Hi Theresa,
Got Tiffy's SS updated for you this morning. I'm ready for your training session on Sunday at 6PM. Time to teach you how to update the SS yourself.
There are a couple of notes on the SS that concern me.
1. On 6/19 PM. You thought you did a fur shot. You guessed how much went into Tiffy and then gave an additional 1U.
Please, Please, Please never do that again. There is no good way to tell how much insulin actually got into Tiffy with a suspected fur shot. Giving additional insulin when that happens, is not recommended because the 'guesstimate' can be way off and the BG's can drop too low, resulting in a hypo. Hypos can kill quickly if not managed with food and simple sugar. What if you had done this in the morning and then gone off to work? People have come home to find their cats dazed and confused, like the cat had seizures while they were away. We want to keep Tiffy safe because we know how much you love her.
I know you thought you were doing the right thing by giving more insulin but it could have resulted in a hypo. Yes, those high numbers are scary, but remember one of our sayings "Better too high for a day, than too low for a minute". High numbers do damage over the long term. They are not immediately as concerning as the low numbers which can kill quickly.
2. Giving water does not dilute the blood enough to bring down the BG numbers. Let me explain how the insulin works so you can understand why I say the lower BG's you are seeing and the water you are syringing are a coincidence.
You inject the insulin under the skin. The blood vessels in that area slowly absorb the insulin. You feed and the body starts to process the food, so you see a rise in the BG numbers, what we call a food spike in about 30 minutes to an hour. The insulin takes an hour or two to start taking affect to moderate the food intake and help to process the food and bring down the BG numbers. A little more time passes and the insulin has more of an effect. You see the BG numbers dropping. Maximum affect of the insulin is usually somewhere around the middle of the cycle, sometimes earlier, sometimes later. Cats on Prozinc often have an earlier nadir (low point, peak) for the first month or two and the insulin does not seem to last the full 12 hour cycle. After, the low point or nadir, the BG number starts to rise again as the insulin has been used up trying to process all that food. The numbers keep getting higher, and a bit higher still after the nadir is passed, at the end of the cycle.
Tiffy's body has also become used to those higher numbers as being the new normal. It takes time for the cells in the pancreas to heal and regenerate. It takes time for her body to become adjusted to those lower BG numbers and not panic. When her body 'sees' those low numbers in the 200's, it panics. Mr. Liver as we call him, panics and pumps out sugars and counter regulatory hormones to bring those BG's back into line with what the body has become adjusted to.
We call this steep rise a "bounce". She will bounce until she doesn't anymore. Cats can take up to 72 hours to clear the bounce. You have to be patient here and let things settle a bit.
Here is a definition of a "Bounce" written by someone else.
Here is definition of a bounce. Get used to them.. Most cats bounce for a while..
Bounces - what are they and is my cat doing them?
When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver ”panics” and reacts by releasing counter regulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
Feeding a large quantity of food after the insulin has been all used up will simply cause the BG's to rise higher.
I'd like to see you trying to spread out the food intake. Feeding all that food at one time can cause the BG numbers to be higher and more uneven. Spreading out the food into more mini-meals would help Tiffy.
What is Tiffy's weight right now and how much should she weigh? Do you have a bathroom scale you could step on, holding Tiffy then let her down and weigh only you. Subtract to get Tiffy's weight.
We may want to rethink how much food you are feeding her.
By the way, Are you syringing the water by mouth? or sub-Q?
