Is Duke dropping too fast...

Duke been to the vets today and is starting on Prozinc in the morning with 1.5 units twice a day. He's been fairly high for a few months now, from 8.2 mmol/L glucose levels, (148mg/dL) in March to 12.9 mmol/L (232mg/dl) at the end of September, but we think the Steroid injection for his arthritic back leg he had at the end of September tipped him over because his blood glucose shot up to 19.7 mmol/L (355 mg/dl) by the 1st December. He been on a low carb diet for months now but it hasn't brought his levels down.
So we start insulin tomorrow at 8 am.
Test, feed and wait 20 mins, shoot 1.5u prozinc

Emergency kit sorted
Honey, Tate & Lyle golden syrup
Gourmet gold in gravy
Webbox Lick-e-Lix salmon
keytone strips testing daily

I will be testing his blood glucose every 2 or 3 hours with the Alphtrak for the first week or so, then as we hopefully get him stable reduce the testing to maybe 4 times daily with a human meter, we have a freestyle lite and a Gluco Navii.
If i have missed anything or there is something that i am doing is wrong please let me know.
Thanks Elizabeth and Bertie Bandit's Mom Wendy&Neko Sam-cat for your invaluable help and advice.
Tee.

 

That's a high starting dose. If you've not already seen the information in the Prozinc forum on dosing, there is great information there. This is a link to the forum. You'll want to look over the sticky notes.

 

Thanks Sienne and Gabby (GA), have you seen his spreadsheet today, just spoken to the vet and he said drop his dose down to 1 unit twice a day, i have just fed him and will check him again in 10 minutes. His bloods are coming down really quickly and getting close to danger, hopefully they will come back up. All i am doing is following the vets advice but i will certainly be posting on the forum for advice.

 

I see his last reading is in the hypo danger zone. Have you given him any food?

How to treat HYPOS - THEY CAN KILL! Print this Out!!


@Critter Mom
@Sienne and Gabby (GA)

 

Yes, just gave him a belly full and his reading has come up slightly to 4.0mmol/L (72 mg/dl). I will check him again in about 1 hour, god this is frightening.
I have posted a thread on the Prozinc forum for help and advice.
Thanks for your help, it's really appreciated.
Tee.

 

I would test again in 20-30 minutes.

When Lola's BG dropped rapidly (but never into the danger zone) I was advised to feed a small amount, and test in 20. We did that a few times, spacing the interval out to 30 minutes until it was clear that she was holding her BG without the aid of food.

 

On the plus side, at +8 he's likely past his nadir. And, by Forum guidelines he's earned a .25u decrease. (Although I hasten to stress that I am not qualified to give dosing advice! Please see the PROZINC DOSING METHODS)

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

@JanetNJ
@Shelley & Jess

 

Thanks Pookie for your help, i will check him again in 20 minutes, fingers crossed they have gone up.
I have started a new thread in the appropriate forum. https://www.felinediabetes.com/FDMB/threads/are-dukes-bloods-dropping-too-fast.240790/
Tee

 

I saw that after I responded initially here. Since there seems to be little activity on the ProZinc forum this morning, I think this is a wise place to be.

I would suggest that you change the title of your post from "Duke's starting..." to something like "Is Duke dropping too fast.." so people know that it's not a general status post.

ETA: It was during Lola's dramatic drop into lower numbers that we both become quite better at testing

 

Hi, I have changed the title, just going to check him again in a few minutes, i gave him some Golden syrup to bring him up a bit.

 

I've been hoping that someone more experienced would have joined us by now, but in the meantime I've been doing some searching. I know this post (#7) is quite old (from 2015) but I don't think the guidelines will have changed much:

If she drops below 50, you give a teaspoon or 2 of the "gravy" from a Gravy Lovers type food. Don't feed a lot of the meat part. What we do is pop the top, put it back down and squeeze to get as much of just the gravy as we can out and into a bowl or tupperware dish.

