Beginning Journey for Ottie - CKD and diabetes

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Due to time constraint, and my initial inclination... I have decided to not carry out a shot tonight. I don't feel that I am confident to measure a microdose tonight.

BUT the question still remains... What unit do I shoot tomorrow? Do I continue with a 0.25 unit tomorrow, or a 0.1 unit tomorrow.
 
You don’t want to continue with .25 since he went under 90. We need you to decrease the question is how do you measure it? Did you read my comment above about getting u100 syringes? PS this is why I like the like feature so I don’t have to keep asking you if you read my comment because once you like it, I know you did. That helps me a lot. I disagree with Sienne on this
 
Kili said:
What unit do I shoot tomorrow? Do I continue with a 0.25 unit tomorrow, or a 0.1 unit tomorrow.
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Kili, your BG testing has shown you that you kitty's BG dropped too low on the 0.25 dose. So a reduced dose IS needed - that's assuming your cat's pre-shot BG is high enough for insulin of course, and assuming that you are able to test and monitor BG (I know you've been having some challenges there).
 
@Ale & Bobo & Minnie (GA)
She uses the ProZinc U40 needles I believe, with which the drop may work, but with the most popular veterinary syringes here (Sol-Vet) the method you outlined doesn't work. I tried it, both with U40 and U100. Their plunger is actually "properly" fitted, so there is no room for a drop. It's what you pull is what you get. This is my experience, with those specific syringes though. I never used the ProZinc ones. I'm just saying this on the basis of a calliper or a U100 with 1/2 unit markings would be safer for her, especially so since she's dropped into deep water with all this diabetes info and microdosing.

Also, this is just a speculation, because I have no experience with ProZinc itself, but could Ottie have seen a carryon effect from last night's 0.5 IU, hence the 2.5 mmol/L drop? We do not actually know his true reaction to a 0.25 IU as it was always administered after a 0.5 IU. (Again, I'm not sure whether it's even relevant.)
Would it perhaps be an option for her, after skipping tonight, to try a 0.25 IU tomorrow, so we can see what it really does to Ottie? (That is if she can monitor her during the day, of course.)
 
Elizabeth and Bertie said:
Kili, your BG testing has shown you that you kitty's BG dropped too low on the 0.25 dose. So a reduced dose IS needed - that's assuming your cat's pre-shot BG is high enough for insulin of course, and assuming that you are able to test and monitor BG (I know you've been having some challenges there).
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0.1 unit seems to be pretty much what would be in the needle. How would you even make sure it's in Ottie's body, when it's so microscopic. You don't even feel the plunger.

Did his BG drop too low on 0.25 dose because of the 0.5 dose the prior night?
 
Kili said:
Did his BG drop too low on 0.25 dose because of the 0.5 dose the prior night?
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I'm not seeing any actual evidence of the increased drop being caused by the previous dose. More likely, I think, is just that your cat's body is healing and needs less insulin. But there's not a lot of BG data as yet, and the situation will become clearer as you get more data...

With micro doses, yes, you don't really feel like you're injecting anything. But you are... Both of my diabetics were on micro doses for a long time (0.1 of a unit, and 'needle juice'). And they certainly do have an effect. ..My first diabetic actually had a hypo on just 0.1 of a unit...
 
.:. in.active .:. said:
Elizabeth!!! :arghh: We want her to shoot the 0.1 IU, not to scare her into not shooting at all :smuggrin:
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Just stating a fact... Micro doses can still have an effect, even though it may 'feel' as though nothing at all is being injected... That's why it's important to get a pre-shot test, to shoot an appropriate amount of insulin, and to monitor the BG after the event, especially when a cat's insulin requirement is decreasing.
 
Elizabeth and Bertie said:
Just stating a fact... Micro doses can still have an effect, even though it may 'feel' as though nothing at all is being injected... That's why it's important to get a pre-shot test, to shoot an appropriate amount of insulin, and to monitor the BG after the event, especially when a cat's insulin requirement is decreasing.
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What's a preshot test?
In preparation for 0.1U... I have been practicing tonight with a syringe and water to get used to drawing 0.1U. It produces a tiny drop, but it is about half the size of the 0.25U drop.
I don't think it's precise, but as precise as it can be.

Because I just saw what a 0.25U looks like on my hand... and the fact that this tiny amount caused hypo on Ottie today... I do believe these microdosing has an effect.
I haven't spoken to my vet yet about his dosing... But I presume if I talk about this microdosing to a vet, I will see some dumbfounded looks. How are vets so clueless about diabetes in cats when it's so common.

So are we all in agreement that tomorrow morning... I start with 0.1U microdosing shot? I then maintain that for 7 days... unless I experience another hypo.
 
