? Before shot numbers help?

[AmyB]

Salem's pre-shot numbers have normally been in the 300s (still getting him regulated) but I just tested him for his PMPS and it was 229? I know 200s is the okay range but this is a big drop from the numbers I've been getting pre-shot and I still haven't determined when his nadir is bc I haven't had the time to do a curve yet. Should I go ahead and give him his 2 units? He's only been on this dosage since Wednesday night and we're going to see the vet in the morning. I'm just so terrified of him getting a hypo even though I know that isn't likely at this point and I'm still getting used to all this testing and stuff. Any advice would be appreciated and I've tried to update his spreadsheet as much as possible.

 

[AmyB]

Okay I ended up giving him a little less than 2 U, more like 1.8 just be safe. I'm going to talk to the vet about all of this tomorrow. I just don't know how much ProZinc is going to tank his numbers, and since I've been feeding him food with less carbs I want to be safe. If any has any information or advice about how ProZinc usually runs, I'd appreciate it. I've read some of the info, but I'm confused as to when he should be hitting his nadir and whatnot. I'm going to check his BG at +5, 6, and 7 tonight to get an idea of what's going on (even though it means no sleep for me). I have used the wet food guide to only buy foods with 10% or less carbs so I wonder if that will make a big difference. I just feel like I have so many questions and it's so stressful trying to get him regulated right now but I keep telling myself it's only been two weeks and his BG has dropped from the 500s to the 200s now. Sorry to ramble a bit I just to need to talk to someone who aren't my parents about this (they keep telling me to calm down but I'm a person with chronic anxiety now with a diabetic cat so good luck with that).

 

[Harukyo]

Hello AmyB and Salem! Girl, I am so with you with the anxiety and being info hungry lol. Okay so ProZinc usually hits its peak around +3 to +6. Which means Salem will be at his lowest BG reading at some point during that window. Then when it hits around +7 time his BG levels will start to climb back up.

I'm not very experienced in dosing, but I can offer what I would do if I was in your position for your consideration. I'm not familiar Salem's and being a new diagnosis we don't have enough data yet, so if anything I say sounds off or doesn't apply to you feel free to ignore it. With that being said, let's see..

How long ago did you switch Salem to low carb wet food?

He seems to be doing okay with the 2 units. I know it's scary starting out, but really you're mostly looking for him to be under 200 before we start skipping shots or reducing doses. If he was reading in the 300s for PS then getting 2 u and dropping to greens/lime greens then we would start considering reducing his insulin. I saw on his SS that his levels rose a bit after the 1.8 dose, so that pretty much tells you that he's doing well with 2 units. He could even need more than that, but again that all depending on when his low carb diet was started and the testing data that you'll gather over time.

The good news is that he is very well out of hypo ranges on all of his numbers, even the blue ones so hopefully that helps you feel more relieved I see that you have a couple of mid cycle tests too which is great! Those tests are crucial in helping us determine where to go with his dose, so keep getting them in whenever you can (once-twice a day between +3 to +6 time).

Being new to testing, the magic number you're looking for is 200. If he's below 200 for PS then skip, and make another thread titled something like "New to testing, PS under 200" and someone will be able to help you decide what to do for the next shot!

You're doing great being so vigilant and getting in all the testing. It will pay off in the end!

Do you have a hypo kit set up for Salem? (Cans of FF gravy lovers, Karo syrup, etc.)

 

[AmyB]

Hi Harukyo,

That makes me feel better lol I’m just panicking about all of this a lot. It’s been pretty overwhelming and while I like my vet they’re just checking his BG once a week and making decisions on that which I’m not sure I’m entirely comfortable with. He seemed supportive of me home testing so I’m going to talk to him about that today. I agree that Salem might need a little more than 2U but not too much more. I’m off for a couple of days later this week so I’m going to try and do a full curve. How accurate are they over time? Like if I do one one day is that about how his numbers are in general? I’m trying to feed him the same amount every day but it’s hard because I have two cats and he’s always trying to gobble up the other cats food. I switched him to wet food at about the same time I started insulin and I’ve recently researched and I’m only getting the low carb ones now. It’s just difficult bc I’m also watching his calories bc he needs to lose a few pounds.

 

[Harukyo]

It really is overwhelming, there is so much info to go through. Take your time reading through some of the stickies in this forum because they are really helpful.

I'm in the same boat with a cat who needs to lose weight, and honestly, I think its best to tackle one thing at a time. Theres a lot of variable going on right now and so its going to be kind of hard to narrow on one thing like his BG levels since we won't know what exactly is contributing to them. I'd work on having him lose some weight after getting closer to regulation. Thats what my vet and I agreed to do for my cat. As far as having multiple cats, I just feed one in one room and keep them separated until they are done. I even ended up putting my other non diabetic cat on the same food and schedule so I didn't have to worry about her eating kibble. Some other members might have more advice on that, I know its kind of tricky to balance that on top of all the other diabetic stuff..

Also yes, checking in once a week at the vet is not only not affordable for most people, but Salem's numbers can be influenced by stress there. Home testing is the best way to get the most "accurate" readings. I put accurate in quotes because using a human meter doesn't necessarily give you what his ACTUAL blood glucose readings are compared to a pet specific meter like an Alpha Trak 2. However, that being said, the majority of users here (including me) use a human meter because of how much more affordable the test strips are (which you will go through a lot of them) and because when you track the data on your spreadsheet, it pretty much mimics what patterns you'd get from the pet specific meters anyway. Also don't even bother comparing the pet specific meter numbers to human meter numbers because there is no conversion for them. There is a 20% +/- meter variance on any reading and you'll drive yourself crazy (like I almost did) if you try to compare the two side by side. So pick a meter whether is a human meter or pet specific meter and stick to it!

As far as the curve, you can't say that the numbers will stay the same over time, but the pattern of Salem's blood sugar levels dropping and rising will be about the same (though that too can change sometimes). If you do a curve (testing every 2 hours during a 12 hour cycle) what you are looking for is a pattern for how Salem reacts to the insulin. For ProZinc, an example of a normal curve will be high AMPS/PMPS, +2 same to lower, +4 lower-lowest, +6 low, +8 rising ,+10 rising, then back to AMPS/PMPS. Now, Salem's curve might look different from this and thats okay! ECID - every cat is different, and thats why having at least one curve is important because you will be able to predict around what time he will need monitoring (whether thats 3 hours after the shot or 5 hours after the shot).

After you've establish his pattern, you won't have to test him every 2 hours, but rather around the time he would be dropping to his lowest point. That reading is what we usually use to determine if he's getting the correct amount of insulin for him at the time.

The fact that he has switched to a LC diet can start influencing his blood glucose levels which is why he may have dropped from 300s to 200s and thats why its super important to always test before you feed and give insulin.

The most important things I have found in managing this disease and getting my cat into remission is consistency, testing, and making sure they don't have access to ANY high carb food. My kitty is a kibble addict and will even eat dog food if its there! Crazy cat.. anyway, let me know if you have any more questions or if I can better explain something!