You recheck every 20-30 minutes...if it climbs into the upper 60's or so, you stop giving the high carb and try only regular low carb food ...if she stays too low, (or drops back down under 50) you give more gravy and retest in 20-30 minutes (we call that "Lather, rinse, repeat"....LOL)

Once they're in the high 60's or above, you want to give one more snack of low carb food and then no more (unless they drop again) You need to continue testing until it's been about 2 hours since they had any food and they're still staying in safe numbers​

 

Thanks, Pookie unfortunately i'm in the UK and that's not available, but we have Gourmet gold in gravy a similar thing i think. Just checked him again and he's up to 5.3 mmol/L (95mg/dl). will check again in 30 mins.

 

Since he's going up that sounds like a good plan to me.

FYI, you can enter multiple readings in one square on the SS. (Something like "xx@+8; yy@+8.5") It may look a little wonky, but it puts the information immediately at hand.

 

Hi Tee,

I've only just seen this.

Very glad you caught the 3.4 (Alphatrak).

Full disclosure: I've not used Prozinc so any help I can offer is based on general principles of treating a diabetic cat with insulin and a very basic and patchy understanding of the specifics of Prozinc. Hopefully experienced Prozinc users will be able to weigh in with much more specific information and help for you. Because it's the holiday period, it may be a little longer than usual before you get more tailored replies. (Tagging: @Deb & Wink, @JanetNJ and @Panic to alert them to this thread.)

First up, Prozinc is an in-out insulin, so you've some bit of dosing flexibility (compared to Lantus and Levemir). In this instance, if you don't hear back from an experienced user here to the contrary, I would recommend following your vet's advice to drop the dose down to 1.0IU tonight. (It can always be adjusted again should it be too low, but it's better and safer to "start low, and go slow".)

Glad to see Duke's back up to 5.3.

* * * * Don't feed. Test again 30 minutes from the time of the 5.3 test. * * * *

Questions:

* Is Duke's appetite good?

* Which varieties of Gourmet Gold do you have in the house. Please be very specific about the varieties and flavours. (I need to look them up to check the carb values.)


Mogs
.

 

Also, have you got plenty of test strips for the Alphatrak?


Mogs
.

 

I was wondering if i could do that, thanks.

 

Thanks Critter Mom yes his appetite is good.
The food is Gourmet Gold chunks in gravy chicken and liver.
Loads of Alphatrak strips, but i have a human meter Gluco Navii if needed.
Do you think i should dose him tonight as i'm really reluctant because of what has happened on his first day on prozinc and i cannot check him during the night.
Tee.

 

@teetee (UK) -

Thanks for replying. I'm going to try to look up the food now. While I'm doing that, another question:

* Does Duke have any history of testing positive for ketones or episodes of diabetic ketoacidosis?


Mogs
.

 

(For any UK members following this thread, the Gourmet Gold Chicken & Liver Chunks in Gravy is a high carb food - works out at 25% kcals from carbs.)

.

 

We check Duke everyday for ketones and they are negative. His bloods are back down to 4.1 mmol/L (73.8 mg/dl) so i have given him some Gourmet gold chunks in gravy chicken and liver, he woofed it down. Check again in 30 minutes.

 

If you haven't already done so, Tee, please can you check Duke's BG now and let me know the reading.

As long as the result is above 3.8, please don't feed him anything. Post the result and wait to hear back from me.

If he is below 3.8, please give a teaspoon of the GG chunks and some of the gravy, then post the result.


Mogs
.

 

We cross-posted.

The 4.1 is safe for now. Test again in 30 minutes. Please follow the recommendations in my post above (#21) when you take the next reading.

For future reference, the golden syrup you gave will have helped boost the levels when you got the 5.3. Syrup or honey can boost numbers quickly but it also wears off quickly, hence why we use higher carb foods to steer numbers when a cat's running on the low side: it helps keep numbers up for longer (but you still need to keep testing to check whether more feeding is needed).

