Is Sara heading for hypo?

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JenBen2087

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I dont know that I did this google ss correct, but sara was just diagnosed last Weds and got her first shot of insulin Thursday. I have not been able to do a curve but will do a full one today. Her AMPS and PMPS have been:

10/22 +6=227, +8=230, PMPS=193 (I just found out about testing) 2u Prozinc in am and pm
10/23 AMPS=238, PMPS=278 2u in am and pm
10/24 AMPS=279, PMPS=188 2u in am 1u in pm
10/25 AMPS=153, +2=103 1u in am

It is getting so hard to prick her ear. She was good about it at first and now I feel like I am making her a sticking pad :-(

I am concerned because she seems to be getting lower and lower and even though she is in the normal range right now I am afraid the 1u I gave her this morning is going to throw her into a hypo episode. I am prepared if it happens other than not knowing when it will happen unless it is right after testing.
 
You are very right to question whether she should have had insulin today...for future reference, I'd use 200 as your cutoff and give only 0.5 units at that kind of number until you see more data. The other thing you REALLY need to know is what is happening in between shots, to know how low she is going. But I'm so glad you are now testing because you are really starting to see how she's responding!!!

To answer your question about whether she's headed too low, see above...we don't know because you have just started testing and you don't know how low she's going between shots. Are you able to test her today for the next while? Usually the lowest point or nadir is at approximately 6 hours post shot (for PZI in general), but it varies with each cat. I know testing is getting more difficult but today of all days you need to. I'm talking +2, +3, etc all the way to +6.

Jen
 
I would get another test at +3, don't wait for +4. She could be dropping pretty fast since the onset is usually around +2. That's already a big drop for this early in the cycle.

Do you have high carb food? Karo syrup?
 
At +3 she was 82. Testing again in another 1.5 hours (trying to give her a little break because I am having to prick her multiple times because she is fighting me. Gave her some of her low carb food based on what I read here on mild hypo.

I hate this and I hate that I gave her 1u of insulin this morning!
 
Should I wait until her next test (I'll do one at +4 since I just did +3) before giving her any karo syrup and high carb food?
 
I wouldn't give her karo unless she's showing the signs of hypoglycemia. Do you have that information? Melissa has a great post on it and it should be on either this forum or under health links. For now, regular snacks are fine but have dry food ready if needed. I know this is rough, but at least you caught it right?
 
That's good, giving her a little food...just don't overdo feeding her at this point. You don't want her to get too full in case she drops very low, and won't eat because she is full. I know it can be very hard to get the tests in the beginning, but in a situation like this it really is very important to get those hourly tests.

Don't feel bad about giving the 1u, what's done is done....you didn't know better, now you do. It will be ok, you just need to monitor and feed her as necessary to keep her from dropping too low. :smile:

Many of us use the gravy from high carb wet food to help boost low numbers, it doesn't fill them up and you can give a bit by itself or with a tsp of her low carb food to help her stay in good numbers without making her go zooming up.

I was asking about the karo just to make sure you have it on hand...you don't need it unless she gets very low...below 50..or shows hypo signs.

What meter are you using?
 
I wouldn't wait another hour. I'd test in 30 minutes to be on the safe side. And if you are having trouble testing on the back, furry side of the ear then test on the front, inner part of the ear so maybe you can see better. Are you warming by either rubbing the ear between your thumb and forefinger, warm washcloth, warm makeup pad before testing?
 
My last post didn't take for some reason. I am testing every hour now with her +4 in the next 5 mins. I gave her a little of her low carb food and after I test if she dropped again I will give her the higher carb food I have in her hypo kit. Depending on how she drops I will give her karo syrup too. Yes I warm her ear, but she just hates it all so much. I just need to suck it up and do this. I am using a One Touch Ultra meter and strips. it is very accurate as I used to use it on myself because I am diabetic but now I use another one because I shouldn't share our meters. I suffer from severe anxiety and depression so this is all a little much for me right now (I just moved cross country about 3 weeks before Sara was diagnosed) so we are all stressed.

I will suck it up and do what needs to be done. Off to test now and will report back shortly.
 
You are doing great. The trick is to react, but not overreact. if some food (gravy or low carb depending on the numbers) will bring her up, that will be great. If not, you are prepared.

Are you sure giving her a treat after each poke so she has something to look forward to? and you can put a dab of neosporin on her ears to help them heal.

The good news here is that she is reacting well to insulin and diet!
 
Jen..it is Jen, right?...you're doing great, you are in control of this with testing and giving her the right food when she needs it. If she is much lower at this test, give her a little of the high carb wet food, you don't need the whole can...a tsp or 2 is enough. As Sue said, you don't want to overreact.

Thanks for the meter info, I just wanted to make sure it wasn't a pet meter because the safe range is different.

See you in a few minutes.
 
Ok her +4 reading was 87 so 5 points up from her +3 reading. What do I do now? I would ask my vet but they are apparently ignorant of anything to do with diabetes and had I not found this board I may well have killed her since they told me 2u 2x a day no matter what and sent me home with diabetic formula dry food and wet food with the second ingredient listed as RICE! Thankfully I started the low carb varieties of Fancy Feast right after her diagnosis and she took to it. (now I know you should phase diet in). Sorry, but I am very angry with my vet as they seem to be more interested in taking money than taking care of my cat and being knowledgeable about such a common disease. My lord they take classes on cold laser therapy to treat my parents dog! Ok, sorry for the rant.

Can someone help me with the following?

