New to testing and SS

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lillymaet

lillymaet

Member Since 2021
Hi there, I am Lilly and I care for a lovely old cat named Saint Amos who we adopted in April. He was in a shelter for 8 months - receiving insulin but not consistently low carb food.

He had numbers in the 20's when we got him and was very thin. Since switching to a low carb food in the months we have had him, we have seen drastic improvement in his BG levels and he has gained weight.
Last week he had a hypo and I realised I need to up my testing game. I have started a SS but I'm not sure on what the advice is.

Vet has said to test pre-feeding, and if below 6 to feed, then test again and shoot 30 mins later. When he has these normal numbers, he generally only goes up to around 8 after food. I don't like to shoot if he is below 8 but the vet said I should.

Questions I have:
1. What is the number that FDMD advises is a NS number?
2. When we don't shoot, his BG before his next meal are always high - 16-18. This fluctuation feels dangerous, is it normal for NS?
3. Does this indicate we need to have a lower dose of insulin? We went from 2units to 1.5 of Prozinc last week.

I don't quite know what to look for in the SS but it is linked below.
NB: Today I have a mini curve scheduled so please ignore the times at the very bottom of the page as they are for my ref and will be deleted once the data is collected and inputted into the SS.

Thank you so much for all your help FDMD! This is such a valuable resource.

Lilly + Amos
 
Hi Lilly and Amos and welcome to the forum. Thanks you so much for adopting an old diabetic kitty. He looks a sweetheart.:cat:
I can’t see your spreadsheet. I don’t think you have given permission to be shared. I will ask @Bandit's Mom to have a look…she will contact you. when you said he had a hypo….how low did I he drop?
With prozinc you test, feed and shoot in that order. If the BG is too low to shoot I would suggest you stall, don’t feed and test again in 20 minutes to see if the BG is rising.
Always test before the dose is given to see it is safe to give the dose and then test during the cycle around +4 to +7 to see how low the dose is taking Amos.
Here is a link to USING PROZINC BASICS

Also I can see in your signature that you are only feeding twice a day. We recommend to feed a good meal before the dose is given and then to give two or three snacks of a couple of teaspoons of low carb food during the first half of all the cycles. So give the pre shot meal and then give the snacks at say +2 +4 and +6. It is much better for the pancreas to have these smaller meals.

Do you have a hypo kit set up? HYPO KIT LINK

At the moment until we get some data we recommend you don’t shoot under 200 (11).
If you skip a dose it is normal that the next BG will be high.
Once we can see some data and see what the BGs are doing it will be easier to help you. In the meantime I am going to tag @FrostD as she uses prozinc.
 
Hi Bron, thank you so much for your reply.

Weird about the spreadsheet - here it is again, I have double checked that it set to public so hopefully you'll be able to see it!

He went to 1.1 (20) at +5, with no symptoms. I luckily caught it and gave him loads of high carb snacks etc. I tested for 2 hours every 15 mins and he came out of it easily with the snacks.
I think he is currently in the middle of another hypo as following the vet's advice, we gave him insulin this morning when we was 7.8 - he is down to 2.2 at +6 but I am feeding him snacks and he is showing no symptoms. Will call vet. I think we may need to lower his dose again.

Thank you for your help!



Bron and Sheba (GA) said:
Hi Lilly and Amos and welcome to the forum. Thanks you so much for adopting an old diabetic kitty. He looks a sweetheart.:cat:
I can’t see your spreadsheet. I don’t think you have given permission to be shared. I will ask @Bandit's Mom to have a look…she will contact you. when you said he had a hypo….how low did I he drop?
With prozinc you test, feed and shoot in that order. If the BG is too low to shoot I would suggest you stall, don’t feed and test again in 20 minutes to see if the BG is rising.
Always test before the dose is given to see it is safe to give the dose and then test during the cycle around +4 to +7 to see how low the dose is taking Amos.
Here is a link to USING PROZINC BASICS

Also I can see in your signature that you are only feeding twice a day. We recommend to feed a good meal before the dose is given and then to give two or three snacks of a couple of teaspoons of low carb food during the first half of all the cycles. So give the pre shot meal and then give the snacks at say +2 +4 and +6. It is much better for the pancreas to have these smaller meals.

Do you have a hypo kit set up? HYPO KIT LINK

At the moment until we get some data we recommend you don’t shoot under 200 (11).
If you skip a dose it is normal that the next BG will be high.
Once we can see some data and see what the BGs are doing it will be easier to help you. In the meantime I am going to tag @FrostD as she uses prozinc.
Click to expand...
 
lillymaet said:
Hi Bron, thank you so much for your reply.