My furchild needs edibles. Back shortly...


Mogs
.

 

Hi Mogs, his last reading about 10 minutes ago was 4.1 mmol/L (73.8 mg/dl). Sorry i have fed him a desert spool of the Gourmet gold chunks in gravy chicken and liver before i read your post, i panicked when i saw the numbers come down again.

 

Glad you are reducing to 1 unit! Good catch! I am so glad you're testing. Duke is lucky to have you.

 

You're doing fine. He's in a safe range.

 

Thank you so much everybody for you help.
I have just checked Duke again and he's back up to 7.7 mmol/L (138 mg/dl). I will check him again in 30 minutes.
Should i dose him tonight i'm so worried now, or should i just give him 0.5 unit.
Thank you

 

That's mild! Saoirse only ever had one hypo event (when I took the vet's advice to hold a dose against my own thoughts that I should have reduced it). I shoved the contents of an entire 5.5oz can of Purina DM mixed with a spoon of honey under her nose and she wolfed down practically the whole lot. (She was only at 4.4 on an Alphatrak at the time but she was zoned out and lethargic so symptomatic, after the too high Caninsulin dose caused a massive drop in her BG levels in less than 3 hours.)

You're keeping Duke safe, Tee. You're doing grand.


Mogs
.

 

Janet, is there any chance you could give input on the dosing, please? (Tee advised above that ketone status is checked daily and thus far has been negative.) Also, I'd be grateful if you could take over keeping an eye on Tee and Duke as well (I'm struggling with quite severe fatigue right now). Would that be OK with you?


Mogs
.

 

Thanks Mogs you have been a fantastic help, you sit down and have a nice brew. Thank you, thank you, thank you.
Tee.

 

That's OK. Others have helped me with this stuff in the past.

I won't leave till I know that someone's here to keep an eye out for you two.


Mogs
.

 

Is your next test due, Tee?


Mogs
.

 

I am just going to do it now Mogs as he's due his +11 test anyway.

 

Hi Mogs he's now at 11.5 mmol/L (207 mg/dl), hopefully we are past the worst thank god. Now what to do in 1 hour when he's due his insulin.

 

That's it, Duke. Work that chandelier!

Checking back on the earlier posts. BRB...


Mogs
.

 

Hi Mogs--

I'm around-- looks like Duke is heading well out of danger, but if you need to log off for a bit I can keep an eye on things for a while.

 

Thank you so much.

 

As long as it's high enough at preshot I'd probably go with 0.75-1

 

Thanks Janet.
I'm doing his PMPS in about 3/4 of an hour so i will post the result and if possible could you advise on dosage please.
Tee.

 

From the Prozinc Dosing Methods sticky - Start Low, Go Slow Method:

Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
• Generally, shots are to be given 12 hours apart.

[Emphasis mine]

As I mentioned earlier, I've not used Prozinc so can only give suggestions based on general experience of insulin treatment for diabetic cats. People with Prozinc experience are likely to give you much more specific advice.

Considerations for tonight's dosing decision:

* Duke has no history of DKA or ketosis.
* Daily checks for ketones are ongoing and all results to date have been negative.
* Duke was biochemically hypoglycaemic on 1.5IU dose today.
* You've only just started insulin treatment. Therefore you're only in the discovery stage of what Duke's response will be like, and there's only limited BG data available (obvs!).
* You're feeding Duke a low carb, wet diet.
* The Prozinc guide recommends a starting dose of 0.5IU for a cat just starting insulin treatment who's on a wet, low carb diet.
* You can't monitor tonight.
* Duke hadn't come up too high by +11 (11.5 on Alphatrak), even after the high carb food used earlier to steer his numbers.

Based on the above considerations, I'd suggest skipping tonight (less of an issue when a cat doesn't have a history of being ketone prone). If you were to choose to give insulin, I'd suggest you consider the 0.5IU dose recommended in the FDMB Prozinc guide as a maximum.

