Waiting on a call back from vet

C

Chez

Member Since 2019
But in the meantime... Came home and checked wimbleys BG (no food before) it was 139 so I haven't given him his dose. I checked twice just to be sure and got the same number both times. I'm using the pet test advocate if I hold off his dose any later than 8pm then I won't be able to give him his shot tomorrow morning since I have to leave for work.. Man I thought being a single mommy was stressful.. This adds a whole new level of stress that I didnt imagine
 
Yes, do not shoot a 139. I have to agree with what @Djamila said on your other thread, that 3u is a high starting dose, especially since you’ve changed foods. We usually start at 1u and increase slowly by .25u at a time. What are you feeding now?
 
I switched from friskies to fancy feast mainly, I did buy some grain free natural wet food (forgot the name brand) just to see if he would tolerate it (he's super picky) he ate the grain free food this morning and evening and actually ate all of it! Took away the dry food.
 
Fancy Feast pate? Dry food is high in carbs, so if you switch to a low carb, wet food, Wimbleys blood glucose can drop significantly and he will definitely need less insulin, or risk a hypo. Talk to you vet and tell her about the switch and see what she says, but lowering the dose will do no harm(unless ketones are present). Have you fed him dinner yet? Here’s some info on hypos
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

ETA Here we suggest you skip the shot if glucose reading is under 200
What meter are you using?

http://www.felinediabetes.com/FDMB/threads/so-very-new-to-this.216129/
Link to your last thread
 
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I did tell her that I switched prior to his actual diagnosis (I noticed the peeing and drinking a lot so I knew something was up) so she called back and said yes the dose may be too high so I'm to not give it to him tonight and take again tomorrow morning and call them with the number (thankfully they are a 24 hour vet yay!) So I guess we will go from there.
 
Sharon14 said:
Fancy Feast pate? Dry food is high in carbs, so if you switch to a low carb, wet food, Wimbleys blood glucose can drop significantly and he will definitely need less insulin, or risk a hypo. Talk to you vet and tell her about the switch and see what she says, but lowering the dose will do no harm(unless ketones are present). Have you fed him dinner yet? Here’s some info on hypos
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

ETA Here we suggest you skip the shot if glucose reading is under 200
What meter are you using?

http://www.felinediabetes.com/FDMB/threads/so-very-new-to-this.216129/
Link to your last thread
Click to expand...
Oh I'm using the pet test advocate
 
Do you have any suggestions om how to check cats ketones in a multi cat house and when I'm not home for 10 hours out of the day???
 
There are blood meters, but the strips are expensive. Has he ever had ketones? Maybe you could test in the evenings, or could he stay in a room by himself for a bit? Sorry I’m not full of answers on that one. Hopefully someone else will chime in soon!
 
Saturday he didn't, Monday she said they were very slightly elevated but she wasn't concerned
 
So this morning his BG was 417 :arghh:called vet with number and she advised to feed and give insulin so I did.
 
I'll check again tonight and we go in tomorrow. Maybe the grain free food made it dip so low?? Went back to fancy feast this morning
 
How much insulin did you give? Which Fancy Feast are you feeding? Some are lower carb than others.
 
I was instructed to give the 3 units. I'm giving the fancy feast with gravy. I know its the pate that is recommended but he will not eat pate. He only eats the shreds.
 
Uggggh so I get home and his BG was 75 . what is happening????? I called the vet again and expressed my concern if its this low 12 hours later how low is it actually going through the day??? I'm really tempted to leave out a low carb dry food for him to snack on through out the day. He seems fine when I get home he runs to the door and greats me and is a savage with his food but this is so utterly confusing and really really stressing me out.... Send wine
 
3u is too much insulin! The starting dose should be 1u. Please do not shoot tonight and in the morning if he’s over 240, reduce dose to 1u. He may need a higher dose than that, but he will be safe as you test and slowly raise the dose. I’ll tag a couple prozinc folks to see what they think. @Djamila @Rachel what do you think?

Also tag @JanetNJ
 
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Vet called back and said do not give insulin tonight and don't give it tomorrow either I am instructed to call in the morning to give his BG level and they will instruct me from there. The plan tomorrow was I was going to give his dose at 5am and his appointment was 7 hours later for them to see where he's at but obviously this cat has way different plans. I'm going to bring my meter with me just to make sure we are getting the same numbers. Any one with experience with pet test advocate meter?? I'm really hoping they just lower it for me tomorrow
 
When my cat was diagnosed my vet wanted to start him on 2u. I told him I was afraid of hypo and he was fine with starting at 1u and slowly raising the dose. You are Wimbleys advocate, he cant speak for himself and you are also the one that has to worry about him when your not at home. Tell your vet your concerns and she should listen to you and understand.
 
