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Angus' mom

Angus' mom

Member Since 2023
Hi!
My little one is a 9 year old tabby named Sir Angus Stinkypants McGee. He was recently diagnosed, and the day I learned how to give injections is the same day we found out he was DKA. I know you all know how expensive and nerve racking that is. We got his ketones to zero, fixed the upper respiratory that caused him to stop eating and are trying to get him regulated. I feel like I haven't slept in weeks with all the all night checks. I check his bg constantly, and today was my third day at attempting to record a home curve for the vet. The first attempt he must have found some of his siblings dry food because he went from a 7.4 to a 20.9 in an hour. The next attempt he dipped into 4.7 so I panicked and gave him food and corn syrup. The vet told me to wait until he hits 4 to give syrup again. So today's attempt he hit 3.6 and I did syrup and food. I'm scared that we have his insulin too high(started at 2 units, now at 1.5), but the vet is happy with his low numbers. He says that since we haven't seen a clinical hypoglycemic episode its ok. The only reason I'm reacting is the numbers. But I find it so stressful seeing his numbers dip so low. Is anyone else's vet aggressive with lowering the numbers, has it gone ok?
His numbers on the 18th of September were high to mid 30s pre insulin, down to the low teens, now his pre insulin numbers are in the low teens down to 5s and 4s. I switched him to all fancy feast wet food, he doesn't like the dm.
 
Angus' mom said:
Hi!
My little one is a 9 year old tabby named Sir Angus Stinkypants McGee. He was recently diagnosed, and the day I learned how to give injections is the same day we found out he was DKA. I know you all know how expensive and nerve racking that is. We got his ketones to zero, fixed the upper respiratory that caused him to stop eating and are trying to get him regulated. I feel like I haven't slept in weeks with all the all night checks. I check his bg constantly, and today was my third day at attempting to record a home curve for the vet. The first attempt he must have found some of his siblings dry food because he went from a 7.4 to a 20.9 in an hour. The next attempt he dipped into 4.7 so I panicked and gave him food and corn syrup. The vet told me to wait until he hits 4 to give syrup again. So today's attempt he hit 3.6 and I did syrup and food. I'm scared that we have his insulin too high(started at 2 units, now at 1.5), but the vet is happy with his low numbers. He says that since we haven't seen a clinical hypoglycemic episode its ok. The only reason I'm reacting is the numbers. But I find it so stressful seeing his numbers dip so low. Is anyone else's vet aggressive with lowering the numbers, has it gone ok?
His numbers on the 18th of September were high to mid 30s pre insulin, down to the low teens, now his pre insulin numbers are in the low teens down to 5s and 4s. I switched him to all fancy feast wet food, he doesn't like the dm.
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@Bron and Sheba (GA)
 
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Welcome. Love his name :cat:
Tap on the blue link
Here is the link so you can set up your signature and spreadsheet
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

The signature is at the end of everyone's post in gray ,information about our cats
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
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.

Also almost all of us use human meters that's what our numbers are based on
 
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Just to show you about the Spreadsheet
Don't be nervous about the spreadsheet
About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it
 
Sorry just seeing this tag…thanks Diane.
hi and welcome Angus and Mom.
A few questions first.
What insulin are you giving?
What type of glucose meter are you using?
What food are you feeding?

if you can set up the spreadsheet and signature as Diane suggested, that would be helpful. I will ask @Bandit's Mom id she can help you with the spreadsheet as it would be good to get it set up asap.

With DKA in the recent past there are some important things you need to be doing
  • you need to give one and a half times as many calories as he normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
  • Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
  • Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all. If you don’t have a bottle of Ketostix to test the urine, get one from Walmart or a pharmacy..testing for ketones is very important.
  • Give antinausea medication if needed such as cede is or Ondansetron.
  • Give appetite stimulant if needed after the antinausea medication
  • Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
  • Ask the vet about subQ fluids
  • Set up a spreadsheet and test the BG frequently
  • Post daily with updates and ask for help as often as needed.
Angus' mom said:
I feel like I haven't slept in weeks with all the all night checks. I check his bg constantly, and today was my third day at attempting to record a home curve for the vet. The first attempt he must have found some of his siblings dry food because he went from a 7.4 to a 20.9 in an hour. The next attempt he dipped into 4.7 so I panicked and gave him food and corn syrup. The vet told me to wait until he hits 4 to give syrup again. So today's attempt he hit 3.6 and I did syrup and food. I'm scared that we have his insulin too high(started at 2 units, now at 1.5), but the vet is happy with his low numbers. He says that since we haven't seen a clinical hypoglycemic episode its ok. The only reason I'm reacting is the numbers. But I find it so stressful seeing his numbers dip so low. Is anyone else's vet aggressive with lowering the numbers, has it gone ok?
His numbers on the 18th of September were high to mid 30s pre insulin, down to the low teens, now his pre insulin numbers are in the low teens down to 5s and 4s. I switched him to all fancy feast wet food, he doesn't like the dm.
Click to expand...

