Remission Help

HeidiD

HeidiD

New Member
Hi,
My girl (Fat Kat) has started getting some stable numbers during a curve and is started to drop about 4hrs after her shot. She's on a low dose of ProZinc now (.4 unit x2 a day). My belief she may be close to remission. Wondering on everyone's thoughts...as well what can I do to start steps to getting off the insulin.

Here is the info from her last curve. Sorry I don't have a spreadsheet. I'm using an AlphaTrek2 monitor.
8:15am - Breakfast (1/3 of 5.5oz ProPlan DM canned food plus water)
9:01am - 3.9
9:04am - .4 unit
10:54am - 3.8
1:03pm - 2.2
1:10pm - Lunch (1/3 of 5.5oz ProPlan DM canned food plus water)
3:03pm - 3.4
5:00pm - 4.7 (Had to poke like 3 times before getting enough blood...she wasn't happy by the end)
5:03pm - Snack (Small handful of freeze dried chicken liver treats)
5:30pm - Snack (Small handful of cooked pork)
7:00pm - 4.3
7:05pm - Supper (1/3 of 5.5oz ProPlan DM canned food plus water)

We are also currently dealing with high pH levels. Tried doing some natural remedies with no luck. We are scheduled to get a urine sample in another week.

I don't currently test regularly, unless just her curves. That was mostly because of the job I was working and my boyfriend not willing to test (he gives her 98% of her shots so he's totally forgiven). I am working a more regular, stable job. Where I can test more often...depending on day...and what I need to do. I'm willing to do my best on this. I'm not sure how flexible testing is.

Thank you in advance. I appreciate everyone's help! I tried to provide as much info as I can!
 
HeidiD said:
My girl (Fat Kat) has started getting some stable numbers during a curve and is started to drop about 4hrs after her shot
Click to expand...
She's dropping too far.
I think your cat is being overdosed, on 0.4U of insulin.

Any BG number < 90 mg/dL (5 mmol/L) calls for a dose reduction using our SLGS dosing protocol.
Since ALL of those curve numbers were < 90 mg/dL, you definitely need to reduce the dose in my opinion.
Or even perhaps stop the insulin all together for a bit. That would be my recommendation right now. No insulin, test for ketones, test the BG's before each insulin shot, test before you feed, what we call the pre-shot test.

Any BG number < 68 mg/dL (< 3.7 mmol/L) using an Alphatrak meter is getting into hypoglycemic territory.
We want to help you keep your cat safe.

Even after 8+ years here, my mind does not easily convert the mmol/L BG values to the mg/dL values we use here in the US. I have to use a calculator and multiply the numbers you listed by 18 to see something that is understandable to me.

If you set up a World version of the spreadsheet (SS), you enter your mmol/L values on the World tab, and the US tab is automatically populated by some formulas behind the scenes of the SS.

I strongly urge you to set up a SS. Directions to do that are in this thread here, and there are instructions for doing the setup on a pc, tablet, smartphone. You would want to choose the pet meter version of the SS. It will be much easier to guide you, if we can see the trends in the BG levels, and the color coding that is applied to the cells.

If you need help setting up the SS, ask for help. There are a couple of members here that do the SS setup for people. I've tagged one of them for you.
Sticky FDMB SPREADSHEET INSTRUCTIONS

@Bandit's Mom Would you help setup a spreadsheet for this person? Please?
 
Deb & Wink said:
Heidi, these instructions on how to enter data on the SS were just updated today, 1/18/21.
Sticky HOW TO USE THE SPREADSHEET
Click to expand...
Thank you Deb & Wink!
I will look into getting a SS set up. I'm not as familiar with SS and thought I may have issues. I knew you guys would be able to help! So with pretesting (to make sure I'm understanding correctly)...I would test before feeding & before her shot. Would you recommend a mid day test? How can I test for ketones?
The information pushed down from my vet is that she should be between 4 and 6 (on my AlphaTrek2 meter). I knew if she drops below 2, to call my vet and I'm assuming I would even up giving her some corn syrup to bring her levels back up.
We are currently using U100 needles so trying to do less insulin may be harder, without getting new needles. I'm thinking you may be correct on probably stopping the insulin.
What is the approach to deciding whether or not I should give her a shot? This part is where I getting confused about.
 