If it were my cat and I couldn't monitor, I would skip tonight. Other members may offer additional/different suggestions.


Mogs
.

 

That'd be great, Nan. You're a topper!

@teetee (UK) -

Tee, you're in good hands now. Glad Duke's OK. You did great today.


Mogs
.

 

Thanks Mogs you've been fantastic, just going to check Duke now, but as you say i would prefer to skip his dose tonight as i would never sleep.
Thanks again Mogs.
Tee.

 

Just checked Duke's PMPS and he's 14.8 mmol/L (266 mg/dl). Should i leave him for tonight and not give him insulin and start again in the morning with 1.0 unit, Also am i to expect a bounce with what's gone on today?

 

I'd certainly expect some kind of bounce; that may be part of what you're seeing right now.

As long as there's no history of ketones, I think you'd be safe to skip. He's definitely high enough to shoot, but you might prefer to get a good night's sleep after today's excitement and re-visit things tomorrow .

 

I wouldn't blame you for skipping either you've had a heck of a first day!

We expect Duke to bounce but a kitty can be sensitive to insulin after a low like you got today too. We just don't know what way it will go with Duke yet.

I'm leaning towards reducing to 0.5u (when you do restart) because we're at the end of 3 months after a steroid shot.

 

Thanks Nan, i'm not going to give him anything tonight, Duke's worn out, i'm worn out and stressed. We go again in the morning.

 

Yes i think your right Shelly and i will reduce to 0.5u in the morning and see where we go from there, thank you for that.
Tee.

 

Id do at least 0.5.

 

Do you mean 0.5u tomorrow or tonight Janet?

 

I'm in agreement with skipping the insulin for tonight, and starting over at a much lower dose in the morning. The 0.5U dose would be my recommendation.

A combination of Duke being 3 months post steroid shot, the low carb diet, and the lows today are saying to me that Duke needs less insulin than the 1.5U he got this morning.

He's bouncing for sure, from that low neon green 3.4 mmol/L (61 mg/dL). Duke EARNED that dose reduction. YOU earned a good night's sleep. "Nighty night, sleep tight, don't let the bedbugs bite."

p.s. Yes, Duke was dropping too fast.

 

I would have done the 0.5 tonight, but skipping is fine.

 

Thank you so much everybody for your help yesterday, i don't know what i would have done without you all, thank you, thank you, thank you and a very happy new year to you all.
We go again today with a 0.5u injection and hopefully it will be a better day for Duke.
Just a quick question about the steroid, @Deb & Wink @Shelley & Jess what is it about the 3 month post steroid injection, does it stay in the system for so long?
Tee.

 

Oh, crikey, Tee, what a New Year's Eve for you.... Well done for dealing with that. I know how scary it can be. And it's great that you got such good support and advice.

Don't be surprised if you just see higher 'flatter' numbers today. Although you may not. A 'bounce' can last anything from hours to several days. But don't let any higher numbers over that time tempt you into raising the dose.
Quick explanation of a 'bounce': When the blood glucose drops too low or too fast (or both) the body can respond to that stress by releasing stored glycogen to raise the blood glucose level. It can also release counter-regulatory hormones that cause temporary insulin resistance. The net result of this is typically higher blood glucose levels that may be 'flat' and unresponsive to insulin. There's nothing to be done except wait for it to clear. And it will clear...

Steroid-induced diabetics have a higher than average chance of going into remission. And some only need a short time on insulin to give the body the support it needs to heal enough to do that.
Because of Duke's diabetes 'probably' being steroid-induced it will be important to keep an eye on those blood glucose levels, especially over the coming weeks when he is new to insulin.

