Hershey's Nadir was 167 today...

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Judy and Hershey

Judy and Hershey

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If it is that or 200 do I still shoot at his PM dose. I will test him before. He was +167 today. As you can see by my spreadsheet that yesterday I gave him a furshot and he was up. Should I lower his dose to say 1.0, in lieu of 1.5 that I have been giving him. Thanks!
 
Hi, Judy (hey, that's my sister's name!) -- I am not seeing pre-shot tests in the AMPS/PMPS columns of your spreadsheet. Are you testing before each shot of ProZinc?
 
I ask this because it is hard for us to advise you on when to shoot, any adjustment in dose, etc. without seeing the pre-shot #s. (A single 167 @ mid-cycle is not quite enough data for me to assess your situation.)

And you really do need to test right before every dose, i.e.: test BG/feed/shoot; otherwise you're essentially "shooting in the dark" - and that could put your Hershey in danger. (Dose could be too high, etc.)
 
Unfortunately because he has been in the process of being regulated I was not that concerned, he has just come down into the 200's in the last 2 weeks. So guilty as charged. It took 3 of us today to get a tiny drop. We had to wrap him in a towel. I will get a before PM shot tonight, and do my bet in the morning. I leave for work at 6 for it isn't the best time for help. Looks like I will have to based on his results today. I will wait and see what he is tonight. Thanks again for your advice
 
I'm sorry you're having trouble with testing your kitty's BG, Judy, but it really MUST be done every time @ AMPS & PMPS to keep your cat safe.
(I am assuming your vet told you it was "fine" to go ahead and dose am & pm without testing first: I cannot tell you how wrong-headed that kind of advice is!)

Many of us here had some difficulties in getting that blood droplet out of our sugar-cats in the beginning. (My own cat is really cranky in general, so I understand what you've been going through in attempting to test.)

Applying a warm compress to the ear can be a big help; there are some great tips about home-testing on our Main FAQ page, and here's a handy link:
Hometesting Links and Tips

Please, please bite that bullet and get those pre-shot tests. Wishing you good luck with that! :bighug: - Robin
 
Hi Judy! Have you been giving a low carb treat at test time? Those bribes...er...I mean treats...really help! Gypsy grew to love test time (as did my civvies since I gave out treats to all!). Lots of love and praise after helps too.

What gauge lancets are you using? Using the larger gauges like 26 gauge might help get the drops of blood. Also, I tried doing two pricks right next to each other at first...that helped me get those drops of blood too! It won't take long before the ears "learn to bleed" and it gets easier.

A tip: if you try testing and you aren't successful 3 times, let it go. Take a break for 5 or 10 minutes, (give a treat to Hershey anyway), walk away, take a deep breath, and then try again.

As Robin says, it's super important to get the test before shot. One morning, with NO warning, my kitty was 90 preshot! We were still really early in the game, so if I had shot then, we could have had a very serious situation on our hands.

You've been doing great getting some sporadic testing in! I know it's scary at first...BELIEVE me...but you'll get used to it, as will your kitty! Don't forget once you get a successful test in to reward yourself! I gave myself a nice piece of chocolate (or a glass of wine!). I know I NEEDED a treat at first after my testing.

You'll get this! Let us know how we can help.
 
Hershey was more agreeable tonight, the test went easier. I was able to get a tiny drop in one poke, thank goodness. His BGPM was 262. I just fed him and want to give him his shot now, if anyone is on, opinions would be appreciated. I thought I would just stay with 1.5 u and test again the morning?
 
I like 1.5. Can you get a test in 2 or 3 hours to see where he's headed tonight? It's hard to say for sure what to do without data so a before bed test would make sure he wasn't headed super low. Glad the testing was easier!
 
I am using 26 gauge lancets, and yes he gets purebits and his favorite cat grass. Yes the vet was not concerned, he felt just bringing him in once a month for testing once regulated was sufficient. He charges $30/each time for just the test. So that is not possible. I took him every Sat since May, until I started testing in July. If I had it the vet's way he would still be on 3 units x 2. I totally understand how to do the test. Yes I warm up the ear, for me it is just like the shot, I hate any kind of needles. It was hard enough to get good at the injections, I have already pierced through his ear twice and it was awful..... So tonight I think I should stick with 1.5 units? Any other advice welcome.
 