Weird about the spreadsheet - here it is again, I have double checked that it set to public so hopefully you'll be able to see it!

He went to 1.1 (20) at +5, with no symptoms. I luckily caught it and gave him loads of high carb snacks etc. I tested for 2 hours every 15 mins and he came out of it easily with the snacks.
I think he is currently in the middle of another hypo as following the vet's advice, we gave him insulin this morning when we was 7.8 - he is down to 2.2 at +6 but I am feeding him snacks and he is showing no symptoms. Will call vet. I think we may need to lower his dose again.

Thank you for your help!
Click to expand...
@Bron and Sheba (GA)
 
Ignore these haha - on the world tab they are showing as times. They are just for today as I am doing a mini curve and I wanted to write down the times I needed to test him. They are being inputted into the spreadsheet as I take them.

Diane Tyler's Mom said:
What are these dates you have on your spreadsheet?
01/06/1900

12/30/1899

12/30/1899

12/30/1899

12/30/1899
Click to expand...
 
Update: I have just spoken to the vet who said his fructosomine test has come back with normal, but the high side of normal, numbers. We need to keep him on 1.5units of prozinc for a couple of weeks so we can take another blood test, but she said we will likely reduce the dose again.
 
lillymaet said:
Update: I have just spoken to the vet who said his fructosomine test has come back with normal, but the high side of normal, numbers. We need to keep him on 1.5units of prozinc for a couple of weeks so we can take another blood test, but she said we will likely reduce the dose again.
Click to expand...
Here are the two dosing methods for Prozinc , you need to follow one
https://felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/
You have TR on your SS there is no TR with Prozinc
It's either SLGS or Modified Prozinc Method


What ? your vet is crazy telling you to keep him on 1.5 units for a couple of weeks

You shouldn't have shot this morning with a 6.7 (120) BG or the 7.2 (129) especially 1.5 units of Prozinc

So what was the fructosomine number? Did she say?

He has already has 2 hypos one on 2 units and now on 1.5 units
I'm no expert but with that 2.2 you just got @+6 you need to reduce that dose
Can't have him going that low all the time on 1.5 units
You do have high carbs food and honey
If you are going to follow method SLGS
SLGS SAYS
Anytime he drops under 90 you need to reduce

Modified Prozinc Method
  • If there is a significant drop in blood glucose that results in a number below 50 on a human meter (or 68 on a pet meter), then the dose should immediately be reduced.
Tagging
@Bron and Sheba (GA)

@FrostD
I know you ladies aren't a prozinc user Elise, Wendy, Sienne and Suzanne but can you look at her SS and
her intro post

Her vet doesn't know what she's talking about
@tiffmaxee

@Wendy&Neko

@Sienne and Gabby (GA)

@Suzanne & Darcy


You said in your post #3 just now

I think he is currently in the middle of another hypo as following the vet's advice, we gave him insulin this morning when we was 7.8 - he is down to 2.2 at +6 but I am feeding him snacks and he is showing no symptoms. Will call vet. I think we may need to lower his dose again.


Ladies if you see times listed in n her SS it's for her because she's said
Ignore these haha - on the world tab they are showing as times. They are just for today as I am doing a mini curve and I wanted to write down the times I needed to test him. They are being inputted into the spreadsheet as I take them.



Lilly. Bron said in her post #2

At the moment until we get some data we recommend you don’t shoot under 200 (11).
If you skip a dose it is normal that the next BG will be high.
Once we can see some data and see what the BGs are doing it will be easier to help you. In the meantime I am going to tag @FrostD as she uses prozinc.
 
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Oops sorry - I am working and watching Amos! I am feeding him high carb snacks and checking often, his BG is up to 5.3 @ +7.5.

Thank you for that info above, I am working through everything and finding the amount of info here quite overwhelming, along with the info from the vet. Trying to parse it all.

The vet didn't give me the numbers - technically Amos is a long term foster, so the charity he is from pays for all his vet bills and provides insulin, but also makes all of his medical decisions. We look after him here, it's his retirement home.
In saying that, I will drop his dose to 1.25 despite her saying to leave it at 1.5 for a couple of weeks until she sees him again. I will also be adding a third meal at lunch time, and won't shoot if he is lower than 11 again. The vet didn't like me telling her about not shooting but we don't always work from home to check him in the middle of the day, so vet is going to have to deal with the NS days!

note: I have removed those weird numbers at the bottom of my SS as the mini curve is no longer really giving accurate info as I am giving him snacks at the moment.