I have an advocate pet test glucometer. I used it for a while because the strips were slightly less expensive than the AT2 while having comparable numbers. I was happy with how it works, but am using a human meter at the moment for day to day testing due to cost. I keep advocate pet test strips on hand now just to do monthly curves that I can share with the vet.
 
I'm just throwing this out there, but you are not required to follow everything your vet instructs you to do. I'm not saying don't listen to your vet; that decision is personal and entirely up to you. I'm just saying that you do not have to. I know it seems counterintuitive because surely this person who went to vet school would know more about treating diabetes than a bunch of people on the internet, but Sophie has seen many many vets and well, most of them don't, especially not when it comes to dosing. Most of them have been very nice people and I trust them with all of her other vet care, but not about her dosing.
Sophie's ideal dosage right now is 0.25 units: that a quarter of a unit! If I had listened to the vet's advice instead of looking at her BG numbers and only adjusted in whole units as they kept instructing me to do, she would have had several hypos by now.
 
Thanks! I'm going to tell them tomorrow i am not happy with the dosage and feel that these numbers are too all over the place (ive been writing down every date, time and BG number to bring with me) I think because I'm so so new to this its all very overwhelming so I dont know any better yet. Neither of my cats have needed any sort of medical attention other than normal shots or teeth cleaning... Heck even my 6 year old son is super healthy and rarely visits a doc other than his annual... So this whole situation is extremely new territory. One more question wimbley has been RAVENOUS like he's been stealing food off my plate is this normal? Will he adjust? I feel like I'm starving him and feel awful about it. He's 15 pounds btw maybe that'll help figuring out how much he should be eating
 
Wimbley is ravenous because he is not able to utiilize the food he consumes efficiently. Insulin is like a key that allows the doors to the body's cells to be opened to take in the fuel they need to function. Until Wimbley is better regulated he will be hungry. He may also be hitting lower BG levels that you are not seeing given how high the dose is and that too will make Wimbley very hungry the same way humans get when their BG is low.

I don't mean to sound like an echo chamber, but having to call the vet and wait for a call back twice every day to get instructions doesn't seem practical to me in the long term. I also would have some concerns about having multiple vets giving dosing advice. They may be open 24/7 BUT no one vet can follow Wimbley 7 days a week, 24 hours a day so the dosing advice you get may not be consistent. We can help you learn how to understand what is going on with Wimbley, help with dosing and help you learn to make dosing judgement calls for yourself. The decision is of course yours but most of us here, look after the dosing ourselves because we are the ones involved in the hands on treatment of the diabetes 24/7 and we hold the syringe. :)
 
Peacock said:
I have an advocate pet test glucometer. I used it for a while because the strips were slightly less expensive than the AT2 while having comparable numbers. I was happy with how it works, but am using a human meter at the moment for day to day testing due to cost. I keep advocate pet test strips on hand now just to do monthly curves that I can share with the vet.
Click to expand...


Using a human meter do you have to adjust numbers in your head or does it read somewhat comparable to the pet ones? I originally had a human one and fhe vet told me to return it and get the one for pets.
 
A human meter will read lower than a pet meter, but there is no conversion table. The higher the number, the larger the difference. We use the human ones mostly due to cost. Hypo range on a pet meter starts at 68 and on a human meter it starts at 50. For now I suggest you stick with your pet meter since it’s the one your vet wants you to use, but think about the switch if you need to bring costs down and we can help you interpret the numbers. You can also do as Peacock does and use human meters for everyday testing and the pet meter for curves and any tests you want to show your vet.
 
I would LOVE to bring costs down. I'm single mommy and already $600 in the hole not counting today's visit. I calculated the pet test strips testing 2x a day not counting curves id need to replenish every 25 days. At 39.99 that's a steep hole. Plus vet visits, meds, needles, and the new food. So any advice, tips, articles would be greatly appreciated! Thanks again!!
 
