hypo yesterday and needing help figuring out insulin today

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Holly and Josie

Holly and Josie

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First of all, thanks to everyone who gave me such great suggestions on my thread yesterday.

Secondly, I need some help figuring out my kitty's insulin today. I have also posted this on the PZI thread, as she is on ProZinc.

As my previous thread indicated, Josie's BG was at 29 yesterday at 4+. Through a combination of high carb food and some Karo, her numbers got up quickly. She was at 146 within an hour or so. Now, we probably overdid it with the food and Karo because last night, before her injection, she was at 573. That is the highest she has EVER been by a LOT. (It's rare for her to be in the 400's at home.) We gave her 1 unit, which is half her normal dose. (She generally gets 2 units at midnight and 1.5 at noon). By 6+ she was at 280.

I expected her PS number to be really high, but it's only 304. So really, it barely moved from 6+. This seems strange to me. And I'm having trouble figuring out how much insulin to give her. I am thinking .50?

Does anyone have any suggestions? I would appreciate any advice you could give!

Here is the link to my post from yesterday:

viewtopic.php?f=28&t=64398

I am sorry I don't have a spreadsheet, I am working on that!
 
Re: hypo yesterday and needing help figuring out insulin tod

Need to know some info:
What dose was being regularly given?
What time(s)?
What test values you've gotten on 'normal days'?
What are you normally feeding and how much?

When in doubt, being conservative is best. You can't take insulin out once its in.
 
Re: hypo yesterday and needing help figuring out insulin tod

BJM - Thanks for your reply.

- The vet began her on 3 units, twice daily, but once we switched to lower carb food we got her down to 2 units in the late evening and 1.5 units in the early afternoon.

-We give her insulin around midnight and noon. (This is weird, I know, but it's due to my husband's work schedule.)

-Unfortuntely, her numbers are kind of all over the place. They are always lower after her noon shot than after her midnight shot, which is why we give her less insulin at noon. Still, even though we give her less then, when she goes very low it's always after the noon shot. Her normal "peak" number can be anywhere from low 100's to mid 200's and her preshot number varies from high 100's to high 300's. Twice this week she has gone well below 100 (59 & 29 at 4+). I am working on a spreadsheet now.

-She is currently eating Innova Evo Grain Free dry and some wet food (Usually Wellness or Evo). She free feeds and is given 1/4 cup of the Evo per day (It's supposedly very high in calories, so I would think that's an OK amount, but maybe not?) but she doesn't always eats all of that. She also eats a tablespoon or two of wet food twice per day, right before her injection.

We went ahead and gave her the .5 units at noon and I am really hoping that it was a good decision.
 
Re: hypo yesterday and needing help figuring out insulin tod

Holly,
I think you did fine on the .5 decision. Once your SS is up and running, we'll be able to see all the numbers and make sense of them. It looks like she was high as expected at midnight, and the 1 unit did a good job bringing her numbers back down.

Let us know if you get any more numbers this afternoon or evening.

Carl
 
Re: hypo yesterday and needing help figuring out insulin tod

Holly and Josie said:
-She is currently eating Innova Evo Grain Free dry and some wet food (Usually Wellness or Evo). She free feeds and is given 1/4 cup of the Evo per day (It's supposedly very high in calories, so I would think that's an OK amount, but maybe not?) but she doesn't always eats all of that. She also eats a tablespoon or two of wet food twice per day, right before her injection.
Click to expand...

There's the probable issue - the variable consumption of the dry food. Your best results will be from consistently feeding ONLY a low carb canned food. Although it may be the Evo cat and kitten dry (one of the lower carb dry foods out there), the carb calories per volume will still be more than the canned food due to the calorie density of dry food. Additionally, dry food is a water-depleted diet, which stresses the kidneys, the last thing any cat needs, much less one that is diabetic. If it is a budget issue, reduce the dry to 1/8 cup, which she may finish, and as much low carb canned as she'll eat on top of that within the 12 hours.
 
Re: hypo yesterday and needing help figuring out insulin tod

BJM said:
There's the probable issue - the variable consumption of the dry food. Your best results will be from consistently feeding ONLY a low carb canned food. Although it may be the Evo cat and kitten dry (one of the lower carb dry foods out there), the carb calories per volume will still be more than the canned food due to the calorie density of dry food. Additionally, dry food is a water-depleted diet, which stresses the kidneys, the last thing any cat needs, much less one that is diabetic. If it is a budget issue, reduce the dry to 1/8 cup, which she may finish, and as much low carb canned as she'll eat on top of that within the 12 hours.
Click to expand...

Yeah, I have been thinking that not knowing exactly how much she is eating each day is causing a lot of the problems. Nope, it's actually not a budget issue. I really want to start feeding her all wet food. But I have two issues with that... One, I am scared that her numbers will drop faster than I can reduce her insulin. Since I am already having issues with hypos, this really scares me. Two, I guess I'm not quite sure how transition her. I don't know how to make her eat more than a tablespoon of wet food at a time. And if I take away all the dry, she obviously needs to be eating a lot more wet. I just don't know how to make the transition. She never used to like wet food AT all and now she will gobble up at least half the wet food I give her and I can usually prod her to eat the rest. I am just having trouble figuring out how to get started.
 
Re: hypo yesterday and needing help figuring out insulin tod

carlinsc said:
Holly,
I think you did fine on the .5 decision. Once your SS is up and running, we'll be able to see all the numbers and make sense of them. It looks like she was high as expected at midnight, and the 1 unit did a good job bringing her numbers back down.

Let us know if you get any more numbers this afternoon or evening.

Carl
Click to expand...

Thanks for your reply! I am working on that spreadsheet and I hope to have it up tomorrow!
 
Re: hypo yesterday and needing help figuring out insulin tod

Holly and Josie said:
Yeah, I have been thinking that not knowing exactly how much she is eating each day is causing a lot of the problems. Nope, it's actually not a budget issue. I really want to start feeding her all wet food. But I have two issues with that... One, I am scared that her numbers will drop faster than I can reduce her insulin. Since I am already having issues with hypos, this really scares me. Two, I guess I'm not quite sure how transition her. I don't know how to make her eat more than a tablespoon of wet food at a time. And if I take away all the dry, she obviously needs to be eating a lot more wet. I just don't know how to make the transition. She never used to like wet food AT all and now she will gobble up at least half the wet food I give her and I can usually prod her to eat the rest. I am just having trouble figuring out how to get started.
Click to expand...

Given how low her insulin level is, take the weekend and go for it. Change the food completely and STOP the insulin while you do it. Test for ketones and glucose levels as if you were doing a curve. It you're lucky, you may have a diet controlled diabetic.

Its OK to leave the canned food out for 12 hours so she can nibble when she wants - I do it all the time. If concerned, put an ice pack under it, or freeze some of it to thaw during the day.
 
Re: hypo yesterday and needing help figuring out insulin tod

BJM - First of all, I am SO very sorry to hear about your kitty. I posted on your other thread, but I just wanted to tell you here how incredibly nice you are to still be posting on my thread, given what you've been through since last night. So thank you so much for your help and advice.

I think I do need to just go for it, in terms of switching her food. But I have to admit it makes me a tiny bit nervous to stop her insulin completely, given how high her numbers have been the past day or two. But of course, I don't want to risk her numbers getting dangerously low, so maybe it's for the best.
 
Re: hypo yesterday and needing help figuring out insulin tod

Since she has been so volatile in terms of numbers, I would be nervous also. You can change food slowly, keeping an eye on the numbers, adding a little more wet a bit at a time, until you are all the way there.
 
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