anything for the neuropathy? Just looking for any factors that might be contributing to the bouncing. It's most likely just as Kris and Rachel said - she's new to the insulin and needs some time to settle - but might as well check on everything else while we're at it! :)
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Fancy feast classics
Never treats
No other pets
No meds

I’m staying the course! :D
 
It is okay to give treats - as long as they're low carbs! ;) You also might consider giving her some zobaline to help with the neuropathy. Many cats see quite an improvement after a few weeks on it. How much does the arthritis effect her? Inflammation can increase BG numbers, so I'm wondering if some meds for that might help her?
 
Djamila said:
It is okay to give treats - as long as they're low carbs! ;) You also might consider giving her some zobaline to help with the neuropathy. Many cats see quite an improvement after a few weeks on it. How much does the arthritis effect her? Inflammation can increase BG numbers, so I'm wondering if some meds for that might help her?
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I used to give freeze dried but she turned her head to those after a couple of weeks. She’s doing fine without treats . I mean sometimes she gets table scraps (purely meat only) so she is doing just fine lol.
Her arthritis is severe, she has carpal hyperextension to the nth degree and has hip and joint issues. I tried meds but she just won’t take any and I stopped forcing her. She has slowed down plenty so although there may be some daily pain, her body is not requiring her to do more than lay around in her elder years so she is not making it worse by a huge amount of activity. It is a huge deal getting Meds in her and in her frail senior state, I really don’t want to put her through a daily fight/struggle. She is better just left alone as much as possible. The neuropathy has improved. She used to drag her leg around and slip around when she ate , now she can put weight on it a bit more and looks much more comfortable. Not sure why. Anyway, I think she will just always be a high kitty and I will do my best to keep her low in the time I have left with her. Thanks again.
 
Jena4277 said:
I used to give freeze dried but she turned her head to those after a couple of weeks. She’s doing fine without treats . I mean sometimes she gets table scraps (purely meat only) so she is doing just fine lol.
Her arthritis is severe, she has carpal hyperextension to the nth degree and has hip and joint issues. I tried meds but she just won’t take any and I stopped forcing her. She has slowed down plenty so although there may be some daily pain, her body is not requiring her to do more than lay around in her elder years so she is not making it worse by a huge amount of activity. It is a huge deal getting Meds in her and in her frail senior state, I really don’t want to put her through a daily fight/struggle. She is better just left alone as much as possible. The neuropathy has improved. She used to drag her leg around and slip around when she ate , now she can put weight on it a bit more and looks much more comfortable. Not sure why. Anyway, I think she will just always be a high kitty and I will do my best to keep her low in the time I have left with her. Thanks again.
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Some people have found Adequan injections help a lot with arthritis pain. Have you ever investigated that? @JanetNJ has used it I believe.
 
Jena4277 said:
I used to give freeze dried but she turned her head to those after a couple of weeks. She’s doing fine without treats . I mean sometimes she gets table scraps (purely meat only) so she is doing just fine lol.
Her arthritis is severe, she has carpal hyperextension to the nth degree and has hip and joint issues. I tried meds but she just won’t take any and I stopped forcing her. She has slowed down plenty so although there may be some daily pain, her body is not requiring her to do more than lay around in her elder years so she is not making it worse by a huge amount of activity. It is a huge deal getting Meds in her and in her frail senior state, I really don’t want to put her through a daily fight/struggle. She is better just left alone as much as possible. The neuropathy has improved. She used to drag her leg around and slip around when she ate , now she can put weight on it a bit more and looks much more comfortable. Not sure why. Anyway, I think she will just always be a high kitty and I will do my best to keep her low in the time I have left with her. Thanks again.
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Definitly try adequan shots for the arthritis!!! No pill to force in. Easy shots 2x a week for 8 weeks, then once every 2-4 weeks to maintain.
 
@JanetNJ @Djamila @Kris & Teasel blood work came back. Dx today pancreatitis and hyperthyroid. Starting cream Rx tomorrow on ears. Told me prednisone steroids for pancreatitis. I told them no. She was on prednisone and it gave her DKA with seizures that summer 2016. No thanks. She had bad reaction. It started all of this diabetes mess. Treating thyroid first then will explore other options for pancreas.
 
Jena4277 said:
@JanetNJ @Djamila @Kris & Teasel blood work came back. Dx today pancreatitis and hyperthyroid. Starting cream Rx tomorrow on ears. Told me prednisone steroids for pancreatitis. I told them no. She was on prednisone and it gave her DKA with seizures that summer 2016. No thanks. She had bad reaction. It started all of this diabetes mess. Treating thyroid first then will explore other options for pancreas.
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Pancratitis is treated with cerenia for nausea, sub q fluids, and bupe for pain.
 
Pancreatitis attacks tend to be self limiting but can come and go over time. Janet is right - and my vet told me this too - treatment is aimed at relieving symptoms: cerenia for nausea (and vomiting if it's happening), pain meds and fluids.
 
Here is a great place to start in learning about pancreatitis: http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

Unfortunately, a lot of our sugar-cats suffer from both. Steroids are a possible treatment depending on severity and frequency, but in general, if the kitty is eating and keeping food down, it is managed with pain meds, nausea control, fluids, and time.

The pain meds will likely help with her arthritis as well. Bupe is pretty easy to administer and seems to work fairly quickly to bring some relief for the pancreatitis.
 