I'll just repeat what everyone else has said:
1. You will not be able to rely on your vet to adjust the dose because (a) vets simply don't know enough about FD (b) they aren't responsive enough if you have to call, leave a message, wait for a call back.... (c) it's too expensive
2. It doesn't matter what meter you use.
3. The current dose is too high
4. There are plenty of people here who can help guide you: with dosing, with getting your cat onto lower carb food, with saving money, etc.

So here is the link to the spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

That is a powerful tool in figuring out how to adjust your dose. Once you get it set up and enter the data you have so far, we can help you figure out next steps. If you have trouble getting it set up, ask for help. There are some tech-y folks around here who can help if you need it.

There is a lot to learn at the beginning, but it will get easier, and we'll help you get it sorted out. :bighug:
 
She lowered wimbleys dose! She put it at 2 units and taught me ways I can make an informed decision on lowering it myself based on his readings. She also put him on an antibiotic just in case there is an underlying infection there causing the drastic dips. She doesn't expect to see me again until I regulate his dose myself and hes been on it for a steady 3 weeks with consistent numbers. I'm excited that I feel a bit more in control of this!
 
Djamila said:
I'll just repeat what everyone else has said:
1. You will not be able to rely on your vet to adjust the dose because (a) vets simply don't know enough about FD (b) they aren't responsive enough if you have to call, leave a message, wait for a call back.... (c) it's too expensive
2. It doesn't matter what meter you use.
3. The current dose is too high
4. There are plenty of people here who can help guide you: with dosing, with getting your cat onto lower carb food, with saving money, etc.

So here is the link to the spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

That is a powerful tool in figuring out how to adjust your dose. Once you get it set up and enter the data you have so far, we can help you figure out next steps. If you have trouble getting it set up, ask for help. There are some tech-y folks around here who can help if you need it.

There is a lot to learn at the beginning, but it will get easier, and we'll help you get it sorted out. :bighug:
Click to expand...

Eek opened the spread sheet and I have no idea what I'm even looking at any way anyone could screen shot a pic of theres so I can get a better understanding of this? Right now I'm literally making a calendar everyday, time, bg, if I gave insulin or not..
 
There is a link to my spreadsheet in my signature if that helps! For setting it up, I would follow the directions in the sticky (I'm not very tech savvy myself), but as far as interpreting it, AMPS is the AM Preshot reading, PMPS is PM Preshot reading, U is for units of insulin and then +1, +2, etc stands for how long after the shot you take the reading. So +4 is 4 hours after shot time. When you entering the reading from the meter, it should automatically color code it for you. If you still can't figure out how to set it up based on the instructions, I'm sure someone will be along who can help you(:
 
If you need help setting up the spreadsheet, let us know and we’ll tag someone to do it for you.
 
Jci
Chez said:
Vet called back and said do not give insulin tonight and don't give it tomorrow either I am instructed to call in the morning to give his BG level and they will instruct me from there. The plan tomorrow was I was going to give his dose at 5am and his appointment was 7 hours later for them to see where he's at but obviously this cat has way different plans. I'm going to bring my meter with me just to make sure we are getting the same numbers. Any one with experience with pet test advocate meter?? I'm really hoping they just lower it for me tomorrow[/QUOTE Cienega do you have, an Alphatrak? I usually use freestyle insulinx strips with it which I wait for a good deal on ebay for.

For reading ketones every so often I use this meter
Keto-Mojo Blood Ketone and Glucose Testing Kit, Monitor Your Ketogenic Diet, 1 Meter, 1 Lancing Device, 10 Lancets, 10 Ketone Test Strips, 10 Glucose Test Strips, Carrying Case https://www.amazon.com/dp/B0789G8KTG/?tag=felinediabetesfdmb-20
Click to expand...
 
Sarah&Soph said:
There is a link to my spreadsheet in my signature if that helps! For setting it up, I would follow the directions in the sticky (I'm not very tech savvy myself), but as far as interpreting it, AMPS is the AM Preshot reading, PMPS is PM Preshot reading, U is for units of insulin and then +1, +2, etc stands for how long after the shot you take the reading. So +4 is 4 hours after shot time. When you entering the reading from the meter, it should automatically color code it for you. If you still can't figure out how to set it up based on the instructions, I'm sure someone will be along who can help you:)
Click to expand...

