? Don't know what to do - PMPS low

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AmyB

AmyB

Member Since 2019
Posting this to the main forum so more people might see it.

This is Salem's second dose of 2.5U of Prozinc. I'm still working on getting him regulated so I'm still not 100% sure when his nadir is. I just took his PMPS on the AlphaTrak2 and it was 132 which seems way too low to give him anything, but I called the vet earlier and asked him about it and he thought it would be okay since his BG goes up a lot after he eats. I just don't know what to do cause it's like he hits nadir around +6 and then just goes flat with this dosage. I didn't give him his shot last night after it being 168 on the AT2 and he shot up into the 400s and stayed there all night. I just don't know what to do, do I skip this shot again or give him a lowered dosage (like 2U) and then check on him all night?
 
I wouldn't skip because you've seen what that does to his numbers.

Can you test as much as you need to tonight? Do you have plenty of supplies like testing strips, high carb food and/or Karo/honey/syrup?

Have you fed him yet? If not, try waiting 20-30 minutes and testing again
 
Just retested him and he's at 138 :(. I have all of the supplies and I don't work tomorrow so I can wake up and test him. I don't want to give him 2.5 if I do give him his shot, and the vet said I could lower him to 2 for the weekend since I'm working. I don't know if the 2.5 dose is too high. I just don't have a lot of data yet which makes me nervous.

Last night when I skipped I tested him +2 after eating and he was in the 400s, which means hopefully after eating he'll shoot up a bit?
 
It normally doesn't hit him until at least +3 so I'll have to keep an eye on him all night. I just still don't know how exactly Prozinc works so I don't know how to be safe with it? Like if his BG shoots up after eating surely it's okay to give him some? It's just hard for me when the advice on here is different from what the vet is telling me, but I want to be safe and I really can't afford an emergency vet visit rn.
 
That's why we test....to keep them away from the ER vet!!

In the 6 years I've been here, I've never seen ONE cat that had to go to the ER when the caretaker was testing except for one time when a cat was accidentally given a double dose.
 
That makes me feel better. I'm going to go ahead and feed and then give the 2U. I'm going to keep him on 2 all weekend just bc I won't be home to watch him, but I'm going to test late tomorrow to see what it does when his nadir hits. I just don't understand why he's dropping and just sitting there on the 2.5. Guess I'm going to be up all night!
 
Not necessarily.....let's see how the cycle goes.

Are you going to be using only the AT meter for now? Because you have 2 spreadsheets.

You don't have a lot of data on how he was really doing on the 2U since you didn't get many mid-cycles ...it's possible a dose like 2.25 might work better for him but let's see how it goes for now
 
I have both the AT and the Relion, and I've been using the AT but now I'm running low on strips for that one and I'm going to save them for emergencies. I have plenty of strips for the ReliOn though so I'll use that tonight unless he gets super low. I just tested him with the ReliOn and it was 90. Would the 2U be okay or would something like 1.5U be safer? And yeah the problem is the vet was testing him at around +4 and based it off of that which now I'm realizing he nadirs later so I'd like to try the 2U for a few days and get some data on that. I know the ReliOn runs lower, but it's not too much lower usually.
 
I would do a lowered dose. Especially if it shot up last night after no shot. 2u sounds ok. If you’re very worried do the 1.5 tonight but still test tonight several times if you can.
 
I'm setting alarms for every hour lol. He just ate a decent amount so I'm going to go ahead and give the 2U. This is just so stressful but I'm hoping I'm close to figuring out his dosage. It's only been 3 weeks since he was diagnosed. The vet also thinks he has some kind of intestinal disease so I have that to deal with too.
 
I totally understand. I’m up late with mine even though I got 3 hours sleep last night cuz she had a low. Tonight we on lower dose but at +4 she is at 85 I think I will be testing again in an hour. So tired my eyes feel like they gonna fall out.
 
Oh no, that sounds rough. Does it get easier once they're regulated? I'm prepared with a bunch of food and Karo if I need it. I just hope I can get him to eat it if I need to.
 
It does get easier. She was regulated for awhile and then her surgery/teeth cleaning threw everything off I believe so now I’m having to back her dose way back down. I’m doing a curve since I’m off tomorrow and I’m even thinking I might lower the dose another .5 to 1.5 for the curve. This was 2u tonight. She just got herself a snack lol she is happy about it. You can never test enough. My vet is always like you don’t have to test like that. I would rather be safe than sorry. If I didn’t I would have known she was at 36 last night. Trust your gut.
 
Yeah I'm trying to balance what my vet is telling me with what I'm learning on my own. I want to trust him and I do, but I'm a very anxious person by nature and I can't stand doing all of this without knowing what is going on. I'm backing him down to 2U until I get more testing in bc I feel like 2.5 is too high. And yeah I would much rather cost myself a night of sleep than something happen. Not that I can sleep when I'm this worried anyways.
 
I know it. It’s hard to sleep when you’re worried. I had to switch vets because the one that diagnosed Kya said oh only once a day with the insulin. Um not!! She got super sick and had to be hospitalized for 2 days. I took her somewhere else for hospital and treatment. I like the ones we have now but sometimes I’m like umm no. Then she goes for checkup and they do BG test I show numbers and they say yep doing a great job. I have to say yeah cuz I test her daily.
 
