failing miserably at this

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Holly and Josie

Holly and Josie

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I cannot seem to get my kitty Josie regulated at all. Her numbers were starting to look good for a few days late last week, but then she was diagnosed with a urinary tract infection and things have been a mess ever since. Her BG's go extremely high, extremely low and back again. I have no idea if she is rebounding?

She went hypo this afternoon, although there were no symptoms. This is not the first time and she's only been on insulin for 5 weeks. I am trying my best but I feel like I am failing her and myself.

I do home test, thankfully. It isn't easy and I am terrible at it and my husband is only a little better. Her poor ears look awful. I feel like a monster.

My husband gave her 1.5 units of her ProZinc at 12:30 this afternoon. Her BG was at 299 before the injection. She usually gets 1.5 units around noon and 2 units around midnight. I know those are weird times but my husband works evenings and he is the better tester/shot giver of the two of us and that is when he is awake and home. Anyway, as I said, he gave her the 1.5 units at 12:30 and at 4:30 I had him test her. She was at 29. 29!!!!!! After just 4 hours!!! So he gave her some Karo (a teaspoon?) and some high carb canned food with gravy. She climbed pretty quickly. At about 8 hours after her injection she is at 379. I feel horrible. We obviously completely overdid it.

I don't know what I'm doing here. I'm afraid I'm going to seriously hurt her. Her numbers have gotten that low once before and pretty close a few other times. (On Monday she got to about 59 after 5 hours.)

I am frustrated, stressed out and terrified. I am also having trouble with the medication she is on for the UTI. First she was on Clavamox, but that made her sick. Now she is on Albon liquid. Supposedly, this medication can cause hypoglycemia and that could be the problem with her numbers, but I don't know. Her numbers were pretty steady yesterday even though she was taking this medicine. She has also gotten really low numbers like this before the medication, so I'm thinking it's something else.

The one and only constant I can figure out is that when she does go very low, it is always, ALWAYS around 5pm. So I don't know if her pancreas is kicking in then? Or if it's a food issue? Or if it is the medication? She never goes low like this at night. Only in the afternoon.

I have no idea how much insulin I should give her tonight.

I am lost and I feel like I am failing my poor Josie Belle. I'm completely heartbroken. I would welcome ANY advice anyone could give me. I feel like I am losing my mind.
 
Well, first thing you should do is to change your subject to something catchy like
Unable to regulate on PZI Dropping low, please help

that should be enough to catch the eyes of people who know PZI (not me)

Now about your failing miserably, that's not true.... you just haven't found what works for Josie, that's all.

OK you are home testing... great! people are going to say let me see these lousy numbers and we can point out what is going wrong.
Here's a link that seems to be the latest for creating a spreadsheet in which you can record your BG test numbers.
Create your Spreadsheet

Next, food, what are you feeding and when because it will make a big difference to your results.

What meds is Josie on now and how are they working.
What about any ongoing health issues aside from the UTI.. the UTI is confirmed as cleared?

I don't know about the hypos, but maybe the insulin dose is too high or maybe you can manipulate Josie's numbers by feeding mini-meals every hour at the start of the cycles to see if you can slow down Josie's crazy big drops.

It's so tough in the start; so much info to learn and interpret, and so much adjusting for Josie as well. Quite often, we don't know how long our cats have been diabetic and through no fault of ours because our cats are sly and hide how they are feeling pretty well, so give yourself a break and just keep plugging along and in time, you, your husband and Josie will be just coasting along, routine in place, a smooth running machine.

I can't help you with the insulin you are using, but you have already come quite a ways for only a month, so give yourselves pats on the backs.

Give it some time, for the insulin to settle, for Josie's body to adjust, and for your routine to be in place.
 
Hi Holly -

Sorry to hear Josie's having a rough go of it. I'm only about as experienced as you, so I don't know I can offer that much help, except to say that I'll be on for a while and if I can offer any assistance - like bringing some of the more experienced folks over to respond, I'm glad to do that.

The only wisdom I feel comfortable sharing is that if she's going too low, you need to decrease the dose. However, it sounds like you're already on top of things, as you were able to address the low numbers very effectively.

Good luck!

