??? ALERT/ LOW BG!!!

[CORKY]

At 6:00PM Corky's meal and dosing his Nadar (BG) was 124. So as suggested in the ProZinc sticky I did not dose.
this is the first time I've taken this action, I would like to know what could happen next and if his BG will rise way over 400 since normally by 6:AM it's at min high 200-300, will there be any danger, or concern I should know about? of course I will be testing as usual every 2 hours except once I retire around his last meal 11:00PM Please Advise

 

[Sienne and Gabby (GA)]

Maria -

Do you know what the nadir is? I think you meant his PMPS. Please learn the terminology. Not everyone will open Corky's spreadsheet. If I hadn't done so, my reaction would have been there's not an issue with a nadir of 134.

To respond to your question, there is fundamentally no difference between giving insulin with a PMPS of 158 or 167 and tonight's PMPS of 134. The reason for this is that there is a +25% measurement error with any test. So the 167 that you shot on 11/23 could have been as low as 134 when you take the 20% into account (i.e.,, 167 - 33 = 134) or the 158 could have been as low as 127 (158 - 31 = 127). You could have given Corky his shot and then monitored to make sure he was doing well.

Ideally, you want to be able to shoot progressively lower numbers.

To be honest, I don't have a crystal ball. There's no way to tell you what will happen without his PM dose. I suspect there's a good chance he will be in numbers that are over 200 by AmPS.

 

[CORKY]

Maria -

Do you know what the nadir is? I think you meant his PMPS. Please learn the terminology. Not everyone will open Corky's spreadsheet. If I hadn't done so, my reaction would have been there's not an issue with a nadir of 134.

To respond to your question, there is fundamentally no difference between giving insulin with a PMPS of 158 or 167 and tonight's PMPS of 134. The reason for this is that there is a +25% measurement error with any test. So the 167 that you shot on 11/23 could have been as low as 134 when you take the 20% into account (i.e.,, 167 - 33 = 134) or the 158 could have been as low as 127 (158 - 31 = 127). You could have given Corky his shot and then monitored to make sure he was doing well.

Ideally, you want to be able to shoot progressively lower numbers.

To be honest, I don't have a crystal ball. There's no way to tell you what will happen without his PM dose. I suspect there's a good chance he will be in numbers that are over 200 by AmPS.

Thank you for correcting me could I dose him now , I would hate to wake up in the morning, and find him in the 400's, he's BG at 8:00PM was 152

 

[CORKY]

Thank you for correcting me could I dose him now , I would hate to wake up in the morning, and find him in the 400's, he's BG at 8:00PM was 152

I am very pleased with the decision I made by not dosing Corky last night as his BG was 132. I was very afraid he would wake up with a BG of over 300+ to 400 BG yet it was amazing seeing his numbers this morning. I am very proud of the personal decision I made

 

[CORKY]

Thank you for correcting me could I dose him now , I would hate to wake up in the morning, and find him in the 400's, he's BG at 8:00PM was 152

Thank you for correcting me could I dose him now , I would hate to wake up in the morning, and find him in the 400's, he's BG at 8:00PM was 152

I am very pleased with the decision I made by not dosing Corky last night as his BG was 132. I was very afraid he would wake up with a BG of over 300+ to 400 BG yet it was amazing seeing his numbers this morning. I am very proud of this personal decision I made

 

[Suzanne & Darcy]

Hi Maria. I see that you skipped the dose last night. If I had seen this yesterday evening, I would have advised that you not skip the dose and that perhaps you would shoot a somewhat reduced dose -- as long as you could test him during his cycle. As it is, he was in mid yellows this morning and got down into a lower blue today (which I am glad to see). Hopefully, he will get back on track as he had been doing really well on the 1.25 unit dose.

 

[Snickers and Chrissy]

i am very pleased with the decision I made by not dosing Corky last night as his BG was 132. I was very afraid he would wake up with a BG of over 300+ to 400 BG yet it was amazing seeing his numbers this morning. I am very proud of this personal decision I made

It's wonderful that you're so concerned about Corky and keeping them safe. You're doing great!

