Please help - pre shot borderline low numbers - do I give the shot?

[Draíocht]

Hi, at my preshot test my cat's BG was 11.4. I waited 20 minutes and tested again and now it's 11.3.

I have read the info that says not to give the shot if it's lower than 11 but this is very close to 11 so I'm not sure what to do. Kitty is not regulated yet and I'm reluctant to miss a shot but I'm also very nervous because she's had a few big dips recently.

 

[Blanche]

Hi, at my preshot test my cat's BG was 11.4. I waited 20 minutes and tested again and now it's 11.3.

I have read the info that says not to give the shot if it's lower than 11 but this is very close to 11 so I'm not sure what to do. Kitty is not regulated yet and I'm reluctant to miss a shot but I'm also very nervous because she's had a few big dips recently.

Hi Draícoht,

I'm in no way able to assist you but I saw that you are on PZ. Maybe you have to move your post in the PZ forum for the experienced members to see it.
Here it will be probably answered later. And you have a question try add ? as prefix in your thread's title.

And hang on, someone will assist you!

 

[Draíocht]

Hi Draícoht,

I'm in no way able to assist you but I saw that you are on PZ. Maybe you have to move your post in the PZ forum for the experienced members to see it.
Here it will be probably answered later. And you have a question try add ? as prefix in your thread's title.

And hang on, someone will assist you!

Thanks so much for your reply. I posted in the main forum because I could see that my helper in the Prozinc forum isn't online and I thought more people would see it here. I know the time difference doesn't help!

After another 20 minutes it was 11.4. I went ahead and gave her 1 unit instead of 1.4 but then at +1 she went way up to 17. We will see how it goes later.

 

[Blanche]

Thanks so much for your reply. I posted in the main forum because I could see that my helper in the Prozinc forum isn't online and I thought more people would see it here. I know the time difference doesn't help!

After another 20 minutes it was 11.4. I went ahead and gave her 1 unit instead of 1.4 but then at +1 she went way up to 17. We will see how it goes later.

Time different is a beach! (Yes, I intentionally misspelled it )
I've be in your shoes so many times lately and I can feel you. If it wasn't for @hellen_maggie (same timezone ) I would probably lost it.
The only advice can give you in such cases is calm and close monitoring.
Have a nice day!

 

[Gill & George]

After another 20 minutes it was 11.4. I went ahead and gave her 1 unit instead of 1.4 but then at +1 she went way up to 17. We will see how it goes late

Looks like she had a little food bump just before she had onset of her shot, she's now dipped at +2, by approx 50pts (US numbers), I'd get a +3 just before you feed, if she's dropped a lot you can choose to increase the carbs in her +3 feed if you feel it's necessary, to slow her down.

 

[Draíocht]

Thanks so much for the replies! All went ok today thankfully but I hope it doesn't lead to a few higher days again now.

I haven't been doing a feed at +3 unless she needs it. So far I've been following my vet's advice to just feed her with her shots and not in between but she has been having her nadirs quite early so I want to slow it down and try to keep her in lower numbers for longer. I want to transition her to have a small snack at +2 and maybe +4 depending on her numbers so I set it up on my spreadsheet but I'm still nervous because I don't want her to spike back up. So far, I've only given the extra feed when her numbers have been lower or she's having a steeper drop. Should I try giving her less at her main feed with her shot?

I haven't been able to get her numbers consistently low yet and whenever she does get a bit lower she seems to have a couple of days bouncing afterwards.

 

[Gill & George]

I haven't been doing a feed at +3 unless she needs it. So far I've been following my vet's advice to just feed her with her shots and not in between

I'm not sure about the feeding, the only feed twice a day with the shot seems to be a recommendation we see from vets, I'm not sure what the thinking is.
I used la tus, which is slower acting and fed up until about +6/+7 , I tried to keep to a routine, ps, +2 +4+6 unless the cycle demanded steering.
I'm not really sure with PROZINC, but I would have though it's not dissimilar with regards to feeding, though with it usually being faster, and slightly shorter acting the details would vary.
@Suzanne & Darcy

Might be able to share her thoughts on that sshe has a lot of experience with PROZINC

haven't been able to get her numbers consistently low yet and whenever she does get a bit lower she seems to have a couple of days bouncing afterwards

