Day 3 of FF Classic PMPS=125, +6=79

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greenae

greenae

Member Since 2013
Bubbles got her first green BG tonight. Feeling nervous about going to sleep, so I gave her 2 spoonfuls of Medley with the 79. I hope that was ok to do? If you can, please look at her SS and tell me what you think?
 
You should try to stick with low carb unless Bubbles drops below 50...the idea is to give enough carbs to slow them down, but not send them too high. The problem with giving a higher carb food so soon is that you won't know for at least 2 more hours if it's the food that's keeping the number above 50 or you're past the nadir and it's safe to go to bed.

We usually recommend that if you have a pre-shot number under 200, that you don't feed and ask for help so we can walk you through the first few times. As you get more data on how Bubbles reacts to both insulin and food, that number comes down

You don't really have enough data yet to know when Bubbles nadir is...it can skip around, so to be safe, I think I'd not feed any more and retest at +7..see where she's at

I'll see if I can find some more experienced eyes to help
 
Re: Day 3 of FFClassic. NUMBERS DROPPING, I think

I can't test during weeknights because of sleep/work. She was 123 this am and I fed 1 can FF Classic. So her "treat" while testing should be Classic? I have many Medley cans (before I knew carb content). I use a teaspoonful as a treat while testing. I gave 2 tsp last nite when I got 79. Don't want hypo but don't want blue either. Have been isn search of her nadir. Please let me know what you think. I only shot 1.5u this am cuz I have work.
 
So her "treat" while testing should be Classic?
Click to expand...

Everything Bubbles eats should be low carb unless you're purposely trying to get her numbers up. Lot of us use freeze dried chicken or there's a list of low carb treats you can look at. I just buy chicken when it's on sale, boil one piece, chop it up and freeze the rest.

Bubbles numbers are really looking pretty darn good!
 
Re: Day 4 of FF Classic +8=86

My second GREEN (My favorite color!)
Should I keep dose at 1.5u PZI q12h, or go by her PMPS?
THANK YOU ALL!
 
I would keep to this dose unless she drops under 50 - her numbers look good. This weekend I would do some spot checks at various times to make sure she isnt dropping low at other times. Plus we need to let this dose settle.

Wendy
 
Ok, so 1.5u q12h, unless I get wacky numbers. And I will spot check at different times during the 12h. Thank you!
 
PMPS =137, gave 1.5u PZI, +6 =93

So now do I continue giving 1.5u, or do I go back to 2.0u to get all green numbers? I have not seen any signs of hypo.
 
You need to hold the 1.5 for at least 6 cycles. Let's see where she's at after you get some more tests in before seeing if she needs to go back to 2 units.

She's really got some pretty great numbers as it is!
 
And, if after holding the dose, it looks like you need to increase, only increase 0.25 units. You'll have to eyeball it, as syringes don't measure that finely.
 
Day 5 of Classic, AMPS=143, AMPS 4 hrs late

I am guessing I stay at 1.5u as long as her numbers stay under 200? I am wondering if 2.0u would keep her numbers green? But I know I don't want to risk hypo. I have given shots below 150 without a problem, but that was when I lowered the dose. Don't I want her always "green?" I am a little confused. By lowering her dose, I am changing vet's orders, and raising her numbers. And using ReliON, so aren't her numbers really about 30 points higher (at the low end)? And I think I know the answer...need more BG testing.
 
There are people here that won't shoot a cat if their BG is under 200. At some point, you need to start shooting the lower numbers, even if you are using Prozinc. People using Lantus and Levimir learn to shoot low.

The key, is knowing how low your cat drops from the pre-shot to the nadir. Knowing this, you can gauge different amounts of insulin to shoot based on the preshot numbers and the patterns you have built up with testing. You would be building a sliding dosing scale.

Know thy cat. It's key.

So yes, some more testing would be helpful.

Yes, you do want to see more of those greens. Just not ones under 50, our built in safety margin kicks in at BG's of 50 where you want to be able to monitor more closely and feed to bring the numbers up a bit if necessary.

The food change in combination with the lower dose seem to be helping a lot. I don't think you want to raise the dose back up to 2U at this point. Give the food change a few more days, then we reevaluate.
 
Thank you. Thankfully testing has gotten easier with Bubbles, Having Time to test, is the problem. I am trying to get numbers all over her cycle. I guess the "Don't shoot below 200," has me confused. I want to keep her on schedule, and I do want GREEN. I will keep her on 1.5U PZI for a few days, but I think my vet may not be happy I changed her dose. (He has been great!) And I was really happy to see that even 4 hrs late, she was at 143.
 
I do not agree. ProZinc works very sifferently than Lantus, which gives you a longer time to react to a low. Even experienced ProZinc users seldom shoot under 150, and then only a tiny dose. I would suggest testing at +2/3 and nadir to make sure she doesn't go too low.
 
