Feeling hopeless!

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k kitty

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Hi everyone! This is my first time posting but I love this message board and thankfully you guys are here to help people with this sometimes sad and frustrating disease. So, my kitty Morax has had diabetes for a year and although he has gotten better since we got him diagnosed I am really sad that he is no where near regulated. I have been reading tons and admitantly, it has taken me sometime to get him on the right foods and test his glucose readings on a daily basis. And since Ive been doing that, I have found that he is consistantly in the high 400s and 500s, before and after insulin. I have recently put him on a raw diet and he is still reading the same (but maybe that needs more time). I give him prozinc and we are now at 3 and 1/2 units 2x daily and I see no response just little fluctuations. I just stepped up my insulin 1/2 a unit today after getting results back from the vet and that is what she recommended. Tonight his readings were 490 1 hr preshot and 526 1 hr postshot and food.
ok, so that is the situation... questions... how quickly should his glucose readings go down after giving the insulin and food? Do you think he may be resistant (I am doing everything right with injecting and storage and such)? What could I give him if he is? Is there anything else I can do, herbs etc? I am soooo freaked out and I feel like a total failure (almost in tears about it, writing this), due to my delay in getting him diagnosed, he was pretty sick by the time I got him in. Its just depressing and I dont know how much longer he will live with high levels like this. He really seems happy, hes such a sweet boy, but hes always hungery and drinking and peeing alot and I wonder if its the right thing to do to keep this going. I am going to keep trying but I worry about his quality of life. Ok, so if anyone has any advice, suggestions, experience, and hope...would love to hear some.
Thank You,
Kathy
 
i'm sorry you are feeling overwhelmed....i think everyone here can tell you we totally understand where you are at....i'm sorry i can not be of help as i don't know anything on the insulin you are currently giving...

have you thought of switching insulin? how often do you feed?

on raw diet i know nothing about....sorry...

i just wanted to post in your condo here for you to know that someone out there read what you had to say and that you are not alone...

you mention you read posts....have you ventured off to reading on Lantus insulin group here? that's where Rocket and I are a member....that insulin has great success...and as i said..i know nothing of your type of insulin so perhaps others with that experience can lend you a hand....

continue to read as much as you can....get your SS updated....and i would totally encourage you to start posting in the insulin group that you are giving...it helps others get to know you and Morax....this board is amazing and you will know without a doubt that you have found in here a cyber family like no other....

good luck and hope you get Morax feeling better soon....

hugs to you both!
 
Hello Kitty and Morax,

I hear how frustrated you are. Many of us have felt the same way early in this process. You'll find lots of support and guidance here. I'm sorry I'm not as familiar with Pro Zinc as with Lantus (glargine). As Claudia suggested, you might want to go to the PZI support group to get more specific guidance and information there. One thing that will help. No matter what else you do, get a spreadsheet started and fill in all the data you gather. It will be a tremendous help to you to see exactly what happens with BG levels throughout the cycle and in response to eating and insulin.

It may be that another insulin would work better for Morax. Have you discussed this with your vet?

Sorry I can't be more specifically helpful, but I do want you to know people are here who have been through pretty much everything with diabetic kitties.

Ruth & Beethoven
 
Kathy, We understand how hopeless it feels. All of us have been there.

I let the folks in the PZI group (INSULIN SUPPORT GROUPS (ISG) from the main board and then PZI) know about your post. They are wonderful and will help. When you have time, go over a post a note. They know about your post on the health board.

It's very hard to watch our sugar cats suffer but you're headed in the right direction finding FDMB and asking for help.
 
Claudia & Rocket said:
have you thought of switching insulin?
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I don't think switching insulins is the first thing this individual [or other PZI newbies] need to be worried about. I think there are things we can work on before an insulin switch is recommended and that would benefit them long term if they ever did chose to change insulins. From personal experience, planting the seeds of doubt in this line can lead to needless energy consumed worrying about things that may not be needed. It can also be an issue if the vet is not on board with that thinking. Hopefully we can work with what we have right now - and help this individual with what she can work on tonight. :smile: ProZinc/PZI has benefits that other insulins lack and other insulins have benefits that PZI/ProZinc lacks.