Tinker58 said:
Thanks Robin. I will do 1.25 tonight. I will try and do a +3 tonight.
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Hi, Judy - I think you meant Rachel in your last post (sorry I'd missed your question after you got that PMPS test) but Rachel gave you exactly the answer I would have given. :)

You did a great job getting that blood glucose check tonight; I'm so proud of you for persisting! I know you hate needles (me, too!), but just keep reminding yourself that this is what will help you get Hershey back to good health - and you know what? You'll be a real "expert" at ear-poking before long. (Hershey will get used to it, too - if my fractious Bat-Bat:mad: did, any kitty can!)

So what was your final dose decision on the insulin tonight? 1.5 or 1.25?
 
Hi Robin, yes you are right I did mean Rachel. I did 1.25 units. Is it my understanding that at + 6-7 that is where his BG is lowest and at +11-12 that is his highest? You base your insulin on the low or the high?
 
Generally you're right Judy. On ProZinc, for most kitties, +5 to +7 is the lowest (nadir) and +12 is highest. Of course, ECID (every cat is different). Some cats have later or earlier nadirs, some have the insulin either last too long or not long enough. Really, it's good to run a curve when you get the hang of testing. I ran a curve where I tested every 2 hours, and tested each hour at +5, +6, and +7 to figure out where her nadir was. I'm not saying do this now...give yourself time to get used to testing first. That way, you will know for sure where things fall for YOUR cat.

We base our shots on both really. We want to know how low the dose takes the cat...too low means you need a reduction usually. But we also base on where you're at preshot. Since ProZinc is an "in and out" insulin, you figure out how low a certain dose will take you with a certain preshot number...and go from there. That's why we like to get tests at both AM and PM preshots and also at nadir. That way, we can figure out what a good dose is. For now, for you, it's data collecting. Getting tests when you can helps us put the picture together of how the insulin works for your cat specifically.
 
You don't want to shoot insulin into your kitty if his pre-shot (AMPS or PMPS) BG # is less than 200. Your decision on whether or not it is safe to shoot your cat is determined by that pre-shot blood test.

Perhaps your vet told you that your cat's BG low point is at +6 or +7? THIS IS NOT ALWAYS TRUE. As you gather more & more data through regular blood glucose testing at home, you may find that your own cat's low point (also called the nadir) could be as early as +3, or as late as, say +7. (My own cat usually hits her low on-insulin at +3.5, for example.)

Every cat is different (ECID - we say that a lot here), and there's no hard & fast, cookie-cutter approach to treating diabetes (sounds like that's the road your current vet travels - I wonder how many of his diabetic kitty patients are still alive).
Because every cat is different, that's precisely the reason why we stress closely monitoring your cat's BG #s closely at home.
Insulin is a powerful hormone. But without the data, shooting a dose of insulin into a cat could set you up for the tragedy of a lethal hypoglycemic event. (This is why we all shake our heads here at vets who tell people they "don't need to test BG at home.)

I would advise you to get - at minimum - a +3 tonight; if it were me and I had as little data to go on as you do at this time (thanks to your vet; you didn't realize that wasn't ok), I would actually be getting a +3, +4 or +5 and a +6.
 
Btw, Rachel's right about the way we consider both AMPS or PMPS and the "drop" at nadir in determining dose adjustments.
I just wanted to make certain you realize that you shouldn't be shooting insulin (not at this point in treatment, anyway) if your cat's pre-shot test is less than 200.
 
Thanks, Robin, for posting that! I got all caught up in discussing how we dose and why and forgot the super important point of not shooting below 200!!!! Robin is absolutely correct, Judy. If you see below 200, don't shoot! If you are close (say 180ish) try stalling 20 minutes WITHOUT FEEDING (very important) and test again. You want to see if the number is rising and can get over 200 with no food influence. If it doesn't rise, or if it's lower than 180 or somewhere in that range, I would probably just skip for now. It'll mean high BG next cycle, but that's okay. Eventually, you may get to a lower preshot number...but you have to have lots of data to back that up and be sure your kitty is good with it.