Lu-Ann
 
Hi Holly,
Deep breath hon, more than one...as many as you need. In mid-may last year, I was "you" right now. Ten weeks later, using pzi, my kitty Bob stopped needing insulin. I had no clue what to do, didn't even know a cat could have diabetes. The fact you looked for and found this place tells us you want to do the absolute best for Josie. We'll help you do just that.

First thing. Why not kick back the dose to just 1 unit for the next couple of shots till we can help sort out his numbers? Also, when does Josie eat each day? If he always dips around five pm, then maybe you can adjust his feeding times to deter that from happening. A small meal around 3 or 3:30 can boost that low up to a safer number.

I'll try to get some more PZI/prozinc eyes to see this and chime in.

Breath again
Carl
 
First let me say that you are not failing at this.

I want to help you, but I am not totally comfortable advising you on this alone. I use Prozinc--- I am going to go to the PZI board and link your post and see if I can get some other people to chime in. In the meantime, can you post the test results that you have for the last few days, in a form similar to below, so it will be easier to see what is going on?

AMPS 000
+2 000
+6 000
 
You are doing so many things right for your Josie. If you hadn't been home testing, you wouldn't have caught the low numbers and it could have been very dangerous.

I don't know about the medication. Did the vet say it lowers bg levels? You got some possible alternatives in your other thread.

Her numbers are pretty good. If she were mine, I would probably skip tonight because of the hypo. Her high number tonight can be a bounce from the low and a reaction to the high carbs of the syrup. After tonight, I would start over at a low dose - maybe one unit twice a day - even if she is high tomorrow am. (that can be still be a hypo and the cycle without insulin if you skip). I like Carl's idea of feeding her at that low point.

One of our mantras is better too high for a day than too low for a minute. Once you get down to a basic dose, you can always rise if the numbers indicate. Get your spreadsheet up and come over to the PZI forum. Members post their numbers daily and get advice and feedback. We can look at her history of doses and numbers and help you figure it out.

You don't have to be alone. The forum can be a support system for you. Everyone is in the same boat and ready to help.
 
Hi Hollie and Josie and welocme,
You are doing a great job! The hardest part is in the beginiing
you will gain more confidence as time goes by.
I would definately reduce the dose tomorrow and not shoot tonight due to the hypo
If the vet said that the medicine can cause Hypo's I might even shoot .50 unit tomorrow
There are so many variables, but eating is important, Carl is right about some midaay food
to help bring Josie up
hang in there and we are all here for you.
ask any questions you might have and feel free to vent away
 
Hi Everyone. Thank you so much for all of your responses. I am going to take a deep breath (as suggested by some of you!) and reply to all of your posts in just a minute. I REALLY appreciate your support and encouragement. Thanks so much.
 
Holly and Josie said:
Hi Everyone. Thank you so much for all of your responses. I am going to take a deep breath (as suggested by some of you!) and reply to all of your posts in just a minute. I REALLY appreciate your support and encouragement. Thanks so much.
Click to expand...

Holly,

Believe me when I say that how you feel right now is how every one of us has felt before.
We have been where you are now, and we can help you to get where we are now.

To know the road ahead, ask those coming back.
 
Gail Shadoe and Oliver - Thanks for the link to the spreadsheet. I am going to try to get on that tomorrow!

About her food... She is currently eating Innova Evo Grain-Free with some low carb wet as well. I would like to transition her completely to wet, but I am actually scared to do so. Her numbers are so unpredictable that I'm afraid of what will happen if I do.

About her meds... the only thing she is taking (other than insulin) is Albon Liquid for her UTI. She still has another 7 days or so to go on that.

Grayson & Lu - Thanks for your encouragment! I'll take anyone's advice that you might happen to send my way!

carlinsc - That is awesome that your kitty is now off insulin. It gives me hope that someone who was also having a rough time was able to come so far!

I was kind of thinking about doing just 1 unit for awhile until I could get this sorted out. She usually gets 2 units at night so maybe that would be OK?

Josie free feeds from the dry food above. We always feed her some wet before her injection. The problem is that how much dry she eats varies a bit from day to day, which I think is impacting her numbers.

OK, I will respond to the other posts in just a minute! Thanks guys so much for your help!
 
Holly, you've found the best place you can be. I still freak out regularly and everyone comes to help me thru it. We'll all help you too.
 
kse - Below are her numbers for the last few days. Thanks in advance to you and/or anyone who is willing to take a look at them.

