Help please

Lisa and little

Lisa and little

Very Active Member
PS # 98. Tested twice. Holy reverse Teasel Batman @Kris & Teasel - just fed normal meal. How long should I wait and what the heck do I dose based on number I get after stall? had pet sitter for am shot and just got home an hour ago so no data for today’s cycle... but of course!!:banghead:
 
Normally we'd say stall without feeding and retest. If he's rising give insulin, likely a reduced dose in this instance. Because he's already eaten, wait 45 minutes and retest. Depending on that BG we can decide on a safe dose. This isn't the usual approach but it can be done in a pinch.
 
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Lisa and little said:
911. After food 45 min BG 54!!
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Did you retest to make sure that's correct? Are you sure your pet sitter gave the correct dose this AM?

No insulin tonight for sure! The AM dose should wear off eventually. You could give him a snack of higher carb food now and retest in 30 minutes or so.
 
Are you using U100 syringes to give the ProZinc? Could the sitter have accidentally drawn up the dose on the conversion chart into a U40 syringe by mistake? The BGs for today aren't making sense if the usual fat 2 u was given this AM. The late lime green AFTER a 98 and a meal doesn't make sense either. Have you reviewed everything in your mind to see what out of the ordinary thing might have happened?
 
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Another thing: I see a reference to new strips on your SS. Did you set the code on your AT meter for the new strip vial?
 
Yes to all. Just tested again 45 min after snaack 1.5 hrs after regular meal... 53 with AT2 strip gave HC food. What on earth could be going on?? I’m getting freaked. I confirmed with the pet sitter. He was absolute about the dose being correct
 
I typically use insulin X strips and compare to AT2 when a new vial opened. Comp yesterday was 210/213. As stated just used AT2 strip for last test and same 53. I’m scared
 
Do you know what time he gave the shot, Lisa? 12-14 hours is typically the duration of a dose, and I would think you'd be close to that by now?
 
Yes around 8 am ... so just at 14. But 53 and 54 AFTER food? So confused Again she’s alert and eating... could my meter be broken??
 
Nope, it doesn't make any sense, but if the shot was 14 hours ago, I would think that the external insulin would be nearly out of her system, even if it's a marathon cycle.

Let us know what her next test is -- should be about now?
 
That's great! I *think* the next step is to wait one hour w/o feeding and see if she holds her numbers on her own. (Again, the external insulins should be out of her system, so I would think her number would continue to rise.)

Someone please correct that if I'm not getting it right!
 
Can someone explain the “reverse teasel” again. I thought if PS was low the “protocol” was to feed, retest after 30/45 min and if numbers were up shoot... am I wrong? Should I not feed and wait 30/45 and re test on low PS #s?
 
For people: Injecting in the same spot over and over can cause scar tissue and deteriorate the fatty layer. That can cause a delay in absorption. So can injecting too far into a fatty layer. I'm not sure for how long, however. And I am not sure what the prevalence in cats is or how many injections in one spot constitutes enough to damage that area. Anyone have any idea about that?
 
Lisa and little said:
“reverse teasel”
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I have no clue what that means. Generally I stall 30 minutes, test again without feeding, stall 30 minutes again without feeding if the BG is still too low and test again. I'm sure there is wiggle room, but after an hour, that is when I decide whether to give regular dose, partial dose, or skip.
 
Tina and Boozle said:
For people: Injecting in the same spot over and over can cause scar tissue and deteriorate the fatty layer. That can cause a delay in absorption. So can injecting too far into a fatty layer. I'm not sure for how long, however. And I am not sure what the prevalence in cats is or how many injections in one spot constitutes enough to damage that area. Anyone have any idea about that?
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Good info. I move the injection site around daily. As for “too far” into the fatty layer... not sure what that would feel like so don’t know if I or my sitter have done this in the past. Any hints on how NOT to do that?
 
Tina and Boozle said:
I have no clue what that means. Generally I stall 30 minutes, test again without feeding, stall 30 minutes again without feeding if the BG is still too low and test again. I'm sure there is wiggle room, but after an hour, that is when I decide whether to give regular dose, partial dose, or skip.
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Thank you
 
Tina: that is very interesting and good to know about the scar tissue and delayed absorption. Thanks!