Are you testing before giving every dose of insulin and again during the cycles? Once we can see what insulin you are giving and what meter you are using and some BG data on the spreadsheet we will be able to help you more.
.
 
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Sorry it posted before I was ready….the vet most likely will be wanting to make sure Angus is getting enough insulin to stop the ketones. It is insulin and food that will help stop ketones reappearing. Most vets like to see higher numbers, but it is most likely because of the recent DKA.
Which country are you living in? it sounds like it is not the US as you are using world BG numbers.
It is going to take more than a few weeks to get him regulated. It doesn’t happen quickly.
How is his appetite? Is he eating well?
 
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Welcome to you and your sweet little tabby! You got plenty of very useful info from Bron and Diane; if there are things that you can't do or are not familiar with, post for help! Don't be shy, ask as many questions as you need!

It's a lot to start with and we all feel overwhelmed at the beginning but remember you're not alone ! You'll see that it's not as bad as you think. In a couple of months, everything will be part of your routine and your little Angus will start feeling better!
 
Welcome to FDMB!

It sounds like both you and Angus have been through a tough time. Most of the members here know how overwhelming managing their cat's diabetes is. When you add in DKA, it's even more overwhelming. We really do understand. My kitty was a DKA survivor.

The basic recipe for ketones is an infection/inflammation + not enough calories + not enough insulin. That said, when a cat is hospitalized with DKA, generally the cat is given a considerable amount of insulin but is on a dextrose IV drip. They balance each other out. It's harder once your cat is home since the stress of being at the vet's office is gone and the stress also contributes to higher blood glucose numbers.

Bron has outline a number of questions that will help us to provide you with more information and support. Please let us know how we can help.
 
He is eating well, I am giving him fancy feast, he eats about 1 and a half cans per meal and he is hungry in-between and if he gets like that he eats anything he shouldn't, string, plastics, artificial flowers, so we have started feeding him a snack in between. We have a microchip feeder We'll be putting a snack into so he can eat ot when he's ready(prob the dm food). We'll see how this works or if he just gobbles it all right away. When he was diagnosed he had a bad upper resp which stopped him from eating. We literally got one shot into him before it all went sudeways. Went back to the vet for him bot eating due to the upper resp and found ketone up to 3.5, our vet got that sorted in the office with us taking him home at night for monitoring and with sub q fluids. Our er vet was closed due to staff shortages and no one else was accepting. We got him to the er vet 2 days later, and by that time we had him down to zero, but they kept him for 2 days for the upper respiratory and because he still wouldn't eat. We brought him home on the 18th, on the 19th he finally sneezed out the blockage and started eating again.
He is doing so much better, is eating, has stopped drinking and urinating as much, is playing again.
We started on 2 units of prozinc, with the vet saying 2 weeks ago he'd be happy with levels between 20 and 15 (canada) but now if I haven't had to react to low numbers he is now lower then that. I'll update my spreadsheet soon.
Originally it was use corn syrup if he goes down past 10, then 7, now 4. He tends to fluctuate quickly, esp in the beginning.
I asked about ketone testing, but the vet said to hold off on a tester, and we have 4 more cats so checking urine won't really work. My vet is keeping an eye on those though. I am in almost daily contact with him.
 
I am testing, prob more then I should. We test before insulin every time and usually at least once. Lately more often since his numbers have gone so low. I've learned right now his peak insulin time is 4.5 to 5 hours in. So I usually am very watchful then.
 
Sorry lol, updated spreadsheet, some of the fluctuations are due to my reacting to the low numbers, it has been a learning curve for us too. He usually will get corn syrup and some dry kibble. I am getting more used to the lower numbers, under 4 still terrifies me. The vet said at 4 to give syrup.
A few may be due to him finding his siblings kibble. They are now on a microchip feeder with dry reg food. He sneaks in sometimes, but very rarely now. He was on dry and wet for the first chunk of monitoring due to trying to switch him to wet and getting the others feeder climatized.
 
If you think you test too much, I was a testaholic!! With the new continuous glucose monitors, there are members who have no what spaces on their spreadsheets!

This is a link to our Prozinc forum. There are a number of sticky notes at the top of the board. You may find them helpful since they provide a description of the insulin along with information on dosing.

