Just diagnosed: Regulating question

Status
Not open for further replies.
sarahannew

sarahannew

Member
Mama was diagnosed a couple of weeks ago and I'm trying to regulate her. I posted on the main forum and told the whole story here: http://www.felinediabetes.com/FDMB/view ... 28&t=89412

But my question is, I gave her 1U last night because her sugars were 236 at 9:15. In the morning they were up to 425! So I gave her 2 this morning about 7:30 am. I didn't have to go to work till noon and tested again around that time and they were 274, so I gave her .5 U. Gave her plenty of food before I left. Just got home, and it's 7:30pm and she's at 254. Not too shabby, I'd say. But now I'm stumped. Should I try 1.5? Should I give it to her now?

Now it's 8:30 and I am not still not sure what to do. I think I'd like to try 1.5, but not sure.
 
I want to make sure I have this correct.

This morning, at 730, you gave 2 units? BG of 425?
Then you tested again at noon, saw a 274 and gave another shot? .5 units?
And now it's 7:30 and she's at 254?

Carl
 
The one unit last night didn't look like enough but she had been all over the place so it seemed wise to let things settle and start increasing instead of worrying that the dose is too much.. You are really bouncing around with doses. Did you shoot at amps and then 5 hours later? You can shoot TID with ProZinc, but we suggest you have a couple weeks of data first (so you can easier predict her patterns) and you do want to make sure the number is rising, not falling. If falling (which your 274 was) you can really run into trouble shooting more insulin before the first dose is gone.

Could you please set up a spreadsheet? We have this great colored coded sheet that will give us your history of numbers and doses at a glance, when you need advice. Here are the directions:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207. It's a little tricky so if you need help, let me know and I can help.

As for tonight's dose, I would not give another shot until +12. The dose would depend on the number.
 
Did you shoot at amps and then 5 hours later? You can shoot TID with ProZinc,

I'm sorry, I don't understand what you mean. What is shoot at amps and shoot TID mean. Sorry, super newbie.

What, also, do you mean by +12? I gave the shot at 7:30 am, then .5 at noon. so do you mean midnight?
 
Sorry. We use lingo. Glad to see the spreadsheet it really helps. Amps = morning number before food

TID = dosing three times a day. You can do this but as I said, after you have data. You divide a dose into 3 equal doses and give the insulin every 8 hours instead of every 12.

We use +# to indicate the times, since we are all over the US in different time zones. So +3 is 3 hours after the shot, +6 is 6 hours etc. 7:30 doesn't compute for me and Carl. He is in NC; I am in Colorado. So yes, +12 would be 12 hours since the last shot.
 
I think I understand what you mean, I will wait till it's rising for sure. I guess I knew I was going to be gone to where I couldn't monitor it and thought maybe it would remain more stable with just that .5.
 
Thanks for that clarification. I hope I can stick with the 12 hour because of my schedule. Obviously, I wouldn't be here if I weren't willing to go the extra mile. I need to go pick up some more test strips! I'm all out. Poor Mama's ears...this is still a learning experience! Is there anyway you can make a suggestion on the dose? If it's within a certain range, what do you recommend? I don't know if you'll be up midnight central time ;-)
 
As far as her ears, hold the spot you poked for a few seconds to help with bruising. You can also use Neosporin (with or without pain relief).
 
I've been feeding her Blue Wilderness Senior, but have transitioned mostly to the canned Fancy Feast classics. Actually, she has eaten that every night for the last couple of years and I used to feed her IAMS in the morning. I recently transitioned. Her diagnosis came after she was treated for a UTI but after 2 weeks was still urinating frequently and drinking a lot of water. I had a full chemistry panel done and her sugars were at 500. For one week I gave her 2U religiously every 12 hours, then I figured out how to home test her glucose and when it was still 450 I panicked and called the vet she said I could give her 3 U but that was too much too soon and the next morning her sugar was at 48. I panicked again and backed off, and have been trying to get it right ever since. Trying to make sure my technique is good, it's staying refridgerated, etc.
 
Just wanted to outline BID dosing, versus TID dosing.

BID dosing is twice a day, 12 hours or so apart. There is some flexibility on the 12 hours, like an hour either way may not be crucial, in my opinion. But if you decide to shoot early, you should only do so if you have tested to make sure the number is rising. If you decide to shoot late, then you should also feed late. Not feed at the 12 hour mark, and then shoot an hour later when you test and get a higher number. Because the higher number will be due to the food Mama ate an hour earlier, not because the BG is rising on it's own.

TID dosing is 3 shots a day, 8 hours apart. This can work for some cats. But you don't want to do that until you know for sure that Mama is not getting more than 8 hours from a shot. People who try that have collected a great deal of data that shows that the Prozinc seems to hit the system quicker than normal, reaches peak effect (nadir) before normal, and wears out before normal.