 

[Suzanne & Darcy]

I see that Corky had a lovely blue number last night at about +4. His typical nadir (lowest point in the cycle) is around +4 to +6, I have noticed. So the right thing to have done last night at +4 would have been to give him a small amount of his regular low carb wet food before you went to bed. I hope you didn’t get frightened and feed him anything with higher carbs.

What an excellent job you are doing of testing him! We have so much more information now to see how Corky handles his insulin.

 

[CORKY]

I see that Corky had a lovely blue number last night at about +4. His typical nadir (lowest point in the cycle) is around +4 to +6, I have noticed. So the right thing to have done last night at +4 would have been to give him a small amount of his regular low carb wet food before you went to bed. I hope you didn’t get frightened and feed him anything with higher carbs.

What an excellent job you are doing of testing him! We have so much more information now to see how Corky handles his insulin.

thank you for the complement. and yes, I did feed him 2 tsp of his low carb diet plan, just to be on the safe side, and he di have quite a good number in the morning. Actually, I was not terrified for the first time, I am beginning to understand how to handle lows, since I have not seen on him such low number since the beginning, I am just hoping he stays this way ang gets better.
neither Corky or Coco had not pooped for about 4 days, I called the Vet and suggested Mineral oil,
IT WORKED !! because the Miralax was not working. I need to buy the Mirataz, the cream that goes on the inner ear for appetite, she's not eating the full portion during meals and that is unusual for her. But I am happy for Corky's progress and this Forum that has been there every time I'm in need with the right answers, and yes, I personally feel very proud of my consistency, and dedication to my babies they are both the only family I have, and they have depended on me and I of them for my mental health and loneliness since tiny kittens. Thank you.

 

[Snickers and Chrissy]

thank you for the complement. and yes, I did feed him 2 tsp of his low carb diet plan, just to be on the safe side, and he di have quite a good number in the morning. Actually, I was not terrified for the first time, I am beginning to understand how to handle lows, since I have not seen on him such low number since the beginning, I am just hoping he stays this way ang gets better.
neither Corky or Coco had not pooped for about 4 days, I called the Vet and suggested Mineral oil,
IT WORKED !! because the Miralax was not working. I need to buy the Mirataz, the cream that goes on the inner ear for appetite, she's not eating the full portion during meals and that is unusual for her. But I am happy for Corky's progress and this Forum that has been there every time I'm in need with the right answers, and yes, I personally feel very proud of my consistency, and dedication to my babies they are both the only family I have, and they have depended on me and I of them for my mental health and loneliness since tiny kittens. Thank you.

I'll have to remember that about mineral oil in case I ever have another problem with Snickers. Thanks for that tip!

 

[CORKY]

I'll have to remember that about mineral oil in case I ever have another problem with Snickers. Thanks for that tip!

I am concerned about one thing that I cannot get my head around, why is it that Corky's lowest point is always at 10PM ?? and is the last time I test him before I give him his last small meal and bedtime it is! I personally been going to bed after 12AM not wanting to close my eyes. I am always so afraid that by 6AM he would be unresponsive or something. What can I do about this? bedtime is the only time of the 24hours of the day I fully rest, and I recently been having a difficult time doing so with bad dreams about Corky although I do not wake up, can anyone help me thru this?

 

[Snickers and Chrissy]

I am concerned about one thing that I cannot get my head around, why is it that Corky's lowest point is always at 10PM ?? and is the last time I test him before I give him his last small meal and bedtime it is! I personally been going to bed after 12AM not wanting to close my eyes. I am always so afraid that by 6AM he would be unresponsive or something. What can I do about this? bedtime is the only time of the 24hours of the day I fully rest, and I recently been having a difficult time doing so with bad dreams about Corky although I do not wake up, can anyone help me thru this?

I totally understand and wish I had better input to offer you. I have been nervous about insulin many times before, but I think that the more you do it, the easier it gets. Actually I had two nightmares about my cat last week! So you're definitely not alone, if that helps in any way.

