Oh boy

Lisa and little

Member Since 2018
please look at my Ss from last night and this am. What is going on? I assume that as I suspected my previous bottle of prozinc must have lost efficacy as we were getting totally different numbers on the same dose. Or is my meter broken?!!:banghead: I fed her normal meal since she is so low a 30 min stall would probably still be a NS #. will re test in an hour to see if I should give a token dose. Thoughts on +1 and dosing? If she’s up around 150 should I give maybe 1.5? I will be home today to monitor. Sheesh!
 
It looks like you gave 1.5u? I think that was as good a guess as any. Given the lime greens last night, Little earned a reduction to 1.75u anyway, and given the low AMPS, I can understand dropping the dose a little more. She may be a bit high tonight, but she'll likely be bouncing for a few cycles from those low numbers, so no matter what she shows you later today/tonight, don't give more than 1.75u.
 
Yes. Thanks Djamila. Didn’t even cross my mind to go to 1.75. Damn. My thinking was the rise was a food spike since I fed her her regular meal prior so wasnt sure she was rising on her own. Hope I didn’t screw her up too much. Thanks for the input. It is always so valuable.
 
It looks like you gave 1.5u? I think that was as good a guess as any. Given the lime greens last night, Little earned a reduction to 1.75u anyway, and given the low AMPS, I can understand dropping the dose a little more. She may be a bit high tonight, but she'll likely be bouncing for a few cycles from those low numbers, so no matter what she shows you later today/tonight, don't give more than 1.75u.
Oh god. +3 is 47!!! What the heck!!! I fed and will re test. Heart in mouth.
 
Just seeing this. How are you and Little doing now? I assume you have retested....what is BG after food? Did you give Little high carb food when you fed her?
 
I gave LC and she only registered 52 which is the same as 47 Gave more( but different) LC food and will test again in 30 min. She seems fine! What on earth??!! Thanks Janet. I am sick to my stomach as of course I have travel planned this week :arghh:
 
Deep Breathes Lisa! You need to get Little up over 70 at least and preferably 80 so if you have any higher carb food, give her a tsp or so now. If you do not have higher carb food, do you have honey or syrup (maple or corn syrup) you can mix into her LC food to bring the carbs up?
 
Yes. Thanks Djamila. Didn’t even cross my mind to go to 1.75. Damn. My thinking was the rise was a food spike since I fed her her regular meal prior so wasnt sure she was rising on her own. Hope I didn’t screw her up too much. Thanks for the input. It is always so valuable.
Deep Breathes Lisa! You need to get Little up over 70 at least and preferably 80 so if you have any higher carb food, give her a tsp or so now. If you do not have higher carb food, do you have honey or syrup (maple or corn syrup) you can mix into her LC food to bring the carbs up?
yes. Going in for a test now. Will give HC if she’s not up. This is so stressful...
 
If the high carb doesn't bring her up, rub a little honey or syrup on her gums or cheeks. It won't last long but it will pump her up. Does your high carb food have gravy on it? If so, I'd try just giving her the gravy so you don't fill her up too much to the point where she won't eat.
FYI, if you get any reading under 68 on the AT2 meter, I'd go straight for HC food immediately.
 
The 68 we use as a warning number allows for some cushion. Some non-diabetic cats will run a little lower. You are also using the Insulinx strips so they could be reading a tiny bit low. Do you have any AT2 strips available to do a double check?
 
Did a double check this am with AT2. It’s consistent. +5ish is still 57! Gave honey on gums ( and face and neck) she is mad now. But still acting normal and eating no problem. What do I do from here? This is so unusual that she doesn’t come up with food especially HC which I have only had to do once. I am a nervous wreck as I have a sitter for tomorrow PM and Thursday AM. My job sucks with all the travel
 
Give Little another tsp of high carb food with some honey mixed in (1/2 tsp) or if she doesn't like that, do you have any vanilla ice cream? If so you could get her to lap a tsp or so of that up on her own instead of trying to ply her with syrup. Been there done that trying to get syrup into my girl's mouth. She was not amused either.
 
As for your trip, it seems apparent Little is sending you a message that her dose needs to be reduced and definitely more than you had intended. She will probably be a little more sensitive to insulin right now so let's see where she lands at PMPS tonight before making any dosing decisions.
Does Little have any history of ketones or DKA? Does your sitter test/shoot or just shoot?
 
Sitter just shoots unfortunately.and I am away almost all next week to boot. In any case +6 was 72. Should I feed anymore? I’m afraid she’s going to explode if I give her any more ! No ketones or DKA are you asking because I have to lower her dose and we know doing that will make her run high? Or is there something else I am not aware of?
 
No more food for now. She may be reaching nadir or been there already. Let's see what she does without food for 30 minutes and check her again.