Again, well done for dealing with that. (((Big hug)))

Eliz

 

Morning Eliz, happy New Year.
Thanks for explaining everything.
It was a terrible day yesterday, we were pleased and very apprehensive to get Duke started on the insulin to try and get him sorted and then that happened. I was expecting it to happen at some time in the future but not on his first day, it's a good job we had the hypo kit sorted prior to him starting. I'm checking him again every two hours again but as you say i'm not expecting any true numbers.
Tee.

 

ECID (Every Cat is Different) but when the effects of a steroid injection start wearing off they can tumble down the dosing ladder quite quickly especially if the diabetes was caused by the steroid injection in the first place. Taking into consideration your steroid injection 3 months ago, the low carb diet and that his numbers weren't terribly high before the injection, I'd rather see you start out at a lower dose and work your way up in 0.25u increments if needed rather than starting high and risking hypo numbers (again).

Jess was getting steroid medication daily, we tapered the dose down slowly and when the effects finally cleared her system it was like I had a different cat. She still needs a bit of insulin but she's doing great. Another member I can think of off the top of my head, @NoahFL (Rebecca and her kitty Max), had a steroid shot and when the effects started wearing off for him he didn't just tumble down, he rocketed down the dosing ladder. You can peek at his spreadsheet here: https://docs.google.com/spreadsheet...tCcG_k13ZS9g68NHrGt5iqW0zYmbU71TfNxWN/pubhtml

I'm not saying the same thing will happen with Duke - just giving you an idea why it won't hurt to be a little cautious going forward.

 

Wow that's some drop Shelley, be nice if that happened with Duke and got me thinking as to what his BG would have been just after his steroid injection, it must have been really high. I don't understand the 3 month thing though, does it stay in the body so long? Duke had one of those 2 week long lasting injections.
Tee.

 

Well i have just done Duke's bloods and it looks like he's going through a bounce after yesterdays episode, i will check him again at +10 and +11 to see where he's at. Hopefully he won't go too high.

 

Good question!

I'm voicing my concerns from personal experience and general observation of numerous kittys that have had steroid injections and have come and gone (some rather quickly) here at FDMB.

@Juls and Billy can you help us out here since Billy used to get steroid injections too?

 

Tee @teetee (UK), that has all the hallmarks of a bounce...
If you look at the SS today the blood glucose starts off high, but then as the insulin gets close to the peak of the cycle (when the effect of the insulin is strongest), it manages to briefly pull the numbers down a bit. But as soon as it's past the peak of the cycle the blood glucose is yanked up again.... That is the effect of those counter-regulatory hormones. ....But it will wear off.... Honestly....

What are you feeding Duke at the moment?

 

Tee @teetee (UK) , I know this is hard to watch, because pretty much all we can do is to 'sit on our hands' and wait....
However, with my own diabetics (only two of them, not legions, hehe!) I've found it helpful to feed the lowest carb foods, and also to add as much water as possible to help keep the kitty hydrated. Adding a bit of warm water to food and making it 'soupy' can increase fluid intake; and the warmth of the food can give encouragement for them to eat if the high numbers make them a bit nauseous.

 

Thanks Eliz, just a bit concerning at the moment that his numbers are so high, his keytones are fine, just checked them. Food wise we are going to give him the Feringa 'Pure Meat Menu' Pure Salmon with potato & parsley that's 1.9 carbs but higher calories as we don't want him losing anymore weight as he's only getting fed twice a day before his insulin or the Wild Freedom Green Lands, lamb & chicken at 2.6 carbs as a backup just in case he won't eat the Feringa.
Should i keep his dose at 0.5u or up it to 0.75u.
Tee.

 

Hi @Elizabeth and Bertie
Food wise we also have Lily's Kitchen Organic Fish Dinner and the Lovely Lamb Casserole both zero carbs but lower in calories, suppose we could give him a couple to keep his calories up.
Just going to do his +11
Tee.

 

Personally, I'd keep it at 0.5U for now. Give it a few cycles and wait for the bounce to clear before evaluating this dose. You can always go up later, but you can't take away insulin you've already given if 0.75U turns out to be too much.