Ok so as per what the vet said, if his BG is under 150 skip the dose and go down a whole unit next time. Last night his bg was pretty high he skipped 2 doses and then the stress of the vet put him in the 400s I gave 2 units that was at 5pm I over slept lol and checked him at 640am and he was 146 I saw on Sophie's sheet at 145 you didnt give the insulin so I'm skipping this morning and going down to 1 unit tonight. Does this sound correct or should I go down a half a unit?
 
So there are people who are MUCH more experienced than me who should give you dosing advice, but when you’re first starting out I think the recommendation is not to give insulin if your kitty is below 200 preshot. Then once you start to figure out how they respond to the insulin you’ll know what the better “no shoot” number is. Sophie is also on a different type of insulin as well so her chart probably isn’t directly comparable.
@MrWorfMen's Mom may be able to help, she has helped me with Sophie (:

But it does sound like he may need a reduced dose! Also you may know this already (I didn’t know until recently which is why I’m mentioning it), but make sure preshot tests are before you feed him. Makes obvious sense to me now but it took me a while to realize that lol
 
While you can learn a lot by studying other people's spreadsheets (we all have them linked in our signatures), it's very important to be sure that you're looking at a spreadsheet with the same kind of insulin, as different insulin types have very different dosing "rules". It's also absolutely essential to remember that Every Cat Is Different (ECID - we've even turned it into an acronym we say it so often!), and while one person can give their cat insulin on quite low numbers and he'll be fine, other people cannot - even on the same insulin. How long the cat has been diabetic, what it eats, how much healthy pancreas function it has, etc. can all play into what makes a dose safe or not for a given cat.

Your vet is giving you dosing advice based on the manufacturer directions. Whole unit dose changes can be rather harsh and cause overly dramatic reactions for cats. Plus, they generally make them feel lousy. I would really encourage you to read the information on the yellow "sticky" posts at the top of our Prozinc forum here. They will explain how we approach dosing and dose changes, and might help you sort out which approach you are more comfortable with. I don't recommend trying to follow both vet dosing advice and the approach here - mixing and matching can set your kitty up for some unpredictable and possibly dangerous reactions.

Here is a link to the first sticky to get you started: http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/

And the another one that's particularly helpful: http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.165103/

Some people find it helpful to print those out and highlight and make notes. As you read them, note any questions you have, and ask away! We are all here to help!
 
So the vet said under 150 skip shot and reduce a whole unit next time. If between 150-200 go down half a unit. But wait between 3-4 days to go up so if I add a half a unit I cant go up again for 3-4 days. Does this make sense to you guys please by all means spam me with how you guys adjust the dose by the numbers.
 
Until you get more data and see how low any particular dose is taking your kitty's BG, we recommend not giving insulin unless BG is over 200 pre-shot with no food for at least 2 hours prior to that pre-shot test. Sliding scale dosing such as your vet has recommended can work in regulated cats but it seriously complicates figuring out the best dose for a kitty who is not yet regulated. You'd be far better off IMHO lowering the dose to 1u and holding it for a few days while getting a mid cycle test every day sometime in the period 4 to 7 hours post shot. When you can't get a mid cycle test during the day, get one at night. If BG drops too low then you decrease the dose immediately by 0.25u. If BG isn't going down enough, then you increase accordingly by 0.25u and repeat the process. The trick is to dose consistently morning and night and make small incremental changes so you don't skip over the best dose.

If you need help with the spreadsheet, just holler. I can set it up for you.:)
 
Is it possible that pzi just isn't the correct insulin? I feel it doesnt matter how much I give (I recently dropped to 1 unit) the 12 hour later check is still too low. I've only been giving one shot a day since Sunday. Ill be home Thursday so im going to try to do a curve on him. I also want to mention that when we went to vet on,Saturday I made them compare our machines the alpha Trac measured a good 60 points lower than my pet test which worried the crap out of me I have since purchased a relion which seems to be giving me readings at the same low point that the alpha Trac gave at the vet. I'd rather have a machine that is measuring low than one that is measuring too high. I feel there's less room for deadly errors.
 
What kind of numbers are you getting? Have you set up the spreadsheet? We need to see the numbers to really see what’s going on. It may be he needs less than 1u.
 