Those green numbers look good! Keep in mind that normal blood glucose range is 50 - 120. Sir Angus is making good progress.
 
Hello and welcome. Waving from central Ontario.

Tagging @Suzanne & Darcy who has used Prozinc and can suggest next steps.

Normal range in world numbers is 2.8 to 6.7

Since you are using a pet meter, your take action number is 3.8.

If you are not using these already, here is a link to half unit U40 syringes in Canada. Recommended increases and decreases are done by 0.25 units so you don't go past the ideal dose: https://www.petsdrugmart.ca/en/Product/CarePoint-Vet-Insulin-Syringes-119693/5676

There is such a thing as a blood ketone meter. The strips are expensive but much less expensive than an emergency vet visit. Here is the link to the information:
Apologies for overwhelming your already overwhelmed self. Diabetes is a steep learning curve but it will become second nature quickly.
 
Thank you for the needle link, my vet charged me for the prozinc container and needles and it was a lot more expensive.
 
@Angus' mom Hi there I was looking at your Spreadsheet and the dates you have in the US Tab? have me confused lol, they just don't make sense to me like they do on your world tab

You have the date of 4-4 on your US tab for today's AMPS , on the World you have 10-7 which is correct
When you do list them can you list the dates like this 10-7-23 :cat:
We also increase or decrease by 0.25 units at a time using half unit marking syringes that Kelly ( Red & Rover ) listed for you
I see in your SS you are not sure yet about what dosing method you want to choose
I would suggest to follow SLGS method to start with but I'll tag Suzanne for you since she's a prozinc user

This is from the SLGS sticky for prozinc
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
@Suzanne & Darcy
 
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Angus' mom said:
Thank you for the needle link, my vet charged me for the prozinc container and needles and it was a lot more expensive.
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If you get a prescription from your vet, you can also order your Prozinc from them.
https://www.petsdrugmart.ca/en/Product/ProZinc-Insulin-3213300/3742

Bye-the-bye, strips on pet meters are crazy expensive. Strips for a human meter run roughly 80¢ each. Now, there is no correlation between pet meters and human meters (believe me, many people here have tried) but before pet meters, vets used human meters and quite a few people here use human meters. We can work with either one.
 
My vet won't let me do home curves on a human meter. I know their pricey but worth it to not force him to the vet for a curve. We started on my husbands(free strips cause he never checks himself) and they weren't happy with that. We have a 5 point difference in the 2 meters, we know this but....
 
Angus' mom said:
My vet won't let me do home curves on a human meter. I know their pricey but worth it to not force him to the vet for a curve. We started on my husbands(free strips cause he never checks himself) and they weren't happy with that. We have a 5 point difference in the 2 meters, we know this but....
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It is not up to your vet to decide if you want to do the curves with human meter. It is your decision.
If you can get free strips from your husband I would stick to the human meters. Your vet is just being a princess. Until pet meters came on the market ....all vets used the human meters...and never thought twice about it.
Just tell him you cant afford the pet meter strips (they are around a $1 each). He can't argue with that.
You pay the vet for advice, it doesn't mean you have to follow it.
If you post your results here, we can help you with dosing any time.
I would definitely not send Angus to the vet for curves. apart from the expense, they are not accurate and it stresses the cat unnecessarily.
 
Red & Rover (GA) said:
$2 per in Canada.
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I get the ones for his meter for about $1 each from Amazon. I talked to my husband and he wants to keep using the pet one because hes worried he may run out of strips and not get the dr to prescribed more without documentation so he'd be in a had spot plus the insurance company is putting a cap on how many he can get so ‍♀️
Hope your Thanksgiving was great!
 
Angus' mom said:
I get the ones for his meter for about $1 each from Amazon. I talked to my husband and he wants to keep using the pet one because hes worried he may run out of strips and not get the dr to prescribed more without documentation so he'd be in a had spot plus the insurance company is putting a cap on how many he can get so ‍♀️
Hope your Thanksgiving was great!
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Fair enough
 
Hi Rachel, what time zone are you in? Personally, I really like all of the (normal, healthy healing green numbers that I see on Angus' spreadsheet -- not that lime green, but the others.) That looks good to me. We need you to keep on doing the good job of testing that you have been doing. We need to see how he responds to a dose and to see where his nadir usually is. Have you read through the dosing method sticky note on the ProZinc forum? You will see that with SLGS (Start Low Go Slow) method, you will reduce the dose by .25 units when he goes under 90 (which he did yesterday so you would have reduced to 1.25 units.) For now, I am assuming that you are following SLGS. Are you testing daily for ketones? If there should be any ketones above a trace amount, then I would probably recommend adjusting insulin more frequently than is done under SLGS. Did you shoot only 1 unit today because of his AMPS number? You did shoot a lower preshot than today's on 10/4 and 10/5 and he was okay. Remember that your "take action number" for your pet meter is 68 (3.7) That means you need to bring up his BG with high carb food and possibly a little karo syrup (or honey/pure maple syrup) and you will retest in 20-30 minutes (20 at first and then if the BG is coming up you can extend to thirty minutes.) Let me know what other questions I can answer.
 