It takes time, to get there safely, kitty is making progress, bouncing is part of the process, the more kitty sees healthy numbers the more likely the bouncing is to subside. Although some cats never stop and just bounce their way into remission. It's not a sign you're doing anything wrong

 

[Mary & Jude]

For those of you in contrasting time zones from the bulk of members on the forum, let me make a couple of suggestions. @Bandit's Mom on this forum is in India, so she's probably going to be awake when you are and can field questions if she's available. Alternatively, don't hesitate to post over on the Facebook page that is associated with this group; here is the link: Facebook (be sure it's this group!). Bhooma (Bandit's Mom) is an admin on that group, so you can tag her (Bhooma Varadrajan) or you can tag Kim Nesrallah, Chris Ronkoski, or Karen Nicholson (though I believe they are all in N. America time zones). The Facebook group is a great resource, and when I have needed input but couldn't raise anyone here on the forum, I was always able to get help on the FB group. Just be aware that people are eager to be helpful on the FB group, and it's a large goup with a lot of people posting, so you'll need to give careful consideration to the advice you receive. The folks I've mentioned in this post, though, are quite knowledgeable.

 

[Draíocht]

I'm not sure about the feeding, the only feed twice a day with the shot seems to be a recommendation we see from vets, I'm not sure what the thinking is.
I used la tus, which is slower acting and fed up until about +6/+7 , I tried to keep to a routine, ps, +2 +4+6 unless the cycle demanded steering.
I'm not really sure with PROZINC, but I would have though it's not dissimilar with regards to feeding, though with it usually being faster, and slightly shorter acting the details would vary.
@Suzanne & Darcy

Might be able to share her thoughts on that sshe has a lot of experience with PROZINC







It takes time, to get there safely, kitty is making progress, bouncing is part of the process, the more kitty sees healthy numbers the more likely the bouncing is to subside. Although some cats never stop and just bounce their way into remission. It's not a sign you're doing anything wrong

Thank you, that is reassuring. Yes, Suzanne has been helping me on the Prozinc forum and it was her suggestion to add some food in at those times so that's why I want to give it a try.

There seem to be more people using Lantus. I'm wondering if it's worth switching since Kitty's cycles don't seem to be getting any longer. Maybe she just needs more time. I might talk to my vet about it.

 

[Draíocht]

For those of you in contrasting time zones from the bulk of members on the forum, let me make a couple of suggestions. @Bandit's Mom on this forum is in India, so she's probably going to be awake when you are and can field questions if she's available. Alternatively, don't hesitate to post over on the Facebook page that is associated with this group; here is the link: Facebook (be sure it's this group!). Bhooma (Bandit's Mom) is an admin on that group, so you can tag her (Bhooma Varadrajan) or you can tag Kim Nesrallah, Chris Ronkoski, or Karen Nicholson (though I believe they are all in N. America time zones). The Facebook group is a great resource, and when I have needed input but couldn't raise anyone here on the forum, I was always able to get help on the FB group. Just be aware that people are eager to be helpful on the FB group, and it's a large goup with a lot of people posting, so you'll need to give careful consideration to the advice you receive. The folks I've mentioned in this post, though, are quite knowledgeable.

Thanks, I don't use facebook but I will have a look for Bandit's Mom on here. Are there any european members I should look out for? Also, on the side I can see a list of members recently online but is there anywhere to see a list of members currently online?

 

[Gill & George]

I'm in Spain. Send me a PM if it's urgent, I do work so may not be around at certain times. But I'd try to get to you.

@xelo y sinver ard in Spain too. She used prozinc for a while but is back on Lantus now

 

[Gill & George]

There seem to be more people using Lantus. I'm wondering if it's worth switching since Kitty's cycles don't seem to be getting any longer. Maybe she just needs more time. I might talk to my vet about it.

PROZINC has worked well for some kitty's, but generally it's shorter acting.

It perhaps also gives you a little more flexibility in shot times if you're on an irregular schedule. With Lantus and the protocol we follow on the forum you'll get the best results of you stick to a 12 hour shooting schedule, it's a depot insulin so with each dose a little gets 'storef' which then impacts the next cycle. Once the depot is full the slow release from this store is what helps lengthen the cycle and give you a flatter curve.