Deb & Wink said:
She's dropping too far.
I think your cat is being overdosed, on 0.4U of insulin.

Any BG number < 90 mg/dL (5 mmol/L) calls for a dose reduction using our SLGS dosing protocol.
Since ALL of those curve numbers were < 90 mg/dL, you definitely need to reduce the dose in my opinion.
Or even perhaps stop the insulin all together for a bit. That would be my recommendation right now. No insulin, test for ketones, test the BG's before each insulin shot, test before you feed, what we call the pre-shot test.

Any BG number < 68 mg/dL (< 3.7 mmol/L) using an Alphatrak meter is getting into hypoglycemic territory.
We want to help you keep your cat safe.

Even after 8+ years here, my mind does not easily convert the mmol/L BG values to the mg/dL values we use here in the US. I have to use a calculator and multiply the numbers you listed by 18 to see something that is understandable to me.

If you set up a World version of the spreadsheet (SS), you enter your mmol/L values on the World tab, and the US tab is automatically populated by some formulas behind the scenes of the SS.

I strongly urge you to set up a SS. Directions to do that are in this thread here, and there are instructions for doing the setup on a pc, tablet, smartphone. You would want to choose the pet meter version of the SS. It will be much easier to guide you, if we can see the trends in the BG levels, and the color coding that is applied to the cells.

If you need help setting up the SS, ask for help. There are a couple of members here that do the SS setup for people. I've tagged one of them for you.
Sticky FDMB SPREADSHEET INSTRUCTIONS

@Bandit's Mom Would you help setup a spreadsheet for this person? Please?
Click to expand...
Her urine test from a month ago had a n by ketone. We are doing another test soon so I'll see the results on her file online.
 
HeidiD said:
So with pretesting (to make sure I'm understanding correctly)...I would test before feeding & before her shot.
Click to expand...
Yes, you want to test before you feed your cat. That first test of the insulin cycle is also before you give your cat the insulin shot.
All other tests during the 12 hour insulin cycle, we expect to be food influenced.

The reason for doing the pre-shot test is two-fold. 1. It let's you know if your cat's BG level is high enough to give her the shot. 2. It's a baseline for the cycle, so it gives any mid-cycle tests a context. Something you can compare to. It let's you know how low the insulin is taking your cat.

If the BG reading at the pre-shot test is not high enough, you can stall. That means no food, no insulin, retest in about 20 minutes. You are looking for a rising BG level, rising more than simply the 10-15% meter variance. (Meters are allowed to be within 10-15% of the BG test and still be considered to be accurate enough). With Prozinc, you can stall for up to 1 hour, and still stick to your usual shot schedule.

Would you recommend a mid day test?
Click to expand...
Yes, you also want some mid-day (mid-cycle) tests. You are looking for the nadir or lowest point that the insulin takes your cat. Our dosing protocols are based on a combination of the pre-shots and what happens during the cycle, the nadir.
How can I test for ketones?
Click to expand...
There are 2 ways to test for ketones, in the urine or in the blood. People on the Keto diet use these test methods also.
For urine testing, you would want a urine ketone test strip, available at a pharmacy (chemist, drugstore). Ketodiastix are only one brand. There are special meters that can test the blood for ketones, as well as checking the blood glucose level (BG). The strips for ketone testing using a blood ketone/BG meter are more expensive. You use a different test strip in the ketone/BG meter if you want to check the blood glucose levels. Some people prefer the ketone meters, especially if it's difficult to catch fresh urine from their cat for the urine ketone test.

Here is the link to a document on some urine catching tips. >>>>>>>> Urine Catching Tips

An N next to the ketones column on the test done at the vet means no, no ketones were present.
 
Ok, I see you have your User Id signature setup, and there is a link to your spreadsheet (SS) there. Good job! Thanks so much! That will make life easier.