Congrats Kathy on getting the home testing going! That is a big step. And on getting the diet optimized. Those are two very big steps and you have conquered two of the steepest parts of the learning curve.

I do suggest reading the Sticky at the top of the PZI ISG. http://felinediabetes.com/FDMB/viewforum.php?f=24 It has a newbie checklist that has a lot of good info and links. It also describes how ProZinc/PZI works to answer your question about onset - or when it should go to work.

Now that you are home testing I'm hopeful you can get your numbers into a spreadsheet. The instructions for that are found in the PZI Newbie Checklist or the Tech Supoprt Forum. Please note in your SS [spreadsheet] the date that you converted to low carb wet food only [or raw].

No herbs.

You may also want to see an incomplete list of things that can cause wonky numbers:
http://felinediabetes.com/FDMB/viewtopi ... 223#p77223

Also if you make a profile of your kitty and maybe address the issues in that list [to the best of your ability] as well as the questions in the Profile Template that will really help us.

Feel free to join us over in the PZI group when you are ready.

Hopefully we can work with you to make improvements for your kitty. :smile:
 
Welcome.
I am glad you reached out. It is certainly not hopeless and there are many things you can do to take control and really make a difference in your cat's life to see him thrive once more.

I would encourage you to start by reading the FDMB faqs, and arming yourself with the knowledge to be found there. http://binkyspage.tripod.com/faq.html
All of us can help you understand the basics, no matter what insulin you are on, as it all starts from the same place ie: moving to a lower carb ( under about 10% carbs ) Diet and adjusting dose down when you do, moving gently to finding the the right dose, preventing ketones by testing urine, and others as you see in the FAQS.

Diabetes is the same syndrome whether using PZI, Caninsulin, Lantus, Levemir, it is the insulin that responds differently.
There are things you can do to help you understand how this insulin is responding in your cat however.

I would really encourage you to do a full curve and see what is happening through out the cycle of the insulin, every 2 hours, for 12 hours.
This will begin to show you when the insulin is starting to work ' onset', when it peaks 'nadir' and when it runs out of steam or its 'duration'

The right insulin is the one that works for your cat and time, and a little understanding of what you are looking at as you hometest will make a big difference.
Would you mind answering a few questions for us to help you further?

What are your feeding routines and how much food of what type?
What size syringe are you using?
What dose was he at when you began home testing?
What dose did you start treatment on?
Are there any other medical issues that led to his diagnosis or are happening now?
Have you noticed him become lethargic or wonky during the 12 hour cycle of insulin ever?
Is there a certain amount of time after insulin when he seems really hungry?

I know it feels like the world is covered in a grey cloud, but there is a light. Hang in there. You are not alone.
((hugs))
Kimmee
 
Thank you thank you! i will post on the prozinc page and the info on prozinc was awesome. I really didnt know the onset and it was really not helping. I just got a reading of 350 3 hrs postshot which is the lowest yet after raising his dose a 1/2 unit. So I am feeling better and It feels awesome that there are nice, caring people here to ask questions and for support and have been through this. Super awesome and now I dont feel so crazy. I will do another test soon and see where we are at. I have a zillion questions about prozinc so I will gear my questions over there. I always wished I knew people who knew about having diabetic kitties and now I do. So glad there are others that will go to great lengths to help our kitties. I wish I didnt take so long to get this far but at least im here.
much love
Kathy & Morax
 