Thanks Robin for making sure to point that out! :)
 
Tinker58 said:
Yes the vet was not concerned, he felt just bringing him in once a month for testing once regulated was sufficient. He charges $30/each time for just the test. So that is not possible. I took him every Sat since May, until I started testing in July. If I had it the vet's way he would still be on 3 units x 2.
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Judy, I think your gut is already telling you what I'm going to tell you, too: You need to shop for a new vet, pronto. Your kitty will thank you for this later.:cat:
@BJM - Could you jump in here & provide the link to your notes for interviewing veterinarians? Thanks!
 
I'm with Robin here. Not to overwhelm you (I know you've got all this going on with the testing and everything else!) but I think a new vet might give you more support and make you feel more comfortable. I'm not even saying bring Hershey in for a visit. Just maybe call and see if you can do a quick phone interview or visit and do a quick interview? Or even email? That way, before getting locked in to a visit, you know if they will be supportive. I managed Gypsy without much help from my vet...however, that was because my vet was so comfortable with me doing so. She encouraged me to home test, encouraged a human meter, saying pet meters were too expensive, and encouraged me to visit this board to get help after I told her about it. She never tried to get me to bring her in for testing or anything. She and I disagreed on prescription foods, but that was our only thing, and I just told her Gypsy wouldn't eat it. Beyond that, I knew she was supportive of my choices, and that made taking the advice of this board SO MUCH EASIER for me. I knew my vet wasn't going to try to tell me differently. It's hard to ignore the vet's advice EVEN with all the people on here who know better since they live it. Possibly a more supportive vet would make you feel better?

I know it's a lot to think about with everything else going on. If you do choose to go vet shopping, don't feel rushed. Take your time checking out vets nearby, calling them, getting answers and then meeting the ones you like to see if they are the right fit. Don't stress over this, but I honestly think it might help ya. If you are interested, you might start by posting on health and asking for vet recommendations in your area. Someone might live nearby!
 
And just so you know ... I have had SO much help from the other members @ FDMB - Bat-Bat would not be doing as well as she is today, on ProZinc, without the great guidance & kind support that comes from so many here! We're ALL committed to your success in treating your kitty--- and to healthy, happy cats! :cat:

Just the long way of saying: We've got your back, Judy! :bighug::bighug::bighug: - Robin
 
Thanks Robin and Rachel, I will continue to do my best and at least get the pre-short testing now. Hershey needs to adjust to yet another thing, as I do. I may eventually do a curve, but right now, I'm taking it one day at a time. My lifestyle is incredibly busy, and everyone I our family is working to get this right. Night ladies.
 
Should you decide to go vet shopping, please see my signature link Vet Interview Topics, compiled from suggestions everyone on the board has made.
If you're in the US, go to Google and search on "veterinarian near[]" and replace the brackets with your address. A map will display showing the vets around you.
 
I wouldn't do a curve just YET. It can be helpful to have one on the books, but I agree with you, that for now, it isn't necessary. Getting the hang of testing takes time for both you AND Hershey...neither of you needs the added stress of a curve yet. On the days you're able to, try to grab a test in that +5 to +7 range...that will help us determine nadir. I used to get in that range when I could and from the days I could just grab one test anywhere in there, I slowly figured out when Gypsy usually nadired. Does that make sense? Still on my first cup of coffee...sometimes things only make sense to me! :)

Anyway, one day at a time is the perfect way to take this! Don't stress yourself and stop us if we overwhelm you. You're doing what you need to do so far. We're here for any help you need!
 
Hi Rachel, I leave for work at 6:00 a.m. and do not return home until 4:30p.m. I will try and do a nadir on Sat/Sun. Yesterday was a good day for Hershey. I don't think he or I will ever be happy testing. I still can't figure out where to poke his ear, they say the sweet spot, but when I poke that in between spot nothing comes out. I did poke the same place this morning and the blood came right away, I just hate for his little ears to be scarred up.... :(
 
I understand that! My work meant I could only check nadir on the weekends. You do what you can when you can.

Have you tried using a flashlight to check out the sweet spot? I did that and it really helped me....I could see the vein and the spot between it and the edge of the ear where I needed to aim. Remember, you might need to milk the ear a little after pricking to get blood. It WILL get easier. The ear does learn to bleed over time, I promise!

You're doing a great job! Don't let this get you down...you'll get the hang of things.
 
Judy sent a pm with her +11.5 per shot (251). Judy, I'd do one unit if you can watch him. Your pre shots have been in this range with one unit and he has been fine
 
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