New to Forum - Diabetic Kitty Comes Home Today

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Good morning! Merlin and I are up. It is 7:15am here. I hoped to keep him on a 9 and 9 schedule because it works perfectly for my schedule. However, I just took his glucose to see how it was doing. It was 174 last night at 8:30pm so my vet said 1 unit of ProZinc. This morning it is 351. I'm not how sure this meter is when it gets this high, he could be higher. In the past, this meter matches the vet's meter at low numbers but could be 150 points low once his bs is high. Is it safe to have him wait until 9:00am to get insulin or should I feed him now and get some insulin in him? Getting nervous...

Is it normal to be so high in the morning? I wonder if he should have had 2 units last night instead.
 
Good morning!

It's OK to wait until 9am to shoot-- the high numbers aren't going to hurt him until then.

The high numbers could be due to not enough insulin, but they could also be a reaction to the low (61) he had at the vet yesterday. Assuming that's a pet meter, that's below our usual 'take action' (feed high carb) number of 68, so his body could be reacting to that, dumping sugars into the blood as a defense mechanism. We call this kind of thing a 'bounce', it's so common in newly diagnosed cats it's actually unusual when they don't do it at first. So it's nothing to worry about.

I'll leave the dosing suggestions for the Prozinc folks. One thing, we usually try to have the pre-shot BG reading as free of food influence as possible (usually trying to keep a 2hr window). Merlin is a special case right now, if he's willing to eat we don't want to withhold food just to follow that rule, so I'd say if he's hungry now feed him even though it's (just) inside the two-hour window. I'm mostly just mentioning this so that you know, and (if you can) try to avoid feeding him close to the pre-shot BG reading so we can get a clear picture of where he is then.

And finally, big welcome home for Merlin! What a trouper!
 
Morning, Kelly!

Hope yourself and Merlin feel better for the sleep. :)

A higher reading in the morning may be affected by 'dawn phenomenon' and also Merlin's BG may have dropped to a safe but unfamiliarly low level overnight, in which case the body reacts by dumping too much sugar into the bloodstream to compensate (bouncing). As you accumulate BG readings it will help you to learn Merlin's 'style' of response to his Prozinc.

I can't help on the dosing side of things 'cause I've not used Prozinc, but it's OK for a cat to be in higher numbers at the beginning of the cycle. Regulation will take some time, so don't panic if you see numbers in the higher range.

IMPORTANT: Please do not give any insulin now. You need to wait until Merlin's normal shot time of 9am.


Mogs
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Good morning
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Thank you all! He is eating now. I actually kept him in a very large crate near my bed last night with a litter box and bedding because I was afraid if he threw up it would be someplace I wouldn't see right away. He did good all night. Because he was crated, I know he hasn't eaten since last night.

I went ahead and gave him a 2oz packet of food at 7:45am because he acted so ravenous. The food is Purely Fancy Feast Natural White Meat Chicken and Shredded Beef Entrée in a Delicate Broth at 50 calories per packet. The packet says feed a whole packet for every 2-2.5 lb of body weight each day. That would be 3-4 packets, so I'm confused how I would do that when most of what I read says only feed twice a day at insulin time. How do I make sure he is getting enough calories? He seems to have ate a little less than half and drank all of the liquid in it. He just came back and is eating some more as I am typing this, but has stopped again. It looks like a TINY bit more is gone now.

The 351 was prior to eating. I will wait and give the insulin at 9:00.

This is my first day back to work since I joined this forum (I'm working from home due to the pandemic). I have sooooo many questions. I will be here at my computer all day and will definitely be reading through all of the information here.

Should I just leave this food out and available to him for the day but not give him more until tonight's insulin feeding?

Thank you all again!
Kelley
 
Kelley Lynette said:
Thank you all! He is eating now. I actually kept him in a very large crate near my bed last night with a litter box and bedding because I was afraid if he threw up it would be someplace I wouldn't see right away. He did good all night. Because he was crated, I know he hasn't eaten since last night.