Prozinc "should" start to work 2-3 hours after a meal and shot. It "should" reach peak effect between 5-7 hours after the shot. Then it should start to wear off after that, but not completely peter out until 10-12 hours after a shot.

What you don't want is one shot reaching peak effect just about the same time a second shot is kicking in. That "could" happen when you shoot twice in less than 8 hours (it was 5 hours today). Fortunately, it doesn't look like it happened today, and it was a good thing that the second shot was a smaller dose.

Carl
 
We would have suggested increasing from 2 to 2.5 units. We like increasing slowly. So the question is where to go now. Some cats do best with a dose and keeping it for a few cycles. Others do fine adjusting from shot to shot, but generally with that .5 increment. I don't know how much of her bouncing is due to the doses or if it is influenced by the different doses.

So if +12 will be midnight and you can't set that up as your new schedule, we don't have a while lot of options. I'd like to see what Carl and Robin think. I am wondering about just waiting till 7:30 tomorrow morning. She will most likely be high, but you can get back on track
 
sarahannew said:
Midnight and noon will not work. It's better 7:30 and 7;30 around that time.
Click to expand...

In that case, I think tonight gives you a great opportunity. You can just not give any more insulin until 7:30 AM tomorrow. By that time you will know for sure that any insulin she got today is "gone" from her system.

Carl
 
Sorry I didn't see your ss the first time around.

The starting dose for Prozinc is 1 unit. I would start over and go with 1 unit for a few cycles so Mama can even out and we can see how that is working for her.
 
Keeping in mind that after one week solid (her first week) of giving her 2U every 12 hrs, she was still 450 in the morning the first time I home tested. Last night after giving her 1U she was up to 425 this morning. So keeping that in mind, is it still better to jump back to 1U? Or should I assess in the morning based on the reading. And based on the reading, if it's upwards of 400, should it be slightly higher than that? Just picked up some new test strips, so Mama and I are ready to roll!
 
That's where a spreadsheet and all this data you've been working to collect come in handy. Those are good points.

You could go with two units, or 1.5 (I'm a big fan of "following your gut") if you see a number in the morning that you feel it makes sense to do that. A number over 400 would fit that category in my opinion.

I don't know if you were getting any mid-cycle checks during that first week. But this time around, if you can get a test or two in the middle hours of the AM cycle, you'll be able to see what the 2u dose actually is doing? As long as you can be there to test, follow your gut. And if you see a number that you think is too low, make sure to give her some food to slow the drop in numbers. If you see a lot of activity from whatever dose you shoot, you'll know if it was too high.

Carl
 
It's hard for us to know. The more data we have, the better advice we can give. And she has only a few cycles to look at. It looks like the one unit last night wasn't enough, but we can't be sure because she was still falling last night at preshot. It is very helpful any time you can to get a midcycle test. For people who work, they often set their alarm and get a test at night. Sometimes they can bounce from a low number and if you don't see the low, you think the high is too little insulin.

I think we are thinking one unit for a few cycles will fill out the picture and help us see what is really happening. If you do reduce, you should test for ketones also. If you don't know about ketone testing, just ask.

But always, you hold the needle. If you aren't comfortable going down to one unit, then give a little more. But try to stay with the 12/12 schedule and test as often as you can.
 
Great! That sounds perfect. I will wait until 7:30 am, test and go from there...I feel good about that. Thank you guys for really trying to help me, and for informing me on the Prozinc dosing. Now I know how to better collect data. Unfortunately, I don't have any from that first week. I'll give it another go and continue to read up on all the excellent information on this site! Mam and I both thank you ;-)
 
Update! I've updated my spreadsheet since the 21st and Mama has been doing great...I think. Still trying to get the hang of this. Would you please look at today and yesterday. I need advice on whether I should give her an injection tonight. I panicked when I saw her a.m. reading at 421 on 2/23 and gave her 1.5 U instead of just 1. Since then, her sugar fell (may have been too low, but not sure since I was gone the entire day) but has been more or less normal and I haven't given her an injection since yesterday!! Please take a look. Should I give her anything tonight?
 
So she is going up and safe to shoot. One unit? To be safe, you could get a before bed test and make sure she is looking okay.

If the food after the pink number midcycle made her go down, not up, it can mean her pancreas is waking up. That would be good news!
 
Ok that sounds good. Wish I had gotten another reading after she had eaten this afternoon. But she seems to be doing much better...and acting much more herself. I'm going to test again tonight. THANK YOU!
 
Status
Not open for further replies.
Back
Top