Okay he's up to 185 +1 on the ReliOn but he doesn't hit nadir until around +6. I'm going to be panicking all night aren't I. I feel like I should have given him a lower dose but I made my decision so now I have to stick with it.
 
AmyB said:
I'm going to be panicking all night aren't I. I feel like I should have given him a lower dose but I made my decision so now I have to stick with it.
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Not necessarily.....he may be starting a bounce but yeah, you're going to need to test for another couple of hours to be sure.
 
bounce: when cat's liver releases glucose to the blood when cat's system senses that the BG is "too low" or "fell too fast"
food spike: when cat's BG rises because cat ate carbohydrates (and sometimes fat will do it)

the "too low" is in quotes, because it's not actually too low in relation to what normal BG is, it's lower than what cat has become accustomed to
 
Sometimes the BG starts to drop to rapidly so then the body freaks out and dumps more glucose into the bloodstream because it’s not used to having a lower BG.
 
Bounces happen when 1. they drop too low, 2. they drop too quickly, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3)

The liver releases stored sugars and hormones to bring the blood glucose back up quickly. It can take up to 6 cycles for those sugars and hormones to clear out of the bloodstream
 
Hmm I haven't been testing him enough to know what his actual lowest number has been, but yesterday it was 89 at +6 on the AT2 and then it stayed in the 100s until last night when I didn't give him a dose and he ate and it shot up to the 400s. Does the insulin have to wear off for him to bounce or does it just happen whenever?
 
I would bet that 407 this morning was partially a bounce from the green yesterday and partially from the NS.

I would have shot that 179 last night or stalled without feeding for 20-30 minutes and re-tested.....I would bet that number would have been higher due to the bounce kicking in so it would have been safe to go ahead and shoot.
 
Yeah, that makes sense. I mean when I talked to the vet he didn't sound too concerned about me giving him his dose tonight, but he said to keep him on the 2U this weekend. I need to do more late cycle tests on the 2U to see what it does I think. The vet made it sound like the longer they're on a dose the more effective it is? Which he wasn't on the 2U that long.
 
He's already dropped to 140 +2 and his nadir isn't usually until +6. Should I just keep monitoring?
 
AmyB said:
He's already dropped to 140 +2 and his nadir isn't usually until +6. Should I just keep monitoring?
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That's about the same as the 132 PMPS (AT) and higher than the 90 (human) so I don't think there's any reason to panic.

I'd get a +3....you could always give him a small snack of his regular low carb food to encourage him to surf.

It's really important for you to decide on one meter to use from now on. It gets really confusing trying to go back and forth between meters/spreadsheets.
 
I'm just using the human meter right now. But with ProZinc the Insulin starts working at 2-3 so he won't get lower until 5-7? He's been eating off and on at least.
 
AmyB said:
But with ProZinc the Insulin starts working at 2-3 so he won't get lower until 5-7?
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not necessarily....if our cats would read the manual, you'd be right....but they absolutely refuse to do it!

The +3 should tell you if you need to continue to test ….if it's lower, than yes, you're going to want to test again later (depends on how much lower to make the decision of whether you need to test in 30 minutes or a couple of hours)
 
I'm just terrified bc I thought his numbers would be higher after he ate but they haven't risen that much and based on what I've gotten so far, he falls a lot after +3.
 
I do, I just don't know when I need to start giving it. I just don't know how I'm going to make it another 5 hours.
 
If he were to drop a significant amount between now and the next test (like from 140 to 110 or less) you could give him a teaspoon or two of medium carb food to slow him down.
 
That's okay, I understand. I'm just going to try and make sure he eats a snack here and there and I'll give high carb if necessary.
 
AmyB said:
That's okay, I understand. I'm just going to try and make sure he eats a snack here and there and I'll give high carb if necessary.
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We have a tradition here....if someone tells you to shoot on a lower number than you're comfortable with, they agree to stay on with you as long as necessary to make sure everybody is safe.

I knew that when I suggested you shoot the 2U....and if I couldn't find someone with experience to take over, I would stay up as long as necessary to make sure you were comfortable and Salem was safe.

Bron is in Australia so it's earlier there....and I'd trust her with my own cat
 
Thank you all so much. It's just been rough dealing with all of this by myself and I'm trying to listen to the vet and do my own research but it's just a lot to handle right now and I've been very overwhelmed.
 
AmyB said:
Thank you all so much. It's just been rough dealing with all of this by myself and I'm trying to listen to the vet and do my own research but it's just a lot to handle right now and I've been very overwhelmed.
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We all know how you feel. Its a crash course in feline diabetes 101.
But its a great feeling when you figure out your cats patterns & how to keep him/her level with the bg. Its like you want to do a little embarrassing dance that your cat will give you a funny face for...lol:p:D:joyful:
 
It's at 84 and he just ate some more food like 10 minutes ago. Should I try giving him some more?
 
It was some FF Naturals in Gravy. I'm assuming the gravy part might bring him up a bit?
 
AmyB said:
It's at 84 and he just ate some more food like 10 minutes ago. Should I try giving him some more?
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I’d give him some medium carb food as Chris suggested.... not too much a couple of teaspoons. We don’t want to fill him up. Just confirming you are using a human meter?
 
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