I get your concern but we'll help you figure this out and keep Little safe. She doesn't have any history of ketones or DKA does she?
 
No history of either. Can you tell me why you are asking? Is just because we assume that with a reduced dose which in emeinent she will run higher and may be at risk for that?
 
When there is a history of ketones/DKA, then skipping doses or even reducing too much is more problematic. If Little has no history, then we don't need to worry about it. Some cats are more prone to ketones than others and their dosing decisions need to take that into consideration. I certainly didn't mean to panic you and no I don't think letting her run a bit higher especially given how well (too well) she has been doing lately. Depending on what she does over the next cycle or two, you may need to consider skipping a dose or two with no testing/monitoring being done while you are away. Running higher for a couple of cycles isn't going to suddenly cause ketones.
 
I know how scary this is. I remember when my girl suddenly and unexpectedly starting having totally green cycles. It's like you are right back to square one trying to figure them out. As scary as this is, I think it's looking very promising. :)
 
Have you tested Little again lately? I see a "57" on the SS after the 72. Did she drop down again and you gave more honey? If she did and it's been 30 minutes, please test her again.
 
No the bottom line are the actual + numbers and the top line are the intermittent tests through the incident.(feeding/testing and retesting in 30-40 min intervals ) I would love to believe this is looking promising but I am wondering if it all has to do with a new bottle of prozinc started the morning of the 11th Seems my previous bottle may have lost efficacy so I’m not sure what these numbers mean other than it’s a bad time to travel. True +8 is 263. Any thoughts appreciated. At least I can breathe but what a mess. And I think she hates me AND what a way to burn through test strips :):banghead:
 
I think that 263 is mostly bounce and honey and high carb food and probably a little bit of "I've had enough of all this poking!" LOL!

Things to consider
  1. Had your old vial of ProZinc lost its efficacy? I see you started the previous vial in February so that seems to be unlikely unless it was mishandled at some point before you received it or did you leave it out of the fridge for an extended period at some point that could have rendered it less potent? I honestly think you would have seen a bigger drop on the day cycle of the 11th with the dose from the new vial if any of this was related to insulin efficacy.
  2. Have those higher BG through Feb/early Mar been a product of too much rather than too little insulin? I'm kind of leaning in this direction. On the 2nd of Mar. Little went down to 74 but you didn't take any reduction in dose at that time. I think one was warranted. With meter variance that is pretty close to your warning of potential low BG and taking some action. I would have reduced to 1.75u then.
  3. With there being 2 cycles March 9/10 when Little has been given insulin but no pre-shot or mid cycle tests were done, it's quite possible she has dipped down lower than you thought, causing some bouncing to higher numbers again on your return and making it look like everything was status quo. Her BG mid-cycle on the day of the 9th suggests her BG may have already been heading in a downward direction.
The low yesterday seems to support my hypothesis because the defence systems that work to push numbers up do eventually get exhausted so if stored glucose gets low, you then see low numbers. The lows yesterday could have made Little a bit more sensitive to insulin today but given how low she went, I'm inclined to think the dose still needs to be lowered. The big question is by how much.

All that said, I have limited experience with ProZinc so while I would suggest you try a dose of no more than 1u tonight if you are able to monitor (otherwise I'd knock it down more), I'd like to see what the more seasoned ProZinc users think.

@Djamila
@Rachel
@Kris & Teasel

Lisa and Little need some guidance and you have far more experience than I do so we'd all appreciate your thoughts. Thx.
 
I appreciate all of your advice support and help with this today. Thank you for keeping me sane. As for the prozinc being less effective, that vial was opened on Christmas so it was almost at the 3 month mark. I too have already thought of most of what you said. Just makes me so nervous having to leave. I am an anxiety ridden ness. Will def not do more than 1u tonight for sure. I kinda just want to cry
 
Oh Lisa..... I so get where you are at. And if you feel like having a cry, do it. It's actually very therapeutic.

I've been in that position with my girl and it isn't fun but Little has given you a bit of warning so that you can plan accordingly. My girl didn't and her low BG came on 2 days into my week long cruise. You are only going to be gone for 2 shots right now so if need be, she misses a couple of shots as long as she is not running really high before your departure. Not ideal I admit, but safety has to be the first consideration. And you need to be able to work without Little's well being preying on your mind constantly while you are away.
 
It weighs on my mind always. I am more worried about my next trip which is 6 whole days!! I know I shouldn’t freak out about it yet but i am. Crazy question. You may think I’m nuts ... her schedule is now off by 1 hr. Would it be crazy if I went 1/2 hr early tonight? Obviously I’ll test first but I’d like to get her back to her normal time as that’s when I have the sitter set up for. Nuts I know but since she was at 263 at +8 ~I’m ASSUMING ... she will be in the 300s at +11 1/2
 
Done. Don’t know how much sleep I’ll get as I’m guessing she’s gonna stay high which makes me unhappy as well but at least she should be safe. She only ate about 2/3 of her meal... geez I wonder why? Lol again thank you so much for all of your help today. You kept me sane :bighug::bighug::bighug:
 
So I just got on here and apparently I missed the party today! So sorry, it's been a busy day. I think a 1 unit dose was a great choice. That way, Little can have a chance to hopefully reset while still getting some insulin to hopefully bring her very gently down.

