is it time to change dosage?

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NadjaAndSam

NadjaAndSam

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Sam started on Prozinc on 2/16 taking 1U 2 x a day.
Yesterday I gave him 0.5U since his levels were low. This morning I tested Sam, it had been 9 hrs after his shot, he was on empty stomach he tested 94 mg. 20 min. after he ate he was 87. I called the vet because I was worried since I don't know what I am doing, they asked to bring him in and they used alphatrack, the vet was impressed that my human meter wasn't "that off". Sam tested 78 with alphatrack and 11.5 hrs after his shot.

The vet at first wanted me to keep at 0.5U but she said since I don't have half mark on my syringe to give him 1U tomorrow. She also told me to skip his shot tonight.
I'm returning on Tuesday for another quick glucose test and if Sam is low like this she will have me change dose to 0.5. She also wants me to test him once a day, she said we are treating him not the numbers :?

So basically I give him 1U at 9am tomorrow, test him at 1pm, and give another 1U at 9pm. Come back on Tuesday . I don't know how I feel about that. She doesn't like the idea to eyeball 0.5 so so prefers me to give him 1U tomorrow and we will see what his levels are on Tuesday to possibly reduce dose which I'm sure it will to happen.
Now she pretty much wants me not to test him before giving his shot. She said to test him 1x a day around 1pm ish :? Even though she liked the fact I reduced his dosage from 1U 2x a day to 0.5 2x a day she still wants me to give him 1U 2x a day tomorrow to avoid eyeballing it.

What do you think about this? Should I eyeball 0.5 or do as my vet said? should I test Sam right before his shot or test him once like she asked me to do? :?
 
I know it is hard to get advice from "crazy cat people on the Internet" that is contrary to your vet. You can't treat your cat without treating him by his numbers. We are interested in how the whole cat is doing - playing, playing, eating, preening. But the most important thing is his blood glucose levels. We always say if it were our 2 legged child, we wouldn't give insulin blind. We do the same with our 4 legged ones.

I have no problem with skipping tonight. I think getting some more numbers will help you see how his body is working without insulin - whether he stays in a non diabetic range or not. (the idea that you are not capable of shooting half a unit is laughable. I have confidence that you manage it. :mrgreen: )

As far as your dose in the morning, I would argue it will depend on his bg levels. Just giving him one unit without knowing what his numbers are is dangerous and not a good treatment plan,IMHO.
 
I totally agree with Sue. Shooting blind is just not safe for your kitty - or any kitty.

When I first came here, it really tore at me to not follow my vet's directions...but I also knew in my gut the directions were not right. Sue and others helped me feel better about not following my vet's directions to the letter. Basically, you and your vet want the same thing - a healthy and safe kitty. Shooting blind is not the way to keep kitty safe - and may be the opposite of keeping kitty healthy. (Many vets just don't have experience of owners/parents willing to test.)

Keep home testing before the shots, and at least once around nadir. That's three times a day minimum. And if you're doing the testing, there's no need for the expense of having your vet do the same testing. :-D You can do a curve on a day off. :-D

If kitty has BGs below 100, those are not diabetic numbers and do not need insulin. I would be hesitant to shoot any insulin if BGs are below 200.

What food is Sam eating? Is he on all low carb?
 
I would go with 0.5 units. His numbers are low; he's in no danger from not getting enough insulin. Maybe 12 hour cycles are not right for him, or maybe the dosage is too high. Either way, you don't want him going any lower, so I would recommend you do not give him 1U 2x a day.

HTH,
Lori
 
:mrgreen: I have to agree with you. It doesn't make sense to just check his levels once at 1pm but I want to check his levels before his shot. We only know I shouldn't give him insulin tonight because I tested him.
I'm going to test him tomorrow morning before his shot on empty stomach and we'll see from there :D but I think If yesterday I gave him 0.5U and today he is low I can't imagine how he would have been if I had given 1U instead. Vets are "funny".

