? Need dosing advice ASAP

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garbagecat

garbagecat

Member Since 2021
Sorry not sure if this is a real 911 but it’s dose time and I am NOT sure what to do.

Need dosing advice ASAP - my cat Frank’s BG this morning is 159 on the relion prime (209 on the cat specific pet test meter)

Do I still give his 2u of ProZinc?

Here is his spreadsheet: https://docs.google.com/spreadsheets/d/1FJ1sGKdxCjPCmc-uRVuOzVgOrIkrG-zE3sCmw4KOFDM/edit

Thank you!

His BG levels were so high earlier this week - finally we realized that his numbers are directly correlated with how much he eats and when. Now he gets 1 can of ff/bbf in the morning, 1/3 for lunch, one at night and another 1/3 before bed.
 
Hi thank you! I can monitor him and we will be home all day. We were actually planning on running a curve today since it’s been a little over a week on his new dose.

I can’t delay him any longer, unfortunately that was delayed (it was 153, 159 on the relion prime and then 209 on the pet test meter)

I just fed him breakfast.

It’s shot time, do you think I should go with the full 2u? It doesn’t seem to affect him super intensely (his curves before have all been fairly flat but this is by far the lowest preshot I’ve gotten )
 
If you can monitor him, I would give the full dose. You want to gradually reduce your "no-shoot-below" number with time :)

ETA: Please take down the 911 and get a +1 and +2. Thanks.
 
It could be possible you did a 'fur shot', I would just check his BG again in 30 minutes to an hour. There have been other days where his BG went up after breakfast around the same time.

ETA: Sorry, forgot you were doing a curve. At +4 is fine too
 
phakewishard said:
It could be possible you did a 'fur shot', I would just check his BG again in 30 minutes to an hour. There have been other days where his BG went up after breakfast around the same time.

ETA: Sorry, forgot you were doing a curve. At +4 is fine too
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That was my initial thought but I know it wasn’t a fur shot, I watched the needle go in. So weird!
 
Interesting, I'm guessing he's having the same breakfast he always does? Do you have any readings from last night?
 
Yes, same breakfast, slightly larger volume than last night bc the initial BG level was way lower than normal. So he had a can of ff pate and 1/3 of a can of bbf pate from the fridge.
 
It looks like it's coming down, it was more than likely the extra food he got that made him spike like that. That's good info to know!
 
phakewishard said:
It looks like it's coming down, it was more than likely the extra food he got that made him spike like that. That's good info to know!
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this is all so confusing - the prevailing advice is to feed your cat when it’s hungry, but food spikes the blood glucose. He should be getting two meals a day according to my vet, but then according to advice here he should be fed as much as he wants throughout the day, except 2 hours before preshot tests. My vet said if I insist on feeding him midday, I should give him something with absolutely no carbs at all, like plain chicken - not even a low carb pate. But lots of the advice here is to obviously give a meal before insulin and then set a timed feeder throughout the day, feed as much as they’ll eat etc ...why is this so conflicting? Especially when it seems to indicate that the amount of food even if it’s a small change spikes the BG level so much?

Previously his blood sugar was super high and it comes down and is all over the place - we’re trying to figure out how to feed him the appropriate amount of calories per day and when. I’m so confused as to what exactly I am supposed to do
 
With insulin, you want to have food out in case their sugar drops low. Especially when you're not home to monitor symptoms. Think of a person who's diabetic, would you tell them they can't have orange juice when their sugar is crashing, because it's not breakfast/lunch/dinner time?

I believe your vet has good intentions, I just don't think diabetes in cats is a big focus in vet education in general. I could be 100% wrong on that, it just seems that way to me.

A timed feeder really could be the best way to go with him, and just have a bunch of 'snack' meals instead of big ones. That way his BG stays more consistent, and you don't have to worry about big drops and spikes.

Also, take all of my advice with a grain of salt lol I'm for sure not the most experienced person here, and I know a lot of others will have better answers than me.
 
phakewishard said:
With insulin, you want to have food out in case their sugar drops low. Especially when you're not home to monitor symptoms. Think of a person who's diabetic, would you tell them they can't have orange juice when their sugar is crashing, because it's not breakfast/lunch/dinner time?

I believe your vet has good intentions, I just don't think diabetes in cats is a big focus in vet education in general. I could be 100% wrong on that, it just seems that way to me.

A timed feeder really could be the best way to go with him, and just have a bunch of 'snack' meals instead of big ones. That way his BG stays more consistent, and you don't have to worry about big drops and spikes.

Also, take all of my advice with a grain of salt lol I'm for sure not the most experienced person here, and I know a lot of others will have better answers than me.
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Thank you haha!! I’m just trying to figure it out too... my thought process so far is:

if we’re controlling exactly what he eats and when, and doing a preshot test, and the amount of insulin he gets stays the same every day, and I’m semi regularly doing a full day curve and intermittent spot checks throughout the week, why would he need to free feed throughout the day? Blood sugar should never just randomly drop - it’s more likely he would continue to just eat a meal whenever he wants and have spikes in his blood sugar and just be unpredictable and never regulated, right?

it just doesn’t really make sense to me when the numbers seem to indicate he is much closer to the normal range when being fed a strict amount on a strict schedule

ugh I wish I understood this better!
 
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I'm going to be honest, I don't know enough to tell you one way or the other. I do know cats can go into remission, or require less or more insulin as time goes on. I also am not familiar with how ProZinc acts. Others may be able to provide better/more information. In the end, whatever you think is best for Frank is what you should do!
 
I suspect you're seeing the rise in numbers during the AM cycle because Frank was in lower numbers during the PM cycle last night. He started the PM cycle at 250. You expect to see numbers drop by nadir AND he was at 159 at AMPS. To my eyes, this suggests that Frank was in blue or lower numbers last night. The jump back up into the pinks is due to his bouncing off of the lower numbers.

What the important take away message is that it's critical to get at least a "before bed" test every night. Without that information, you have no idea how low numbers were overnight and whether a dose reduction is warranted. Even more importantly, you need to know if your cat is in safe numbers since many cats experience lower numbers during the PM cycle.

With regard to food, in general, I would refrain from feeding after nadir. Once your cat is past nadir, there's less insulin available to counter the effect of food. Having information from curves can also tell. you what your cat's pattern of insulin response is. My kitty was notorious for dropping into low numbers early in the cycle. As a result of her early nadir, I spread out her food over the first few hours of the cycle to help soften her drop in numbers. You can steer the curve with food.
 
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