During the day, I have pet cameras everywhere so that if I leave the house I can check on Snickers. The cameras won't tell me her glucose or anything, but I can usually tell from the way she's laying or holding herself how she is feeling. So if you get nervous during the day I would highly suggest a pet camera. I think the ones I have I paid around $30 for, so not crazy expensive.

Of course, that doesn't help you at night when you need to sleep. I think that @Suzanne & Darcy have been offering you some very good advice. Maybe they can share some tricks for easing your mind. Otherwise I think it just takes time, and learning to trust yourself and the process. You're doing great!

 

[CORKY]

Thank you for your suggestion and yes, I had not thought about the camaras because I don't go anywhere any longer if I have to be away from the house more that 2 hours to be able to test him even though he was diagnosed on July 8th this year I continue to see random days of BG, I am blessed that the diabetes was caught on time and there was organ damage and when I read other posts for members it terrifies me the illnesses, these kitties get from the diabetes because of organ damage, so I am blessed Corky is awesome he gained all his weight back within 2 months

Hi Maria. I see that you skipped the dose last night. If I had seen this yesterday evening, I would have advised that you not skip the dose and that perhaps you would shoot a somewhat reduced dose -- as long as you could test him during his cycle. As it is, he was in mid yellows this morning and got down into a lower blue today (which I am glad to see). Hopefully, he will get back on track as he had been doing really well on the 1.25 unit dose.[/QUOTE

Good morning, Suzanne, I hope that I understood your suggestion of not missing a dose, I also read the ProZinc dose info and it said no shot if under 150, so for the AMPS this morning I mixed the two suggestions could you please review Corky's spreadsheet, and you can tell me where I go from here in reference to the PMPS shot. I hope this morning was a correct decision

 

[Sienne and Gabby (GA)]

What +hour is 10:00? Without knowing the +time (the number at the top of the spreadsheet) there's no way to know if what you're seeing is Corky's nadir.

 

[CORKY]

What +hour is 10:00? Without knowing the +time (the number at the top of the spreadsheet) there's no way to know if what you're seeing is Corky's nadir.

I do not understand your question and so far, I am far from knowing the difference between Nadirs and BG's, so no, I do not see Corky's Nadir on the spreadsheet. This is the first time anyone has asked me this question, other members have been able to advise by reviewing Corky's spreadsheet,
which to members say is impressive, perhaps you can explain further?

 

[Christie & Maverick]

Perhaps this little extract of basic concepts will help you, you may not have seen them yet, and it’s part of the general information and important links sticky as well:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

Because we have members all over the world, when people post, it’s better to refer to the BG test not at what time it occurred (i.e. don’t say 10:00, since your 10:00 may be different than mine, depending on my time zone) but better to say when the BG test was taken relative after the shot, i.e. +1 is one hour after shot, +2 is 2 hours after shot, +3 is 3 hours after shot, and so on. Some of his nadirs do occur at +4 but he also has had some around +6 based on the data from the last few days. Does this help?

 

[Christie & Maverick]

And perhaps also one additional comment, nadirs are not always at the same time each cycle, they can and do move around.

 

[Snickers and Chrissy]

I do not understand your question and so far, I am far from knowing the difference between Nadirs and BG's, so no, I do not see Corky's Nadir on the spreadsheet. This is the first time anyone has asked me this question, other members have been able to advise by reviewing Corky's spreadsheet,
which to members say is impressive, perhaps you can explain further?

BG stands for "Blood Glucose." It refers to all those numbers you put in Corky's chart every time you test him. Each of those numbers is a BG (blood glucose) reading. The "Nadir" refers to the lowest number. A "Cycle" is the length of time from one shot to the next.

So, for an example, let's look at Corky's spreadsheet for yesterday, Dec. 2. The morning pre-shot number (AMPS) was 304. 304 is a blood glucose (BG) number. At + 2 you had 217, then 213, 196, 226, 196, and then an evening pre-shot (PMPS) of 171. Each and every one of those numbers is a BG reading. Does that make sense? That's what you are doing when you poke Corky's ear and test his blood. You are getting a BG reading.