Ok I will answer the questions... i really havent been taking care of this the way I should have been and i realize this now :( but here we go..
I feed twice a day wet food. sometimes I would have Purinia DM and sometimes a wiskas in natural juices pouch...which i realize has wheat gluten and bad stuff in it. So then I fed some wellness wet food and I also was feeding just regular purina (yuck, i know) so then I got blue buffalo wilderness (not on blinkys page) which I realized has potatoes in it but it said it was low carb so I got it so that is what is out for the kitties now (maybe not the right choice). But I really dont see him eating much of it anyway. I have four cats so feeding them all raw food doesnt seem possible but maybe in the future. But just yesterday I bought the primal raw cat food and he loves it. He really likes the wet food, and sometimes i feel so bad for him that I give him a snack of wet food (oops). but the raw food seems to have satisfied him more and he hasnt been meowing at me as much today. (so really i havent been feeding him right until now)
I also spoke with the vet about his fructosamine reading and she said it was very poor so we decided to raise his dose by 1/2 a unit. i use U40 syringes, we started at 2 units then to 2 &1/2 then I raised it to 2 &3/4 for a long while then to 3 just this week, when I started to check his blood and now to 3 &1/2.
he has no other health problems and what led me to diagnosis was he was very thin and peeing all over the house and eating anything he could find. And he does sometimes look a bit tired but not extremely just maybe a bit. And he always seems hungry but most so at regular feeding times. but I will watch more for that but he will eat as much wet food as I give him and completely pig out.
So I hope I answered your questions. So glad you are helping me help Morax! It would be amazing to see him healthy again and I realize now that I had no idea what I was doing for the longest time. geezz, poor buddy!
Just did a another test and it was back up to 432 5 hrs post shot. i was so hoping it was going down :(
 
"Sometimes less is more" and you stated that he was started on 2 units but you were not hometesting till just a short while ago. There is the possibility that you actually went beyond the dose he may have need. Please read all about Somogyi in this link http://petdiabetes.wikia.com/wiki/Somogyi_rebound There is also the possibility that Prozinc just isn't going to work well for him and hopefully, now that you are doing curves at home, you will find that out also.
 
k kitty said:
I have four cats so feeding them all raw food doesnt seem possible but maybe in the future. But just yesterday I bought the primal raw cat food and he loves it. He really likes the wet food, and sometimes i feel so bad for him that I give him a snack of wet food (oops). but the raw food seems to have satisfied him more and he hasnt been meowing at me as much today. (so really i havent been feeding him right until now)
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Raw food is fine to feed. Primal Pet is a good brand. It's grain-free and low carb. A little low carb canned food won't hurt at all. You don't need to feel guilty if your cat doesn't get a canned food snack. He'll be ok :smile:

There are people here with multiple cats who feed only raw food. A homemade raw diet seems to be the most economical and costs much less than commercial raw food.

k kitty said:
I also spoke with the vet about his fructosamine reading and she said it was very poor so we decided to raise his dose by 1/2 a unit. i use U40 syringes, we started at 2 units then to 2 &1/2 then I raised it to 2 &3/4 for a long while then to 3 just this week, when I started to check his blood and now to 3 &1/2.
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Just so you know, you can use U100 insulin syringes with U40 insulin. You can more easily fine tune insulin doses. You must use this conversion chart: http://felinediabetes.com/insulin-conversions.htm

3.5 units of ProZinc would be measured somewhere between the 8.5 unit and 9 unit line on a U100 insulin syringe that has half unit markings.
 
Hi Kathy and Morax! Welcome to the boards. You're doing great so far with testing and finding the right foods. I fed blue buffalo wilderness at first, but switched cuz they cost an arm and a leg. I called the company and they told me that those cans have 1% carbs, so they are very low carb! I use 9- lives cans now, the varieties under 6% carbs (97 cents for 4 cans). Come on over to the pzi board when you're ready! We'd be glad to have you there, and will do anything we can to help.
 
It could be that you missed his correct dose but now that you are hometesting, starting over at a lower dose may help you find the right dose. But, I have to ask, are you sure your insulin is still good? I don't use my insulin up fast enough and always end up tossing ours before I use it up.
 