Take a look at sinver, he was poorly a while back and vet wanted celo to swap to PROZINC, after a couple of months, celo wasn't really seeing progress, his cycles were not lasting, generally giving rise to high PS, silver in addition is bouncy and as he wasn't spending enough time on healthy numbers he was also bouncing irrationally. So celo swapped back to lantus (unbeknown to the vet).

Have a look how his BG has evolved over the last month....
@xelo y sinver

 

[Gill & George]

Speak to your vet, you may struggle to get them to prescribe Lantus....EU regs

 

[Gill & George]

So take your data and make a case for him if you decide you want to give it a try.

 

[Gill & George]

I remember reading through a comparative study on remission rates.
PROZINC is a much better choice than vetsulin for cats, as it's a longer lasting insulin, and is the preferred animal specific product.
Lantus however can be prescribed off label in the EU, it depends on your vet agreeing that the glycaemic control with PROZINC is not adequate.
Depending on your relationship with your vet you might be able to pressure for a change

 

[Gill & George]

FWIW, although Blanche is bouncing, I do agree with you that she's not really getting the duration at present.
Eg 16/3 even she got to green, was red by amps and back down to low blue at nadir then back up high by pumps on the 17th,

Those highs are lack of duration not a bounce. BIPO(big insulin poop out)

If it's a bounce you will see them go up after an episode of low numbers and they will stay high and flat for AT LEAST one cycle and upto about 6.

I'm not seeing that lately.

 

[Draíocht]

FWIW, although Blanche is bouncing, I do agree with you that she's not really getting the duration at present.
Eg 16/3 even she got to green, was red by amps and back down to low blue at nadir then back up high by pumps on the 17th,

Those highs are lack of duration not a bounce. BIPO(big insulin poop out)

If it's a bounce you will see them go up after an episode of low numbers and they will stay high and flat for AT LEAST one cycle and upto about 6.

I'm not seeing that lately.

Thanks so much. My cat's not Blanche but I think you're talking about my spreadsheet when you describe those numbers so maybe just the wrong name!

That makes a lot of sense. I do feel like it's just not lasting long enough. Maybe I need to get some more tests done later in the cycle. Is it something that can improve over time, as in, I should give it more of a chance or is there anything I can do to help it last longer? Or do you think it's worth asking my vet about Lantus now based on Kitty's numbers so far?

I'm still not sure how to work the feeding as well. Last night I tried to spread out her feeds but she dropped so quickly and I ended up giving her quite a big meal at +4 because of the steep drop and how agitated and hungry she was acting. I probably gave her too much because then she jumped up at +5. As well as trying to slow the curve, we are trying to get her to gain weight and she's already eating more than enough for two cats. I'd love to figure out the best times to feed her so she actually gets the most calories from the food.

 

[Draíocht]

I'm in Spain. Send me a PM if it's urgent, I do work so may not be around at certain times. But I'd try to get to you.

@xelo y sinver ard in Spain too. She used prozinc for a while but is back on Lantus now

That is so kind, thank you!

 

[Gill & George]

Thanks so much. My cat's not Blanche but I think you're talking about my spreadsheet when you describe those numbers so maybe just the wrong name!

Yes, I just renamed Kitty

Maybe I need to get some more tests done later in the cycle. Is it something that can improve over time, as in, I should give it more of a chance or is there anything I can do to help it last longer?

Changes with insulin therapy do take some time it's not usual to see an immediate response.
If you look at Kitty's SS, what do you see? Look at the colours when she first started and look to see any changes over time.
Do you see a shift? What conclusion, if any can you draw from what you see? Are you seeing improvement?

Does she still have access to dry? If you're anxious to see more rapid improvement in BG is it worth considering TR? @Suzanne & Darcy

Feeding high carbs or too late in the cycle, can shorten the cycle, I assume kitty is on low carb wet, I don't think your feeding too late from what I see on your SS.?
I guess she's lost a lot of weight at diagnosis? As she gets into better numbers she will start to put weight back on, be patient.