Now, from the AMPS to the PMPS is one twelve-hour cycle. Put another way, the morning shot to the evening shot equals one cycle. Then the evening shot through overnight to the next morning shot is another twelve-hour cycle. Each day has two cycles. Does that make sense? So, again referring to Dec. 2: 304, 217, 213, 196, 226,196, and 171 are all part of the first cycle. Then you gave Corky his evening dose of insulin and got the following numbers: 194, 157, 155. Those are his second cycle. Got it?

The nadir is Corky's lowest number each cycle. So on Dec. 2 Corky's lowest number of the morning cycle, also known as his nadir, was 171, the same as his PMPS. His lowest number in the evening cycle, also known as a nadir, was 155. The nadir is also a BG number, because every reading is a BG number.

I hope this makes sense.

 

[Sienne and Gabby (GA)]

@Snickers and Chrissy - actually the pre-shot can be the lowest number of the cycle. It helps to remember that some cats may have an early or late nadir. In particular, with Lantus/glargine, because there's overlap between the cycles, it's entirely possible for the pre-shot to be particularly low. With any insulin, if a bounce is breaking, a nadir at pre-shot is also a possibility. And then there are those cats that "double dip" but that's probably a different discussion!!!

To add to what Chrissy outlined, for today, Corky's numbers are:

• AMPS 129
• +2 194
• +5 163

We don't refer to "time" as the hour on the clock. Like Christie pointed out, the time zone you are in may not be the time zone for other people reading your thread. Bron is a great example -- she lives in Australia. What is important for those of us reading your thread is to know what time you're referring to with reference to shot time. The 163 from today is your AMPS plus 5 hours. That puts you close to the middle of the cycle.

When you're saying you worry about Corky's numbers at 10:00, I have no idea what that means. Even if we are in the same time zone, if your shot time is at 8:00 it's a very different scenario than if your shot time is at 5:00.

From what I can tell, your shot time is at 6:00. So 10:00 is your +4. The +4 tells us a great deal more than what time it is on your clock. You need to think about when you typically see Corky's lowest number in the cycle. That is your nadir. As Christie explained, nadirs can and do change -- sometimes from cycle to cycle other times, they are relatively consistent except when they are not.

 

[Snickers and Chrissy]

@Snickers and Chrissy - actually the pre-shot can be the lowest number of the cycle. It helps to remember that some cats may have an early or late nadir. In particular, with Lantus/glargine, because there's overlap between the cycles, it's entirely possible for the pre-shot to be particularly low. With any insulin, if a bounce is breaking, a nadir at pre-shot is also a possibility. And then there are those cats that "double dip" but that's probably a different discussion!!!

Ah! Thanks for clarifying that for me. I guess I'm still learning too. That's why I like lurking around here. I think I'll go back and edit my post so as not to confuse anyone.

 

[Snickers and Chrissy]

@Snickers and Chrissy - actually the pre-shot can be the lowest number of the cycle. It helps to remember that some cats may have an early or late nadir. In particular, with Lantus/glargine, because there's overlap between the cycles, it's entirely possible for the pre-shot to be particularly low. With any insulin, if a bounce is breaking, a nadir at pre-shot is also a possibility. And then there are those cats that "double dip" but that's probably a different discussion!!!

I think I'm starting to overthink this now, and confusing myself. If you don't mind my asking one question. If, like with Corky on Dec. 2, the nadir is also the PMPS (at 171), is that nadir part of the first cycle or the second cycle. Each cycle is 12 hours, AMPS to PMPS, and I guess I've been thinking that the PMPS was part of the evening cycle. But now I'm thinking it's actually part of the AM morning cycle since you haven't given the evening shot yet. Which I guess would make the AMPS part of the evening cycle? Does my question make sense? Am I understanding this right? I feel like I should know this already, but I guess it hasn't really come up for Snickers. Her nadirs are usually around +4.

 

[Sienne and Gabby (GA)]

Your question makes sense. I can also see why we can give ourselves a headache over it.

 

[Snickers and Chrissy]

Your question makes sense. I can also see why we can give ourselves a headache over it.