We shot lower today because it's our Thanksgiving and we wouldn't be home all day and he has been going low early lately requiring some action, and didn't want to chance anything.
We're in EST, and dose him around 10. He is hitting his nadir at about 5+. I read about lowering dosages, but when I talked with my vet friday he wanted me to stay at 1.5. I have been in almost daily contact with him right now.
The other days was because he ate a lot less, and there was one am and one pm we were away overnight and had the sitter lower dose him because we wouldn't be home and I was really uncomfortable since they wouldn't pre-test him. :) I am erring in the direction of caution, but feel like my vet would prefer a more intense action so we're still figuring this out together.
 
He seemed ok today, he tends to do better on days when I'm not monitoring as much. At night because im not seeing the numbers i just go by his behaviours, when i get up to the bathrom he always comes and checks on me, if he doesnt then i check him just in case, otherwise i leave him be, so im not reacting to any lows or highs. Hi, I'm the problem it's me lol.
Will a cat in the 3.8/3.2(64/57) area always show signs?
I have a renfest this coming weekend as well near London, ON, so overnight for 2 nights and my dad is coming to learn injections this week(yay!) But I will prob have him getting a few lower(1 unit doses) for then too. He doesn't eat as well when we're gone so I figure this is much safer. Better a bit higher then too low. The vet agreed last time we had to go overnight this was probably best. Last show of the season that I will have to worry about it.
 
Angus' mom said:
Will a cat in the 3.8/3.2(64/57) area always show signs?
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No. 50s and 60s are very healthy normal numbers for a cat (human meter) and anything above 68 (pet meter) is just fine as well. And I have seen MANY cats in the 40s show absolutely no signs of hypoglycemia either -- and some in the 30s recently as well -- happy cat just acting normally! But we do NOT want them in those numbers nevertheless. You can't always tell by just looking at them. Many of our members have been surprised when their cat was acting/looking normal and they did a spot glucose check and found them lower than they wanted them to be.
 
I definitely agree with reducing the dose when you are not around -- especially since he almost earned another reduction today when he hit 68 on your pet meter (I say "another" reduction because he earned a reduction, which was not taken on 10/6/23.) By the weekend he may have earned another one so you may not even want to shoot 1 unit (your dad, that is) but you can wait and see how the rest of the week goes. Very good job of testing today.
 
We have reduced to one unit. Did his first curve on it today. I am a little sad to see so much greens lost, but maybe he'll even out later in the week. At least I'm not freaking out about his lows :)
 
With SLGS, we usually do reductions in increments of .25 units. But I understand that you are going out of town, and you wanted to make sure he would be safe while you were gone. That’s this weekend, right? His numbers aren’t bad - he dipped into green. It’s looking like that one unit should be okay for the weekend. What do you think? I do understand about being disappointed in the higher numbers?
 
So dad got no readings while we were gone, so he gave 1 unit, maybe a smidgen less. I put him up to 1.25, but today he was off and started the day lower then he had been so gave him 1 unit. +2.5 he was at 4.4(79) and I was going out and his peak is at +5 so I caved and gave a high carb wet snack and 65g of ff which he ate. Got home expecting him to be in the high teens, and he was at 6.2(111.6) at +6, so im glad I did. Depending on tonight's numbers I'll give 1.25 units again? I'm planning on being home all day tomorrow, so if I have enough strips I'll try doing a check every 2 hours to see what's up. I think he has pica, and it kicks in bad if he's hungry, so we have started leaving him extra wet food or feeding him when he demands it, but there was a possibility today was a fluke and he had thrown up at some point in yesterday's pm insulin cycle. Which is why I'm thinking if he is ok and eats well pmps I'll give him the 1.25.
 
I think, given that he is seeing green nadirs on the 1 unit dose, that you should hold the dose for now to see how he does on 1 unit. Today he had a 79 on a pet meter, which is awfully close to the take action number of 68 (pet meter.). Even with the HC food you gave him, he didn’t go that high. So I think that safety dictates holding the 1 unit dose and collecting data for this dose. Are you okay with that?
 
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