Now, could you enter some data on the SS?
I know you said you don't test all the time, but at least a week of data would be useful. The most recent 2 weeks would be better if you have it. If you only have a few tests and not for every day, don't worry about it. Put in the insulin dose for each cycle also.

You should enter a row for each day. Remember, you want to put the data on the World tab of the SS. You need to open your google email account in order to do the actual updating of the SS, and update from there. The link in your User Id signature is "View Only", even for you.

Using U100 syringes is fine. Please note that at the very top of the SS, after the words "Current Insulin: Prozinc" so we know you are using U100 syringes and not U40 syringes.

p.s. @Bandit's Mom Thanks for the SS setup assist!
 
Wow this has all been super helpful! Thank you so much! Especially breaking it down to be understandable.
I'm not currently home testing everyday but I will be starting tomorrow morning. Now with deciding if she is high enough for the shot...would I be look at numbers like...10 and higher? From my understanding, from the info I got from my vet, 4-6 range is ideal. Am I correct on this?
I just got home from work, so I'm going to read how to fill in the SS and at least enter her curve numbers (hope I can do that). Bandits Mom is stand by incase I run into some issues!
I'll include the needle size too, as you suggested.
 
Deb & Wink said:
Ok, I see you have your User Id signature setup, and there is a link to your spreadsheet (SS) there. Good job! Thanks so much! That will make life easier.

Now, could you enter some data on the SS?
I know you said you don't test all the time, but at least a week of data would be useful. The most recent 2 weeks would be better if you have it. If you only have a few tests and not for every day, don't worry about it. Put in the insulin dose for each cycle also.

You should enter a row for each day. Remember, you want to put the data on the World tab of the SS. You need to open your google email account in order to do the actual updating of the SS, and update from there. The link in your User Id signature is "View Only", even for you.

Using U100 syringes is fine. Please note that at the very top of the SS, after the words "Current Insulin: Prozinc" so we know you are using U100 syringes and not U40 syringes.

p.s. @Bandit's Mom Thanks for the SS setup assist!
Click to expand...

I think I got it all set up with all of her curves. The SS is great. I think I'm understanding all of this alittle more now. So is it better to be in the dark green or blue? Definitely can tell the bright green is a no go.

Would I be able to send this SS to my vet for her to view?
 
HeidiD said:
From my understanding, from the info I got from my vet, 4-6 range is ideal. Am I correct on this?
Click to expand...
A BG range of 4 mmol/L ( 72 mg/dL) to 6 mmol/L (108 mg/dL) is the normal range for a non-diabetic cat or a cat in remission (diet controlled) or a cat that is very closely monitored during the 12 hour insulin cycles.

I don't think you have enough data on how low the dose takes your cat, the nadir, to shoot any insulin if the BG level is <5 mmol/L (<90 mg/dL).

I'm guessing that the "n" you put in the dose column for today, 1/20/21 indicates you gave Fat Kat no insulin for today. Would you please change that to have the number 0 (zero). Thanks. Those notes in the Remarks column about when you feed are very useful too. Since we all live in different parts of the world and are in different time zones, we express time in a + hour format. So saying breakfast at 10 am doesn't have any meaning to me. Would you change those times to the + hour format? Hours are counted from the time of the insulin shot, or what would have been the time of the insulin shot if you are skipping the shot for a particular cycle.

HeidiD said:
So is it better to be in the dark green or blue? Definitely can tell the bright green is a no go.
Click to expand...
Yes, it's safer for your cat to be in the dark green or blue color coded BG ranges that you see on the SS. Any numbers in the bright neon green colors are bordering on hypoglycemic territory. There are ways to manage those lows, and bring the BG numbers up quickly. Do you have a hypo toolkit ready, just in case? jojo and bunny's HYPO TOOL BOX

That and many other documents can be found by searching the Health Links/FAQS forum Index thread. Here is that thread:
Sticky INDEX: Health Links/FAQs

HeidiD said:
Would I be able to send this SS to my vet for her to view?
Click to expand...
Yes, you could send your vet the link to your SS, to share it with her.