Last night she went from 190 to 130 in two hours that's not too fast. But it did seem as though she's clearing the bounce. I might have given her her normal snack, waited an hour and seen where her BG was, if I had to sleep, and she was screaming for food, (and this is what she does when she drops then I'd have probably let her have a bigger meal or more carbs in a deliberate attempt to shorten the cycle)

I Always found it useful to look back at a cycle with the benefit of hindsight you can start to draw conclusions of how Kittys BG will behave. Even if what you try doesn't work out how you thought it might there is always something to learn.


How many calories is she getting daily? What is her healthy weight? Is she still loosing?

I gave George his main meal at PS it was a tin of thrive complete chicken breast, 75g, about 2% carbs, onset with lantus was about +2 with him so I didn't want BG spiking before the cycle onset so I kept carbs low at PS, I'd take a +1 or +2 depending on where his BG was at PS, based on that number I'd decide what he would get carb wise, if BG was dropping normally, then he got his regular 4-5 % if I suspected a very active cycle I'd crack out higher carb food. (% according to how quick he was going)
It took a while to fine tune, I made choices that didn't pan out how I thought they would ('not mistakes') the important thing is to look back each cycle and reflect on how it went and what you could have done differently to achieve the desired outcome.

 

[Draíocht]

Yes, I just renamed Kitty

Changes with insulin therapy do take some time it's not usual to see an immediate response.
If you look at Kitty's SS, what do you see? Look at the colours when she first started and look to see any changes over time.
Do you see a shift? What conclusion, if any can you draw from what you see? Are you seeing improvement?

Well yeah, it's definitely improving but she's far from regulated I think. I'm managing to hit some lower numbers but she's still coming back up into high ones and it's not consistent day to day. I can't predict how low she will go or not and I'm not seeing a reliable pattern but maybe that's my inexperience!

Does she still have access to dry?

No, she's only on low carb wet food. I have listed all of her regular food flavours in a tab on my spreadsheet as well as the medium carb and high carb food I have on hand. You can see her regular foods (the Mac's brand) are very low carb but there is a small variation between flavours.

If you're anxious to see more rapid improvement in BG is it worth considering TR?

It's not that I necessarily need to see rapid improvement but just that I don't have the experience to know if she's trending towards becoming regulated or if it looks like the Prozinc isn't long lasting enough for her. I just want to give her the best chance possible of remission.

What is TR?

I don't think your feeding too late from what I see on your SS.?

She seemed to do well until I gave her the feed at +4 last night and then she had a bit of a jump up again. I wonder if I shouldn't do the +4 feed because it's a bit close to her nadir. It looks like she's been having her nadir between +4 and +5. I was trying to delay the nadir and lengthen the curve of the insulin cycle with adding in the extra feeding times but the last thing I want is for that to have the opposite effect.

I guess she's lost a lot of weight at diagnosis?

Yeah, she used to be overweight and then she lost a lot very suddenly and started drinking lots, which is why we got her checked.

How many calories is she getting daily? What is her healthy weight? Is she still loosing?

She's getting around 300 - 350 calories per day and she's not particularly active. She has been very slowly gaining in the last month, which is great. I'm trying to get her up to 4.5kg. She used to be about 5.5kg, went down to 3.2kg and now she's at about 3.6kg. My vet said to let her eat as much as she wants at the time of her shot but some days she would eat more than others and I wondered if that was partially causing the massive difference between her numbers each day. I started measuring out her food to try to have some consistency but I'm still figuring out the best amounts. I want to make sure she keeps gaining and doesn't lose any weight.

I'm not sure if this is the best way to do it or if I should go back to letting her eat as much as she wants with her shot and just record the amounts, rather than trying to control it.

It took a while to fine tune, I made choices that didn't pan out how I thought they would ('not mistakes') the important thing is to look back each cycle and reflect on how it went and what you could have done differently to achieve the desired outcome.

Yeah, that's always my attitude! I'm very analytical and I'm just trying to learn as much as possible. Hopefully I can figure it out.

Thanks so much for your help!

 

[Gill & George]

I'm not sure if this is the best way to do it or if I should go back to letting her eat as much as she wants with her shot and just record the amounts, rather than trying to control it.

Personally I preferred controlling it so I could have more control of the cycles.
My guy was overweight, and lost quite a bit before diagnosis, and whilst unregulated and especially when his numbers were high would have eaten a cow if if given it to him.