Pz has a very long life as long as it's stored properly and handled gently. On this dose it should easily outlast the amount of time it takes for her to use it up.
 
Charliemeow said:
Pz has a very long life as long as it's stored properly and handled gently. On this dose it should easily outlast the amount of time it takes for her to use it up.
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Just wondering about the insulin since dx was a year ago, if it's the same bottle from dx it could be something to think about.
 
Hope + (((Baby)))GA said:
"Sometimes less is more" and you stated that he was started on 2 units but you were not hometesting till just a short while ago. There is the possibility that you actually went beyond the dose he may have need. Please read all about Somogyi in this link http://petdiabetes.wikia.com/wiki/Somogyi_rebound There is also the possibility that Prozinc just isn't going to work well for him and hopefully, now that you are doing curves at home, you will find that out also.
Click to expand...


I agree with what Hope said. It is very possible that you missed his optimal dose. With Somogy rebound, in order to protect itself from becoming hypoglycemic from too much insulin, the body produces extra glucose to counteract the insulin. That is why you have higher BG readings. You may want to consider dropping back to 1 unit twice a day and gradually (over several weeks) raise the dose up to the dose you find that works best.
 
Hi thanks everybody. The insulin bottle is brand new so no probs there. And Ive been thinking about doing the raw stuff at home. I just am not sure really where to start. I dont have a grinder. And actually Im a vegan so i dont have a clue about meat and feeding raw. But that would be ideal. so any suggetions about that would be great. I have posted over on the PZI group so I will see what they say about lowering his dose.
Thank you all for you support and comments. Hopefully morax will get on the right track soon
Kathy & Morax
 
If you do end up lowering the dose, then make sure you are checking for ketones. Any pharmacy will have a bottle of ketostixs behind the counter for human diabetics. You just stick the long test strip in the urine stream, or set up the litter box so you get a puddle and can test that way. It is possible that you missed the dose, but you also aren't seeing much of a drop. If kitty isn't going too low, then would the body still pump glucose into the system to protect itself? A couple of days of curves could also tell you how much he is dropping and if you get a steep drop every few days, then it would be symogi rebound. Dunno - just food for thought.
 
The term somogyi effect is rather outdated in the human medical terminology; it is now called rebound hyperglycemia in many text. Regardess of what it is called, this phenomenon does occur in human diabetics and is widely accepted in the medical community. I am saying this because there are some individuals who tell newcomers this doesn't exist and it is just a "panicky liver". If this cat were one of my human patients I would definately be concerned with numbers in the 400s or 500s for days or weeks at a time. I would certainly encourage you to test your cat for ketones. Both cats and people can quickly develop DKA with a BG that high. Since the cat is already on prozinc it would probably be logical to try to adjust the dose on that insulin first. It is sad that some vets and even human health care providers get "stuck" on one particular insulin or medication as their only treatment option. Whenever there is a one treatment fits all mindset, then the patient ( wether pet or person) loses.
 
I don't doubt that it is a proven thing. I have seen both my diabetic cats go through "rebound hyperglycemia". I am just saying to gather enough data to rule out the rebound part. If there is no number that the cat would be rebounding from, then it is possible that this kitty is possibly somewhat insulin resistant. My Oscar took us going up to almost 5u before we saw any difference in his numbers. He was ketone prone, so when we cut the dose down to do a rebound check, his ketones spiked.
 
if it was somogyi effect wouldnt I see a sharp decline in his blood glucose and then it would raise back up. Im not sure that is happening.ive never got a sugar level lower that 350 no matter when I tested. but I would love to know more about this but Im not sure that is what is happening.
 
Oooh, a vegan feeding a homemade raw diet! I'm a strict vegetarian and I applaud you. I wouldn't be able to do it. I know that when it's done properly it is closest to their "natural" diet (whatever that means after hundreds of years of domestication), but I can't stant the sight/smell/thought of meat. I find the canned food repulsive enough. :thumbup
 
haha! totally. I felt so guilty buying chicken from whole foods yesterday. The guy at the regester was like "looks like your having a rough day." haha. I have a farm so I may just start raising chickens again to feed to my cats, i would rather know the chickens were treated well and do it myself than buy it. The lengths I will go to save my cat :-D . Luckly my dogs eat mostly vegetarian except for some raw meat snacks a couple times a week. Even my pitbull puppy prefers the veg kibble over her puppy food. Such a smart puppy!
 
More info on Somogyi

I wish I could find Shirley/Pico's original post. This is the best I could find.

What exactly is somogyi rebound?



Easy answer: term to describe the process in which the body reacts to low blood sugar or a rapid drop in blood sugar. When the body perceives a fast or low drop in glucose, it protects itself by releasing natural glucagons from the liver, which raise the blood sugar; (from the FDMB glossary).



Harder answer: hypoglycemia induced hyperglycemia. If too much insulin is received, the body will try to protect itself and responds by releasing glucose (glucagon) from the liver and secreting diabetogenic hormones which induce hyperglycemia.



It is important to note that a hypoglycemic episode does not have to happen for somogyi to set in. A drop in blood glucose that the body thinks is too fast will result in glucagon being released and the sugars being raised.



So basically, somogyi is a result of the body's defense mechanisms against hypoglycemia.



How do I know if my cat is experiencing somogyi rebound?



First, know that somogyi is very difficult to document and as a result a lot of health care professionals don't think it happens very often. My own experience and that of others I've talked with has led me to believe that it is much more common than people think.



Clue #1 - Consistently higher preshots and spotchecks than usual. Note, preshot numbers going higher can also point to infection, absorption issues, a need for more insulin, or poorly mixed/damaged/old insulin**. So this is a pretty general clue but is an important clinical sign to monitor more closely in any event. It does not mean that when kitty has a bad day and gives a sudden preshot in the 500s that you should presume somogyi - that's just a cat being a cat. Numbers that creep up over time however are to be watched.

**Note, for Humulin insulins (N, L, U) Eli Lilly recommends a bottle be used for no more than 60 days or 100 pokes...so if you've noticed numbers change month 3 or 4 with the same bottle, probably a good idea to get a new bottle. Also, don't "shake" insulin as it is delicate and will be damaged. Most folks roll the vial between their palms to mix it properly.

Clue #2 - Very rapid drops in blood glucose numbers as detected through spot testing. Last time we suspected rebound we were up to the high 500s preshot - before we had been in the 300s. We did a spot test at +2 one night and went from a preshot of 561 to a +2 of 275. That's a drop of almost 300 "points" in 2 hours -- much too rapid for the longer acting insulin we were using.



How much of a drop is too much? That will vary for each cat - like everything else with diabetes. But for our purposes, dropping over 200 points in the first 2 hours was too fast and kitty's body responded by spilling out glucagon. I think a general statement like "close to 100 points an hour for a drop is relatively safe but on the high side" is okay to say.



Clue #3 - Hypoglycemic episode. Too much insulin is almost always the cause of a hypoglycemic episode. This is a warning sign and unfortunately sometimes comes too late. Following a hypo many cats are thought to be more sensitive to insulin so a dose decrease is usually suggested for the first few days immediately following a hypo. However, if a dose decrease is not made and the same amount of insulin is given over a period of time - the cat may hypo again or may enter into a rebound situation as the body tries to prevent another hypo.



Clue #4 - Flat curves. If you are seeing higher preshots and suspect rebound you should do at least one curve to see what's really going on. Somogyi often results in a period of insulin resistance** (remember, the body is trying to protect itself from dropping too much so will keep spilling out glucagon) and you may see nothing but high numbers no matter how much you check the glucose that day.