Lol so true

 

[CORKY]

What +hour is 10:00? Without knowing the +time (the number at the top of the spreadsheet) there's no way to know if what you're seeing is Corky's nadir.[/QU

BG stands for "Blood Glucose." It refers to all those numbers you put in Corky's chart every time you test him. Each of those numbers is a BG (blood glucose) reading. The "Nadir" refers to the lowest number. A "Cycle" is the length of time from one shot to the next.

So, for an example, let's look at Corky's spreadsheet for yesterday, Dec. 2. The morning pre-shot number (AMPS) was 304. 304 is a blood glucose (BG) number. At + 2 you had 217, then 213, 196, 226, 196, and then an evening pre-shot (PMPS) of 171. Each and every one of those numbers is a BG reading. Does that make sense? That's what you are doing when you poke Corky's ear and test his blood. You are getting a BG reading.

Now, from the AMPS to the PMPS is one twelve-hour cycle. Put another way, the morning shot to the evening shot equals one cycle. Then the evening shot through overnight to the next morning shot is another twelve-hour cycle. Each day has two cycles. Does that make sense? So, again referring to Dec. 2: 304, 217, 213, 196, 226,196, and 171 are all part of the first cycle. Then you gave Corky his evening dose of insulin and got the following numbers: 194, 157, 155. Those are his second cycle. Got it?

The nadir is Corky's lowest number each cycle. So on Dec. 2 Corky's lowest number of the morning cycle, also known as his nadir, was 171, the same as his PMPS. His lowest number in the evening cycle, also known as a nadir, was 155. The nadir is also a BG number, because every reading is a BG number.

I hope this makes sense.

Wow thanks, I can't believe how elementary it was I was so confused all this time between BG and Nadir. So I wanted to consult with you a situation, Corky's BG's become quite low for bedtime, really quick, on 11/29 I followed the ProZinc , it reads that under 150 to skip the dose which I did. Suzanne's advises are always on point she suggested not to skip but give a lower dose instead for the AMPS of today I dosed 0.75, Should I go back on today's 6:00 PMPS to his 1.25 or stay on the 0.75; he has done quite well with this small decrease Please Advise, if you can before 6:00PM

 

[Snickers and Chrissy]

I'm not an expert on Prozinc as I used Lantus, but I know that @Suzanne & Darcy are real pros at this, and I would follow their advice each time. So if she said to give Corky .75 if he's under a certain number, that's what I would do. If she has told you to go back up to 1.25, I'd do that. I'm sorry I can't be of more help in this situation.

 

[Sienne and Gabby (GA)]

When you have a lower than expected pre-shot and you opt to shoot a lower dose, it's a temporary reduction. All things being equal, you go back to your. usual dose at the next shot time. If you think about it a little differently, if you skipped the shot, you would go back to your usual dose when it's your next shot time. It's the same principle.

 

[CORKY]

I'm not an expert on Prozinc as I

When you have a lower than expected pre-shot and you opt to shoot a lower dose, it's a temporary reduction. All things being equal, you go back to your. usual dose at the next shot time. If you think about it a little differently, if you skipped the shot, you would go back to your usual dose when it's your next shot time. It's the same principle.

thank you, I already gave the same reduced dose since I did not get an answer on time, I didn't
give that much time either for response, thank you for support, I will go back to his usual dose of 1.25u unless his BG is under 150 then I should resort to 0.75u, I have not left my house in two weeks, I need to run to Walmart for kat food litter and a new litter box, the one that was shipped from Chewy was supposed to be Jumbo and I got a medium I'll leave after his +4 testing should be back in less than two hours I do not want to come back home to a lethargic Corky, thank you so so much have a great week


used Lantus, but I know that @Suzanne & Darcy are real pros at this, and I would follow their advice each time. So if she said to give Corky .75 if he's under a certain number, that's what I would do. If she has told you to go back up to 1.25, I'd do that. I'm sorry I can't be of more help in this situation.

When you have a lower than expected pre-shot and you opt to shoot a lower dose, it's a temporary reduction. All things being equal, you go back to your. usual dose at the next shot time. If you think about it a little differently, if you skipped the shot, you would go back to your usual dose when it's your next shot time. It's the same principle.