I haven't I honestly havnt had the time and I know that sounds awful. Ive been writing everything down in a journal with the intention of transferring it all. I'm off Thursday so I'm hoping I can get that off the ground then. I'm getting numbers around 120 when I'm getting home in the evening last night I took with both monitors relion was 123 and pet test was 172. I gave no insulin this morning relion gave me 278 so I gave 1 unit but I'm willing to bet tonight's reading will be back in the 120s. I have changed to fancy feast classic pate and to my surprise he's actually eating it. (That's a first). I'm hoping Thursday's mid day readings will give me a better idea of what this cat is doing during the day.
 
Although that seems like a crazy difference between the two meters, it’s actually not too far off. On a human meter the range you want him to be in is 60-120, and I forget the lower value for the pet meter but the upper value is either 150 or 180 I think, so he’s actually in the upper range of good on both meters. My advice is to pick the meter you like the best and stick with that one for the most part, because trying to compare the two readings will drive you crazy lol.
 
But I am correct with no shot at the 123? I like the relion only bc it reads lower. The fact that the pet test is reading high concerns me.
 
If that was his preshot number then I personally would have skipped as well, especially with one unit. But as Sharon said, it’s hard to give dosing advice without seeing his spreadsheet and how he’s responding to the insulin.

The ReliOn meter certainly is cheaper so if that’s the one you feel comfortable with, use that one(: I use it as well, and it is nice to have some cushion with the numbers. But it’s not that the other meter is “high” I don’t think, you just have to know what range of values you’re working with
 
It would definitely be preferable to find a dose that you can shoot twice daily so that BG is maintained at a good level throughout the whole 24 hour period each day. The FF pates may be lower carb than what you feeding and if that's the case, that alone will lower BG for most cats.

Don't worry about the pet meter numbers being higher. That is totally normal. If you do side by side tests with both meters and graph them over time, the pattern will look very very similar and the pattern helps determine the course of treatment along with the actual BG readings.

Ideally with ProZinc, I'd aim to keep kitty's BG about 80 to 90 on the human meter for now until you find the optimal dose so I'd reduce the dose to perhaps 0.5u and see if that evens out the day and night cycles. Many cats drop lower at night and I can't help wonder whether your kitty may have dropped lower last night than you are aware of and that led to the higher BG this morning as a result of bouncing. Bouncing occurs when kitty drops low, drops quickly or drops to levels they have become unaccustomed to. It is a normal biological occurrence you can't stop but you can lessen to some degree with proper dosing and meal distribution.
 
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He's on pzi not vetzulin is that just a different name for prozinc?
MrWorfMen's Mom said:
It would definitely be preferable to find a dose that you can shoot twice daily so that BG is maintained at a good level throughout the whole 24 hour period each day. The FF pates may be lower carb than what you feeding and if that's the case, that alone will lower BG for most cats.

Don't worry about the pet meter numbers being higher. That is totally normal. If you do side by side tests with both meters and graph them over time, the pattern will look very very similar and the pattern helps determine the course of treatment along with the actual BG readings.

Ideally with Vetsulin, you don't want your kitty's BG dropping below about 80 to 90 on the human meter so I'd reduce the dose to perhaps 0.5u and see if that evens out the day and night cycles. Many cats drop lower at night and I can't help wonder whether your kitty may have dropped lower last night than you are aware of and that led to the higher BG this morning as a result of bouncing. Bouncing occurs when kitty drops low, drops quickly or drops to levels they have become unaccustomed to. It is a normal biological occurrence you can't stop but you can lessen to some degree with proper dosing and meal distribution.
Click to expand...
 
Oh sorry. I looked at Sarah's signature. I'll correct the post. You still don't want your cat dropping too low when you are not there to monitor and are still learning how any given dose works.
 
Hi guys! So a little update, I have not been able to run a curve on wimbley every time I have a day off and I'm ready for it his BG is low in the am and I can't give him his shot. I can't really play around with the times I give it to him bc it would mess up my times when I returned to work the next day so I need to stick to the 630am/630pm schedule. I've dropped him down to .5 and decided to stick to that being I felt anything else was just to high for him. Monday morning he was 240 but then Monday night, Tuesday morning, Tuesday night and this morning he's been in the 90s all before food using a human meter. So my guy hasn't gotten a shot since Monday morning. I should also mention he's done with the antibiotics the vet has prescribed so not sure if that has anything to do with this bg drop im seeing. He's eating, peeing, acting normal but not sure why his numbers aren't going above 90? I still haven't done my spread sheet once I determined I couldn't curve him for the day I decided to do fun stuff with my son so I was out and about on my days off and didnt figure it out.
 
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