Advice on insulin amount?

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sofietca

sofietca

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Hi everyone, I posted my first message a couple days ago to the Health forum and had such a warm welcome. :) It was suggested that I come over to the PZI forum since I'm using ProZinc. I'm wondering if anyone has advice on how to know figure out how much insulin to shoot when my kitty is down around 180-220 and it's shot-time. Her pmps glucose has been down in that range quite a few times and I feel like I always get it wrong because no matter what I give she always goes up and by morning is in the high 300s. How do you figure out how much insulin is the right amount when the kitty is hovering around 200 for a couple hours up until shot-time? Any suggestions? She's at 197 right now, and I'm due to give a shot in about 3-4 hours... Thanks! Sarah

(p.s. I'm using U40 syringes so when I put .4, etc. on the spreadsheet it's my best estimate.)
 
Welcome! The PZI forum is usually fairly busy in the am and at night. It is great if you can give us some lead time, like you did this morning to get a response. (I am in Colorado so I am not too helpful to the east coast posters in the am.)

As long as Trouble is right around 200 at shot time, it is generally okay to shoot your normal amount. You do want to be sure he is headed up, not down. (So if you have a 250 at +9, and then 200 at +12, you would be more cautious than if you had 140 at +6 and 200 at +12)

It would be best, even at 200 and headed up, if you could get a test mid cycle, or if you can't do that, to leave out food.

As soon as you can, get some more mid cycle numbers. That will really help you and us to see how the insulin is working. If he stays in the high 100s midcycle, it is a different scenerio than if he is dipping into the double digits at midcycle. Early on in this sugar dance, it is a guessing game to dose because you aren't sure how he is reacting. Once you get some more testing in, it will be easier to figure out what to do.

Is that clear as mud?
 
Hi Sarah and Trouble!
Just popping in to say welcome to PZI Land :)
The wonderful people here are knowledgable and supportive.
:YMHUG:
Donna and Asher
 
Welcome to our little group!

I am short on time, but wanted to say "Hello"---

Kim and Kitty
 
Sue and Oliver (GA) said:
Welcome! The PZI forum is usually fairly busy in the am and at night. It is great if you can give us some lead time, like you did this morning to get a response. (I am in Colorado so I am not too helpful to the east coast posters in the am.)

As long as Trouble is right around 200 at shot time, it is generally okay to shoot your normal amount. You do want to be sure he is headed up, not down. (So if you have a 250 at +9, and then 200 at +12, you would be more cautious than if you had 140 at +6 and 200 at +12)

It would be best, even at 200 and headed up, if you could get a test mid cycle, or if you can't do that, to leave out food.

As soon as you can, get some more mid cycle numbers. That will really help you and us to see how the insulin is working. If he stays in the high 100s midcycle, it is a different scenerio than if he is dipping into the double digits at midcycle. Early on in this sugar dance, it is a guessing game to dose because you aren't sure how he is reacting. Once you get some more testing in, it will be easier to figure out what to do.

Is that clear as mud?
Click to expand...

Thanks Sue. :)
Unfortunately I keep being gone from the house or asleep in the hours before I get a high pre-shot reading, so I haven't been able to do a curve and see what's going on. I've actually noticed that as a trend that as long as I am home and awake, her numbers stay lower! I'll try to get some more readings soon, I've also been trying to let her little ears have a bit of a break so I've only been testing about 4-5 times a day.

I am hesitant to give 1 unit when she's around 200 since the same amount at 350+ brings her down about 150+ points, and if that would hold true at 200 it might be too much for her... Does that seem right? She made it down into the double digits a couple times a couple weeks ago, but then she started having erratic curves and since then if she goes much below 200 she spikes up to the high 300s at the next shot. I worry that I'm giving too much, but also I worry that in my worrying about giving too much I'm actually giving too little and that's why her next reading is high! So confusing!

I'll be testing again in about an hour before I leave for the day and I'll have a better idea of where she's at. Is it a good sign when she hovers around 200 a couple hours past when her shot was due, even after eating? I hope so, a good sign would be nice. :)

Thank you!
 
Yes, staying flat after eating is a good sign. When they are first diabetic, food often brings their numbers up. One of the tests to determine if the pancreas is working is to feed and then test. If the number goes down, it means the pancreas is helping out.