 

Thank you Nan, we will 100% keep it at 0.5U.
Just done his +11 and it's down a bit to 27.6 mmol/L (497 mg/dl) back into the red.

 

Hi Tee,

Nice to see Duke in your avatar.

Just double-checking that this is a posting error and that you meant Duke gets fed *before* he gets his insulin dose.


Mogs
.

 

Your right Mogs it's an error, he gets fed before his insulin, well spotted thanks. I have corrected it now.
The pic was taken a couple of years ago when he was a bit fatter, half a moustache Duke.

 

This made me smile.


Mogs
.

 

Well i've been doing Duke's BG all day and his readings haven't changed much all day, could this be that i have done a fur shot or that it's the bounce still going on. I will check him again in two hours.

 

Hi Tee,

Might still be the bounce.

If you watch how the colours trend in the spreadsheet through the different ranges you start getting a bit better feel for bounces. Longer ones are a bit like an ocean swell, rising through reds - possibly into blacks - and then dropping down again. Duke's risen up into the blacks, dropped down through reds and now he's back in the pinks (and numbers seem to be still gradually dropping).


Mogs
.

 

Bounces can last up to six insulin cycles , so it's possible. It's fine to back off on testing on a day when it looks like he isn't going anywhere.

We sometimes see that a day in "flat, high, yellows" can precede a bounce-breaking cycle. That's on a human meter, which runs lower than the AT2, so those flat pinks might mean it's just possible that he's planning on breaking the bounce tonight.

 

Thanks @Critter Mom @Nan & Amber (GA) , i do hope he's coming out of it because he's so fed up now, it's a good job he's so gentle and keeping his claws safely tucked away lol.
Nan i love that word tonight.
Tee.

 

Last BG test done for today and it looks like Duke has finally settled down and hopefully tomorrow we can start again on on even keel.
Thank you so much everybody for you help.

 

Dukes BG has behaved today, should i increase his dose to .75U this evening? I will check him again at +11, but i think maybe he ready. Any advice please.

 

It does look like Duke needs more insulin, but I will leave dosing to others who have experience with Prozinc.

Just wanted to stop by and say that you should get at least one test every night before bed. A lot of cats go low at night and bounce in the day. One before-bed test (at whatever time), should give you an idea of how he fared.

 

Thanks @Bandit's Mom i will definitely do that tonight and every night.
Tee.

 

My goodness, he is really making that bounce last... But they can easily last 6 cycles, and this is the sixth...? ..The numbers have come down a smidge during this cycle, and I just 'wonder' if the bounce will break this evening...
I know this is immensely frustrating (my current girl is a serial bouncer since she's come out of remission ) but, if this were my cat, I'd probably wait one more cycle before considering increasing the dose.... The reason for the caution is that 'bounce clearing' cycles can have a lot of momentum to them, and extra insulin in the mix may cause an even steeper drop. Those kind of things can be harder to keep track of at night...

But, I fully accept that the 0.5 dose may be insufficient and may need to be increased... It would just be good to get a clear idea of what his baseline response is to the 0.5...
That's just my ten cents though...

Eliz

 

Thanks @Elizabeth and Bertie , Here's me thinking he was over his bounce, would it be wise to go another 24 hours on his current 0.5U and have the same conversation tomorrow evening regarding his dose?
Tee.

 

I agree. How about holding 0.5u for one more cycle and getting a couple of tests in tonight.

From the GENERAL INFORMATION AND IMPORTANT LINKS

• Following a bounce, a cat’s BG may stay high and flat for several cycles. Avoid the temptation to increase the dose at this point. If the BG does not return to normal in 6-8 cycles, an increase might be needed based on the method of regulation you are following.

