? Skye's Thread

symian277

symian277

Member Since 2020
Good afternoon everyone. I am super new here.
A little overview... We are working with a new diagnosis (09/02/2020). My girl is not very controlled yet and has been running in the low 300's and high 200's. We have an appointment next week for a curve (I'm going to do one this weekend so maybe just a phone consult if they let me get away with it.)
So my question today: I have an appointment today that will get me home later than she is due for her PM insulin. It could be only 1/2 hour or so but may be later. I will of course check her levels but should I give her the insulin tonight if I am later than that?
 
You should be fine. :) Like Shelley said, Prozinc has some wiggle room. If you are under 1 hr later you can just go back to regular time in the morning, or you can move the time back in 15 min increments if you prefer. It's easier when you're a little late vs a little early. If you're really late tonight and it's going to throw your schedule off tomorrow you can skip.

If you are testing yourself I wouldn't bother paying for a curve, just do it at home and send them the results. It will be more accurate in your home anyway. If they fuss tell just tell them it's more affordable for you to do it yourself.
 
I ended up not giving her the dose last night. I got home too late. I was pretty happy though. She seems to LOVE Weruva pate so we are doing a switch. I am hoping that by the end of the next couple of weeks we will be a crunchy-free house. This morning, I got both of her ear picks first time with no problems. I was feeling all sassy and confident...until I wondered if I actually gave her the shot this morning. :blackeye::banghead:
Another question though... She hasn't had insulin since this yesterday morning at worse (or this morning if I'm just not remembering). Last night she was the most interactive and playful that I have seen her since starting insulin. This morning she was also super interactive before I left for work. Is it possible the insulin is making her feel unwell?
 
Thank you :) It was just curious that other than increased drinking and peeing I would have never known she was sick. I start treating her and she looses some of that sparkle and attitude.
 
Ok guys - I am pretty sure no insulin since Thursday at 0800. I just got a 187 mg/dL back on Skye. I am stalling for another 10 minutes and checking again. I am thinking no insulin still if she stays below 200 mg/dL. Eeep!
 
Could you update her spreadsheet please?

When stalling you wait 20-30 minutes, then re-test. If numbers are still between 150-200 you can skip or give a token dose. A token dose is 10-25% of the normal dose.
If you choose to give a full dose lower than you're used to, or even a token dose, you can ask for someone to check with you on the Main Health forum to keep kitty safe.

How to handle a lower than normal preshot number when following SLGS:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin once you have data and understand your cat’s cycles. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Prozinc users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.

We usually don't suggest or recommend shooting a preshot number less than 90 mg/dL when following the SLGS Method. Remember that with SLGS, generally speaking, your goal is to achieve flat numbers that are greater than 90 mg/dL. However, let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat.
 
I just updated. :) I got posted on my phone but needed to boot up my computer to update the spreadsheet. :bookworm:
This is way below what I have seen in her. I am SO HOPING that this is going to be her trend now that I am at day one of the 50/50 Weruva to Glycobalance. :cat:
 
Next reading was 208 mg/dL. I am doing a curve on her tonight and tomorrow so we can avoid the vet next week so I will be feeding and monitoring.

Question on that - for the vet curve should I keep using the ReliOn glucometer or switch to the AlphaTrak2 for the vet?
 
Thank you! :cat:

Okay, you could skip or give her a token dose, since she's lower than usual. Eventually you'll have to start shooting those low numbers but you can do baby steps for now. :D And always make sure you're able to monitor!

Some people use Alphatrak for their vet curves to make their vets happy I know. If it were me I'd just use the ReliOn and not mention it but I'm a rebel. ;)
 
She is munching right now. I am going to keep checking but I may skip tonight. She is 100+ mg/dL lower and I am not supplying that addict crunchies unless I HAVE TO. LOL
We have been crunchy-free for 36 hours and I'm wondering if that is starting to show. I am leaning toward not shooting those 200 mg/dL numbers until she is 100% on her new food. For all that she is chonky she is such a picker and never really ate the "recommended" amount of food.
 
Oh okay, so we're switching food?? What kitty crack was she on and what is she switched to? That does make a difference!
Tagging @Deb & Wink for any insight but another member was switching from high-carb to low and the recommendation was to reduce dose by 30-50% for safety.

Could you do me a huge favor and fill in your signature? :) Age, diagnosis date, food, meter, insulin, any other health issues, etc.
 