This beginning part is one of the hardest. You are scared and you aren't sure how things are working. And you have made several changes at once - insulin and food. It is a real juggling act, but data is your friend. The more you have, the better decisions you can make. If you can only get a few tests in, try for ones between 4-6 hours after the shot. (lots of people have to set the alarm and get a +6 at night)

Post your number before you leave. I will be around this morning.
 
Hey again!

Like I said earlier, I am short on time...but, I wanted to comment on this after reading your last post.

I had a REALLY hard time understanding how you could shoot the same units on a 250 shot preshot as you could a 350 preshot--like you said, the math didn't work for me! Some of the more experienced people can address this concern for you--but, simply the insulin and math do not work like that.

I would advise you to go and look at some of the other spreadsheets---not mine...it is a total mess, as my Kitty is quiet the mystery. But, if you go and look at Donna and Asher's possibly, you will see the consistent dosing even on different preshots and the responses they are getting.

Trust me, I know exactly how you feel! Do not shoot anything you are not comfortable with, but I think if you look at the spreadsheets it will make you more confident in your dosing.

Maybe I missed this, but where are you located?

Kim
 
We have another kitty, Shakes, whose numbers are much better when his mom is home too. He goes lower on weekends....

There is not a direct correlation that if you give one unit at 200 and the same one unit at 300, he will go down 100 points each time. The sugar dance would be so much easier to choreograph if that was the case. The only data that helps is to know that you gave, for example, 1 unit at 200 and his nadir (+6) was 150 on a given date. That helps you think that he might have a similar response the next time.....

Of course, they are cats.......
 
Just a quick thank you and note before I leave for work - she made things easy on me this morning and her bs is at 338! I'm going to give just about 1 unit - is "thin" the right term?
 
kse said:
Hey again!

Like I said earlier, I am short on time...but, I wanted to comment on this after reading your last post.

I had a REALLY hard time understanding how you could shoot the same units on a 250 shot preshot as you could a 350 preshot--like you said, the math didn't work for me! Some of the more experienced people can address this concern for you--but, simply the insulin and math do not work like that.

I would advise you to go and look at some of the other spreadsheets---not mine...it is a total mess, as my Kitty is quiet the mystery. But, if you go and look at Donna and Asher's possibly, you will see the consistent dosing even on different preshots and the responses they are getting.

Trust me, I know exactly how you feel! Do not shoot anything you are not comfortable with, but I think if you look at the spreadsheets it will make you more confident in your dosing.

Maybe I missed this, but where are you located?

Kim
Click to expand...

I'm running short on time too... :) I'm in Florida, near Tampa.
 
Hi & welcome!!!

Miscellaneous tidbits:

- We usually say skinny and fat if the dose is just under or over the line.

- You can kind of view PZI in %s rather than absolute #s. So if you got from 300 to 100 that's a 2/3s drop or about 66%, so if you had a PS of 180 you could expect a similar drop, so a nadir of something like 60, rather than subtracting the 200 point drop from the new PS :shock: It's not at all a hard & fast rule and many kitties like to do their own thing and be pretty unpredictable :? but that can help make sense of the lower PSs. If you get a PS that is lower than 200 you might reduce by 0.2 if you got good results on a higher PS, gather data, and make sure that or the full dose is safe. If you didn't get a good nadir though on the higher PS, there's no real need to reduce on the lower one. And if you get PSs under 150 though, then you don't want to shoot on that low a number, then you definitely need to wait until they are above 150 to give the insulin.

- Generally there's no need to test more than once or twice a day (in addition to PSs). You can either do sort of a curve or mini-curve (every 3 hours) periodically, or you can test one or two spot tests a day, and vary the times to fill out the picture. There is a tendency here to test a LOT, but don't feel like you *have* to do that. You have a ton of data so far, I don't think you probably need to test quite that much most days. But you do want nadir tests when you can get them, as that combined with PSs is the best way to evaluate the dose (and then spot tests at other times here and there to fill out the curve).
 
I came here tonight with the same problem as the OP with having low PM BG and then in the morning it is back up to high 300's or low 400's. Tonight at +11 Lucky's BG was the lowest it's ever been close to his PMPS (218) and I'm kind of scared of going to bed and it going too low after his full dose.

I'm going to test him again in about 30 mins. Not quite sure where the full dose will take us tonight, but we are going to find out! Last night we saw blue for the first time since he was diagnosed!

OP, I will keep an eye on your SS...interested to see what our kitties numbers decide to do!
 
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