I went ahead and gave him a 2oz packet of food at 7:45am because he acted so ravenous. The food is Purely Fancy Feast Natural White Meat Chicken and Shredded Beef Entrée in a Delicate Broth at 50 calories per packet. The packet says feed a whole packet for every 2-2.5 lb of body weight each day. That would be 3-4 packets, so I'm confused how I would do that when most of what I read says only feed twice a day at insulin time. How do I make sure he is getting enough calories? He seems to have ate a little less than half and drank all of the liquid in it. He just came back and is eating some more as I am typing this, but has stopped again. It looks like a TINY bit more is gone now.

The 351 was prior to eating. I will wait and give the insulin at 9:00.

This is my first day back to work since I joined this forum (I'm working from home due to the pandemic). I have sooooo many questions. I will be here at my computer all day and will definitely be reading through all of the information here.

Should I just leave this food out and available to him for the day but not give him more until tonight's insulin feeding?

Thank you all again!
Kelley
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Most of us feed more than twice a day. I feed four times a day. I leave the food out. My cats are all grazers. Just no food 2 hours prior to the preshot test so the number is not food influenced.
 
Furshots happen, Kelley. :bighug:

Whatever you do, DON'T give another dose of insulin. There's no way of knowing how much went in.


Mogs
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I just tested his bs again and it says 361, only 10 points higher. Of course, it may be much higher on a cat meter. This one doesn't seem accurate as it gets higher. So, should I hold food until his next dose tonight? Or let him finish this plate of food as he is interested?
 
Back when I was waiting on the Lantus, I ordered U100 syringes with a 5/16 needle to hopefully avoid this. Then we switched to ProZinc and the vet gave me U40 syringes with a 1/2 needle. Is it possible to remove the shorter needles from the old syringes and put on the new U40 syringes as I use them? I may just go ahead and start drinking today...
 
Kelley Lynette said:
I just tested his bs again and it says 361, only 10 points higher. Of course, it may be much higher on a cat meter. This one doesn't seem accurate as it gets higher. So, should I hold food until his next dose tonight? Or let him finish this plate of food as he is interested?
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You should always let your cat eat if he's hungry. No reason to hold food from him. You only need to hold the food 2 hours prior to the preshot test... otherwise he can eat whenever he wants.
 
Probably the easiest thing would be to see if you can get U-40 syringes with your preferred needle length and gauge. I don't think you can swap needles out, unless your syringes are made very differently than mine.

An alternative: you may be able to use the U-100 syringes directly. You would have to convert the dosage, however, using this conversion chart. For example, the 2.0U of prozinc drawn up in a U-40 syringe is equivalent to drawing up 5.0U on a U-100 syringe.

Obviously, it's absolutely critical that you keep the syringes separate and always double-check which one you are using. You do not want to shoot 5.0U using a U-40 syringe!
 
Kelley Lynette said:
Thank you. I def don't want to try to convert from the U100 to the U40. I'll just reorder some U40 syringes with the shorter needle.
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Sounds like a plan! Hang onto the U-100s, you may want them later. Despite the range on that conversion chart, what most people use it for is to do tiny doses (0.4, 0.2) of U-40 insulins more easily. So at some point, when Merlin is on one of those tiny doses, you may reconsider! But I agree, it's probably not something you want to deal with at the beginning of FD, when there's so much other stuff to worry about.
 
Kelley Lynette said:
So, should I hold food until his next dose tonight? Or let him finish this plate of food as he is interested?
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Apart from the two-hour period before each preshot check, I'd suggest you let Merlin eat as much as he wants. After all the problems he's had with appetite over the last week, it'll aid his recovery greatly to keep him eating regularly. Also, too long a fast can lead to tummy acid build-up so making sure Merlin eats a little something at least every 3 hours or thereabouts may help prevent that. Also he needs to regain weight so there's no need to restrict calories at the moment.