You may shoot as low as 150 mg/dL on the PZI type insulins. Move down to that gradually and get mic-cycle tests to make sure you keep safe.

For example, you might set 190 mg/dl as your no shot limit this week, 180 next week, then 170, 160, and finally 150 ... if your mid-cycle tests show it is safe (does not take the glucose below 50 mg/dL)
 
Ok. I think I am getting confused. If I don't shoot below 150, am I delaying the shot, or am I skipping it? If I delay, am I waiting til her number goes above 150? If I skip, I am just sending her numbers back up, no? My understanding is that PZI peaks at 6-8 hrs. Her lowest number was 79. The ReliOn tests about 30 higher at the low end? So, her numbers are not hypo, and she hasn't had any signs of hypo. I want Bubbles safe, but I also want her BGs normal. I will test as much as I can this weekend. going to get a + 2 right now. Thank you so much for all of your help, I don't want to break any "rules" but I want her BGs normal. I know I am new to feline diabetes, but I have experience with humans, so I am a bit aggressive with her treatment. My fingers are crossed every day for the past 3 weeks.
 
When you have a pre-shot under you no shot limit, wait without feeding for 30 minutes and re-test.
If the number is rising, you may be good to go. If you are concerned, you may want to reduce that dose a tad or monitor around nadir.
 
There are no "rules". She's your cat and you hold the needle. We aren't vets so we are just sharing our experiences. It's a peer reviewed board and if we disagree with someone's advice, we say so. Deb is very experienced with Lantus and they do "shoot low to stay low". It is not advice I would give to a ProZinc user. As BJ said, when you get a lower preshot, wait and see if it is sure rising and give a reduced dose.

One of the factors here is that she is adjusting to a diet change and the insulin. Her patterns are still unpredictable and my personal bias is for new users to err on the side of caution.

96 at +2 is a sharp drop. I would test again at +3.
 
Day 5 of FF, + 2=96

Thank you all for your advice, I Really Appreciate it! And I am going to test again in a bit. I can see that these lower numbers have her pooping in the box again and less urinary output (Yay!). So now I see that if her number is low, I can wait, re-test, and if it's going up, I can shoot. Sheesh, on weekdays, Work has to get in my way...but this weekend I will monitor more closely, now that testing no longer a battle.
 
You might want to shift your shot schedule 30 minutes earlier so you can do that!
 
Day 5 of Classic, +4=71

Good idea! But 5a seems so much earlier than 530a... :smile:
Her numbers are dropping before typical peak time of PZI. I am watching very closely. No signs or symptoms of hypo. Awake and alert. She is now my ICU patient. ;-)
 
Glad you are watching. Do you have some higher carb food avaialbe and some honey, if needed? If she drops below 50, first feed a little regular food and retest in 15 minutes. If she is still dropping, feed a few tablespoons of higher carb foos and retest. If she is in the 40s, you'll want to test often and watch carefully, maybe putting some honey on her gums. Post with a 911 icon so people can help you. It takes two rising numbers before you can relax.

I hope she doesn't drop that low. I figure if I give you the info, you won't need it. :mrgreen: The drop from +2 has slowed a little, so that may be a good sign.

FYI. Often there are no real "symptoms" until they are very low and in dangerous territory. If she howls or loses vision or begins to act strangely, it is likely time to go to an emergency vet.
 
Who has the 'patience pants' pic to post? :lol:

The sugardance is a marathon....not a sprint. ;-) :roll:

My sugar-kitty was diagnosed in February of 2013 and with the help of everyone here (especially on the PZI board), we are still working on dosage amounts. I keep my ss very up-to-date and through testing/member advice/etc. after so many months been able to make good judgments regarding how much to shoot at what numbers. It does take time to be able to do this ... your ss info will be very important to help you make decisions (when you are more experienced) and help others help you along.

Back in March....my vet told me to give RumpelT 1.5 units (we use ProZinc) twice a day and to only test at AMPS/PMPS. Well......RumpelT HYPO'd at that dose !!!! Good thing I had already been a member of FDMB and was home testing before this "vet instruction" + members helped me through the hypo....I had called vet who was not in and did not call me back until the next day !!! Can't wait until next vet appointment (only go when I need more insulin) to see her face when I show her how good RumpelT is doing on such low doses.....heeee heeeee.

Thanks to my ss and members here, RumpelT is on very very very low doses now and is doing well....has her bounces every now and then, but we know how to deal with them.

I have a goofy work schedule (especially on weekends...ohhh geee...that starts tonight :roll: ) + 6 civvies to feed on RumpelT's schedule. :roll: BUT...we work through it every day.

