Kitty's AMPS is 77!!! NEED ADVICE!!

I checked this twice. 2 readings were 77 and 83.
This caught me off guard. Need advice on if and when to shoot and how much.
Kitty seems perfectly fine. I just feed him.

 

Wow! Please do not shoot. New users on Prozinc should not shoot when numbers are below 200. My advise would be to skip this morning's shot all together.

 

Sev,

You've already fed him right? I don't use your insulin so I can help with the dosage, but for future reference when you get a low preshot like that the normal protocol is to not feed and wait 30 minutes retest and see if he comes up enough to shoot. I second Marcy...NO SHOT this am

But on the other hand...Congrats on waking up to such beautiful and perfectly normal morning numbers.

Mel, Maxwell, Musette & The Fur Gang

 

I would love to see numbers like that every day. :smile:

I am going to test in a few minutes to see where he is at.

 

Was there anything different about last night? Did he eat the same amount?

 

Nothing different that I recall. It was a mix of Blue wilderness chicken and Merrick Southern delight. I have been feeding around 2.75oz.

 

@ AM +.5 he is 110.

 

I was just reading through your post from yesterday. Since you will not be around today to monitor Kitty, I would definitely not shoot. Glad Kitty is acting normal. :smile:

 

Well I can adjust my schedule. I'll probably only be out a couple hrs.
One of the perks of being a contractor.

 

Hi Sev,
I have not posted previously in your threads, but Kitty's spreadsheet is scary. It is unusual when on insulin for a cat to have that many +500 BGs and they could very well be indicative of rebound gone crazy since you have an unusual low this morning, which obviously started last night.

http://petdiabetes.wikia.com/wiki/Rebound

The unfortunate thing is that because of this 77 you are going to see more of them later today.

She is responding to the insulin, but prozinc does not have a shed like the longer-acting insulins, so when it's done, it's done and it can often produce these rapid declines and rapid increases in BGs that aren't necessarily rebounds. It is called swinging.

For the cat, it's miserable. Just ask any human diabetic how it feels when their blood sugar does this.

Unfortunately I'm working today, but I hope those conversing with you today will discuss what to do going forward. If you made a diet change, that could also be helping create this lower BG, but you are going to have a difficult time controlling BGs on prozinc. I hope you are open to an insulin change, because if those 500s aren't dealt with soon they are going to cause more serious issues such as DKA.

You might be very lucky and she had a break-through. Hopefully others would agree that once she gets over 200 today she should have a dose of insulin, perhaps .5U. And has anyone discussed dosing prozinc on a sliding scale? That could be a possibility for you to use prozinc successfully with her since it seems you are able to test her frequently.

Good luck, and hope I haven't stepped on other toes since several others have been helping.

 

Thanks Vicky.

You answered my next question. I was thinking a mid cycle shot at 1/2 dosage.
Unfortunately I wont be available to do a sliding scale as I have will be finishing a house renovation shortly.

+1 is 151

 

Wow! She throws some curves. It may be that she has unusual reactions to ProZinc including the long time to react to a dose change and the huge rebounds. I would also be racking my brain to see if there was something different today than yesterday.

I am reminded of another ProZinc user, Sue and Samwise. She had unusual patterns on ProZinc except that hers were high amps (500) and low nadir(50). She changed to Lantus and has had very similar patterns......

The nice thing about ProZinc is that you can vary the cycles and use a sliding scale (giving a different amount am and pm) because you don't have to account for a shed.

Sev, could you start copying your post over on the PZI forum also? We have some people doing some innovative things and they might have ideas for you. It is a much smaller forum than this one so you need to check back in for responses. It is busiest in the pm.
viewtopic.php?f=28&t=57552

 

+2 is 190.
Perhaps the rise is leveling out.

 

There is absolutely no dry food in the house? Any dog food that she might be sneaking? The obvious thing is to look for a logical explanation first. Did she go out and maybe get into some other food?

 

Nope, nope and nope.

 

If Kitty is in the 200's by +6 should I go with .75 units???

 

I discovered that Spitzer can have a food spike of 200 points in 1 hour, so your kitty is doing pretty well. If he starts coming back down, rather than rising, it could be a sign his pancreas is starting to function a bit. Cross your fingers! (well ... in between working with them, anyway!)

 

If you will be around To check her and if it wouldn't mess up your 12/12 schedule, I would go with .5. With her crazy patterns, she is unpredictable. Better too little than too much, IMHO?