I don't think +4 is too late, maybe she was going to head up anyway, keep trying for a few days and see what's happening try not to swap and change to often, give kitty time to adjust to changes.

 

[Draíocht]

Personally I preferred controlling it so I could have more control of the cycles.
My guy was overweight, and lost quite a bit before diagnosis, and whilst unregulated and especially when his numbers were high would have eaten a cow if if given it to him.

I don't think +4 is too late, maybe she was going to head up anyway, keep trying for a few days and see what's happening try not to swap and change to often, give kitty time to adjust to changes.

Thanks, that makes sense!

I saw you mentioning TR. Can you tell me what that means?

 

[Gill & George]

What is TR?

My bad with PROZINC it's modified dosing method.

Hers the link in the PROZINC forumDosing method with PROZINC

 

[Draíocht]

My bad with PROZINC it's modified dosing method.

Hers the link in the PROZINC forumDosing method with PROZINC

OK thanks. Yeah, I have seen that. I am lucky to have a great vet and she calls me weekly to discuss the dose so I'm only making increases with her advice. She's already given me the ok to make reductions if necessary (if Kitty goes below 5) but if I need to increase, I've been waiting until the end of the week so I'm not sure if that would work. It might be something I could talk to her about.

 

[Gill & George]

She's getting around 300 - 350 calories per day and she's not particularly active. She has been very slowly gaining in the last month, which is great. I'm trying to get her up to 4.5kg. She used to be about 5.5kg, went down to 3.2kg and now she's at about 3.6kg

Looks like you're heading in the right direction,

I'm not a fan of giving them as much as they want, their BG can vary due to a number of factors , dose is one, and how much they eat is another, both of which we have done control over.

Then there are other factors, exercise, stress, infection, absorption hormones...all these can affect BG levels and we don't have control over those.

So I feel like it's important to control those that we can in order to head in the right direction of regulation.

I think it's still relatively early days for Kitty, you have been seeing some improvement, I'd be inclined to give it a little longer. If you feel like progress plateaus then you might want to look to change.

I got George into remission with TR, and Lantus, if I had another diabetic cat La tus would be my first choice insulin. Not just because it worked for him but because it has outperformed PROZINC in remission rates in comparative studies(I'll see if I can find those for you, I had a quick look yesterday and couldn't locate them). PROZINC is much better than previous animal insulin and it works well for a significant number of cats.

 

[Gill & George]

OK thanks. Yeah, I have seen that. I am lucky to have a great vet and she calls me weekly to discuss the dose so I'm only making increases with her advice. She's already given me the ok to make reductions if necessary (if Kitty goes below 5) but if I need to increase, I've been waiting until the end of the week so I'm not sure if that would work. It might be something I could talk to her about.

It looks to me like her dose reduction might have failed 'id be looking to take her up'

If you have a vet that will discuss with you that's great, speak to her

 

[Gill & George]

If she's not on enough of a dose you will also see shorter duration

 

[Draíocht]

Here is an example of how unpredictable it is.

This morning we weighed out exactly the same amount of food as last night with her shot. Last night she came down a nice amount by +2 and today she has hardly budged at all in the same time.

Today's food flavour was actually slightly lower carbs than last night's and nothing else is different. I decided not to give her a +2 feed this morning and she's not acting like she wants it anyway. Last night she was starving at +2.

I'm trying to be consistent but I'm also trying to react to each cycle as it happens so I'm not sure which is the best approach!

 

[Draíocht]

It looks to me like her dose reduction might have failed 'id be looking to take her up'

If you have a vet that will discuss with you that's great, speak to her

Do you mean I should ask the vet about increasing her to 1.6 again? On 1.6 she kept dipping below 5. On 1.4 she has still been getting down into blue numbers, but not consitently enough.

Why does she have to go lower at night than during the day! I'm losing my mind with the lack of sleep. Anyway, we have another 5 days before I'll be talking to her again so we can see how 1.4 does over that time.

 

[Suzanne & Darcy]

Thanks so much for your reply. I posted in the main forum because I could see that my helper in the Prozinc forum isn't online and I thought more people would see it here. I know the time difference doesn't help!

After another 20 minutes it was 11.4. I went ahead and gave her 1 unit instead of 1.4 but then at +1 she went way up to 17. We will see how it goes later.

