Home tested and Jayne is at 94 -- still give insulin?

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Daphne and Jayne

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Hi, everyone. We have just started hometesting Jayne yesterday and ran a couple of trial runs. Tonight we tested her right after eating, and it was 88. We tested again a few minutes later and it was 94. I don't feel comfortable giving her her 3 units of PZI with levels this low, but I know the levels will go up as she digests her food. Any thoughts on this would be greatly appreciated.
Her last injection was at 7:45 this morning, 3 units of PZI.
 
94 is a great number to have :thumbup

No, do not give any insulin. I would test bgs again in an hour. If the bg hasn't gone up over 200, then just skip the insulin for tonight. Your cat will be ok with a missed injection.
 
Just be ready for a high number tomorrow, Daphne, since you will be 24 hours since insulin. Don't react to it with your usual dose. I would cut it at least in half.
 
3U PZI is a lot of insulin. Do you want to tell us how you arrived at that dose?

We usually tell people not to shoot lower than 200 when first starting, 150 when experienced with lots of data.

Congrats on the home testing, on the low numbers, and on posting! Ask any other questions you might have. We'd like to be of help.
 
This is a prefect example of why people should home test and why people shouldn't just blindly give the dose recommended by their vet. If you had given your cat three nits of PZI when the BG was that low, you could have overdosed your cat.

You will probably have to do some fine tuning on the dose; We all have to in the beginning. I agree that at least cutting the dose in half is a good place to start.
 
The vet had done an initial glucose curve at the beginning of Feb. and determined that Jayne needed 2 units of PZI 2x/day. He also prescribed Hill's w/d. After 10 days, he did a more extensive curve -- and kept her longer because she "wasn't responding to insulin." When we picked her up, they said she actually needed 3 units 2x/day.

I have an appointment with another vet tomorrow for a second opinion. I would like to switch Jayne to a lower-carb food but wanted to make sure it wouldn't alter her levels and change her dosage needs. Now that I'm home-testing, I definitely understand how knowing the number before giving a shot makes a huge difference. I'm hoping this other vet can provide guidance on getting Jayne more on track.

Her level was at 430 this morning, and I gave her 1.5 units of insulin. She seems A-OK so far.

Thanks again for taking the time to respond!
 
Good job this morning, Daphne. It was a high number but to be expected after skipping last night.

If you can switch over to wet lo carb, you should continue to see lower numbers. When we switched Oliver over from dry to wet, he dropped 100 points overnight.

Now that you are testing, you can compensate for any downward changes by lowering the insulin amount

Hope you can find a more progressive vet who will understand how important diet and testing are. If you want to start a new thread with your city and state and ask for a FD vet, someone may live near you and know one.
 
If your cat is giving you a 94 while on WD, I can only imagine how much better things would be if you weren't feeding that $#&* food :)
 
I definitely want to switch Jayne from the Hill's w/d. I noticed from the Binky's page that it's still quite a lot higher in carbs than many foods. But then the Hill's Science Diet page says that the fiber in the w/d can help regulate the GC levels... Kind of confusing.

Also, if Jayne's levels are still high tonight, would that call for me to go back to giving her 3 units? Is there a PZI chart on this site that can help determine how much insulin to administer for different GC levels? I'm wondering how to proceed with her dosage if she reads 200-300, 300-400, etc. Plus, she eats more at some meals than at others. I've looked at some of the spreadsheets, but I'm not sure how the dose is arrived at given the GC levels. Thanks for any help/explanation about this. I'm trying to learn how all of these factors work together.
 
The old school of thought is fibre to smooth insulin levels, but the carb levels are so high and the ingredients are so NOT species appropriate that it is just not a good food to feed.

Honestly? I don't want to tell you what dose to give but given that she's had such good duration, I'd consider going to half a dose for now and testing to see how she responds. Some people develop a sliding scale for dosing according to preshot levels, but you can't safely or intelligently do that until you've collected data for a consistent dose. Of course, you can't be consistent if she throws you curveballs like low numbers :lol:

Does this help?
 
Yes, it does help. I definitely don't mean to put anyone on the spot as far as telling me exactly what to do, but I'm interested in hearing about how others make decisions about dosage. It's hard to follow my vet's instructions when to say across the board to give her 3 units a half an hour after eating twice a day just doesn't seem logical to me. But, of course, I'm not a doctor -- so it's difficult to make calls about what dose I'm putting in Jayne's body.
 
It IS a tough spot and I have been there. Testing will help give you answers, reeducing the dose meanwhile will give you a better safety margin. Testing urine for ketones will also help that safety margine as insufficient insulin can also cause issues

Jen
 
Hi Daphne,
You are asking good questions about dosage. There is no set PZI protocol,, but if you go to the PZI insulin support group forum you will find "stickies" with lots of information.
We usually suggest that people start out with 1U twice daily 12 hours apart. Then we slowly increase till we get BG numbers that we want. That way you do not miss the optimum dose. Aond it is recommended that there is a no shoot number of 200 for newbies until you have enough data to be sure it is safe to shoot lower than that.
If you read some of the PZI posts, you will find lots of discussions about deciding what dosage to give in the next shot.
Hope the vet you are seeing tomorrow turns out to be a good one!
 