Mogs
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I've added a profile picture of Merlin. It's an older pic. I caught him mid-yawn and he looks like a vampire kitty. I figured it was appropriate for Halloween. He also has a FB page if anyone would like to add him. I haven't updated it in quite a while, but there are some photos of him and our other furry family members. I adopted Merlin and a beautiful, sweet, orange kitty on the same day. The orange kitty is no longer with us. His name was King Arthur.

Merlin's name on FB is Merlin Romanov (the second name is a whole story...) and the profile pic is the same one I used here.

Kelley
 
Kelley Lynette said:
Hi everyone, just a quick update before Merlin and I go to bed. His bs was 61 when I picked him up from the vet at 4:30. We came home and I spent a long time just lovin' on him! He is eating well. I first tried some Fancy Feast low carb tuna and mackerel wet food. He took a few bites, but I think he doesn't like it that much. Then he found a couple of dog kibbles on the floor and ate that (first time ever!) so I gave him a little of his usual dry food and he gobbled it up! Then he ate about a quarter can of the urgent care wet food and right before his insulin I gave him about a half jar of turkey baby food. This was all over about 5 hours. I'm literally just feeding him small amounts of anything right now. I took his blood sugar at 8:30 and it was 174. Then he ate the turkey baby food and I gave him his potassium paste, antibiotic, and 1 unit of ProZinc. He's super alert and following me all over the house. Now he and I are getting ready for bed. It's been a long week. We will check in again tomorrow!

Kelley
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Way to go Merlin ! ( & Kelley of course) glad he's getting more back to his loving self.
 
Kelley Lynette said:
Has this happened to all of you at some point?
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Oh yes ! Most definitely ! In fact i managed one on Saturday - the first time in ages since changing to u100 syringes so I could have a shorter needle (using a conversion chart of course). I swapped because Mac's a bit of a fidget so furshots were a little too easy to get. Eliz gave me the tip and I love the u100s so much more but it is all a matter of taste .
It's a pain in the UK as you can only get u40s with the longer needles so u100s was the only way I could go to get shorter ones. Least outside the UK there are more u40 options.
 
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Here is a thought. The 2units is dropping him to the 60s which is fine but then goes right up to the 300s. If I read correctly above the 1 unit isn't enough.

What about giving 1.75 units? See if he stabilizes must be bit?
 
Olive and Paula, I'm thinking the same about the 1 unit not being enough. Below is how the vet is recommending dosing him.

I just gave his morning insulin (2 units) at 9:00am. His bs was 369. I'd like to take it a couple of times today to see how far and how fast these two units bring it down. What time intervals do y'all recommend that I test for this?

He got 2 units last night at 9:00pm. But his bs was in the mid-300s this morning. I'm wondering if it is the dawn phenomenon like Mogs said the other day. Is there a good time to test in the middle of the night to determine if that is what it is? If I tested at 1:00am or 2:00am would I see a low number if it is the dawn phenomenon?

Vet dosing recommendation (ProZinc):

under 100 - hold insulin
100-175 - 1 unit (yeah there's a gap between 175-200, so I'm not sure how many units for the 175-200 range - I also worry a little about 1 unit at 100, how low would that drop him?)
200+ - 2 units
 
Kelley Lynette said:
I do want to set up a spreadsheet. I will read this information. I opened the one on Mogs profile yesterday, got overwhelmed, and closed it. :nailbiting: I've been keeping notes on my phone that I can transfer over.
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Mine's a bespoke number, Kelley. The standard FDMB sheet is much simpler. Here's an example of one of the standard sheets for another kitty:

https://docs.google.com/spreadsheet...5WVl5oTbj9v316LvjjroBaCoY/edit#gid=1182885903

Essentially the spreadsheet is just a grid where you record the doses you give and then fill in the BG readings you take relative to the time the dose was given (plus helpful remarks about food, meds, and so forth). All the colour coding happens automatically after you enter your BG number into a cell. Here's a helpful thread explaining further:

Understanding the Spreadsheet Grid

If you need any assitance getting going just give a shout out and we'll find someone to help you. :)


Mogs
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Yeah the ss can be a little scary when you look at it the first time. However, you will be surprised of the whole picture if you print out in color every so often. It's an eye opener and you will see patterns emerging.