 

Wonder how low he went before that 77. Are you using the U100 syringes and the conversion chart or are you using U40 syringes? Snow apparently took Comcast down just after I had posted last night...everything went out.

 

I am using U-40.
No way to know. He was at 130 at midnight. Probably should have stayed up till 1:00AM.
Going to test again in about 15 minutes.

 

+3 is 245.
Now what?

 

I am going to have to run out for a few hours. No food is going to be left out.
With then numbers now above 200 what is advised?

 

Your ss shows you gave 1.5 this am but you haven't given any, right? So this 245 is 15 hours after the last shot, right? I would give .5 if you are not going to be around and I would leave out low carb food. (If you were going to be around your .75 would probably be fine....)

 

Fixed that on the chart. Good catch.
I will be out for about 2hrs. I plan to be back by +6. At the latest +7
Why 1.75??? I have been giving 1.5.

 

So sorry. Good catch yourself. That should be .75 I will go back and change it.

 

I am going to get a +4 reading in a few minutes. I will probably be away for under 2hrs.
So lets see what it says and see if I should give a 50% dose.

 

I am leaving for awhile, Sev. I think as long as he is headed up (sorry, I have been calling him a her.....) and you will be back in 2 hours, your 1/2 dose should be fine. It will be interesting to see if you get a monster bounce tomorrow. Some cats settle in and bounce less and less; some don't.....

 

Well he came in at 268. Almost appears to be leveling off. I say almost.

Oh.

And Kitty is not Tigger. The will be no bouncing!!! ;-) :smile:

 

Left fresh turkey out as a snack.

 

@ +6.5 reading is at 405.
Now what?

 

I can't give you any advice on the dosage, as I'm still too new to this. However, along the lines of if kitty could possibly be getting into anything else to eat--what kind of litter do you use? Some cats will eat the corn or wheat based litters. Just a thought...

 

Its corn cob litter. We were using strictly cedar.
However I never once seen kitty eating out of the box.

 

+7 461

 

Not unexpected. The liver probably dumped some glucose into the body in reaction to the 77 and it is influencing the numbers. Just sit it out and let's see what tonight looks like.

 

I'm wondering it the high, high high, followed by a very low glucose indicate a dose that is too high.

On the spreadsheet, you have only 1 day at 1 unit and it looked reasonable to increase ... but the high mid-cycle might have been due to the liver kicking out glucose. It is a conundrum!

Try to hang with a lower dose for a couple days, while monitoring for ketones.

 

Oh by the way last evening I give them some catnip. Between 5 and 6 o'clock.

 

Catnip is not known to raise BG...

It's a good thing....PLAY TIME !!!

 

Well that.s good because I am growing some.

 

Exercise can lower bg also.

 

He has a 5-6 month old Main Coon Kitten that is providing plenty of exercise.

 

+9 was 506.
I gave the .75 unit shot on the side earlier.

Should I go back to 1.5 units this evening?

 

There will be overlap due to the delayed shot from earlier; I'd be inclined to do another 0.75 and in the morning, go to 1 unit for a few days to see how it played out.

 

You have high numbers now, but you got a huge reaction to 1.5 last night. Will this be 12 hours since you gave insulin this am?

I am wondering about BJ's comment that Kitty is getting too much insulin overall. Let's see what others think.

 

That goes back to what Vicky posted earlier today about Kitty looking like he's getting "rebound" cycles. I am inclined to agree with her on that. You may have to reduce significantly (even less than 1u) to rule that possibility out. Not only did last night's numbers go pretty low, but not sure exactly how low, you got a really long duration overnight and that doesn't go along at all with the high and odd cycle you had yesteday during the daytime.
No matter what, with numbers that are so far above the renal threshold for most of the day lately, I would strongly encourage ketone testing any time you happen to catch him near or in the litter box.

Carl

 

Sev, I'm not positive, but I think Vicky was considering a scale of shooting based on PS numbers (adjusted dose based on a range of test numbers), and not with regard to shot timing.... understand you'll be tied up with the job, but you'll still be able to test every 12 hours, right? If so, a scale might work. Any scale needs to be tailored to the specific cat, however. They shouldn't be generic. ECID.

 

Looks like you guys are spot on on the numbers.

I just tested twice and got 353 and 395.

 

Ahhh. I see.

I should be able to test a couple times in the morning and perhaps starting at +10 again.

 

I am liking the idea of a lower dose (.5?) for a few cycles to see if he has been getting too much insulin.