Even if I am not online, I will get an email if someone posts on the ProZinc forum. I have not been available very much for about the last ten days — off and on, but I have tried to reply if I did get an email in my inbox. Right now, I am trying to review this thread to get caught up on what has been happening with Kitty. How is everything?

 

[Suzanne & Darcy]

I haven't been doing a feed at +3 unless she needs it. So far I've been following my vet's advice to just feed her with her shots and not in between but she has been having her nadirs quite early so I want to slow it down and try to keep her in lower numbers for longer. I want to transition her to have a small snack at +2 and maybe +4 depending on her numbers so I set it up on my spreadsheet but I'm still nervous because I don't want her to spike back up.

It’s important with ProZinc to give a small snack of low carb wet food at +2 and also at +4 if you can do it. Will she eat at those times? I mean, is she hungry? It isn’t a whole meal, of course. It could even be a tablespoon of wet Lc food. Some people choose to take the total amount of food that they want their cat to eat for the day and break it up into the breakfast and snacks. That’s another way it can be done. A tablespoon of LC wet food is going to help prevent Kitty from dropping too quickly— it helps prevent bouncing— and that small amount of LC isn’t going to hijack the cycle.

 

[Suzanne & Darcy]

Thanks, that makes sense!

I saw you mentioning TR. Can you tell me what that means?

It’s the Modified ProZinc Method (MPM). It does have some similarities to TR. I can help you if you would like to try it. It’s definitely worth giving it a try before switching insulin. It’s just going to give us more flexibility in changing doses and will allow Kitty’s BG to be in a better place. Reductions in dose would only be taken if Kitty drops below 50. You should eead through the dosing methods (MPM specifically) over on the ProZinc forum. It really would not work, though, if you are waiting on your vet to approve or disapprove every dose adjustment. That would also be the same even if you switched insulins — you need to have the flexibility to manage the doses on your own based upon the spreadsheet data that you get.

 

[Suzanne & Darcy]

Kitty was doing much better on the 1.6 dose. I would take her back up to 1.6. You do not need to be afraid of the good green numbers that she was getting on that dose. Anything 50 and above is safe. If you follow MPM then our target nadirs would be 50-120 (which are normal BG numbers for a cat.

 

[Suzanne & Darcy]

You are not getting terrible duration. You have still been in good numbers into +8 and beyond in some cases on the 1.6 dose. Sometimes the jump up that you are seeing is the beginning of a bounce (which of course you can’t always see at the time but can see later when you see the sustained high numbers.)

 

[Suzanne & Darcy]

I have to be off the Board now for a while. I will check back in with you in the afternoon (your early evening .) If you have an urgent question, please do post on the ProZinc Forum so I will get an email in my personal email Inbox. Then I will try to answer. We need to move this over there anyway, but we can at least wrap this thread up with answered questions.

 

[Gill & George]

Thanks for stopping by

I have to be off the Board now for a while. I will check back in with you in the afternoon (your early evening .) If you have an urgent question, please do post on the ProZinc Forum so I will get an email in my personal email Inbox. Then I will try to answer. We need to move this over there anyway, but we can at least wrap this thread up with answered questions.

Thanks for stopping by Suzanne

 

[Blanche]

FWIW, although Blanche is bouncing, I do agree with you that she's not really getting the duration at present.

Thanks so much. My cat's not Blanche but I think you're talking about my spreadsheet when you describe those numbers so maybe just the wrong name!

Did I hear my name called?

 

[Draíocht]

It’s important with ProZinc to give a small snack of low carb wet food at +2 and also at +4 if you can do it. Will she eat at those times? I mean, is she hungry? It isn’t a whole meal, of course. It could even be a tablespoon of wet Lc food. Some people choose to take the total amount of food that they want their cat to eat for the day and break it up into the breakfast and snacks. That’s another way it can be done. A tablespoon of LC wet food is going to help prevent Kitty from dropping too quickly— it helps prevent bouncing— and that small amount of LC isn’t going to hijack the cycle.

Thanks! Yes, I have started doing that over the last few days but sometimes her numbers are still really high so it seems counterintuitive to give more food, especially if she's not hungry. Sometimes she's ravenous at those times and sometimes she's really content. There doesn't seem to be a logical pattern to it. I have been reacting to the numbers and to her behaviour to decide whether or not to give the snacks. I can get her to eat a tablespoon of anything, anytime so that's never a concern. She has never refused food before. But if she's up quite high in the numbers and fast asleep not looking for food, I'm not sure it makes sense to give it?