Random thought, how can I make a cat to spot picking on his brother? My cat Franklin is usually picking on Sam, I tell him "no" but it doesn't seem to help. Franklin is about 5 yrs younger than Sam and has lots of energy, Sam wants to be left alone :?
 
thank you everyone!

Sam is eating Nature's variety wet food, Chicken and rabbit. I want to start making my own food but I have to wait until I have funds to get a grinder :D
So is nadir his lowest level measurement? even though I'm not giving his shot tonight should I continue to test him?
 
Based on the numbers you've seen so far, I would absolutely test him before each and every shot, and not shoot if he is below 200. If you didn't test and you gave him a unit of insulin when his blood sugar was 80 he would almost certainly have a hypo.

I agree with others, it is hard to go against your vet's recommendations, but he's your cat. You are the one administering the insulin. Testing can't hurt and may help, please do it before every dose. If your vet doesn't see the value in the information you are providing, so be it, you can get another vet or you can take his advice with a grain of salt. The advice of the people on this board went against what my vet said, but it worked. My vet is thrilled with Scout's progress even though I did not take her advice at all times.

Good luck and keep us posted!

Lori
 
thank you Lori I will keep you all posted :D

I know it's hard to go against the vet's advice and I"m sure they might feel disrespected but I want to test my cat so I will :D
So is nadir his lowest level measurement? even though I'm not giving his shot tonight should I continue to test him today or should I test him tomorrow morning before his shot?
 
Nadir is the lowest BG during the cycle, yes. If you're not giving insulin tonight there is no need to test...unless you are just gathering data on how Sam's BGs go without insulin.

Definitely test in the morning before giving any insulin. And since Sam has been getting too much insulin, regardless of how high he might test in the morning, go with the reduced dose. If his BG is below 200...don't feed, and re-test in 20-30 minutes. Post here for assistance. :smile:

We've all been in your shoes...learning this crazy sugar dance. :-D
 
Nadir is the lowest point in the cycle, when the cat is on insulin. The ideal curve for a diabetic kitty is a smile, with the two sides the preshot numbers and the nadir the bottom of the smile.

If you can, I would get some tests in tonight. It will help you figure what dose to give in the am and give you information that your vet ahould be able to use. Besides, it's good practice. The more you poke, the better and easier it gets.
 
thank you I will keep you posted! so the best way to find out the nadir is by ding the curve right? testing him every 2 hrs for 12 hrs?
I will test him tonight out of curiosity and I will keep you posted :]
 
Yes, the curve will show you exactly. You can get a +4 and a + 7 and not be sure when the nadir was.

But if you aren't giving insulin, it probably won't tell you much.

Up to you. Data is good, but more meaningful if he is on insulin. You could get some numbers tonight but spare his ears for another day?
 
yes you are right. I will give him a break tonight since I'm skipping insulin but I'll be back to my poking activities tomorrow :twisted: :mrgreen:
So tomorrow when he is still fasting, before he eats I test him, if he is lower than 200 don't feed him and test again 30 min later, if he is still low can I feed him and then about 20-30 min after he ate I can test him again?
I will start another thread tomorrow :D

oh another question, right now he is eating 1 can 6oz of food a day. I just don't know if this is enough or not because I used to free feed him dry food. He seems to want more than 6z he weights 10.9 currently. How should I know how much to feed him? according to the vet he needs to loose a little more weight but Ijust don't know if I should give him food every time he asks or not..!
 
I would expect him to be pretty high tomorrow. I'd be real surprised if he is in low numbers.

We usually say to feed new diabetics more than usual. Their body isn't utilizing the food well while they are unregulated. You could feed him another 1/2 can or so, but divide it up into mini meals during the day and night. You can also add water to it and make it kinda soupy. It will feel like more food.
 
got it. Thank you for being here for my little Sammy :] he being a bit obnoxious now, wants to go outside to the porch (the furthest he goes)!!
 
But yes, you are absolutely right about what to do if he is near 200. The ladies in the Breakfast Club will be able to help you figure out a dose in the am.
 
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