Lisa: that is something that Kris has in her bag of tricks, but it is *not* the standard protocol, as per my signature block. It’s basically a way of shooting based on where you can confidently, based on lots of data, “predict” where your cat will be by the time the injection takes effect, usually 2-3 hours after the shot. We use it bc Josie tends to have long cycles, which gives her about two hours of “overlap” between when when one shot is wearing off and the next is onsetting. But I’m looking at your SS, and I don’t think any possible misunderstanding is at play here. Little’s PS numbers are relatively high. Feed-then-test (the “reverse” of the standard protocol) might bring the numbers up a bit, but not from an unsafe number to the 300s or 400s. (We use it so that we can shoot when the initial PS is in the low 100s.)
 
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Lisa and little said:
Can someone explain the “reverse teasel” again. I thought if PS was low the “protocol” was to feed, retest after 30/45 min and if numbers were up shoot... am I wrong? Should I not feed and wait 30/45 and re test on low PS #s?
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I’ve never heard of a reverse teasel. Is that something @Kris & Teasel came up with? Lol. Until you know how your kitty responds to food and low numbers, it is a good idea to withhold food while stalling to see if numbers will come up on their own. If you feed, you know the numbers are food influenced but you don’t know how much the food affected where the numbers were headed naturally. Make sense?
 
Jenna Josie said:
Tina: that is very interesting and good to know about the scar tissue and delayed absorption. Thanks!

Lisa: that is something that Kris has in her bag of tricks, but it is *not* the standard protocol, as per my signature block. It’s basically a way of shooting based on where you can confidently, based on lots of data, “predict” where your cat will be by the time the injection takes effect, usually 2-3 hours after the shot. We use it bc Josie tends to have long cycles, which gives her about two hours of “overlap” between when when one shot is wearing off and the next is onsetting. But I’m looking at your SS, and I don’t think any possible misunderstanding is at play here. Little’s PS numbers are relatively high. Feed-then-test (the “reverse” of the standard protocol) might bring the numbers up a bit, but not from an unsafe number to the 300s or 400s. (We use it so that we can shoot when the initial PS is in the low 100s.)
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I think I understand and and based on a 98 PS I fed then retested after 30/45 minutes to see if it brought number up to shoot maybe partial. (In this case it didn’t work) but did I do the correct thing or should I have NOT FED and retested after 30 min? I have done the above feed -retest -shoot before on the rare occasion I got a lower than usual PS
 
I can’t answer that, unfortunately. :( The first time I saw it suggested, I remember posting that it was too confusing and stressful, and I was going to pretend it wasn’t a possibility, lol. But my cat doesn’t have normal, smile-shaped curves very often. She is either flat or has a sort of ski slope where she hits a nadir and then just rides there until like +14. It was screwing up her injections, causing us to pull the dose and mess her up. We had lots of trial and error data with the normal no-feed-stalls/pulled doses before we tried reversing it and many of those with copious follow up testing before we felt comfortable with it as a strategy. It typically works for her (though fingers crossed for this cycle :rolleyes: ), but ECID.
 
I hear ya. I’ve been on quite a roller coaster ride with her too. There does not seem to be a “normal” whether high or low for too long. Stress is the new normal!! Wasn’t gonna have a glass of wine tonight but that went out the window lol. Thank you and everyone else here tonight for guiding me through. Very thankful and grateful for all the help and advice. Going in for one more poke and then hopefully taking her furry butt to bed. Agin thank you all so very much
 
Lisa and little said:
I think I understand and and based on a 98 PS I fed then retested after 30/45 minutes to see if it brought number up to shoot maybe partial. (In this case it didn’t work) but did I do the correct thing or should I have NOT FED and retested after 30 min? I have done the above feed -retest -shoot before on the rare occasion I got a lower than usual PS
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Hi Lisa! Stalling is basically just to know whether or not kitty is rising WITHOUT food. That means kitty is on her way up and when insulin kicks in, her number will be higher than the PS number since food influencing BG will eventually wear off. I can't quite remember the time it wears off but I think up to an hour. But again, ECID. So that's maybe why Kris and others use Reverse Teasel (first time hearing about it too!).
 
With the 98 the typical response would have been to stall with no food for half an hour or an hour. At that time it was still possible that the numbers could have increased and you may have been able to give a shot. As it turned out she was still headed down, but you didn’t know that after the first test. As soon as you saw the lower number at the next test, you know a shot is off the table for tonight so you would have been ok to go ahead and feed medium or high carb food to get the numbers up.
 