 

[Draíocht]

It’s the Modified ProZinc Method (MPM). It does have some similarities to TR. I can help you if you would like to try it. It’s definitely worth giving it a try before switching insulin. It’s just going to give us more flexibility in changing doses and will allow Kitty’s BG to be in a better place. Reductions in dose would only be taken if Kitty drops below 50. You should eead through the dosing methods (MPM specifically) over on the ProZinc forum. It really would not work, though, if you are waiting on your vet to approve or disapprove every dose adjustment. That would also be the same even if you switched insulins — you need to have the flexibility to manage the doses on your own based upon the spreadsheet data that you get.

Thank you, you are a wonderful help. I will look into it a bit more and talk to my vet about it.

 

[Draíocht]

Kitty was doing much better on the 1.6 dose. I would take her back up to 1.6. You do not need to be afraid of the good green numbers that she was getting on that dose. Anything 50 and above is safe. If you follow MPM then our target nadirs would be 50-120 (which are normal BG numbers for a cat.

I was quite nervous when she was on 1.6 and especially at night. My vet said she doesn't really want her going below 5 (90) until her curves are a bit more consistent and her patterns a bit more predictable. There were a couple of nights when she went below 5 and only came back up because we intervened. If I can't stay awake until 3am every night, how do I know she won't keep dipping lower? She wasn't too far from 50 on the 16th.

I'm already not coping with the lack of sleep so I'm not keen on a dose that brings her that close to the safe cut off point. If I could get her to a dose that brought her close to around 5 and I could trust that she wouldn't keep going lower, I'd feel safer. I could try to give 1.5 but it would be between markings on the syringe so I'm not sure if that would be accurate enough.

 

[Gill & George]

Her Nadir's have been trending up since the reduction, what you will likely find if you stick to this dose is that they will continue to rise.

Holding on to a dose that isn't getting a cat into Nadir's in the 'healthy range' (50 to 80) is counter productive.

The methods we follow do have built in safety.

It's ok to take it slower, but you will see her in the hypoglycemic range for longer.

IT is hard on the sleep when they decide to have low cycles at night.

Are you going anything different in the pm cycle? Good type? Play? Size of snack?

What time do you shoot?


I used to shoot on a 6am/6pm schedule meant that I could get a +5 and it would only be 11pm, so I could get a decent rest, on the morning I would test feed and shoot, grab an extra nap for an hour or two if I needed.thst helped with the sleep issues.

I

 

[Suzanne & Darcy]

Thanks! Yes, I have started doing that over the last few days but sometimes her numbers are still really high so it seems counterintuitive to give more food, especially if she's not hungry. Sometimes she's ravenous at those times and sometimes she's really content. There doesn't seem to be a logical pattern to it. I have been reacting to the numbers and to her behaviour to decide whether or not to give the snacks. I can get her to eat a tablespoon of anything, anytime so that's never a concern. She has never refused food before. But if she's up quite high in the numbers and fast asleep not looking for food, I'm not sure it makes sense to give it?

If she’s asleep and high in BG, I probably wouldn’t worry about it— unless she is in need of gaining weight— in that case I would.

 

[Suzanne & Darcy]

Thank you, you are a wonderful help. I will look into it a bit more and talk to my vet about it.

Well, I would just love to see Kitty in better numbers and I do think it’s possible.

 

[Suzanne & Darcy]

I was quite nervous when she was on 1.6 and especially at night. My vet said she doesn't really want her going below 5 (90) until her curves are a bit more consistent and her patterns a bit more predictable. There were a couple of nights when she went below 5 and only came back up because we intervened. If I can't stay awake until 3am every night, how do I know she won't keep dipping lower? She wasn't too far from 50 on the 16th.

I'm already not coping with the lack of sleep so I'm not keen on a dose that brings her that close to the safe cut off point. If I could get her to a dose that brought her close to around 5 and I could trust that she wouldn't keep going lower, I'd feel safer. I could try to give 1.5 but it would be between markings on the syringe so I'm not sure if that would be accurate enough.