Tonight - only if over 200 and only on a rising number and preferably 12 hours after your last shot.

What do you think?

 

I shot .75 units at +4. That puts me at 11:00PM for the next shot to be on 12 hours.
I am planning on feeding at around 6:50

 

I concur on giving a reduced dose for a couple cycles (& check for ketones).

 

Sev, don't remember if you said earlier, but did you shoot on the side today instead of the scruff?
Carl

 

Yes I did. @ +4. .75 units.
he started rising rapidly after that.
Any food that was consumed during the day was turkey.

 

So. Whats everybody think?

 

the rise after the shot makes no sense to me. you tested him every hour and never saw a dip. why is it still rising?
I think you have to let the cycle play out till 11 if that's "+12" and see what he does in the next 4-5 hours.
Stick with the plan to feed him on schedule. At least if we see a rise after that it'll make sense.... confused_cat
Carl

 

oh, I didn't see the last two tests.....ok, so he dropped, which I assume is the insulin kicking in at +4 from the shot. All he's eaten is turkey? I don't see how just the turkey would cause that big rise.....

 

Here is what I am thinking. I shoot .75 and not .5.
It would seem to me if the thinking 1.5 was to high. Then removing a full unit would make it to low.

The question is. When do I shoot. And if there is a disagreement on the amount. How much?

 

I think you get the prize for the craziest spreadsheet.

I may be in the minority but I would like to see you give .5 units for a few cycles, testing for ketones daily and see if his numbers settle in and improve. I am wondering if he is just overdosed.

Can you wait till +12?

 

To shoot?
And what does that do to my morning shot?

 

Sue,

Granted I only know Lantus but I went back and looked at Kitty's original bloodwork here http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=57070

He was much lower when dxed, so I like you have been wondering if he is being overdosed. Especially since the highest his bloodwork went was 310 when first dxed, now he is hitting the 400s & 500s This was exactly what Musette was doing before I got her and reduced her dose down. I had to take her below her ideal to get her to stop bouncing all over the place, then start slowly upping her dose again.

Just a thought.

Mel, Maxwell, Musette & The Fur Gang

 

Your morning shot would then be at a new time....12 hours after tonight's shot, so 11?

If you don't want to do that, or it just won't work going forward, then we need to plan around that.
In a perfect world, when would you want to shoot AM and PM?

Carl

 

Thats not going to be doable. Once I get this project going I have to be out of the house by 9 AM at the latest.
How about going down to .25-.3 at 7PM or skipping the cycle till morning.

 

I think I would skip till morning. Then .5 or .75 for a few cycles?

 

I dont mind reducing to either.
I just need to keep the shoot times where they are possible.
Missing another cycle will not cause problems?
Also he is at 371 right now. Its been pretty level for 3 hours.

Also I need to schedule getting his teeth cleaned.

 

Yes, skipping can make him higher tomorrow. Where are you - + 6 or +7?

I am just not positive that he will continue up. He makes me nervous.

 

Right now I am at +8 from the .75 unit shot.

 

At +8 you should be okay to shoot. I would try the .5 or .75 and test again tonight. Sound okay?

 

I can wait till Plus 9. Which is 8:00PM. However I am trying to keep the morning feeding around 6:30-7:00. They get miffed any later than that.

 

Then you would have to put off testing till 1.5 hours (at least) after they eat. Then shoot. Will that work?

 

I dont know. Are the injections supposed to be close to feeding time to keep spikes down?


Its going to be 8.5 in a minute.
I think I will shoot at .5 tonight just to be safe. That will keep me within a closer range and I can ease the shoot time back over the course of a day or so.

 

If you want the AM shot to be at 7am going forward...... then the longer you wait tonight, the lower the dose should be. That's because the time between 7am and now is less than 12 hours already. So in effect, tomorrow morning would be an early shot in relation to tonight's.
Once you get to 7am, then it would stay at 7am and pm and you won't have to adjust due to time issues.

I would not go with more than .5 tonight or tomorrow. But like anything, Sev.....we advise, you decide.....sort of like Fox News, only better!

Carl

 

I did .5 units.
Lets see what happens.

 

Going to have to shift the +1 half an hour.

 

i don't have any words of wisdom for you or anything, i'm new, too but i can tell you that i read some of your posts and i'm inspired by your love and dedication to your babies! sending you and your posse healing thoughts!

 

Why thank you.

Its the least an adopted human can do. ;-) :razz: