Help, first read 11.3, what next?

Lola+Cali

Lola+Cali

Member
Cali just started 0.5u x2 daily, 12 hrs apart yesterday. I just got a Contour Next Gen today, and her pre-dinner read was 11.3.

With this in mind, am I ok to give her the insulin after she eats in a few minutes?

I know it's a low dose (SLGS), but I am anxious it will lower her BG too much.

(Can someone link me to the thread/info where I find the instructions on what to do based on the BG readings?)
 
Hello and welcome. Here is the link to your first post here: New Member I had to go back and look at what insulin you are using - turns out Prozinc, so I could point you in the right direction. We do like the insulin type in the signature too.

At the top of our Prozinc / PZI forum, there is a Sticky Note on Dosing Methods that is the instructions on what to do for dosing with Prozinc. However, I can say that for new members, as long as there is no recent diagnosis of DKA or ketones, then we recommend not shooting below 200 until you get more data. Note, that 200 is in mg/dL units, as opposed to the mmol/L that you are using. To convert, multiply your mmol/L by 18, or if you have a spreadsheet set up (used the World version), it does the conversion for you. FYIW, 11.3 mmol/L = 203 mg/dL. I'm replying well after your post, so I'm afraid you didn't get the answer it time.

Good for you though, on getting testing working for you!
 
Wendy&Neko said:
Hello and welcome. Here is the link to your first post here: New Member I had to go back and look at what insulin you are using - turns out Prozinc, so I could point you in the right direction. We do like the insulin type in the signature too.

At the top of our Prozinc / PZI forum, there is a Sticky Note on Dosing Methods that is the instructions on what to do for dosing with Prozinc. However, I can say that for new members, as long as there is no recent diagnosis of DKA or ketones, then we recommend not shooting below 200 until you get more data. Note, that 200 is in mg/dL units, as opposed to the mmol/L that you are using. To convert, multiply your mmol/L by 18, or if you have a spreadsheet set up (used the World version), it does the conversion for you. FYIW, 11.3 mmol/L = 203 mg/dL. I'm replying well after your post, so I'm afraid you didn't get the answer it time.

Good for you though, on getting testing working for you!
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Hello!

Thanks for the great advice and the link to the Prozinc dose page - I am scouring it now! (I don't think I posted correctly for a quick response. There were instructions somewhere on keywords to use and which forum, but I couldn't find them when I needed them last night! If you could point me in the right direction, that would be great!)

Cali just tested at 9.6mmol (172.8mg) pre-meal (breakfast). So, I am skipping her insulin this morning. I understand this means her numbers will be a bit higher at dinner, but that is to be expected.

She has never been tested for DKA or ketones. This all sprang up last Wednesday when her blood sugars spiked to 27.6 (496.8) after a week in pain + surgery. I will have to read up more on these issues and will see if my vet will/needs to test for these.

Thanks again!!
 
Laura:

You have options when you run into a lower than expected pre-shot test result. The options are:
  • Do not feed Cali and stall. Wait about 20 minutes or so and re-test. If numbers are close to or above 200, give Cali her shot. You can repeat the "stall" process a few times but if you're getting close to 2 hours past shot time, go ahead and skip the shot. Stalling is a useful strategy if it works for your schedule. Remember, that the next shot will be due 12-hours after you gave the stalled injection.
  • Reduce the dose. You can shoot less insulin if you need to. I would suggest posting and asking for help if you choose this option.
  • Skip
When you're still new at managing your cat's diabetes, I would recommend posting and asking for help. There's usually an experienced member around who can lend a hand. Putting something indicating that you need help in your subject line will get members to drop by and provide input.
 
@Lola+Cali
My Corky also uses ProZinc although I am knowledgeable in dosing in low numbers, being new in this forum I referred you to Sienne, but if you have concerns about low numbers before dosing, I will be more than happy to coach you
 
Thank you! I skipped the dose this morning as she was under 11, and the 0.5u dose she typically gets seems so incredibly tiny, I don't know that I could even do a half dose accurately. Thank you for the coaching offer, at this point I will absolutely take all the help I can get!

I understand anything under 11 (198), I can skip, postpone or half-dose. But postponing throws her schedule way out of whack, and I understand the occasional dose a little out of step of the 12 hour mark is ok, but not ongoing - so readjusting back to the original schedule would be quite the ongoing adjustment. And half-dosing SEEMS impossible to me given the tiny amount she receives.

Would love to hear what you do when these "lower than 11" / "lower than normal" readings pop up. Cali doesn't have a normal yet as we just started testing regularly last night (so, twice now).

Thanks!

L&C
 
Sienne and Gabby (GA) said:
Laura:

You have options when you run into a lower than expected pre-shot test result. The options are:
  • Do not feed Cali and stall. Wait about 20 minutes or so and re-test. If numbers are close to or above 200, give Cali her shot. You can repeat the "stall" process a few times but if you're getting close to 2 hours past shot time, go ahead and skip the shot. Stalling is a useful strategy if it works for your schedule. Remember, that the next shot will be due 12-hours after you gave the stalled injection.
  • Reduce the dose. You can shoot less insulin if you need to. I would suggest posting and asking for help if you choose this option.
  • Skip
When you're still new at managing your cat's diabetes, I would recommend posting and asking for help. There's usually an experienced member around who can lend a hand. Putting something indicating that you need help in your subject line will get members to drop by and provide input.
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Hello! Thanks so.much for this info and advice.

When you postpone/stall a shot, which moves the next shots back - it changes their feeding schedule and shot schedule. How do you get them back to their normal schedule? If I postpone a dinner shot, her breakfast shot might have to be after I leave for work. Wondering how you manage this?

The vet gave Cali the first shot at the clinic so she could show how it's done ... but that was 4 hours after she had eaten that morning. The vet said her next shot is fine to give 10 hours later - but I read in this forum that is not advisable (especially as I didn't have a glucometer yet). So, I made a schedule for the next 6 days that slowly changed her feeding and insulin times in short increments. Meaning she was scheduled to receive insulin every 11hrs 45 minutes (instead of a 2 hour jump like the vet said) until she was on a schedule. Was I overthinking this? No idea, but based on what I read here, it sure seems safer.

*My vet just called to see how Cali is doing and said only if her BG is <8, that I should skip or delay insulin. But that's way lower than what I keep reading in this forum and my research so far (<11). Any advice for/against this recommendation?

How do you halve a 0.5u dose accurately? It seems so inifinitesimal, and I have to turn all the big lights on and wear glasses just to line up the 0.5u dose correctly!

Re posting for help - I did put "Help" at the start of the subject line, but maybe I posted in the wrong forum for a quicker response? I swear, I hit a certain age and now I can't even post on a forum correctly. (Soon I'm going to be that lady with a magnifying glass in her purse so I can read packaging details at the store! I feel it coming...)
 
Having to work is so inconvenient!! (Just kidding. I worked throughout Gabby's diabetes.) You would have to take your work schedule into account. That would likely entail stalling for only as long as your work schedule would accommodate or possibly shooting a reduced dose. You'll have a better feel for what works for you and Cali as you start to accumulate test data. At this point, it's mostly theoretical. We advise moving the shot time back in small increments so you less chance of having to deal with a big drop in numbers.

I'm tagging @Suzanne & Darcy since she's an experienced Prozinc user and will correct me if I'm off base. Basically, I disagree with your vet. Prozinc is a longer acting insulin. It's duration can range from 10 - 14 hours. Unless I knew how my cat was responding to this particular insulin, I would not assume it's duration is 10 hours and it would be OK to shoot at what would be your +10. And frankly, even if your cat's duration was routinely 10 hours, I would not make a "rule" that it's OK to shoot unless I saw what the pre-test number was. There were times with my cat that I'd get a surprisingly low pre-test number. Cats do not like to be predictable.

We do encourage gradually shooting lower numbers. However, it's much easier on the caregiver's nervous system if you emphasize the word "gradually" in the previous sentence. I doubt that your vet will be easily accessible if you shoot a number that's less than 8 mmol (we tend to rely on US numbers and 8 = 144) and Cali's numbers drop into quite a low range and you need guidance. The good news is that usually someone is on the Health forum that can lend you a hand with managing low numbers and we do have a sticky note for reference. I would follow the guidelines in the Prozinc dosing methods post. Over time, you can reduce the "no shot" number from 200 to a lower point.

Adding "Help" to your subject line is good!! There's also an icon with a question mark you can add to the subject line. If no one is responding, it may be there's no one who feels equipped to answer your question. I'm not usually patrolling the board during the day since I'm at work. I had a slow point in my schedule and came online to see what was going on.
 
Lola+Cali said:
How do you halve a 0.5u dose accurately? It seems so inifinitesimal, and I have to turn all the big lights on and wear glasses just to line up the 0.5u dose correctly!
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Yes. You will have to eyeball it. Place the plunger between the half unit mark on your U-40 syringe and the “zero” mark. It is a small amount of insulin.

If you shoot late, work your shot time back to the time that you want to in no more than 30 minute increments per day. Do this even if the preshot numbers are high.
 
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