If you ever need help quickly on low numbers, it's better to post a thread in the Feline Health (Welcome & Main) forum. Many more people there to help you. There are only a few of us experienced enough with Prozinc that handle the Prozinc ISG forum and can guide you, but most anyone with a bit of time here can help walk you through a low numbers event.

I hope you will consider trying your cat with no insulin for a while. I think that Fat Kat may be ready to try an OTJ trial. OTJ means off-the-juice, insulin being the juice.

p.s. Posting issues on the message board yesterday. Only now able to get back to you.
Apologies for the long reply. I'm not really good at short explanations.
 
Deb & Wink said:
A BG range of 4 mmol/L ( 72 mg/dL) to 6 mmol/L (108 mg/dL) is the normal range for a non-diabetic cat or a cat in remission (diet controlled) or a cat that is very closely monitored during the 12 hour insulin cycles.

I don't think you have enough data on how low the dose takes your cat, the nadir, to shoot any insulin if the BG level is <5 mmol/L (<90 mg/dL).

I'm guessing that the "n" you put in the dose column for today, 1/20/21 indicates you gave Fat Kat no insulin for today. Would you please change that to have the number 0 (zero). Thanks. Those notes in the Remarks column about when you feed are very useful too. Since we all live in different parts of the world and are in different time zones, we express time in a + hour format. So saying breakfast at 10 am doesn't have any meaning to me. Would you change those times to the + hour format? Hours are counted from the time of the insulin shot, or what would have been the time of the insulin shot if you are skipping the shot for a particular cycle.


Yes, it's safer for your cat to be in the dark green or blue color coded BG ranges that you see on the SS. Any numbers in the bright neon green colors are bordering on hypoglycemic territory. There are ways to manage those lows, and bring the BG numbers up quickly. Do you have a hypo toolkit ready, just in case? jojo and bunny's HYPO TOOL BOX

That and many other documents can be found by searching the Health Links/FAQS forum Index thread. Here is that thread:
Sticky INDEX: Health Links/FAQs


Yes, you could send your vet the link to your SS, to share it with her.

If you ever need help quickly on low numbers, it's better to post a thread in the Feline Health (Welcome & Main) forum. Many more people there to help you. There are only a few of us experienced enough with Prozinc that handle the Prozinc ISG forum and can guide you, but most anyone with a bit of time here can help walk you through a low numbers event.

I hope you will consider trying your cat with no insulin for a while. I think that Fat Kat may be ready to try an OTJ trial. OTJ means off-the-juice, insulin being the juice.

p.s. Posting issues on the message board yesterday. Only now able to get back to you.
Apologies for the long reply. I'm not really good at short explanations.
Click to expand...

You're amazing! You have been super helpful during all of this.

SS is giving me issues again, so once I am able to, I will fix the things you mentioned.

We are day two without the insulin. I stopped yesterday morning and successfully gone through yesterday and today.

I don't currently have a hypo kit, I do always have corn syrup on hand thankfully. I'm going to set up a kit though, just as an incase. I'll need options as the 24hr Emergency Vet is at least 40mins away.

Everything seemed to go well today with her numbers. Very happy with the numbers so far.
 
HeidiD said:
We are day two without the insulin. I stopped yesterday morning and successfully gone through yesterday and today.
Click to expand...
So enter a row on your SS with that information, noting that on 1/19/21 the dose was zero. Don't worry if you don't have any test data. It's still important to see that the dose is zero.

I agree, Fat Kat did have very good numbers today. :)
 
And you really need to do some PM testing too.
Cats drop lower at night, and you're getting low amps so you definitely need to be careful and test during the nights too.
 
SashaV said:
And you really need to do some PM testing too.
Cats drop lower at night, and you're getting low amps so you definitely need to be careful and test during the nights too.
Click to expand...
Definitely plan on. A wrench got thrown into the mix for me last night....dealt either a bad migraine.
Today is a new day :) I got my morning test, I'll get my mid day before work, then start testing again that night once I'm home :)
 
You must log in or register to reply here.
Back
Top