Diane Tyler's Mom said:
@lillymaet been waiting for you to come back and post
for a while now , I hope you have been feeding high carb food
Click to expand...
 
lillymaet said:
Oops sorry - I am working and watching Amos! I am feeding him high carb snacks and checking often, his BG is up to 5.3 @ +7.5.

Thank you for that info above, I am working through everything and finding the amount of info here quite overwhelming, along with the info from the vet. Trying to parse it all.

The vet didn't give me the numbers - technically Amos is a long term foster, so the charity he is from pays for all his vet bills and provides insulin, but also makes all of his medical decisions. We look after him here, it's his retirement home.
In saying that, I will drop his dose to 1.25 despite her saying to leave it at 1.5 for a couple of weeks until she sees him again. I will also be adding a third meal at lunch time, and won't shoot if he is lower than 11 again. The vet didn't like me telling her about not shooting but we don't always work from home to check him in the middle of the day, so vet is going to have to deal with the NS days!

note: I have removed those weird numbers at the bottom of my SS as the mini curve is no longer really giving accurate info as I am giving him snacks at the moment.
Click to expand...

Please update your spreadsheet with the 5.3 you got @7.5
So the charity you got him from makes all the dosing decisions ,so they have a vet there?
Too bad if the vet didn't like you telling her about not shooting
Your cat went hypo twice listening to the vet

As for the feeding goes we give the bigger meal at AMPS and PMPS and a small snack maybe @+2 and @+4
Is that a human meter you are using ?
Well I'm glad you are going to reduce to 1.25 but still monitor his BG a lot
Hopefully one of the members I tagged will give you some advice , they are more experienced than I am

Note. When you do a curve the only time you withhold food is 2 hours before your first test in the AM and the PM so the BG is not food influenced ,other than that you can go ahead and feed him a couple of times during each 12 hour cycle
 
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I have but it isn't updating, hopefully it will in a moment.

Yes the charity has a few vets, and I spoke to the one I have been working with for a little while earlier on the phone. The charity deals with hundreds of rescues, they are wonderful but incredibly busy.

Do you advise using an automatic feeder for middle of the night feeds and for when you can't be home? I would love to be here all the time to feed him but sadly it's not a reality!

Before Amos we fostered a lovely old boy called Stitch from the same place, who developed diabetes late in life He had FIV and sadly got quite sick with cat flu and we didn't get the chance to get his diabetes under control - he ALWAYS has numbers above 15 poor little man. While I don't like these super low numbers, it's nice to see that Amos is trending towards remission - we have had him since April and his numbers were very high back then, and he was in the shelter for 8 months without luck in getting it under control. I hope we can sort it out for him.

Diane Tyler's Mom said:
Please update your spreadsheet with the 5.3 you got @7.5
So the charity you got him from makes all the dosing decisions ,so they have a vet there?
Too bad if the vet didn't like you telling her about not shooting
Your cat went hypo twice listening to the vet

As for the feeding goes we give the bigger meal at AMPS and PMPS and a small snack maybe @+2 and @+4
Is that a human meter you are using ?
Well I'm glad you are going to reduce to 1.25 but still monitor his BG a lot
Hopefully one of the members I tagged will give you some advice , they are more experienced than I am

Note. When you do a curve the only time you withhold food is 2 hours before your first test in the AM and the PM so the BG is not food influenced ,other than that you can go ahead and feed him a couple of times during each 12 hour cycle
Click to expand...
 
40 is much too low, for now I am assuming our more conservative method where reductions are at 90.

Ultimately, for now you want him in the 90-150 range as much as possible. If remission is your goal, you want him 50-100...that said, he's a bit far post-diagnosis and still a relatively high dose (compared to cats approaching remission) for me to say remission is definitely in his future.

So you kind of have two options here:
1. Reduce to 1U, and shoot that any time he's above 120 (6.7). This is my preference, as you want to keep shooting lower numbers to help keep him flat. Having to skip insulin (as I will note in your next option) is less than ideal because the lack of consistency throws things out of whack.

2. If you want to keep a higher dose given your restrictions with vet and charity, you will need to skip insulin sometimes. If you are going to stick with 1.25U, I would skip insulin whenever he is below 150 (8.3). Alternatively, you can do a partial dose (10-50%, depending on the preshot)...this will take some experimenting.

Either way, be sure to monitor well and keep hypo kit stocked. Something (good!) is going on so must be careful. If you cannot be around, err on the side of a reduced dose or a skip.
 
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