The confusing thing is that she gets her injections at midnight and noon. So I guess we'll call the midnight shot the AM Shot and noon the PM shot.

Monday
AMPS - 225 (gave 1.5 units)
+6 - 142

PMPS - 424 (we had just come back from the vet and I think she was stressed.) (We gave 1.5 units)
+4 - 104
+5 - 66
At this point I gave some high carb food and 15 minutes later it was 59. I then gave a small amount of Karo and 15 minutes later it was 89. 15 minutes after that it was 151.
+6 - 213
+9 - 302

Tuesday
AMPS - 373 (gave 2 units)
+6 - 204

PMPS - 158; waited an hour, retested - 243 (gave 1 unit)
+4 - 235
+6.5 - 249

Wednesday
AMPS - 360 (gave 2 units)
+6 - 253

PMPS - 299 (gave 1.5 units)
+4 - 28 (tested again - 29)
At this point we gave high carb wet food and 15 minutes later it was still 28. We then gave Karo and 15 minutes later it was 60. I gave some high carb dry food (20 pieces?) and 15 minutes later it was 99.
+5.5 - 146
+6 - 231
+8 - 379

Gosh, just writing this I feel like a jerk. I think I needed to give the high carb food today, but on Monday I think I overreacted. And I am wondering if I should have given any Karo either day. She was basically without symptoms both days, I just happen to get lucky and catch it.
 
Welcome Holly and Josie!

I'm pretty new to this so I shall just say welcome! This is the best place to be for advice.
 
KT's 5 steps to learning this dance:

* My cat has diabetes, poor baby, he's so sick, he's going to die
* OK, how do I treat this? I can't stick my cat
* I can't do this! I'm failing and I'm killing my cat
* See! I CAN do this!
* 60 seconds down and all done, treats given

Look! You're already THRU step 3 and embarking on step 4! I can't help with dosing but the experts already here can do that.

HUGS! YOU CAN DO THIS JUST FINE!!!
 
No, you are not a jerk. You are trying to learn a lot of things in a compressed time period, and it's hard. That's why the PZI support group forum is so important. Someone else has already gone through what you are going through, and they can help.

The second low number is much easier than the first. You did a great job today. This stuff doesn't come naturally. There is a ton of info on this site which we will be glad to share, but it takes time to absorb. Until then, use what others have learned and applied.

I'd think about one change at a time. I'd reduce the dose and start posting on the PZI forum for input on numbers/ dosing. The forum is busiest in the am and pm so you may want to post before you need to dose, as your schedule is unusual. If there is no one there, post here.

You'll be amazed how fast you get it and start applying what you learn.
 
Sue and Oliver - Thanks for the encouragement!

No, unfortunately the vet didn't tell me much of anything about this medicine. I found that information out through my own research. What I read said it can cause hypoglycemia, even in non-diabetics. The whole medicine thing is so upsetting. It seems like a weird choice for a UTI, I don't even know if it's helping and it might be causing hypoglycemia. I SO wish she could have taken the Clavamox!

I am debating between skipping her dose tonight, giving her .50 tonight or giving her 1 unit tonight. I'm just really not sure. For whatever reason, she seems to run much higher at night and in the early morning hours than in the late afternoon/evening. So I think I'd be OK to give her a small dose, but I don't know for sure.

I will definitely work on my spreadsheet on join the PZI forum.

dmartini4 - Thanks for your reply!

So you would shoot nothing tonight, also? That feels like a safer option, but when I see those SUPER high numbers it scares me.

No, unfortunely the vet didn't mention the hypos. I'm not even sure he knows it's a possible side effect. I read that on my own.

Arozeboom and Squeaky and KT - Thanks for your words/support!

Thanks again everyone!
 
Holly and Josie said:
I do home test, thankfully. It isn't easy and I am terrible at it and my husband is only a little better. Her poor ears look awful. I feel like a monster.
Click to expand...

I can't help much with the other stuff, but I'll tell you you're no monster. The ears will heal. You can apply neosporin with pain relief to aid the healing. After you've sucked enough blood into your meter, be sure to apply pressure to the ear for 30 seconds or so, this will prevent or at least help reduce the bruising. They'll heal, and you'll get better at it with practice, don't worry:).
 
