An update on Smokie

[Smokie’s Mom]

Hi everyone. I wanted to say thanks to everyone who helped me through Smokie’s DKA episode two weeks ago. I stopped responding and then got logged out and forgot my password and I apologize for not getting back on this board to post sooner. Everyone is SO knowledgeable and the advice I’ve read has definitely saved Smokie’s life and given me the confidence to take care of him.

I think I was successful in creating my signature and spreadsheet. I was hoping some of you could look at the spreadsheet and offer some insight. For several days now, his BG has been too low for his PM shot. I don’t like only giving him one shot per day but it’s been too low. I do plan on doing another curve one or both days this weekend. I also backed down on the dose because I’m wondering if 2.5 is too high. Also, when his numbers have been so low, he has been acting like his usual self and never exhibited any hypo symptoms.

Thank you all so much!

 

[Rachel]

Hello! I'm so glad to hear that Smokie is doing well!

Well, when you're getting one cycle a day where the preshot is too low, that means you probably need a lower dose. You want to give a dose that gives you a nice curve that doesn't last so long you can't shoot at night! And if you can shoot twice a day, most likely, your preshots at AMPS will be lower since he'll have insulin onboard overnight.

It's always hard to know how much to drop by. I'd suggest sticking with that 1.5 for a few cycles (say 3 or 4 cycles) and see where that gets you. If it gives you shootable preshot numbers, we can see if we need to raise it up or not. Try to get whatever mid cycles you can (and I don't just mean nadir...if +2 or +4 or other numbers are what you can get, get those!). We DO want to keep him from being in high numbers with the DKA in his past, but we also want to make sure he can get a shot twice a day.

 

[Smokie’s Mom]

Thanks for your input, I will definitely try to get some mid cycle tests in, and I will stick with 1.5 for a few days. Just curious - is the general rule (I know, ECID) to not shoot if I get a PS below 200?

 

[Bama Kitty Mom (GA)]

Thanks for your input, I will definitely try to get some mid cycle tests in, and I will stick with 1.5 for a few days. Just curious - is the general rule (I know, ECID) to not shoot if I get a PS below 200?

Looks like you only have a couple weeks worth of data to go by and still new to all this—testing, monitoring and shooting—so keeping your no shoot number @ 200 may be advisable for a while until you get more tests in and your SS filled out. I haven’t searched for your previous posts to know Smokie’s whole story. Did you change his diet to all low carb after dx? If so, that can account for the lower numbers you’re getting. A good thing but still, those light greens can be scary as can the blacks given his DKA. Keep testing, posting and reading the forums. Look at others’ spreadsheets and learn as much as you can.

 

[Kris & Teasel]

Thanks for your input, I will definitely try to get some mid cycle tests in, and I will stick with 1.5 for a few days. Just curious - is the general rule (I know, ECID) to not shoot if I get a PS below 200?

This is from the ProZinc user's guide in the yellow info stickies at the top of this forum's thread list:

• The proper sequence for dosing insulin is: Test/Feed/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle. NOTE: Because pet-specific meters (such as theAlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.

 

[Djamila]

I would just add that eventually you will need to shoot below 200, but the first few times you do that it's with great caution and monitoring, often lowering the dose a bit and collecting data to determine your cat's responses. Looking at your spreadsheet though, those doses you skipped were a good idea. Do try the trick Kris just posted though - stall for a little bit and see if the number rises. Prozinc usually lasts 10-14 hours, so at the end of the cycle, the numbers can sometimes rise quite quickly. You might have a number that is too low to shoot, but if you wait 20-30 minutes, it's all of a sudden high enough and then you can avoid skipping the shot.