Geez another hour and I’m at 88 so she’s holding. Do you guys think it’s safe for us to go to bed? She had no shot tonight. This is crazy
 
Jenna Josie said:
I can’t answer that, unfortunately. :( The first time I saw it suggested, I remember posting that it was too confusing and stressful, and I was going to pretend it wasn’t a possibility, lol. But my cat doesn’t have normal, smile-shaped curves very often. She is either flat or has a sort of ski slope where she hits a nadir and then just rides there until like +14. It was screwing up her injections, causing us to pull the dose and mess her up. We had lots of trial and error data with the normal no-feed-stalls/pulled doses before we tried reversing it and many of those with copious follow up testing before we felt comfortable with it as a strategy. It typically works for her (though fingers crossed for this cycle :rolleyes: ), but ECID.
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How did your cycle turn out tonight... you had to stall as well?
 
Lisa and little said:
Wasn’t gonna have a glass of wine tonight but that went out the window lol.
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^^^That's me every night.

As far as whether or not you did something wrong -- I think, not being clear on why this happened, there is a whole lot of gray area there. That was a sharp turn Little took and rather quickly. I might be corrected on this thought, but I think I would be glad I fed something when you did.
 
Lisa and little said:
Geez another hour and I’m at 88 so she’s holding. Do you guys think it’s safe for us to go to bed? She had no shot tonight. This is crazy
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This is tough. She’s holding steady and the Prozinc should be mostly out of her system... but if it were Spot I’d check again in an hour just to be sure...
 
Hidsight being 20/20 yes but I never could have imagined she’d go lower after food. I would have thought that to be impossible. So tonight’s lesson is NOTHING is impossible in the land of sugar babies
 
SpotsMom said:
This is tough. She’s holding steady and the Prozinc should be mostly out of her system... but if it were Spot I’d check again in an hour just to be sure...
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My thoughts exactly. No sleep for the weary. I guess I’ll use the time to clean the blood off my couch. This has not been a fun evening....
 
Tina and Boozle said:
^^^That's me every night.

As far as whether or not you did something wrong -- I think, not being clear on why this happened, there is a whole lot of gray area there. That was a sharp turn Little took and rather quickly. I might be corrected on this thought, but I think I would be glad I fed something when you did.
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Is that why you named kitty Boozle? Lmfao. In college I had a cat named Cuervo... I am not proud
 
Lisa and little said:
Hidsight being 20/20 yes but I never could have imagined she’d go lower after food. I would have thought that to be impossible. So tonight’s lesson is NOTHING is impossible in the land of sugar babies
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I’m pretty sure that means her pancreas decided to kick in some natural insulin.
 
Well... AMPS 417. Can’t figure out what happened yesterday but guess today is back to “normal”. Will shoot the FAT 2 I have been and monitor.
 
Well, wasn't that exciting! :woot: First, an explanation of the "Reverse Teasel". It certainly isn't a standard technique and it was given its Important Name by @Jenna Josie after she tried it a few times. I had suggested it because it was something I did with Teasel occasionally when he was on ProZinc. This is what I did: if his PS was a little low for comfort (and I didn't want to/couldn't stall repeatedly) I fed him, waited 45 minutes or so for food to be well into his bloodstream, retested and, given that his BG was usually up a fair bit from food, gave him a very slightly reduced dose or the full dose depending on my feeling about it.

The preferred, official method is to stall without feeding for about 30 minutes, retest and if BG is rising, give the full dose or maybe a slightly reduced dose based on your experience and knowledge of your own kitty's patterns. The stall without food can be repeated for another 30 minutes if needed because ProZinc gives you about an hour's leeway with dose timing.

Re Little's surprise response last night: I agree that it could have been a big "sputter" from her pancreas. BG will generally drop after a meal in a kitty who isn't diabetic. What's not typical in Little's scenario is to see evidence of a sputtering pancreas in among the pinks, reds and mid blues. However, ECID as they say! My advice is to be EXTRA vigilant with testing post shot and be prepared to drop the dose right away if this happens more often. It's a good sign but can lead to a little extra stress. :)
 
Boy this is fun... thanks for being there. Hindsight this am I should have fed and waited 30 to test just to see if her number went down on its own after eating ... just for the data. Oh well can’t un shoot.
 
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