You are doing good so far....Darn....who had the "patience pants" pic????? Someone posted it to me a few times in the beginning. :lol: I wanted quick results in the beginning too, but I have learned many new sugardance "steps" since February. I have nicknamed RumpelT "Tigger" (bounces) + "Rubik's Cube" (she has puzzling numbers sometimes) + "Stinky Poop" (wow...smells up the whole house) . :lol:
 
Pick a pair you like...We have lots of pairs of patience pants!! :-D

images
 
If you never shoot lower than a 200 with Prozinc, how do you ever get a cat into remission with Prozinc? I was saying she needed to gather data, so she would know how her cat reacted to different doses, and learn when she can shoot some of those lower numbers. The shoot/no shoot threshold of 200 is a generalization for new members. ECID. I wasn't suggesting she shoot low to stay low in every instance. I was suggesting she lower the shoot/no shoot threshold as she gathers more test data to show it's safe for her cat.

Would I suggest she shoot her cat under 100 on Prozinc? No, absolutely not. Is every lower number shootable with Prozinc? Of course not! At some point that shoot/no shoot threshold can be adjusted. Yes, Prozinc has a quicker onset, a steeper curve than Lantus, doesn't last as long, rarely the entire 12 hour cycle, but you still want to see those green numbers at mid-cycle when using Prozinc, to give the pancreas time to heal and repair the damaged cells.

I suggested she build up the test data, so she can develop more knowledge of how her cat reacts and possibly develop a sliding scale for the dosing of the Prozinc, since Prozinc is one of those in and out insulins that can have the dosing at least partially based on the pre-shot (PS) number. For example, if the PS is 200 then 1.5 U, if the PS is 150 than .75U insulin, if the PS is 300 then 2U.

If she always skips the shot if the BG is under 200, how is the cat ever regulated? How is remission ever possible? I know it can happen with Prozinc kitties, but it sure doesn't seem to happen very often here.

During the week, when you're away, you may not want to shoot those lower pre-shots, because you will not be around to monitor and see how she's doing.

This food change looks to be having a very good impact on those numbers. Your vet may not like the fact that you lowered the dose, but with the food change you are doing, it was the safe thing to do. You may need to lower the dose again, and soon.
 
Deb, maybe it would be better if we discuss philosophy via pm. This am her cycle was 16+ hours and she had a 143. She has only been on insulin 10 days and recently changed food. As I said, Pzi users shoot below 200 when they have data. Some shoot at 150 - seldom lower - most have a threshold of 170 - 180 when they have data. She can be as aggressive as she feels safe being. I gave the advice I felt comfortable giving, having dealt with PZI kitties for 8 years or so.
 
You guys are great! I love seeing the pros and cons, it helps me learn. I probably don't have a lot of patience when it comes to dealing with deadly diabetes. I want results, but not at the risk of harming Bubbles. Thanks to all of your helpful hints, testing is no longer a problem. I am happy to say her +6=96.
A 150 with the ReliOn is not my goal. I prefer 70-90. 20 years ago, we were happy to see a human with 150, now it's 100. Similar, but different, I know.
Bubbles is 15, and I am trying to extend her life. I was ready to let her go. Your forum has changed everything for us. I am not trying to rush this marathon, just trying to give her normal cat BG. A GIANT THANK YOU!!!
 
You forgot about the treats for you ;)

Numbers are looking good today though - will be interesting to see the PMPS. You might want to get a +11 so you can come here and ask for help if it doesnt look like she will reach 150.

Wendy
 
+10 =129
Heading back up. so, 1.5u is ok, methinks? I'll see what her PMPS is in a bit. What do you think?
 
Is this 10 from the time of the am shot or her normal cycle +10 time?

I tend to be conservative when advising new diabetics, so you need to do what you think. She has consistently been coming down on smaller doses. It is harder to monitor at night. I would not shoot under 170 or so and i wouldn't shoot more than one unit. Your 1.5 worked on the 143 this am. But only 20 points lower would have been in hypo territory.

You hold the needle. She's your kitty.
 
Thanks, Sue. I just got 121 at 11.5 hrs. My "+" numbers are always number of hours from the previous shot. So she is about ready for the PM shot and a late dinner.
 
Lowered Dose to 1.0u PZI, Day 17 of insulin, Day 5 of Classi

+4 = 110. Lowered to 1.0u of PZI after PMPS=121. Wonder how this will play out? Gonna be a long night. Why do I have a feeling numbers will go up?
 
I am not a PZI expert and I think Sue said not to shoot under 150. But if you do, I would use 1 unit. If its under 100 you might want to skip and see how he does today without it.

Wendy
 
Prozinc is not Lantus.
99 is a "nondiabetic" BG number. It is within the normal range of 40-120.

You could stall without feeding to see if it comes up to 150 or so.

The "trick" to shooting low numbers with Prozinc is to adjust the dose down depending on the number you get at shot time.

I personally, would never advise a caregiver to shoot below 120 with Prozinc. You don't give insulin on a number in the normal range. It might work well with Lantus, but with Prozinc, it's like asking for a hypo.
 
I started a new post with her 30 minute retest. Thank you for your input. I am torn between wanting her to get some insulin to keep the good numbers, and worrying about hypo, and not wanting to throw off schedule.
 
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