I think I have it all...
The food thing is a bit wonky right now since she is going through a transition from a transition. I have had her on Royal Canin Weight Control for a little over a year. she was free fed dry and given about a can of wet split between two meals. I was trying to slim her down before her health was affected - you know, something like diabetes :confused: Since she was already on Royal Canin prescription food the vet just switched her to a prescription for Glycobalance. So when we started this last Friday I had both the dry and the wet food. As I learned more here I was really trying to limit to extinction her dry food. She was winning the dry food battle for a few days as I did not want to leave her home alone after insulin when she would only pick at the canned. She has been dry food free for about 36 hours at this point. I also noted that the canned wasn't the best thing for her either. I kept seeing the Weruva on Cole and Marmalade and figured I would give it a try. The fight over the dry food stopped when I brought that home. She LOVES it. I have given both my cats little tastes of four of the Showcase Chowdown pack and they ate that part first. So the first day I was 100% Glycobalance with no Weight Control I started transitioning both cats over to Weruva. Skye, the little brat, licks the Weruva out from the Royal Canin bits no matter how much I try to squash them into a paste. :rolleyes: So as soon as I can she is going to be 100% Weruva chicken pates with occasional fish flavours mixed in. My other cat, Finnegan, has a good stash of Royal Canin Instinctive to finish but ASAP he's going to be 100% Weruva too. There is a complete moratorium on any crunchies entering this house ever again. When I get a few minutes I'm going to find some diabetic friendly treats for her pokes so maybe I can find something with a little crunch if she still needs it.
 
Gotcha! Well that explains the lower pre-shot. I wonder if it might be beneficial to reduce her dose a smidge for the full transition, then bump her back up as-needed. Hopefully Deb will be online tonight.

If you're looking for some crunch, how about PureBites? They're freeze-dried treats (get the chicken or turkey), they're a bit hit!
 
Thank you! Sounds like a great idea. I decided to stick with the chicken Weruva since it was such a hit during the trial. Many of the flavours have fish in them so I didn't want to serve that on the regular. Chicken treats might do the trick.
 
symian277 said:
until I wondered if I actually gave her the shot this morning.
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Try putting 2 insulin syringes in a mug, and keep that next to the insulin. As you use 1 needle, only one needle will be left in the mug/cup/container.

See if that helps you to remember better. Then, you have to remember to refill the mug each day.;)

Since you are changing the food to a lower carb wet food, I'd definitely suggest reducing the dose by 0.25U. So only 0.75U for the PM cycle, if you see this reply in time.

Halo Liv-a-little chicken treats were a hit with Wink. Bravo has some nice treats in both chicken and turkey flavors. A bit pricey. Plain cooked chicken pieces, boiled in water worked just fine or microwave little bits. Boiling let's you shred the chicken easier I think. Your choice on cooking method. No crunch with the plain cooked chicken though. :(

If you skipped the shot last PM, 9/10/20, please enter 0 (zero) in the units column. Otherwise, we might think you forgot to enter the dose on the SS.
 
Deb & Wink said:
Try putting 2 insulin syringes in a mug, and keep that next to the insulin. As you use 1 needle, only one needle will be left in the mug/cup/container.

See if that helps you to remember better. Then, you have to remember to refill the mug each day.;)

Since you are changing the food to a lower carb wet food, I'd definitely suggest reducing the dose by 0.25U. So only 0.75U for the PM cycle, if you see this reply in time.

Halo Liv-a-little chicken treats were a hit with Wink. Bravo has some nice treats in both chicken and turkey flavors. A bit pricey. Plain cooked chicken pieces, boiled in water worked just fine or microwave little bits. Boiling let's you shred the chicken easier I think. Your choice on cooking method. No crunch with the plain cooked chicken though. :(

If you skipped the shot last PM, 9/10/20, please enter 0 (zero) in the units column. Otherwise, we might think you forgot to enter the dose on the SS.
Click to expand...

