Help -need dosing advice on PZI

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Kacie and Sadie

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So she had her can of fancy feast last night around 430pm and now this morning at 430am. Before she ate, her number was 133 after 4 attempts to get the blood (She was not very cooperative). I let her eat and waited about 10 minutes and took it again and really warmed her ear and it bled pretty good from the back. Her number was 133 again. Did I wait long enough to test after eating? How long am I supposed to wait? I read don't shoot if its around 200 so I don't shoot right? I'm sorry now I'm confused and dumb.

Kacie and Sadie
 
Re: Another Question...

Hi

I'm not familiar with PZI, but when is your shot time suppose to be? How long can u stall?

can u add HELP to ur subject line? just edit your first post here...I'll see if any PZI users are around.
 

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Re: Another Question...Help

Hi!

Her shot is supposed to be about 5am to be exact. I don't know if this affected the numbers or not, but yesterday AM, she had Hills M/D with a bit of fancy feast and at dinner it was all fancy feast as well as this AM. (I read about how M/D wasn't good so I changed). Could the food affect numbers that fast?
 
Re: Another Question...

133 is too low to shoot. I'd wait for an hour or 2 and test again if you're going to be home. If not, skip the shot until tonight. And yes, switching from M/D to FF can be the explanation. You've gone from a high carb food to a low carb food, or the human equivalent of feeding donuts to oatmeal.
 
Re: Another Question...

Did I screw up by going straight to Fancy Feast and not mixing more into the M/D first? Now I'm really getting worried.
 
Re: Another Question...

kCinLB said:
Did I screw up by going straight to Fancy Feast and not mixing more into the M/D first? Now I'm really getting worried.
Click to expand...

Some people prefer to make the transition more slowly, but there isn't a right or wrong way. You got great results by making the switch. Now you just need to make some adjustments in her dosage and the timing of it for the next day or two. It's not a big deal.
 
Re: Another Question...

Ok that made me feel a little better. But can you explain a little more about making adjustments and the timing? I'm going to take another test in about 15 minutes. I'm sorry that I'm probably asking stupid questions...
 
Re: Another Question...

There are no stupid questions. This is important stuff and you SHOULD be asking questions.

When a cat (or person) eats a higher carb diet (like M/D), they need more insulin to help remove the carbs from their bloodstream. So if you start out giving enough insulin to manage a high carb diet, when you switch to a low carb diet, it is frequently too much insulin. So you have to make an adjustment in the dose.

There are several ways in which "too much insulin" manifests itself. Sometimes the insulin will remove too much glucose which creates what is called hypoglycemia (reading of 50 or less), or insufficient carbs to satisfy the brain's needs. You don't have that problem.

Another way in which too much insulin shows itself is for the cat to stay too low to shoot. This isn't really a problem as long as you are testing. When this happens, you just have to wait until glucose levels are high enough to shoot (200 for you since you are so new to this). Then you will also want to reduce the amount of the insulin you give in order to avoid hypoglycemia. The general advice is to cut the dose in half. So if you were shooting 2 units twice a day, next shot give 1 unit as soon as you get a test reading of around 200.
 
Re: Another Question...

I just took her test and it was 134 at 619am! So no shot. My boyfriend will check again when he gets home from work in 6 hours. Her dinner is not until 430pm when we will test again. I think I might have asked this question but I will ask again...How long after she eats do I wait to test if she didn't get a shot and the same if she did eat and get a shot, how long do I wait to test? Does that make sense?

I appreciate all of your advice - you are all fantastic!

Kacie and Sadie
 
Re: Another Question...

This is GOOD news, Kacie. If you get a low number, and you can avoid feeding her for a while, take another test in 30 minutes or so to see if she has risen enough to shoot. If you do give a shot, with PZI, it would be nice to establish her nadir (the time when her bg levels are the lowest in the cycle). With PZI, that usually is 5-7 hours after the shot. So that's a good place to start - try for a +5, +6 +7 - on different days if necessary. Whenever you test, record the information along with when fed and what fed. The data will give you a picture over time of how the insulin and food is working together.

Do not be surprised if she is high tonight. Stick with your regular dose.
 
Re: Another Question...

kCinLB said:
How long after she eats do I wait to test if she didn't get a shot and the same if she did eat and get a shot, how long do I wait to test?
Click to expand...