Daphne and Jayne said:
Yes, it does help. I definitely don't mean to put anyone on the spot as far as telling me exactly what to do, but I'm interested in hearing about how others make decisions about dosage. It's hard to follow my vet's instructions when to say across the board to give her 3 units a half an hour after eating twice a day just doesn't seem logical to me. But, of course, I'm not a doctor -- so it's difficult to make calls about what dose I'm putting in Jayne's body.
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Glad to see you got a handle on the hometesting Daphne. :) Wow, that could have been a disaster!

I think the others have answered your questions, but as far as a guide for testing it is generally said to start out at a low dose and hold it for a few days to a week or so and then see how she responds.

While you are doing this try to get some mid-cycle tests in to see how the PZI insulin is working after each shot.

Then you would either raise the dose slightly or lower it according to your testing data that you have gathered.

At the same time you could try eliminating the dry food as well with this lower dose and because you are hometesting you can see how this will effect her levels.

You can always check in here with questions about the results you are seeing.

Glad to see you are seeing this new vet tomorrow. :) I am sure after your visit a lot of this will make much more sense. Take a list of questions with you and any recent bloodwork that Jayne has had. Did you get copies from the other vet? Always ask for copies of all tests and bloodwork.
 
Thanks, Pamela -- yes, I requested all of Jayne's records, and I'm picking them up in the morning so I can take them with me.

When you say eliminate the dry food, do you mean stick with the canned w/d, or are you talking about the gradual move to a lower carb food? What I mean is, are you saying it's better to give canned w/d than dry, even though it's higher in carbs than other kitty foods? I wanted to wait to talk to the vet tomorrow before shifting Jayne over to a totally new food, just so I don't shock her system.

I'm so glad I tested and posted about the low glucose levels, because if I hadn't I would have had no idea how low they already were. Thank you and everyone here for your willingness to help.
 
Daphne and Jayne said:
Thanks, Pamela -- yes, I requested all of Jayne's records, and I'm picking them up in the morning so I can take them with me.
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Good for you! :)

Daphne and Jayne said:
When you say eliminate the dry food, do you mean stick with the canned w/d, or are you talking about the gradual move to a lower carb food? What I mean is, are you saying it's better to give canned w/d than dry, even though it's higher in carbs than other kitty foods? I wanted to wait to talk to the vet tomorrow before shifting Jayne over to a totally new food, just so I don't shock her system.
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Oh okay, I didn't know you were feeding canned W/D too. I thought you said in another post that you were feeding the Fancy Feast and that she didn't like the W/D dry very well.

Any canned food (even W/D) is better than dry. But if it were me I would go with the Fancy Feast for now as long as you are going to lower the dose to one unit and are spot checking each cycle (on the other hand, I am almost thinking now even a .5 unit if you go with the Fancy Feast).

Like Judy said though, have a cut off point in the beginning until you see how she reacts to the insulin. She mentioned 200. I think that is a safe number to go by for now especially if you are going to eliminate the dry food.

But since you are meeting with Elisa's vet tomorrow, wait and see what she thinks if that will ease your mind better. :) I hope she agrees with starting at a low dose. And if you feed Jayne the canned W/D before going please let her know since it is so high in carbs.

Let us know how it goes.
 
Yes you are right about even the canned prescription diabetic food being high in carbs! It is sort of ironic, like weight watchers putting out a snack with 800 calories. I would stay away from both the canned and dry prescription foods. Save yourself some money and buy some of the low carb. Varieties of fancy feast, friskies and nine lives.

Good luck tomorrow. Be sure to read some of the threads about Patrick777 's cat. When he first came to this site two and half weeks ago his vet had prescribed six units of PZI twice a day! His cat is now on less than one unit to PZI twice a day.
 
Just to clarify, I had been giving her Fancy Feast again after the emergency vet told me if Jayne wasn't eating, it was better to get her to eat a good amount of something, rather than a small amount of what was prescribed. (I went to the emergency vet the day after Jayne came home the first time because I was fearful of hypoglycemia, something my vet had not mentioned at all.) I opted for the canned w/d because I thought Jayne would like it better, which she did.

janelle and Nomad said:
Yes you are right about even the canned prescription diabetic food being high in carbs! It is sort of ironic, like weight watchers putting out a snack with 800 calories. I would stay away from both the canned and dry prescription foods. Save yourself some money and buy some of the low carb. Varieties of fancy feast, friskies and nine lives.

Good luck tomorrow. Be sure to read some of the threads about Patrick777 's cat. When he first came to this site two and half weeks ago his vet had prescribed six units of PZI twice a day! His cat is now on less than one unit to PZI twice a day.
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Wow, from six units down to less than one. Amazing.

She was at 392 tonight before dinner. I'm going to go buy some Ketostix tonight and try to start on that, too. (Again, no mention of ketones from my vet, although the emergency vet did talk to us about it.)

I'll let you know how the visit goes tomorrow... I'm very optimistic. Thanks again.
 
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