When will you be out of town, Lisa?
 
So I just got on here and apparently I missed the party today! So sorry, it's been a busy day. I think a 1 unit dose was a great choice. That way, Little can have a chance to hopefully reset while still getting some insulin to hopefully bring her very gently down.

When will you be out of town, Lisa?
You sure did!! Geez. This day was good for my diet but that’s about all. I Leave tomorrow afternoon and hopefully back by PM shot on Thursday. My big anxiety is coming from next week. Will be gone the 20-25th. I’ve tried to show my sitter how to test but so far no luck. I think he’s just scared as we all were at first.
 
Well shoot, I missed all the fun! :D

A couple of notes about hypos:
- you've probably read me telling people to try low carb food first. That is particularly true when the lime green is getting closer towards usual nadir time. When you get an early lime green like that, medium or higher carb food is fine, and probably even the better option.
- rubbing karo/honey on a cat's gums should only be done if they are unable to eat themselves. If they are still conscious and can eat on their own, just keep feeding the high carb food. a healthy cat will come up, but it may take a little time. as long as they are not symptomatic, that's okay. And if they become symptomatic, then they can't eat for themselves and at that point you can force it (i.e. rub it on their gums). honey and karo are very short lived, and you're really aiming to steer the kitty safely into better territory, so the food (carbs+protein+fat) is a better solution as long as the cat is still able to eat.
- encouraging drinking seems to help too. Now the disclaimer on this one: I haven't read any research about that. It's just something I've learned from Sam. Whenever he goes low too fast, he drinks water. He's not much for drinking, so there is something about it that helps him feel better. Just thought I'd throw it out there in case it might help some other kitty too.

Okay, now onto the dose. While Little is a bit bouncy, I don't think you've been overdosing (up until now ;)). I think today's margarita party (limes....get it :smuggrin: haha) has to be considered in the context of the cycles near it. Little had a flat yellow cycle yesterday AM. For whatever bizarre and unexplainable reason, those often precede active cycles. Which you saw last night with those lime greens during the night. Then this morning, she was rising, but was still significantly lower than normal when you gave the shot. The insulin kicked in faster (we'll get to that in a minute) and brought her crashing down. I don't think 1.5u was too much. It was just too much for today. And unfortunately, we can't really predict that. Sometimes it just happens.

But here's where we might have been able to guess it would happen: we just went through a time change. Most of the kitties are out of their usual patterns right now, and will be for another day or so. We are too. Remember how hard it was to go to sleep last night? And how much harder it was to wake up when your alarm went off? When we change times, even by just an hour our hormones get all messed up. It's why our sleep is off, and if you're a particularly sensitive soul, you may be finding that you're hungry at the "wrong" times too. Our cats are going through the same thing. And since insulin is a hormone, and it's interacting with other hormones and complex physiology, their patterns and responses are wonky.

So again, I think on any other day, that 1.5u would have probably been just fine. But it was the perfect storm of a hypo last night, a number that wasn't quite high enough at PS, and hormones that are all over the place because of the time change.

And it all conspire to give you quite a scare today. :bighug::bighug::bighug:

I do hope you sat down and had that cry. As Linda said, it really is therapeutic and important for our own sanity to let ourselves release that angst. Crying is an incredibly healing thing. Plus, as mentioned, your hormones are going to be messed up for another few days as well, so might as well just roll with it and cry (or laugh) as much as you need to right now! Sending you lots of love and hope for a good and peaceful sleep tonight. You both need it!
 
Great explanation although I had her adjusted to daylight savings prior by moving her in 15 minute Increments a few days before so that her normal shot time would be daylight savings time. Do you still think that could be part of it? As for the LC vs HC food that makes perfect sense -thank you. I assume you are explaining the same thing to Rachel and Gizmo right now. Lol Some margarita party. The only salt was from my tears. All this said- any thoughts for am dose if she is 250 or above?
 
And what are your thoughts on why the insulin kicked in so soon? I swear you have become my guru.. you make so much sense. You must have some kind of a science or medical background??
 
LOL...definitely not a science background. I've learned a lot from reading research on this, and I've learned a TON from Kris & Teasel, who does have a science background.

Given that you had walked her into the time change slowly, that may not be a factor. And in that case, we will want to be a little more careful with the pet sitter dose. Good to know!
 