**Cortisol and epinephrine are released during a somogyi event. In "basic" terms, both contribute to glucagon release and interfere with glucose utilization by the body -- ultimately resulting in insulin resistance and continued high blood glucose numbers.


Here's an example of a somogyi curve (see more examples at Pets with Diabetes Somogyi Page):

PS
542

+2
417

+3
395

+4
421

+6
447

+8
430

+10
452




How do I test for somogyi and treat it?



The answer to somogyi is LESS insulin, not more. This is where it gets confusing. Usually, high numbers would mean more insulin is needed. However, with somogyi the higher numbers are from the body spilling out glucose because its already getting too much insulin. So the best way to test for somogyi is to cut your dose.



Again, every cat is different and the amount you cut the dose will vary from cat to cat. It is best to take your cats whole clinical history into the decision-making process and discuss changing the dose with your vet. You do not want to cut the dose in a cat that may have infection (instead of somogyi) - first rule out infection (via trip to vet). Also, gather as much curve/spot testing data as possible so that you feel comfortable that kitty doesn't need more insulin.



REMINDER: Whenever you are seeing higher than normal numbers and/or are cutting the insulin dose, it is a good time to be more diligent in your ketone testing (see our Ketone Library for more info).



So, if you make a substantial decrease in dose and allow the dose to settle in -- and then see improved numbers, you can feel pretty confident that you were dealing with somogyi. (Yeah! Its not winning the lottery but a clear answer in diabetes is worth a million dollars in my book).



You may eventually work back up to that old dose in time - but remember to take things slow and increase only after a series of curves and with small increments like .25 or .5 units at a time. This will be your key to success!
 
rebound can look either like a steep drop and steep rise, or high flat numbers. There are risks dropping the dose and doing a ketone check, but if you don't you may end up spinning your wheels for longer.
 
interesting. Morax's SS is in my signature. I would love your opinion if you think he might be having this. I thought I read somewhere that his numbers would crash and then come back up but those numbers you gave look alot like mine. And the increase in dose doesnt seem to be helping that much. I will probably keep an eye and then call my vet but I would love your opinion.
Thanks for the research,
Kathy & Morax
 
I plan on raising some chickens (just hens for eggs) when we move (hopefully this year!) to a house with some land. I think id feel better about feeding him chicken that I raised, too. But I could never slaughter one. It'd have to die on it's own of natural causes. So, looks like poor Charlie will never taste a healthy raw diet! :lol:
 
I just remember way back when Shirley first came on with Pico...the more insulin, the higher he went until she found FDMB and read about Somogyi. She never saw a crash number and as you can see, it doesn't have to go way down to a hypo number. Some people over the years just cut the dose in half.....some skipped a shot for one day or night to get insulin out of the system......some started over again at 1 unit. There are 3 things to look at.....type of insulin is not working ........somogyi.......or possible acromegaly.
 
Or resistance, right? Or kitty just needs a higher dose. Not all kitties are going to be controlled on lower doses of insulin. Some kitties just need more insulin to break through their resistance.
 
But of course it could be resistance. Problem is, that IF the starting dose was too high, then it is impossible to know whether the cat is receiving too much OR too little. If the cat had been started at 1 unit, it would be a much simpler discussion.
 
One way to approach ruling out rebound and being cautious to not drop dose too far, is to split the current does on half for about 2 days, test vigillantly for ketones and see what kind of movement you get.

If it is rebound, there should be a slow but steady decrease to the levels in the curve, if not rebound, not much will change, but at least you know you need to keep pushing through at a higher dose to break what may be resistance.

It is tricky, but while increasing takes more time, a rebound check does not need to, and at least you have an idea where you stand.
I would personally do this for about 3 days, testing for ketones daily and post levels on the health board for lots of eyes who seen and bounced around with rebound to have a look, and hopefully help you see what is or is not going on.

You are doing great weeding through all the info. Way to go :)
 
What do you do if he has ketones? I really dont know much about it. I have dread about the whole subject because he has been high for a while.
Thanks for all the support. Really its been a wonderful help.
 