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This thread is getting really long and VERY confusing, I'm really reluctant to jump in, but this needs addressing:
Ale & Bobo & Minnie (GA) said:
In my U100 1/2 marked the first line was .1
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In a U100 syringe with 1/2 unit markings - the first line is marked at 0.5 units to measure a dose of U100 insulin.
Ale & Bobo & Minnie (GA) said:
If the .25 was at the first line after the zero line
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Ale & Bobo & Minnie (GA) said:
It looks like that very first line is .25 right?
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This has really got me puzzled - in all half unit marked syringes the first line is 0.5 units - that's why they're called half unit marked syringes - half of 1.0 units = 0.5 units.

Ale & Bobo & Minnie (GA) said:
I’m looking at the conversion chart and you might have to do a drop instead.
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I'm not sure where you're going with this & not sure what the conversion chart has to do with it either, again this thread is getting really confusing, I can only imagine how @Kili feels trying to wade through all this.
A drop dose is a drop dose, no matter what syringe you use.
 
Guys I just yanked out my baking supplies at past 11pm here to concoct a water-food colour mix and draw out 0.5, 0.25 and 0.1 IU compared to nothing in the syringe, to show the difference.
Can I post those here, or shall I drop it straight to Kili in a DM not to clog this thread further?
Please don't let my efforts go to waste :arghh:
 
I was going to say we need to start a new thread. I hate being the thread length policy but yes, more than 50 comments is too long.

@Shelley & Jess when I was giving Bobo .1 and 1 drop of Lantus in my u100 syringes there’s a line above the very first 1/2 unit mark and that was what I was told was .1 and how I was dosing his .1 doses. I wasn’t sure if a drop is a drop regardless of the syringe but the conversion chart on the link I posted from the prozinc forum on syringes got me questioning that.
 
.:. in.active .:. said:
Guys I just yanked out my baking supplies at past 11pm here to concoct a water-food colour mix and draw out 0.5, 0.25 and 0.1 IU compared to nothing in the syringe, to show the difference.
Can I post those here, or shall I drop it straight to Kili in a DM not to clog this thread further?
Please don't let my efforts go to waste :arghh:
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Please drop it here since she’s the one who will have to start a new thread tomorrow. I’m curious since I’ve only ever seen u100s
 
Kili said:
Due to time constraint, and my initial inclination... I have decided to not carry out a shot tonight. I don't feel that I am confident to measure a microdose tonight.

BUT the question still remains... What unit do I shoot tomorrow? Do I continue with a 0.25 unit tomorrow, or a 0.1 unit tomorrow.
Click to expand...
That’s fine. I answered over on the ProZinc forum. It’s so confusing having two different places with a conversation going on. I will copy my responses from over there to over here.

But about fine dosing, I would not attempt a .1 dose on a u-40 syringe. I would use a U-100. Here is what I recently advised another member who needed to draw a .1 unit dose while using ProZinc:

“My U-40s have larger markings/ more space between the markings (they’re the kind with half unit markings.). I don’t know if I could draw a small enough amount on them. But with the U100 you would draw the syringe back to the .25 mark on your U-100 syringe in order to give her .1 units of ProZinc (according to the conversion chart.)”
 
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In reply to what to shopt for the pm dose, I said:

“I don’t see 2 hypos in a row on the spreadsheet but maybe it was before the spreadsheet was started. But I sure do see the 45 on his SS for today! So he has earned a reduction to the .1 unit dose that we sent you photos for. I’m sorry for all of your stress, but I’m excited for Ottie. Since you have skipped tonight’s dose, then try the .1 unit dose for tomorrow and keep doing your excellent job of monitoring.”
 
I also said:
“Just for me trying to figure out how he ended up at 45 today at +4, can you please tell me what and when he ate leading up to the lime green 45. He should have been eating snacks of low carb wet food every hour or so between shot time and +4. When he hit the lime green 45, what did you feed him?”
 
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I did it with a U100 too, but the principle is the same. In fact, my U40s had a skinnier plunger, and the syringe itself (its wall) wasn't as thick, so made it easier to fine tune the dose.
0.5 - plunger top is aligned with the 1/2 mark line
0.25 - plunger top is half way between bottom of line zero and the 1/2 mark line (there is a hairline of greenery between the zero line and the plunger top)
0.1 - the plunger top touches the bottom of the zero line - side view to show that there is some green liquid in the syringe
empty - there is nothing in the syringe, plunger touches the top of the zero line (that empty hairline you see above the plunger is just the perforation - there is no space/air there for a "drop" suction previously discussed)

I'm not really sure whether it helps make things clearer. If you guys disagree with the explanation or execution, let me know and I delete the images.

(Edit: wow, all zoomed in it looks like a skinny 0.25, but I don't have my contacts in and I'm blind without them :blackeye:)
 

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Ottie's journey with diabetes and CKD continues here.

Can you post the pictures of the syringes in the part 3 thread please?
 
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