Oh sorry! I keep forgetting to finish my answers before I hit "post" (see what I mean about the time change? ;))

The insulin may have kicked in faster because of hormone-wonkiness (although I think you've debunked that one). or it could have been an absorption issue. This is where prozinc seems to be much more sensitive than the L insulins. Hydration can make a difference in how fast/slow it kicks in, the location of the shot (even if just over by a few millimeters), or injection-site movement (rubbing/pushing on the injection site, the kitty deciding to suddenly sprint around the house, rubbing up against the furniture, etc). None of those are things you can see or predict, but they can impact how fast the insulin hits. For most cats, there will be a 'normal' that is fairly predictable, but sometimes something as little as picking her up after the shot and squeezing where you just injected can make a difference. I am NOT saying you shouldn't snuggle your kitty after the shot. We have to just make peace with a little unpredictability sometimes! Oh, and the "over by a few millimeters" part -- I read this fascinating article (I wish I had bookmarked it!) that showed the tree-like pattern insulin makes after it's injected as it works around the connective tissue. This is another aspect that you can't predict or control, but sometimes the "tree" ends up in bad spot, or doesn't spread out, or spreads out too much. And that can impact onset as well.

Oh, there is so much we can't control! We just have to do our best and take what we get!
 
Well I am thankful for your brain always. I know talking about AM is irrelevant without a number but can you give me your thoughts on AM dose assuming PS is 250 or higher which I suspect it will be as she just got into some more food ... still LC but not her usual. I left it out as no one finished dinner tonight for obvious reasons. They are stuffed! More concerning is what to do about tomorrow PM as I won’t have a test:oops: definitely not sleeping tonight worrying about that.
 
Oh sorry! I keep forgetting to finish my answers before I hit "post" (see what I mean about the time change? ;))

The insulin may have kicked in faster because of hormone-wonkiness (although I think you've debunked that one). or it could have been an absorption issue. This is where prozinc seems to be much more sensitive than the L insulins. Hydration can make a difference in how fast/slow it kicks in, the location of the shot (even if just over by a few millimeters), or injection-site movement (rubbing/pushing on the injection site, the kitty deciding to suddenly sprint around the house, rubbing up against the furniture, etc). None of those are things you can see or predict, but they can impact how fast the insulin hits. For most cats, there will be a 'normal' that is fairly predictable, but sometimes something as little as picking her up after the shot and squeezing where you just injected can make a difference. I am NOT saying you shouldn't snuggle your kitty after the shot. We have to just make peace with a little unpredictability sometimes! Oh, and the "over by a few millimeters" part -- I read this fascinating article (I wish I had bookmarked it!) that showed the tree-like pattern insulin makes after it's injected as it works around the connective tissue. This is another aspect that you can't predict or control, but sometimes the "tree" ends up in bad spot, or doesn't spread out, or spreads out too much. And that can impact onset as well.

Oh, there is so much we can't control! We just have to do our best and take what we get!
So I’ve read that one as well and did a test a while back where I documented where I shot her. Kinda easy as she’s a tux so I used black/white markings for a few cycles each to see if there was a difference. I didn’t really see anything noticeable. I have it on my SS as B or W. kris asked once what the heck that was... just my little experiment. Any way-TODAY I CONSCIOUSLY MOVED THE SITE OVER closer to the shoulder instead of the middle. Hmmmmm...: co-inky dink? Perhaps not
 
Interesting hypothesis about different injection sites and injection site contact. With Lantus and the depot, rubbing the shot area can break down the depot somewhat and cause different release state but I never thought of that being an issue with ProZinc. As for injection sites, I never found any difference between scruff and flank but had a vet tell me scruff wasn't the best spot to inject due to poorer absorption. Possibly another one of those ECID things.....live and learn!
 
I believe there are websites that have digital Magic 8 balls you could consult ;)

Please please try to sleep tonight. You need some rest after today! Honestly, we might need the dart board for your travel dose! Are you going to be around tomorrow during the day? Or will you be at work? Little has dropped a little over 100 points at +2.5 tonight, which is more than one might expect given that she's stuffed with carbs and should be having her food spike. I don't think she's in any danger of going low again -- just that the 1u might not be such a small dose after all. If she's yellow or low pink, another cycle at 1u might be in order. If she's low yellow or blue :confused:, then all bets are off. o_O
 
+5 281. She wasn’t really stuffed with carbs. Maybe 2 teaspoons HC and the honey. Also starting to wonder if no carbs (really the diet she’s on if you look at chart) might be bad. Been thinking about that lately. Maybe she needs a FEW carbs? Anyway. Thanks all. I’m not setting another alarm. Well see what we get in the AM. Hugs to you all for being with me. Xoxox I will be around tomorrow till about 3 pm so will be able to test
 
I hope you got some sleep, Lisa! I'll check in later to see how things ended up for AMPS as long as things don't go sideways at work. :)
 
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