Harrison's Principals of Internal Medicine, the text used in many medical schools, defines the Somogyi effect as a specific type of early hypioglycemia followed by post breakfast hyperglycemia caused by overinsulinization (excessive insulin dose over therapeutic level). In any case I doubt anyone would ever ask me that now I am out of grad. schooll. Whatever you call it, the rebolund effect definately exists. I agree the only way to rule this out is to do a curve .

I certainly don't want to get into another ketone debate. The presence of ketones above a trace level should at least trigger some concern and be monitered. There is another board member who uses shorter acting R insulin to reduce the BG and then gives sub-Q fluids. This might work if the cat's ketone level doesn't rise rapidly. By the time my cat tests for serum or urine keytones, his ph is usually already becomming acidic. At that point I certainly wouldn't try to do IV fluid. And electrolytes at home.
 
I am thinking about cutting his dose tonight. If anyone has the time to look over Morax's SS', I would love your opinion and as many opinions as I can get. It just seems very wierd that his highest numbers were when they should be the lowest. I am thinking I will cut the dose in half and test him through the night.
 
I agree with cutting the dose, but testing throughout the night seems highly unnecessary as it can take up to 3 days for the stress hormones associated with rebound to dissipate. You need to cut the dose for a few shots at least to give the test a chance.
 
328!!!! 3 hrs after shot!! I cut his dose and no it seems I made the right secision to cut his dose. So awesome!
 
crazy, isn't it? Seems counterintuitive that those numbers would drop after DECREASING the dose but it happens sometimes!
 
My vet is not happy with me. She wants me to give 2 units tonight and I had to talk her down from 3. When I told her about 328, all she said was "well thats still not very good," I was like "Its better than almost 600". She really didnt belive that he was rebounding and I was just like I really just wanted to check and 328 is the lowest number ive gotten since I started testing. Im honestly kinda annoyed so I think I might try somewhere else.Anyone know any good diabetic kitty vets in Columbus, Ohio? I am thinking about Ohio State University Vet.
 
Hi.
I am really happy to see that lower level already. Well done you., I know it is hard to take advice that is counter to your vet from cyberspace.

Heads up, you may see some weird numbers as this all settles down.
Don't worry it is normal as the stress hormones are clearing out of the body.

Not having a vet who understands this is frustrating.
If you like your vet other than this, perhaps consider sharing your ss with her after you have seen a difference with the decrease?
Diabetes, due to its nature, must be managed in the home. This is why hometesting is so important and being able to understand what you are seeing to make an adjustment also important.

How is he acting with that lower level this morning?
 
One more thing.
It is not clear on your SS what you preshot level is?
As things are changing it is even more important to always get a preshot test within 30 minutes prior to giving the shot.
This will let you know everytime, it is safe to give insulin.

:)
 
Kimmee, Mishka needs a pre-pre shot :roll: She has been known too many times to not even start using the insulin till much later in the cycle so I always try and get a test at +10 or+11 so when I do her preshot test I know which way she is going. I remember also when I first adopted Hope I got what I thought was a great preshot of 229. Learned just a short while later she was just starting and I knew that by the time her evening shot kicked in she'd be too low. She was on IDEXX, same as Mishka still is. We had a very long night.....get her up, wait, test, down again, get her back up. Lesson learned well by me. I do preshot tests a.m. and p.m. before even doing a normal preshot test.

k kitty, maybe print off the info on Somogyi that I posted and show your vet? Either way, stick with what you have done and watch the numbers. Give kitty a few days and then consider maybe even decreasing down some more. Remember, she was started at 2 so you have no idea if 1 or 1.5 would be a better dose.
 
yeah I meant to do the preshot. Slept in and in a sleepy state told my boyfriend to give him the shot. opps. I have sleep issues and when Im stressed it gets crazy. Im gunna try to do better tomorrow. @-)
 
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