I have been writing things down in a notebook before typing them into the spreadsheet since that can be right on hand while I'm doing the 18 things I need to do while poking a cat. LOL I am a stickler for entering in medication administration times and doses. There isn't a notation in my notebook so I'm almost positive I missed it. :(

The mug would be a great idea if my second cat wasn't a ninja about getting on the counter. With the way he is I'd find him with a needle sticking out of his mouth. I have to make sure I police up all of my testing equipment immediately while he is around. The turkey head swatted a lancet of the table right next to me while I turned my head to make sure that Skye's ear had stopped bleeding. :rolleyes:

I decided to not give her any insulin tonight. I'm not crazy about the amount of food she is eating with the mix. I swear if I wasn't worried about her getting nauseated or diarrhea I'd just give her straight Weruva. Her majesty has spoken.:facepalm:
 
symian277 said:
I have been writing things down in a notebook before typing them into the spreadsheet since that can be right on hand while I'm doing the 18 things I need to do while poking a cat. LOL I am a stickler for entering in medication administration times and doses. There isn't a notation in my notebook so I'm almost positive I missed it. :(

The mug would be a great idea if my second cat wasn't a ninja about getting on the counter. With the way he is I'd find him with a needle sticking out of his mouth. I have to make sure I police up all of my testing equipment immediately while he is around. The turkey head swatted a lancet of the table right next to me while I turned my head to make sure that Skye's ear had stopped bleeding. :rolleyes:

I decided to not give her any insulin tonight. I'm not crazy about the amount of food she is eating with the mix. I swear if I wasn't worried about her getting nauseated or diarrhea I'd just give her straight Weruva. Her majesty has spoken.:facepalm:
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...As I was typing that last the little maniac jumped on top of the refrigerator and stole the loaf of bread. I can't even make this stuff up....
 
And now we're doing 160 mg/dL.

My syringe will only do 1/2 and whole Units? Anyone have any advice about giving a 1/2 Unit in two hours if it stays this low? I don't really want to skip a dose again because it climbed pretty high last night...:confused::confused::confused:
 
Oh - and her Majesty has informed me that she is DONE with Glycobalance. She at not one bit of it this morning. She just at the Weruva out of it. I know it is supposed to be a 7 day transition but if she just won't eat it AT ALL would I be better just giving in and letting her eat what she wants?
 
If this is going to be the first time without any dry you may be safer giving her .5 units until we see that she needs an increase (she may not).

Syringes don't do quarter units so you'll have to eyeball it. :)

If she's still dropping by PMPS you might prefer to skip. If maintaining/rising but still lower than usual you might consider a token dose of 0.10u
 
Panic said:
If this is going to be the first time without any dry you may be safer giving her .5 units until we see that she needs an increase (she may not).

Syringes don't do quarter units so you'll have to eyeball it. :)

If she's still dropping by PMPS you might prefer to skip. If maintaining/rising but still lower than usual you might consider a token dose of 0.10u
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Not sure I know how to do 0.1 either. Eeep!
 
symian277 said:
But the Glycobalance canned is still 14% carb.
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Okay gotcha, still higher carb so it counts.
I've never had to do .10u but I think it's like, barely a drop haha.

49822973598_f0540f7a37_w.jpg
 
The concept is the same, for placement of the syringe plunger with U40 or U100 syringes. Barely over that first line, the zero (0 units) mark on the syringe.

So next time that Skye is really low at pre-shot test, eyeball the dose and give that token dose.

Over here in the Prozinc forum, our decision making pre-shot BG level (aka shoot/ no shoot BG) is 150.
You haven't been testing Skye very long, since you only recently got the glucometer and the diabetes diagnosis is VERY new for Skye.

"Better too high for a cycle, than too low for a moment."
Eventually you have a feel for when to shoot the full dose, when to skip, and when to stall.

Do you know what stalling is?

By the way, food raises BG, insulin lowers the BG levels. So a BG test 1 hour after food, is likely to be higher than the pre-shot test, as long as Skye ate well.
 
Deb & Wink said:
The concept is the same, for placement of the syringe plunger with U40 or U100 syringes. Barely over that first line, the zero (0 units) mark on the syringe.

So next time that Skye is really low at pre-shot test, eyeball the dose and give that token dose.

Over here in the Prozinc forum, our decision making pre-shot BG level (aka shoot/ no shoot BG) is 150.
You haven't been testing Skye very long, since you only recently got the glucometer and the diabetes diagnosis is VERY new for Skye.

"Better too high for a cycle, than too low for a moment."
Eventually you have a feel for when to shoot the full dose, when to skip, and when to stall.

Do you know what stalling is?

By the way, food raises BG, insulin lowers the BG levels. So a BG test 1 hour after food, is likely to be higher than the pre-shot test, as long as Skye ate well.
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I just did a +1 on her and it is up a little bit. We're only at 170 mg/dL. She doesn't seem like she is going to eat more very soon. I gave her a couple of the PureBites Chicken and Catnip and she LOVED it so those are a hit.