-Should I wait until her +5 results come in before taking any action?
-At what point do I resume insulin? When she is 200 or over?
-She has uveitus and I haven't given her her eye drops yet (which are steroids). Should I? She has been on them since last Monday night and the vet told me to use them until gone.
-She has another vet appointment this Thursday. Should I leave her home and just bring in her results? I would like to get her eyes checked again but I don't want to stress her out more than needed. You can be sure they won't be doing an in house test on her since I will be doing them for now on.
 
It sounds like she is doing good and so are you! As long as she is not dipping into the 40-50s, a little low carb food is fine. I think you could wait till closer to +5 before testing again, if you want to give both of you a break.

Depending on how long she goes, you may get a bounce for your pm number. You don't want to react to it as a higher number. Yes, I would not give insulin under 200. Post your number tonight and get specific advice.

You could look at this as an opportunity to educate your vet and pay it forward for his next diabetic patient. Maybe he will be willing to learn about diet and home testing from you. Vets are like gps; they know a little about a lot of things, but are not fd specialists.
 
JenBen2087 said:
Ok her +4 reading was 87 so 5 points up from her +3 reading. What do I do now? I would ask my vet but they are apparently ignorant of anything to do with diabetes and had I not found this board I may well have killed her since they told me 2u 2x a day no matter what and sent me home with diabetic formula dry food and wet food with the second ingredient listed as RICE! Thankfully I started the low carb varieties of Fancy Feast right after her diagnosis and she took to it. (now I know you should phase diet in). Sorry, but I am very angry with my vet as they seem to be more interested in taking money than taking care of my cat and being knowledgeable about such a common disease. My lord they take classes on cold laser therapy to treat my parents dog! Ok, sorry for the rant.

Can someone help me with the following?

-Should I wait until her +5 results come in before taking any action? no action is needed unless she goes below 40-50, in which case she is in hypo territory
-At what point do I resume insulin? When she is 200 or over? in the absence of further info, 200 could be your cutoff, and I'd give maybe 0.5 and see how that works for her
-She has uveitus and I haven't given her her eye drops yet (which are steroids). Should I? She has been on them since last Monday night and the vet told me to use them until gone.yes, she should have her eye drops. just because they are steroids doesn't mean she doesn't need them
-She has another vet appointment this Thursday. Should I leave her home and just bring in her results? I would like to get her eyes checked again but I don't want to stress her out more than needed. You can be sure they won't be doing an in house test on her since I will be doing them for now on.
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Does she need her eyes checked? If yes, then you should take her but she doesn't need to be there for long. but perhaps you can ask your vet about postponing
 
Jen, that's a great number. It looks like the low carb food is keeping her from dropping. If you want to, you can give her just a little more of the low carb food to keep her up. Then test again at +5.

Many vets don't have the most up to date info on diabetes, and honestly, many people would not go to the amount of trouble that we do here to treat it....so the vets tend to give some basic care instructions in the hope of getting an acceptable level of control over the diabetes. We just have a higher standard here, and we can focus on one disease, FD, while vets have to know so much about so many things! I think most vets do try to do the best they can.

You should have a no shoot number, 200 is usually what newbies start out with. Depending on what that number below 200 is, you can give a reduced dose, you can wait and retest 30 minutes later and shoot the full dose if above 200, or repeat the wait and test until she gets to a number you are comfortable shooting, or skip the shot. What you do depends on your comfort level and situation. As Jen & Squeak suggested, when you get a PS # like today, you could try 0.5u and collect some data to see how that works for Sara. If you weren't going to be home to monitor, you might want to reduce more or skip the shot depending on the PS #. Some people use a sliding scale with PZIs (including ProZinc), they shoot different doses depending on what the PS # is. If you haven't been there yet, I would suggest that you take a look at the PZI insulin support group. There's info there that can help you, and you can post there for more help with the insulin. You can still post here too! http://www.felinediabetes.com/FDMB/view ... 24&start=0

I would suggest that, going forward, you try to get some daily spot checks (tests) during the curve in addition to the AM & PM preshot tests. That will help you to see how the insulin is working and how low Sara is going. That data will help you adjust doses.

I would give the eye drops, follow the vets instructions on that for sure. I would take her in for the recheck if it is for her eye, and take a copy of your SS with you to show how Sara is doing. Great job on the SS, BTW! You don't need to have curves done there, but I would certainly do whatever followup care is necessary for Sara's eye.
 
Her +5 was 88 so I am hopeful. Will test her again at +6 and as long as she doesn't drop I will go back to every 2 hour tests for the remainder of the day. Would that be ok?
 
Sounds like a good plan, Jen! Very nice job catching that number and taking action! :-D

FWIW, with ProZinc, the nadir is often early in the cycle (+3-+5) when you first start with the insulin, and shifts to a later time after the cat adjusts to it. ECID though, so you will need to gather test data to see where her nadir is.

Keep posting and asking questions as you think of them.
 
Thanks all! +6 reading was 97 so I will now go every 2 hours for testing and for her PMPS I will make sure to get advice before dosing (if I dose at all).
 
Sara never went below the 80's, right, Jen? Since it has been a stressful day, you can play it safe with .5 units. She didn't really go low enough for a bounce. Right now, you are just gathering data and figuring out how the food and insulin is going to work for her.


Your numbers for the day are great, really, but I know you were nervous.
 
Thanks Sue. Yeah, the lowest she went was 82. I am just so glad I only gave her 1u last night and this morning instead of the 2 my vet prescribed. Wish it would have been .5. I will give her .5 tonight and then see how she is in the am. I am done poking her tonight :-)
 
Jen, those were great numbers, but I know it was stressful for you. I'm sure you already gave the 0.5u, and that's fine! I would suggest that you try to get at least one test sometime before bed, just to see how the dose works. It will help you figure out what dose to give at that preshot.

Great job today!
 
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