Brian - Thanks for your suggestions. I currently use regular Neosporin on her ears, but I will get some of the kind with pain relief. I do try to hold the guaze to her ears for a bit when I test, but maybe I need to make sure I am holding it up there for a full 30 seconds to a minute.
 
Holly,
Be sure to get the 'ointment' rather than the 'creme' Neosporin. The ointment is oil based and will help with blood beading while the creme will make the blood soak into the hair. Ears really WILL heal and you'll both get better!

BIG HUG!
 
You are not failing miserably at this - you are learning. The more you learn, the more in control you will feel and the failing miserably feeling will stop.

So, to help you learn, here are a few links.

http://petdiabetes.wikia.com/wiki/Rebound

http://www.indulgedfurries.com/petdiabetes/somogyi.htm

Yes, the higher numbers you are seeing after the lows are rebound. Continuing to give 1.5U and 2U is not safe!

http://petdiabetes.wikia.com/wiki/Blood_glucose_level

Although 300s and 400s are high, cats can tolerate high BGs better than humans. Newbies to FD often freak out over those kind of numbers, but as long as their kitty is reacting to the insulin (yours definitely is!) they are not such a problem in the short term.

You are home-testing, which is your #1 defense against "failing miserably!" You will eventually learn the patterns which emerge and understand what you need to do about her dose. For now, lowering the dose both AM & PM to 1U will help level the blood glucose so you can begin to see what pattern emerges that is not influenced by rebound hormones. Even if the results are higher BGs, there won't be any sudden drops and you can gradually increase her dose if her blood glucose won't come down. But I bet it will!
 
I tested Josie at midnight last night (when she would normally get her injection) and she was at 573! I was horrified. She has never, EVER been that high. She was ony at 463 when diagnosed. I feel so, so guilty. Apparently we panicked way too much when she got down to 29 and should have just given her a bit of HC wet food, NOT several tablespoons of HC wet and Karo. We went ahead and gave her 1 unit because we were terrified of what might happen if she went any higher. 1 unit is half her normal nighttime dose, plus her BG's seem to go higher at night vs. in the afternoon, so we felt reasonably comfortable with that decision. at 6+ she was at 280. Hardly ideal, but at least she wasn't sky high or hypo. I am nervous about what her numbers will be when we test her in two hours.
 
Vicky and Gandalf - Thanks for your help and all of the links! I think you are absolutely right about lowering her dose to just 1 unit twice daily. At this point, I'm afraid to give her any more than that!

This is all just so confusing to me because it seems like when we give her 1 unit it's not nearly enough, but when we give her 1.5 units during the day it's way too much. (At night 1.5-2 units never seems to be a problem.) And the confusion is compounded even more by the fact she seems to go much lower during the day than at night. Does anyone else here have a cat that seems to need a higher dose at night and lower during the day or vice versa? Maybe I should create a separate post on this.
 
I think your one unit is fine. Collect some numbers as you can and we can see how she settles into the dose. Every Cat is Different: she may come right out of the hypo and be more normal or you could get some odd readings for a few days. And some cats do differently on insulin depending partly on food intake. Does she eat at night? If not, that might be part of the difference between day and night.

Don't ever beat yourself up over being cautious and using syrup. Her high numbers will clear. Maybe if you hadn't done what you did, she could ended up in the ER. Much worst outcome than a few high numbers.
 
Sue and Oliver - She mostly free feeds, except for the wet food we give her before her injection. She probably eats a bit more at night than she does during the day.

Don't ever beat yourself up over being cautious and using syrup. Her high numbers will clear. Maybe if you hadn't done what you did, she could ended up in the ER. Much worst outcome than a few high numbers.
Click to expand...

This made me feel better, thanks! :-)
 
So my husband just tested Josie and she was only at 304. Since she was at 280 this morning, I expected her to be MUCH higher than that. I'm very glad she's not, but is it strange that she's barely gone up at all from +6 to +12? At this point I am thinking I should only give her .50 unit rather than 1 unit. If anyone reading this has any advice, I would appreciate it. If not, I think I am going to go with .50. Better safe than sorry.
 
[made a post mainly saying, that its a good idea to make a separate post for new questions, and then I saw you did that already and got help from Carl, so deleted this one.]
[waves]
ps my cat was always higher in the AMPS than the PMPS, a bit like yours.
 
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