Another possibility:
I'm trying to read between the lines here, guessing what may have happened in the PM cycles.
PM cycle 01/01 - PMPS 513, +2 412. This is a 20% drop in 2 hours, *usually* indicative that a kitty will go lower during the cycle. Prozinc generally doesn't start working until +2 or later.
And because he has been high and flat yesterday and today I'm wondering if he went low(er) than his body is used to during the PM 01/01 cycle too.

 

Thanks @Shelley & Jess, I understand what you are saying and i will test him tonight. Is there any specific times i should test him to help evaluate him better.
Tee.

 

just a sec, brb

 

I've got to get my bookmarks all in one place!

This document is a great guideline when first starting out: Why the +2 Test is Important - more detail information for Prozinc users by Deb & Wink

Start with the +2 and depending on the number go from there. If it looks like a 'normal' cycle maybe another test around the +5 or +6 mark to try and catch the nadir. If the +2 is lower than the PS, a few extra tests are always a good idea. If you have any questions after reading the above document let us know!

 

Just going to do his PMPS so i will post result as soon as i have done it.

 

I keep all of mine in a Google Drive WP document.


Mogs
,

 

His PMPS is 18.8mmol/L (338 mg/dl). I don't know but i am beginning to think that i'm doing fur shots with those results, but i can feel resistance with the needle when i give him his injection.
Tee.

 

Whenever I wonder about a fur shot first I feel for any wet then bury my face in her fur where I shot and have a good smell. For me, I can smell a very faint 'bandage' smell if it ever happens.

Draw a little extra insulin next time and squirt the excess out on a cotton pad or something similiar and smell to see if you pick up any scent from it. Some say they do, others don't.

 

Much easier to detect fur shots with Lantus: it's rather pungent.

Thanks for the practical hints on checking for a fur shot when using Prozinc. Handy thing to learn about.


Mogs
.

 

Just tried the smell test and i could smell nothing yet my wife said it was a very strong smell, something like anesthetic or a dentists, something like that.

 

I would try 1 unit at next shot.

 

Thanks Janet, i'm doing Dukes BG all night tonight but his numbers are just not coming down. I just cannot understand why.
Tee.

 

Get some sleep. It's not going to go too low. I think it's just too low of a dose. 1.5 was a little too much and it did earn a reduction, but I think the dose was dropped too low. It's a marathon. We will find what works.

 

Thanks Janet, as you say i will up his dose to 1 unit on the AM shot and keep a keen eye on his BG throughout the day. I will do a couple more at +6 and +7 then call it a night i think.
Tee.

 

There's no point to more testing tonight. Go to bed. Lol

 

Yea you're right Janet, my eyes are starting to sting now. Thank you so much for your help.
Tee.

 

Well i think he's doing fine on his new dose at 1 unit. I have been checking frequently to try to find his nadir and the BG drop has been gradual compared to his starting dose of 1.5U, so fingers crossed he going to accept the new dose without a bounce.
Tee.

 

Should i create a new thread as this one is over 90 posts long?

 

Yes, that'd be a good idea, especially as the early posts are now quite out-of-date.

You can include a link to this whole thread in your new thread, that way anyone who wants to review history can easily go back and read up .

 

New thread created.
https://www.felinediabetes.com/FDMB/threads/is-duke-dropping-too-fast-cont.241003/

 

Just adding my 2 cents regarding furshots. If you give a furshot or think you give a furshot or partial furshot NEVER give an additional shot. You have no idea how much insulin went into kitty in the first place and you could end up double dosing. Once the insulin is injected there is no way of getting it out!

 

Thanks for the advice Judy, rest assured that i would never do that and i would just wait until the next injection.
Tee

 

Hi @Shelley & Jess. Not sure how I missed this tag, sorry. Yes, Max was a steroid kitty and towards the beginning of remission, we were doing dose reductions very frequently. We had a lot of hypo pajama parties. I’m happy to report he is still in remission, chubby and happy. He’s still on his wet Fancy Feast classic pate and loving life. In my experience, frequent testing is a must for cats would have become diabetic due to steroids.