I understand. I am sorry you have been losing so much sleep. But it seems like her numbers have gone so high now with mostly yellow nadirs during the day and at least some blues at night. What is your shot time in your local time?

Many vets do not want their client’s cats in the lower (normal, healthy) BG numbers because they are afraid of hypo because their clients are not testing the cat’s BG at home or at least aren’t doing it very frequently. If you are monitoring the cycles, then you are in control. I would not use HC food unless my cat was lower than 50 or at least at 50 (depending on what point in the cycle it was and the rate of drop, etc.) Some regular food usually helps them surf in green. Other options are higher end low carb food with 8 or 9 percent carbs— or medium carb foods around 10-14 percent. Now, having said that— I totally understand doing it when you are really getting exhausted at night and need to go to sleep!

 

[Gill & George]

I was quite nervous when she was on 1.6 and especially at night.

1.6 is very low 28 xin the units we usually talk about, when was that I can't see it in the SS? It is scary when they get that low, that happened to me once with George.

Just wondering if it's just me being dense and not seeing it or if there has been some confusion in the conversion, easily done when we're in a panic.

50 our cut of point for reduction/carbs is 2.8
40 is 2.2, 30 is 1.7

To get from your values to US you multiply by 18.

From US to ours you divide.

 

[Gill & George]

How was your evening? Did you manage some sleep?

 

[Draíocht]

How was your evening? Did you manage some sleep?

Thank you I managed to catch up on a bit of sleep but I'm still exhausted. She was so hungry at the PM shot so we gave her as much as she wanted and we all slept until +4 and woke up to test her. It is really hard.

 

[Draíocht]

1.6 is very low 28 xin the units we usually talk about, when was that I can't see it in the SS? It is scary when they get that low, that happened to me once with George.

Just wondering if it's just me being dense and not seeing it or if there has been some confusion in the conversion, easily done when we're in a panic.

50 our cut of point for reduction/carbs is 2.8
40 is 2.2, 30 is 1.7

To get from your values to US you multiply by 18.

From US to ours you divide.

No confusion! I get the conversion. 1.6 was her dose, not her BG. She had 1.6 units and went down to 3.7 at 2.30am on the 16th.

 

[Draíocht]

Her Nadir's have been trending up since the reduction, what you will likely find if you stick to this dose is that they will continue to rise.

Holding on to a dose that isn't getting a cat into Nadir's in the 'healthy range' (50 to 80) is counter productive.

The methods we follow do have built in safety.

It's ok to take it slower, but you will see her in the hypoglycemic range for longer.

IT is hard on the sleep when they decide to have low cycles at night.

Are you going anything different in the pm cycle? Good type? Play? Size of snack?

What time do you shoot?


I used to shoot on a 6am/6pm schedule meant that I could get a +5 and it would only be 11pm, so I could get a decent rest, on the morning I would test feed and shoot, grab an extra nap for an hour or two if I needed.thst helped with the sleep issues.

I

We're not doing anything different in the PM cycle. The food is the same. During the day she sits by the window looking out or if we're outside she sits out with us. She goes between that and napping and having some cuddles. At night she just sleeps apart from those times when she's suddenly starving and she paces and cries for food.

We get up at 6.30am and we give her shots at 6.45am and pm. I'm always sleepy by 10pm so +4 at 10.45pm is a little bit late for us but is just about manageable. If we need to check her beyond that it really affects me.

No matter what time we do it, there's always going to be a maximum of just under 8 hours between +4 and the next shot. That sounds like it should be enough sleep but it really isn't for me, especially when the quality of the sleep I get isn't great anyway. I don't always sleep well because I'm worrying about her and I keep having nightmares about losing her. When she's in the lower numbers, I barely sleep at all.

 

[Draíocht]

Well, I would just love to see Kitty in better numbers and I do think it’s possible.

Yes, I would love that too! I wish I could just keep her in the low blues for a while until I get more comfortable with it. And I wish she would stop going back up so high. And most of all I just wish it would be a bit more consistent and not all over the place.

At 1.4 units she's not really going below yellow very much but at 1.6 she was dropping very quickly and suddenly into greens. I have read about using a calipers to measure between the lines on the syringe. I wonder if I should try 1.5?