Each row covers 24 hrs. Broken down into the 12 hr cycle. So you have the date, 2nd column is the meter reading at shot time. 3column is the number of units you give. The +1 is 1 hr after shot, +2 is 2 hrs after shot, etc. Until +11. After that is the meter reading at pm shot time, then dose of insulin and it starts with the +1 again.

What helped me was at top of column where the +1 numbers are I put the time above it.

Any time you add anything but a number you have to fill in the color manually.

I also created more work for myself since vet wasn't techy enough to access ss. I kept daily hard copy (in excel) but used 2 rows for each day. Second row I put in meds, poops, vomits, meals so vet saw everything that goes on with her then emailed every 2 weeks. 2wks fit on page and was easier to manage through out the day for me. I can only enter numbers to ss using phone, but use my kindle daily for everything else in my life. If any major reformatting had to be done I had to use pc. So paper copy in place of 3 devices for hourly/daily use, then every couple days updated copy for vet was just easier for me.

Look at Ollie's ss below, you will see the times I used at top.
 
Merlin's pre-shot was 189 at 8:30 tonight. I'm thinking about skipping this dose based on the ProZinc Dosing Methods page. I'm concerned because this afternoon he dipped down to 46 around 4.5 hours post shot. I've got to get this spreadsheet filled out early tomorrow morning.
 
Kelley Lynette said:
I just gave his morning insulin (2 units) at 9:00am. His bs was 369
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Kelley Lynette said:
He's 2 hours out and down to 131.
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Kelley Lynette said:
this afternoon he dipped down to 46 around 4.5 hours post shot.
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:eek: :eek: :eek: :eek:

The 2.0 dose is definitely too high. Any time he goes below 50, you need to take action to bring the numbers up-- feed a little high-carb snack, and post here for help in managing the numbers. The spreadsheet will really help folks keep an eye on what's going on as well -- that 131 today was a warning sign that he was in a dive, but it was easy to miss as a single post in what has become a pretty long thread.

I hope you did end up skipping tonight... I'm thinking sliding scale is not going to work for Merlin, he'll probably be better off just getting a consistent (smaller) dose. (prozinc folks may have more detailed recommendations, but they'll probably need the spreadsheet to make them).

Don't worry if he's sky-high in the morning, that's a normal reaction to the day he had today.

This, by the way, is a very good sign of Merlin's progress!
 
Please Kelly help us help you. Your signature is an important to help us help you. TRUST ME You will be glad you set this up.
  • Click on Signature. This is where you will put information that helps us give you feedback.
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    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
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Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Good morning. I started uploading the info to the ss last night. I just finished. Now I'm going to try to follow JT's instructions to add it to my signature.

Nan, I agree that 2 units seems too much. The vet said something yesterday about going to 3 and everything in me was saying nooooooo. I told her about the low number (46) yesterday afternoon. I ended up giving 1 unit before bed last night as his BS was going up and was at 229.

I'm about to attempt adding the spreadsheet to my signature.
 
Kelley Lynette said:
Good morning. I started uploading the info to the ss last night. I just finished. Now I'm going to try to follow JT's instructions to add it to my signature.

Nan, I agree that 2 units seems too much. The vet said something yesterday about going to 3 and everything in me was saying nooooooo. I told her about the low number (46) yesterday afternoon. I ended up giving 1 unit before bed last night as his BS was going up and was at 229.

I'm about to attempt adding the spreadsheet to my signature.
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WELL DONE!
 
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