Djamila said:
Here is a great place to start in learning about pancreatitis: http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

Unfortunately, a lot of our sugar-cats suffer from both. Steroids are a possible treatment depending on severity and frequency, but in general, if the kitty is eating and keeping food down, it is managed with pain meds, nausea control, fluids, and time.

The pain meds will likely help with her arthritis as well. Bupe is pretty easy to administer and seems to work fairly quickly to bring some relief for the pancreatitis.
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I am at my wits end. :(
She has been great with her sugar for weeks and now this weekend it’s been in 200 or 300(today) at +6 when it’s usually less than 100!
Can all this stuff going on with her affect her sugar? I can’t believe this. Why isn’t the insulin working? These were not fur shots. I don’t know anymore....so much money, so much stress. :(
 
Pancreatitis can raise BG because it an inflammation. Also she might be bouncing on the 1.25 u dose. I'm basing that on the fairly recent 54 and 44. As hard as it might to get more data through the middle section of a cycle and/or in the evening would be very helpful. Insulin doses usually have to be tweaked up and down a little to keep BG under control. By that I mean after a few days, not AM and PM.
 
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Kris & Teasel said:
Pancreatitis can raise BG because it an inflammation. Also she might be bouncing on the 1.25 u dose. I'm basing that on the fairly recent 54 and 44. As hard as it might to get more data through the middle section of a cycle and/orin the evening would be very helpful. Insulin doses usually have to be tweaked up and down a little to keep BG under control. By that I mean after a few days, not AM and PM.
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I wasn’t pricking her bc she didn’t feel well and i was giving her and me a break. She hasn’t really bounced for several weeks. The 1.25 has held her in healing numbers. I don’t think the 40 and 50 is that alarming bc she was behaving just the same and her preshot numbers have been consistent. The last time she’s had pancreatitis this didn’t happen. I really don’t want to increase it when I am not home to test. What a mess. It’s a hard day for me emotionally. Thanks for your reply.
 
300's down to 50 is A HUGE difference... Your cat may be bouncing from the steep drops. I know you said your cat is not having symptoms of hypoglycemia, but mine didn't either. She was 44 on a pet meter (under 68 is hypo). No symptoms. I rushed her to the er. Cats can go from seemingly fine to seizure or coma. So just be careful. If you lower the dose just slightly you may find her preshots come down a little as she won't be bouncing as much.
 
Yes, pancreatitis definitely raises their numbers, and when my kitty is having a flare up, I have to increase his dose in order to stay on top of it. However, I don't know that that's what's happening here. I agree with Kris, that there is evidence of the 1.25u possibly causing some rebound. A cat acting normally doesn't mean the cat is safe. They generally act just fine right up until the point that they fall over and have a seizure. I'm not one for panicking at a lower number as many healthy cats can handle the occasional low number just fine, however I also don't think it's good to ignore them. That lime green should have resulted in an insulin reduction.

The two high numbers recently could be rebound, or they could be pancreatitis. I do understand the desire to avoid testing- I hate testing my kitty and I've been at this for a long time, but you can't know what's going on with this many gaps in the data. Any advice we give would be nothing more than a guess, and any change you elect is again nothing more than a guess without filling in some of the gaps for a few days. The current dose isn't doing what Abby needs, increasing could drop her too low based on the low numbers you're already seen, and decreasing could help, or it could hurt if she's rising from inflammation - and that can lead to ketones. So for now I'm afraid we're a bit stuck. If you can get some mid-cycle numbers today and a before bed test tonight, having data from two consecutive cycles will help sort out what's happening.

What meds/doses is she taking for the pancreatitis right now?
 
I am at work and cannot test unless it is weekends and the week like
I said has been pretty unbearable.

It was my assumption by our last conversation that 1.25 was a good number to keep her at. Now I am confused. What number should she be in at her nadir to keep her ok? My Vet said I was doing a good job. I really am confused. You’re telling me for weeks I have had her on the wrong dosage? I thought it was doing what she needs because of the way she curves to the blues and greens and rises when it wears off. She was on 1.0 and it wasn’t dropping her low enough.
I can reduce the dose but I have no idea what her numbers will be until this weekend.
I am in shock right now.
 
Djamila said:
What meds/doses is she taking for the pancreatitis right now?
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Cerenia last day for nausea for pancreatitis.
Just picked up the transdermal gel for hyperthyroid and it’s been two applications so far, last night and this morning.
She is due at 5pm est for Insulin, second cream application, and last 1/4 of cerenia.
 
I also am trying to balance the war testing and cream application bc apparently if I am exposed to it on my skin I can get thyroid or health issues myself bc that stuff is potent. I am calling the Vet tomorrow for more specific instructions.
 
Jena4277 said:
Cerenia last day for nausea for pancreatitis.
Just picked up the transdermal gel for hyperthyroid and it’s been two applications so far, last night and this morning.
She is due at 5pm est for Insulin, second cream application, and last 1/4 of cerenia.
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does she seem to be feeling better? Does she seem to be in pain? is she eating ok? Once she's feeling better, maybe try a fat 1... meaning JUUUUUST over the line of the 1, but not quite a 1.25 to see if the bouncing settles a bit. Her mid day numbers right now may be a bounce, or they may be a response to pain from the pancreatitis. She's not getting any pain killers? Does she seem comfortable?
 
Maybe start a new thread asking about prozinc dosing. I'm just going by what I see as a steep drop, but truth be told I've never used prozinc, so if prozinc users would chime in, that would be helpful.
 
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