I am totally on board for the high for cycle - especially since we are all low carb tonight. I plan to watch her sugar again for at least the next few hours about every two hours. I am also thinking about lowering her dose in the morning to 1/2 Unit to see if we can't level out these peaks and troughs a bit. 433 mg/dL to 150 mg/dL cannot be all that great for her, even if it is over a span of 12 hours. Since I am going to be home tomorrow I can see how she does with it. It also sounds like the adage that if a little is good more is better is not applicable here at all. I love seeing these blues on the spreadsheet but I would rather they not be associated with reds during a cycle.
 
Saturday, 9/12/20 was really her very first day on low carb food.

It can take a few days for food to move through the digestive tract of a cat.
Patience.

Plus, you totally skipped the dose last PM cycle, 9/12/20. That is another reason for the BG levels to be high.
As well as the bouncing that Nan mentioned.
 
This is nerve-wracking. I am glad I stuck to the 1/2 dose. Her evening +4 is back into the blue. My boyfriend is a no animals in the bedroom kind of guy and now I'm nervous to leave her to sleep. I might be sofa surfing tonight... Sigh...
 
As long as Skye eats something, before the shot of insulin, or soon after, she should be fine.
In fact, looks like she got a good "food spike" at the +2 test.
 
Tonight’s +4 is at 77 mg/dL.
The vet that was in today kind of admonished me this evening for only giving her a half unit and that her sugar was still too high. I tried to tell her that I was also switching food and I didn’t want to bottom her out. I don’t think she listened very much. Tomorrow I have a conversation with my vet about the glucose curve that was scheduled Wednesday and whether we still have to do it. Currently at half past midnight I’m glad I stuck to my guns and just did the 0.5 when I got home.
 
Are these 200 mg/dL drops in a matter of a couple of hours normal at this stage? Skye seems to like to do this a lot.

+5 @ 83 mg/dL
 
Usually, if your cat is dropping that much, the dose is too high.

With that 118 BG level and the fact that you had to skip the shot this morning, I Skye needs another dose reduction.

Try to eyeball a 0.25U dose. It's just above the first line (the 0 zero) line on the insulin syringe.
You want to try and give the same dose, AM and PM, whenever possible.

With a food change, yes, those BG levels can drop fast and furiously.
Skye may not need insulin for long. The food change may be enough to get her back in normal numbers.

Very glad to see you trusted yourself and what was going on with Skye, and dropped the dose.
You can do the curve yourself at home, and it's a much more relaxed environment, so more likely truer, more accurate BG numbers. Not influenced by stress and strange surroundings and barking dogs and strangers and ...............................
A curve is testing from one pre-shot to the next, every 2 hours. So pre-shot, +2, +4, +6, +8, +10 +12 (your next pre-shot test).

"Her Majesty" wants to be served at her preferred dining table does she? :joyful::joyful::joyful:
 
Deb & Wink said:
Usually, if your cat is dropping that much, the dose is too high.

With that 118 BG level and the fact that you had to skip the shot this morning, I Skye needs another dose reduction.

Try to eyeball a 0.25U dose. It's just above the first line (the 0 zero) line on the insulin syringe.
You want to try and give the same dose, AM and PM, whenever possible.

With a food change, yes, those BG levels can drop fast and furiously.
Skye may not need insulin for long. The food change may be enough to get her back in normal numbers.

Very glad to see you trusted yourself and what was going on with Skye, and dropped the dose.
You can do the curve yourself at home, and it's a much more relaxed environment, so more likely truer, more accurate BG numbers. Not influenced by stress and strange surroundings and barking dogs and strangers and ...............................
A curve is testing from one pre-shot to the next, every 2 hours. So pre-shot, +2, +4, +6, +8, +10 +12 (your next pre-shot test).

"Her Majesty" wants to be served at her preferred dining table does she? :joyful::joyful::joyful:
Click to expand...

