Levels all over the place

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Consorte_bella

Consorte_bella

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Hi everyone! You may have seen my post in the main health board, but I thought it would be good to post here too. My cat Nigel has been all over the place with his levels. He would test in the 400s and then test under 100. I basically started over with his dosage and took a curve last night. You can read the whole process in the other post here- viewtopic.php?f=28&t=110416&p=1165824#p1165824

I just tested him and he was at 82, when the prior test was in the 400s. What I need to know is, should I feed him and basically start over again this afternoon or should I wait and retest in an hour?
 
Can you test Nigel now and post his number to see where he is at? Did you feed him anything since the 82 test?
 
I fed him a half can about 30 mins after I posted. I was thinking of waiting a few hours for the food to digest and test him again. I will probably wait until later tonight and start the process over again with 1 unit. This time I will just stay with that dosage for a few days, to let it even out. I keep forgetting how even a little extra will throw things off.
 
Did you see Sue's post in health?

She said
I'd feed and watch for a couple hours to see if he gets over 200. Definitely reduce from last night's dose
Click to expand...

I would agree with her.
 
He's been so erratic, I'm thinking a restart at 0.5 or 1.0 units might be advisable.

Aim for consistent shot times.
Test feed, and shoot within about 15 minutes time.
Shoot as close to 12 hours apart as you can manage.
ProZinc's nadir is usually between +5 to +6 hours post shot.
 
I am getting a smile shape for Nigel's levels for a few doses in a row. He is still getting up fairly high (400s) so I am going to up the next dose to 1.25. Thoughts?

Happy Holidays!
 
Hmmm. Hard to be sure. It's possible that there was a lower number before or after that yellow. If so, the reds are probably a bounce. The drop from preshot to +6 is over 50%. If you increase, I would only increase by .25?
 
He's at 1 unit now, so that is why I am thinking 1.25 at the am dose in 12 hours. I wasn't able to take many in-between dose checks because his am dose is so early and it knocked my sleep cycles all out of whack (I have a sleep cycle disorder) and I slept until 11:30am.

I am going to take a level check every few hours tonight before I go to bed to see if I can get an idea of where the nadir is on the 1 unit before I switch to 1.25. I am still having problems figuring out how bounces work, so any help understanding this would be great!

Thanks :)
 
Sunday, when I checked +5, +5.5, and +6 on Gracie, her nadir ws @ +5.5.
Each cat is different, but that's the time period to check for nadir.


I hear you about the sleep disorder! I've been told I have 1) mixed central apnea (I don't keep breathing when deeply asleep) or 2) idiopathic daytime hypersomnolence (fancy way to say I get real sleepy during the day). Either way, disruptions to my sleep schedule have adverse consequences.
 
It looks like the nadir may be either 5.5 or 6, but I have to take another level in an hour. I couldn't get blood at 5 (went over my 3 poke rule even), but I am hoping the levels at 4, 6 and 7 will be enough to tell.

Once I figure out the nadir, how can I use this to find a good dosage? Last time we regulated him, we went by the pre-stick numbers. Now I feel like we can get better with the nuances of the curve, so it would be helpful to learn how to do it so it is more accurate. We can also tell when he is getting off because his asthma acts up (he has more attacks).
 
Here is a protocol for ProZinc to follow.

And below are some glucose reference ranges with some examples following at the bottom of how to use them.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​

How to use the glucose reference values chart:

When you get a test, look for the number on the chart that either equals, or contains, the test value you have. Read the information. As needed, make a decision and act.

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
BJM,

Thanks for the post. It is a little overwhelming, but I think I can follow it.

I am getting a little frustrated right now because it seems like 1 unit isn't enough, but 1.25 is getting him into low numbers. He got down to 47 today with only hunger as a symptom (which for him is not that unusual). I have updated his spreadsheet if anyone can take a look.

I am thinking about going back to 1 unit and setting up a feeding schedule for his snacks to see if that makes a difference. Any other options?
 
Using U-100 syringes with the ProZinc, which is U-40.
How it works:
U-100 insulins have 100 units per mL.
U-40 insulins have 40 units per mL; the concentration is 40% of a U-100 insulin.

We can apply this to adjust the measurements on a U-100 syringe so we can use them for U-40 insulin.
Each mark on the U-100 syringe will be 40% lower if measuring a U-40 insulin.

U-100 *0.4 = U-40 dose
0.5 * 0.4 = 0.2
1.0 * 0.4 = 0.4
1.5 * 0.4 = 0.6
2.0 * 0.4 = 0.8
2.5 * 0.4 = 1.0
 
BJM,

I'm sorry, but I can't follow at all what you just posted. Are you saying I need to get different syringes? The ones I have now came with the insulin and only show whole and half units. Is that what you mean by U-40?
 
There should be markings on the package which tell you what kind of syringes you have.

Do they say U-40 or U-100?

ProZinc is a U-40 insulin. That means it has 40 units in 1 mL. It is difficult to find U-40 syringes with half unit markings, so I'm wondering if you already have U-100 syringes.
 
Okay, so you can adjust based on the preshot number. If you give 1.25 at a red preshot, you don't want to give that same amount at a yellow preshot. You adjust the dose down because he has less room to drop(a 50% drop from a red will be fine, a 50% drop from a yellow can be too low - as you saw on the 26th)

If you update your ss, we can help with what you're seeing today.
 
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