Some cats get a spike in glucose levels from food. So if you don't test before she eats, then you want to test within 30 minutes of when she finishes eating (hopefully she eats quick in that case).

Today, since you don't know how food effects her glucose levels, test again 1 hour after the first test (written as +1) and then again 2 hours after the first test.

Those tests today should let you know if the insulin from last night is still working OR if this morning's breakfast caused her to spike OR if it tempted her pancreas to produce some insulin on its own. You won't know which of these is the case, but it's good information to have as you work out a new dosage for her.
 
Re: Another Question...

It would help us a lot if we knew a little bit more about your kitty. When did he start insulin? what dose, etc. It looks like changing to a low carb diet REALLY helped your kitty, but it is important to keep an eye on those readings because his insulin requirements seemed to have changed because of it.

I saw on a different post that you were planning to do more testing (home curve) Monday, assuming that his numbers are high enough to shoot. That should tell you a lot. Try to test:
- before food and shot,
- 1 hour later (food should be kicked in, but PZI frequently kicks in about +2,)
- then try to get some spaced out readings between +4 through +9 so you can find his nadir, (lowest) frequently around +7. if the numbers start getting higher you know you have the Nadir.
Then test before the next meal/shot.

Since you are off Monday, I would do a series of readings even if you don't shoot, because it will help you figure out what the change to low carb did for your kitty. Also, in my experience, the PZI and food in his system from the previous day can have a carryover effect. In other words, the duration may be longer than 12 hours.

Your doing great- keep testing!
 
Re: Another Question...

Terri and Lucy said:
133 is too low to shoot. I'd wait for an hour or 2 and test again if you're going to be home. If not, skip the shot until tonight. And yes, switching from M/D to FF can be the explanation. You've gone from a high carb food to a low carb food, or the human equivalent of feeding donuts to oatmeal.
Click to expand...


I agree and maybe it was too soon after she ate to take the test food usually from what i have been informed takes about 20 mins to 30 mins before it will affect the results. I could be wrong though. It gets easier with the cat as I know.

David
 
Re: Another Question...- just tested with high #

Hi all-

Sadie started her insulin about a month ago. The vet had us start with 2 units once a day and that went on for about a couple weeks. Then she had gastritis and ended up in the hospital the week of Christmas for 6 days. The vet stopped the insulin and restarted with 1 unit a day 2x. When that didn't have any effect on her numbers, they upped it to 2 units 2x a day. (The vet had called me everyday with report). By the 6th day, they upped to 3units 2x a day and that seemed to lower her numbers down to 240. It went as high as 450. We've been on 3 units 2x a day since December 29th and been doing very well. After reading a ton of stuff on this site, I decided to hometest. We started on Jan. 15th. All numbers required us to shoot. As I said in the earlier post, we changed to fancy feast. This morning her number was133 at 425am, 133 446am, 134 626am, and now way up to 462 at 1114am which is freaking me out. Her dinner is between 430-500pm. Do I do anything until it's time to test before dinner?

Also, when I put the food down, how long can I leave it because she doesn't eat all of it at one time and likes to come back to snack.

Thanks so much,
Kacie and Sadie

I am going to try to attempt to fill out spreadsheet tonight.
 
Re: Another Question...

Her body might be reacting to going much lower than the 133... So hang tight and give her a bit of food which might help her pancreas create a bit of its own insulin. You need to stay on schedule with Lantus so no shot until the next one.


You might need to lower that dose so please change your subject line to "PZI dosage question for PMPS" That will get some attention.
 
Re: Another Question...on PZI

Take a breath,

I'm guessing changing to low carb diet suddenly lowered her numbers suddenly, so you skipped the next dose and her + 19 hrs numbers went up. High numbers are not as scary as really low numbers so , take a breath.

Let's see if we can get some more experienced help here. I'm not sure, but you might want to slow down and cut back on the next dose until you see what the low carb food is doing to her numbers.

It might be good it you edited your post to say HELP
 
Okay, see if we have this right.

You are on PZI. You started with 3 units in December. You recently changed the food to wet lo carb and started hometesting. Very recently, you started getting some low (130s numbers) You skipped this morning's shot. Your most recent test was +19. She is due for a shot at +24.

With PZI, you don't have to be super concerned about the feeding times - it doesn't tend to be a harsh insulins that drops numbers fast. The reasons we usually test then feed and shoot is to be sure the number is okay to shoot and that it isn' heavily influenced by food. We always gave Oliver his insulin during feeding because he never seemed to notice the shot. The only caution is that you want to be sure they will indeed eat, as you don't want insulin sitting on an empty stomach.

You can let her free feed during the day or give a few snacks daily - just be consistent. It is, in fact, good for a recovering pancreas. You may want to pull up the food about 1 hour or two before you are ready for the shot - so that numbers won't be food influenced and so she will indeed be hungry after getting the shot.

I am sure you will be getting more advice from PZI users. If she were mine, I would give 1 unit twice a day for a few days, checking bg levels often. I would also get some ketone strips and check for ketones. If she is in the 200-300 range for the next few cycles, you can adjust upward. I think the nice thing about PZi is that you don't have a shed to build up and you can adjust dosages more easily than with other insulins.

Don't let that high number freak you out. PZI lasts only 10 - 12 hours in most cats. It has pooped out. The next shot will be a new ball game.

That's my two cents. Let's see what others say.
 
Re: Another Question...- just tested with high #

kCinLB said:
This morning her number was133 at 425am, 133 446am, 134 626am, and now way up to 462 at 1114am which is freaking me out. Her dinner is between 430-500pm. Do I do anything until it's time to test before dinner?

Also, when I put the food down, how long can I leave it because she doesn't eat all of it at one time and likes to come back to snack.
Click to expand...

Since you've changed her diet and she's getting such long duration, I'd cut the dose in half and give her 1.5 units starting tonight. You could have given the shot at 11 am, but it's better to just keep her on schedule now.

You can leave the wet food out until she eats it. It may look disgusting to you, but she won't mind.
 
Hi Kacie! I don't have any advice to add, but just wanted to chime in for moral support. Please keep asking any questions you have, and don't worry about feeling confused and such. It is a VERY confusing and overwhelming time learning about all this and getting your cat regulated. Believe me, I bugged the h*eck out of people here (probably still do LOL ;-) ) when I was struggling to get things under control for BIx. You've got to do what you need to for your cat, and lots of these things don't make sense til you've heard it a few times and done some trial & error of your own. So hang in there, keep asking about anything that confuses you, and you'll get there!

Hope Sadie is feeling pretty good! :-D
 
Thank you thank you to everyone!

Sadie was tested at 309pm and her number was 318 and then at 430pm with a number of 430. We called the vet today and she wanted us to drop it to 2 units and tested at 730pm and her number was 186. Tomorrow I am going to do the blood curve all day and we'll see how her numbers go.

As for Sadie, she is acting completely normal and alert. She's not happy about all the ear pricking and I feel bad for her bruised ears. :sad:

Thanks so much again for the support- I really appreciate it.

Kacie and Sadie
 
She's doing great Kacie! When you report blood test results, please make sure you report how long it's been since her last shot. Time since shot is needed to understand the test number. For example, the 309 at 3pm yesterday was something like 4 hours past her scheduled shot time, right? So it would have been written as 309 at +16. Shot time, called preshot is written as +12 (when it's given on time).

Good luck with today's curve.
 
I could be reading your posts wrong, but it seems you're getting readings after she eats? As has been mentioned, if you wait too long after a meal, the number will be artificially high due to having food in the system. I test Snickers before she eats, so I have a number that's not been influenced by food. If it's too hard to test before eating, just make sure you're getting a reading immediately after the meal, so that you aren't basing your dose on numbers that are higher due to food.

It's great you're seeing numbers in the 100s, though!
 
Kacie,

I suppose your 12 hour test is about done, How did it go?

Try to post your numbers on a spreadsheet when you get a chance. You can find directions for this in the Tech Forum.
 
Hi everyone,

Here's how Sadie's tests went and I hope I I'm writing this correctly (pls correct if I'm wrong)

Before shot - 293 She received 2 units at 5am after her meal
+1 346 (6am)
+5 142 (10am)
+7 106 (12pm)
+9 76 (2pm)

I was shocked to see the 76 reading. I was trying to find the hypoglycemic numbers - does this fall in that category?

Thanks for your help-

Kacie and Sadie

p.s. she was a really good girl and sat still for all her tests!! Made me feel much better.
 
76 is a non-diabetic number--it's lovely. In fact, it's a very nice curve.

Hypo numbers are below 50.

Did she happen to eat between the +7 and +9 test?
 
Yes she did have a snack at +7. It was about a tablespoon of fancy feast. How often should I be doing a curve? But I always test before shot correct?

Thanks for your support!

Kacie and Sadie
 
That's great!! Please post your PMPS before you give insulin. We just want to make sure it's safe to do so... I'm hoping she hangs in those low numbers a bit longer. I bet she feels great.
 
kCinLB said:
Yes she did have a snack at +7. It was about a tablespoon of fancy feast. How often should I be doing a curve? But I always test before shot correct?
Click to expand...

Little bits of food are great. They help her be calm and they can also stimulate her pancreas to produce insulin on its own.

Yes, you always test before you shoot.
 
She had her meal today at about 445pm and we tested prior which was 160 at +11. We tested again at +13 and it was 172. It's still to low for her 2nd shot. She's already off schedule so do we just skip tonights shot and test in the am?
 
kCinLB said:
She had her meal today at about 445pm and we tested prior which was 160 at +11. We tested again at +13 and it was 172. It's still to low for her 2nd shot. She's already off schedule so do we just skip tonights shot and test in the am?
Click to expand...

Woo Hoo! Diet changes do work. If you're at +14 (or thereabouts), I'd go ahead and give her a reduced dose (something like 1.0 unit). If it's much later than +14, skip the shot and expect to see a high number tomorrow morning. Based on today's response, I'd cut the dose back to 1.5 units.

Great progress--congratulations!
 
It will really help you, and others when you get that spreadsheet up. You can see trends and save precious info and even show it to your vet. Once you collect even more info it tends to get lost, mixed up and harder to communicate it.

To summarize what you saw today: is this correct?
AMPS 293 (5AM 2units PZI after food ) = (AM pre-shot "AMPS")
+1 346
+5 142
+7 106 1 tbsp ff eaten
+9 76
+11 160
+12 meal, no shot
+13 172

I'm no expert but
-It looks like her low point or nadir today was AROUND +9hrs ;
-Her AMPS was 24 hrs after the previous shot, because you skipped the previous night due to low numbers.
-She had approx 50 pt spike from breakfast
-if she ate much at her dinner (+12), she didn't get much of a spike from the food (160 to 172) which makes me think the PZI is still working or her pancreas is kicking in or both.

Does that make sense? Others with more experience may see more.

Did you skip the 2nd shot? Are you on east coast time? You must be an early bird (5 AM feeding)! Probably off to sleep right now...
If she were mine and I was going to work, I think I might give less insulin and try to get on a 2x/day schedule, numbers allowing.
***** You should always test before shooting, and try to test around +8--+10 just to see how low she might be going.
 
Hi there!

Sorry for the late reply...we're on the westcoast (Long Beach, CA) and went to bed. We ended up skipping the 2nd shot. Your summary looked right. I plan to work on the worksheet this weekend. For now, I'm putting all the info in a journal. We are early bird feeders because of work (Disneyland) and we are trying to be on a consistent schedule no matter what. :) I can't believe how Sadie's numbers changed for the better from changing her diet and it was all because of all of you with your help- thank you for your continued support! I totally agree with keeping her on a 2x a day schedule if numbers allow. This morning her AMPS was 340. 5am shot of 2 units- Then at +10 it was 82 and then at +12 it was 151. At +13 it was 168. Since it's too low for a shot, we"re going to skip. I am calling the vet tomorrow to discuss her numbers and see what they say but I think we need to lower it a bit like you said.

Kacie and Sadie
 
Agree you need to lower the dose. You are giving insulin only once a day because it is taking her too low - but then overnight, she is without insulin for 12 hours. In the morning she is high again. Rollercoasters don't feel very good - going from highs to lows. Much better to give less, twice a day. How about the 1 unit twice a day we suggested?
 
One nice thing about PZI is that you don't have to be on the strict 12/12 schedule--you can shoot as needed. My Snickers can often go 24 hours with one shot, but yesterday, for example, she was increasing quickly after +12 and I gave her a shot at +17. If your cat is too low to shoot at + 12 (like Snickers almost always is), you can keep testing and give a shot when you're getting a reading over 200 (a reduced dose, though).
 
Hi Kacie--do you know there is a PZI support group here on FDMB? Several of the folks who post there and help newbies are west coasters like you, so you might get quicker responses on insulin questions there:
viewforum.php?f=24
 
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