This is so scary and frustrating. When my vet called today she said the same thing the other vet from the office that we had never met did yesterday - she absolutely needs that 1 Unit dose. Look how how that blood sugar is... :facepalm:
The one yesterday acted like I was insane when I was talking about rebounding her sugar after a drastic drop. They have been wonderful vets up until now and I'm seriously trying to not piss them off but after what I saw last night it will be a cold day before I give her an entire unit. My vet didn't see last night's drop but she will when I send in a copy of my spreadsheet. Unfortunately she will also see that she is higher today than she was yesterday. Skye didn't get any insulin this morning since 118 mg/dL is essentially normal. By the time I got home is was in the high 300's.
My poor girl has been picked so many times. All of these curves. It's a wonder she doesn't smother me in my sleep.
Tomorrow morning I will go with the 0.25. Are there actually syringes that will do these low doses accurately? I have some of my father's U100 syringes but the smallest increment is 1.
 
symian277 said:
Tomorrow morning I will go with the 0.25. Are there actually syringes that will do these low doses accurately? I have some of my father's U100 syringes but the smallest increment is 1.
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No, there are no syringes that have 0.25U markings on the insulin barrel.
You have to "eyeball" it and try to be consistent with the dose.
Try taking a used syringe, and drawing up some colored water or juice. Practice the tiny dose first.

Are your dad's U100 syringes the 3/10 cc volume syringe? 30 units fit in the 3/10 cc syringe.
Or are they the 5/10 (1/2 cc - 50 units fit in that syringe) or 1 cc (100 units fit in that syringe) volume syringes?

It's so VERY difficult to measure tiny doses with U100 syringes that are larger than the 3/10 cc syringes. Trust me, I did it with Wink and had an awful time until I got some 3/10 cc syringes from the cat shelter.

So ask yourself, would you rather keep your cat Skye alive and prevent a symptomatic hypo? Or make your vets a bit mad with you? Who suffers if Skye has a hypoglycemic episode and has seizures or falls into a coma, or heaven forbid dies? The vet? I don't think so but please correct me if I'm wrong.

What has your vet suggested as the lowest BG level that you should give insulin? Do they even have a lowest BG threshold? Most vets are not used to their customers (clients) home testing. You have real time data to show them, uninfluenced by "vet stress". Yes, there really is such a thing, and I'll link the study for you if you want it.

Who knows your cat better, you or your vet?
Who is there to observe her behavior, monitor her food intake, see how much she is peeing in the litter box, see how much water she is drinking, playing, purring, grooming and being her normal self?

I think the answer to those questions is Carrie.



Did they give you a list of signs and symptoms to look out for in case of hypoglycemia?
Are your vet's open 24 hours a day, or would you have to take Skye to a 24 hour emergency vet? How far away is that 24 hour vet from your home?
 
I believe my father's are 5/10 but there are some 3/10 syringes kicking around too. If the 3/10 are helpful then I can get some more.

I am a total advocate for Skye. Like I said, it's going to be a cold day in Hell before I give her an entire Unit right now. Hyperglycemia causes all kinds of problems long term but hypoglycemia kills very quickly. I KNOW that is wrong for her. I will never give her anything that I know will actively harm her. I want them onboard, however. If I have to I will switch vets, but I really hope that doesn't become necessary. We actually have an endocrinologist not too far from here. Fingers crossed that isn't necessary and the change in diet is enough to move her to remission.

I'm frustrated at her bouncing so hopefully decreasing her dose levels that out a bit. She is better than she was prior despite all of this. She is drinking and peeing a lot less. She is also grooming more. Her fur hasn't look this nice in some time. I thought it was because she was stiff from arthritis that she wasn't getting her fur as clean as it once was. Either the joint supplement is working or the decrease in her blood sugar overall has helped - possibly both.

I always know exactly where the emergency vets are whenever I move to a different area. Fortunately I have not had to rush anyone for an immediate life threatening crisis, but we have needed their services. They are about 10 minutes away. My vet is less than 5 but no they are not open 24 hours.
 
Skye is again having a slightly Sub-150 morning. I feel like not giving insulin is not the correct choice as she went from 118 to 387 without it yesterday but this is uncharted territory. After some counselling yesterday I decided I was going to lower her dose to 0.25 Units to try to smooth her out some more but I'm not sure that is a good idea right now... Anyone have any advice?
 
I gave her a token dose of 0.1 about 0800 since I was going to be home for a few hour and I hated the climb last night.

@Panic can you maybe take a look at Skye's spreadsheet. Did I even get any in her?
 
Thank you!

I'm supposed to send a copy to my vet. I am glad she is staying blue/yellow. Hopefully she is going to agree with me on the reduced dose instead of trying to talk me into the 1 Unit again. Totally NOT happening! As a matter of fact if she stays around here we're doing 0.25. Hopefully the yo-yo numbers stop.
 
I feel like we might be heading the right direction. Skye's blood sugar was only 211 mg/dL when I got home. We are trying the 0.25 Unit injection tonight and we will see where it will go. Fingers crossed nothing above a yellow and nothing below a dark green!
 
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